Multitask Language Mapping to Visualize the Spatial Configuration of Polyfunctional Language Cortex

Area of Science:

• Neuroscience
• Neurosurgery
• Cognitive Science

Background:

• Direct electrical stimulation (DES) is the gold standard for mapping eloquent language cortex.
• Single-task mapping may miss modality-specific or distributed language areas.
• Defining polyfunctional language cortex requires advanced mapping techniques.

Purpose of the Study:

• To define the spatial extent of polyfunctional language cortex using multitask DES.
• To integrate multitask DES with the Yale Brain Atlas (YBA) for precise anatomical localization.
• To supplement DES findings with population-based structural connectivity data.

Main Methods:

• Retrospective analysis of 15 patients with drug-resistant epilepsy undergoing extraoperative DES language mapping.
• Six language tasks administered: visual/auditory naming, reading, repetition, auditory/written comprehension.
• Responses mapped to YBA, aggregated, and analyzed for intertask correlations; structural connectivity assessed via tractography.

Main Results:

• Multitask DES identified a reproducible language core (superior temporal gyrus, pars triangularis, supramarginal gyrus, basal temporal area).
• A tiered task strategy (visual naming, auditory naming, reading) captured >99% of language sites.
• Structural connectivity analysis revealed significant involvement of arcuate fasciculus, parietal aslant tract, and superior longitudinal fasciculus.

Conclusions:

• Multitask DES with YBA provides a precise, reproducible platform for language mapping.
• A focused task set is efficient and sensitive for identifying language areas.
• Integrating DES with structural connectivity offers network-level insights for surgical planning and understanding language representation.