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Frontal pathways in cognitive control: direct evidence from intraoperative stimulation and diffusion tractography
Guglielmo Puglisi1,2, Henrietta Howells1, Tommaso Sciortino2,3
1Laboratory of Motor Control, Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, and Humanitas Research Hospital, IRCCS, Milan, Italy.
Brain : a Journal of Neurology
|July 27, 2019
Summary
This study reveals that specific white matter tracts, particularly cortico-subcortical ones near the right inferior frontal gyrus, are crucial for interference control. Preserving these tracts is vital during brain surgery to maintain cognitive abilities.
Area of Science:
- Neuroscience
- Cognitive Psychology
- Neurosurgery
Background:
- Cognitive control, specifically interference control, is essential for goal-directed behavior.
- The right frontal lobe's role in interference control is known, but the underlying white matter tracts are not well understood.
Purpose of the Study:
- To identify the white matter tracts essential for interference control.
- To investigate the impact of transient and permanent white matter disruption on interference control.
Main Methods:
- Intraoperative direct electrical stimulation during a Stroop test in patients with right frontal glioma.
- Lesion-symptom mapping comparing patients with resections to controls.
- High angular resolution diffusion imaging (HARDI) tractography to examine white matter tracts.
Main Results:
- Electrical stimulation induced errors primarily in white matter medial to the right inferior frontal gyrus.
- Resection of the right inferior frontal gyrus correlated with slower postoperative Stroop performance.
- Cortico-subcortical tracts, including inferior fronto-striatal tracts, were most frequently implicated in interference control deficits.
Conclusions:
- The right inferior frontal gyrus plays a critical role in interference control.
- Cortico-subcortical tracts, rather than cortico-cortical connections, appear vital for efficient cognitive control.
- Preservation of these tracts is important during right frontal tumor resections.
Keywords:
awake neurosurgerydirect electrical stimulationexecutive functionfronto-striataltractographyMore Related Videos
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