Persian Paradigm for Language Cortical Mapping: Development, Feasibility, and Evaluation

Intraoperative language tasks often inadequately assess complex grammatical processes. This study aims to improve Persian cortical mapping by integrating object naming and sentence completion tasks. Multi-task language (MTL), consisted of an object naming task and a semantically relevant verb, was designed.

The content validity ratio (CVR) and index (CVI) were calculated to determine task items retention. Twenty-five right-handed patients with brain mass lesions in language-associated regions were enrolled. Each patient received a medical recommendation for awake surgery, and preoperative fMRI data were collected through verb and syntax generation tasks. Activations in language-related regions for object naming, word generation, and MTL were compared. Lateralization of brain activity was evaluated for each participant by calculating the Laterality Index (LI).

The CVR for all items ranged from 0.9 to 1 (0.93 ± 0.09), while the CVI ranged from 0.8 to 1 (0.94 ± 0.07). Significant activations were identified during object naming, particularly in the left precentral gyrus and inferior frontal gyrus (z = 7.53). For word generation, activations were bilateral in the fusiform gyrus and Broca (z = 5.54). The MTL task showed its highest activation in the fusiform and inferior temporal gyrus (z = 6.86). A significant difference was found between the LI of object naming and word generation (p = 0.003), while MTL comparisons were not statistically significant.

The developed Persian intraoperative language paradigm, named MTL, demonstrated validity and feasibility, with significant activation in key language areas, particularly the left inferior frontal gyrus.