A topographic study on the evaluation of speech and language in the acute phase of a first stroke

Abstract

Evaluation of speech and language may help in localization of site and extension of brain lesions, particularly in the absence of other neurological signs or radiologically defined injuries. Objective: To verify what language tasks are best correlated to which brain regions, in order to develop a test for neurologists in emergency settings. Method: Thirty-seven adult first-stroke patients were submitted to cognitive and language tests, and then paired with thirty-seven healthy controls. Patients underwent CT and/or MRI for topographic correlation with test results (p<0.05). Results: All tests were able to distinguish patients from controls, but only word/sentence repetition, naming, ideomotor praxis and, non-significantly, comprehension and counting 1-20 predicted left hemisphere lesions. Repetition was related to perisylvian structures, comprehension to the posterior portion of the middle cerebral artery territory, and fluency to frontal lesions, while naming was accurate only for lesion side. Conclusion: Language and cognitive tasks can help in the localization of acute stroke lesions. Key words: linguistics, aphasia, apraxias, stroke, brain infarction, language, speech, disability evaluation.Um estudo topográfico da avaliação de fala e linguagem na fase aguda de um primeiro infarto cerebral RESUMO Avaliação de fala e linguagem pode ajudar na localização do sítio e da extensão de lesões cerebrais, especialmente quando ausentes outros sinais neurológicos ou radiológicos. Objetivo: Verificar quais tarefas linguísticas se correlacionam melhor com quais regiões cerebrais, a fim de desenvolver um teste para uso pelos neurologistas em emergências. Método: 37 pacientes e 37 controles pareados passaram por avaliação linguístico-cognitiva. Pacientes foram submetidos a TC e/ou RM para correlação topográfica com os resultados da avaliação (p<0,05). Resultados: Todos os testes diferenciaram pacientes de controles, mas apenas os de repetição de palavras/sentenças, nomeação, praxia ideomotora e, de forma não-significativa, compreensão e contagem 1-20 puderam predizer lesões no hemisfério esquerdo. Os testes de repetição estavam relacionados com estruturas perisylvianas, compreensão com a porção posterior do território da artéria cerebral média, e fluência com regiões frontais, enquanto os de nomeação localizavam apenas o lado das lesões. Conclusão: Testes linguístico-cognitivos podem ajudar a localizar infartos cerebrais agudos. Palavras-Chave: linguística, afasia, apraxias, acidente cerebral vascular, infarto encefálico, linguagem, fala, avaliação da deficiência.

Aspects correlates with Scandinavian Stroke Scale for predicting early neurological impairment

“…Diverse studies emphasize that the territory irrigated by the MCA presents greater cortical representation for the hand and speech, given that brachial paresis, global aphasia and comprehension disorders are found with greater frequency in infarcts in these territories 20,21 . The SSS is currently utilized to predict the severity of the neurological impairment 22,23,24 .…”

Verbal Neuropsychological Functions in Aphasia: An Integrative Model

“…Impairments in such domains may be related to comprehensive and expressive aphasias. However, the interaction among verbal comprehension, verbal expression and other well known verbal domains such as repetition, naming, reading, writing, phonological processing, spelling, and verbal memory (Anthony et al 2007;Buchsbaum et al 2011;Chen et al 2008;Crockett et al 1981;de Oliveira and Damasceno 2011;Goodglass and Kaplan 1996;López-Barroso et al 2013;Mano and Osmon 2008;Nadeau 2001;Rohrer et al 2008;Tomblin and Zhang 2006;Shewan and Kertesz 1980;Sinanović et al 2011;Waters and Caplan 2003;Weems and Reggia 2006) needs to be elucidated.…”