title: Intraoperative electrical stimulation of language switching in two bilingual patients.
abstract: BACKGROUND
  Language switching (LS) is an important phenomena usually observed in some bilingual communities. The ability to switch languages is a very fast, efficient and flexible process, being a fundamental aspect of bilingual efficient language communication. The aim of the present study was to characterize the specific role of non-language specific prefrontal regions in the neural network involved in LS in bilingual patients, during awake brain surgery and using electrical stimulation mapping (ESM).
  
  
  METHODS
  In order to identify the neural regions involved in LS we used, a new specific ESM protocol in two patients undergoing awake brain surgery. Besides, functional magnetic resonance imaging (fMRI), neuropsychological testing and the assessment of daily conversational LS patterns post-surgery were used as complementary imaging and behavioral assessments.
  
  
  RESULTS
  The outcome of the multimodal ESM-fMRI neuroimaging comparison in both patients pointed out to the crucial involvement of the inferior and middle frontal cortices in LS.
  
  
  CONCLUSIONS
  The present results add to previous findings highlighting the important role of non-language specific frontal structures in regulating LS. The new protocol developed here might allow neurosurgeons to plan ahead for surgical intervention in multilingual patients to ensure the preservation of regions involved in LS and therefore the prevention of pathological language mixing after intervention.
authors.affiliation: Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona 08907, Spain; Department of Basic Psychology, Campus Bellvitge, University of Barcelona, L'Hospitalet de Llobregat, Barcelona 08907, Spain.
authors.forename: Joanna
authors.initials: J
authors.lastname: Sierpowska
authors.forename: Andreu
authors.initials: A
authors.lastname: Gabarrós
authors.forename: Pablo
authors.initials: P
authors.lastname: Ripollés
authors.forename: Montserrat
authors.initials: M
authors.lastname: Juncadella
authors.forename: Sara
authors.initials: S
authors.lastname: Castañer
authors.forename: Ángels
authors.initials: Á
authors.lastname: Camins
authors.forename: Gerard
authors.initials: G
authors.lastname: Plans
authors.forename: Antoni
authors.initials: A
authors.lastname: Rodríguez-Fornells
mesh_terms: D000328:Adult; D001931:Brain Mapping; D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery; D004558:Electric Stimulation; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007432:Intraoperative Period; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019303:Multilingualism; D010100:Oxygen / Q000097:blood
chemical_list: D010100:Oxygen
keywords: Electrical stimulation mapping; Language switching