Elementalism: A Cognitive Neuroscience Framework for Neurosurgical Language Testing

Abstract

Testing linguistic function during awake craniotomy is the gold standard for preserving quality of life for neuro-oncology patients. Designing tests requires communication between linguistics, neuroscience, and oncology. While many task batteries exist, not all are sensitive enough to capture all linguistic abilities. Additionally, cognitive categories derived from observing behaviour (e.g., ‘semantics’) can be challenging to link to underlying deficits. To address these issues, this paper has two related goals. First, to set out relevant cognitive neuroscience principles; second, to apply these principles to neurosurgical language testing practice. Recent efforts to reconceptualising objects of cognitive neuroscientific study motivate an alternate approach to defining its constructs: Elementalism. Suggesting that delineating between neurocognitive functions via neurostimulation evidence may be most productive, it yields a mathematical model of elements and processes. The discovery of elements may stimulate a novel empirical agenda, particularly for neurosurgical language testing given the need to establish brain-behaviour relationships. Elementalism may also empower clinicians to test by individual patients’ needs by communicative function and cognitive generality. The approach suffers limitations, but may bear fruits for neurosurgical task design and other approaches to cognitive neuroscience where objects of study seem multiply neurobiologically constituted, such as in consciousness, neurodivergence, and animal cognition.

Keywords: neurobiology of language, neurosurgical language testing, awake craniotomy, linguistics, cognitive neuroscience