Neuropsychology Review

, Volume 24, Issue 2, pp 185–199 | Cite as

Language Mapping with Verbs and Sentences in Awake Surgery: A Review

  • Adrià Rofes
  • Gabriele Miceli


Intraoperative language mapping in awake surgery is typically conducted by asking the patient to produce automatic speech and to name objects. These tasks might not map language with sufficient accuracy, as some linguistic processes can only be triggered by tasks that use verbs and sentences. Verb and sentence processing tasks are currently used during surgery, albeit sparsely. Medline, PubMed, and Web of Science records were searched to retrieve studies focused on language mapping with verbs/sentences in awake surgery. We review the tasks reported in the published literature, spell out the language processes assessed by each task, list the cortical and subcortical regions whose stimulation inhibited language processing, and consider the types of errors elicited by stimulation in each region. We argue that using verb tasks allows a more thorough evaluation of language functions. We also argue that verb tasks are preferable to object naming tasks in the case of frontal lesions, as lesion and neuroimaging data demonstrate that these regions play a critical role in verb and sentence processing. We discuss the clinical value of these tasks and the current limitations of the procedure, and provide some guidelines for their development. Future research should aim toward a differentiated approach to language mapping – one that includes the administration of standardized and customizable tests and the use of longitudinal neurocognitive follow-up studies. Further work will allow researchers and clinicians to understand brain and language correlates and to improve the current surgical practice.


Awake surgery Language mapping Sentence processing tasks Verb processing tasks Review 



Arcuate fasciculus


Angular gyrus


Blood oxygenation level dependent


Event-related potential


Fronto-parietal articulatory loop


Human immunodeficiency virus-1


Inferior frontal gyrus


Inferior fronto-occipital fasciculus


Inferior longitudinal fasciculus


Inferior temporal gyrus




Middle frontal gyrus


Middle temporal gyrus


Middle longitudinal fasciculus


Periventricular white matter


Postcentral gyrus


Precentral gyrus


Superior frontal gyrus


Superior longitudinal fasciculus


Supramarginal gyrus


Superior temporal gyrus


Subcallosal fasciculus


Uncinate fasciculus


Author Note

Funding was provided by the PAT (Provincia Autonoma di Trento) and Fondazione CaRiTRo (Cassa di Risparmio di Trento e Rovereto) to GM; and by the Erasmus Mundus PhD Program IDEALAB (International Doctorate for Experimental Approaches to Language And Brain: Macquarie University, Newcastle University, University of Groningen, University of Trento and University of Potsdam) to AR. The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Center for Neurocognitive Rehabilitation (CeRiN) and Center for Mind/Brain Sciences (CIMeC)University of TrentoRoveretoItaly
  2. 2.International Doctorate for Experimental Approaches to Language and Brain (IDEALAB)University of TrentoTrentoItaly

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