Parcellation System Research Articles

Neuroanatomical comparison of treatment-resistant and treatment-responsive schizophrenia patients using the cloud-based brain magnetic resonance image segmentation and parcellation system: An MRIcloud study

Recent developments in neuroimaging have improved our understanding of the biological mechanisms underlying schizophrenia. However, neuroimaging findings in treatment-resistant schizophrenia (TRS) remain unclear. In the present study, we aimed to explore potential neuroanatomical regions that may be associated with treatment resistance in schizophrenia patients by comparing neuroanatomical regions of TRS and non-TRS patients using the MRICloud method. A total of 33 schizophrenia patients (meeting DSM 5 diagnostic criteria for schizophrenia) were included in the study. Patients were dichotomized into TRS (n = 18) and non-TRS (n = 15) groups, and all patients underwent MRI. Neuroanatomical regions of TRS and non-TRS patients were compared using the MRICloud method. Disease severity was measured using the Positive and Negative Syndrome Scale (PANSS). Interestingly, a statistically significant greater left Corpus Collosum (CC) thickness was found in TRS patients compared to non-TRS patients. It is clear that further studies comparing TRS patients with non-TRS patients are needed, and these studies should focus on the circuits in the corpus callosum that are thought to play a role in treatment resistance. Further longitudinal studies are also needed to complement the cross-sectional studies, using a multimodal imaging approach in the patients with clearly defined TRS criteria.

Associations between Age and Cortical Thickness in Brain Regions Supporting Speech Motor Control

AbstractBackgroundPrior research has demonstrated consistent associations between age and cortical thickness, as well as longitudinal reductions in cortical thickness in older adults (e.g., Salat et al., 2004; Storsve et al., 2014). To date, the aging of regions supporting speech production has not been directly investigated. Such information is, however, needed to differentiate age‐related cortical atrophy in speech regions from that occurring due to underlying neurodegenerative diseases. We examined cross‐sectional associations between age and cortical thickness of brain regions supporting speech motor control. These areas include subregions of the premotor cortex, primary motor area, supplementary motor area, pars opercularis, posterior inferior frontal sulcus, and insula as defined by the Directions Into Velocities of Articulators (DIVA) model ‐ a model for neural representation and mechanisms of speech motor control (Tourville & Guenther, 2011).MethodThe data were obtained from the Alzheimer’s Disease Neuroimaging Initiative GO/2 (ADNI). Participants included 163 (77 M, 86 F) cognitively intact adults aged 56‐89 years (Mean = 73.45, SD = 6.23). All participants were right‐handed and had at least 12 years of education (Mean = 16.53, SD = 2.55). Whole‐brain T1‐weighted MRI images were acquired by a 3‐Tesla Siemens scanner. FreeSurfer software was used for cortical surface reconstruction and to extract the cortical thickness of speech regions as identified by the SpeechLabel Parcellation System (Cai et al., 2014) developed based on the DIVA model.ResultSignificant associations between age and cortical thickness was observed in subregions of left premotor cortex, primary motor area, supplementary motor area, and presupplementary motor area with more limited effects in the right hemisphere. Cortical thickness of pars opercularis, posterior inferior frontal sulcus, and insula did not show significant changes over the aging process. Cross‐sectional interactions were found with regions in the left hemisphere being thicker at younger ages and having a larger negative age slope compared to their corresponding regions in the right hemisphere.ConclusionThe findings of the study suggest that certain speech‐related regions show atrophy with aging, however, these changes are not uniform. In addition, laterality in cortical thickness of speech regions at younger ages was observed to diminish over the normal aging process.

Tractography-based navigated TMS language mapping protocol.

