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 l...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-11-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844023091922 |
| _version_ | 1797429785911099392 |
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| author | Leonie Kram Beate Neu Axel Schröder Bernhard Meyer Sandro M. Krieg Sebastian Ille |
| author_facet | Leonie Kram Beate Neu Axel Schröder Bernhard Meyer Sandro M. Krieg Sebastian Ille |
| author_sort | Leonie Kram |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-09T09:18:08Z |
| format | Article |
| id | doaj.art-c7981c66826c4413a89ffe96b5c88c31 |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-03-09T09:18:08Z |
| publishDate | 2023-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-c7981c66826c4413a89ffe96b5c88c312023-12-02T07:04:50ZengElsevierHeliyon2405-84402023-11-01911e21984Improving specificity of stimulation-based language mapping in stuttering glioma patients: A mixed methods serial case studyLeonie Kram0Beate Neu1Axel Schröder2Bernhard Meyer3Sandro M. Krieg4Sebastian Ille5Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Germany; Department of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, GermanyDepartment of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, GermanyDepartment of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, GermanyDepartment of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, GermanyDepartment of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Germany; Department of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, Germany; Corresponding author. Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany.Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Germany; Department of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, GermanyObjective: 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.http://www.sciencedirect.com/science/article/pii/S2405844023091922Navigated transcranial magnetic stimulationDirect cortical stimulationStutteringLanguage mappingGlioma |
| spellingShingle | Leonie Kram Beate Neu Axel Schröder Bernhard Meyer Sandro M. Krieg Sebastian Ille Improving specificity of stimulation-based language mapping in stuttering glioma patients: A mixed methods serial case study Heliyon Navigated transcranial magnetic stimulation Direct cortical stimulation Stuttering Language mapping Glioma |
| title | Improving specificity of stimulation-based language mapping in stuttering glioma patients: A mixed methods serial case study |
| title_full | Improving specificity of stimulation-based language mapping in stuttering glioma patients: A mixed methods serial case study |
| title_fullStr | Improving specificity of stimulation-based language mapping in stuttering glioma patients: A mixed methods serial case study |
| title_full_unstemmed | Improving specificity of stimulation-based language mapping in stuttering glioma patients: A mixed methods serial case study |
| title_short | Improving specificity of stimulation-based language mapping in stuttering glioma patients: A mixed methods serial case study |
| title_sort | improving specificity of stimulation based language mapping in stuttering glioma patients a mixed methods serial case study |
| topic | Navigated transcranial magnetic stimulation Direct cortical stimulation Stuttering Language mapping Glioma |
| url | http://www.sciencedirect.com/science/article/pii/S2405844023091922 |
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