Post-stroke aphasia prognosis: a review of patient-related and stroke-related factors.

RATIONALE, AIMS AND OBJECTIVES Recovery of language function in individuals with post-stroke aphasia is associated with a variety of patient and stroke-related indices. Amidst a complex interaction of a multitude of variables, clinicians are faced with the arduous challenge of predicting aphasia recovery patterns and subsequently, long-term outcomes in these individuals. Unfortunately, predictive factors are highly variable making prognosis of aphasia recovery difficult. Therefore, the objective of this review was to assess the influence of patient-related and stroke-related factors on language recovery in individuals with post-stroke aphasia. METHODS We completed a literature review to assess and identify evidence-based patient and stroke-related variables shown to be influential in aphasia recovery. RESULTS A range of patient-related (gender, handedness, age, education, socio-economic status and intelligence) and stroke-related indices (initial severity, lesion site and lesion size) were identified as potential influential factors to post-stroke aphasia recovery. Initial severity of aphasia emerged as the factor most predictive of long-term aphasia recovery. Other influential factors of post-stroke language recovery included lesion site and size. CONCLUSIONS Stroke-related factors, including aphasia severity, lesion site and lesion size, appear most critical to post-stroke aphasia recovery. The findings presented in this review offer clinicians an evidenced-based framework to assist in prediction of post-stroke aphasia recovery patterns and subsequent long-term functional communication outcomes.

[1]  John Hart,et al.  Delineation of single‐word semantic comprehension deficits in aphasia, with anatomical correlation , 1990, Annals of neurology.

[2]  J. Avery.  Critical review. , 2006, The Journal of the Arkansas Medical Society.

[3]  D. Knopman,et al.  Mechanisms of recovery from aphasia: Evidence from serial xenon 133 cerebral blood flow studies , 1984, Annals of neurology.

[4]  D. Knopman,et al.  Computed tomographic scan correlates of auditory comprehension deficits in aphasia: A prospective recovery study , 1983, Annals of neurology.

[5]  Piotr Lass,et al.  The contribution of the left and right hemispheres to early recovery from aphasia: A SPECT prospective study , 2005, Neuropsychological rehabilitation.

[6]  A. Kertesz,et al.  The epidemiology of aphasic and cognitive impairment in stroke: age, sex, aphasia type and laterality differences. , 1981, Brain : a journal of neurology.

[7]  J W Krakauer,et al.  Variability in language recovery after first-time stroke , 2007, Journal of Neurology, Neurosurgery, and Psychiatry.

[8]  T. Kahan,et al.  Aphasia in acute stroke and relation to outcome , 2001, Journal of internal medicine.

[9]  M. Alexander,et al.  Recovery Rates after Stroke and Their Impact on Outcome Prediction , 2000, Neurorehabilitation and neural repair.

[10]  O. Godefroy,et al.  Vascular Aphasias: Main Characteristics of Patients Hospitalized in Acute Stroke Units , 2002, Stroke.

[11]  M. Berthier.  Poststroke Aphasia , 2005, Drugs & aging.

[12]  M. Naeser,et al.  Neuroimaging and Language Recovery in Stroke , 1994, Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society.

[13]  M. Uchino,et al.  Aphasia during the Acute Phase in Ischemic Stroke , 2008, Cerebrovascular Diseases.

[14]  C. Skilbeck,et al.  Raven IQ and language recovery following stroke. , 1984, Journal of Clinical Neuropsychology.

[15]  F. Gutzwiller,et al.  Epidemiology of Aphasia Attributable to First Ischemic Stroke: Incidence, Severity, Fluency, Etiology, and Thrombolysis , 2006, Stroke.

[16]  M. Naeser,et al.  Late recovery of auditory comprehension in global aphasia. Improved recovery observed with subcortical temporal isthmus lesion vs Wernicke's cortical area lesion. , 1990, Archives of neurology.

[17]  N. Lincoln,et al.  Prognostic indicators and the pattern of recovery of communication in aphasic stroke patients. , 1983, Journal of neurology, neurosurgery, and psychiatry.

[18]  Walter J Koroshetz,et al.  The prognosis for aphasia in stroke. , 2012, Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association.

[19]  G. Schlaug,et al.  Evidence for Plasticity in White‐Matter Tracts of Patients with Chronic Broca's Aphasia Undergoing Intense Intonation‐based Speech Therapy , 2009, Annals of the New York Academy of Sciences.

[20]  董瑞国,et al.  Aphasia , 2003, The SAGE Encyclopedia of Human Communication Sciences and Disorders.

[21]  K Hojo,et al.  [Localization of lesions in aphasia--clinical-CT scan correlations (Part III): Paraphasia and meaningless speech]. , 1985, No to shinkei = Brain and nerve.

[22]  M. Alexander,et al.  Broca's area aphasias , 1990, Neurology.

[23]  C. Price,et al.  Right anterior superior temporal activation predicts auditory sentence comprehension following aphasic stroke. , 2005, Brain : a journal of neurology.

[24]  K. Fiscella,et al.  Effects of Patient and Physician Practice Socioeconomic Status on the Health Care of Privately Insured Managed Care Patients , 2003, Medical care.

