P06.09.a Preserving Spontaneous Speech? Proof-of-concept Use of Intraoperative Picture Description as Endpoint Measurement in Brain Tumor Surgery
Year: 2025
Type: article
Abstract: BACKGROUND Awake surgery is aimed at preserving quality of life while maximizing the extend of resection. Spontaneous speech, as the ability to communicate, is vital to participate in daily life and has been established to be at risk after awake surgery. Yet, the outcome of language preservation in awake surgery is often only months after surgery reliably assessable, due to post-operative effects such as edema. At the end of surgery, these factors don’t interfere with cognitive functioning yet. Moreover, language impairments in glioma patients are not always evident in standard language tasks but do affect spontaneous language and as such hamper their daily life. A picture description task is a well-established tool to evaluate elicited spontaneous speech, while gaining information on the integrity of underlying cognitive-linguistic components, including semantics, phonology and syntax. This study explores whether assessment of spontaneous speech at the end of awake surgery is feasible and may provide information on post-operative language functioning. MATERIAL AND METHODS Elicited spontaneous speech is assessed days pre-operatively (T0), at the endline of awake surgery (T1), and days (T2) and 4 months (T3) post-operatively, using standardized versions of oral picture description tasks (CAT-NL, Cookie Theft, Cat in the Tree). Responses are recorded and scored using parallel and standardized scoring forms. For the total scores and for each linguistic variable (lexical semantics, lexical retrieval, syntax, fluency, errors) Reliable Change Indices (RCI’s) are calculated. RESULTS To date, 10 patients who underwent awake surgery with intra-operative language mapping for a glioma in the left hemisphere (including both high- and low-grade gliomas in the frontal, parietal, temporal and insular lobe) are included in the study, who are assessed on T0, T1 and T2. Data collection will continue and be extended to T3. Administration of the picture description task at the endline of awake surgery appeared feasible in all patients. Compared to pre-operative levels, performance at the intra-operative endline was lower in 83% and remained stable in 17% of patients. Directly after surgery, 83% increased and 17% remained stable compared to the intra-operative endline. Inspection of the linguistic variables shows that errors (specifically paraphasias) are most congruent with the overall picture description performance changes. CONCLUSION The first results show that administration of the picture description task at the endline of awake surgery is feasible and informative. In particular, paraphasic errors seem explanatory as a measure of spontaneous speech. As data collection expands, more light will be shed on the predictive value of picture description at the endline of awake surgery with regards to post-operative language functioning.
Source: Neuro-Oncology
Language: English
Subfield: Cognitive Neuroscience
Field: Neuroscience
Domain: Life Sciences
Open Access status: bronze
OpenAlex ID: W4414792247
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