Why Is It Difficult to Predict Language Impairment and Outcome in Patients with Aphasia after Stroke?

Abstract

One of the most devastating consequences of stroke is aphasia. Communication problems after stroke can severely impair the patient's quality of life and make even simple everyday tasks challenging. Despite intense research in the field of aphasiology, the type of language impairment has not yet been localized and correlated with brain damage, making it difficult to predict the language outcome for stroke patients with aphasia. Our primary objective is to present the available evidence that highlights the difficulties of predicting language impairment after stroke. The different levels of complexity involved in predicting the lesion site from language impairment and ultimately predicting the long-term outcome in stroke patients with aphasia were explored. Future directions and potential implications for research and clinical practice are highlighted.

The canonical semantic network supports residual language function in chronic post‐stroke aphasia

“…Language recovery after LMCA stroke is variable, with many survivors experiencing chronic deficits [Charidimou et al, 2014; Lazar et al, 2008; Pedersen, 1995]. Current theories of aphasia recovery are based primarily on evidence obtained from functional neuroimaging studies [Heiss and Thiel, 2006; Saur and Hartwigsen, 2012; Turkeltaub et al, 2011].…”

Transcranial Direct Current Stimulation in Poststroke Aphasia Recovery

“…It is now acknowledged, for example, that patients having one type of aphasia in the acute phase may present with a different form of aphasia weeks or months hence 37 . Many patients with aphasia have symptoms which, in fact, defy textbook categorization 38–39 .…”

“…The reorganization of dendrites following ischemic lesions can be highly variable 4 . Additionally, patients may experience psychosocial issues such as depression and anxiety which make it difficult to participate optimally in speech therapy during the acute phase 38 .…”

Distorted Multisensory Experiences of Order and Simultaneity

“…efron, 1963a, p. 404 Aphasia is associated with the loss of one's ability to speak and/or comprehend language along with the inability to read and write, usually caused by stroke or brain tumor. Research on aphasia has focused on the identification of the disrupted cognitive processes underlying language, along with the classification of aphasia depending on the symptoms and the brain areas affected (e.g., Charidimou et al, 2014). Efron (1963a), however, proposed that aphasia may be related to impaired temporal processing emphasizing the importance of correct phoneme ordering in language and the aphasic symptoms of jargon, neologisms, and "word-salad" in speech.…”