Precision in long-term language evaluation after awake brain tumor surgery

Background Language deficits caused by gliomas can persist beyond the short-term, and should not be overlooked due to their influence on a patient’s quality of life. The aim of this study was to investigate language impairments and long-term outcome after awake surgery. Methods The Diagnostic Instrument for Mild Aphasia (DIMA) and traditional language tests were administered preoperatively (T1; n=79), and 3 (T2; n=68) and 12 months (T3; n=35) postoperatively in the groups of patients with less (Group 1) and more (Group 2) invasive brain tumors. Results Preoperative deficits were found with DIMA at the level of lexico-syntax in Group 1 in both hemispheres and at the level of phonology and lexico-syntax in Group 2. With traditional language tests, preoperative deficits were detected at the level of word retrieval and verbal fluency in all groups. Only DIMA revealed long-term mild language impairments, which were observed at the phonological and semantic level in patients with left-hemispheric tumors, and at the lexico-syntactic level in those with right-hemispheric tumors. Conclusions In this cohort mild language impairments were noted long-term with DIMA across different linguistic levels, irrespective of hemispheric tumor location. Alongside the traditional language tests, DIMA represents a valuable addition for the diagnostic evaluation of language impairments in patients with gliomas.