Broca’s area concept doesn’t exist in low grade gliomas – a case series

Introduction: Broca`s area is a region located in the left inferior frontal gyrus and is classically correlated to language. However, we observe preservation of speech function after tumor resection in this area. Awake surgery with direct brain stimulation is a reliable method to evaluate the functional role in this area. Objective: To evaluate the Broca´s area function. Methods: In a series of 69 patients with tumors in eloquent areas, 7 patients with tumors involving Broca´s area undergoing awake surgery with direct brain stimulation between 2007 and 2017 were retrospectively evaluated. Results: From 7 patients with Broca´s area stimulation, 5 did not show any alteration of speech. One patient, Portuguese native speaker, started to speak in English during the stimulation. The last patient diagnosed with glioblastoma already had a partial speech deficit, and showed a complete interruption of speech during the stimulation of Broca`s area. Conclusions: Broca`s area does not seem to be crucial for language function in patients with gliomas involving this area, particularly in lowgrade gliomas. The direct brain stimulation is a very useful tool to analyze the correlation between anatomy and brain function.