Leukoaraiosis Is Not Associated With Recovery From Aphasia in the First Year After Stroke.

IF 3.6 Q1 LINGUISTICS Neurobiology of Language Pub Date : 2023-10-31 eCollection Date: 2023-01-01 DOI:10.1162/nol_a_00115
Alexandra C Brito, Deborah F Levy, Sarah M Schneck, Jillian L Entrup, Caitlin F Onuscheck, Marianne Casilio, Michael de Riesthal, L Taylor Davis, Stephen M Wilson
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Abstract

After a stroke, individuals with aphasia often recover to a certain extent over time. This recovery process may be dependent on the health of surviving brain regions. Leukoaraiosis (white matter hyperintensities on MRI reflecting cerebral small vessel disease) is one indication of compromised brain health and is associated with cognitive and motor impairment. Previous studies have suggested that leukoaraiosis may be a clinically relevant predictor of aphasia outcomes and recovery, although findings have been inconsistent. We investigated the relationship between leukoaraiosis and aphasia in the first year after stroke. We recruited 267 patients with acute left hemispheric stroke and coincident fluid attenuated inversion recovery MRI. Patients were evaluated for aphasia within 5 days of stroke, and 174 patients presented with aphasia acutely. Of these, 84 patients were evaluated at ∼3 months post-stroke or later to assess longer-term speech and language outcomes. Multivariable regression models were fit to the data to identify any relationships between leukoaraiosis and initial aphasia severity, extent of recovery, or longer-term aphasia severity. We found that leukoaraiosis was present to varying degrees in 90% of patients. However, leukoaraiosis did not predict initial aphasia severity, aphasia recovery, or longer-term aphasia severity. The lack of any relationship between leukoaraiosis severity and aphasia recovery may reflect the anatomical distribution of cerebral small vessel disease, which is largely medial to the white matter pathways that are critical for speech and language function.

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脑白质增多症与卒中后第一年失语症的康复无关。
中风后,失语症患者通常会随着时间的推移而恢复到一定程度。这种恢复过程可能取决于幸存大脑区域的健康状况。脑白质增多症(MRI上反映脑小血管疾病的白质高信号)是大脑健康受损的一种迹象,与认知和运动障碍有关。先前的研究表明,脑白质疏松可能是失语症预后和恢复的临床相关预测因素,尽管研究结果并不一致。我们研究了脑卒中后第一年脑白质疏松症和失语症之间的关系。我们招募了267名急性左半球卒中患者,同时进行液体衰减反转恢复MRI检查。患者在中风后5天内评估失语症,174名患者出现急性失语症。其中,84名患者在中风后约3个月或之后接受评估,以评估长期言语和语言结果。多变量回归模型适用于数据,以确定脑白质疏松症与最初失语症严重程度、恢复程度或长期失语症重度之间的任何关系。我们发现90%的患者存在不同程度的白细胞疏松症。然而,脑白质疏松症并不能预测失语症的初始严重程度、失语症恢复或长期失语症严重程度。脑白质疏松症的严重程度和失语症的恢复之间缺乏任何关系,这可能反映了大脑小血管疾病的解剖分布,该疾病主要位于对言语和语言功能至关重要的白质通路的中间。
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来源期刊
Neurobiology of Language
Neurobiology of Language Social Sciences-Linguistics and Language
CiteScore
5.90
自引率
6.20%
发文量
32
审稿时长
17 weeks
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