Transient aphasias after left hemisphere resective surgery

Stephen M Wilson, Daniel Lam, Miranda C. Babiak, David W. Perry, Tina Shih, Christopher P. Hess, Mitchel S. Berger, Edward F. Chang

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Object Transient aphasias are often observed in the first few days after a patient has undergone resection in the language-dominant hemisphere. The aims of this prospective study were to characterize the incidence and nature of these aphasias and to determine whether there are relationships between location of the surgical site and deficits in specific language domains. Methods One hundred ten patients undergoing resection to the language-dominant hemisphere participated in the study. Language was evaluated prior to surgery and 2-3 days and 1 month postsurgery using the Western Aphasia Battery and the Boston Naming Test. Voxel-based lesion-symptom mapping was used to identify relationships between the surgical site location assessed on MRI and deficits in fluency, information content, comprehension, repetition, and naming. Results Seventy-one percent of patients were classified as aphasic based on the Western Aphasia Battery 2-3 days postsurgery, with deficits observed in each of the language domains examined. Fluency deficits were associated with resection of the precentral gyrus and adjacent inferior frontal cortex. Reduced information content of spoken output was associated with resection of the ventral precentral gyrus and posterior inferior frontal gyrus (pars opercularis). Repetition deficits were associated with resection of the posterior superior temporal gyrus. Naming deficits were associated with resection of the ventral temporal cortex, with midtemporal and posterior temporal damage more predictive of naming deficits than anterior temporal damage. By 1 month postsurgery, nearly all language deficits were resolved, and no language measure except for naming differed significantly from its presurgical level. Conclusions These findings show that transient aphasias are very common after left hemisphere resective surgery and that the precise nature of the aphasia depends on the specific location of the surgical site. The patient cohort in this study provides a unique window into the neural basis of language because resections are discrete, their locations are not limited by vascular distribution or patterns of neurodegeneration, and language can be studied prior to substantial reorganization.

Original languageEnglish (US)
Pages (from-to)581-593
Number of pages13
JournalJournal of Neurosurgery
Volume123
Issue number3
DOIs
StatePublished - Sep 1 2015

Fingerprint

Aphasia
Language
Frontal Lobe
Temporal Lobe
Prefrontal Cortex
Blood Vessels
Cohort Studies
Prospective Studies
Incidence

Keywords

  • Aphasia
  • Resective surgery
  • Voxel-based lesion-symptom mapping

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)
  • Clinical Neurology

Cite this

Wilson, S. M., Lam, D., Babiak, M. C., Perry, D. W., Shih, T., Hess, C. P., ... Chang, E. F. (2015). Transient aphasias after left hemisphere resective surgery. Journal of Neurosurgery, 123(3), 581-593. https://doi.org/10.3171/2015.4.JNS141962

Transient aphasias after left hemisphere resective surgery. / Wilson, Stephen M; Lam, Daniel; Babiak, Miranda C.; Perry, David W.; Shih, Tina; Hess, Christopher P.; Berger, Mitchel S.; Chang, Edward F.

In: Journal of Neurosurgery, Vol. 123, No. 3, 01.09.2015, p. 581-593.

Research output: Contribution to journalArticle

Wilson, SM, Lam, D, Babiak, MC, Perry, DW, Shih, T, Hess, CP, Berger, MS & Chang, EF 2015, 'Transient aphasias after left hemisphere resective surgery', Journal of Neurosurgery, vol. 123, no. 3, pp. 581-593. https://doi.org/10.3171/2015.4.JNS141962
Wilson, Stephen M ; Lam, Daniel ; Babiak, Miranda C. ; Perry, David W. ; Shih, Tina ; Hess, Christopher P. ; Berger, Mitchel S. ; Chang, Edward F. / Transient aphasias after left hemisphere resective surgery. In: Journal of Neurosurgery. 2015 ; Vol. 123, No. 3. pp. 581-593.
@article{f940c4d8c568479bbe101e27ca2765a3,
title = "Transient aphasias after left hemisphere resective surgery",
abstract = "Object Transient aphasias are often observed in the first few days after a patient has undergone resection in the language-dominant hemisphere. The aims of this prospective study were to characterize the incidence and nature of these aphasias and to determine whether there are relationships between location of the surgical site and deficits in specific language domains. Methods One hundred ten patients undergoing resection to the language-dominant hemisphere participated in the study. Language was evaluated prior to surgery and 2-3 days and 1 month postsurgery using the Western Aphasia Battery and the Boston Naming Test. Voxel-based lesion-symptom mapping was used to identify relationships between the surgical site location assessed on MRI and deficits in fluency, information content, comprehension, repetition, and naming. Results Seventy-one percent of patients were classified as aphasic based on the Western Aphasia Battery 2-3 days postsurgery, with deficits observed in each of the language domains examined. Fluency deficits were associated with resection of the precentral gyrus and adjacent inferior frontal cortex. Reduced information content of spoken output was associated with resection of the ventral precentral gyrus and posterior inferior frontal gyrus (pars opercularis). Repetition deficits were associated with resection of the posterior superior temporal gyrus. Naming deficits were associated with resection of the ventral temporal cortex, with midtemporal and posterior temporal damage more predictive of naming deficits than anterior temporal damage. By 1 month postsurgery, nearly all language deficits were resolved, and no language measure except for naming differed significantly from its presurgical level. Conclusions These findings show that transient aphasias are very common after left hemisphere resective surgery and that the precise nature of the aphasia depends on the specific location of the surgical site. The patient cohort in this study provides a unique window into the neural basis of language because resections are discrete, their locations are not limited by vascular distribution or patterns of neurodegeneration, and language can be studied prior to substantial reorganization.",
keywords = "Aphasia, Resective surgery, Voxel-based lesion-symptom mapping",
author = "Wilson, {Stephen M} and Daniel Lam and Babiak, {Miranda C.} and Perry, {David W.} and Tina Shih and Hess, {Christopher P.} and Berger, {Mitchel S.} and Chang, {Edward F.}",
year = "2015",
month = "9",
day = "1",
doi = "10.3171/2015.4.JNS141962",
language = "English (US)",
volume = "123",
pages = "581--593",
journal = "Journal of Neurosurgery",
issn = "0022-3085",
publisher = "American Association of Neurological Surgeons",
number = "3",

