Department of Neurology, Gui de Chauliac Hospital, Montpellier University Medical Center, 80 Avenue Augustin Fliche, 34295 Montpellier, France.
J Neurooncol. 2012 May;107(3):633-41. doi: 10.1007/s11060-011-0789-9. Epub 2012 Jan 24.
Awake surgery with intraoperative brain mapping is highly recommended for patients with diffuse low-grade gliomas in language areas, to maximise the extent of resection while preserving the integrity of functional networks and thus quality of life. The picture-naming test "DO.80" is the gold standard for language assessment before, during, and after surgery. Cognitive functioning is correlated with quality of life, itself linked with return to work. Our objective was to evaluate the significance of measuring naming speed, and its correlation with the return to professional activities. Two complementary studies are reported. In the first retrospective study, eleven patients were examined post-operatively. Five patients were selected because they were not able to resume their professional activities ("no return group 1"). They were compared with a control group of six patients who are working normally after surgery ("return group 1"). The eleven patients performed a global language and neuropsychological assessment, with a post-operative median follow-up of 35 months. In a subsequent prospective study, twelve patients were examined pre-operatively and post-operatively. Six patients who were not able to return to work ("no return group 2") were compared with a control group of six patients who were working normally after the surgery ("return group 2"). The twelve patients performed a pre and post-operative language assessment, with a median follow-up of 9 months. Our results show, for the first time, that naming speed is significantly correlated with a major criterion of quality of life: the return to professional activities. There were no differences between the two groups regarding other measures of cognition. Assessing naming times, and not only naming accuracy, is essential in the management of low-grade glioma patients, before, during, and after surgery, to preserve their quality of life by resuming their previous professional activity. Our results have fundamental implications concerning the comprehension of language processing and its relationship with cognitive functioning.
清醒开颅术中进行脑功能区定位对于语言区弥漫性低级别胶质瘤患者非常重要，可以最大限度地切除肿瘤，同时保持功能网络的完整性，从而提高生活质量。图片命名测试“DO.80”是手术前后语言评估的金标准。认知功能与生活质量相关，而生活质量又与重返工作相关。我们的目的是评估测量命名速度的重要性及其与恢复专业活动的相关性。报告了两项互补的研究。在第一项回顾性研究中，对 11 名患者进行了术后检查。选择了 5 名患者，因为他们无法恢复其专业活动（“无返回组 1”）。将他们与 6 名手术后正常工作的对照组患者（“返回组 1”）进行比较。这 11 名患者进行了全面的语言和神经心理学评估，术后中位随访时间为 35 个月。在随后的前瞻性研究中，对 12 名患者进行了术前和术后检查。选择了 6 名无法返回工作的患者（“无返回组 2”），并与 6 名手术后正常工作的对照组患者（“返回组 2”）进行比较。这 12 名患者进行了术前和术后语言评估，中位随访时间为 9 个月。我们的研究结果首次表明，命名速度与生活质量的一个主要标准显著相关：恢复专业活动。两组在认知功能的其他测量指标上没有差异。在手术前后评估命名时间，而不仅仅是命名准确性，对于保留患者的生活质量，使其能够恢复之前的专业活动非常重要。我们的研究结果对于理解语言处理及其与认知功能的关系具有重要意义。
