Improving specificity of stimulation-based language mapping in stuttering glioma patients

• Verfasst von: Kram, Leonie [VerfasserIn]
• Verfasst von: Neu, Beate [VerfasserIn]
• Verfasst von: Schröder, Axel [VerfasserIn]
• Verfasst von: Meyer, Bernhard [VerfasserIn]
• Verfasst von: Krieg, Sandro [VerfasserIn]
• Verfasst von: Ille, Sebastian [VerfasserIn]
• Titel: Improving specificity of stimulation-based language mapping in stuttering glioma patients
• Titelzusatz: a mixed methods serial case study
• Verf.angabe: Leonie Kram, Beate Neu, Axel Schröder, Bernhard Meyer, Sandro M. Krieg, Sebastian Ille
• E-Jahr: 2023
• Jahr: 07 November 2023
• Umfang: 12 S.
• Fussnoten: Gesehen am 09.04.2024
• Titel Quelle: Enthalten in: Heliyon
• Ort Quelle: London [u.a.] : Elsevier, 2015
• Jahr Quelle: 2023
• Band/Heft Quelle: 9(2023), 11, Artikel-ID e21984, Seite 1-12
• ISSN Quelle: 2405-8440
• DOI: doi:10.1016/j.heliyon.2023.e21984
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Direct cortical stimulation
• Sach-SW: Glioma
• Sach-SW: Language mapping
• Sach-SW: Navigated transcranial magnetic stimulation
• Sach-SW: Stuttering
• K10plus-PPN: 188532944X

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. Comparison with Existing Method(s): 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.