Language mapping: A systematic review of protocols that evaluate linguistic functions in awake surgery

Nowadays, numerous neuropsychological tests are available for multidisciplinary teams to perform awake brain surgery but none-or very few-of them constitutes a mandatory prerequisite. No consensus has been reached about the choice of intraoperative tests, which can be relatively simple for certain primary functions, but can be much more difficult for high-level cognitive functions. This review aims to give an overview about the assessment of language during awake brain surgery in adults and focus on the analysis of the different language protocols that have been published, to compile the most used standardized tests that evaluate different linguistic cognitive processes. We performed a systematic review about awake brain surgery studies that mentioned a specific test or protocol for assessing language in adults from the last 15 years. The search yielded 3,504 articles. 120 studies reported a linguistic protocol or test. This review allowed to obtain a defined neuropsychological picture of the essential tasks that a linguistic protocol in awake surgery should compile. This review will help clinicians in selecting tasks for monitoring cognition during awake brain surgery as well as contributes to enlighten the efficacy of linguistics protocols in order to minimize language deficits in awake surgery.