Chronic aphasias after left-hemisphere resective surgery

Brain Lang. 2023 Apr:239:105244. doi: 10.1016/j.bandl.2023.105244. Epub 2023 Mar 6.

Abstract

Surgical resection of brain tumours is associated with an increased risk of aphasia. However, relatively little is known about outcomes in the chronic phase (i.e., >6 months). Using voxel-based lesion symptom mapping (VLSM) in 46 patients, we investigated whether chronic language impairments are related to the location of surgical resection, residual tumour characteristics (e.g., peri-resection treatment effects, progressive infiltration, oedema) or both. Approximately 72% of patients scored below the cut-off for aphasia. Action naming and spoken sentence comprehension deficits were associated with lesions in the left anterior temporal and inferior parietal lobes, respectively. Voxel-wise analyses revealed significant associations between ventral language pathways and action naming deficits. Reading impairments were also associated with increasing disconnection of cerebellar pathways. The results indicate chronic post-surgical aphasias reflect a combination of resected tissue and tumour infiltration of language-related white matter tracts, implicating progressive disconnection as the critical mechanism of impairment.

Keywords: Aphasia; Resective surgery; Tumours; Voxel-based lesion-symptom mapping.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aphasia* / diagnostic imaging
  • Aphasia* / etiology
  • Brain / pathology
  • Brain Mapping
  • Comprehension
  • Humans
  • Language
  • Magnetic Resonance Imaging
  • Stroke* / complications