This study explores the feasibility of implementing a tractography-based navigated transcranial magnetic stimulation (nTMS) language mapping protocol targeting cortical terminations of the arcuate fasciculus (AF). We compared the results and distribution of errors from the new protocol to an established perisylvian nTMS protocol that stimulated without any specific targeting over the entire perisylvian cortex. Sixty right-handed patients with language-eloquent brain tumors were examined in this study with one half of the cohort receiving the tractographybased protocol and the other half receiving the perisylvian protocol. Probabilistic tractography using MRtrix3 was performed for patients in the tractography-based group to identify the AF's cortical endpoints. nTMS mappings were performed and resulting language errors were classified into five psycholinguistic groups. Tractography and nTMS were successfully performed in all patients. The tractogram-based group showed a significantly higher median overall ER than the perisylvian group (3.8% vs. 2.9% p <.05). The median ER without hesitation errors in the tractogram-based group was also significantly higher than the perisylvian group (2.0% vs. 1.4%, p <.05). The ERs by error type showed no significant differences between protocols except in the no response ER, with a higher median ER in the tractogram-based group (0.4% vs. 0%, p <.05). Analysis of ERs based on the Corina cortical parcellation system showed especially high nTMS ERs over the posterior middle temporal gyrus (pMTG) in the perisylvian protocol and high ERs over the middle and ventral postcentral gyrus (vPoG), the opercular inferior frontal gyrus (opIFG) and the ventral precentral gyrus (vPrG) in the tractography-based protocol. By considering the white matter anatomy and performing nTMS on the cortical endpoints of the AF, the efficacy of nTMS in disrupting patients' object naming abilities was increased. The newly introduced method showed proof of concept and resulted in AF-specific ERs and noninvasive cortical language maps, which could be applied to additional fiber bundles related to the language network in future nTMS studies.

Altered functional connectivity of cerebellar networks in first-episode schizophrenia.

Abnormalities of the cerebellum have been displayed to be a manifestation of schizophrenia (SCH) which is a detrimental psychiatric disorder. It has been recognized that the cerebellum contributes to motor function, sensorimotor function, cognition, and other brain functions in association with cerebral functions. Multiple studies have observed that abnormal alterations in cerebro-cerebellar functional connectivity (FC) were shown in patients with SCH. However, the FC of cerebellar networks in SCH remains unclear. In this study, we explored the FC of cerebellar networks of 45 patients with first-episode SCH and 45 healthy control (HC) subjects by using a defined Yeo 17 network parcellation system. Furthermore, we performed a correlation analysis between cerebellar networks' FC and positive and negative symptoms in patients with first-episode SCH. Finally, we established the classification model to provide relatively suitable features for patients with first-episode SCH concerning the cerebellar networks. We found lower between-network FCs between 14 distinct cerebellar network pairs in patients with first-episode SCH, compared to the HCs. Significantly, the between-network FC in N2-N15 was positively associated with positive symptom severity; meanwhile, N4-N15 was negatively associated with negative symptom severity. Besides, our results revealed a satisfactory classification accuracy (79%) of these decreased between-network FCs of cerebellar networks for correctly identifying patients with first-episode SCH. Conclusively, between-network abnormalities in the cerebellum are closely related to positive and negative symptoms of patients with first-episode SCH. In addition, the classification results suggest that the cerebellar networks can be a potential target for further elucidating the underlying mechanisms in first-episode SCH.

HOA2.0-ComPaRe: A next generation Harvard-Oxford Atlas comparative parcellation reasoning method for human and macaque individual brain parcellation and atlases of the cerebral cortex.

Comparative structural neuroanatomy is a cornerstone for understanding human brain structure and function. A parcellation framework that relates systematically to fundamental principles of histological organization is an essential step in generating structural comparisons between species. In the present investigation, we developed a comparative parcellation reasoning system (ComPaRe), which is a formal ontological system in human and non-human primate brains based on the cortical cytoarchitectonic mapping used for both species as detailed by Brodmann. ComPaRe provides a theoretical foundation for mapping neural systems in humans and other species using neuroimaging. Based on this approach, we revised the methodology of the original Harvard-Oxford Atlas (HOA) system of brain parcellation to produce a comparative framework for the human (hHOA) and the rhesus monkey (mHOA) brains, which we refer to as HOA2.0-ComPaRe. In addition, we used dedicated segmentation software in the publicly available 3D Slicer platform to parcellate an individual human and rhesus monkey brain. This method produces quantitative morphometric parcellations in the individual brains. Based on these parcellations we created a representative template and 3D brain atlas for the two species, each based on a single subject. Thus, HOA2.0-ComPaRe provides a theoretical foundation for mapping neural systems in humans and other species using neuroimaging, while also representing a significant revision of the original human and macaque monkey HOA parcellation schemas. The methodology and atlases presented here can be used in basic and clinical neuroimaging for morphometric (volumetric) analysis, further generation of atlases, as well as localization of function and structural lesions.

