Naming errors and dysfunctional tissue metrics predict language recovery after acute left hemisphere stroke

Meier, Erin L.; Goldberg, Emily; Head, Catherine R.; Ubellacker, Delaney; Walker, Alexandra; Hillis, Argye E.

doi:10.1016/j.neuropsychologia.2020.107651

Cited by 14 publications

(8 citation statements)

References 80 publications

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“…To note, we included <10% of patients with prior chronic stroke because our primary aim was to understand the recovery mechanisms after acute stroke damage and with these limited subject inclusions, prior stroke history is not a significant factor accounting for language recovery. 43 The control group consisted of 13 non-brain damaged participants (three male, 11 right-handed) with normal cognitive ability (Mini-Mental State Examination Scores > 26) 44 matched in age and education with the patient group (| t |’s < 1.77; p’ s > 0.08). Mean age and education were 55 (SD = 14, range = 37–78) and 16 (SD = 3; range = 12–22) years, respectively.…”

Section: Methodsmentioning

confidence: 99%

Anterior Connectivity Critical for Recovery of Connected Speech after Stroke

Ding

Schnur

2022

Preprint

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Connected speech recovers to different degrees across people after left hemisphere stroke, but white matter predictors of differential recovery from the acute stage of stroke are unknown. We assessed changes in lexical-syntactic aspects of connected speech in a longitudinal analysis of 41 individuals (19 females) from the acute stage of LH stroke (within an average 4 days post-stroke) to subacute (within 2 months) and chronic stages (early: 6 months, late: 1 year) while measuring the extent of acute lesions on white-matter tracts to identify tracts predictive of recovery. We found that acute damage to the frontal aslant tract led to decreased recovery of the fluency and structural complexity of connected speech during the year following left hemisphere stroke. In addition, acute damage of the frontal aslant tract and the posterior and long segments of the arcuate fasciculus negatively impacted the recovery of syntactic accuracy, although the associations did not survive correction for multiple comparisons. Results were independent of baseline performance, overall lesion volume, and the proportion damage to tract-adjacent gray matter. This longitudinal analysis from acute to chronic stroke provides the first evidence that recovery of fluent and structurally complex spontaneous connected speech requires intact left frontal connectivity via the frontal aslant tract. That the frontal aslant tract was critical for recovery at early as well as later stages of stroke demonstrates that anterior connectivity plays a lasting and important role for the reorganization of function related to the successful production of connected speech.

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Section: Methodsmentioning

confidence: 99%

Anterior Connectivity Critical for Recovery of Connected Speech after Stroke

Ding

Schnur

2022

Preprint

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“…The final sample included 29 patients (13 women; mean age: 60.76 ± 12.65 years). Different data from some participants were included in recent publications (Goldberg et al, 2021 ; Keator et al, 2020 ; Keser et al, 2020 , 2021 ; Meier et al, 2020 ).…”

Section: Methodsmentioning

confidence: 99%

Executive control deficits and lesion correlates in acute left hemisphere stroke survivors with and without aphasia

Meier

Kelly²,

Goldberg

et al. 2021

Brain Imaging and Behavior

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In contrast to the traditional definition of the disorder, many individuals with aphasia exhibit non-linguistic cognitive impairments, including executive control deficits. Classic lesion studies cite frontal lobe damage in executive dysfunction, but more recent lesion symptom-mapping studies in chronic aphasia present mixed results. In this study, we compared executive control abilities of acute stroke survivors with and without aphasia and investigated lesion correlates of linguistic and non-linguistic cognitive tasks. Twenty-nine participants with acute left hemisphere stroke resulting in aphasia (n = 14) or no aphasia (n = 15) completed clinical MRI and testing, including three NIH Toolbox Cognition Batteries (Pattern Comparison Processing Speed, Flanker Inhibitory Control and Attention, and Dimensional Change Card Sort Tests) and the Boston Naming Test. We compared performance between groups using Wilcoxon rank sum tests. We used Least Absolute Shrinkage and Selection Operator Regression to identify neural markers (percent regional damage, hypoperfusion within vascular territories, and total lesion volume) of executive control deficits and anomia. Group performance was comparable on the Pattern Comparison Processing Speed Test, but people with aphasia had poorer standard scores, lower accuracy, and slower response times on the Dimensional Change Card Sort Test than people without aphasia. Damage to extrasylvian regions (dorsolateral prefrontal cortex, intraparietal sulcus) was related to executive control deficits, whereas language network damage (to inferior frontal and superior and posterior middle temporal gyri) was linked to naming impairments. These results suggest people with aphasia can exhibit comorbid executive control impairments linked to damage outside classic language network areas. Supplementary Information The online version contains supplementary material available at 10.1007/s11682-021-00580-y.

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“…We believe language summary z-scores are a good general reflection of overall language deficits regardless of the battery used. Such summary scores have been employed with success in recent work [29,61,62].…”

Section: Plos Onementioning

confidence: 99%

The contribution of white matter pathology, hypoperfusion, lesion load, and stroke recurrence to language deficits following acute subcortical left hemisphere stroke

Sharif

Goldberg²,

Walker³

et al. 2022

PLoS ONE

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Aphasia, the loss of language ability following damage to the brain, is among the most disabling and common consequences of stroke. Subcortical stroke, occurring in the basal ganglia, thalamus, and/or deep white matter can result in aphasia, often characterized by word fluency, motor speech output, or sentence generation impairments. The link between greater lesion volume and acute aphasia is well documented, but the independent contributions of lesion location, cortical hypoperfusion, prior stroke, and white matter degeneration (leukoaraiosis) remain unclear, particularly in subcortical aphasia. Thus, we aimed to disentangle the contributions of each factor on language impairments in left hemisphere acute subcortical stroke survivors. Eighty patients with acute ischemic left hemisphere subcortical stroke (less than 10 days post-onset) participated. We manually traced acute lesions on diffusion-weighted scans and prior lesions on T2-weighted scans. Leukoaraiosis was rated on T2-weighted scans using the Fazekas et al. (1987) scale. Fluid-attenuated inversion recovery (FLAIR) scans were evaluated for hyperintense vessels in each vascular territory, providing an indirect measure of hypoperfusion in lieu of perfusion-weighted imaging. We found that language performance was negatively correlated with acute/total lesion volumes and greater damage to substructures of the deep white matter and basal ganglia. We conducted a LASSO regression that included all variables for which we found significant univariate relationships to language performance, plus nuisance regressors. Only total lesion volume was a significant predictor of global language impairment severity. Further examination of three participants with severe language impairments suggests that their deficits result from impairment in domain-general, rather than linguistic, processes. Given the variability in language deficits and imaging markers associated with such deficits, it seems likely that subcortical aphasia is a heterogeneous clinical syndrome with distinct causes across individuals.

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Naming errors and dysfunctional tissue metrics predict language recovery after acute left hemisphere stroke

Cited by 14 publications

References 80 publications

Anterior Connectivity Critical for Recovery of Connected Speech after Stroke

Anterior Connectivity Critical for Recovery of Connected Speech after Stroke

Executive control deficits and lesion correlates in acute left hemisphere stroke survivors with and without aphasia

The contribution of white matter pathology, hypoperfusion, lesion load, and stroke recurrence to language deficits following acute subcortical left hemisphere stroke

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