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Brain Advance Access first published online on August 18, 2005
This version published online on August 25, 2005
Brain, doi:10.1093/brain/awh621
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© The Author (2005). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received May 26, 2005
Revised July 8, 2005
Accepted July 26, 2005

Article

Brain stimulation reveals critical auditory naming cortex

Marla J. Hamberger 1*, William T. Seidel 2, Guy M. Mckhann II3, Kenneth Perrine 4, and Robert R. Goodman 3

1 Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
2 Cephalon, Inc., West Chester, PA, USA
3 Department of Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York, NY, USA
4 Department of Neurological Surgery, Weill Medical College of Cornell University, New York, NY, USA

* To whom correspondence should be addressed.
Marla J. Hamberger, E-mail: mh61{at}columbia.edu


  Abstract

One challenge in dominant temporal lobe epilepsy surgery is to remove sufficient epileptogenic tissue without compromising post-operative language functioning. Pre-resection 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 post-operative language decline. In addition to visual object naming, we included a more ‘ecologically valid’ auditory description naming task in our pre-resection cortical mapping protocol. Of the seven patients who had auditory naming (AN) sites removed, six declined post-operatively, whereas of the 12 patients who did not have AN sites removed, only 3 declined post-operatively (P = 0.02), suggesting an association between AN site removal and post-operative 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.

Keywords: language mapping; naming; cortical stimulation.
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