MRI-based Parcellation and Morphometry of the Individual Rhesus Monkey Brain: the macaque Harvard-Oxford Atlas (mHOA), a translational system referencing a standardized ontology.

Investigations of the rhesus monkey (Macaca mulatta) brain have shed light on the function and organization of the primate brain at a scale and resolution not yet possible in humans. A cornerstone of the linkage between non-human primate and human studies of the brain is magnetic resonance imaging, which allows for an association to be made between the detailed structural and physiological analysis of the non-human primate and that of the human brain. To further this end, we present a novel parcellation method and system for the rhesus monkey brain, referred to as the macaque Harvard-Oxford Atlas (mHOA), which is based on the human Harvard-Oxford Atlas (HOA) and grounded in an ontological and taxonomic framework. Consistent anatomical features were used to delimit and parcellate brain regions in the macaque, which were then categorized according to functional systems. This system of parcellation will be expanded with advances in technology and, like the HOA, will provide a framework upon which the results from other experimental studies (e.g., functional magnetic resonance imaging (fMRI), physiology,connectivity, graph theory) can be interpreted.

Multimodality Language Mapping Using Cortical Stimulation in Paediatric Patients With Epilepsy

Abstract INTRODUCTION Pediatric patients with epilepsy often undergo language mapping using electrical cortical stimulation. Previous studies have shown general localization of auditory naming in the anterior temporal lobe and visual naming in the posterior parietal and temporal lobe. No probabilistic map exists, however, that quantifiably details the location of the different language modalities for pediatric patients with epilepsy. METHODS A series of 41 consecutive pediatric patients underwent cortical language mapping (24 female; range 5.2-18.5 yr; mean age 13.8 yr), either extraoperative (n = 34) or intraoperative (n = 7), prior to epileptic focus resection. The exact location of where an error occurred was recorded and transposed on a cortical parcellation system. Statistical analysis used a binomial one sided exact test with a cut off set at 60%. RESULTS Results show an increased range of sites for both visual and auditory naming as compared to adults. Cortical stimulation language testing was conducted 2102 times; 1201 visual and 901 auditory. Visual naming sites extended into the anterior temporal lobe. Auditory naming sites extended from the anterior temporal lobe to the middle temporal and posterior temporal gyrus. CONCLUSION The anterior temporal lobe is a commonly resected region, often felt to be of minimal risk. Knowledge of how these 2 language modalities extend into the temporal lobe in addition to how they differ from adults provides insight into which areas are safe to resect and which areas to spare during pediatric epilepsy surgery.

Cloud-Based Brain Magnetic Resonance Image Segmentation and Parcellation System for Individualized Prediction of Cognitive Worsening.

