Publications

Abstract

Background
Reliable language mappings require sufficient language skills. This study evaluated whether linguistic task properties impact feasibility and reliability of navigated transcranial magnetic stimulation (nTMS)-based language mappings in aphasic glioma patients.

Methods
The effect of linguistic complexity on naming accuracy during baseline testing without stimulation and on the number of errors during nTMS was evaluated for 16 moderately and 4 severely expressive aphasic patients.

Result
During baseline, items acquired later in life and used less frequently, a higher amount of multisyllabic, compound, and inanimate items were named inaccurately. Even after removing these more complex items, less frequent and multisyllabic items were more error-prone during stimulation.

Conclusion
Higher linguistic item complexity was associated with decreased naming accuracy during baseline and resulted in a potentially higher false positive rate during nTMS in aphasic glioma patients. Thus, tailoring task complexity to individual performance capabilities may considerably support the preservation of residual functionality.

Abstract

Objective: Stimulation-based language mapping approaches that are used pre- and intra-operatively employ predominantly overt language tasks requiring sufficient language pro-duction abilities. Yet, these production-based setups are often not feasible in brain tumor patients with severe expressive aphasia. This pilot study evaluated the feasibility and reliability of a newly developed language comprehension task with preoperative navigated transcranial magnetic stimulation (nTMS).
Methods: Fifteen healthy subjects and six brain tumor patients with severe expressiven aphasia unable to perform classic overt naming tasks underwent preoperative nTMS language mapping based on an auditory single-word Comprehension TAsk for Perioperative mapping (CompreTAP). Comprehension was probed by button-press responses to auditory stimuli, hence not requiring overt language responses. Positive comprehension areas were identified when stimulation elicited an incorrect or delayed button press. Error categories,case-wise cortical error rate distribution and inter-rater reliability between two experienced specialists were examined.
Results: Overall, the new setup showed to be feasible. Comprehension-disruptions induced by nTMS manifested in no responses, delayed or hesitant responses, searching behavior or selection of wrong target items across all patients and controls and could be performed even in patients with severe expressive aphasia. The analysis agreement between both specialists was substantial for classifying comprehension-positive and -negative sites. Extensive left-hemispheric individual cortical comprehension sites were identified for all patients. Apart from one case presenting with transient worsening of aphasic symptoms.