}

TY - JOUR

T1 - Transient aphasias after left hemisphere resective surgery

AU - Wilson, Stephen M

AU - Lam, Daniel

AU - Babiak, Miranda C.

AU - Perry, David W.

AU - Shih, Tina

AU - Hess, Christopher P.

AU - Berger, Mitchel S.

AU - Chang, Edward F.

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Object Transient aphasias are often observed in the first few days after a patient has undergone resection in the language-dominant hemisphere. The aims of this prospective study were to characterize the incidence and nature of these aphasias and to determine whether there are relationships between location of the surgical site and deficits in specific language domains. Methods One hundred ten patients undergoing resection to the language-dominant hemisphere participated in the study. Language was evaluated prior to surgery and 2-3 days and 1 month postsurgery using the Western Aphasia Battery and the Boston Naming Test. Voxel-based lesion-symptom mapping was used to identify relationships between the surgical site location assessed on MRI and deficits in fluency, information content, comprehension, repetition, and naming. Results Seventy-one percent of patients were classified as aphasic based on the Western Aphasia Battery 2-3 days postsurgery, with deficits observed in each of the language domains examined. Fluency deficits were associated with resection of the precentral gyrus and adjacent inferior frontal cortex. Reduced information content of spoken output was associated with resection of the ventral precentral gyrus and posterior inferior frontal gyrus (pars opercularis). Repetition deficits were associated with resection of the posterior superior temporal gyrus. Naming deficits were associated with resection of the ventral temporal cortex, with midtemporal and posterior temporal damage more predictive of naming deficits than anterior temporal damage. By 1 month postsurgery, nearly all language deficits were resolved, and no language measure except for naming differed significantly from its presurgical level. Conclusions These findings show that transient aphasias are very common after left hemisphere resective surgery and that the precise nature of the aphasia depends on the specific location of the surgical site. The patient cohort in this study provides a unique window into the neural basis of language because resections are discrete, their locations are not limited by vascular distribution or patterns of neurodegeneration, and language can be studied prior to substantial reorganization.

AB - Object Transient aphasias are often observed in the first few days after a patient has undergone resection in the language-dominant hemisphere. The aims of this prospective study were to characterize the incidence and nature of these aphasias and to determine whether there are relationships between location of the surgical site and deficits in specific language domains. Methods One hundred ten patients undergoing resection to the language-dominant hemisphere participated in the study. Language was evaluated prior to surgery and 2-3 days and 1 month postsurgery using the Western Aphasia Battery and the Boston Naming Test. Voxel-based lesion-symptom mapping was used to identify relationships between the surgical site location assessed on MRI and deficits in fluency, information content, comprehension, repetition, and naming. Results Seventy-one percent of patients were classified as aphasic based on the Western Aphasia Battery 2-3 days postsurgery, with deficits observed in each of the language domains examined. Fluency deficits were associated with resection of the precentral gyrus and adjacent inferior frontal cortex. Reduced information content of spoken output was associated with resection of the ventral precentral gyrus and posterior inferior frontal gyrus (pars opercularis). Repetition deficits were associated with resection of the posterior superior temporal gyrus. Naming deficits were associated with resection of the ventral temporal cortex, with midtemporal and posterior temporal damage more predictive of naming deficits than anterior temporal damage. By 1 month postsurgery, nearly all language deficits were resolved, and no language measure except for naming differed significantly from its presurgical level. Conclusions These findings show that transient aphasias are very common after left hemisphere resective surgery and that the precise nature of the aphasia depends on the specific location of the surgical site. The patient cohort in this study provides a unique window into the neural basis of language because resections are discrete, their locations are not limited by vascular distribution or patterns of neurodegeneration, and language can be studied prior to substantial reorganization.

KW - Aphasia

KW - Resective surgery

KW - Voxel-based lesion-symptom mapping

UR - http://www.scopus.com/inward/record.url?scp=84965089599&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84965089599&partnerID=8YFLogxK

U2 - 10.3171/2015.4.JNS141962

DO - 10.3171/2015.4.JNS141962

M3 - Article

C2 - 26115463

AN - SCOPUS:84965089599

VL - 123

SP - 581

EP - 593

JO - Journal of Neurosurgery

JF - Journal of Neurosurgery

SN - 0022-3085

IS - 3

ER -