Cortical language localization in the bilingual brain with a brain tumor: evidence from electrical stimulation mapping
Moving beyond the pure localizationist dogma, language processing is now conceived within the hodotopical model that encompasses the frontal, temporal, and parietal regions, extending subcortically toward the basal ganglia and supporting language production, grammar, and semantics. Nevertheless, this perisylvian language network, including frontal, temporal and parietal regions, exhibits variability across individuals, leading to unique and specific language maps. These differences among individuals may arise from various factors, such as their unique language experience (e.g. the number of languages acquired) or the presence of specific brain lesions (e.g. brain tumors), both of which trigger plasticity mechanisms, and hence modify the theoretical neuroanatomy of language. Despite the evolution in language localization knowledge, thanks to the incremental growth of techniques such as direct cortical stimulation (DCS) or fMRI, it is still a matter of discussion how language function, and especially its adaptation and reorganization in the context of brain injury, may be determined. As of today, no study has addressed the confluence of bilingualism and brain tumors in determining cortical language organization in the left-dominant hemisphere. Therefore, in the present study we described cortical language organization in bilinguals harboring brain tumors in the left hemisphere who underwent electrical stimulation mapping. With this, we aim to contribute to the definition of the bilingual language network in brain tumor patients and, hence, delineate the simultaneous effect of bilingualism and lesion-induced plasticity on cortical language organization.
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