039-23 – Postoperative language changes following awake craniotomy for glioma resection: examining lexical retrieval speed and accuracy in object naming and action naming with finite verbs

Introduction: Low-grade glioma (LGG) patients undergoing awake surgery (AS) are screened with aphasia tests designed for assessment of severe language impairments in stroke (e.g., Broca’s aphasia). Based on accuracy (AC) measures alone, these tasks cannot capture subtler retrieval difficulties (e.g., delays); consequently, LGG patients who perform tasks with minimal errors may be deemed clinically unimpaired, despite language processing delays. The aim of the present study was to further understand the LGG language profile by examining both reaction time (RT) and AC on speeded picture naming tasks. Methods: Three patients (RS, GD, and MW) undergoing AS for LGG resection were recruited from the Walton Centre NHS Trust. Patients completed speeded object naming (ON) and past/present tense action naming with finite verbs (ANFV) at three timepoints (preoperative, postoperative, and 3-month follow-up). Using a case-control design, patient performance (AC and RT) was compared to that of healthy matched control groups. Results: The results demonstrated both improvement and decline in RT and AC compared to preoperative baseline in different patients and tasks over the postoperative course. However, RTs were more frequently impaired than AC across tasks relative to control performance in frontal (RS) and temporal (MW) cases. Performance on ANFV appeared to be worse than ON, with MW and RS producing significantly more errors. Conclusions: in agreement with recent evidence suggesting that the LGG language profile reflects a generalised decline of language abilities, reduced RT relative to AC may be a key feature of this profile both pre- and postoperatively. However, AC impairments may be more prominent when the cognitive load is higher (e.g., ANFV). More sensitive linguistic testing using RT measures and tasks with higher cognitive demand will improve the ability to capture subtle language deficits in LGG patients before and after surgery.