Dataset Information

The Frontal Aslant Tract: A Systematic Review for Neurosurgical Applications.

ABSTRACT: The frontal aslant tract (FAT) is a recently identified white matter tract connecting the supplementary motor complex and lateral superior frontal gyrus to the inferior frontal gyrus. Advancements in neuroimaging and refinements to anatomical dissection techniques of the human brain white matter contributed to the recent description of the FAT anatomical and functional connectivity and its role in the pathogenesis of several neurological, psychiatric, and neurosurgical disorders. Through the application of diffusion tractography and intraoperative electrical brain stimulation, the FAT was shown to have a role in speech and language functions (verbal fluency, initiation and inhibition of speech, sentence production, and lexical decision), working memory, visual-motor activities, orofacial movements, social community tasks, attention, and music processing. Microstructural alterations of the FAT have also been associated with neurological disorders, such as primary progressive aphasia, post-stroke aphasia, stuttering, Foix-Chavany-Marie syndrome, social communication deficit in autism spectrum disorders, and attention-deficit hyperactivity disorder. We provide a systematic review of the current literature about the FAT anatomical connectivity and functional roles. Specifically, the aim of the present study relies on providing an overview for practical neurosurgical applications for the pre-operative, intra-operative, and post-operative assessment of patients with brain tumors located around and within the FAT. Moreover, some useful tests are suggested for the neurosurgical evaluation of FAT integrity to plan a safer surgery and to reduce post-operative deficits.

SUBMITTER: La Corte E

PROVIDER: S-EPMC7959833 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Publications

The Frontal Aslant Tract: A Systematic Review for Neurosurgical Applications.

La Corte Emanuele E Eldahaby Daniela D Greco Elena E Aquino Domenico D Bertolini Giacomo G Levi Vincenzo V Ottenhausen Malte M Demichelis Greta G Romito Luigi Michele LM Acerbi Francesco F Broggi Morgan M Schiariti Marco Paolo MP Ferroli Paolo P Bruzzone Maria Grazia MG Serrao Graziano G

Frontiers in neurology 20210224

The frontal aslant tract (FAT) is a recently identified white matter tract connecting the supplementary motor complex and lateral superior frontal gyrus to the inferior frontal gyrus. Advancements in neuroimaging and refinements to anatomical dissection techniques of the human brain white matter contributed to the recent description of the FAT anatomical and functional connectivity and its role in the pathogenesis of several neurological, psychiatric, and neurosurgical disorders. Through the app ...[more]

PMID: 33732210

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Project description:The frontal aslant tract (FAT) is a recently described intralobar tract that connects the superior and inferior frontal gyri. The FAT has been implicated in various speech and language processes and disorders, including motor speech impairments, stuttering disorders, opercular syndrome, and verbal fluency, but the specific function(s) of the FAT have yet to be elucidated. In the current study, we aimed to address this knowledge gap by investigating the underlying role that the FAT plays in motor aspects of speech and language abilities in post-stroke aphasia. Our goals were three-fold: 1) To identify which specific motor speech or language abilities are impacted by FAT damage by utilizing a powerful imaging analysis method, High Angular Resolution Diffusion Imaging (HARDI) tractography; 2) To determine whether damage to the FAT is associated with functional deficits on a range of motor speech and language tasks even when accounting for cortical damage to adjacent cortical regions; and 3) To explore whether subsections of the FAT (lateral and medial segments) play distinct roles in motor speech performance. We hypothesized that damage to the FAT would be most strongly associated with motor speech performance in comparison to language tasks. We analyzed HARDI data from thirty-three people with aphasia (PWA) with a history of chronic left hemisphere stroke. FAT metrics were related to scores on several speech and language tests: the Motor Speech Evaluation (MSE), the Western Aphasia Battery (WAB) aphasia quotient and subtests, and the Boston Naming Test (BNT). Our results indicated that the integrity of the FAT was strongly associated with the MSE as predicted, and weakly negatively associated with WAB subtest scores including Naming, Comprehension, and Repetition, likely reflecting the fact that performance on these WAB subtests is associated with damage to posterior areas of the brain that are unlikely to be damaged with a frontal lesion. We also performed hierarchical stepwise regressions to predict language function based on FAT properties and lesion load to surrounding cortical areas. After accounting for the contributions of the inferior frontal gyrus, the ventral precentral gyrus, and the superior precentral gyrus of the insula, the FAT still remained a significant predictor of MSE apraxia scores. Our results further showed that the medial and lateral subsections of the FAT did not appear to play distinct roles but rather may indicate normal anatomical variations of the FAT. Overall, current results indicate that the FAT plays a specific and unique role in motor speech. These results further our understanding of the role that white matter tracts play in speech and language.

Project description:The Frontal Aslant Tract (FAT) is a tract recently described as having implications on language function. The originally proposed anatomical FAT definition characterizes a connection between Broca's territory and anterior supplementary and pre-supplementary motor areas in the Superior Frontal Gyrus (SFG). Here we propose an extended definition of the FAT (the exFAT) that propagates more anteriorly into the SFG. A sample of 834 subjects from the WU-Minn HCP 900 subjects data release (S900) was selected. The bilateral exFATs were reconstructed for the whole sample using an automated pipeline and thresholded adjusted tract volumes were calculated. A laterality test was performed on the whole sample. The frontal cortex has known implications on superior cognitive functions, so here we evaluate the implications of exFAT volume on performance in a language task and on a set of working memory tasks. Two sub-samples of 70 subjects each were drawn from the S900 sample by selecting the 35 top-performers and 35 bottom-performers for both language and working memory tasks. Additional laterality tests were performed on each subsample. We did not find the exFAT to be lateralized in any of the samples. We found statistically significant differences in left adjusted exFAT volume between top-performers and bottom-performers in the language task. We also found statistically significant differences in right adjusted exFAT volume between top-performers and bottom-performers for 2-back working memory tasks. To check for the predictive power of the exFAT volumes as correlates for performance, we ran a repeated random sub-sampling cross-validation procedure based on a Support Vector Machine (SVM) classifier that was capable of correctly classifying holdout subjects to their corresponding group (top-performer vs bottom-performer) with an average accuracy of 74.5% for language task performance based on left exFAT volume and an accuracy of 64.2% for Working Memory performance based on right exFAT volume.

Dataset Information

The Frontal Aslant Tract: A Systematic Review for Neurosurgical Applications.

Publications

The Frontal Aslant Tract: A Systematic Review for Neurosurgical Applications.

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