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J Neurol Surg A Cent Eur Neurosurg 2020; 81(02): 138-146
DOI: 10.1055/s-0040-1701625
Original Article
Georg Thieme Verlag KG Stuttgart · New York

When Right Is on the Left (and Vice Versa): A Case Series of Glioma Patients with Reversed Lateralization of Cognitive Functions

Emmanuel Mandonnet
1   Department of Neurosurgery, Lariboisière Hospital, Paris, France
2   University Paris 7, Paris, France
3   Frontlab, INSERM, Institut du Cerveau et de la Moelle (ICM), Paris, France
,
Charles Mellerio
4   Imaging center Centre Cardiologique du Nord (CCN), Saint-Denis, France
,
Marion Barberis
1   Department of Neurosurgery, Lariboisière Hospital, Paris, France
,
Isabelle Poisson
1   Department of Neurosurgery, Lariboisière Hospital, Paris, France
,
Johan Martijn Jansma
5   Department of Neurosurgery, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
,
Geert-Jan Rutten
5   Department of Neurosurgery, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
› Author Affiliations
Further Information

Publication History

11 December 2018

22 October 2019

Publication Date:
17 February 2020 (online)

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Abstract

We report a case series of four patients operated on for a glioma in awake conditions and in whom task-based functional magnetic resonance imaging (fMRI) demonstrated right-dominant activity during a language production task. Language functional sites were identified intraoperatively by electrical stimulations only in the patient with a right-sided lesion. Furthermore, the pre- or postoperative cognitive evaluations in the three patients operated on for a left-sided glioma revealed right spatial neglect and dysexecutive syndrome, hence demonstrating that, in patients with right-dominant activity on language fMRI, the left hemisphere is implicated in spatial consciousness and cognitive control. This study supports the interest of presurgical task-based language fMRI to identify patients with a reversed lateralization of cognitive functions and to make an adequate selection of the battery of intraoperative cognitive tasks to be monitored in those rare outliers.

Keywords

functional magnetic resonance imaging - brain mapping - reversed lateralization - language dominance - electrical stimulation
 

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