Writing fluency in patients with low‐grade glioma before and after surgery

Abstract

BackgroundLow‐grade glioma (LGG) is a type of brain tumour often situated in or near areas involved in language, sensory or motor functions. Depending on localization and tumour characteristics, language or cognitive impairments due to tumour growth and/or surgical resection are obvious risks. One task that may be at risk is writing, both because it requires intact language and memory function and because it is a very complex and cognitively demanding task. The most commonly reported language deficit in LGG patients is oral lexical‐retrieval difficulties, and poor lexical retrieval would be expected to affect writing fluency.AimsTo explore whether writing fluency is affected in LGG patients before and after surgery and whether it is related to performance on tasks of oral lexical retrieval.Methods & ProceduresTwenty consecutive patients with presumed LGG wrote a narrative and performed a copy task before undergoing surgery and at 3‐month follow‐up using keystroke‐logging software. The same tasks were performed by a reference group (N = 31). The patients were also tested using the Boston Naming Test (BNT) and word‐fluency tests before and after surgery. Writing fluency was compared between the patients and the reference group, and between the patients before and after surgery. Relationships between performance on tests of oral lexical retrieval and writing fluency were investigated both before and after surgery.Outcome & ResultsDifferent aspects of writing fluency were affected in the LGG patients both before and after surgery. However, when controlling for the effect of typing speed, the LGG group differed significantly from the reference group only in the proportion of pauses within words. After surgery, a significant decline was seen in production rate and typing speed in the narrative task, and a significant increase was seen in pauses before words. Strong positive relationships were found between oral lexical retrieval and writing fluency both before and after surgery.Conclusions & ImplicationsAlthough aspects of writing fluency were affected both before and after surgery, the results indicate that typing speed is an important factor behind the pre‐surgery differences. However, the decline in overall productivity and the increase in pauses before words after surgery could be related to a lexical deficit. This is supported by the finding that oral lexical‐retrieval scores were strongly correlated with writing fluency. However, further exploration is needed to identify the language and cognitive abilities affecting writing processes in LGG patients.

Influences on cognitive outcomes in adult patients with gliomas: A systematic review

“…The identified studies found wide variability in the reported effects of tumor-related factors on cognitive outcomes in patients with gliomas. Anatomical location of the tumor has been shown to be an important influence on cognitive outcomes in some studies ( 23 – 35 ), but not in others ( 3 , 36 – 40 ); although most of the studies providing evidence for and against a role of anatomical location were prospective cohort studies (some study designs in both groups were not specified), the studies suggesting no role of anatomical location were fewer and tended to have smaller numbers of participants, and on balance anatomical location is most likely to be relevant overall for cognitive function. Location of the tumor has been shown to influence the likelihood of developing deficits in some but not all cognitive domains ( 41 ), and in another study was found to predict spontaneous speech deficits and naming scores in HGG but not LGG patients ( 42 ); the authors of the latter study hypothesize that this implies that large functional reorganization occurs in LGG, and highlights the importance of glioma grade in macrostructural plasticity mechanisms that modulate brain-behavior relationships.…”

Using a digital spelling aid to improve writing in persons with post‐stroke aphasia: An intervention study

“…The logging program appears as a plain word processor with a document in which the writers produce their texts. Keystroke logging has been used for a variety of purposes, including to analyse the writing of dyslexic students (Wengelin, 2002), persons with brain tumours (Antonsson et al ., 2018), persons with Alzheimer's disease (Van Waes et al ., 2017) and persons with post‐stroke aphasia (Behrns et al ., 2008, 2009a; Johansson‐Malmeling et al ., 2021a,b). In the present study, the logging tool was used for all written tasks.…”

Exploring Revisions in Academic Text: Closing the Gap Between Process and Product Approaches in Digital Writing

“…Similarly, other studies have taken a more active look at the role of language in texts composed on a computer, and have moved into areas such as the frequencies with which parts of speech occur (Behrns et al, 2008(Behrns et al, , 2010Wengelin, 2007), pause lengths between language units as indicators of language impairment (Antonsson et al, 2018;Van Waes et al, 2017), and how writers consult and use sources (Leijten et al, 2019). However, there is little research into how language (or meaning) unfolds in written text (cf.…”