[25]  L. Jongbloed.  Prediction of function after stroke: a critical review. , 1986, Stroke.

[26]  L. Avila,et al.  Spontaneous evolution of aphasia after ischaemic stroke , 1992 .

[27]  L. Lapointe.  Aphasia And Related Neurogenic Language Disorders , 1997 .

[28]  N. Lincoln,et al.  Spontaneous recovery of language in patients with aphasia between 4 and 34 weeks after stroke. , 1985, Journal of neurology, neurosurgery, and psychiatry.

[29]  Christine A. Sinsky,et al.  Who is at greatest risk for receiving poor-quality health care? , 2006, The New England journal of medicine.

[30]  Harlan M. Krumholz,et al.  Influence of Patients’ Socioeconomic Status on Clinical Management Decisions: A Qualitative Study , 2008, The Annals of Family Medicine.

[31]  K. Furie,et al.  Functional recovery following rehabilitation after hemorrhagic and ischemic stroke. , 2003, Archives of physical medicine and rehabilitation.

[32]  T. Olsen,et al.  Aphasia in acute stroke: Incidence, determinants, and recovery , 1995, Annals of neurology.

[33]  M. Mimura,et al.  Prospective and retrospective studies of recovery in aphasia. Changes in cerebral blood flow and language functions. , 1998, Brain : a journal of neurology.

[34]  T. Olsen,et al.  Aphasia after Stroke: Type, Severity and Prognosis , 2003, Cerebrovascular Diseases.

[35]  Global aphasia without hemiparesis: language profiles and lesion distribution , 1999, Journal of neurology, neurosurgery, and psychiatry.

[36]  Daniel B Hier,et al.  Gender and Aphasia in the Stroke Data Bank , 1994, Brain and Language.

[37]  C Caltagirone,et al.  Influence of age, sex, literacy and pathologic lesion on incidence, severity and type of aphasia , 1981, Acta neurologica Scandinavica.

[38]  G. Goldenberg,et al.  Influence of Size and Site of Cerebral Lesions on Spontaneous Recovery of Aphasia and on Success of Language Therapy , 1994, Brain and Language.

[39]  A. Kertesz,et al.  Intelligence and aphasia: Performance of aphasics on Raven's coloured progressive matrices (RCPM) , 1975, Brain and Language.

[40]  H. Karbe,et al.  Brain Plasticity in Poststroke Aphasia: What Is the Contribution of the Right Hemisphere? , 1998, Brain and Language.

[41]  A. Smith,et al.  AMBIGUITIES IN CONCEPTS AND STUDIES OF “BRAIN DAMAGE” AND “ORGANICITY” , 1962, The Journal of nervous and mental disease.

[42]  José M. Ferro,et al.  Recovery from Aphasia and Neglect , 1999, Cerebrovascular Diseases.

[43]  C. McKevitt,et al.  Socioeconomic status and stroke , 2006, The Lancet Neurology.

[44]  E. Ringelstein,et al.  Handedness and hemispheric language dominance in healthy humans. , 2000, Brain : a journal of neurology.

[45]  K Herholz,et al.  Long-term prognosis of poststroke aphasia studied with positron emission tomography. , 1995, Archives of neurology.

[46]  A. Smith.  Objective indices of severity of chronic aphasia in stroke patients. , 1971, The Journal of speech and hearing disorders.

[47]  M. Albert,et al.  Severe nonfluency in aphasia. Role of the medial subcallosal fasciculus and other white matter pathways in recovery of spontaneous speech. , 1989, Brain : a journal of neurology.

[48]  E. Capitani,et al.  Sex Differences in Recovery from Aphasia , 1982, Cortex.

[49]  C. Millikan,et al.  Factors that influence prognosis in acute focal cerebrovascular lesions. , 1953, A.M.A. archives of neurology and psychiatry.

[50]  E. Renzi,et al.  The Influence of Sex and Age on the Incidence and Type of Aphasia , 1980, Cortex.

[51]  William D. Hula,et al.  Translational research in aphasia: from neuroscience to neurorehabilitation. , 2008, Journal of speech, language, and hearing research : JSLHR.

[52]  D. Knopman,et al.  A longitudinal study of speech fluency in aphasia , 1983, Neurology.

[53]  A. Kertesz,et al.  The Structural Determinants of Recovery in Wernicke′s Aphasia , 1993, Brain and Language.

[54]  D. Mozaffarian,et al.  Heart disease and stroke statistics--2010 update: a report from the American Heart Association. , 2010, Circulation.

[55]  M. Albert,et al.  Effect of Socioeconomic Status on Aphasia Severity and Recovery , 2001, Brain and Language.

[56]  Robert H. Brookshire,et al.  Introduction to Neurogenic Communication Disorders , 1991 .

[57]  T. Kurth,et al.  The socioeconomic stroke puzzle. , 2007, Stroke.

[58]  M. Naeser,et al.  Relationship between lesion extent in 'Wernicke's area' on computed tomographic scan and predicting recovery of comprehension in Wernicke's aphasia. , 1987, Archives of neurology.

[59]  M. Sarno,et al.  Gender and Recovery from Aphasia after Stroke , 1985, Journal of Nervous and Mental Disease.