利用术中电刺激的方法研究优势侧纹状体在语言功能中的作用  

The role of dominant striatum in language: A study using intraoperative electrical stimulations

作　　者：Robles S.G. Gatignol P. Capelle L. H. Duffau 李一明 

机构地区：[1]Service de Neurochi rurgie, Hpital de la Salpê triê re, 47- 83 Bd de l’ hpital, 75651 Pari s Cedex 13, France Dr.

出　　处：《世界核心医学期刊文摘（神经病学分册）》2005年第10期25-26,共2页Digest of the World Core Medical Journals:Clinical Neurology

摘　　要：Background: The role of the striatum in language remains poorly understood. I ntraoperative electrical stimulation during surgery for tumours involving the ca udate nucleus or putamen in the dominant hemisphere might be illuminating. Objec tives: To study the role of these structures in language, with the aim of avoidi ng postoperative definitive aphasia. Methods: 11 patients with cortico- subcort ical low grade gliomas were operated on while awake, and striatal functional map ping was done. Intraoperative direct electrical stimulation was used while the p atients carried out motor and naming tasks during the resection. Results: In fiv e cases of glioma involving the dominant putamen, stimulations induced anarthria , while in six cases of glioma involving the dominant caudate, stimulations elic ited perseveration. There was no motor effect. The striatum was systematically p reserved. Postoperatively, all patients except one had transient dysphasia which resolved within three months. Conclusions: There appear to be two separate basa l ganglia systems in language, one mediated by the putamen which might have a mo tor role, and one by the caudate which might have a role in cognitive control. T hese findings could have implications for surgical strategy in lesions involving the dominant striatum.Background: The role of the striatum in language remains poorly understood. I ntraoperative electrical stimulation during surgery for tumours involving the ca udate nucleus or putamen in the dominant hemisphere might be illuminating. Objec tives: To study the role of these structures in language, with the aim of avoidi ng postoperative definitive aphasia. Methods: 11 patients with cortico- subcort ical low grade gliomas were operated on while awake, and striatal functional map ping was done. Intraoperative direct electrical stimulation was used while the p atients carried out motor and naming tasks during the resection. Results: In fiv e cases of glioma involving the dominant putamen, stimulations induced anarthria , while in six cases of glioma involving the dominant caudate, stimulations elic ited perseveration. There was no motor effect. The striatum was systematically p reserved. Postoperatively, all patients except one had transient dysphasia which resolved within three months. Conclusions: There appear to be two separate basa l ganglia systems in language, one mediated by the putamen which might have a mo tor role, and one by the caudate which might have a role in cognitive control. T hese findings could have implications for surgical strategy in lesions involving the dominant striatum.

关 键 词：侧纹状体 电刺激 语言功能 胶质瘤 研究优势 壳核 肿瘤手术 语言中枢 尾状核 优势半球 

分 类 号：R739.4[医药卫生—肿瘤]