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Usability and validity of a phone battery to assess language functions in brain tumor patients undergoing awake surgery

Elke De Witte1, 2*, Vitória Piai3, Mitchel Berger4 and Nina F. Dronkers5
  • 1 UCSF Medical Center, Department of Neurological Surgery/Center for Aphasia and Related Disorders, United States
  • 2 Vrije Universiteit Brussel, Department of Clinical and Experimental Neurolinguistics, Belgium
  • 3 University of California Berkeley, Knight Lab, United States
  • 4 UCSF Medical Center, Department of Neurological Surgery, United States
  • 5 Veterans Affairs Northern California Health Care System, Center for Aphasia and Related Disorders, United States

INTRODUCTION: Awake surgery in eloquent brain regions is performed to preserve language functions. Although in general no major permanent language deficits are found after awake brain surgery, clinically relevant impairments are detected and language recovery takes longer than generally assumed (3 months) (Satoer et al., 2014). Unfortunately, follow-up of tumor patients in the San Francisco (California) area is difficult since most patients are not local and come from far. Therefore, we developed a short language phone battery for pre- and postoperative language assessments. METHODS: The study is divided into 2 phases. Phase 1: task and item selection of the phone battery. The development of the phone battery was based on the short Dutch Linguistic Intraoperative Protocol (De Witte et al., 2015) and existing standardized English batteries. Two parallel versions were composed and tested in healthy native English speakers. The test items were controlled for linguistic variables such as word frequency, imageability, word length, morphological and phonological form. Phase 2: clinical use of the phone battery in tumor patients. The phone battery was administered in a group of 10 tumor patients before surgery and at 1 week after surgery. Follow-up test moments at 1 month and 3 months postsurgery are planned. These patient data will be compared with language data collected in a group of 10 age/education matched controls. In addition, for most patients in-person language assessments were conducted as well, as such a comparison can be made between the language data from the phone battery and the in-person language data. RESULTS: Phase 1: The phone test battery includes phonological, semantic and syntactic tests (auditory verbal comprehension, repetition of words/sentences, semantic noun/verb selection, sentence completion, story completion) as well as a verbal naming test (adapted from Yochim et al., 2015) and fluency tests (letter/category fluency). It takes less than 20 minutes to administer (7 short tests in total). The healthy participants had no difficulty performing any of the seven language tests via the phone, attesting to the feasibility of a phone assessment. Phase 2: In the tumor group wordfinding, phonological and fluency problems were found at 1 week postsurgery. Longer follow-up data from the phone battery will be analysed and compared with the in-person assessments. The results of this pilot study will provide valuable information with regard to the validity of this phone battery in the tumor population. DISCUSSION: The use of telephone batteries to conduct language assessments from afar can provide convenience, reduce costs (for traveling), and optimise patient care as assessment services might be unavailable locally. If the validity of the test battery appears to be high the phone assessment can be used for various clinical and scientific purposes. With the advances in technology, our future studies will focus on developing reliable camera and web based assessments, which will become important adjuncts to phone assessments.

References

De Witte, E., Satoer, D., Robert, E., Colle, H., Verheyen, S., Visch-Brink, E., & Mariën, P. (2015). The Dutch Linguistic Intraoperative Protocol: A valid linguistic approach to awake brain surgery. Brain and Language, 140, 35–48.
Satoer, D., Visch-Brink, E., Smits, M., Kloet, A., Looman, C., Dirven, C., & Vincent, A. (2014). Long-term evaluation of cognition after glioma surgery in eloquent areas. Journal of Neuro-Oncology, 116(1), 153–160.
Yochim, B. P., Beaudreau, S. A., Kaci Fairchild, J., Yutsis, M. V., Raymond, N., Friedman, L., & Yesavage, J. (2015). Verbal naming test for use with older adults: development and initial validation. Journal of the International Neuropsychological Society: JINS, 21(3), 239–248.

Keywords: phone assessment, Language Tests, awake brain surgery, Aphasia, brain tumor patients

Conference: 54th Annual Academy of Aphasia Meeting, Llandudno, United Kingdom, 16 Oct - 18 Oct, 2016.

Presentation Type: Poster Sessions

Topic: Academy of Aphasia

Citation: De Witte E, Piai V, Berger M and Dronkers NF (2016). Usability and validity of a phone battery to assess language functions in brain tumor patients undergoing awake surgery. Front. Psychol. Conference Abstract: 54th Annual Academy of Aphasia Meeting. doi: 10.3389/conf.fpsyg.2016.68.00136

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Received: 01 May 2016; Published Online: 15 Aug 2016.

* Correspondence: Dr. Elke De Witte, UCSF Medical Center, Department of Neurological Surgery/Center for Aphasia and Related Disorders, San Francisco, United States, elkedewitte@gmail.com