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Balancing task sensitivity with reliability for multimodal language assessments.

Alexander A Aabedi¹, Sofia Kakaizada¹, Jacob S Young¹

¹1Department of Neurological Surgery, University of California, San Francisco, California; and.

Journal of Neurosurgery

|May 28, 2021

Summary

This summary is machine-generated.

Text reading (TR) and auditory object naming (AN) tasks show stable accuracy during awake language mapping. Other tasks declined intraoperatively, highlighting the need for repeated testing to ensure reliable results during neurosurgery.

Keywords:

awake craniotomy language mapping language task reliability surgical technique

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Area of Science:

Neurosurgery
Neuroscience
Linguistics

Background:

Awake language mapping is crucial for brain tumor resection.
Perioperative sedatives can impair patient attention and arousal, affecting task performance.
Existing language tasks may lose accuracy in the operating room, complicating eloquent cortex identification.

Purpose of the Study:

To identify language tasks with high accuracy in both preoperative and intraoperative settings.
To ensure that speech errors during mapping indicate direct cortical stimulation, not general performance decline.

Main Methods:

Administered five language tasks: picture naming (PN), text reading (TR), auditory object naming (AN), 4-syllable word repetition (4SYL), and sentence production (SYNTAX) to 44 patients.
Assessed performance using the quick aphasia battery preoperatively and intraoperatively.
Analyzed accuracy changes and predictive relationships between tasks and settings.

Main Results:

Accuracy declined intraoperatively for PN, 4SYL, and SYNTAX, but remained stable for TR and AN.
Intraoperative accuracy in PN and AN predicted performance on other tasks.
Low preoperative accuracy in SYNTAX predicted intraoperative decline.

Conclusions:

Text reading (TR) accuracy is stable across testing settings, though it has limited baseline sensitivity.
Preoperative accuracy in most tasks did not predict intraoperative performance.
Repeating language tests before stimulation mapping is essential to confirm reliability during awake surgery.