Connected speech in transient aphasias after left hemisphere resective surgery.
Angelica McCarron, Ashley Chavez, Miranda Babiak and 3 others
PMID 29056810WHAT IT FOUND
Within 2-3 days after left hemisphere resection, all 10 connected speech measures worsened in the 29 patients with aphasia; by 1 month most improved, but phonological errors and lexical access remained above pre-surgery levels.
Key findings
01At 2-3 days after surgery, all 10 connected speech measures showed statistically significant impairment, and WAB Aphasia Quotient and Boston Naming Test scores declined.
02Among 14 patients who did not meet WAB criteria for aphasia at 2-3 days after surgery, no connected speech or standard language measure showed a statistically significant change after the researchers adjusted for the many comparisons they made.
03At 1 month, follow-up testing in 24 of 29 patients with acute aphasia showed statistically significant improvement on 8 of 10 connected speech measures, but phonological errors and lexical access difficulties were still higher than before surgery.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Speech samples were short picture descriptions, and many were below the 150-word level generally recommended for reliable connected speech analysis. One-month follow-up was obtained for 24 of 29 patients with acute aphasia, but not for the 14 patients without acute aphasia, so residual deficits in the whole cohort could not be precisely quantified. The study did not compare connected speech changes by surgical site or etiology, so it cannot say which resections cause which patterns. CHAT coding collapsed some related impairments and did not distinguish agrammatism from paragrammatism, and transcription involved subjective decisions. The sample was limited to native English speakers with left hemisphere language dominance who had complete data; 36 of 79 consecutive eligible patients were excluded because required data were missing.
The easy way to misread this
Do not conclude that connected speech analysis reveals hidden deficits in patients who do not meet WAB aphasia criteria at 2-3 days after surgery. In the 14 such patients, none of the connected speech or standard language measures changed significantly after correction for multiple comparisons, and the speech samples were short.