For patients with cognitive disorders and dementia, accurate prognosis of cognitive worsening is critical to their ability to prepare for the future, in collaboration with health-care providers. Despite multiple efforts to apply computational brain magnetic resonance image (MRI) analysis in predicting cognitive worsening, with several successes, brain MRI is not routinely quantified in clinical settings to guide prognosis and clinical decision-making. To encourage the clinical use of a cutting-edge image segmentation method, we developed a prediction model as part of an established web-based cloud platform, MRICloud. The model was built in a training dataset from Alzheimer's Disease Neuroimaging Initiative (ADNI) where baseline MRI scans were combined with clinical data over time. Each MRI was parcellated into 265 anatomical units based on the MRICloud fully automated image segmentation function, to measure the volume of each parcel. The Mini Mental State Examination (MMSE) was used as a measure of cognitive function. The normalized volume of 265 parcels, combined with baseline MMSE score, age, and sex were input variables for a Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis, with MMSE change in the subsequent two years as the target for prediction. A leave-one-out analysis performed on the training dataset estimated a correlation coefficient of 0.64 between true and predicted MMSE change. A receiver operating characteristic (ROC) analysis estimated a sensitivity of 0.88 and a specificity of 0.76 in predicting substantial cognitive worsening after two years, defined as MMSE decline of ≥4 points. This MRICloud prediction model was then applied to a test dataset of clinically acquired MRIs from the Johns Hopkins Memory and Alzheimer's Treatment Center (MATC), a clinical care setting. In the latter setting, the model had both sensitivity and specificity of 1.0 in predicting substantial cognitive worsening. While the MRICloud prediction model demonstrated promise as a platform on which computational MRI findings can easily be extended to clinical use, further study with a larger number of patients is needed for validation.

Relationship Between Perisylvian Essential Language Sites and Arcuate Fasciculus in the Left Hemisphere of Healthy Adults.

Essential language sites and the arcuate fasciculus (AF) have been extensively researched. However, the relationship between them remains insufficiently studied, especially in healthy people. Navigated transcranial magnetic stimulation (nTMS) is increasingly used in language mapping. While enjoying the advantage of non-invasiveness, it is also capable of inducing a virtual lesion in the brain. Thus, it offers the possibility of using the virtual-lesion method to study the healthy brain. This study combined nTMS and diffusion tensor imaging (DTI) tractography to investigate the relationship between essential language sites and the AF in 30 healthy right-handed volunteers. A total of 143 essential language sites were identified using nTMS, and a total of 175 AF terminations were identified using DTI tractography. Sixty-six sites had a direct correlation with the AF, accounting for 46% of the total essential language sites. Forty-seven AF terminations harbored essential language sites, accounting for 27% of the total AF terminations. Upon data rendering to the cortical parcellation system, a region-related heterogeneity of the correlation rate was found. This study provides the first data on the relationship between essential language sites and the AF in healthy adults.

Entorhinal Cortex: Antemortem Cortical Thickness and Postmortem Neurofibrillary Tangles and Amyloid Pathology.

The entorhinal cortex, a critical gateway between the neocortex and hippocampus, is one of the earliest regions affected by Alzheimer disease-associated neurofibrillary tangle pathology. Although our prior work has automatically delineated an MR imaging-based measure of the entorhinal cortex, whether antemortem entorhinal cortex thickness is associated with postmortem tangle burden within the entorhinal cortex is still unknown. Our objective was to evaluate the relationship between antemortem MRI measures of entorhinal cortex thickness and postmortem neuropathological measures. We evaluated 50 participants from the Rush Memory and Aging Project with antemortem structural T1-weighted MR imaging and postmortem neuropathologic assessments. Here, we focused on thickness within the entorhinal cortex as anatomically defined by our previously developed MR imaging parcellation system (Desikan-Killiany Atlas in FreeSurfer). Using linear regression, we evaluated the association between entorhinal cortex thickness and tangles and amyloid-β load within the entorhinal cortex and medial temporal and neocortical regions. We found a significant relationship between antemortem entorhinal cortex thickness and entorhinal cortex (P = .006) and medial temporal lobe tangles (P = .002); we found no relationship between entorhinal cortex thickness and entorhinal cortex (P = .09) and medial temporal lobe amyloid-β (P = .09). We also found a significant association between entorhinal cortex thickness and cortical tangles (P = .003) and amyloid-β (P = .01). We found no relationship between parahippocampal gyrus thickness and entorhinal cortex (P = .31) and medial temporal lobe tangles (P = .051). Our findings indicate that entorhinal cortex-associated in vivo cortical thinning may represent a marker of postmortem medial temporal and neocortical Alzheimer disease pathology.

