Poster D55, Friday, August 17, 4:45 – 6:30 pm, Room 2000AB
Picture description versus picture naming: assessing language deficits following dominant hemisphere tumour resection.
Sonia Brownsett1,2, Kori Ramajoo1,2, Katie McMahnon3, Hanna Gauvin1,2, Greig de Zubicaray1,2;1Faculty of Health, School - Psychology and Counselling, QUT, 2Institute of Health Biomedical Innovation, QUT, 3Faculty of Health, School - Clinical Sciences, QUT
‘Picture description’ is a valuable clinical tool that is often quicker and easier to complete with patients than impairment-based assessment. In both neurodegenerative disease and post-stoke aphasia, picture-description has been shown to be sensitive to language difficulties (1, 2) and is an excellent predictor of residual language skills in post-stroke aphasia (3,4). Prior to dominant-hemisphere tumour resection, rapid assessment of speech and language skills is essential to informing clinicians of the risk of surgically induced aphasia following removal of eloquent tissue. In addition to the debilitating impact of aphasia on social and financial well-being, McCirt and colleagues (5), suggested that surgically induced aphasia can also impact on survival rates. It is therefore, imperative that surgical planning aims to avoid inducing such deficits and also establishes a baseline assessment of pre-surgical language function in order to accurately report consequences of surgery. A common test of language skills used by neurosurgical teams remains picture naming (6, 7); a test that does not adequately capture language performance per se. A recent study of 5 tumour patients suggested that the use of spontaneous speech analysis was comparable to formal testing in detecting language impairments (8). Methods: We assessed a group of 16 people, following surgical resection of a left-sided tumour, using the Comprehensive Aphasia test (CAT) (9). All patients were assessed between 6-12 months post-surgical removal of a primary tumour, all spoke English as their primary language and were right-handed. The battery included sub-tests of naming and picture description tasks. Naming tasks were scored in a binary method. Transcriptions of the picture description task were analysed using the breakdown of contents recommended in the CAT including: (i) appropriate information carrying words (ICW) (ii) inappropriate ICW; (iii) syntactic variety; (iv) grammatical well-formedness and (v) speed of delivery. Scores were then standardized by converting to t-scores. Results: Using the Comprehensive Aphasia test 8/16 and 9/16 patients demonstrated a language deficit on the spoken and written picture description tasks respectively. In contrast, using the picture naming task, only 1/16 patients presented with a ‘language deficit’. Discussion:The subtle language deficits exhibited in people following tumour resection are not always detected using quick comprehensive screening assessments tools and are certainly not adequately detected using picture naming tasks. However, picture description tasks can quickly and reliably demonstrate the presence of language impairment and can therefore be more accurately used to guide surgical decision -making than picture naming tasks. Results can also be used to triage for more extensive formal language testing. Picture description permits language to be explored at a number of different levels from the phonemic to pragmatic and even cognitive skills such as initiation and attention shifting. In this case series, the picture description task has been shown to be more reliable than a picture naming task at detecting the presence of language impairment in patients who have undergone dominant-hemisphere tumour resection.
Topic Area: Language Disorders