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Post-surgical effects on language in patients with presumed low-grade glioma

Journal article
Authors Malin Antonsson
Asgeir Store Jakola
Francesca Longoni
Louise Carstam
Lena Hartelius
Magnus Thordstein
Magnus Tisell
Published in Acta Neurologica Scandinavica
Volume 137
Issue 5
Pages 469-480
ISSN 0001-6314
Publication year 2018
Published at Institute of Neuroscience and Physiology
Pages 469-480
Language en
Links https://doi.org/10.1111/ane.12887
Keywords brain tumour, language impairment, language tests, low-grade glioma, tumour surgery
Subject categories Logopedics and phoniatrics, Linguistics, Neurosurgery

Abstract

Objectives: Low-grade glioma (LGG) is a slow-growing brain tumour often situated in or near areas involved in language and/or cognitive functions. Thus, language impairments due to tumour growth or surgical resection are obvious risks. We aimed to investigate language outcome following surgery in patients with presumed LGG, using a comprehensive and sensitive language assessment. Materials and methods: Thirty-two consecutive patients with presumed LGG were assessed preoperative, early post-operative, and 3 months post-operative using sensitive tests including lexical retrieval, language comprehension and high-level language. The patients’ preoperative language ability was compared with a reference group, but also with performance at post-operative controls. Further, the association between tumour location and language performance pre-and post-operatively was explored. Results: Before surgery, the patients with presumed LGG performed worse on tests of lexical retrieval when compared to a reference group (BNT: LGG-group median 52, Reference-group median 54, P = .002; Animals: LGG-group mean 21.0, Reference-group mean 25, P = 001; Verbs: LGG-group mean 17.3, Reference-group mean 21.4, P = .001). At early post-operative assessment, we observed a decline in all language tests, whereas at 3 months there was only a decline on a single test of lexical retrieval (Animals: preoperative. median 20, post-op median 14, P = .001). The highest proportion of language impairment was found in the group with a tumour in language-eloquent areas at all time-points. Conclusions: Although many patients with a tumour in the left hemisphere deteriorated in their language function directly after surgery, their prognosis for recovery was good.

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