EP 23. Cortical language mapping by rTMS compared to fMRI in healthy volunteers

Introduction Functional magnetic resonance imaging (fMRI) is considered to be the standard method regarding non-invasive language mapping. However, repetitive navigated transcranial magnetic stimulation (rTMS) gains increasing importance with respect to that purpose. However, comparisons between both methods are sparse. Objective To compare the results of rTMS and fMRI language mapping in healthy volunteers. Patients & methods We performed fMRI and rTMS language mapping of the left hemisphere in 40 healthy, right-handed subjects in combination with the tasks that are most commonly used in the neurosurgical context (fMRI: word-generation = WGEN task; rTMS: object-naming = ON task). Different rTMS error rate thresholds (ERTs) were calculated, and Cohen’s kappa coefficient and the cortical parcellation system (CPS) were used for systematic comparison of the two techniques. Results Overall, mean kappa coefficients were low, revealing no distinct agreement. We found the highest agreement for both techniques when using the 2-out-of-3 rule (CPS region defined as language-positive in terms of rTMS if at least 2 out of 3 stimulations led to a naming error). However, kappa for this threshold was only 0.24, indicating fair agreement. Conclusions Regarding the comparison of fMRI and rTMS, language mapping results seem to differ in a wide range, at least when the tasks of the present trials are used. Since it is not possible to verify the present results via direct cortical stimulation (DCS) as the gold standard method, we must be careful to call one of the two techniques the true one. However, this study yields valuable results regarding the comparison of these frequently used mapping techniques for the most common language tasks applied in the neurosurgical routine.

P72. Impairment of non-invasive language mapping by lesion location a fMRI, rTMS, and DCS study

Objective Language mapping by repetitive navigated transcranial magnetic stimulation (rTMS) is in-creasingly used and already replaces functional magnetic resonance imaging (fMRI) in some institutions for preoperative mapping of neurosurgical patients. However, some factors affect the concordance of both methods with the gold standard direct cortical stimulation (DCS). We therefore analyze the impairment of rTMS and fMRI by intraparenchymal lesions as compared to the results of DCS during awake surgery. Methods We performed language mapping in 27 patients with left-sided perisylvian lesions by DCS, rTMS, and fMRI using an object-naming task, and assigned the obtained language eloquent sites of each method to Corina’s cortical parcellation system (CPS). Subsequently, we calculated the receiver operating characteristics for rTMS and fMRI compared to DCS, and analyzed different subgroups with (W) and with-out (WO) lesion in the mapped areas. Results Within the W subgroup we revealed an overall sensitivity of 100% (WO: 100%), a specificity of 8% (WO: 5%), a PPV of 34% (WO: 53%), and a NPV of 100% (WO: 100%) for the comparison of rTMS with DCS. For the comparison of fMRI with DCS within the W subgroup we obtained an overall sensitivity of 32% (WO: 62%), a specificity of 88% (WO: 60%), a PPV of 56% (WO: 62%), and a NPV of 73% (WO: 60%). Conclusion With this study we were able to show that rTMS is less affected by a brain lesion than fMRI, particularly when performing mapping of language-negative cortical regions based on sensitivity and NPV. With this in mind, rTMS could be useful for the language mapping assessment prior to the gold standard DCS.

Impairment of preoperative language mapping by lesion location: a functional magnetic resonance imaging, navigated transcranial magnetic stimulation, and direct cortical stimulation study.

Language mapping by repetitive navigated transcranial magnetic stimulation (rTMS) is increasingly used and has already replaced functional MRI (fMRI) in some institutions for preoperative mapping of neurosurgical patients. Yet some factors affect the concordance of both methods with direct cortical stimulation (DCS), most likely by lesions affecting cortical oxygenation levels. Therefore, the impairment of the accuracy of rTMS and fMRI was analyzed and compared with DCS during awake surgery in patients with intraparenchymal lesions. Language mapping was performed by DCS, rTMS, and fMRI using an object-naming task in 27 patients with left-sided perisylvian lesions, and the induced language errors of each method were assigned to the cortical parcellation system. Subsequently, the receiver operating characteristics were calculated for rTMS and fMRI and compared with DCS as ground truth for regions with (w/) and without (w/o) the lesion in the mapped regions. The w/ subgroup revealed a sensitivity of 100% (w/o 100%), a specificity of 8% (w/o 5%), a positive predictive value of 34% (w/o: 53%), and a negative predictive value (NPV) of 100% (w/o: 100%) for the comparison of rTMS versus DCS. Findings for the comparison of fMRI versus DCS within the w/ subgroup revealed a sensitivity of 32% (w/o: 62%), a specificity of 88% (w/o: 60%), a positive predictive value of 56% (w/o: 62%), and a NPV of 73% (w/o: 60%). Although strengths and weaknesses exist for both rTMS and fMRI, the results show that rTMS is less affected by a brain lesion than fMRI, especially when performing mapping of language-negative cortical regions based on sensitivity and NPV.

