A hospital-based study of post-stroke aphasia: frequency, risk factors, and topographic representation

Abstract

Background and objective: The crude prevalence rate of stroke in Qena, Egypt, is high (922/100,000). For the first time, we estimate the frequency of aphasia following the first-ever ischemic stroke and its relationship to the site of lesion in Arabic-speaking countries. Methods: The study was conducted on 180 acute or subacute ischemic stroke patients. Aphasia was diagnosed with the short form of the Boston Diagnostic Aphasia Examination after establishment of the cases (at least 10 days of stroke onset). Computed tomography and/or magnetic resonance imaging were performed for topographic localization of stroke, and routine laboratory investigations were done to evaluate the possible stroke risk factors. Results: The frequency of post-stroke aphasia was recorded in 20%, and atrial fibrillation (AF) represents a high-risk factor for ischemic stroke with aphasia. The following categories were observed: global aphasia in 50%, motor aphasia in 27.7%, sensory aphasia in 11.1%, nominal aphasia in 2.8%, and conductive aphasia in 8.3%. Global aphasia was mainly associated with complete middle cerebral artery (MCA) territories infarction. Motor aphasia was associated mainly with frontal or frontoparietal operculum lesions as well as basal ganglionic lesions. Sensory aphasia was associated with temporal lobe lesions, inferior parietal lobe, and basal ganglia. Conductive aphasia showed lesions in the deep white matter of the frontal and parietal lobes. Anomic aphasia was associated with inferior parietal lobe lesion. Conclusion: Our data are consistent with other reports as regards the frequency and risk factors of post-stroke aphasia. Atrial fibrillation represents a high-risk factor for ischemic strokes with aphasia. Global and motor aphasia are the major subtypes. The lesion locations are predictive of aphasia subtypes.

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“…16 Up to 38% of stroke patients suffer from aphasia. 17 Post-stroke aphasia affects patients’ ability to express or understand language and disrupts their socialisation and work. Patients most often receive speech and language rehabilitation, neuromodulation, and pharmacological therapy (eg, bromocriptine, piracetam, and donepezil).…”

“…The US National Aphasia Association estimated that 2 million people in the country and 250 000 people in the UK suffered from post-stroke aphasia in 2016 16. Up to 38% of stroke patients suffer from aphasia 17. Post-stroke aphasia affects patients’ ability to express or understand language and disrupts their socialisation and work.…”

The effects of COVID-19 on the rehabilitation of persons with aphasia: A scoping review

“…Of the publications that were deemed relevant for the study, a few discussed rehabilitation and aphasia independent of stroke, and the emphasis is on multidisciplinary rehabilitation as opposed to just reporting on speech language pathology. This is because of the close association of stroke and aphasia (Khedr et al, 2020 ). By its nature, a stroke usually affects different areas including motor, communication, psychological and cognitive abilities, often impacting on participation and quality of life of the stroke survivor and their facilities.…”

“…Stroke is the most common cause of aphasia (Khedr et al, 2020 ). Approximately a third of stroke survivors experience aphasia (Van Oers et al, 2018 ).…”

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“…It has been estimated that about 21-38% of stroke patients develop aphasia. It has been reported that 20-40% of aphasias are of the global type, whereas the classic aphasia types, such as Broca's or Wernicke's aphasia, are found in a quarter of patients, and 10-15% of patients are unclassifiable according to traditional typologies during the acute stage of stroke (Khedr, et al .2020).…”