Variability in subcortical aphasia is due to variable sites of cortical hypoperfusion

Hillis, Argye E.; Barker, Peter B.; Wityk, Robert J.; Aldrich, Eric M.; Restrepo, Lucas; Breese, Elisabeth L.; Work, Melissa

doi:10.1016/j.bandl.2004.01.007

Cited by 99 publications

(92 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…NIHSS, median (range) 5 (2-17) 11 (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) Values are means ± standard deviations unless otherwise indicated. * High education = 5 (high school education) to 7 (university degree)…”

Section: Discussionmentioning

confidence: 99%

“…This explanation would suggest that reducing the volume of the lesion is not sufficient to ameliorate cognitive functioning in the long term after stroke. Other factors, such as the location of the lesion [17], the volume of hypoperfusion [18], or neuronal metabolic changes [19] have indeed been shown to be equally or more important for cognitive recovery after stroke. Alternatively, it is possible that rt-PA reduces lesion volume resulting in an improvement of focal cognitive functioning, but that, at the same time, rt-PA is neurotoxic [8] resulting in a concurrent global cognitive decline in some cases.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cognitive and functional outcome after intravenous recombinant tissue plasminogen activator treatment in patients with a first symptomatic brain infarct

Nys

Zandvoort

Algra³

et al. 2005

J Neurol

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cognitive and functional outcome after intravenous recombinant tissue plasminogen activator treatment in patients with a first symptomatic brain infarct

Nys

Zandvoort

Algra³

et al. 2005

J Neurol

View full text Add to dashboard Cite

“…In the acute phase of stroke cognitive impairment is related to direct local effects of the stroke, but also to hypoperfusion (Hillis et al, 2003(Hillis et al, , 2004 and functional deactivation (diaschisis) in nearby or remote areas of the brain (Ferro, 2001). Large variability in cognitive function exists among acute stroke patients, depending in part on the location and size of the lesion.…”

Section: Introductionmentioning

confidence: 99%

Domain-specific cognitive recovery after first-ever stroke: A follow-up study of 111 cases

Nys

Zandvoort

Kort

et al. 2005

J. Inter. Neuropsych. Soc.

137

119

View full text Add to dashboard Cite

The objective of this study is to examine the prognosis of acute cognitive disorders post-stroke, and to evaluate which clinical factors predict domain-specific cognitive recovery. We followed the course of cognitive functioning in 111 stroke patients and 77 healthy controls by administering two neuropsychological examinations with a 6 to 10 month interval (mean interval, 7.5 6 1.3 months). The baseline examination was administered within three weeks post-stroke (mean interval, 7.9 6 4.2 days). To examine determinants of domain-specific cognitive recovery, we recorded vascular risk factors, clinical variables, and lesion characteristics. Recovery in visual perception0construction (83%) and visual memory (78%) was the most common. An acute cognitive disorder predicted a long-term disorder in the same domain (all p , .05), except for visual perception0construction. Factors associated with poor cognitive recovery were age (all p , .01), preexistent verbal ability (all p , .005), lesion locations involving the temporal (all p , .05), frontal ( p , .05) and occipital lobe (all p , .05), lesion volume ( p Յ .001), and diabetes mellitus ( p , .01). An early neuropsychological examination provides valuable information on long-term cognitive performance. The prognosis of higher-level visual disorders is the most favorable. Cognitive recovery is associated with age, preexistent ability, lesion volume, lesion location, and diabetes mellitus. (JINS, 2005, 11, 795-806.)

show abstract

“…That is, the volume of the penumbra is calculated by subtracting the abnormality seen in DWI from that seen in PWI. The resulting figure is the volume of tissue that, while compromised, has not experienced irreversible infarction (Hillis, Barker, Beauchamp, Gordon, & Wityk, 2000;Hillis et al, 2004). If the IP is reperfused, normal function will resume but if the area remains hypoperfused, permanent cell death will occur (Payabvash et al, 2010).…”

Section: Stages Of Recoverymentioning

confidence: 99%

“…Techniques such as Arterial Spin Labelling (ASL) measure blood perfusion levels and can identify hypoperfused regions not always identifiable with a structural scan. In acute aphasia, the degree of hypoperfusion is currently considered a more reliable predictor of neurological deficit than the size of the lesion (Hillis et al, 2000) and has been shown to have an influence on language function in the acute stages post-stroke (Hillis et al, 2000;Hillis et al, 2004). However, studies have also demonstrated that cerebral perfusion is still present in chronic stroke patients (Brumm et al, 2010), correlates with the severity of aphasia even at one month post-stroke and is actually a more reliable predictor of aphasia severity than lesion size (Fridriksson et al, 2002).…”

Section: Limitations and Future Directionsmentioning

confidence: 99%

Neurophysiological Markers of Language Recovery in Subacute Stroke

Roxbury¹

View full text Add to dashboard Cite

Most patients with aphasia recover language function to some degree, but there is significant variability in the speed, nature, and extent of language recovery that occurs in the months following a stroke. Currently, there is no effective method available to predict how an individual with aphasia will recover. The most accurate predictors of recovery to date rely on global outcome measures which do not provide relevant information regarding recovery of symptoms that are targeted in therapy. The overall goal of this thesis was to examine whether language-related brain activity predicted recovery of specific symptoms in aphasia. The first aim was to gain a clearer understanding of the neural mechanisms which underpin word processing in healthy individuals.Brain activity associated with spoken word processing was investigated firstly in a group of healthy young adults, then in a healthy older cohort in order to ascertain whether task performance was preserved in ageing and if so, whether a preserved performance was underpinned by age-related changes in the neural mechanisms. The second main aim was to investigate the neural substrates which underpin language processing in the subacute (2-6 weeks) and chronic (6 months) phases of aphasia recovery and to determine whether the timing and extent to which these mechanisms are recruited contributes to a good or poor language outcome. An auditory lexical decision task with a novel pseudoword condition was employed to investigate language recovery mechanisms and was selected to ensure that patients with aphasia in the subacute stage would be able to perform the task with sufficient accuracy. The real word stimuli consisted of concrete and abstract items. The stimuli were presented in an event-related fMRI task to young healthy controls, older healthy controls, and patients with aphasia during the subacute and chronic phases post-stroke. A range of behavioural language measures was administered to all three cohorts and at both time points for patients with aphasia.In the healthy young group, concrete words elicited increased activity in a widely distributed network of brain regions including bilateral angular gyrus (AG), left posterior cingulate and left dorsolateral prefrontal cortex, compared to abstract words. Meanwhile, no region showed increased activity for abstract compared to concrete words, rather differences were only observed in bilateral AG when abstract words were contrasted with pseudowords. In the healthy older group, region of interest (ROI) results identified that a preserved performance was associated with an altered pattern of left hemisphere activity in the inferior and middle frontal regions, the AG and the fusiform gyrus.Differences between the healthy older and healthy young group were identified in key language regions, with the left inferior frontal gyrus (IFG) showing increased activity for abstract and pseudowords compared to concrete words while increased activity in the left AG was observed in the younger group only.ii In patients with a...

show abstract

Variability in subcortical aphasia is due to variable sites of cortical hypoperfusion

Cited by 99 publications

References 32 publications

Cognitive and functional outcome after intravenous recombinant tissue plasminogen activator treatment in patients with a first symptomatic brain infarct

Cognitive and functional outcome after intravenous recombinant tissue plasminogen activator treatment in patients with a first symptomatic brain infarct

Domain-specific cognitive recovery after first-ever stroke: A follow-up study of 111 cases

Neurophysiological Markers of Language Recovery in Subacute Stroke

Contact Info

Product

Resources

About