All patients underwent detailed neurological and psychological evaluations before surgery. Two neurosurgeons completed a neurological function assessment and motor function was scored using a standard muscle strength score ranging from 0 to 5 (0, complete paralysis; 5, entirely normal strength). Neuropsychologists evaluated the general cognitive function of the patients using a brief psychiatric examination. All patients were assessed for handedness using a standardized questionnaire (Edinburgh Handedness Inventory) and were examined with the Mini-Mental State Examination (MMSE). Language function was assessed using an aphasia screening chart, a dysarthria chart, and naming of images. Aphasia screening included oral, written, and sign language comprehension and expression. The dysarthria chart was evaluated by orofacial movement, vowels, and consonant articulation, with a total score of 14 points. The picture naming task was to name 80 black and white pictures with a naming accuracy rate ≥95% being normal. The grade of neurological deficits are presented in Table 1. Within 3 days before surgery, MRI was performed using a 3.0-T scanner (GE HealthCare, Chicago, IL, USA) to obtain T1, T2, T2-fluid attenuated inversion recovery (FLAIR), gadolinium enhanced diffuse tensor imaging (DTI), magnetic resonance spectrum (MRS) and perfusion-weighted sequences. All patients were informed in detail about the risks of surgery and the intraoperative stimulation monitoring procedure was performed by a trained nurse responsible for intraoperative motor and language testing.
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