Pre-operative language ability in patients with presumed low-grade glioma

Abstract

In patients with low-grade glioma (LGG), language deficits are usually only found and investigated after surgery. Deficits may be present before surgery but to date, studies have yielded varying results regarding the extent of this problem and in what language domains deficits may occur. This study therefore aims to explore the language ability of patients who have recently received a presumptive diagnosis of low-grade glioma, and also to see whether they reported any changes in their language ability before receiving treatment. Twenty-three patients were tested using a comprehensive test battery that consisted of standard aphasia tests and tests of lexical retrieval and high-level language functions. The patients were also asked whether they had noticed any change in their use of language or ability to communicate. The test scores were compared to a matched reference group and to clinical norms. The presumed LGG group performed significantly worse than the reference group on two tests of lexical retrieval. Since five patients after surgery were discovered to have a high-grade glioma, a separate analysis excluding them were performed. These analyses revealed comparable results; however one test of word fluency was no longer significant. Individually, the majority exhibited normal or nearly normal language ability and only a few reported subjective changes in language or ability to communicate. This study shows that patients who have been diagnosed with LGG generally show mild or no language deficits on either objective or subjective assessment.Electronic supplementary materialThe online version of this article (10.1007/s11060-017-2699-y) contains supplementary material, which is available to authorized users.

Functional and structural biomarkers of cognitive outcomes after brain tumor resection

“…These studies have traditionally proposed patients' age and tumor location as the most significant variables for postsurgical prognosis (Armstrong et al, 2003;Habets et al, 2014;Klein et al, 2001). For instance, Kaleita et al (Kaleita et al, 2004) Previous studies have considered language impairments to be the ones most impacting on patients' quality of life and have included them as the primary outcome to be predicted in the studies (Antonsson et al, 2018;Duffau, Gatignol, Mandonnet, Capelle, & Taillandier, 2008;Kim et al, 2009). Our results highlighted the importance of the inferior and superior longitudinal fasciculi, relevant for language production and comprehension, when introducing connectivity variables.…”

“…Previous studies have considered language impairments to be the ones most impacting on patients’ quality of life and have included them as the primary outcome to be predicted in the studies (Antonsson et al, 2018; Duffau, Gatignol, Mandonnet, Capelle, & Taillandier, 2008; Kim et al, 2009). Our results highlighted the importance of the inferior and superior longitudinal fasciculi, relevant for language production and comprehension, when introducing connectivity variables.…”

Organizing Variables Affecting fMRI Estimates of Language Dominance in Patients with Brain Tumors

“…The presence of a brain tumor around the language network can disrupt the assessment of language dominance with fMRI [13,26,27]. Based on prior research [1,12,28,29], it is suggested that fMRI estimates of language dominance can be distorted (usually decreased) by two subcategories of tumor-related confounds: (a) tumor characteristics [1,12,28,29], and (b) tumor-induced conditions [30][31][32]. These two subcategories are presented in Table 2.…”

“…(a) Aphasia-disrupted language comprehension and/or production has been reported in between 10.4 to 36.4% of individuals with brain tumors residing in the languagedominant left hemisphere [30,[52][53][54][55]. The vast discrepancies in aphasia reports may result from methodological differences in patient selection and assessments between studies, such as including patients with both low and high tumor grades or enrolling patients with recurring tumors [30]. In general, patients with low-grade gliomas have milder or no language impairments compared to high-grade gliomas.…”

“…In general, patients with low-grade gliomas have milder or no language impairments compared to high-grade gliomas. A faster rate of growth of high-grade brain tumors may not provide sufficient time to recruit other brain structures to compensate for language disruption [30,56,57]. Patients with brain tumors who suffer from aphasia have been found to have reduced BOLD signal during resting-state fMRI in the left inferior frontal gyrus when compared with tumor patients with no aphasia who displayed retained BOLD signal in this area [56].…”