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Background/Aims Fecal incontinence (FI) is a prevalent condition among community-dwelling women, and has a major impact on quality of life (QoL). Research on treatments commonly used in clinical practice―Kegel exercises, biofeedback, electrostimulation, and transcutaneous neuromodulation―give discordant results and some lack methodological rigor, making scientific evidence weak. The aim is to assess the clinical efficacy of these 4 treatments on community-dwelling women with FI and their impact on severity, QoL and anorectal physiology. Methods A randomized controlled trial was conducted on 150 females with FI assessed with anorectal manometry and endoanal ultrasonography, and pudendal nerve terminal motor latency, anal/rectal sensory-evoked-potentials, clinical severity, and QoL were determined. Patients were randomly assigned to one of the following groups: Kegel (control), biofeedback + Kegel, electrostimulation + Kegel, and neuromodulation + Kegel, treated for 3 months and re-evaluated, then followed up after 6 months. Results Mean age was 61.09 ± 12.17. Severity of FI and QoL was significantly improved in a similar way after all treatments. The effect on physiology was treatment-specific: Kegel and electrostimulation + Kegel, increased resting pressure (P < 0.05). Squeeze pressures strongly augmented with biofeedback + Kegel, electrostimulation + Kegel and neuromodulation + Kegel (P < 0.01). Endurance of squeeze increased in biofeedback + Kegel and electrostimulation + Kegel (P < 0.01). Rectal perception threshold was reduced in the biofeedback + Kegel, electrostimulation + Kegel, and neuromodulation + Kegel (P < 0.05); anal sensory-evoked-potentials latency shortened in patients with electrostimulation + Kegel (P < 0.05). Conclusions The treatments for FI assessed have a strong and similar efficacy on severity and QoL but affect specific pathophysiological mechanisms. This therapeutic specificity can help to develop more efficient multimodal algorithm treatments for FI based on pathophysiological phenotypes. (J Neurogastroenterol Motil 2021;27:108-118)

Background Animal fluency is a widely used task to assess people with Alzheimer's disease (AD) and other neurological disorders. The mechanisms that drive performance in this task are argued to rely on language and executive functions. However, there is little information regarding what specific aspects of these cognitive processes drive performance on this task. Objective To understand which aspects of language (i.e., semantics, phonological output lexicon, phonological assembly) and executive function (i.e., mental set shifting; information updating and monitoring; inhibition of possible responses) are involved in the performance of animal fluency in people with AD. Methods Animal fluency data from 58 people with probable AD from the DementiaBank Pittsburgh Corpus were analyzed. Number of clusters and switches were measured and nine word properties (e.g., frequency, familiarity) for each of the correct words (i.e., each word counting toward the total score, disregarding non-animals and repetitions) were determined. Random forests were used to understand which variables predicted the total number of correct words, and conditional inference trees were used to search for interactions between the variables. Finally, Wilcoxon tests were implemented to cross-validate the results, by comparing the performance of participants with scores below the norm in animal fluency against participants with scores within the norm based on a large normative sample. Results Switches and age of acquisition emerged as the most important variables to predict total number of correct words in animal fluency in people with AD. Cross-validating the results, people with AD whose animal fluency scores fell below the norm produced fewer switches and words with lower age of acquisition than people with AD with scores in the normal range. Conclusion The results indicate that people with AD rely on executive functioning (information updating and monitoring) and language (phonological output lexicon, not necessarily semantics) to produce words on animal fluency.

Background: CHEK2 variants are associated with intermediate breast cancer risk among other cancers. We aimed to comprehensively describe CHEK2 variants in a Spanish hereditary cancer (HC) cohort and adjust American College of Medical Genetics and Genomics and the Association for Molecular Pathology (ACMG-AMP) guidelines for their classification. Methods: First, three CHEK2 frequent variants were screened in a retrospective Hereditary Breast and Ovarian Cancer cohort of 516 patients. After, the whole CHEK2 coding region was analyzed by next-generation sequencing in 1,848 prospective patients with HC suspicion. We refined ACMGAMP criteria and applied different combinatorial rules to classify CHEK2 variants and define risk alleles. Results: We identified 10 CHEK2 null variants, 6 missense variants with discordant interpretation in ClinVar database, and 35 additional variants of unknown significance. Twelve variants were classified as (likely)-pathogenic; 2 can also be considered “established risk-alleles” and one as “likely risk-allele”. The prevalence of (likely)-pathogenic variants in the HC cohort was 0.8% (1.3% in breast cancer patients and 1.0% in hereditary non-polyposis colorectal cancer patients). Conclusions: Here we provide ACMG adjustment guidelines to classify CHEK2 variants. We hope that this work would be useful for variant classification of other genes with low effect variants

