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Electrical Cortical Stimulation for Language Mapping in Epilepsy Surgery-A Systematic Review.

Honglin Zhu¹, Efthymia Korona², Sepehr Shirani^1,3

¹Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AB, UK.

|December 24, 2025

Summary

This summary is machine-generated.

Electrical cortical stimulation (ECS) language mapping in epilepsy surgery shows distinct task-region specializations. Standardizing these tasks can minimize post-surgical language deficits and improve patient outcomes.

Keywords:

cortical language areas electrical cortical stimulation epilepsy surgery language mapping language tasks

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Area of Science:

Neuroscience
Neurosurgery
Epileptology

Background:

Language mapping is crucial in epilepsy surgery to prevent postoperative deficits.
Electrical cortical stimulation (ECS) is a key tool, but variability in techniques and tasks affects outcomes.
The precise validity of different linguistic tasks for mapping specific cortical regions is not well-defined.

Purpose of the Study:

To systematically evaluate linguistic tasks used in ECS for epilepsy surgery language mapping.
To analyze task-specific responses across different cortical regions.
To assess evidence for optimal task selection in various brain areas.

Main Methods:

Systematic literature search (PubMed, Scopus) from 2013-2025, following PRISMA guidelines.
Screened 956 articles, including 45 meeting criteria for language testing with ECS in epilepsy surgery.
Extracted data on language tasks, stimulation modalities, cortical regions, and error types.

Main Results:

Identified heterogeneity in language testing techniques across centers.
Visual naming deficits linked to temporal lobe and fusiform/parahippocampal gyri.
Auditory naming impairments associated with temporal, angular, and fusiform gyri.
Spontaneous speech errors: phonemic (inferior frontal/supramarginal gyri), semantic (superior temporal/parietal regions).

Conclusions:

Task-specific language mapping reveals distinct cortical specializations.
Variability in protocols and lack of standardization hinder reproducibility.
Standardizing language tasks can improve outcomes and minimize language impairment.
Future research needs prospective multicenter studies to validate task-region associations.