Lesion Site Patterns in Severe, Nonverbal Aphasia to Predict Outcome With a Computer-Assisted Treatment Program

Abstract

Lesion site patterns on computed tomographic scans are helpful to define candidacy for C-ViC training, and to predict outcome level. A practical method is presented for clinical application of these lesion site results in combination with aphasia test scores.

Lesion characteristics related to treatment improvement in object and action naming for patients with chronic aphasia

“…Hence, the differences in image quality can be easily accommodated by this approach. Given the previous success of this technique in revealing important commonalities in lesions between aphasia patients (Naeser et al, 1998; Naeser & Hayward, 1978; Naeser et al, 1989), given the guidance of the Matsui and Hirano (1978) atlas in locating objective ROI boundaries for cortical ROIs, and given our ability to train raters to a high degree of reliability (r=.887) on an independent set of images, we are confident that the degree of lesion was adequately captured by application of Naeser’s technique. Finally, in the current study, use of the ROI method allowed for the statistical control of particular regions (using partial correlations) in order to more clearly observe correlations between other regions and various naming measures.…”

“…Lesions were analyzed using a modified version of a protocol developed by Naeser and colleagues (Naeser et al, 1998; Naeser & Hayward, 1978; Naeser et al, 1989). According to the Naeser method, lesions are localized with the aid of a set of axial templates representing the angle at which CT scans are typically acquired (15 degrees from the canthomeatal line).…”

“…More detailed descriptions of the lesion analysis technique, including templates, are available, and will not be reproduced here (Parkinson, 2006; Naeser et al, 1998). For scans which were not able to be viewed at the standard angle, landmarks were identified using alternative templates (Damasio & Damasio, 1989).…”

Lesion characteristics related to treatment improvement in object and action naming for patients with chronic aphasia

“…Hence, the differences in image quality can be easily accommodated by this approach. Given the previous success of this technique in revealing important commonalities in lesions between aphasia patients (Naeser et al, 1998; Naeser & Hayward, 1978; Naeser et al, 1989), given the guidance of the Matsui and Hirano (1978) atlas in locating objective ROI boundaries for cortical ROIs, and given our ability to train raters to a high degree of reliability (r=.887) on an independent set of images, we are confident that the degree of lesion was adequately captured by application of Naeser’s technique. Finally, in the current study, use of the ROI method allowed for the statistical control of particular regions (using partial correlations) in order to more clearly observe correlations between other regions and various naming measures.…”

“…Lesions were analyzed using a modified version of a protocol developed by Naeser and colleagues (Naeser et al, 1998; Naeser & Hayward, 1978; Naeser et al, 1989). According to the Naeser method, lesions are localized with the aid of a set of axial templates representing the angle at which CT scans are typically acquired (15 degrees from the canthomeatal line).…”

“…More detailed descriptions of the lesion analysis technique, including templates, are available, and will not be reproduced here (Parkinson, 2006; Naeser et al, 1998). For scans which were not able to be viewed at the standard angle, landmarks were identified using alternative templates (Damasio & Damasio, 1989).…”

Changes in Language Function and Recovery-Related Prognostic Factors in First-Ever Left Hemispheric Ischemic Stroke

“…Large lesion size has been mentioned as a negative prognostic factor for language recovery in previous studies [26][27][28][29][30]. In terms of post-stroke aphasia severity, our study is consistent with previous reports, in that the severity of aphasia increased with an increase in the volume of the stroke lesion, as the average lesion volumes were 5.0±8.8, 5.8±10.6, and 13.8±20.4 in the mild, moderate, and severe groups, respectively [15].…”

Lesion-site-dependent responses to therapy after aphasic stroke

“…Past studies have suggested that responses to treatment for word-finding deficits (anomia) after stroke may be related to pretreatment behavioural skills5 or lesions 6 7. Our results are consistent with that work and also extend it by: (1) quantifying the relative value of pretreatment structural MRI versus demographic and behavioural data, in explaining treatment responses and (2) demonstrating that, in combination (though not separately), these pretreatment data can be used to predict new patients’ responses to treatment.…”

Lesion characteristics related to treatment improvement in object and action naming for patients with chronic aphasia

