Researchers from the HSE Language and Brain Center worked with Russian doctors to address the differences between symptoms of post-stroke aphasia and aphasia caused by glioma surgery. Postoperative patients show moderately severe speech disturbances that affect all aspects of language processing simultaneously. Understanding these differences will help clinicians develop more effective treatments for speech disorders caused by surgical removal of gliomas. The results of the study were published in The brain and language.
Aphasia is an acquired speech disorder. People with aphasia lose the ability to understand speech, read, speak and write. Aphasia can be caused by brain damage, including strokes, brain injuries, and glioma surgery (a glioma is a brain tumor that arises from glial cells). Doctors diagnose these diseases based on clinical symptoms, neuropsychological study data, computer tomography (CT) and magnetic resonance imaging (MRI). There is no cure for aphasia, but speech therapy and neuropsychotherapy can help restore speech faster, thus improving the patient’s quality of life.
Most studies of speech disorders have been conducted in patients who have had a stroke. Symptoms of speech disorder in post-stroke aphasia vary greatly, but can be categorized into a group of syndromes (or range of symptoms). Each syndrome centers around a primary deficit that causes symptoms of the disorder. For example, sensory aphasia syndrome can be detected by symptoms of a speech comprehension disorder, when the patient is unable to distinguish similar sounds (eg “b” and “p”). This occurs because sensory aphasia is based on a primary deficit: impaired vocal discrimination.
Researchers have diagnosed speech disorders among post-stroke and postoperative patients using the Russian Aphasia Test, a diagnostic test for individuals with aphasia. It was developed by researchers from the HSE Center for Language and Brain and the Center for Speech Pathology and Neurological Rehabilitation. The test makes it possible to determine the profile of a language impairment both qualitatively and quantitatively, as well as to determine the type and severity of aphasia.
The paper’s authors then performed a cluster analysis of the data using the K-mean method. The analysis showed that patients with glioma after surgery rarely display a voice deficit (speech sound processing disorder) independently without affecting other aspects of speech. This is not the case with patients with post-stroke aphasia, who show specific vocal deficits. The researchers also found that in individuals who underwent surgery for glioma, impairments of absolutely all aspects of speech correlate with each other, while in cases of post-stroke aphasia, only the aspects most closely related to speech processing (such as understanding sentences) are impaired. texts, or repeating sounds and words). The authors attribute these differences to a reorganization of the speech system in patients with glioma.
Andrey Zyryanov, co-author of the paper and junior research fellow at the HSE Center for Language and Brain, says, “This condition can develop over a period of a few months or years. Despite the fact that gliomas grow to large sizes, patients usually present either no Speech disturbances are present before surgery or only minor disturbances. This means that as the glioma slowly grows, the speech system is reorganized. Surgery for glioma impairs the processes of the reorganized speech system.”
The newly published study shows that aphasia syndromes after glioma surgery differ from those after stroke. In most cases, patients who have undergone brain surgery show moderate-intensity speech disorders that involve not one specific aspect of speech processing, but all aspects simultaneously.
We have called the observed syndrome “moderate global aphasia.” The lack of specificity of disabilities is what distinguishes postoperative aphasia from post-stroke aphasia. It is essential to understand these differences in order to provide effective speech therapy to patients. That is why we analyzed these differences in more detail,” Zyryanov says.
The researchers highlight that the effectiveness of speech therapy is usually tested in patients with post-stroke aphasia. However, aphasia after glioma surgery presents differently. This is why effective speech-repair methods for patients with one type of aphasia can fail (or work less effectively) in the other. That is why it is necessary to research new methods and try them on patients with different types of aphasia.
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Andrey Zyryanov et al., ‘Moderate global aphasia’: a general decrease in language processing caused by glioma surgery, not stroke, The brain and language (2021). DOI: 10.1016 / j.bandl.2021.105057
Provided by the National Research University Higher School of Economics
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