Language Mapping in the Operating Room: HSE Neurolinguists Assist Surgeons in Complex Brain Surgery
Researchers from the HSE Center for Language and Brain took part in brain surgery on a patient who had been seriously wounded in the SMO. A shell fragment approximately five centimetres long entered through the eye socket, penetrated the cranial cavity, and became lodged in the brain, piercing the temporal lobe responsible for language. Surgeons at the Burdenko Main Military Clinical Hospital removed the foreign object while the patient remained conscious. During the operation, neurolinguists conducted language tests to ensure that language function was preserved.
Researchers from the HSE Center for Language and Brain, Maria Protopova (Prokopyeva) and Irina Provlotskaya, worked in the operating room as part of a multidisciplinary team and administered standardised language tasks during direct cortical stimulation. During the operation, the patient was asked to name objects shown in pictures and to repeat pseudowords. These tasks help identify brain regions that are critically important for language and allow clinicians to detect in a timely manner any changes that may occur during the intervention.
Research Assistant, Center for Language and Brain
'If a patient begins to make errors while performing language tasks, this may indicate that the stimulation is affecting areas critical for language. Once these areas are identified, surgeons avoid them during subsequent stages of the operation.'
In this case, the procedure differed in that the patient remained conscious throughout the entire intervention, including the stage of opening the skull. More commonly, during such operations, the patient is kept under anaesthesia until cortical stimulation and language testing begin, after which they are placed back under anaesthesia.
Junior Research Fellow, Center for Language and Brain
'The language testing procedure was generally structured in the same way as in standard awake surgeries, such as the removal of an epileptic lesion or a mass, but in this case it was particularly important to monitor language continuously. We used object-naming tasks during cortical stimulation to identify language-related areas so that surgeons could bypass them during resection. Pseudoword repetition was used directly during the removal of the foreign body to ensure timely detection of any language impairments that might arise while manipulating tissue near the language pathways.'
The HSE Center for Language and Brain has been developing a clinical focus and actively collaborating with leading hospitals and medical centres in Moscow, Nizhny Novgorod, Novosibirsk, and other cities in Russia, as well as abroad. This collaboration helps introduce modern neurolinguistic methods into clinical practice, increasing the safety of neurosurgical interventions and improving the precision with which functionally significant brain areas are preserved.
Director, Center for Language and Brain
'Tests developed by the centre’s specialists for intraoperative language mapping—including object and action naming from pictures and other standardised language tasks—have been successfully used in awake surgeries for nearly 10 years. It is essential for us that these techniques function not only as research tools but also as clinical standards, effectively applied in neurosurgical practice.'
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