Reply: probabilistic map of language regions: challenge and implication.

Sir, We thank Dr Wu and colleagues for their interest in our recent probabilistic map of critical functional regions of the human cerebral cortex (Tate et al. , 2014). In particular, we are pleased to note that in their experience with 69 Chinese-speaking patients the authors confirmed a 79% probability of anarthria/speech arrest with stimulation of the left ventral premotor cortex (PMC), similar to our results (83%). These data support the crucial role of the ventral PMC for speech output, as suggested in previous reports (Duffau et al. , 2003; van Geemen et al. , 2014). Nonetheless, they also found a probability of ‘speech arrest’ in 32% of patients within the left pars opercularis (i.e. Broca’s area), which they stated is similar to the 26.7% rate observed by Sanai et al. (2008). However, if one looks at the primary data from the report by Sanai et al. (2008), which uses a relatively arbitrary 1 × 1 cm grid system, which does not specifically respect anatomic (sulci, gyri) or cytoarchitectural (Brodmann area) cortical features, there are three grids that include a portion of pars opercularis: for the two grids that are completely contained within pars opercularis, one has 0% speech arrest and another has 4.9%—these data are similar to our reported …

[1]  H. Duffau Lessons from brain mapping in surgery for low-grade glioma: insights into associations between tumour and brain plasticity , 2005, The Lancet Neurology.

[2]  Hugues Duffau,et al.  Interfering with the neural activity of mirror-related frontal areas impairs mentalistic inferences , 2014, Brain Structure and Function.

[3]  Han Zhang,et al.  Probabilistic map of language regions: challenge and implication. , 2015, Brain : a journal of neurology.

[4]  Emmanuel Mandonnet,et al.  A re-examination of neural basis of language processing: Proposal of a dynamic hodotopical model from data provided by brain stimulation mapping during picture naming , 2014, Brain and Language.

[5]  Mitchel S. Berger,et al.  Analysis of the subcomponents and cortical terminations of the perisylvian superior longitudinal fasciculus: a fiber dissection and DTI tractography study , 2012, Brain Structure and Function.

[6]  Hugues Duffau,et al.  Mapping the connectivity underlying multimodal (verbal and non-verbal) semantic processing: A brain electrostimulation study , 2013, Neuropsychologia.

[7]  Hugues Duffau,et al.  Does the left superior longitudinal fascicle subserve language semantics? A brain electrostimulation study , 2011, Brain Structure and Function.

[8]  Hugues Duffau,et al.  Inferring a dual-stream model of mentalizing from associative white matter fibres disconnection. , 2014, Brain : a journal of neurology.

[9]  Peggy Gatignol,et al.  The role of dominant premotor cortex in language: a study using intraoperative functional mapping in awake patients , 2003, NeuroImage.

[10]  Matthew C Tate,et al.  Probabilistic map of critical functional regions of the human cerebral cortex: Broca's area revisited. , 2014, Brain : a journal of neurology.

[11]  H. Duffau The huge plastic potential of adult brain and the role of connectomics: New insights provided by serial mappings in glioma surgery , 2014, Cortex.

[12]  Mitchel S Berger,et al.  Functional outcome after language mapping for glioma resection. , 2008, The New England journal of medicine.

[13]  Alberto Bizzi,et al.  Aphasia induced by gliomas growing in the ventrolateral frontal region: Assessment with diffusion MR tractography, functional MR imaging and neuropsychology , 2012, Cortex.

[14]  Hugues Duffau,et al.  Limited plastic potential of the left ventral premotor cortex in speech articulation: Evidence From intraoperative awake mapping in glioma patients , 2014, Human brain mapping.

[15]  H. Duffau,et al.  The anatomo-functional connectivity of word repetition: insights provided by awake brain tumor surgery , 2013, Front. Hum. Neurosci..

[16]  Elsa D. Angelini,et al.  Evidence for potentials and limitations of brain plasticity using an atlas of functional resectability of WHO grade II gliomas: Towards a “minimal common brain” , 2011, NeuroImage.

[17]  Hugues Duffau,et al.  Do brain tumours allow valid conclusions on the localisation of human brain functions? , 2011, Cortex.

[18]  Manuel Lopes,et al.  Intraoperative mapping of the subcortical language pathways using direct stimulations. An anatomo-functional study. , 2002, Brain : a journal of neurology.

[19]  H. Duffau,et al.  Role of fronto-striatal tract and frontal aslant tract in movement and speech: an axonal mapping study , 2014, Brain Structure and Function.

[20]  Nathalie Tzourio-Mazoyer,et al.  New insights into the anatomo-functional connectivity of the semantic system: a study using cortico-subcortical electrostimulations. , 2005, Brain : a journal of neurology.

[21]  Bernard Mazoyer,et al.  Meta-analyzing left hemisphere language areas: Phonology, semantics, and sentence processing , 2006, NeuroImage.