Intraoperative linguistic performance during awake brain surgery predicts postoperative linguistic deficits

Introduction Awake craniotomy pursues a balance between extensive tumor resection and preservation of postoperative language function. A dilemma exists in patients whose tumor resection is restricted due to signs of language impairment observed during awake craniotomy. In order to determine the degr...

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Bibliographic Details
Published in:Journal of neuro-oncology 2018-08, Vol.139 (1), p.215-223
Main Authors: Chang, Wei-Han, Pei, Yu-Cheng, Wei, Kuo-Chen, Chao, Yi-Ping, Chen, Mei-Hui, Yeh, Heng-An, Jaw, Fu-Shan, Chen, Pin-Yuan
Format: Article
Language:English
Subjects:
Adult
Aged
Aphasia
Brain - surgery
Brain Mapping
Brain Neoplasms - surgery
Clinical Study
Craniotomy
Female
Functional plasticity
Humans
Language
Language disorders
Language Disorders - diagnosis
Language Disorders - etiology
Language Tests
Linguistics
Male
Medicine
Medicine & Public Health
Middle Aged
Monitoring, Intraoperative
Neurology
Oncology
Postoperative Complications - diagnosis
Preservation
Prognosis
ROC Curve
Surgery
Visual plasticity
Wakefulness
Young Adult
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Summary:Introduction Awake craniotomy pursues a balance between extensive tumor resection and preservation of postoperative language function. A dilemma exists in patients whose tumor resection is restricted due to signs of language impairment observed during awake craniotomy. In order to determine the degree to which recovery of language function caused by tumor resection can be achieved by spontaneous neuroplasticity, the change in postoperative language function was compared to quantified intraoperative linguistic performance. Methods The modified, short-form Boston Diagnostic Aphasia Examination (sfBDAE) was used to assess pre- and postoperative language functions; visual object naming (DO 80) and semantic-association (Pyramid and Palm Tree Test, PPTT) tests assessed intraoperative linguistic performance. DO 80 and PPTT were performed alternatively during subcortical functional monitoring while performing tumor resection and sfBDAE was assessed 1-week postoperatively. Results Most patients with observed language impairment during awake surgery showed improved language function postoperatively. Both intraoperative DO 80 and PPTT showed significant correlation to postoperative sfBDAE domain scores (p 
ISSN:0167-594X
1573-7373
DOI:10.1007/s11060-018-2863-z