Speech and Language Errors during Awake Brain Surgery and Postoperative Language Outcome in Glioma Patients: A Systematic Review

Collée, Ellen; Vincent, Arnaud; Dirven, Clemens M.F.; Satoer, Djaina

doi:10.3390/cancers14215466

Cited by 6 publications

(5 citation statements)

References 112 publications

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“…As a next step, we investigated the relation between different intraoperative speech and language errors and the postoperative language outcome in a separate second article based on the current systematic search [ 44 ]. This relation could be the foundation of a prognostic severity scale for speech and language errors on postoperative language outcome, which could guide the intraoperative procedure and may potentially reduce postoperative language deficits.…”

Section: Discussionmentioning

confidence: 99%

“…During data collection, it became apparent that there would be too much data to describe in one article. Therefore, the original outline as displayed on PROSPERO was divided into two, resulting in the current article (focusing on intraoperative speech and language errors and brain location) and a second article (focusing on intraoperative speech and language errors and language outcome [ 44 ]).…”

Section: Methodsmentioning

confidence: 99%

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Localization patterns of speech and language errors during awake brain surgery: a systematic review

et al. 2023

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Awake craniotomy with direct electrical stimulation (DES) is the standard treatment for patients with eloquent area gliomas. DES detects speech and language errors, which indicate functional boundaries that must be maintained to preserve quality of life. During DES, traditional object naming or other linguistic tasks such as tasks from the Dutch Linguistic Intraoperative Protocol (DuLIP) can be used. It is not fully clear which speech and language errors occur in which brain locations. To provide an overview and to update DuLIP, a systematic review was conducted in which 102 studies were included, reporting on speech and language errors and the corresponding brain locations during awake craniotomy with DES in adult glioma patients up until 6 July 2020. The current findings provide a crude overview on language localization. Even though subcortical areas are in general less often investigated intraoperatively, still 40% out of all errors was reported at the subcortical level and almost 60% at the cortical level. Rudimentary localization patterns for different error types were observed and compared to the dual-stream model of language processing and the DuLIP model. While most patterns were similar compared to the models, additional locations were identified for articulation/motor speech, phonology, reading, and writing. Based on these patterns, we propose an updated DuLIP model. This model can be applied for a more adequate “location-to-function” language task selection to assess different linguistic functions during awake craniotomy, to possibly improve intraoperative language monitoring. This could result in a better postoperative language outcome in the future.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Localization patterns of speech and language errors during awake brain surgery: a systematic review

et al. 2023

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“…They also show that task‐specific preservation is possible. Identifying pre‐operative deficits is vital as they predict post‐operative language deficits up until 8 months after surgery (Bello et al., 2007; Collee et al., 2022; Ilmberger et al., 2008). Given that current neurofunctional models allow one to identify with imperfect but reasonable accuracy the language skills that may be damaged during surgery given the lesion site, in the interest of the patient it is preferable that all the at‐risk processes be evaluated, including reading and spelling, to improve functional outcome.…”

Section: Discussionmentioning

confidence: 99%

“…As regards spoken language, several studies identified a predictive value of the intra‐operative administration of object naming, word comprehension and/or the Pyramid and Palm Tree Test (PPTT) on acute post‐operative language functioning (Bello et al., 2007; Duffau et al., 2008). Moreover, a review of intra‐operative linguistic assessments in 81 studies showed that word‐finding difficulties and speech errors during surgery were significant predictors of post‐operative language deficits (Collee et al., 2022). However, since in most studies only spoken object naming was administered during surgery, the value of other tasks (including those that explore written language) in predicting post‐operative language outcome remains undetermined.…”

Section: Introductionmentioning

confidence: 99%

Written language preservation in glioma patients undergoing awake surgery: The value of tailored intra‐operative assessment

van Ierschot,

Veenstra,

Miozzo

et al. 2023

Journal of Neuropsychology

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Written language is increasingly important, as contemporary society strongly relies on text‐based communication. Nonetheless, in neurosurgical practice, language preservation has classically focused on spoken language. The current study aimed to evaluate the potential role of intra‐operative assessments in the preservation of written language skills in glioma patients undergoing awake surgery. It is the first feasibility study to use a standardized and detailed Written language battery in glioma patients undergoing awakening surgery. Reading and spelling were assessed pre‐ and post‐operatively in eleven patients. Intra‐operatively, 7 cases underwent written language assessment in addition to spoken object naming. Results show that reading and spelling deficits may arise before and after glioma surgery and that written language may be differently affected than spoken language. In our case series, task‐specific preservation of function was obtained in all cases when a specific written language skill was monitored intra‐operatively. However, the benefits of intra‐operative testing did not always generalize, and non‐monitored written language tasks may not be preserved. Hence, when a specific written language skill needs to be preserved, to facilitate return to work and maintain quality of life, results indicate that intra‐operative assessment of that skill is advised. An illustrative case report demonstrates how profile analyses can be used pre‐operatively to identify cognitive components at risk and intra‐operatively to preserve written language abilities in clinical practice.

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“…In addition to neuromonitoring and preoperative deficits, intraoperative performance on selected tasks and/or positive mapping sites may also be associated with postoperative deficits [ 85 , 140 ]. A recent systematic review reported that intra-operative anomia and production errors were significantly predictive of postoperative language deficits in the acute phase (1 to 10 days), and when combined with a preoperative deficit, the probability further increased [ 140 ]. Importantly, these factors were not associated with postoperative deficits at 3 to 8 months.…”

Section: Managing Expected and Unexpected Intraoperative Eventsmentioning

confidence: 99%

Technical Aspects of Motor and Language Mapping in Glioma Patients

Al-Adli

Young

Sibih

et al. 2023

Cancers

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Gliomas are infiltrative primary brain tumors that often invade functional cortical and subcortical regions, and they mandate individualized brain mapping strategies to avoid postoperative neurological deficits. It is well known that maximal safe resection significantly improves survival, while postoperative deficits minimize the benefits associated with aggressive resections and diminish patients’ quality of life. Although non-invasive imaging tools serve as useful adjuncts, intraoperative stimulation mapping (ISM) is the gold standard for identifying functional cortical and subcortical regions and minimizing morbidity during these challenging resections. Current mapping methods rely on the use of low-frequency and high-frequency stimulation, delivered with monopolar or bipolar probes either directly to the cortical surface or to the subcortical white matter structures. Stimulation effects can be monitored through patient responses during awake mapping procedures and/or with motor-evoked and somatosensory-evoked potentials in patients who are asleep. Depending on the patient’s preoperative status and tumor location and size, neurosurgeons may choose to employ these mapping methods during awake or asleep craniotomies, both of which have their own benefits and challenges. Regardless of which method is used, the goal of intraoperative stimulation is to identify areas of non-functional tissue that can be safely removed to facilitate an approach trajectory to the equator, or center, of the tumor. Recent technological advances have improved ISM’s utility in identifying subcortical structures and minimized the seizure risk associated with cortical stimulation. In this review, we summarize the salient technical aspects of which neurosurgeons should be aware in order to implement intraoperative stimulation mapping effectively and safely during glioma surgery.

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Speech and Language Errors during Awake Brain Surgery and Postoperative Language Outcome in Glioma Patients: A Systematic Review

Cited by 6 publications

References 112 publications

Localization patterns of speech and language errors during awake brain surgery: a systematic review

Localization patterns of speech and language errors during awake brain surgery: a systematic review

Written language preservation in glioma patients undergoing awake surgery: The value of tailored intra‐operative assessment

Technical Aspects of Motor and Language Mapping in Glioma Patients

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