Department of Neurosurgery, Kanazawa University Hospital

Research

Brain Function Mapping Group

The Brain Function Mapping Group performs brain tumor awake surgery to preserve and improve brain function. We are working to understand the neural networks of the cerebrum, analyzing functional localization and neural networks based on neuroanatomy, neuroimaging, and intraoperative electrophysiology. In addition to basic brain functions such as language and motor function, we also study the higher brain functions such as social communication, visuospatial cognition, and working memory, which are essential for human beings to live well.

Representative studies reported by the group
Brain Networks in Language

Proving the existence of the frontal aslant tract, a new nerve fiber bundle that communicates with the Broca language center, and its relevance to language function, in collaboration with the Department of Neurosurgery at the University of Montpellier, France, we found that damage to this neural network results in impaired speech initiation and fluency.

Brain Network of Emotions

To provide the best possible medical care to patients with brain tumors, we would like to further develop the waking surgery, which has been established by our advanced technology and extensive experience, and try to elucidate brain function from the perspective of brain science. We are currently investigating various techniques such as functional mapping, functional MRI, magnetoencephalography, intraoperative cortical electroencephalography, intercortical evoked potentials, statistical analysis of neuroimaging, and micro-white matter dissection to further elucidate the involvement of brain functions and new neural networks. We will continue to collaborate with various fields such as engineering, psychology, and industry to make our discoveries contribute to society beyond the boundaries of medicine.

Preservation of the right frontal lobe and elucidation of its function

We have been working on preserving and elucidating the functions of the right frontal lobe of the brain, which is still largely unexplored. For example, when we interact with others, we can not only perceive the other person’s feelings instantly from their facial expressions (low order mentalizing), but also infer their emotions by considering various information such as their gestures, tone of voice, and social background (high order mentalizing), which enables us to notice smooth human relationships. Using awake mapping and statistical analysis of images, we have shown that lower- and higher-order mentalizing involves the neural circuits of the arched and superior longitudinal bundles and the frontal striatum, respectively, in the complex brain function of human emotions.

Structural networks in the cerebrum

Through white matter anatomy and image analysis, we discovered for the first time that there are about 150-200 small structures in the superficial layer of the cerebrum where nerve fibers gather on each side of the brain, which we named Crossing. This may be the key to explaining the basic structure of the brain network and the plasticity of the brain. (See the official Kanazawa University website at https://www.kanazawa-u.ac.jp/rd/79256）

