Language improvement one week after thrombolysis in acute stroke

Martins, Isabel Pavão; Fonseca, José Simões da; Morgado, Joana; Leal, Gabriela; Farrajota, Luísa; Fonseca, Ana Catarina; Melo, Teresa Pinho e

doi:10.1111/ane.12604

Cited by 10 publications

(8 citation statements)

References 25 publications

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“…With respect to demographic predictors, previous studies that have assessed general aphasia recovery have found that variables such as younger age, being female, higher educational attainment, and lower initial stroke severity are associated with better recovery (5,(32)(33)(34)(35)(36)(37). However, the role of these demographic factors in the recovery and outcome of auditory comprehension deficits in aphasia more specifically has not been well-studied and findings have been mixed.…”

Section: Discussionmentioning

confidence: 99%

Auditory Comprehension Deficits in Post-stroke Aphasia: Neurologic and Demographic Correlates of Outcome and Recovery

et al. 2021

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Introduction: One of the most challenging symptoms of aphasia is an impairment in auditory comprehension. The inability to understand others has a direct impact on a person's quality of life and ability to benefit from treatment. Despite its importance, limited research has examined the recovery pattern of auditory comprehension and instead has focused on aphasia recovery more generally. Thus, little is known about the time frame for auditory comprehension recovery following stroke, and whether specific neurologic and demographic variables contribute to recovery and outcome.Methods: This study included 168 left hemisphere chronic stroke patients stroke patients with auditory comprehension impairments ranging from mild to severe. Univariate and multivariate lesion-symptom mapping (LSM) was used to identify brain regions associated with auditory comprehension outcomes on three different tasks: Single-word comprehension, yes/no sentence comprehension, and comprehension of sequential commands. Demographic variables (age, gender, and education) were also examined for their role in these outcomes. In a subset of patients who completed language testing at two or more time points, we also analyzed the trajectory of recovery in auditory comprehension using survival curve-based time compression.Results: LSM analyses revealed that poor single-word auditory comprehension was associated with lesions involving the left mid- to posterior middle temporal gyrus, and portions of the angular and inferior-middle occipital gyri. Poor yes/no sentence comprehension was associated almost exclusively with the left mid-posterior middle temporal gyrus. Poor comprehension of sequential commands was associated with lesions in the left posterior middle temporal gyrus. There was a small region of convergence between the three comprehension tasks, in the very posterior portion of the left middle temporal gyrus. The recovery analysis revealed that auditory comprehension scores continued to improve beyond the first year post-stroke. Higher education was associated with better outcome on all auditory comprehension tasks. Age and gender were not associated with outcome or recovery slopes.Conclusions: The current findings suggest a critical role for the posterior left middle temporal gyrus in the recovery of auditory comprehension following stroke, and that spontaneous recovery of auditory comprehension can continue well beyond the first year post-stroke.

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Section: Discussionmentioning

confidence: 99%

Auditory Comprehension Deficits in Post-stroke Aphasia: Neurologic and Demographic Correlates of Outcome and Recovery

et al. 2021

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“…Items 1b (LOC questions) add questions about the month and age, and item 1c (LOC commands) add onestage commands. As noted in Table I, additional language assessments used included the Language Screening Test (LAST) (Denier et al, 2016); the Western Aphasia Battery (WAB) (Finch et al, 2014); the French version of the Boston Diagnostic Aphasia Examination (BDAE) (Jacquin et al, 2014); the Lisbon Aphasia Assessment Battery (BAAL) (Martins et al, 2016); and the Basel-Minnesota test (Engelter et al, 2006). The study by de Oliveira and Damasceno (2011) diagnosed aphasia with a collection of informal language tasks described as spontaneous narrative, fluency, yes/no and three stage command, naming six objects and ideomotor praxis.…”

Section: Outcome Measuresmentioning

confidence: 99%

“…The data extracted from this analysis is presented as a harvest plot in Figure 2. None of the studies received the maximum score of 14, the highest score (11), was received by only four studies (Kohrmann et al, 2009;Kremer et al, 2013;Lundstrom et al, 2015;Martins et al, 2016). A strength of all studies were the conclusions, the conclusions were deemed appropriate in all but two studies, Mazza et al (2012) and Saarinen et al (2015).…”

Section: Study Qualitymentioning

confidence: 99%

“…Twelve of the studies recorded outcomes by assessing aphasia with the NIHSS. However, Martins et al (2016) reported that the NIHSS alone is insufficient for providing a diagnosis of aphasia. The NIHSS is considered a valid and commonly used stroke impairment scale that sums the scores from individual elements of neurological examination to provide an overall stroke impairment score, and is considered reliable in the setting of emergent stroke evaluation (Maas et al, 2012).…”

Section: Study Qualitymentioning

confidence: 99%

“…Changes in medical treatments provided in the hyper-acute setting (within the first 24 hours of arrival to hospital) can potentially change the presentation of post-stroke symptoms, such as aphasia. When these hyper-acute medical treatments are utilised, early restoration of blood flow can be achieved, resulting in reductions in the size, pattern, and nature of infarcts following AIS (Martins et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

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