Persian Paradigm for Language Cortical Mapping: Development, Feasibility, and Evaluation

BACKGROUND: Intraoperative language tasks often inadequately assess complex grammatical processes. This study aims to improve Persian cortical mapping by integrating object naming and sentence completion tasks. Multi-task language (MTL), consisted of an object naming task and a semantically relevant verb, was designed. METHODS: The content validity ratio (CVR) and index (CVI) were calculated to determine task items retention. Twenty-five right-handed patients with brain mass lesions in language-associated regions were enrolled. Each patient received a medical recommendation for awake surgery, and preoperative fMRI data were collected through verb and syntax generation tasks. Activations in language-related regions for object naming, word generation, and MTL were compared. Lateralization of brain activity was evaluated for each participant by calculating the Laterality Index (LI). RESULTS: The CVR for all items ranged from 0.9 to 1 (0.93 ± 0.09), while the CVI ranged from 0.8 to 1 (0.94 ± 0.07). Significant activations were identified during object naming, particularly in the left precentral gyrus and inferior frontal gyrus (z = 7.53). For word generation, activations were bilateral in the fusiform gyrus and Broca (z = 5.54). The MTL task showed its highest activation in the fusiform and inferior temporal gyrus (z = 6.86). A significant difference was found between the LI of object naming and word generation (p = 0.003), while MTL comparisons were not statistically significant. CONCLUSION: The developed Persian intraoperative language paradigm, named MTL, demonstrated validity and feasibility, with significant activation in key language areas, particularly the left inferior frontal gyrus.