title: Disrupting the right pars opercularis with electrical stimulation frees the song: case report.
abstract: The authors report the first case of a strikingly unusual speech impairment evoked by intraoperative electrostimulation in a 36-year-old right-handed patient, a well-trained singer, who underwent awake surgery for a right fronto-temporo-insular low-grade glioma. Functionally disrupting the pars opercularis of the right inferior frontal gyrus led the patient to automatically switch from a speaking to a singing mode of language production. Given the central role of the right pars opercularis in the inhibitory control network, the authors propose that this finding may be interpreted as possible evidence for a competitive and independent neurocognitive subnetwork devoted to the melodically intoned articulation of words (normal language-based vs singing-based) in subjects with high expertise. From a more clinical perspective, such data may have implications for awake neurosurgery, especially to preserve the quality of life for singers.
authors.affiliation: Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier;|Institute for Neuroscience of Montpellier, INSERM 1051, Team "Plasticity of Central Nervous System, Human Stem Cells and Glial Tumors," Saint Eloi Hospital, Montpellier University Medical Center, Montpellier;|University of Montpellier 1, Montpellier;
authors.forename: Guillaume
authors.initials: G
authors.lastname: Herbet
authors.affiliation: Functional Neuroscience and Pathologies Lab, EA-4559, Université Lille Nord de France, Loos;
authors.forename: Gilles
authors.initials: G
authors.lastname: Lafargue
authors.affiliation: Department of Neurosurgery, Hôpital Pasteur, Nice;
authors.forename: Fabien
authors.initials: F
authors.lastname: Almairac
authors.affiliation: Institute for Neuroscience of Montpellier, INSERM 1051, Team "Plasticity of Central Nervous System, Human Stem Cells and Glial Tumors," Saint Eloi Hospital, Montpellier University Medical Center, Montpellier;
authors.forename: Sylvie
authors.initials: S
authors.lastname: Moritz-Gasser
authors.affiliation: INRIA, University of Montpellier 2, LIRMM, équipe DEMAR, Montpellier;|Cognition, Action et Plasticité Sensorimotrice, INSERM U-1093, Université de Bourgogne, UFR STAPS, Dijon; and.|Institut Universitaire de France, Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Bonnetblanc
authors.affiliation: Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier;|Institute for Neuroscience of Montpellier, INSERM 1051, Team "Plasticity of Central Nervous System, Human Stem Cells and Glial Tumors," Saint Eloi Hospital, Montpellier University Medical Center, Montpellier;
authors.forename: Hugues
authors.initials: H
authors.lastname: Duffau
mesh_terms: D000328:Adult; D001931:Brain Mapping; D001932:Brain Neoplasms / Q000601:surgery*; D065711:Broca Area / Q000503:physiopathology*; D004558:Electric Stimulation; D005910:Glioma / Q000601:surgery*; D006801:Humans; D064795:Intraoperative Neurophysiological Monitoring; D008297:Male; D063346:Singing / Q000502:physiology*; D013060:Speech / Q000502:physiology*
keywords: DES = direct electrical stimulation; IFGOP = pars opercularis of the right inferior frontal gyrus; awake surgery; electrical stimulation; functional neurosurgery; inhibitory control; right pars opercularis; singing neural system; speech inhibition