后语言区（PLA）或韦尼克区的损伤会导致对侧半球相应区域的皮质重组。然而，同侧半球内部重组的细节尚不完全清楚。在这种情况下，清醒手术期间的直接电刺激可以为研究人脑体内神经调节提供宝贵的机会，而这通过非侵入性方法很难实现。因此，在本研究中，我们旨在研究同侧半球内 PLA 的皮质重组特征。 62 名左半球神经胶质瘤患者根据病变是否延伸至 PLA 进行分组。所有患者都接受了直接皮质刺激以及图片命名任务。我们进一步使用静息态功能磁共振成像（MRI）对一部分患者进行功能连接分析，并计算介数中心性，即大脑区域网络重要性的指数。在直接皮质刺激期间，非PLA组中表现出积极（受损）反应的区域主要位于颞上回后部（pSTG），而PLA组中的表现出积极（受损）反应的区域广泛分布在从pSTG到后缘上回的区域。 pSMG）。值得注意的是，PLA 组 (47%) 的 pSMG 阳性反应百分比显着高于非 PLA 组 (8%)。在功能连接的网络分析中，pSMG 被确定为两个组中具有高介数中心性的枢纽区域。这些发现表明，在病变进展到 pSTG 的患者中，语言区可以从 PLA 扩散到 pSMG（一个中心区域）。语言区域模式的变化可能是维持高效大脑网络的一种补偿机制。© 2024 作者。人脑图谱由 Wiley periodicals LLC 出版。

Damage to the posterior language area (PLA), or Wernicke's area causes cortical reorganization in the corresponding regions of the contralateral hemisphere. However, the details of reorganization within the ipsilateral hemisphere are not fully understood. In this context, direct electrical stimulation during awake surgery can provide valuable opportunities to investigate neuromodulation of the human brain in vivo, which is difficult through the non-invasive approaches. Thus, in this study, we aimed to investigate the characteristics of the cortical reorganization of the PLA within the ipsilateral hemisphere. Sixty-two patients with left hemispheric gliomas were divided into groups depending on whether the lesion extended to the PLA. All patients underwent direct cortical stimulation with a picture-naming task. We further performed functional connectivity analyses using resting-state functional magnetic resonance imaging (MRI) in a subset of patients and calculated betweenness centrality, an index of the network importance of brain areas. During direct cortical stimulation, the regions showing positive (impaired) responses in the non-PLA group were localized mainly in the posterior superior temporal gyrus (pSTG), whereas those in the PLA group were widely distributed from the pSTG to the posterior supramarginal gyrus (pSMG). Notably, the percentage of positive responses in the pSMG was significantly higher in the PLA group (47%) than in the non-PLA group (8%). In network analyses of functional connectivity, the pSMG was identified as a hub region with high betweenness centrality in both the groups. These findings suggest that the language area can spread beyond the PLA to the pSMG, a hub region, in patients with lesion progression to the pSTG. The change in the pattern of the language area may be a compensatory mechanism to maintain efficient brain networks.© 2024 The Author(s). Human Brain Mapping published by Wiley Periodicals LLC.