Reliable language mappings require sufficient language skills. This study evaluated whether linguistic task properties impact feasibility and reliability of navigated transcranial magnetic stimulation (nTMS)-based language mappings in aphasic glioma patients. The effect of linguistic complexity on naming accuracy during baseline testing without stimulation and on the number of errors during nTMS was evaluated for 16 moderately and 4 severely expressive aphasic patients. During baseline, items acquired later in life and used less frequently, a higher amount of multisyllabic, compound, and inanimate items were named inaccurately. Even after removing these more complex items, less frequent and multisyllabic items were more error-prone during stimulation. Higher linguistic item complexity was associated with decreased naming accuracy during baseline and resulted in a potentially higher false positive rate during nTMS in aphasic glioma patients. Thus, tailoring task complexity to individual performance capabilities may considerably support the preservation of residual functionality.
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