Alerting, Orienting, Executive Control and Language Function in Post-stroke Aphasia Patients

Abstract

Background: Aphasia is frequently observed in post-stroke patients, and this population usually presents attention impairment. Attention is considered to play an important role in the language recovery of patients with Post-Stroke Aphasia (PSA). However, it is no idea whether language function correlates with attention performance. In our study, we investigated the association between attention and language function in PSA patients. Methods: This cross-sectional study was performed from September 2020 to May 2021. A total of 26 PSA patients and 26 healthy people without neurological disorders were recruited in this study. And demographic, language performance, attention performance were recorded. The Aphasia Battery of Chinese (ABC) was applied to assess language performance. Attention network tests were used to measure attention performance. The attention scores were compared between the PSA patients and healthy people. The correlation analysis and stepwise linear regression analysis are used to explore the relationship between attention and language in the PSA group. Results: A total of 26 PSA patients (male/female = 21:5) and 26 healthy people (male/female = 21:5) were enrolled in the study. The mean ages were 50.00 ± 9.01 years, 48.88 ± 7.01, respectively. According to ABC, 14 (53.85%) patients experienced Broca’s aphasia. In accordance with Attention Network Test (ANT), there were significant differences in accuracy and reaction time between the PSA group and the control group (all P<0.05). Orienting RT and alerting inverse efficiency (IE) were significant differences between the two groups. The spearman correlation revealed that executive control was associated with aphasia severity grade, repetition correlated with alerting, auditory comprehension correlated with orienting. And after the stepwise regression analysis, executive control RT alone emerged as a significant predictor of auditory comprehension. Alerting IE and orienting RT are the predictors of repetition. Conclusions: The results suggest that among PSA patients, language items (aphasia severity grade, auditory comprehension, and repetition) are related to three specific attention functions: alerting, orienting, and executive control. Disentangling the mechanism of attention deficits in PSA patients may provide a supplement for the rehabilitation strategies in PSA patients.