“…Hence, the differences in image quality can be easily accommodated by this approach. Given the previous success of this technique in revealing important commonalities in lesions between aphasia patients (Naeser et al, 1998; Naeser & Hayward, 1978; Naeser et al, 1989), given the guidance of the Matsui and Hirano (1978) atlas in locating objective ROI boundaries for cortical ROIs, and given our ability to train raters to a high degree of reliability (r=.887) on an independent set of images, we are confident that the degree of lesion was adequately captured by application of Naeser’s technique. Finally, in the current study, use of the ROI method allowed for the statistical control of particular regions (using partial correlations) in order to more clearly observe correlations between other regions and various naming measures.…”

“…Lesions were analyzed using a modified version of a protocol developed by Naeser and colleagues (Naeser et al, 1998; Naeser & Hayward, 1978; Naeser et al, 1989). According to the Naeser method, lesions are localized with the aid of a set of axial templates representing the angle at which CT scans are typically acquired (15 degrees from the canthomeatal line).…”

“…More detailed descriptions of the lesion analysis technique, including templates, are available, and will not be reproduced here (Parkinson, 2006; Naeser et al, 1998). For scans which were not able to be viewed at the standard angle, landmarks were identified using alternative templates (Damasio & Damasio, 1989).…”

Changes in Language Function and Recovery-Related Prognostic Factors in First-Ever Left Hemispheric Ischemic Stroke

“…Large lesion size has been mentioned as a negative prognostic factor for language recovery in previous studies [26][27][28][29][30]. In terms of post-stroke aphasia severity, our study is consistent with previous reports, in that the severity of aphasia increased with an increase in the volume of the stroke lesion, as the average lesion volumes were 5.0±8.8, 5.8±10.6, and 13.8±20.4 in the mild, moderate, and severe groups, respectively [15].…”

Lesion-site-dependent responses to therapy after aphasic stroke

“…Past studies have suggested that responses to treatment for word-finding deficits (anomia) after stroke may be related to pretreatment behavioural skills5 or lesions 6 7. Our results are consistent with that work and also extend it by: (1) quantifying the relative value of pretreatment structural MRI versus demographic and behavioural data, in explaining treatment responses and (2) demonstrating that, in combination (though not separately), these pretreatment data can be used to predict new patients’ responses to treatment.…”

Lesion characteristics related to treatment improvement in object and action naming for patients with chronic aphasia

“…Hence, the differences in image quality can be easily accommodated by this approach. Given the previous success of this technique in revealing important commonalities in lesions between aphasia patients (Naeser et al, 1998; Naeser & Hayward, 1978; Naeser et al, 1989), given the guidance of the Matsui and Hirano (1978) atlas in locating objective ROI boundaries for cortical ROIs, and given our ability to train raters to a high degree of reliability (r=.887) on an independent set of images, we are confident that the degree of lesion was adequately captured by application of Naeser’s technique. Finally, in the current study, use of the ROI method allowed for the statistical control of particular regions (using partial correlations) in order to more clearly observe correlations between other regions and various naming measures.…”

“…Lesions were analyzed using a modified version of a protocol developed by Naeser and colleagues (Naeser et al, 1998; Naeser & Hayward, 1978; Naeser et al, 1989). According to the Naeser method, lesions are localized with the aid of a set of axial templates representing the angle at which CT scans are typically acquired (15 degrees from the canthomeatal line).…”

“…More detailed descriptions of the lesion analysis technique, including templates, are available, and will not be reproduced here (Parkinson, 2006; Naeser et al, 1998). For scans which were not able to be viewed at the standard angle, landmarks were identified using alternative templates (Damasio & Damasio, 1989).…”

Changes in Language Function and Recovery-Related Prognostic Factors in First-Ever Left Hemispheric Ischemic Stroke

“…Large lesion size has been mentioned as a negative prognostic factor for language recovery in previous studies [26][27][28][29][30]. In terms of post-stroke aphasia severity, our study is consistent with previous reports, in that the severity of aphasia increased with an increase in the volume of the stroke lesion, as the average lesion volumes were 5.0±8.8, 5.8±10.6, and 13.8±20.4 in the mild, moderate, and severe groups, respectively [15].…”

Lesion-site-dependent responses to therapy after aphasic stroke

“…Past studies have suggested that responses to treatment for word-finding deficits (anomia) after stroke may be related to pretreatment behavioural skills5 or lesions 6 7. Our results are consistent with that work and also extend it by: (1) quantifying the relative value of pretreatment structural MRI versus demographic and behavioural data, in explaining treatment responses and (2) demonstrating that, in combination (though not separately), these pretreatment data can be used to predict new patients’ responses to treatment.…”