Language in individuals with left hemisphere tumors: Is spontaneous speech analysis comparable to formal testing?

ABSTRACT

Background: The relationship between spontaneous speech and formal language testing in people with brain tumors (gliomas) has been rarely studied. In clinical practice, formal testing is typically used, while spontaneous speech is less often evaluated quantitatively. However, spontaneous speech is quicker to sample and may be less prone to test/retest effects, making it a potential candidate for assessing language impairments when there is restricted time or when the patient is unable to undertake prolonged testing.

Aim: To assess whether quantitative spontaneous speech analysis and formal testing detect comparable language impairments in people with gliomas. Specifically, we addressed (a) whether both measures detected comparable language impairments in our patient sample; and (b) which language levels, assessment times, and spontaneous speech variables were more often impaired in this subject group.

Method: Five people with left perisylvian gliomas performed a spontaneous speech task and a formal language assessment. Tests were administered before surgery, within a week after surgery, and seven months after surgery. Performance on spontaneous speech was compared with that of 15 healthy speakers.

Results: Language impairments were detected more often with both measures than with either measure independently. Lexical–semantic impairments were more common than phonological and grammatical impairments, and performance was equally impaired across assessment time points. Incomplete sentences and phonological paraphasias were the most common error types.

Conclusions: In our sample both spontaneous speech analysis and formal testing detected comparable language impairments. Currently, we suggest that formal testing remains overall the better option, except for cases in which there are restrictions on testing time or the patient is too tired to undergo formal testing. In these cases, spontaneous speech may provide a viable alternative, particularly if automated analysis of spontaneous speech becomes more readily available in the future. These results await replication in a bigger sample and/or other populations.

KEYWORDS:

• Aphasia
• brain tumor
• glioma
• language assessment
• spontaneous speech

Acknowledgments

We express our gratitude to Monica Ricci, Giovanna Cappelletti, Vânia de Aguiar, German Kruszewski, Marco Baroni, and Claudio Bendazzoli for help and comments at different stages of this project.

Disclosure statement

The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Supplemental material

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Additional information

Funding

This work was supported by PAT (Provincia Autonoma di Trento) to G.M.; Fondazione CaRiTRO (Cassa di Risparmio di Trento e Rovereto) to G.M.; the Erasmus Mundus PhD Program IDEALAB (Macquarie University, Newcastle University, University of Groningen, University of Trento and University of Potsdam [agreement number 2014-0025]; the Global Brain Health Institute (Trinity College Dublin and University of California, San Francisco); a Cognitive Science Postgraduate Grant from Macquarie University to A.R.; and an Australian Research Council Future Fellowship [grant number FT120100102] to L.N.