Language screening test in the acute phase of post-stroke aphasia associated with clinical outcome

Abstract

The individual prognosis of aphasia recovery remains difficult to establish initially. The aim of this study was to determine whether some components of language evaluated in the acute phase of stroke could be prognosis factors for aphasia recovery, and if these components could predict the clinical pattern of aphasia in the chronic phase. Were included all consecutive right-handed patients with aphasia, after a first stroke, confirmed by imagery, left hemisphere injured, without dementia. Assessment was performed at the acute phase: Language Screening Test (LAST) and Aphasia Severity Rating Scale (ASRS) of the Boston Diagnostic Aphasia Examination (BDAE). Three months after: LAST, ASRS and BDAE and good recovery from aphasia was defined as an ASRS score of 4 or 5. Twenty-eight patients (30–89 years) were included from November 2013 to February 2014. LAST total, LAST receptive and expression index, item order execution and naming and ASRS were significantly associated with good recovery at 3 months (Mann-Whitney; P < 0.05). Expression index was significantly associated with good recovery (OR = 2.2; CI95%: 1.2–3.8; P < 0.001) in a multi-variable analysis including receptive index and expression index, and also including expression index and ASRS in the acute phase. Naming, order execution, picture recognition, word repetition and automatic speech items of LAST (acute phase) and BDAE (3 months after) were correlated (Spearman and Mann-Whitney; P < 0,05). These results underline the importance of tests in the acute phase of stroke, both in terms of the prediction of recovery, better than severity in the acute phase, and the clinical evolution of aphasia.