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Influence of choice of task and items as well as lesion location on error elicitation under stimulation mapping in brain tumour patients
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Poster B2 in Poster Session B, Tuesday, October 24, 3:30 - 5:15 pm CEST, Espace Vieux-Port
Ann-Katrin Ohlerth1,2, Roelien Bastiaanse3, Severin Schramm4, Sandro M. Krieg2,5, Vitória Piai6,7; 1Neurobiology of Language Department, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands, 2School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Department of Neurosurgery, Munich, Germany, 3University of Groningen, Groningen, The Netherlands, 4Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany, 5Technical University of Munich, TUM-Neuroimaging Center, Klinikum rechts der Isar, Munich, Germany, 6Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands, 7Radboudumc, Donders Institute for Brain, Cognition and Behaviour, Department of Medical Psychology, Nijmegen, The Netherland
Introduction: During language mapping with navigated Transcranial Magnetic Stimulation (nTMS), non-invasive stimulation causing temporary disruption of neural activity in a brain area is coupled with a picture naming task in order to reveal the area's involvement in language production. These nTMS maps are used in neuroscientific research as well as in surgery guidance in brain tumour patients. Few efforts have gone into questioning choice of task during picture naming and its parameters: most centres solely employ home-made, unstandardized versions of the classic object naming (ON). Recently, the benefit of a verb task, Action Naming (AN), in nTMS was unravelled. Yet, which item features (length, age of acquisition etc.) lead to this benefit or which linguistic values drive both tasks remain unexplored. We therefore investigate picture naming during nTMS mapping in a healthy and clinical population using validated tests for both ON and AN, in order to investigate: (1) which task and item factors influence the breakdown of language production during nTMS (2) which patient group, depending on lesion site, is affected most by task and item choice. Methods: 20 controls and 21 tumour patients with heterogeneous lesion location underwent nTMS mapping. This entailed baseline naming of all stimuli (75 AN, 80 ON; formerly standardised (Ohlerth et al., 2020)). During nTMS mapping, 46 left-hemisphere spots were targeted with a 5Hz/5pulse electromagnetic stimulation, while individuals named picture stimuli appearing on screen for 700-1000ms. Trials where the individual was unable to produce the target items, were evaluated as errors. Binomial general mixed-effect models were established, entailing item factors (age of acquisition, length, transitivity etc.) and demographic factors (age, group healthy/clinical, lesion) as predictors. Patterns in lesion location were revealed through hierarchical clustering. Analyses were split into: models (1) including all individuals, task and item factors to reveal predictors driving naming errors; models (2) including clinical cases for recommendations of task and item choice depending on lesion characteristic. Results: Models regarding predictors for errors in all individuals (1) revealed consistently more errors during AN than ON, more errors for clinical than healthy individuals and for longer over shorter items. In ON, longer items and in AN, transitive items led to more errors. In (2) analyses of tumour patients, lesion location was a significant predictor. Discussion: Choice of task (AN over ON) consistently influences language production under nTMS across individuals. We suggest this is driven by higher complexity of lexico-semantic or syntactic weight in retrieval of verbs over nouns (Ohlerth et al., 2021, Ntemou et al., 2021). This is corroborated by the significance of transitivity within AN performance, further increasing retrieval difficulty through more complex argument structure. Moreover, item length seems to affect error count and should be taken into account. nTMS may trigger breakdown of language production at its most challenging point, through increased cognitive load of retrieving long and lexico-semantically complex items. These findings may inform our understanding of nTMS, and lead to recommendations for different lesion locations, calling for an a-priori choice of task and items to best map and preserve language.
Topic Areas: Language Production, Disorders: Acquired