Post-stroke Aphasia as a Prognostic Factor for Cognitive and Functional Changes in Patients With Stroke: Ischemic Versus Hemorrhagic

Seo, Kyung Cheon; Ko, Joo Young; Kim, Tae Uk; Lee, Seong Jae; Hyun, Jung Keun; Kim, Seo Young

doi:10.5535/arm.19096

Cited by 10 publications

(9 citation statements)

References 20 publications

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“…In the final study, significant differences were found between the groups only in the SAS arm control and SAS hand function scores. Different results were reported by Seo et al, where the BI scores were significantly lower in aphasic patients than in non-aphasic controls [ 10 ]. Significantly worse results were found for the group of patients with aphasia, concerning everyday activities (measured with the Functional Independence Measurement), in studies by other authors, both at baseline and at the end of the study [ 12 , 19 ].…”

Section: Discussioncontrasting

confidence: 60%

“…These include age, type of stroke, presence of cognitive impairments and post-stroke depression, acceptance of the disease, level of self-sufficiency, functional status at admission to a rehabilitation ward, motor function and trunk movements [ 3 , 4 , 5 , 6 , 7 , 8 , 9 ]. The presence of aphasia is also relevant [ 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Stroke patients with aphasia are also more likely to have depression, memory disorders and longer stays necessary for rehabilitation [ 12 , 21 , 22 ]. Aphasia may be a risk factor in the development of post-stroke depression [ 23 ] and it can be a prognostic factor for cognitive status [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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A Comparative Analysis of Functional Status and Mobility in Stroke Patients with and without Aphasia

Guzek

Dziubek

Stefańska

et al. 2022

JCM

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All researchers agree that aphasia is a serious consequence of a stroke, but they also report contradictory data regarding the functional outcome. The aim of this study was, therefore, to assess the functional outcomes of stroke patients with and without aphasia, who were undertaking a regular rehabilitation programme. Materials and Methods: The study group consisted of 116 post-stroke patients, including 54 patients without aphasia (G1) and 62 patients with aphasia (G2). The following tests were used before (T1) and after (T2) rehabilitation measurement points: Barthel Index (BI), Sitting Assessment Scale (SAS), Berg Balance Scale (BBS), Trunk Control Test (TCT), Test Up & Go (TUG) and the Timed Walk Test (TWT). Results: The group of post-stroke patients with aphasia had a significantly longer time since a stroke on admission, a significantly longer length of stay in the ward and significantly worse SAS and TCT scores at T2, compared to patients without aphasia. Both groups achieved significant improvement in all studied parameters (SAS, TCT, BI, BBS, TUG and TWT). Aphasia was a predictor of functional status in the stroke patients group, but only at the time of admission to the ward. Conclusions: Patients with and without aphasia have an equal likelihood of improving their functional status and returning to independence. Aphasia should not be an absolute factor that excludes stroke patients from research studies on their functional status.

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Section: Discussioncontrasting

confidence: 60%

Section: Introductionmentioning

confidence: 99%

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A Comparative Analysis of Functional Status and Mobility in Stroke Patients with and without Aphasia

Guzek

Dziubek

Stefańska

et al. 2022

JCM

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“…Despite the mBI scale does not directly measure communication components, it is noticeable the importance of communication levels on functional recovery. In the literature, the role of communication limitations, such as aphasia, is controversial [ 48 , 49 ]. Like other measures of disability, SDC does not explain the specifics of the disorders (aphasia, apraxia, dysarthria, dementia, deafness) which, individually or in combination, can impair communication.…”

Section: Discussionmentioning

confidence: 99%

Cross-validation of predictive models for functional recovery after post-stroke rehabilitation

Campagnini

Liuzzi

Mannini

et al. 2022

J NeuroEngineering Rehabil

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Background Rehabilitation treatments and services are essential for the recovery of post-stroke patients’ functions; however, the increasing number of available therapies and the lack of consensus among outcome measures compromises the possibility to determine an appropriate level of evidence. Machine learning techniques for prognostic applications offer accurate and interpretable predictions, supporting the clinical decision for personalised treatment. The aim of this study is to develop and cross-validate predictive models for the functional prognosis of patients, highlighting the contributions of each predictor. Methods A dataset of 278 post-stroke patients was used for the prediction of the class transition, obtained from the modified Barthel Index. Four classification algorithms were cross-validated and compared. On the best performing model on the validation set, an analysis of predictors contribution was conducted. Results The Random Forest obtained the best overall results on the accuracy (76.2%), balanced accuracy (74.3%), sensitivity (0.80), and specificity (0.68). The combination of all the classification results on the test set, by weighted voting, reached 80.2% accuracy. The predictors analysis applied on the Support Vector Machine, showed that a good trunk control and communication level, and the absence of bedsores retain the major contribution in the prediction of a good functional outcome. Conclusions Despite a more comprehensive assessment of the patients is needed, this work paves the way for the implementation of solutions for clinical decision support in the rehabilitation of post-stroke patients. Indeed, offering good prognostic accuracies for class transition and patient-wise view of the predictors contributions, it might help in a personalised optimisation of the patients’ rehabilitation path.

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“…Although most common screening tools require verbal communication, there are several questionnaires that omit language tasks and may be adapted for patients with aphasia 16,66 . Post‐stroke aphasia is a common consequence of brain injury, diagnosed in approximately one third of acute stroke patients 67 predisposed to post‐stroke cognitive deficits, especially in memory, executive function and attention 68,69 . Therefore, despite diagnostic difficulties, assessment of cognitive function should be an important part of neuropsychological examination of stroke survivors with aphasia.…”

Section: Screening and Diagnosismentioning

confidence: 99%

Current view on post‐stroke dementia

Droś

Klimkowicz‐Mrowiec

2021

Psychogeriatrics

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Dementia is one of the leading complications after stroke affecting about one third of survivors. Prevalence of post‐stroke dementia (PSD) differs between studies due to variability in methodology, characteristics of included patients, type of stroke, diagnostic tools used to identify patients with dementia, or time when the assessment was performed. Patients diagnosed with PSD are at higher risk of mortality, disability, and institutionalization. Aetiology of PSD may include mixed overlapping processes such as vascular brain pathology or Alzheimer's disease. Several risk factors have been found to increase PSD incidence, involving demographics, vascular factors, stroke characteristics, abnormalities on neuroimaging, and stroke complications. However, the influence of some other factors still remains unclear. PSD may coexist with other neuropsychiatric disorders and its association with post‐stroke depression seems to be the most significant. There is a strong need for further research on possible genetic, biological, and inflammatory biomarkers. Also, there are no unambiguously efficacious methods of management. Continuing to address these issues will help to find more effective interventions directly targeting prevention and treatment of PSD in the future.

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Post-stroke Aphasia as a Prognostic Factor for Cognitive and Functional Changes in Patients With Stroke: Ischemic Versus Hemorrhagic

Cited by 10 publications

References 20 publications

A Comparative Analysis of Functional Status and Mobility in Stroke Patients with and without Aphasia

A Comparative Analysis of Functional Status and Mobility in Stroke Patients with and without Aphasia

Cross-validation of predictive models for functional recovery after post-stroke rehabilitation

Current view on post‐stroke dementia

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