Aberrant cerebellar connectivity in motor and association networks in schizophrenia.

Schizophrenia is a devastating illness characterized by disturbances in multiple domains. The cerebellum is involved in both motor and non-motor functions, and the “cognitive dysmetria” and “dysmetria of thought” models propose that abnormalities of the cerebellum may contribute to schizophrenia signs and symptoms. The cerebellum and cerebral cortex are reciprocally connected via a modular, closed-loop network architecture, but few schizophrenia neuroimaging studies have taken into account the topographical and functional heterogeneity of the cerebellum. In this study, using a previously defined 17-network cerebral cortical parcellation system as the basis for our functional connectivity seeds, we systematically investigated connectivity abnormalities within the cerebellum of 44 schizophrenia patients and 28 healthy control participants. We found selective alterations in cerebro-cerebellar functional connectivity. Specifically, schizophrenia patients showed decreased cerebro-cerebellar functional connectivity in higher level association networks (ventral attention, salience, control, and default mode networks) relative to healthy control participants. Schizophrenia patients also showed increased cerebro-cerebellar connectivity in somatomotor and default mode networks, with the latter showing no overlap with the regions found to be hypoconnected within the same default mode network. Finally, we found evidence to suggest that somatomotor and default mode networks may be inappropriately linked in schizophrenia. The relationship of these dysconnectivities to schizophrenia symptoms, such as neurological soft signs and altered sense of agency, is discussed. We conclude that the cerebellum ought to be considered for analysis in all future studies of network abnormalities in SZ, and further suggest the cerebellum as a potential target for further elucidation, and possibly treatment, of the underlying mechanisms and network abnormalities producing symptoms of schizophrenia.

Cortical regions involved in semantic processing investigated by repetitive navigated transcranial magnetic stimulation and object naming

BackgroundKnowledge about the cortical representation of semantic processing is mainly derived from functional magnetic resonance imaging (fMRI) or direct cortical stimulation (DCS) studies. Because DCS is regarded as the gold standard in terms of language mapping but can only be used during awake surgery due to its invasive character, repetitive navigated transcranial magnetic stimulation (rTMS)—a non-invasive modality that uses a similar technique as DCS—seems highly feasible for use in the investigation of semantic processing in the healthy human brain. MethodsA total number of 100 (50 left-hemispheric and 50 right-hemispheric) rTMS-based language mappings were performed in 50 purely right-handed, healthy volunteers during an object-naming task. All rTMS-induced semantic naming errors were then counted and evaluated systematically. Furthermore, since the distribution of stimulations within both hemispheres varied between individuals and cortical regions stimulated, all elicited errors were standardized and subsequently related to their cortical sites by projecting the mapping results into the cortical parcellation system (CPS). ResultsOverall, the most left-hemispheric semantic errors were observed after targeting the rTMS to the posterior middle frontal gyrus (pMFG; standardized error rate: 7.3‰), anterior supramarginal gyrus (aSMG; 5.6‰), and ventral postcentral gyrus (vPoG; 5.0‰). In contrast to that, the highest right-hemispheric error rates occurred after stimulation of the posterior superior temporal gyrus (pSTG; 12.4‰), middle superior temporal gyrus (mSTG; 6.2‰), and anterior supramarginal gyrus (aSMG; 6.2‰). ConclusionsAlthough error rates were low, the rTMS-based approach of investigating semantic processing during object naming shows convincing results compared to the current literature. Therefore, rTMS seems a valuable, safe, and reliable tool for the investigation of semantic processing within the healthy human brain.

