• Salvatore Marino, Grazia Menna, Lal Bilgin, Pier Paolo Mattogno, Simona Gaudino, Davide Quaranta, Naike Caraglia, Alessandro Olivi, Mitchel S Berger, Francesco Doglietto, and Giuseppe Maria Della Pepa.
• Neurosurgery Unit, Department of Neurosciences, Catholic University School of Medicine, Rome, Italy.
• World Neurosurg. 2024 Oct 1; 190: 350361.e20350-361.e20.

BackgroundSubcortical brain mapping in awake glioma surgery might optimize the extent of resection while minimizing neurological morbidity, but it requires a correct interpretation of responses evoked during surgery. To define, with a systematic review: 1) a comprehensive 'map' of the principal white matter bundles involved in awake surgery on language-related networks, describing the most employed tests and the expected responses; 2) In linguistics, a false friend is a word in a different language that looks or sounds like a word in given language but differs significantly in meaning. Similarly, our aim is to give the surgeons a comprehensive review of potentially misleading responses, namely "false friends", in subcortical language mapping.MethodsPreferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Standardized data extraction was conducted.ResultsOut of a total of 224 initial papers, 67 were included for analysis. Expected responses, common tests, and potential "false friends" were recorded for each of the following white matter bundles: frontal aslant tract, superior and inferior longitudinal fascicles, arcuate fascicle, inferior fronto-occipital fascicle, uncinate fascicle. Practical examples are discussed to underline the risk of intraoperative fallouts ("false friends") that might lead to an early interruption (false positive) or a risky surgical removal (false negative).ConclusionsThis paper represents a critical review of the present status of subcortical awake mapping and underlines practical "false-friend" in mapping critical crossroads in language-related networks.Copyright © 2024 Elsevier Inc. All rights reserved.

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