Association of Lesion Location With Long-Term Recovery in Post-stroke Aphasia and Language Deficits

Abstract

Background: Recovery from post-stroke aphasia is important for performing the activities of daily life, returning to work, and quality of life. We investigated the association between specific brain lesions and the long-term outcome of four dimensions of aphasia: fluency, comprehension, naming, and repetition 12 months after onset in patients with stroke. Methods: Our retrospective cross-sectional observational study investigated the relationship between the Korean version of the Western Aphasia Battery scores in 31 stroke patients 1 year after the onset of stroke and stroke lesion location. Brain lesions were assessed using voxel-based lesion symptom mapping (VLSM) in conjunction with magnetic resonance imaging. Results: Damage to the Rolandic cortex, Heschl's gyrus, the posterior corona radiata, supramarginal cortex, superior longitudinal fasciculus, superior temporal gyrus, and insula was associated with a low total AQ score. Lesions in the inferior triangularis and inferior operculum of the frontal cortex, supramarginal cortex, and insula were associated with a poor fluency outcome. Damage to the parietal cortex, angular cortex, temporal middle cortex, sagittal stratum, and temporal superior cortex was associated with poor recovery of comprehension skills. Lesions in the angular cortex, supramarginal cortex, posterior corona radiata, superior longitudinal fasciculus, internal capsule, temporal superior cortex, and temporal middle cortex were associated with poor recovery of naming in patients with stroke. Damage to the superior temporal cortex, posterior corona radiata, and superior longitudinal fasciculus was associated with poor recovery of repetition component. Conclusions: We identified specific brain lesions associated with long-term outcomes in four dimensions of aphasia, in patients with post-stroke aphasia. Our findings may be useful for advancing understanding for the pathophysiology of aphasia in stroke patients.

Predicting language recovery in post-stroke aphasia using behavior and functional MRI

“…developed a model which considers the overlap of lesions with known core language areas to predict individual patient performance on a battery of 21 aphasia measures (mean R 2 = 0.48, n = 70) 18 . This and earlier work suggest that a profile of aphasia impairments and severity can be inferred from lesion location and extent at the patient-level 19 , 20 . However there remains considerable unexplained variance in patient outcomes, and prognostic model performance may benefit from inclusion of additional functional variables 21 , 22 .…”

Is Lateropulsion Really Related with a Specific Lesion of the Brain?

“…For more accurate analyses, the origin of each image (coordinates: 0 × 0 × 0 mm 3 ) was reoriented such that it was located close to the anterior commissure. To analyze the lesion maps, segmentation and normalization were employed [8,11,24]. We used the MR segment-normalize and MR normalize functions of a plugin (available online: https://www.nitrc.org/projects/clinicaltbx/) for mapping in stereotaxic space using the normalization algorithm provided by SPM8 software (available online: http://www.fil.ion.ucl.ac.uk/spm/software/spm8).…”

Changes in local brain function in mild cognitive impairment due to semantic dementia

“…The exact role of Wernicke's area, including the role of the supramarginal gyrus in aphasia, is still controversial. Some studies have shown that it is closely related to aphasia and comprehension disorder 61,62 ; however, it has also been proposed that it only plays the role of phonetic representation rather than language comprehension 63 . If future studies use rs‐fMRI in SD queues to explore this area further, our results suggest that focusing on Wavelet‐ALFF in slow‐2 and slow‐3 bands may be useful.…”