Language and its right-hemispheric distribution in healthy brains: An investigation by repetitive transcranial magnetic stimulation

ObjectRepetitive navigated transcranial magnetic stimulation (rTMS) is increasingly used for preoperative cortical language mapping. Unlike direct cortical stimulation (DCS), and due to its non-invasive character, this technique can provide a map of the distribution of human language in the healthy brain as well as a dysfunctional brain. Although functional magnetic resonance imaging (fMRI) studies have reported interhemispheric functional connectivity between language structures, the way in which the right hemisphere helps bring about language function remains only partially investigated. The present study therefore uses rTMS as a virtual lesion model to investigate the right hemisphere's contribution to language processing in the healthy human brain. MethodsFifty healthy right-handed volunteers (25 males, 25 females, mean age 25.9±5.4years) underwent language mapping of the right hemisphere by rTMS combined with an object naming task. All errors induced by rTMS were categorized into six different error groups (no-response error, hesitation, performance error, neologism, semantic error, and phonological error). Afterwards, the error rates for each category were calculated and visualized through the results' being projected into the cortical parcellation system (CPS). To reveal CPS regions having similar functional properties, an additional principal component analysis (PCA) was performed. ResultsrTMS induced 1485 naming errors out of the 9839 stimulation trains (error rate 15.1%). These errors were located mainly in the right hemisphere's homologues of the left hemisphere's visually cued overt speech area (middle superior temporal gyrus: mSTG) and in the sound-to-articulation dorsal pathway consisting of opercular inferior frontal gyrus (opIFG) and anterior and posterior supramarginal gyrus (aSMG, pSMG) in both male and female brains. In addition, rTMS caused many errors in the global language comprehension area in female brains (right posterior superior temporal gyrus: pSTG), in speech motor areas in the middle and ventral precentral and postcentral gyri (mPrG, vPrG, mPoG, vPoG), and in executive-function areas in the middle and posterior middle frontal gyri (mFMG, pMFG). ConclusionsFor the first time, the present study provides data on the right hemisphere's cortical regions causally related to single word production function (right opIFG, aSMG, pSMG, mSTG), and selectively in female brains (right pSTG), from a large sample of 50 healthy adult brains in a virtual-lesion design. Moreover, speech-motor control regions (right mPrG, vPrG, mPoG, vPoG) and cortical regions supporting language task performance (mMFG, pMFG) in the language-non-dominant right hemisphere are described.

A Comparison of Language Mapping by Preoperative Navigated Transcranial Magnetic Stimulation and Direct Cortical Stimulation During Awake Surgery

Navigated transcranial magnetic stimulation (nTMS) is increasingly used in presurgical brain mapping. Preoperative nTMS results correlate well with direct cortical stimulation (DCS) data in the identification of the primary motor cortex. Repetitive nTMS can also be used for mapping of speech-sensitive cortical areas. The current cohort study compares the safety and effectiveness of preoperative nTMS with DCS mapping during awake surgery for the identification of language areas in patients with left-sided cerebral lesions. Twenty patients with tumors in or close to left-sided language eloquent regions were examined by repetitive nTMS before surgery. During awake surgery, language-eloquent cortex was identified by DCS. nTMS results were compared for accuracy and reliability with regard to DCS by projecting both results into the cortical parcellation system. Presurgical nTMS maps showed an overall sensitivity of 90.2%, specificity of 23.8%, positive predictive value of 35.6%, and negative predictive value of 83.9% compared with DCS. For the anatomic Broca's area, the corresponding values were a sensitivity of 100%, specificity of 13.0%, positive predictive value of 56.5%, and negative predictive value of 100%, respectively. Good overall correlation between repetitive nTMS and DCS was observed, particularly with regard to negatively mapped regions. Noninvasive inhibition mapping with nTMS is evolving as a valuable tool for preoperative mapping of language areas. Yet its low specificity in posterior language areas in the current study necessitates further research to refine the methodology.

