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Regular version of the site

HSE Scientists Explain How to Identify Brain Areas Critical for Language Function During Surgery

HSE Scientists Explain How to Identify Brain Areas Critical for Language Function During Surgery

Photo courtesy of Olga Dragoy

The HSE Centre for Language and Brain conducted a course on tractography, a method that enables visualisation of key brain connections and helps surgeons avoid damaging language-critical areas during surgery. The course was attended by neurosurgeons and radiologists from Moscow and other Russian regions who are interested in methods of preoperative language mapping.

Tractography is a technique for constructing 3D models of the brain’s pathways using diffusion-weighted MRI data. In the brain’s white matter, water primarily diffuses along nerve fibres, and this directionality can be reconstructed using specialised algorithms. One such method is diffusion tensor imaging (DTI), which allows researchers to assess the degree of water molecule diffusion alignment and to map the brain’s white matter tracts.

During the training course, participants not only discussed various theoretical issues related to preoperative and intraoperative mapping of language function and tracts but also gained hands-on experience in manually reconstructing models using the TrackVis software tool, based on pre-processed structural MRI images.

A dedicated lecture focused on linguistic tests for intraoperative mapping, a technique used by clinicians to identify language areas during surgery.

'Localising language function is a critical step in planning surgical interventions for patients with lesions in the language-dominant hemisphere. Experts at the Centre for Language and Brain have accumulated significant experience in preoperative language mapping, which minimises the risk of complications and improves the effectiveness of surgical interventions. We are pleased to share our knowledge and practical recommendations with our surgical colleagues to advance modern neurosurgery and improve the quality of patient care,' said Anna Komissarenko, Junior Research Fellow at the HSE Centre for Language and Brain.

Photo courtesy of Tatiana Bolgina

The HSE Centre for Language and Brain has extensive expertise in providing linguistic support for neurosurgical patients. An important focus of the centre’s work is the development of specialised linguistic tests to identify functionally significant language areas during the planning and performance of neurosurgical operations. The centre’s specialists are investigating how the brain’s language function reorganises in cases of tumours and epilepsy, with special emphasis on the role of white matter pathways in supporting language function. The findings are used in both research and clinical practice—during preoperative mapping and intraoperative language monitoring. The practical course generated great interest among participants and served as a platform for interdisciplinary dialogue between neurolinguists and clinicians.

Anastasia Parshunina, neurosurgeon

'During surgery, it is essential to balance the radicality of the operation with the patient’s functional status. When removing a tumour near the language area in a patient with intact language function, it is crucial that the patient retains the ability to speak and understand speech after treatment. Therefore, the ability to reconstruct tracts is essential for preoperative treatment planning and for understanding the relationship between the tumour and functionally significant structures. The course deepened our understanding of anatomical principles and demonstrated the potential of 3D modelling for preoperative planning. We are thankful to the course organisers. During the two-day course, we gained valuable theoretical knowledge and practical skills in reconstructing pathways using the TrackVis software.

The Centre for Language and Brain thanks all course participants and invites everyone to stay updated on upcoming courses and educational programmes.

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