BACKGROUND Neurorehabilitation strategies for chronic poststroke (PS) oropharyngeal dysphagia (OD) have been mainly focused on the neurostimulation of the pharyngeal motor cortex with only marginal effects. In contrast, treatments targeting the PS oropharyngeal sensory pathway dysfunction offer very promising results, but there is little knowledge on the underlying mechanisms. We aimed to explore the neurophysiological mechanisms behind the effect of three sensory neurostimulation strategies. METHODS We carried out a randomized two-blinded parallel group's crossover sham-controlled clinical trial in 36 patients with unilateral stroke and chronic unsafe swallow to investigate the effect of repetitive transcranial magnetic stimulation (rTMS) of the primary sensory cortex (A), oral capsaicin (B) and intra-pharyngeal electrical stimulation (IPES; C). The effect was evaluated immediately after the interventions with videofluoroscopy (VFS) and motor/sensory evoked potentials (MEP/SEP). KEY RESULTS Interventions induced no changes in the biomechanics of the swallow response during VFS. However, an enhancement of motor cortex excitability (latency shortening and increased size of thenar MEP) was found with active interventions (A + B + C, and B/C alone; P

Background CHEK2 variants are associated with intermediate breast cancer risk among other cancers. We aimed to comprehensively describe CHEK2 variants in a Spanish hereditary cancer (HC) cohort and adjust American College of Medical Genetics and Genomics and the Association for Molecular Pathology (ACMG-AMP) guidelines for their classification. Methods First, three CHEK2 frequent variants were screened in a retrospective Hereditary Breast and Ovarian Cancer cohort of 516 patients. After, the whole CHEK2 coding region was analyzed by next-generation sequencing in 1,848 prospective patients with HC suspicion. We refined ACMG-AMP criteria and applied different combined rules to classify CHEK2 variants and define risk alleles. Results We identified 10 CHEK2 null variants, 6 missense variants with discordant interpretation in ClinVar database, and 35 additional variants of unknown significance. Twelve variants were classified as (likely)-pathogenic; two can also be considered "established risk-alleles" and one as "likely risk-allele". The prevalence of (likely)-pathogenic variants in the HC cohort was 0.8% (1.3% in breast cancer patients and 1.0% in hereditary non-polyposis colorectal cancer patients). Conclusions Here we provide ACMG adjustment guidelines to classify CHEK2 variants. We hope that this work would be useful for variant classification of other genes with low effect variants. This article is protected by copyright. All rights reserved.

RNA analyses are a potent tool to identify spliceogenic effects of DNA variants, although they are time-consuming and cannot always be performed. We present splicing assays of 20 variants that represent a variety of mutation types in 10 hereditary cancer genes and attempt to incorporate these results into American College of Medical Genetics and Genomics (ACMG) classification guidelines. Sixteen single-nucleotide variants, 3 exon duplications, and 1 single-exon deletion were selected and prioritized by in silico algorithms. RNA was extracted from short-term lymphocyte cultures to perform RT-PCR and Sanger sequencing, and allele-specific expression was assessed whenever possible. Aberrant transcripts were detected in 14 variants (70%). Variant interpretation was difficult, especially comparing old classification standards to generic ACMG guidelines and a proposal was devised to weigh functional analyses at RNA level. According to the ACMG guidelines, only 12 variants were reclassified as pathogenic/likely pathogenic because the other two variants did not gather enough evidence. This study highlights the importance of RNA studies to improve variant classification. However, it also indicates the challenge of incorporating these results into generic ACMG guidelines and the need to refine these criteria gene specifically. Nevertheless, 60% of variants were reclassified, thus improving genetic counseling and surveillance for carriers of these variants.

International audience; Frequently preserved in archaeological and palaeontological sites, the tiny size of small‐mammal remains favours percolations into underlying layers along stratigraphic sequences. This is one of the various post‐depositional processes that may affect the integrity of the original deposits and therefore the subsequent scientific interpretations. Recent developments in sample preparation offer the possibility of detecting intrusive episodes through the absolute dating of minute amounts of bone (down to 10 mg), meaning that isolated elements (such as mandibles in this case) are sufficient to obtain reliable radiocarbon dates if collagen is moderately to well preserved. The radiocarbon dates obtained here for small‐mammal bones (recovered from pre‐Bølling to recent deposits) and their comparison with previous dates obtained from other sources (large‐mammal bones, charcoal, botanical samples, etc.), with different protocols and instruments, illustrate the potential of small‐mammal dating to reveal (and eventually contribute a solution to) stratigraphical issues in different archaeological contexts.

