The Dutch Linguistic Intraoperative Protocol: a valid linguistic approach to awake brain surgery

Brain Lang. 2015 Jan:140:35-48. doi: 10.1016/j.bandl.2014.10.011. Epub 2014 Dec 17.

Abstract

Intraoperative direct electrical stimulation (DES) is increasingly used in patients operated on for tumours in eloquent areas. Although a positive impact of DES on postoperative linguistic outcome is generally advocated, information about the neurolinguistic methods applied in awake surgery is scarce. We developed for the first time a standardised Dutch linguistic test battery (measuring phonology, semantics, syntax) to reliably identify the critical language zones in detail. A normative study was carried out in a control group of 250 native Dutch-speaking healthy adults. In addition, the clinical application of the Dutch Linguistic Intraoperative Protocol (DuLIP) was demonstrated by means of anatomo-functional models and five case studies. A set of DuLIP tests was selected for each patient depending on the tumour location and degree of linguistic impairment. DuLIP is a valid test battery for pre-, intraoperative and postoperative language testing and facilitates intraoperative mapping of eloquent language regions that are variably located.

Keywords: Awake surgery; Brain tumour; Corticosubcortical mapping; Direct electrical stimulation; Intraoperative language testing; Language mapping; Standardised test battery.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brain / anatomy & histology
  • Brain / physiology
  • Brain / physiopathology
  • Brain Mapping*
  • Brain Neoplasms / surgery*
  • Case-Control Studies
  • Electric Stimulation
  • Female
  • Humans
  • Language Tests* / standards
  • Linguistics*
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Models, Biological
  • Monitoring, Intraoperative / methods*
  • Netherlands
  • Neuropsychological Tests
  • Reproducibility of Results
  • Semantics
  • Wakefulness / physiology*
  • Young Adult