title: Language system organization in a quadrilingual with a brain tumor: Implications for understanding of the language network.
abstract: In pre-neurosurgery language mapping it is critical to identify language-specific regions in multilingual speakers. We conducted pre-operative functional magnetic resonance imaging, and intraoperative language mapping in the unique case of a highly proficient quadrilingual with a left frontal brain tumor who acquired her second language at age 5, and her third and fourth languages at 15. We found a predominantly different organization in each language with only a few areas shared by all 4 languages. Contrary to existing evidence, impairment across languages was not related to age of acquisition, amount of exposure, or language similarity. This case suggests that the functional structure of the language system may be highly idiosyncratic in multilingual individuals and supports detailed study in this group to inform neurocognitive models of language.
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA 90024, USA; Faculty of English, Adam Mickiewicz University, Poznań, Poland. Electronic address: plmonik@wa.amu.edu.pl.
authors.forename: Monika M
authors.initials: MM
authors.lastname: Połczyńska
authors.affiliation: Division of Neuropsychology, Depts. of Neurology & Neurosurgery, Yale University, 800 Howard Ave, New Haven, CT 06511, USA. Electronic address: christopher.benjamin@yale.edu.
authors.forename: Christopher F A
authors.initials: CF
authors.lastname: Benjamin
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA 90024, USA. Electronic address: kjapardi@gmail.com.
authors.forename: Kevin
authors.initials: K
authors.lastname: Japardi
authors.affiliation: Department of Neurology, Department of Neurosurgery David Geffen School of Medicine, University of California, Los Angeles, Ahmanson-Lovelace Brain Mapping Center Room 163, 660 Charles E. Young Drive South, Los Angeles, CA 90095-7085, USA. Electronic address: AFrew@mednet.ucla.edu.
authors.forename: Andrew
authors.initials: A
authors.lastname: Frew
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA 90024, USA. Electronic address: sbook@ucla.edu.
authors.forename: Susan Y
authors.initials: SY
authors.lastname: Bookheimer
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D001931:Brain Mapping; D001932:Brain Neoplasms / Q000150:complications*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007806:Language Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009483:Neuropsychological Tests; D010100:Oxygen / Q000097:blood
chemical_list: D010100:Oxygen
keywords: FMRI, awake surgery, quadrilingual; Language mapping; Multilingual; Tumor