Fanconi anemia (FA) is caused by biallelic mutations in FA genes. Monoallelic mutations in five of these genes (BRCA1, BRCA2, PALB2, BRIP1 and RAD51C) increase the susceptibility to breast/ovarian cancer and are used in clinical diagnostics as bona-fide hereditary cancer genes. Increasing evidence suggests that monoallelic mutations in other FA genes could predispose to tumor development, especially breast cancer. The objective of this study is to assess the mutational spectrum of 14 additional FA genes (FANCA, FANCB, FANCC, FANCD2, FANCE, FANCF, FANCG, FANCI, FANCL, FANCM, FANCP, FANCQ, FANCR and FANCU) in a cohort of hereditary cancer patients, to compare with local cancer-free controls as well as GnomAD. A total of 1021 hereditary cancer patients and 194 controls were analyzed using our next generation custom sequencing panel. We identified 35 pathogenic variants in eight genes. A significant association with the risk of breast cancer/breast and ovarian cancer was found for carriers of FANCA mutations (odds ratio (OR) = 3.14 95% confidence interval (CI) 1.4&ndash, 6.17, p = 0.003). Two patients with early-onset cancer showed a pathogenic FA variant in addition to another germline mutation, suggesting a modifier role for FA variants. Our results encourage a comprehensive analysis of FA genes in larger studies to better assess their role in cancer risk.

Background Oropharyngeal dysphagia (OD) treatment is moving away from compensatory strategies toward active treatments that improve swallowing function. The aim of this study was to assess the acute therapeutic effect of TRPA1/M8 agonists in improving swallowing function in OD patients. Methods Fifty-eight patients with OD caused by aging, stroke, or neurodegenerative disease were included in a three-arm, quadruple-blind, randomized clinical trial (NCT02193438). Swallowing safety and efficacy and the kinematics of the swallow response were assessed by videofluoroscopy (VFS) during the swallow of 182 ± 2 mPa·s viscosity (nectar) boluses of a xanthan gum thickener supplemented with (a) 756.6 μmol/L cinnamaldehyde and 70 μmol/L zinc (CIN-Zn) (TRPA1 agonists), (b) 1.6 mmol/L citral (CIT) (TRPA1 agonist), or (c) 1.6 mmol/L citral and 1.3 mmol/L isopulegol (CIT-ISO) (TRPA1 and TRPM8 agonists). The effects on pharyngeal event-related potentials (ERP) were assessed by electroencephalography. Key results TRPA1 stimulation with either CIN-Zn or CIT reduced time to laryngeal vestibule closure (CIN-Zn P = .002, CIT P = .023) and upper esophageal sphincter opening (CIN-Zn P = .007, CIT P = .035). In addition, CIN-Zn reduced the penetration-aspiration scale score (P = .009), increased the prevalence of safe swallows (P = .041), and reduced the latency of the P2 peak of the ERP. CIT-ISO had no positive effect on biomechanics or neurophysiology. No significant adverse events were observed. Conclusions and inferences TRPA1 stimulation with CIN-Zn or CIT improves the swallow response which, in the case of CIN-Zn, is associated with a significant improvement in cortical activation and safety of swallow. These results provide the basis for the development of new active treatments for OD using TRPA1 agonists.

CHEK2variants are associated with intermediate breast cancer risk, among other cancers. We aimed to comprehensively describeCHEK2variants in a Spanish hereditary cancer (HC) cohort and adjust the American College of Medical Genetics and Genomics and the Association for Molecular Pathology (ACMG-AMP) guidelines for their classification. First, threeCHEK2frequent variants were screened in a retrospective Hereditary Breast and Ovarian Cancer cohort of 516 patients. After, the wholeCHEK2coding region was analyzed by next-generation sequencing in 1848 prospective patients with HC suspicion. We refined ACMG-AMP criteria and applied different combined rules to classifyCHEK2variants and define risk alleles. We identified 10CHEK2null variants, 6 missense variants with discordant interpretation in ClinVar database, and 35 additional variants of unknown significance. Twelve variants were classified as (likely)-pathogenic; two can also be considered "established risk-alleles" and one as "likely risk-allele." The prevalence of (likely)-pathogenic variants in the HC cohort was 0.8% (1.3% in breast cancer patients and 1.0% in hereditary nonpolyposis colorectal cancer patients). Here, we provide ACMG adjustment guidelines to classifyCHEK2variants. We hope that this study would be useful for variant classification of other genes with low effect variants.

