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Language centers revealed, brain surgery refined with new mapping
Date:1/2/2008

lso allows for smaller craniotomies that expose only the tumor and a small margin of surrounding brain tissue, rather than several centimeters or more of the patients brain. After the craniotomy, the neurosurgeon maps the brain by stimulating a section (1 cm by 1 cm) at a time with a bipolar electrode. The strategy does not require positive identification of language sites (defined as an arrest in speech, inability to name objects or read, or difficulty in articulating words), as in traditional brain mapping, but rather is driven by localization of negative sites -- areas that contain no language function.

Nearly half our patients had no positive language sites in the area exposed, yet their functional outcomes remained nearly identical or better than patients who underwent extensive positive language mapping, said Sanai. In addition, our results show that negative language mapping can be relied upon even when language function is already affected by tumor growth.

Language mapping, originally created to help guide epilepsy surgery, has proved to be an essential tool in helping neurosurgeons identify which parts of the tumor can be safely removed and in protecting patients from damage to speech and language centers, according to Berger. This is the largest study of its kind to show that this technique can be further refined for brain tumor resection without harming the patient.

The language map generated during the study shows that areas processing language function in the brain are widely distributed, sometimes varying in location by as much as several centimeters from patient to patient. This has implications for language organization models, which are currently based on the assumption that specific language functions have fixed anatomical locations.

Over eight years, Berger and his team tested negative language mapping on a total of 250 consecutive patients (146 men and 104 women), all of whom had gliomas -- a common a
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Contact: Vanessa deGier
vdegier@pubaff.ucsf.edu
415-476-2557
University of California - San Francisco
Source:Eurekalert

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