• Marco Riva, Stephen M Wilson, Ruofan Cai, Antonella Castellano, Kesshi M Jordan, Roland G Henry, Maria Luisa Gorno Tempini, Mitchel S Berger, and Edward F Chang.
• 1Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan.
• J. Neurosurg. 2023 May 1; 138 (5): 140314101403-1410.

ObjectiveElectrocortical stimulation mapping (ECS) is widely used to identify essential language areas, but sentence-level processing has rarely been investigated.MethodsWhile undergoing awake surgery in the dominant left hemisphere, 6 subjects were asked to comprehend sentences varying in their demands on syntactic processing.ResultsIn all 6 subjects, stimulation of the inferior frontal gyrus disrupted comprehension of passive sentences, which critically depend on syntactic processing to correctly assign grammatical roles, without disrupting comprehension of simpler tasks. In 4 of the 6 subjects, these sites were localized to the pars opercularis. Sentence comprehension was also disrupted by stimulation of other perisylvian sites, but in a more variable manner.ConclusionsThese findings suggest that there may be language regions that differentially contribute to sentence processing and which therefore are best identified using sentence-level tasks. The functional consequences of resecting these sites remain to be investigated.

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