espanolLos estudios focalizados en la Prehistoria Reciente peninsular han sido escasos en el cauce bajo del valle del Ebro (Tarragona). La investigacion en esta area se caracteriza sobre todo por el estudio de los materiales recuperados en intervenciones arqueologicas de urgencia o bien en su inventario. Esto deriva en la emergencia de una problematica definida por una continua ausencia de interpretaciones validas respecto a las dinamicas ocupacionales del territorio. Para poder analizar las dinamicas ocupacionales y cronoculturales, en este trabajo se presenta el analisis y estudio de varios conjuntos liticos procedentes de prospecciones no sistematicas de cuatro areas −Vall del Llop, La Conca, Vall de Mantons y Vall de Carrinya− desde una perspectiva morfo-tecno-tipologica. Se pretende poder establecer estimaciones cronologicas de los conjuntos y combinarlas con la observacion off-site. Para ello el enfoque se basa en la aplicacion de tecnicas de modelizacion bayesiana que puedan aproximarnos al contexto espaciotemporal de los artefactos analizados. EnglishStudies focused on Late Prehistory have been scarce in the lower Ebro valley (Tarragona). Research in this area is characterized by the study of materials recovered in archaeological salvage excavations or their inventory. This results in the problematic absence of valid interpretations regarding the occupational dynamics of the territory. To analyse the occupational and chrono-cultural dynamics, this work presents the review and study of various lithic assemblages from unsystematic surveys of four areas −Vall del Llop, La Conca, Vall de Mantons y Vall de Carrinya− from a morpho-techno-typological perspective. It is intended to be able to establish chronological estimates of the ensembles and combine them with off-site datasets. To do so, the approach is based on the application of Bayesian modelling techniques that can approximate the spatio-temporal context of the target artefacts.

Background Oropharyngeal dysphagia (OD) treatment is moving away from compensatory strategies toward active treatments that improve swallowing function. The aim of this study was to assess the acute therapeutic effect of TRPA1/M8 agonists in improving swallowing function in OD patients. Methods Fifty-eight patients with OD caused by aging, stroke, or neurodegenerative disease were included in a three-arm, quadruple-blind, randomized clinical trial (NCT02193438). Swallowing safety and efficacy and the kinematics of the swallow response were assessed by videofluoroscopy (VFS) during the swallow of 182 +/- 2 mPa center dot s viscosity (nectar) boluses of a xanthan gum thickener supplemented with (a) 756.6 mu mol/L cinnamaldehyde and 70 mu mol/L zinc (CIN-Zn) (TRPA1 agonists), (b) 1.6 mmol/L citral (CIT) (TRPA1 agonist), or (c) 1.6 mmol/L citral and 1.3 mmol/L isopulegol (CIT-ISO) (TRPA1 and TRPM8 agonists). The effects on pharyngeal event-related potentials (ERP) were assessed by electroencephalography. Key Results TRPA1 stimulation with either CIN-Zn or CIT reduced time to laryngeal vestibule closure (CIN-Zn P = .002, CIT P = .023) and upper esophageal sphincter opening (CIN-Zn P = .007, CIT P = .035). In addition, CIN-Zn reduced the penetration-aspiration scale score (P = .009), increased the prevalence of safe swallows (P = .041), and reduced the latency of the P2 peak of the ERP. CIT-ISO had no positive effect on biomechanics or neurophysiology. No significant adverse events were observed. Conclusions and Inferences TRPA1 stimulation with CIN-Zn or CIT improves the swallow response which, in the case of CIN-Zn, is associated with a significant improvement in cortical activation and safety of swallow. These results provide the basis for the development of new active treatments for OD using TRPA1 agonists.

