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Journal of Neuro-Oncology

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Open Access 01-08-2018 | Clinical Study

Intraoperative linguistic performance during awake brain surgery predicts postoperative linguistic deficits

Authors: Wei-Han Chang, Yu-Cheng Pei, Kuo-Chen Wei, Yi-Ping Chao, Mei-Hui Chen, Heng-An Yeh, Fu-Shan Jaw, Pin-Yuan Chen

Published in: Journal of Neuro-Oncology | Issue 1/2018

Abstract

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 < 0.05), with a higher correlation observed with PPTT. A linear regression model showed that only PPTT predicted the postoperative sfBDAE domain scores with the adjusted R² ranging from 0.51 to 0.89 (all p < 0.01). Receiver operating characteristic analysis showed a cutoff value of PPTT that yielded a sensitivity of 80% and specificity of 100%.

Conclusion

PPTT may be a feasible tool for intraoperative linguistic evaluation that can predict postoperative language outcomes. Further studies are needed to determine the extent of tumor resection that optimizes the postoperative language following neuroplasticity.

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Title: Intraoperative linguistic performance during awake brain surgery predicts postoperative linguistic deficits
Authors: Wei-Han Chang
Yu-Cheng Pei
Kuo-Chen Wei
Yi-Ping Chao
Mei-Hui Chen
Heng-An Yeh
Fu-Shan Jaw
Pin-Yuan Chen
Publication date: 01-08-2018
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 1/2018
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-018-2863-z

At a glance: The STEP trials

Springer Medicine

Intraoperative linguistic performance during awake brain surgery predicts postoperative linguistic deficits

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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