Speech and Language Pathology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Acta Neurol Scand. 2018 May;137(5):469-480. doi: 10.1111/ane.12887. Epub 2017 Dec 18.
Low-grade glioma (LGG) is a slow-growing brain tumour often situated in or near areas involved in language and/or cognitive functions. Thus, language impairments due to tumour growth or surgical resection are obvious risks. We aimed to investigate language outcome following surgery in patients with presumed LGG, using a comprehensive and sensitive language assessment.
Thirty-two consecutive patients with presumed LGG were assessed preoperative, early post-operative, and 3 months post-operative using sensitive tests including lexical retrieval, language comprehension and high-level language. The patients' preoperative language ability was compared with a reference group, but also with performance at post-operative controls. Further, the association between tumour location and language performance pre- and post-operatively was explored.
Before surgery, the patients with presumed LGG performed worse on tests of lexical retrieval when compared to a reference group (BNT: LGG-group median 52, Reference-group median 54, P = .002; Animals: LGG-group mean 21.0, Reference-group mean 25, P = 001; Verbs: LGG-group mean 17.3, Reference-group mean 21.4, P = .001). At early post-operative assessment, we observed a decline in all language tests, whereas at 3 months there was only a decline on a single test of lexical retrieval (Animals: preoperative. median 20, post-op median 14, P = .001). The highest proportion of language impairment was found in the group with a tumour in language-eloquent areas at all time-points.
Although many patients with a tumour in the left hemisphere deteriorated in their language function directly after surgery, their prognosis for recovery was good.
低级别胶质瘤(LGG)是一种生长缓慢的脑肿瘤,通常位于或靠近与语言和/或认知功能相关的区域。因此,肿瘤生长或手术切除引起的语言障碍是明显的风险。我们旨在使用全面而敏感的语言评估来研究疑似 LGG 患者手术后的语言结果。
32 例连续疑似 LGG 患者在术前、术后早期和术后 3 个月使用包括词汇检索、语言理解和高级语言在内的敏感测试进行评估。将患者术前的语言能力与参考组进行比较,但也与术后对照进行比较。此外,还探讨了肿瘤位置与术前和术后语言表现之间的关系。
手术前,疑似 LGG 患者在词汇检索测试中的表现明显低于参考组(BNT:LGG 组中位数 52,参考组中位数 54,P=0.002;动物:LGG 组平均值 21.0,参考组平均值 25,P=0.01;动词:LGG 组平均值 17.3,参考组平均值 21.4,P=0.001)。在术后早期评估中,我们观察到所有语言测试均下降,而在 3 个月时仅在单一词汇检索测试中下降(动物:术前中位数 20,术后中位数 14,P=0.001)。在所有时间点,肿瘤位于语言相关区域的患者中语言障碍的比例最高。
尽管许多左半球肿瘤患者在手术后直接出现语言功能下降,但他们的恢复预后良好。