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White Matter Hyperintensities Predict Response to Language Treatment in Poststroke Aphasia.

ABSTRACT: BACKGROUND:White matter hyperintensities (WMH) are a radiological marker of brain health that has been associated with language status in poststroke aphasia; however, its association with language treatment outcomes remains unknown. OBJECTIVE:To determine whether WMH in the right hemisphere (RH) predict response to language therapy independently from demographics and stroke lesion-related factors in poststroke aphasia. METHODS:We used the Fazekas scale to rate WMH in the RH in 30 patients with poststroke aphasia who received language treatment. We developed ordinal regression models to examine language treatment effects as a function of WMH severity after controlling for aphasia severity, stroke lesion volume, time post onset, age, and education level. We also evaluated associations between WMH severity and both pre-treatment naming ability and executive function. RESULTS:The severity of WMH in the RH predicted treatment response independently from demographic and stroke-related factors such that patients with less severe WMH exhibited better treatment outcome. WMH scores were not significantly correlated with pretreatment language scores, but they were significantly correlated with pretreatment scores of executive function. CONCLUSION:We suggest that the severity of WMH in the RH is a clinically relevant predictor of treatment response in this population.

SUBMITTER: Varkanitsa M

PROVIDER: S-EPMC7572835 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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White Matter Hyperintensities Predict Response to Language Treatment in Poststroke Aphasia.

Varkanitsa Maria M Peñaloza Claudia C Charidimou Andreas A Caplan David D Kiran Swathi S

Neurorehabilitation and neural repair 20200913 10

<h4>Background</h4>White matter hyperintensities (WMH) are a radiological marker of brain health that has been associated with language status in poststroke aphasia; however, its association with language treatment outcomes remains unknown.<h4>Objective</h4>To determine whether WMH in the right hemisphere (RH) predict response to language therapy independently from demographics and stroke lesion-related factors in poststroke aphasia.<h4>Methods</h4>We used the Fazekas scale to rate WMH in the RH ...[more]

PMID: 32924765

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Project description:ObjectiveTo determine if pretreatment nonlinguistic cognition predicted language treatment outcomes and if so, which specific nonlinguistic cognitive subskills predicted naming therapy outcomes.DesignRetrospective.SettingResearch clinic.ParticipantsStudy 1 included data from 67 persons with aphasia who underwent language treatment and a pretreatment cognitive-linguistic assessment battery (N=67). Study 2 included data from 27 study 1 participants who completed additional pretreatment nonlinguistic cognitive assessments.Interventions120-minute sessions of sentence comprehension (n=26) or naming treatment (n=41) 2 times per week for up to 10-12 weeks.Main outcome measuresProportion of potential maximal gain (PMG) (assessed immediately after treatment [10-12wk]; formula=mean posttreatment score-mean pretreatment score/total number of trained items-mean pretreatment score) and proportion of potential maximal gain maintained (PMGM) (assessed 12wk after posttreatment [22-24wk]; formula=mean maintenance score-mean pretreatment score/total number of trained items-mean pretreatment score) as outcome variables; and pretreatment assessment scores as predictor variables.ResultsIn study 1, 37% of participants demonstrated nonlinguistic cognitive deficits. Principal component analyses reduced assessment data to 2 components: linguistic and nonlinguistic cognition. Backward elimination regression revealed that higher linguistic and nonlinguistic cognitive function significantly predicted higher PMG after language therapy. In study 2, principal component analysis of only the nonlinguistic cognitive measures identified 3 components: executive function, verbal short-term memory, and visual short-term memory. Controlling for pretreatment apraxia of speech and auditory comprehension deficits, regression analyses revealed that higher executive function and visual short-term memory significantly predicted higher PMG and PMGM after naming therapy.ConclusionsPretreatment nonlinguistic cognitive function significantly influenced language treatment outcomes and maintenance of therapy gains.

Dataset Information

White Matter Hyperintensities Predict Response to Language Treatment in Poststroke Aphasia.

Publications

White Matter Hyperintensities Predict Response to Language Treatment in Poststroke Aphasia.

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