神経腫瘍 Neuro-oncology

P3-1-235 背側経路と腹側経路の障害で異なる失文法理解 Differential agrammatic comprehension due to white matter damage in the dorsal and ventral pathways ○金野竜太1,2, 村垣善浩3, 丸山隆志3, 太田真理4,5, 酒井邦嘉2,4 ○Ryuta Kinno1,2, Yoshihiro Muragaki3, Takashi Maruyama3, Shinri Ohta4,5, Kuniyoshi L. Sakai2,4 昭和大学横浜市北部病院　内科1, 東京大院・総合文化・相関基礎2, 東京女子医大・医・脳神経外科3, 東京大院・総合文化・生命環境4, 日本学術振興会特別研究員5 Dept of Intern Med, Showa Univ Northern Yokohama Hosp Kanagawa1, Dept of Basic Sci, Univ of Tokyo, Tokyo2, Dept of Neurosurg, Tokyo Women's Med Univ, Tokyo3, Dept of Life Sci, Univ of Tokyo, Tokyo4, JSPS Res Fellow5 In our previous studies, we have reported that a glioma in the left inferior frontal gyrus or left lateral premotor cortex is sufficient to cause deficits in the comprehension of syntactically complex sentences (i.e., agrammatic comprehension). Recent studies using diffusion tensor imaging (DTI) have suggested the roles of two pathways in language processing: the dorsal tract of the arcuate/superior longitudinal fasciculi (AF/SLF) and the ventral tract of the middle longitudinal fasciculus/extreme capsule (MdLF/EmC), both of which terminate in the frontal cortex. However, it remains unclear whether white matter damage (WMD) is actually associated with agrammatic comprehension. The aim of the present study was to examine the relationships between WMD and agrammatic comprehension with lesion-symptoms mapping. We examined 21 patients with a glioma in the left frontal cortex using a picture-sentence matching task, which included three main conditions with different sentence types: canonical/subject-initial active sentences (AS), noncanonical/subject-initial passive sentences (PS), and noncanonical/object-initial scrambled sentences (SS). The patients preoperatively underwent a structural magnetic resonance imaging for identifying WMD, and voxel-based lesion symptom mapping (Bates et al., 2003) was employed for the error rates (ERs) data. To examine which WMD were associated with agrammatic comprehension, we evaluated the difference in ERs between the conditions of noncanonical vs. canonical sentences, i.e., PS - AS or SS - AS. We found that significant differences in PS - AS were associated with WMD in both the L. MdLF/EmC and L. AF/SLF, whereas those in SS - AS was associated with WMD in the L. AF/SLF (FDR corrected p < 0.05). These results demonstrate that WMD in L. MdLF/EmC and/or L. AF/SLF is crucial for agrammatic comprehension with differential effects. The present WMD data would be useful for identifying differential syntax-related networks in future DTI studies.

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