Date of Award:


Document Type:


Degree Name:

Master of Science (MS)


Communicative Disorders and Deaf Education

Committee Chair(s)

Lisa Milman


Lisa Milman


Joann Tschanz


Ronald Gillam


Randy Jensen


Awake craniotomy and language assessment procedures for brain tumor survivors can drastically affect patient outcomes and quality of life. The goal of intra-operative language mapping is to help preserve vital communicative functions. However, there is currently no standardized set of measures for intra-operative language assessment. This systematic review identified behavioral language measures used during intra-operative procedures and the resulting outcomes for adult brain tumor patients, with the aim of helping clinicians and researchers select intra-operative language assessments supported by the highest levels of evidence.

PRISMA guidelines were used to systematically identify articles. Patient demographic and medical information, neuroimaging data, intra-operative language assessment measures, language outcomes, and quality of evidence data was obtained using a data extraction manual and form. Descriptive methods were used for synthesis of the information.

The nineteen identified articles included a total of 471 patients with a variety of tumor types and tumor severity. Direct electrical stimulation (DES) was used across all studies, with a few utilizing supplemental neuroimaging methods. Across studies, 37 language measures were used peri-operatively to assess 21 different language domains, and 26 language measures were used intra-operatively to assess 18 different language domains. The majority of patients (88%) reported as working prior to resection were able to return to work. Eight studies were classified as American Academy of Neurology (AAN) evidence level 3, ten studies as evidence level 2, and one study as evidence level 1. Discussion: This review supports awake language mapping during tumor resection and identifies the most widely used measures and associated language outcomes during post-operative stages. Further research is needed to establish best practice for selecting intra-operative assessments best suited for individual patient needs.