En esta tesis se han estudiado y analizado diversos aspectos de los sorícidos fósiles y actuales de la península Ibérica. En total se han analizado 360 ejemplares de sorícidos extraídos tanto de los yacimientos paleontológicos de Gran Dolina y Sima del Elefante de la Sierra de Atapuerca, como de las colecciones del Museo de Ciencias Naturales de la Universidad de Zaragoza y del Instituto Pirenaico de Ecología. Además, para el estudio ambiental se han identificado más de 5000 restos de microvertebrados entre los que hay un total de, al menos, 2029 individuos de micromamíferos. El estudio ha sido multidisciplinar, de forma que se han estudiado distintos aspectos de los sorícidos: la estructura y la composición del esmalte dental utilizando microscopía electrónica, la sistemática y la biometría de elementos craneales y dentales de especies actuales y fósiles y la reconstrucción en 3D de cráneos a partir de fragmentos.Las aportaciones realizadas se pueden dividir en secciones en función de las líneas de investigación seguidas.Sistemática y reconstrucción paleoambiental de los sorícidos del yacimiento de Gran Dolina de la Sierra de Atapuerca (Pleistoceno Inferior y Medio): - La revisión de los sorícidos de Gran Dolina ha proporcionado el primer registro en el tramo del Pleistoceno Inferior posterior al subcron Jaramillo en la península Ibérica de Sorex. gr. runtonensis-subaraneus, Sorex (Drepanosorex) gr. margaritodon-savini, Asoriculus gibberodon, Neomys cf. newtoni, y Crocidura kornfeldi. - La reconstrucción paleoambiental detallada del yacimiento de Gran Dolina a partir de las proporciones de arvicolinos y las presencias de otros micromamíferos, indica que los niveles inferiores del Pleistoceno Inferior (TD4, TD5 y TD6) son más húmedos y no tan abiertos como el nivel superior, del Pleistoceno Medio (TD10), siendo resultados acordes con estudio paleoambientales previos. La mayor diversidad de especies de sorícidos se da en TD5 y TD6, coincidiendo con la mayor influencia de prados húmedos.Las musarañas actuales del género Sorex en la región central y occidental de los Pirineos. Identificación y biometría de los dientes y mandíbulas:- Se han identificado las especies S. minutus y S. coronatus en los Pirineos centrales y occidentales, concretamente en Aragón, Navarra y País Vasco. Se descarta que los ejemplares de S. coronatus pudieran ser S. araneus, como se proponía en trabajos anteriores de las mismas muestras.- Los ejemplares de S. coronatus de los Pirineos central y occidental disminuyen en tamaño hacia el Atlántico. Siguen la tendencia general que se observa a mayor escala en todos los Pirineos.Reconstrucciones en 3D de los cráneos de Beremendia fissidens y Dolinasorex glyphodon (Pleistoceno Inferior) a partir de fósiles fragmentarios:- El protocolo para la reconstrucción en 3D descrito en esta tesis ha hecho posible reconstruir por primera vez en 3D la los cráneos de dos micromamíferos que se encuentran fragmentados e incompletos sistemáticamente en el registro fósil: Beremendia fissidens y Dolinasorex glyphodon.- El protocolo desarrollado tiene aplicaciones para la investigación de la anatomía y paleobiología de estas especies y también para actividades de divulgación y difusión como exposiciones en museos. Permiten a una audiencia no especializada entender cómo eran los animales extintos. - El procedimiento combina el uso de técnicas como el escáner microCT, la reconstrucción en 3D de las piezas escaneadas y el uso de software desarrollado para el diseño y la impresión 3D.- El protocolo de reconstrucción requiere exclusivamente el uso de software gratuito para cada paso. Permite que se puedan hacer las reconstrucciones utilizando ordenadores comerciales de especificaciones intermedias. Por tanto es accesible para una amplia audiencia con distintos grados de conocimiento del trabajo en 3D y con equipamiento no necesariamente especializado. Estructura y composición del esmalte dental de sorícidos y roedores actuales y fósiles:- Se ha comprobado que la pigmentación roja del esmalte dental de los sorícidos corresponde con la presencia de fases de Fe, que forman nanopartículas equidimensionales redondeadas. Estas fases son óxidos u oxihidróxidos de hierro.- Se ha observado que los óxidos (u oxihidróxidos) de hierro que causan la pigmentación roja y anaranjada de los dientes de soricinos y amarilla en roedores están localizados en la IPM (matriz interprismática) del esmalte.- La estructura del esmalte dental en sorícidos es conservativa. Presenta tres capas con diferente orientación de los prismas de esmalte (interna, intermedia y externa). Esta organización se observa en especies con y sin pigmentación y tanto en actuales como en fósiles del Pleistoceno Inferior.- La distribución de la fase de Fe dentro de la estructura del esmalte varía ligeramente entre distintos taxones. En los soricinos estos cambios permiten diferenciar dos zonas con proporciones de Fe muy distintas, tanto en la capa intermedia como en la externa del esmalte.- En los ejemplares actuales y del Pleistoceno Inferior de Sorex las concentraciones más altas de Fe se localizan en zonas internas, es decir, alejadas de la superficie, y no en la capa externa, como se creía anteriormente. La concentración de Fe varía entre el 0 al 28 % en peso. - En Dolinasorex y Beremendia, las musarañas de gran tamaño y pigmentación más oscura del Peistoceno Inferior, las concentraciones de Fe alcanzan del orden del 35-45% y su localización es más externa que en Sorex.- La estructura del esmalte de los roedores es diferente a la de los sorícidos y comprende dos capas. El Fe en los roedores está en la zona más externa del esmalte y en proporciones más bajas (hasta un 10%). En los roedores destaca que en la parte en la que se forma el esmalte, primero cristaliza el apatito y después en los huecos que quedan entre los prismas, se forma la fase con Fe. - La presencia de hierro en el esmalte dental es por tanto una convergencia evolutiva en Soricidae y Rodentia. El hecho de que el Fe se pueda presentar distintas fases minerales y que su posición en el esmalte y las relaciones estructurales sean distintas sugiere que su función sean también distinta en los distintos órdenes.- La localización de las mayores cantidades de los óxidos (u oxihidróxidos) de Fe en zonas internas del esmalte de algunos sorícidos parece estar relacionada con aumentos en la dureza del esmalte, lo que sugiere que la función principal de estos compuestos sea la de proporcionar resistencia a las fracturas.

