White matter tracts and executive functions: a review of causal and correlation evidence.

Executive functions are high-level cognitive processes involving abilities such as working memory/updating, set-shifting and inhibition. These complex cognitive functions are enabled by interactions among widely distributed cognitive networks, supported by white matter tracts. Executive impairment is frequent in neurological conditions affecting white matter; however, whether specific tracts are crucial for normal executive functions is unclear. We review causal and correlation evidence from studies that used direct electrical stimulation during awake surgery for gliomas, voxel-based and tract-based lesion-symptom mapping, and diffusion tensor imaging to explore associations between the integrity of white matter tracts and executive functions in healthy and impaired adults. The corpus callosum was consistently associated with all executive processes, notably its anterior segments. Both causal and correlation evidence showed prominent support of the superior longitudinal fasciculus to executive functions, notably to working memory. More specifically, strong evidence suggested that the second branch of the superior longitudinal fasciculus is crucial for all executive functions, especially for flexibility. Global results showed left lateralization for verbal tasks and right lateralization for executive tasks with visual demands. The frontal aslant tract potentially supports executive functions, however, additional evidence is needed to clarify whether its involvement in executive tasks goes beyond the control of language. Converging evidence indicates that a right-lateralized network of tracts connecting cortical and subcortical grey matter regions supports the performance of tasks assessing response inhibition, some suggesting a role for the right anterior thalamic radiation. Finally, correlation evidence suggests a role for the cingulum bundle in executive functions, especially in tasks assessing inhibition. We discuss these findings in light of current knowledge about the functional role of these tracts, descriptions of the brain networks supporting executive functions and clinical implications for individuals with brain tumours.

Combining resting state functional MRI with intraoperative cortical stimulation to map the mentalizing network.

OBJECTIVE: To infer the face-based mentalizing network from resting-state functional MRI (rsfMRI) using a seed-based correlation analysis with regions of interest identified during intraoperative cortical electrostimulation. METHODS: We retrospectively included 23 patients in whom cortical electrostimulation induced transient face-based mentalizing impairment during 'awake' craniotomy for resection of a right-sided diffuse low-grade glioma. Positive stimulation sites were recorded and transferred to the patients' preoperative normalized MRI, and then used as seeds for subsequent seed-to-voxel functional connectivity analyses. The analyses, conducted with an uncorrected voxel-level p-value of 0.001 and a false-discovery-rate cluster-level p-value of 0.05, allowed identification of the cortical structures, functionally coupled with the mentalizing-related sites. RESULTS: Two clusters of responsive stimulations were identified intraoperatively - one in the right dorsolateral prefrontal cortex (dlPFC, n = 13) and the other in the right inferior frontal gyrus (IFG, n = 10). A whole group level analysis revealed that stimulation sites correlated mainly with voxels located in the pars triangularis of the IFG, the dorsolateral and dorsomedial prefrontal cortices, the temporo-parietal junction, the posterior superior temporal sulcus, and the posterior inferior temporal/fusiform gyrus. Other analyses, taking into consideration the location of the responsive sites (IFG versus dlPFC cluster), highlighted only minor differences between both groups. CONCLUSIONS: The present study successfully demonstrated the involvement of a large-scale neural network in the face-based mentalizing that strongly matches networks, classically identified using task-based fMRI paradigms. We thus validated the combination of rsfMRI and stimulation mapping as a powerful approach to identify functional networks in brain-damaged patients.

Neural pathways subserving face-based mentalizing.

Over the past few years, considerable progress has been done in clarifying the neural networks underlying mentalizing. However, although the cortical architecture of this function is relatively well understood, the white matter pathways that may be involved in conveying neural signals within the mentalizing network remain to be elucidated. To gain insight into this matter, a detailed stimulation mapping of face-based mentalizing was performed in 27 patients undergoing awake surgery for a right-sided diffuse low-grade glioma (DLGG). Direct electrical stimulation (DES) was applied to both the cortical and subcortical levels. In perfect agreement with previous literature using face-based mentalizing tasks, cortical sites were identified in the posterior inferior frontal gyrus (IFG), the dorsolateral prefrontal cortex (dlPFC), and the posterior superior temporal gyrus (pSTG). Most importantly, critical sites were found along the inferior fronto-occipital fasciculus (IFOF), and within the white matter fibres supplying the dlPFC. Disconnectome analyses confirmed the very high probability of IFOF disconnection during temporal subcortical stimulation, and revealed an additional implication of the superior longitudinal fasciculus/arcuate fasciculus (SLF/AF) during prefrontal subcortical stimulations. Altogether, these findings suggest that functional integrity of both the IFOF and the SLF is required for accurately inferring complex mental states from human faces.