Language deficits following dominant hemisphere tumour resection are significantly underestimated by syndrome-based aphasia assessments

Background: In assessing post-operative language impairment, clinical teams typically rely on aphasia subtype classifications, based on post-stroke patterns of impairment. However, this approach may significantly underestimate the prevalence of post-surgical language impairments due to the different pathophysiological mechanisms involved. There is a paucity of research in chronic post-surgical patients. Aims: We investigated post-surgical language performance in the chronic phase. Methods & Procedures: Using both the Western Aphasia battery Revised (WAB-R) and the Comprehensive Aphasia test (CAT), we assessed a range of language skills in 26 right-handed patients approximately 6-12 months after they underwent surgery to remove a primary tumour in their left cerebral hemisphere. Participants' self-reports of their speech and language skills post-surgery were also collected. Outcomes and Results: Following surgery, 77% of patients scored below normal cut-off on one or more language subtests of the CAT battery. This contrasted with only 27% on the WAB AQ. The CAT findings were supported by subjective data, with 58% of patients self-reporting post-surgical communication difficulty. Conclusions: Our results show that current aphasia subtype testing is inadequate, and is likely to significantly underestimate chronic language deficits in this population. Alternative approaches to formal language assessment need to be used in this group of patients whose pattern of impairments is very different from that observed in post-stroke aphasia.