Aphasia in border-zone infarcts has a specific initial pattern and good long-term prognosis

Flamand-Roze, Constance; Cauquil-Michon, Cécile; Roze, Emmanuel; Souillard-Scémama, Raphaëlle; Maintigneux, Lisa; Ducreux, D.; Adams, David C.; Denier, Christian

doi:10.1111/j.1468-1331.2011.03422.x

Cited by 16 publications

(5 citation statements)

References 20 publications

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“…Our results are more heterogeneous with symptoms mimicking MCA infarction in roughly one-fourth of our patients. Dysphasia was frequent and had a distinct clinical and outcome pattern, with initial transcortical mixed aphasia, evolving according to location to transcortical motor or sensitive aphasia, of excellent long-term prognosis, confirming ours and the data of others 23 27. Our five patients with bilateral C-BZIs differ from previously reported cases by the absence of pseudo-bulbar or pseudo-brainstem syndromes, syncopes, limb shaking or cortical blindness 5 6 15 19.…”

Section: Discussionsupporting

confidence: 89%

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Cortical border-zone infarcts: clinical features, causes and outcome

Join-Lambert

Saliou

Flamand-Roze

et al. 2012

J Neurol Neurosurg Psychiatry

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Section: Discussionsupporting

confidence: 89%

“…Indeed, exclusively deep BZIs were excluded in this study because of the difficulty to differentiate them from the lacunar infarctions due to small-vessel disease (perforating arteries infarcts) (see material and methods section).†Including eight previously reported aphasic patients (Flamand-Roze et al , 2011) 23…”

Section: Methodsmentioning

confidence: 99%

Cortical border-zone infarcts: clinical features, causes and outcome

Join-Lambert

Saliou

Flamand-Roze

et al. 2012

J Neurol Neurosurg Psychiatry

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“…It also allows description of specific aphasic patterns that can be specific to stroke location such as transcortical aphasia in borderzone infarcts [42,43]. We recently developed and validated a brief language screening scale in French, named LAST (Language Screening Test) [44••], for the assessment of patients with acute stroke.…”

Section: Tools For Language Assessmentmentioning

confidence: 99%

Tools and Early Management of Language and Swallowing Disorders in Acute Stroke Patients

Flamand-Roze

Cauquil-Michon

Denier

2011

Curr Neurol Neurosci Rep

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The role of the stroke units in improving morbidity, mortality, and recovery from stroke is clearly demonstrated. However, acute management of language disorders in these specialized units remains controversial, and management of swallowing disorders is usually nonstandardized. The recent validation of a scale for rapid screening of language disorders (LAST [Language Screening Test]) in acute stroke patients should allow optimization of their detection and early management. Swallowing disorders should be screened and managed using a standardized protocol. Following early initial evaluation repeated on a daily basis, they justify tailored rehabilitation sessions, adaptation of food textures, team formation, and families' information. The use of these protocols implies the cooperation and coordination of the medical and paramedical teams and the daily presence of speech therapists. These aspects are crucial for patients in the stroke units to achieve full benefits from the management proposed in this paper, leading to diminution of complications and better long-term functional prognosis.

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“…, the junction between anterior and middle cerebral arteries). These aphasias (motor, sensory and mixed transcorticals and anomic) are characterized by preserved repetition and echolalia with variable deficits in other language domains (spontaneous speech, comprehension and naming) and usually have better long-term prognosis than perisylvian aphasias[ 8 ]. Whereas infarctions account for around 80% of cases, hemorrhages are less frequent[ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Spectrum of neuropsychiatric symptoms in chronic post-stroke aphasia

Edelkraut¹,

López-Barroso²,

Torres‐Prioris³

et al. 2022

WJP

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BACKGROUND Neuropsychiatric symptoms (NPS) have been insufficiently examined in persons with aphasia (PWA) because most previous studies exclude participants with language and communication disorders. AIM To report a two-part study consisting of a literature review and an observational study on NPS in post-stroke aphasia. METHODS Study 1 reviewed articles obtained from PubMed, PsycINFO, Google Scholar and Cochrane databases after cross-referencing key words of post-stroke aphasia to NPS and disorders. Study 2 examined language deficits and activities of daily living in 20 PWA (median age: 58, range: 28-65 years; 13 men) with the Western Aphasia Battery-Revised and the Barthel Index, respectively. Informants of these 20 PWA were proxy-evaluated with the Neuropsychiatric Inventory and domain-specific scales, including the Stroke Aphasia Depression Questionnaire-10 item version and the Starkstein Apathy Scale. In addition, an adapted version of the Hospital Anxiety and Depression Scale was directly administered to the PWA themselves. This observational study is based on the baseline assessment of an intervention clinical trial (EudraCT: 2017-002858-36; ClinicalTrials.gov identifier: NCT04134416). RESULTS The literature review revealed a broad spectrum of NPS in PWA, including depression, anxiety, apathy, agitation/aggression, eating and sleep disorders, psychosis, and hypomania/mania. These findings alert to the need for improving assessment and treatment approaches of NPS taking into consideration their frequent occurrence in PWA. Study 2 showed that the 20 participants had mild- to-moderate aphasia severity and were functionally independent. A wide range of comorbid NPS was found in the post-stroke aphasic population (median number of NPS: 5, range: 1-8). The majority of PWA (75%) had depressive symptoms, followed by agitation/aggression (70%), irritability (70%), anxiety (65%) and appetite/eating symptoms (65%). Half of them also presented symptoms of apathy, whereas euphoria and psychotic symptoms were rare (5%). Domain-specific scales revealed that 45% of participants had apathy and 30% were diagnosed with depression and anxiety. CONCLUSION Concurrent NPS are frequent in the chronic period of post-stroke aphasia. Therefore, further research on reliable and valid assessment tools and treatment for this aphasic population is strongly warranted.

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Aphasia in border-zone infarcts has a specific initial pattern and good long-term prognosis

Abstract: We report a specific aphasic pattern associated with hemispheric BZI, including an excellent long-term outcome. These findings appear relevant to (i) clinically suspect BZI and (ii) plan rehabilitation and inform the patient and his family of likelihood of full language recovery.

Cited by 16 publications

References 20 publications

Cortical border-zone infarcts: clinical features, causes and outcome

Cortical border-zone infarcts: clinical features, causes and outcome

Tools and Early Management of Language and Swallowing Disorders in Acute Stroke Patients

Spectrum of neuropsychiatric symptoms in chronic post-stroke aphasia

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