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Improving specificity of stimulation-based language mapping in stuttering glioma patients: A mixed methods serial case study.

作者信息

Kram Leonie, Neu Beate, Schröder Axel, Meyer Bernhard, Krieg Sandro M, Ille Sebastian

机构信息

Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Germany.

Department of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, Germany.

出版信息

Heliyon. 2023 Nov 7;9(11):e21984. doi: 10.1016/j.heliyon.2023.e21984. eCollection 2023 Nov.


DOI:10.1016/j.heliyon.2023.e21984
PMID:38045205
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10692765/
Abstract

OBJECTIVE: Stimulation-based language mapping relies on identifying stimulation-induced language disruptions, which preexisting speech disorders affecting the laryngeal and orofacial speech system can confound. This study ascertained the effects of preexisting stuttering on pre- and intraoperative language mapping to improve the reliability and specificity of established language mapping protocols in the context of speech fluency disorders. METHOD: Differentiation-ability of a speech therapist and two experienced nrTMS examiners between stuttering symptoms and stimulation-induced language errors during preoperative mappings were retrospectively compared (05/2018-01/2021). Subsequently, the impact of stuttering on intraoperative mappings was evaluated in all prospective patients (01/2021-12/2022). RESULTS: In the first part, 4.85 % of 103 glioma patients stuttered. While both examiners had a significant agreement for misclassifying pauses in speech flow and prolongations (Κ ≥ 0.50, p ≤ 0.02, respectively), less experience resulted in more misclassified stuttering symptoms. In one awake surgery case within the second part, stuttering decreased the reliability of intraoperative language mapping.: By thoroughly differentiating speech fluency symptoms from stimulation-induced disruptions, the reliability and proportion of stuttering symptoms falsely attributed to stimulation-induced language network disruptions can be improved. This may increase the consistency and specificity of language mapping results in stuttering glioma patients. CONCLUSIONS: Preexisting stuttering negatively impacted language mapping specificity. Thus, surgical planning and the functional outcome may benefit substantially from thoroughly differentiating speech fluency symptoms from stimulation-induced disruptions by trained specialists.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8da/10692765/61ec229efb80/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8da/10692765/4f8ef7ab4c83/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8da/10692765/61ec229efb80/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8da/10692765/4f8ef7ab4c83/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8da/10692765/61ec229efb80/gr2.jpg

相似文献

[1]
Improving specificity of stimulation-based language mapping in stuttering glioma patients: A mixed methods serial case study.

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本文引用的文献

[1]
Non-Invasive Mapping for Effective Preoperative Guidance to Approach Highly Language-Eloquent Gliomas-A Large Scale Comparative Cohort Study Using a New Classification for Language Eloquence.

Cancers (Basel). 2021-1-8

[2]
Diagnosing and managing post-stroke aphasia.

Expert Rev Neurother. 2021-2

[3]
Incidence and linguistic quality of speech errors: a comparison of preoperative transcranial magnetic stimulation and intraoperative direct cortex stimulation.

J Neurosurg. 2021-5-1

[4]
Risk Assessment by Presurgical Tractography Using Navigated TMS Maps in Patients with Highly Motor- or Language-Eloquent Brain Tumors.

Cancers (Basel). 2020-5-17

[5]
Awake glioma surgery: technical evolution and nuances.

J Neurooncol. 2020-5

[6]
When imaging meets neurophysiology: the value of navigated transcranial magnetic stimulation for preoperative neurophysiological mapping prior to brain tumor surgery.

Neurosurg Focus. 2019-12-1

[7]
The emerging contribution of speech and language therapists in awake craniotomy: a national survey of their roles, practices and perceptions.

Int J Lang Commun Disord. 2019-11-28

[8]
Dissociating motor-speech from lexico-semantic systems in the left frontal lobe: insight from a series of 17 awake intraoperative mappings in glioma patients.

Brain Struct Funct. 2019-1-14

[9]
Setup presentation and clinical outcome analysis of treating highly language-eloquent gliomas via preoperative navigated transcranial magnetic stimulation and tractography.

Neurosurg Focus. 2018-6

[10]
Neurogenic stuttering: a review of the literature.

Rev Neurol. 2018-1-16

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