Speech-Language Pathology-Related Disorders in Adults with Brain Tumours: A Narrative Review

Brain tumours frequently involve eloquent cortical and subcortical networks, leading to speech-language pathology (SLP) disorders, including aphasia, dysarthria, and dysphagia. Evidence remains fragmented and largely derived from stroke-based frameworks that may not fully reflect neuro-oncological populations. This review synthesised literature on SLP disorders in adults with primary brain tumours across the pre-operative, peri-operative, and post-operative phases. Studies were identified through searches of PubMed/MEDLINE, Embase, CINAHL, Cochrane Library, and Web of Science (2000-2026) and narratively synthesised by domain and clinical contexts. Aphasia is the most studied domain and is typically mild and anomic, particularly in low-grade gliomas. Dysarthria commonly arises from damage to the ventral premotor cortex, periventricular white matter, and corticobulbar fibres, with articulatory severity correlating with subcortical tract involvement. Although less frequently investigated, dysphagia emerges as a clinically relevant complication, especially in posterior fossa and brainstem tumours, where upper oesophageal sphincter dysfunction and aspiration risk may occur. Intra-operative mapping improves functional outcomes, but tumour-specific assessment tools are lacking across all domains. SLP disorders in patients with brain tumours differ substantially from those observed after stroke and have significant consequences for communication, swallowing, and quality of life. There is a critical need for standardised, neuro-oncology-specific assessment and rehabilitation frameworks.