4.6 Article

Early Subacute White Matter Hyperintensities and Recovery of Language After Stroke

期刊

NEUROREHABILITATION AND NEURAL REPAIR
卷 37, 期 4, 页码 218-227

出版社

SAGE PUBLICATIONS INC
DOI: 10.1177/15459683231168384

关键词

cerebral small vessel diseases; aphasia; stroke; white matter hyperintensities; leukoaraiosis; language

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This study investigated the relationship between premorbid WMH severity and longitudinal comprehension and production outcomes in aphasia. Severe WMH were found to contribute to impaired language comprehension but not production in individuals with aphasia. The findings highlight the importance of considering different language domains when studying predictors of aphasia recovery.
Background White matter hyperintensities (WMH) are considered to contribute to diminished brain reserve, negatively impacting on stroke recovery. While WMH identified in the chronic phase after stroke have been associated with post-stroke aphasia, the contribution of premorbid WMH to the early recovery of language across production and comprehension has not been investigated. Objective To investigate the relationship between premorbid WMH severity and longitudinal comprehension and production outcomes in aphasia, after controlling for stroke lesion variables. Methods Longitudinal behavioral data from individuals with a left-hemisphere stroke were included at the early subacute (n = 37) and chronic (n = 28) stage. Spoken language comprehension and production abilities were assessed at both timepoints using word and sentence-level tasks. Magnetic resonance imaging (MRI) was performed at the early subacute stage to derive stroke lesion variables (volume and proportion damage to critical regions) and WMH severity rating. Results The presence of severe WMH explained an additional 18% and 25% variance in early subacute (t = -3.00, p = .004) and chronic (t = -3.60, P = .001) language comprehension abilities respectively, after controlling for stroke lesion variables. WMH did not predict additional variance of language production scores. Conclusions Subacute clinical MRI can be used to improve prognoses of recovery of aphasia after stroke. We demonstrate that severe early subacute WMH add to the prediction of impaired longitudinal language recovery in comprehension, but not production. This emphasizes the need to consider different domains of language when investigating novel neurobiological predictors of aphasia recovery.

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