{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T03:53:46Z","timestamp":1791950026955,"version":"4.3.4"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","license":[{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Broca\u2019s aphasia is a syndrome of impaired fluency with retained comprehension. The authors used an unbiased algorithm to examine which neuroanatomical areas are most likely to result in Broca\u2019s aphasia following surgical lesions.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Patients were prospectively evaluated with standardized language batteries before and after surgery. Broca\u2019s area was defined anatomically as the pars opercularis and triangularis of the inferior frontal gyrus. Broca\u2019s aphasia was defined by the Western Aphasia Battery language assessment. Resections were outlined from MRI scans to construct 3D volumes of interest. These were aligned using a nonlinear transformation to Montreal Neurological Institute brain space. A voxel-based lesion-symptom mapping (VLSM) algorithm was used to test for areas statistically associated with Broca\u2019s aphasia when incorporated into a resection, as well as areas associated with deficits in fluency independent of Western Aphasia Battery classification. Postoperative MRI scans were reviewed in blinded fashion to estimate the percentage resection of Broca\u2019s area compared to areas identified using the VLSM algorithm.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>A total of 289 patients had early language evaluations, of whom 19 had postoperative Broca\u2019s aphasia. VLSM analysis revealed an area that was highly correlated (p &lt; 0.001) with Broca\u2019s aphasia, spanning ventral sensorimotor cortex and supramarginal gyri, as well as extending into subcortical white matter tracts. Reduced fluency scores were significantly associated with an overlapping region of interest. The fluency score was negatively correlated with fraction of resected precentral, postcentral, and supramarginal components of the VLSM area.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Broca\u2019s aphasia does not typically arise from neurosurgical resections in Broca\u2019s area. When Broca\u2019s aphasia does occur after surgery, it is typically in the early postoperative period, improves by 1 month, and is associated with resections of ventral sensorimotor cortex and supramarginal gyri.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2022.6.jns2297","type":"journal-article","created":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T13:07:25Z","timestamp":1659704845000},"page":"847-857","source":"Crossref","is-referenced-by-count":25,"title":["Dissociation of Broca\u2019s area from Broca\u2019s aphasia in patients undergoing neurosurgical resections"],"prefix":"10.3171","volume":"138","author":[{"given":"John P.","family":"Andrews","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, School of Medicine, San Francisco, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Cahn","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, School of Medicine, San Francisco, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin A.","family":"Speidel","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, School of Medicine, San Francisco, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason E.","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, School of Medicine, San Francisco, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah F.","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, School of Medicine, San Francisco, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen M.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchel S.","family":"Berger","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, School of Medicine, San Francisco, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward F.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, School of Medicine, San Francisco, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"Pt 5","key":"b1","series-title":"Brain","first-page":"1432","article-title":"Paul Broca\u2019s historic cases: high resolution MR imaging of the brains of Leborgne and Lelong","volume":"130","author":"Dronkers NF","year":"2007","unstructured":"Dronkers NF, Plaisant O, Iba-Zizen MT, Cabanis EA. 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