Norrelgen Fritjof, Jensdottir Margret, Östberg Per
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Speech and Language Pathology, Karolinska University Hospital, Stockholm, Sweden.
Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.
Clin Neurol Neurosurg. 2020 Aug;195:105946. doi: 10.1016/j.clineuro.2020.105946. Epub 2020 May 20.
Knowledge about the long-term outcome of high-level language ability in awake surgery patients with low-grade gliomas or cavernomas in language eloquent regions is limited, particularly regarding subtle changes in high-level language abilities.
The study group consisted of 27 patients with LGG or cavernoma which involved language eloquent regions in the left hemisphere. A comprehensive assessment battery was used to target subtle changes in overall high-level language ability as well as in language sub skills. Assessments were made preoperatively and at 3 and 12 months postoperatively.
The results showed that overall high-level language ability had not decreased significantly at group level at 3 or 12 months postoperatively. The proportion of patients with a decline of 5 percent or more at follow up 3 and 12 months were 13% and 9% respectively. There was a marked decline in semantic fluency (animals and verbs) at 3 and 12 months postoperatively. Phonemic fluency, while not significantly reduced at three months, improved markedly in the interval between 3 and 12 months. At 12 months, the only significant decline relative to preoperative scores were seen in semantic fluency for animals and verbs. Verbal cognitive speed did not decline significantly postoperatively but approximately 40% of the patients had a decline of 5% or more at 12 months.
Overall high-level language ability was not significantly affected postoperatively at 3 and 12 months in LGG and cavernoma awake surgery patients. Semantic word fluency had deteriorated postoperatively at 3 and 12 months follow-up. Taken together our results indicate a decline in processing speed of verbal material postoperatively in the patient group.
关于位于语言功能区的低级别胶质瘤或海绵状血管瘤患者在清醒手术中的高级语言能力长期结果的了解有限，尤其是关于高级语言能力的细微变化。
研究组由27例左半球语言功能区受累的低级别胶质瘤或海绵状血管瘤患者组成。使用一套综合评估工具来针对整体高级语言能力以及语言子技能的细微变化。在术前、术后3个月和12个月进行评估。
结果显示，术后3个月和12个月时，整体高级语言能力在组水平上未显著下降。在术后3个月和12个月随访时，下降5%或更多的患者比例分别为13%和9%。术后3个月和12个月时语义流畅性（动物和动词）显著下降。音素流畅性在3个月时虽未显著降低，但在3至12个月期间显著改善。在12个月时，相对于术前分数，仅动物和动词的语义流畅性出现显著下降。言语认知速度术后未显著下降，但约40%的患者在12个月时下降了5%或更多。
低级别胶质瘤和海绵状血管瘤清醒手术患者术后3个月和12个月时整体高级语言能力未受到显著影响。术后3个月和12个月随访时语义词流畅性有所恶化。综合来看，我们的结果表明该患者组术后言语材料的处理速度下降。