Approaching expert results using a hierarchical cerebellum parcellation protocol for multiple inexpert human raters

Volumetric measurements obtained from image parcellation have been instrumental in uncovering structure-function relationships. However, anatomical study of the cerebellum is a challenging task. Because of its complex structure, expert human raters have been necessary for reliable and accurate segmentation and parcellation. Such delineations are time-consuming and prohibitively expensive for large studies. Therefore, we present a three-part cerebellar parcellation system that utilizes multiple inexpert human raters that can efficiently and expediently produce results nearly on par with those of experts. This system includes a hierarchical delineation protocol, a rapid verification and evaluation process, and statistical fusion of the inexpert rater parcellations. The quality of the raters' and fused parcellations was established by examining their Dice similarity coefficient, region of interest (ROI) volumes, and the intraclass correlation coefficient of region volume. The intra-rater ICC was found to be 0.93 at the finest level of parcellation.

MRI-based surface-assisted parcellation of human cerebellar cortex: an anatomically specified method with estimate of reliability

We revisit here a surface assisted parcellation (SAP) system of the human cerebellar cortex originally described in Makris, N., Hodge, S.M., Haselgrove, C., Kennedy, D.N., Dale, A., Fischl, B., Rosen, B.R., Harris, G., Caviness, V.S., Jr., Schmahmann, J.D., 2003. Human cerebellum: surface-assisted cortical parcellation and volumetry with magnetic resonance imaging. J Cogn Neurosci 15, 584–599. This system preserves the topographic and morphologic uniqueness of the individual cerebellum and allows for volumetric analysis and representation of multimodal structural and functional data on the cerebellar cortex. This methodology integrates features of automated routines of the program FreeSurfer as well as semi-automated and manual procedures of the program Cardviews to create 64 cerebellar parcellation units based on fissure information and anatomical landmarks of the cerebellar surface. Using this technique, we undertook the parcellation of ten cerebella by two independent raters. The reliability of the resulting parcellation units (64 total) was high, with an average Intraclass Correlation Coefficient (ICC) of 0.724 in the vermis and 0.853 in the hemispheres. Clusters of parcellation units were then created, based on lobar and connectivity data and functional hypotheses. These 36 clusters, when treated as anatomical units, had an average ICC of 0.933. Whereas the individual units provide a high level of detail and anatomical specificity, the clusters add flexibility to the analysis by providing higher reliability.

Gender and age effects in structural brain asymmetry as measured by MRI texture analysis

Effects of gender and age on structural brain asymmetry were studied by 3D texture analysis in 380 adults. Asymmetry is detected by comparing the complex 3D gray-scale image patterns in the left and right cerebral hemispheres as revealed by anatomical T1-weighted MRI datasets. The Talairach and Tournoux parcellation system was applied to study the asymmetry on five levels: the whole cerebrum, nine coronal sections, 12 axial sections, boxes resulting from both coronal and axial subdivisions, and by a sliding spherical window of 9 mm diameter. The analysis revealed that the brain asymmetry increases in the anterior–posterior direction starting from the central region onward. Male brains were found to be more asymmetric than female. This gender-related effect is noticeable in all brain areas but is most significant in the superior temporal gyrus, Heschl’s gyrus, the adjacent white matter regions in the temporal stem and the knee of the optic radiation, the thalamus, and the posterior cingulate. The brain asymmetry increases significantly with age in the inferior frontal gyrus, anterior insula, anterior cingulate, parahippocampal gyrus, retrosplenial cortex, coronal radiata, and knee region of the internal capsule. Asymmetry decreases with age in the optic radiation, precentral gyrus, and angular gyrus. The texture-based method reported here is based on extended multisort cooccurrence matrices that employ intensity, gradient, and anisotropy features in a uniform way. It is sensitive, simple to reproduce, robust, and unbiased in the sense that segmentation of brain compartments and spatial transformations are not necessary. Thus, it should be considered as another tool for digital morphometry in neuroscience.