The articulatory loop: study of the subcortical connectivity by electrostimulation

Although a cortical network involving Broca's area and the supramarginal gyrus (SMG) was widely studied using neurofunctional imaging, the functional connectivity underlying this so-called articulatory loop remains poorly documented. We describe a patient operated on for a glioma invading the left parietal operculum, using intraoperative electrical functional mapping under local anesthesia. Following the identification of cortical language sites within Broca's area and SMG, the subcortical pathways connecting these regions were detected and preserved during the resection. Postoperatively, the patient presented a slight dysarthria, then recovered. This is the first report of direct tracking of the subcortical connectivity underlying the fronto-parietal articulatory loop, allowing to better understand the pathophysiology of this network and the consequences of its damage.