Perilesional Perfusion in Chronic Stroke-Induced Aphasia and Its Response to Behavioral Treatment Interventions

Walenski, Matthew; Chen, Yu-Fen; Litcofsky, Kaitlyn A.; Caplan, David; Kıran, Swathi; Rapp, Brenda; Parrish, Todd B.; Thompson, Cynthia K.

doi:10.1162/nol_a_00068

Cited by 9 publications

(4 citation statements)

References 52 publications

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“…Another found that cerebral blood flow in perilesional areas was similarly unrelated to improvement. In contrast, early evidence from our group 25 and others have demonstrated the importance of perilesional integrity to predict overall severity and aphasia rehabilitation 42 . If we assume that perilesional tissue degraded most in individuals with greater GLE, then the current study can be interpreted as providing further support for the idea that health of perilesional tissue is critical to long-term recovery.…”

Section: Gradual Lesion Expansion Predicts Change In Behavioral Perfo...mentioning

confidence: 63%

Progressive lesion necrosis is related to increasing aphasia severity in chronic stroke

Johnson

Newman‐Norlund

Teghipco

et al. 2023

Preprint

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Background: Volumetric investigations of cortical damage resulting from stroke indicate that lesion size and shape continue to change even in the chronic stage of recovery. However, the potential clinical relevance of continued lesion growth has yet to be examined. In the present study, we investigated the prevalence of lesion expansion and the relationship between expansion and changes in aphasia severity in a large sample of individuals in the chronic stage of aphasia recovery.<break><break> <break><break>Methods: Retrospective structural MRI scans from 104 stroke survivors with at least 2 observations more than 6 months apart (k=301 observations) were included. Lesion demarcation was performed using an automated lesion segmentation software and lesion volumes at each timepoint were subsequently calculated. A paired-sample t-test between initial and final scans was conducted to determine if chronic lesion volumes change over time. <break><break>Finally, we investigated the association between lesion expansion and changes on the Western Aphasia Battery (WAB) in a group of participants assessed and scanned at 2 timepoints (N=54) using a GLM.<break><break> <break><break>Results: Most participants (81%) showed evidence of lesion expansion. A t-test revealed lesion volumes at follow-up scans were significantly larger than initial scans (p<0.0001). <break><break> <break><break>Change on the language performance was significantly associated with change in lesion volume (p=0.025) and age at stroke (p=0.031). The results suggest that with every 100cm3 increase in lesion size, language performance decreases by 8.8 points, and for every 10-year increase in age at stroke, language performance decreases by 1.9 points. <break><break> <break><break>Conclusions: The present study confirms and extends prior reports that lesion expansion occurs well into the chronic stage of stroke. For the first time, we present evidence that expansion is predictive of longitudinal changes in language performance in individuals with aphasia. Future research should focus on the potential mechanisms that may lead to necrosis in areas surrounding the chronic stroke lesion.

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Section: Gradual Lesion Expansion Predicts Change In Behavioral Perfo...mentioning

confidence: 63%

Progressive lesion necrosis is related to increasing aphasia severity in chronic stroke

Johnson

Newman‐Norlund

Teghipco

et al. 2023

Preprint

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“…In chronic stage, perfusion imaging shows the persistence of hypoperfusion in the area surrounding ischemic core ( 94 ). A study from Walenski et al did not find any significant changes over time of tissue perfusion, even in patients that underwent successful rehabilitation ( 98 ). Also, hypoperfusion of areas close to the ischemic lesion was shown to correlate with the clinical status of aphasic patients ( 99 ).…”

Section: Neurophysiological Changes During the Chronic Phasementioning

confidence: 97%

The role of neurophysiological tools in the evaluation of ischemic stroke evolution: a narrative review

Motolese¹,

Lanzone²,

Todisco³

et al. 2023

Front. Neurol.

