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Language Mapping with Verbs and Sentences in Awake Surgery: A Review

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Abstract

Intraoperative language mapping in awake surgery is typically conducted by asking the patient to produce automatic speech and to name objects. These tasks might not map language with sufficient accuracy, as some linguistic processes can only be triggered by tasks that use verbs and sentences. Verb and sentence processing tasks are currently used during surgery, albeit sparsely. Medline, PubMed, and Web of Science records were searched to retrieve studies focused on language mapping with verbs/sentences in awake surgery. We review the tasks reported in the published literature, spell out the language processes assessed by each task, list the cortical and subcortical regions whose stimulation inhibited language processing, and consider the types of errors elicited by stimulation in each region. We argue that using verb tasks allows a more thorough evaluation of language functions. We also argue that verb tasks are preferable to object naming tasks in the case of frontal lesions, as lesion and neuroimaging data demonstrate that these regions play a critical role in verb and sentence processing. We discuss the clinical value of these tasks and the current limitations of the procedure, and provide some guidelines for their development. Future research should aim toward a differentiated approach to language mapping – one that includes the administration of standardized and customizable tests and the use of longitudinal neurocognitive follow-up studies. Further work will allow researchers and clinicians to understand brain and language correlates and to improve the current surgical practice.

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Abbreviations

AF:

Arcuate fasciculus

AnG:

Angular gyrus

BOLD:

Blood oxygenation level dependent

ERP:

Event-related potential

FPAL:

Fronto-parietal articulatory loop

HIV-1:

Human immunodeficiency virus-1

IFG:

Inferior frontal gyrus

IFOF:

Inferior fronto-occipital fasciculus

ILF:

Inferior longitudinal fasciculus

ITG:

Inferior temporal gyrus

MEG:

Magnetoencephalography

MFG:

Middle frontal gyrus

MTG:

Middle temporal gyrus

MdLF:

Middle longitudinal fasciculus

PV:

Periventricular white matter

PoG:

Postcentral gyrus

PrG:

Precentral gyrus

SFG:

Superior frontal gyrus

SLF:

Superior longitudinal fasciculus

SMG:

Supramarginal gyrus

STG:

Superior temporal gyrus

SuF:

Subcallosal fasciculus

UNC:

Uncinate fasciculus

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Author Note

Funding was provided by the PAT (Provincia Autonoma di Trento) and Fondazione CaRiTRo (Cassa di Risparmio di Trento e Rovereto) to GM; and by the Erasmus Mundus PhD Program IDEALAB (International Doctorate for Experimental Approaches to Language And Brain: Macquarie University, Newcastle University, University of Groningen, University of Trento and University of Potsdam) to AR. The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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Correspondence to Gabriele Miceli.

Appendix

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Table 2 Cortical areas in language dominant hemisphere where language processing was detected with each task and error types per area and per test*
Table 3 Subcortical areas in the language-dominant hemisphere where language processing was detected by action naming and error types produced by patients during stimulation of that area

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Rofes, A., Miceli, G. Language Mapping with Verbs and Sentences in Awake Surgery: A Review. Neuropsychol Rev 24, 185–199 (2014). https://doi.org/10.1007/s11065-014-9258-5

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