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Lesion-symptom mapping of pre-surgical language deficits in patients with left-hemisphere primary brain tumours
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Poster C60 in Poster Session C, Wednesday, October 25, 10:15 am - 12:00 pm CEST, Espace Vieux-Port
Greig de Zubicaray1, Elaine Kearney1, Sonia Brownsett2, Kate Drummond3, Emma Murton3, Sarah Olson4, Benjamin Ong4, David Copland2, Gail Robinson2, Valeriya Tolkacheva1, Katie McMahon1; 1Queensland University of Technology, 2University of Queensland, 3Royal Melbourne Hospital, 4Princess Alexandra Hospital
Patients with primary left hemisphere brain tumours have been reported to present with or without language impairments prior to treatment. However, the majority of studies to date have involved brief tests of verbal fluency and confrontation naming, with relatively few administering a comprehensive language assessment. In the present study, we investigated the incidence of pre-operative language impairments in a sample of patients with primary left-hemisphere brain tumours with the Comprehensive Aphasia Test (CAT) and employed lesion-symptom mapping to identify associated tumour sites. Thirty-four patients participated in the present study. Approximately 71% of the sample were classified as aphasic based on their performance on at least one CAT language subtest, with 44% impaired on at least two, and 29% impaired on at least three. Most showed deficits on verb naming, picture description, and word reading and comprehension subtests. After controlling for age, sex, education, tumour grade, and lesion volume, verb naming and comprehension of written word subtests were significantly associated with lesions to the anterior and medial temporal lobe (parahippocampal and fusiform gyri), respectively. Voxel-wise disconnection analyses revealed verb naming deficits were significantly associated with disconnection of the arcuate fasciculus terminations in the middle and superior temporal gyrii, while reading comprehension deficits were associated with disconnection of inferior, middle and superior cerebellar peduncle pathways. These results indicate pre-operative language impairments are common, occurring in the majority of tumour patients in the present cohort. In addition, the prominent language impairments reflect tumour encroachment on language-related temporal lobe regions and connected white matter pathways. This information may prove useful for predicting language outcomes and planning appropriate language therapies following surgery.
Topic Areas: Disorders: Acquired,