Language assessment in awake brain surgery: the Portuguese adaptation of the Dutch linguistic intraoperative protocol (DuLIP)

Abstract

Awake brain surgery, combined with neurophysiological evaluation and intraoperative mapping, is one of the preferential lines of treatment when approaching low-grade gliomas. Speech and language assessment is used while applying Direct Electrical Stimulation (DES) and during the resection of a lesion/tumour, as it allows to establish related eloquent areas and optimise the extent of the resection and avoid impairments. Patients need to be assessed pre, intra and post-surgery, but in under resourced countries such as Portugal, there are still no standardised and validated tools to conduct this type of evaluation. To address this need, the tasks of the Dutch Linguistic Intraoperative Protocol (DuLIP) were adapted to European Portuguese, and the resulting materials were standardised for a group of 144 Portuguese participants. For each task, the impact of age, gender and schooling were measured. The resulting Portuguese version of the DuLIP (DuLIP-EP) consists of 17 tasks, including phonological, syntactic, semantic, naming and articulatory tests. No significant differences were found between male and female participants. However, schooling influenced phonological and syntactic fluency, object naming and verb generation. Schooling and age had a significant impact on semantic fluency and reading with semantic odd word out tasks. This is the first contribution to the standardisation of a tool that can be used during an awake brain surgery in Portugal, which includes a new phonological odd word out task that is not currently available in the Dutch version.

The Aftercare Survey: Assessment and intervention practices after brain tumor surgery in Europe

“…Multilingual adaptations of perioperative tests set a promising avenue for this. 37 , 38 We also have an underrepresentation of professionals from neuro-oncology and therapy units, which could skew the final results in the direction that represents mainly post-surgery interventions, whereas long-term neuro-oncological care could not be depicted to a sufficient extent. Future surveys, continuing this new line of research, should involve more professionals representing neuro-oncology, professional reinsertion, occupational therapy units, and memory clinics.…”

Lesion‐symptom mapping of language impairments in people with brain tumours: The influence of linguistic stimuli

“…syntax). Even though tailored perioperative protocols expand beyond object naming, few of them suggest intraoperative sentence production assessment and even fewer focus on compound production (Alves et al, 2021; De Witte et al, 2015; Ohlerth et al, 2020). This study could then act as a basis for choosing perioperative tasks as well as designing therapy protocols.…”

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

“…To assess this language function in those specific locations, DuLIP includes a task in which three pictures are presented and the picture that is not semantically related to the other two must be named (odd picture out). DuLIP has been adapted to other languages, such as Portuguese [32]. Nowadays, other test batteries and tests for intraoperative use are available as well [33][34][35][36].…”