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Abstract Details

Characterization, Evaluation, Diagnosis, and Treatment of Tumor-related Aphasia: A Scoping Review
Neuro-oncology
P6 - Poster Session 6 (5:00 PM-6:00 PM)
6-009
To systematically examine the characterization, diagnostic approaches, and therapeutic interventions for tumor-related aphasia (TRA).
TRA affects 30-48% of patients with gliomas and significantly impacts quality of life. There are no scoping reviews, to our knowledge, addressing TRA across the disease trajectory.
Following JBI and PRISMA guidelines, we searched six biomedical databases through June 2025. We included primary studies, reviews, and case reports addressing TRA characterization, evaluation, diagnosis, and treatment. Two independent reviewers performed full-text screening with substantial inter-rater reliability (Cohen's κ=0.78, proportionate agreement=0.91), with a third reviewer reconciling disagreements.
Of the 4,345 articles from our search, 163 studies met study eligibility criteria. Most addressed TRA characterization (48%) or diagnostic and surgical planning (33%), while fewer described treatment and rehabilitation (11%) and surgical principles (8%). Study designs comprised predominantly case reports and case series (33%), retrospective cohorts (17%), and narrative reviews (22%), with only three prospective cohort studies (17%). Stroke-based assessments underestimate TRA, detecting aphasia in only 27% of patients compared with 77% identified by neuropsychological batteries. Tumor biology, particularly growth rate and molecular signatures, contributes to compensatory capacity: low-grade gliomas are associated with lesser deficits, while rapidly proliferating tumors resemble stroke-like deficits. Diagnostic approaches have evolved from anatomical mapping to multimodal assessment integrating functional MRI, transcranial magnetic stimulation, and diffusion tensor imaging; awake intraoperative mapping remains the gold standard. Modern surgical approaches prioritize preserving functional network connectivity. Treatment involves early, intensive speech therapy averaging 8.8 hours weekly. One editorial outlined a novel augmentative and alternative communication tool tailored to TRA combining large language models and eye gaze tracking technology. TRA rarely occurs in isolation, typically presenting with broader cognitive impairments, seizures, and medication effects.
TRA represents a distinct entity shaped by neuroplasticity, demanding tumor-specific assessments, network-based surgical strategies, and dynamically adapted rehabilitation integrated with oncological treatment throughout the disease trajectory.
Authors/Disclosures
Paul Miller, Research Assistant
PRESENTER 		Mr. Miller has received personal compensation for serving as an employee of Hillsdale College.
Alexander Finnemore, Medical Student Mr. Finnemore has nothing to disclose.
Maria Thereza Paulino Miss Paulino has nothing to disclose.
Justin Vinh, BS Mr. Vinh has received research support from National Cancer Institute. Mr. Vinh has received research support from University of Virginia.
Amy J. Maguire, PhD (Massachusetts General Hospital) Dr. Maguire has received research support from Baker Family Initiative for Transforming Patient Experience and Outcomes at MGH. The institution of Dr. Maguire has received research support from NIMH. Dr. Maguire has received research support from NICHD.
Rupal Patel, PhD Prof. Patel has nothing to disclose.
David Caplan, MD, PhD Dr. Caplan has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for matteuzzi. Dr. Caplan has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Matteuzzi Law.
carrie G. Wade, MLIS Ms. Wade has nothing to disclose.
James Tulsky, MD Dr. Tulsky has nothing to disclose.
Alexi A. Wright, MD Dr. Wright has received personal compensation in the range of $500-$4,999 for serving as a Consultant for ConcertAI. Dr. Wright has received personal compensation in the range of $0-$499 for serving as a Consultant for Cancer Support Community. Dr. Wright has stock in Microsoft. The institution of Dr. Wright has received research support from National Cancer Institute.
Charlotta Lindvall, MD, PhD The institution of Dr. Lindvall has received research support from National Institutes of Health.
John Y. Rhee, MD, MPH (Dana Farber Cancer Institute, Harvard Medical School) Dr. Rhee has stock in NTAP. Dr. Rhee has stock in TSLA. Dr. Rhee has stock in BABA. Dr. Rhee has stock in ZM. Dr. Rhee has stock in GM. Dr. Rhee has stock in PFF. Dr. Rhee has stock in AMZN. Dr. Rhee has stock in META. Dr. Rhee has stock in GE. The institution of Dr. Rhee has received research support from 好色先生. Dr. Rhee has received personal compensation in the range of $0-$499 for serving as a Director of the Hippocratic Forum with Hippocratic Society.