ispartof: The Early Neolithic of the Eastern Fertile Crescent: Excavations at Bestansur and Shimshara, Iraqi Kurdistan pages:311-352 ispartof: Central Zagros Archaeological Project vol:2 pages:311-352 status: published

En la zona del valle bajo del Ebro la problemática de los palimpsestos artefactuales líticos ha tendido a emerger en estudios que aportan cronologías relativas rígidas y lineales, con poca rigurosidad y teniendo poco en cuenta los procesos posdeposicionales que afectan a tales conjuntos. Para hacer frente a tal problemática y poder especificar y analizar a un mayor nivel estos conjuntos superficiales, se presenta la aplicación de una nueva metodología utilizada en casos de estudio similares del área valenciana. Ésta se enfoca en la inferencia cronológica Bayesiana mediante la computación para la construcción de modelos formados por referentes crono-tipológicos y contextuales, partiendo des del Epipaleolítico hasta el inicio de la Edad del Bronce (13.400-4.200 cal BP.). Se aplicará a nuestros casos de estudio de conjuntos líticos de superficie provenientes de cuatro áreas: Vall del Llop, Vall de Mantons, Vall de Carrinya y La Conca (Aldover-Xerta, Baix Ebre).

BACKGROUND: The relationship between spontaneous speech and formal language testing in people with brain tumors (gliomas) has been rarely studied. In clinical practice, formal testing is typically used, while spontaneous speech is less often evaluated quantitatively. However, spontaneous speech is quicker to sample and may be less prone to test/retest effects, making it a potential candidate for assessing language impairments when there is restricted time or when the patient is unable to undertake prolonged testing.AIM: To assess whether quantitative spontaneous speech analysis and formal testing detect comparable language impairments in people with gliomas. Specifically, we addressed (a) whether both measures detected comparable language impairments in our patient sample; and (b) which language levels, assessment times, and spontaneous speech variables were more often impaired in this subject group.METHOD: Five people with left perisylvian gliomas performed a spontaneous speech task and a formal language assessment. Tests were administered before surgery, within a week after surgery, and seven months after surgery. Performance on spontaneous speech was compared with that of 15 healthy speakers.RESULTS: Language impairments were detected more often with both measures than with either measure independently. Lexical-semantic impairments were more common than phonological and grammatical impairments, and performance was equally impaired across assessment time points. Incomplete sentences and phonological paraphasias were the most common error types.CONCLUSIONS: In our sample both spontaneous speech analysis and formal testing detected comparable language impairments. Currently, we suggest that formal testing remains overall the better option, except for cases in which there are restrictions on testing time or the patient is too tired to undergo formal testing. In these cases, spontaneous speech may provide a viable alternative, particularly if automated analysis of spontaneous speech becomes more readily available in the future. These results await replication in a bigger sample and/or other populations.