Precision in long-term language evaluation after awake brain tumor surgery

Area of Science:

• Neurosurgery
• Neurology
• Linguistics

Background:

• Gliomas can cause persistent language deficits affecting patient quality of life.
• Awake surgery for gliomas necessitates understanding long-term language outcomes.
• Assessing subtle, long-term language impairments is crucial for comprehensive patient care.

Purpose of the Study:

• To investigate language impairments and long-term outcomes following awake surgery for gliomas.
• To evaluate the efficacy of the Diagnostic Instrument for Mild Aphasia (DIMA) in detecting long-term language deficits.
• To compare language outcomes based on tumor invasiveness and hemispheric location.

Main Methods:

• Administered DIMA and traditional language tests preoperatively and at 3 and 12 months postoperatively.
• Compared language function in patients with less invasive (Group 1) versus more invasive (Group 2) gliomas.
• Included 79 patients preoperatively, with follow-up data from 68 and 35 patients at later time points.

Main Results:

• Preoperative deficits in lexico-syntax and phonology were identified by DIMA, varying by tumor invasiveness.
• Traditional tests revealed preoperative word retrieval and verbal fluency deficits in all patients.
• DIMA detected long-term mild impairments at phonological, semantic, and lexico-syntactic levels, depending on tumor location.

Conclusions:

• Mild, long-term language impairments are common after glioma surgery, detectable by DIMA.
• DIMA is a valuable tool for diagnosing language impairments in glioma patients, complementing traditional tests.
• Language deficits can persist across various linguistic levels and hemispheric locations, underscoring the need for specialized assessment.