The newly identified frontal aslant tract (FAT) that connects the posterior Broca’s area to the supplementary motor area is known to be involved in speech and language functions. We successfully intraoperatively monitored FAT using cortico-cortical evoked potentials generated by single-pulse electrical cortical stimulation in a patient with oligodendroglioma.

Citations

• Developmental trajectory of transmission speed in the human brain
  Dorien van Blooijs, Max A. van den Boom, Jaap F. van der Aar, Geertjan M. Huiskamp, Giulio Castegnaro, Matteo Demuru, Willemiek J. E. M. Zweiphenning, Pieter van Eijsden, Kai J. Miller, Frans S. S. Leijten, Dora Hermes
  Nature Neuroscience.2023; 26(4): 537.     CrossRef

Background
s: MEG can measure the task-specific neurophysiologic activity with good spatial and time resolution. Language lateralization using noninvasive method has been a subject of interest in resective brain surgery. We purposed to develop a paradigm for language lateralization using MEG and validate its feasibility.
Methods: Magnetic fields were obtained in 12 neurosurgical candidates and one volunteer for language tasks, with a 306 channel whole head MEG. Language tasks were word listening, reading and picture naming. We tested two word listening paradigms:semantic decision of meaning of abstract nouns, and recognition of repeated words. The subjects were instructed to silently name or read, and respond with pushing button or not. We decided language dominance according to the number of acceptable equivalent current dipoles (ECD) modeled by sequential single dipole, and the mean magnetic field strength by root mean square value, in each hemisphere. We collected clinical data including Wada test.
Results: Magnetic fields evoked by word listening were generally distributed in bilateral temporoparietal areas with variable hemispheric dominance. Language tasks using visual stimuli frequently evoked magnetic field in posterior midline area, which made laterality decision difficult. Response during task resulted in more artifacts and different results depending on responding hand. Laterality decision with mean magnetic field strength was more concordant with Wada than the method with ECD number of each hemisphere.
Conclusions: Word listening task without hand response is the most feasible paradigm for language lateralization using MEG. Mean magnetic field strength in each hemisphere is a proper index for hemispheric dominance.