Achievements
  • Liu X, Kinoshita M, Shinohara H, Hori O, Ozaki N, Hatta T, Honma S, Nakada M. Direct evidence of the relationship between brain metastatic adenocarcinoma and white matter fibers: A fiber dissection and diffusion tensor imaging tractography study. J Clin Neurosci 77:55-61, 2020
  • Shinohara H, Liu X, Nakajima R, Kinoshita M, Ozaki N, Hori O, Nakada M. Pyramid-Shape Crossings and Intercrossing Fibers Are Key Elements for Construction of the Neural Network in the Superficial White Matter of the Human Cerebrum. Cereb Cortex 2020, Online ahead of print.
  • Liu X, Kinoshita M, Shinohara H, Hori O, Ozaki N, Nakada M. Does the superior fronto-occipital fascicle exist in the human brain? Fiber dissection and brain functional mapping in 90 patients with gliomas. Neuroimage Clin 25:102192, 2020
  • Nakajima R, Kinoshita M, Okita H, Yahata T, Nakada M. Glioma surgery under awake condition can lead to good independence and functional outcome excluding deep sensation and visuospatial cognition. Neurooncol Pract 6(5):354-36, 2019
  • Nakajima R, Kinoshita M, Shinohara H, Nakada M. The superior longitudinal fascicle: reconsidering the fronto-parietal neural network based on anatomy and function. Brain Imaging Behav 2019 Aug 29. Online ahead of print.
  • Nakajima R, Kinoshita M, Okita H, Yahata T, Nakada M. Awake surgery for glioblastoma can preserve independence level, but is dependent on age and the preoperative condition. J Neurooncol 144(1):155-163, 2019
  • Nakajima R, Kinoshita M, Yahata T, Nakada M. Recovery time from supplementary motor area syndrome: relationship to postoperative day 7 paralysis and damage of the cingulum. J Neurosurg 8:1-10, 2019
  • Nakajima R, Kinoshita M, Okita H, Yahata T, Matsui M, Nakada M. Neural networks mediating high-level mentalizing in patients with right cerebral hemispheric gliomas. Front Behav Neurosci 6;12:33, 2018
  • Nakajima R, Yordanova YN, Duffau H, Herbet G.: Neuropsychological evidence for the crucial role of the right arcuate fasciculus in the face-based mentalizing network: a disconnection analysis. Neuropsychologia 115:179-187, 2018
  • Nakajima R, Kinoshita M, Miyashita K, Okita H, Genda R, Yahata T, Hayashi Y, Nakada M. Damage of the right dorsal superior longitudinal fascicle by awake surgery for glioma causes persistent visuospatial dysfunction. Sci Rep. 7(1):17158, 2017
  • Kinoshita M, Miyashita K, Tsutsui T, Furuta T, Nakada M. Critical neural networks in awake surgery for gliomas. Neurol Med Chir (Tokyo) 56(11):674-686, 2016
  • Kinoshita M, Nakajima R, Shinohara H, Miyashita K, Tanaka S, Okita H, Nakada M, Hayashi Y. Chronic spatial working memory deficit associated with the superior longitudinal fasciculus: a study using voxel-based lesion-symptom mapping and intraoperative direct stimulation in right prefrontal glioma surgery. J Neurosurg 125(4):1024-1032, 2016
  • Nakajima R, Nakada M, Miyashita K, Kinoshita M, Okita H, Yahata T, Hayashi Y. Intraoperative motor symptoms during brain tumor resection in the supplementary motor area (SMA) without positive mapping during awake surgery. Neurol Med Chir (Tokyo) 55:442-50, 2015
  • Kinoshita M, de Champfleur NM, Deverdun J, Moritz-Gasser S, Herbet G, Duffau H. Role of fronto-striatal tract and frontal aslant tract in movement and speech: An axonal mapping study. Brain Struct Funct, 220(6):3399-0412, 2015.
  • Hayashi Y, Nakada M, Kinoshita M, Hamada JI. Functional reorganization in the patient with progressing glioma of the pure primary motor cortex: A case report with special reference to the topographic central sulcus defined by somatosensory-evoked potential. World Neurosurg 82(3-4):536.e1-4, 2014
  • Hayashi Y, Okita H, Kinoshita M, Miyashita K, Nakada M. Functional recovery from pure dyslexia with preservation of subcortical association fiber networks. Interdisciplinary Neurosurgery 1:59-62, 2014
  • Nakajima R, Okita H, Kinoshita M, Miyashita K, Nakada M, Yahata T, Hamada JI, Hayashi Y. Direct evidence for the causal role of the left supplementary motor area in working memory: a preliminary study. Clin Neurol Neurosurg 126:201-4, 2014
  • Kinoshita M, Nakada M, Okita H, Hamada J, Hayashi Y. Predictive value of fractional anisotropy of the arcuate fasciculus for the functional recovery of language after brain tumor resection: a preliminary study. Clin Neurol Neurosurg 117:45-50, 2014
  • Hayashi Y, Nakada M, Kinoshita M, Hamada J. Surgical strategies for nonenhancing slow-growing gliomas with special reference to functional reorganization: review with own experience. Neurol Med Chir (Tokyo) 53:438-46, 2013
  • Hayashi Y, Kinoshita M, Furuta T, Watanabe T, Nakada M, Hamada J. Right superior longitudinal fasciculus: implications for visuospatial neglect mimicking Gerstmann’s syndrome. Clin Neurol Neurosurg 115:775-7, 2013
  • Hayashi Y, Kinoshita M, Nakada M, Hamada J. Correlation between language function and the left arcuate fasciculus detected by diffusion tensor imaging tractography after brain tumor surgery. J Neurosurg 117:839-43, 2012
  • Kinoshita M, Shinohara H, Hori H, Ozaki N, Ueda F, Nakada M, Hamada J, Hayashi Y. Association fibers connecting Broca’s area and lateral superior frontal gyrus: a microsurgical and tractographical anatomy. Clinical article. J Neurosurg 116:323-30, 2012
  • Kinoshita M, Tanaka S, Nakada M, Ozaki N, Hamada J, Hayashi Y. What bone part is important to remove in accessing to the suprachiasmatic region with less frontal lobe retraction in frontotemporal craniotomies. World Neurosurgery 77:342-8, 2012