Improving specificity of stimulation-based language mapping in stuttering glioma patients: a mixed methods serial case study
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...
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| Main Authors: | , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
07 November 2023
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| In: |
Heliyon
Year: 2023, Volume: 9, Issue: 11, Pages: 1-12 |
| ISSN: | 2405-8440 |
| DOI: | 10.1016/j.heliyon.2023.e21984 |
| Online Access: | Resolving-System, kostenfrei, Volltext: https://doi.org/10.1016/j.heliyon.2023.e21984 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S2405844023091922 
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| Author Notes: | Leonie Kram, Beate Neu, Axel Schröder, Bernhard Meyer, Sandro M. Krieg, Sebastian Ille |
| Summary: | 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. |
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| Item Description: | Gesehen am 09.04.2024 |
| Physical Description: | Online Resource |
| ISSN: | 2405-8440 |
| DOI: | 10.1016/j.heliyon.2023.e21984 |