Aphasia assessment and functional outcome prediction in patients with aphasia after stroke

Abstract

Available studies did not clarify whether a language examination may predict functional and motor outcome in patients with aphasia undergoing rehabilitation. This was the aim of the current study. Language examination considered in this study was the Aachen Aphasia Test (AAT). One hundred fifty-six patients with a primary diagnosis of acute cerebrovascular accident of left hemisphere were included: 105 with and 51 without aphasia. Backward stepwise regression analysis was used to predict final scores in total-, motor-, and cognitive-Functional Independence Measure (FIM). The independent variables were age, gender, stroke type, stroke lesion size, onset to admission interval, National Institute of Health Stroke Scale, Fugl-Meyer Scale, Trunk Control Test, initial motor-FIM, and AAT (spontaneous speech, token test, repetition, written language, confrontation naming, comprehension). In the multivariate regression analysis, comprehension was the only function of the language to be predictor of the final total-FIM (β = +0.35) and final cognitive-FIM (β = +0.61). Comprehension was a predictor of total-FIM (β = +0.27) and cognitive-FIM (β = +0.54) as well, when additional backward stepwise regression analysis (which did not include comprehension and expression scores in the final total- and cognitive-FIM) was performed. When multivariate regression analysis took into consideration only language functions as independent variables, spontaneous speech (β = +0.41) only was the predictor of motor-FIM. The study highlights that AAT is the predictor of functional outcome in the patient with aphasia. Among the functions of language, comprehension seems to be the most important predictive factor of total- and cognitive-FIM, while spontaneous speech seems to be a predictor of motor-FIM.

Montreal–Toulouse Language Assessment Battery: Evidence of criterion validity from patients with aphasia

“…Patients with aphasia also tended to obtain lower scores than the clinical control groups, corroborating the results of other studies in the literature [22,25,35,40,51]. The data displayed in Table 2 show that some participants in the LHDna and RHD groups performed similarly to individuals with aphasia.…”

Noninvasive Brain Stimulation for Treatment of Right- and Left-Handed Poststroke Aphasics

“…In approximately 30% of stroke victims the impairment or loss of language function - aphasia - is the leading deficit, which improves within 6 months in approximately half of the cases [1,2,3]. The disability in daily life due to poststroke aphasia is dependent on the subtype of stroke and its location, which determines the type of language disturbance affecting receptive or expressive functions or both [4,5,6]. Speech and language therapy (SLT) is able to improve various aspects of aphasia, namely functional communication as well as expressive and receptive performance (review in Brady et al [7]), especially when started early in the poststroke phase and continued with 5-10 h a week for an extended period of time [8].…”

Investigating the ability of post-stroke EEG measures of brain dysfuntion to inform early prediction of cognitive impairment or depression outcomes

“…A specific cognitive outcome assessment (such as the MoCA) has not been used, although this is a future aim and this is not the first study to analyse cognitive sub-total scores from the FIM (Gialanella andFerlucci, 2010, Gialanella, 2011 Table 1) from 20 cases indicate that only one patient had a higher NIHSS (5) at follow-up than at the time of EEG (4). These observations indicate that these 20 cases did not include any of progressive strokes, albeit longitudinal imaging data could help confirm this and such topics may be investigated in future studies.…”

“…A sub-score of cognitive items from the FIM assessment have previously been used to assess cognitive outcome in stroke patients (Gialanella andFerlucci, 2010, Gialanella, 2011). Although the FIM-FAM avoids the pitfalls of pen and paper assessment, as detailed previously regarding the MoCA and MMSE, it can be a coarse measure.…”