Objective:

To systematically examine the characterization, diagnostic approaches, and therapeutic interventions for tumor-related aphasia (TRA).

Background:

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.

Design/Methods:

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.

Results:

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.

Conclusions:

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.