Neurophysiologic markers in laryngeal muscles indicate functional anatomy of laryngeal primary motor cortex and premotor cortex in the caudal opercular part of inferior frontal gyrus |
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| Institution: | 1. Laboratory for Human and Experimental Neurophysiology (LAHEN), School of Medicine, University of Split, Split, Croatia;2. Department for Intraoperative Neurophysiology, Roosevelt Hospital, New York, NY, USA;3. University Hospital Bellvitge, Barcelona, Spain;4. Department for Research in Biomedicine and Health, School of Medicine, University of Split, Split, Croatia;1. Department of Neurosurgery, School of Medicine, Asahikawa Medical University, Asahikawa, Japan;2. Guger Technologies OG, Graz, Austria;1. Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States;2. Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States;1. Department of Radiology, Boston Children''s Hospital, Harvard Medical School, Boston, MA, USA;2. Department of Neurosurgery, Boston Children''s Hospital, Harvard Medical School, Boston, MA, USA;3. Department of Psychology, Boston Children''s Hospital, Harvard Medical School, Boston, MA, USA;4. Department of Neurology, Boston Children''s Hospital, Harvard Medical School, Boston, MA, USA;1. Department of Clinical and Experimental Neurolinguistics, CLIN, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium;2. Department of Radiology, Antwerp University Hospital, Wilrijkstraat 10, B-2650 Antwerp, Belgium;3. icoMetrix, Tervuursesteenweg 244, B-3001 Leuven, Belgium;4. Department of Neurosurgery, ZNA Middelheim General Hospital, Lindendreef 1, B-2020 Antwerp, Belgium;5. Department of Radiology, ZNA Middelheim General Hospital, Lindendreef 1, B-2020 Antwerp, Belgium;6. Department of Neurosurgery and Center for Neuroscience, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium;7. VLAC (Vlaams Academisch Centrum), Advanced Studies Institute of the Royal Flemish Academy of Belgium for Sciences and the Arts, Brussels, Belgium;8. Department of Neurology & Memory Clinic, ZNA Middelheim General Hospital, Lindendreef 1, B-2020 Antwerp, Belgium;1. Department of Neurological Surgery, University of California, San Francisco, United States;2. Department Physiology, University of California, San Francisco, United States |
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| Abstract: | ObjectiveThe aim of this study was to identify neurophysiologic markers generated by primary motor and premotor cortex for laryngeal muscles, recorded from laryngeal muscle.MethodsTen right-handed healthy subjects underwent navigated transcranial magnetic stimulation (nTMS) and 18 patients underwent direct cortical stimulation (DCS) over the left hemisphere, while recording neurophysiologic markers, short latency response (SLR) and long latency response (LLR) from cricothyroid muscle. Both healthy subjects and patients were engaged in the visual object-naming task. In healthy subjects, the stimulation was time-locked at 10–300 ms after picture presentation while in the patients it was at zero time.ResultsThe latency of SLR in healthy subjects was 12.66 ± 1.09 ms and in patients 12.67 ± 1.23 ms. The latency of LLR in healthy subjects was 58.5 ± 5.9 ms, while in patients 54.25 ± 3.69 ms. SLR elicited by the stimulation of M1 for laryngeal muscles corresponded to induced dysarthria, while LLR elicited by stimulation of the premotor cortex in the caudal opercular part of inferior frontal gyrus, recorded from laryngeal muscle, corresponded to speech arrest in patients and speech arrest and/or language disturbances in healthy subjects.ConclusionIn both groups, SLR indicated location of M1 for laryngeal muscles, and LLR location of premotor cortex in the caudal opercular part of inferior frontal gyrus, recorded from laryngeal muscle, while stimulation of these areas in the dominant hemisphere induced transient speech disruptions.SignificanceDescribed methodology can be used in preoperative mapping, and it is expected to facilitate surgical planning and intraoperative mapping, preserving these areas from injuries. |
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| Keywords: | Premotor cortex Inferior frontal gyrus Broca area Primary motor cortex for laryngeal muscles Motor speech areas Navigated transcranial magnetic stimulation Electrical stimulation of motor speech areas Neurophysiologic markers |
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