Disruption of frontal aslant tract is not associated with long-term postoperative language deficits
Abstract
Background The frontal aslant tract (FAT) is a white matter fiber pathway connecting the superior frontal gyrus to the Broca area. This tract in the dominant hemisphere has been shown to play a role in speech initiation and production, and direct subcortical stimulation can induce stuttering and speech arrest in a patient. However, controversy remains as to whether disruption of this pathway will lead to a permanent language deficit and if it is even necessary to map this tract during tumor resections of the dominant frontal lobe.Case description Here, we report a case of a patient with a lower-grade diffuse glioma invading the dominant FAT that was removed with an asleep craniotomy. In the immediate postoperative state, the patient had a transcortical motor dysphasia and was unable to initiate speech. These immediate language deficits quickly recovered, and the patient was neurologically intact at the time of discharge a few days after surgery.Conclusions Given the high likelihood for a complete neurologic recovery including transient aphasia, we propose that awake mapping for the purpose of identifying the dominant FAT is unnecessary during tumor resection and that disruption of this tract is not associated with any long-term language deficits.
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The function of the regions of interest, with the exception of aAF, can be compensated for by other undamaged regions, for example after functional reorganization.
“they suggest that the function of our regions of interest, with the exception of aAF, can be compensated for by other undamaged regions (e.g. after functional reorganization; Young et al., 2020).”
From Damage to Broca’s area does not contribute to long-term speech production outcome after stroke (2021) · cites this paper as Young et al., 2020
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- Authors
- Young, J. S., Morshed, R. A., Mansoori, Z., Cha, S., & Berger, M. S.
- Affiliations
- University of California, San Francisco (US)
- Corresponding author
- Berger, Mitchel S.
- Venue
- World Neurosurgery
- Publisher
- Elsevier BV
- Published
- 2020-01
- Volume
- 133
- Pages
- 192-195
- ISSN
- 1878-8750 (ISSN-L)
- OpenAlex
- W2976400890
- Cited by
- 37
- References
- 21
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 5 · 2023: 5 · 2022: 6 · 2021: 7 · 2020: 4
- FWCI
- 2.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- World Neurosurgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neurobiology of Language and Bilingualism
- Health Sciences › Medicine › Genetics › Glioma Diagnosis and Treatment
- Keywords
- frontal aslant tract, language deficits, transcortical motor aphasia, speech initiation, glioma, awake craniotomy, Broca's area, superior frontal gyrus, postoperative recovery
- MeSH terms
- Aphasia, Craniotomy, Female, Glioma, Humans, Magnetic Resonance Imaging, Postoperative Complications, Treatment Outcome, Young Adult, White Matter
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