Chronic aphasias after left-hemisphere resective surgery.

Area of Science:

• Neurosurgery
• Neurology
• Linguistics

Background:

• Surgical resection of brain tumors frequently leads to aphasia.
• Chronic phase outcomes (>6 months post-surgery) of post-surgical aphasia remain under-investigated.

Purpose of the Study:

• To investigate the relationship between chronic language impairments and surgical resection location, residual tumor characteristics, or both.
• To identify specific language deficits and their neuroanatomical correlates in the chronic phase.

Main Methods:

• Voxel-based lesion symptom mapping (VLSM) was employed in a cohort of 46 patients.
• Analysis focused on correlating lesion location with chronic language deficits, including action naming, spoken sentence comprehension, and reading impairments.
• Residual tumor characteristics like infiltration and edema were considered alongside resection effects.

Main Results:

• Approximately 72% of patients exhibited aphasia in the chronic phase.
• Action naming deficits correlated with left anterior temporal lobe lesions, while spoken sentence comprehension deficits were linked to the inferior parietal lobe.
• Voxel-wise analyses identified associations between ventral language pathways and action naming deficits, and between cerebellar pathway disconnection and reading impairments.

Conclusions:

• Chronic post-surgical aphasias result from a combination of resected tissue and tumor infiltration affecting language-related white matter tracts.
• Progressive disconnection of critical white matter pathways appears to be a key mechanism underlying persistent language impairments after brain tumor surgery.