Prognostic factors for long-term improvement from stroke-related aphasia with adequate linguistic rehabilitation

Michitaka Funayama,Masahiro Kato,Yoshitaka Nakagawa,Yoko Sano

doi:10.1007/s10072-019-03956-7

Michitaka Funayama, Masahiro Kato + Show 2 more

Open Access

https://doi.org/10.1007/s10072-019-03956-7

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Abstract

In the past decade, several studies have reported potential prognostic factors for aphasia after stroke. However, these reports covered no more than 1 year after stroke onset, even though patients often continue to improve over longer periods. The present study included 121 patients with aphasia who received cognitive-based linguistic rehabilitation for at least 2 years post-onset. All were right-handed and had a lesion only in the left hemisphere. Aphasia outcome was predicted using multiple linear regression analysis. Age at onset, lesion in the left superior temporal gyrus including Wernicke’s area, and baseline linguistic abilities including aphasia severity and both phonological and semantic functions were significant predictors of long-term aphasia outcome. These findings suggest that the long-term outcome of aphasia following adequate linguistic rehabilitation can be predicted by age at onset, lesion area, and baseline linguistic abilities and that linguistic rehabilitation is particularly recommended for younger individuals with aphasia.

Highlights

Recent studies have reported that age [1], initial aphasia severity [1,2,3,4,5,6,7], aphasia subtype [5], lesion location [8, 9], lesion volume [10], stroke severity [5, 11], and phonology [12] are potential prognostic factors for aphasia after stroke
The stepwise method in the multivariable linear regression model revealed that age at onset, lesion in the left superior temporal gyrus, and baseline linguistic abilities were significant predictors of long-term aphasia outcome (Fig. 1)
The result of the wordlevel or the syllable-level subtest—but not of the sentencelevel subtest—was found to be a significant predictor, suggesting that semantic and phonologic functions rather than syntactic processing are key for predicting long-term aphasia outcome

Summary

Introduction

Recent studies have reported that age [1], initial aphasia severity [1,2,3,4,5,6,7], aphasia subtype [5], lesion location [8, 9], lesion volume [10], stroke severity [5, 11], and phonology [12] are potential prognostic factors for aphasia after stroke Among these factors, initial aphasia severity has been proposed to be the most clinically relevant factor [7]. Fitzpatrick et al [14] reported that chronic

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