Social cognition and language in patients with gliomas: putting feelings into words?

Patients with gliomas often suffer from lower quality of life, and detrimental
social interactions after diagnosis. Two cognitive processes are crucial for
maintaining healthy social relationships and interacting with others: social
cognition and language. Social cognition is the ability to recognize and
process mental and emotional states and to react appropriately in social
situations. Social cognition and language are separate cognitive functions that
can be affected in different ways in patients with brain injury. Also, distinct
cognitive measurement instruments are used to assess both processes. However,
there appears to be a certain overlap between social cognition and language.
Reacting adequately in social situations requires both verbal and non-verbal
communication and to communicate feelings, thoughts and intentions, people
often use language. That is, verbal communication is part of a symbolic system
that makes social interaction possible. Therefore, language abilities seem to
be important to social cognition.

Research shows that language is frequently impaired in adult patients with
gliomas. Importantly, recent evidence suggests that social cognition can also
be impaired in this patient group. However, no studies have been conducted into
the influence of language on social cognition in patients with gliomas.
Increasing knowledge on the influence of language difficulties on social
cognition, will improve diagnostic accuracy. Eventually, this will lead to
better, tailor-made treatments for these problems that negatively affect daily
functioning.

The main research objective is to examine the influence of language impairments
on social cognition (emotion recognition, Theory of Mind (ToM) and affective
empathy), in patients with (suspected) gliomas.

Secondary objectives are
1) to determine if patients with gliomas show impairments in different aspects
of social cognition, i.e. emotion recognition, ToM, empathy and self-awareness;
2) to assess specific language impairments by looking at item-level
characteristics of language tasks (e.g., analyses of word properties of fluency
tasks, errors during object naming or spontaneous speech);
3) to determine which tumor characteristics (low- or high-grade, genetic
mutation, tumor location and volume) are associated with different aspects of
language and social cognition.

Cross-sectional study, data collected 1 to 3 weeks pre-operatively.

The proposed study is an observational study with no known health risks. At
present, a neuropsychological assessment (NPA) is already part of routine
clinical care for all patients with low-grade gliomas referred for surgery. For
these patients, a few tests (2 for social cognition and 3 for language) will be
added to this routine clinical NPA. Thus: only for the patients with high-grade
gliomas referred for surgery, the proposed tests will be an addition to routine
clinical care. The NPA will take a maximum of three hours. The NPA can
potentially be tiring for patients. However, patients will be able to take
breaks in between and an experienced neuropsychologist will supervise the NPA,
thus patients* energetic status and well-being will be carefully monitored. The
neuropsychologists on the department of Neurology/Neurosurgery, unit
Neuropsychology, have ample experience regarding NPA in patients with gliomas.
Overall, it can be concluded that the majority of patients are able to undergo
a NPA of maximum 3 hours, without adverse consequences. There are no direct
benefits for the individual patient from participation. Increasing knowledge
on the overlap between both functions and the relationship with certain tumor
characteristics, will improve diagnostic accuracy and eventually lead to
better, tailor-made treatments for language and behavioral problems that
negatively affect daily functioning.