What's in a Word? (… and Why it Matters)

Abstract

Brain Stimulation Reveals Critical Auditory Naming Cortex Hamberger MJ, Seidel WT, McKhann GM 2nd, Perrine K, Goodman RR Brain 2005;128(Pt 11):2742–2749. One challenge in dominant temporal lobe epilepsy surgery is to remove sufficient epileptogenic tissue without compromising postoperative language functioning. Preresection electrical stimulation mapping enables identification of language areas that can be spared from resection, and also provides a unique opportunity to investigate brain–language relationships. Visual object naming is the gold standard for identifying “essential” language cortex; however, sparing visual naming (VN) sites has not reliably prevented postoperative language decline. In addition to visual object naming, we included a more “ecologically valid” auditory description naming task in our preresection cortical mapping protocol. Of the seven patients who had auditory naming (AN) sites removed, six declined postoperatively, whereas of the 12 patients who did not have AN sites removed, only 3 declined postoperatively ( p = 0.02), suggesting an association between AN site removal and postoperative naming decline. Interestingly, although VN sites were preserved in all patients, AN site removal resulted in decline in both auditory and VN tasks. These findings not only have potentially critical clinical significance, but also argue for modality specificity, with considerable integration within the semantic system.