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Ischemic stroke is characterized by a complex cascade of events starting from vessel occlusion. The term “penumbra” denotes the area of severely hypo-perfused brain tissue surrounding the ischemic core that can be potentially recovered if blood flow is reestablished. From the neurophysiological perspective, there are local alterations—reflecting the loss of function of the core and the penumbra—and widespread changes in neural networks functioning, since structural and functional connectivity is disrupted. These dynamic changes are closely related to blood flow in the affected area. However, the pathological process of stroke does not end after the acute phase, but it determines a long-term cascade of events, including changes of cortical excitability, that are quite precocious and might precede clinical evolution. Neurophysiological tools—such as Transcranial Magnetic Stimulation (TMS) or Electroencephalography (EEG)—have enough time resolution to efficiently reflect the pathological changes occurring after stroke. Even if they do not have a role in acute stroke management, EEG and TMS might be helpful for monitoring ischemia evolution—also in the sub-acute and chronic stages. The present review aims to describe the changes occurring in the infarcted area after stroke from the neurophysiological perspective, starting from the acute to the chronic phase.

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“…The different results of this study were probably caused by overlapping lesion locations or subjectivity in expert clinical assessment. Fluctuations in cerebral blood flow could also possibly contribute to these results (Walenski et al 2022).…”

Section: Lesion Locations In Patients With Motor Aphasiamentioning

confidence: 98%

Characteristics of Aphasia in Ischemic Stroke Patients at Dr. Mahar Mardjono National Brain Center Hospital Indonesia in 2021

Rasya Hapsari Danardhono,

Arman Yurisaldi Saleh,

Ria Maria Theresa

et al. 2023

FMI

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Highlights: 1. To author’s knowledge, this study is the first study done in National Brain Center Hospital In Jakarta2. No similar studies have been done during the pandemic era3. This study can add additional data to further studies about aphasia in comparison with post pandemic era Abstract Global aphasia, sensory transcortical aphasia, motor transcortical aphasia, motor aphasia, sensory aphasia, conduction aphasia and anomic aphasia can occur in ischemic stroke. There are different locations of lesions in each type of aphasia. There has been an increase in incidence and mortality of stroke patients during the COVID-19 pandemic. Before the pandemic, global aphasia was the most common type of aphasia. This study was conducted to determine the type of aphasia, clinical and radiological features, and also management of aphasia in ischemic stroke during the pandemic. This research is a descriptive study with a cross sectional approach. Sampling was done by total sampling technique. The research sample was ischemic stroke subjects with aphasia diagnosed from January 1, 2021 - December 31, 2021 at the National Brain Center Hospital Prof. Dr. dr. Mahar Mardjono Jakarta. Statistical analysis was done using IBM SPSS Statistics for Mac, Version 25.0 (IBM Corp., Armonk, N.Y., USA). There were 162 aphasic subjects with ischemic stroke. Age range was 34 – 87 years. Most subjects were male (59.9%), aged 55-65 years (37.0%). Hypertension (90.1%), diabetes mellitus (50.0%), and dyslipidemia (75.9%) were the dominant risk factors. The most common type of aphasia is global aphasia (43.8%) and motoric aphasia. (33,3%). The parietal lobe was the dominant location of global aphasia (38 subjects) and motoric aphasia (47 subjects). The therapy given to aphasic subjects with a history of ischemic stroke includes speech therapy (85.2%), antiplatelet therapy (98.1%), anticoagulants (19.1%), rTPA (1.2%), and neuroprotectors (3.0 %). In conclusion, in ischemic stroke subjects with aphasia at the National Brain Center Hospital during the pandemic, global aphasia was found to be the most common with the dominant global aphasia lesion location in the parietal lobe.

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Perilesional Perfusion in Chronic Stroke-Induced Aphasia and Its Response to Behavioral Treatment Interventions

Cited by 9 publications

References 52 publications

Progressive lesion necrosis is related to increasing aphasia severity in chronic stroke

Progressive lesion necrosis is related to increasing aphasia severity in chronic stroke

The role of neurophysiological tools in the evaluation of ischemic stroke evolution: a narrative review

Characteristics of Aphasia in Ischemic Stroke Patients at Dr. Mahar Mardjono National Brain Center Hospital Indonesia in 2021

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