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Association between aphasia severity and brain network alterations after stroke assessed using the electroencephalographic phase synchrony index.

ABSTRACT: Electroencephalographic synchrony can help assess brain network status; however, its usefulness has not yet been fully proven. We developed a clinically feasible method that combines the phase synchrony index (PSI) with resting-state 19-channel electroencephalography (EEG) to evaluate post-stroke motor impairment. In this study, we investigated whether our method could be applied to aphasia, a common post-stroke cognitive impairment. This study included 31 patients with subacute aphasia and 24 healthy controls. We assessed the expressive function of patients and calculated the PSIs of three motor language-related regions: frontofrontal, left frontotemporal, and right frontotemporal. Then, we evaluated post-stroke network alterations by comparing PSIs of the patients and controls and by analyzing the correlations between PSIs and aphasia scores. The frontofrontal PSI (beta band) was lower in patients than in controls and positively correlated with aphasia scores, whereas the right frontotemporal PSI (delta band) was higher in patients than in controls and negatively correlated with aphasia scores. Evaluation of artifacts suggests that this association is attributed to true synchrony rather than spurious synchrony. These findings suggest that post-stroke aphasia is associated with alternations of two different networks and point to the usefulness of EEG PSI in understanding the pathophysiology of aphasia.

SUBMITTER: Kawano T

PROVIDER: S-EPMC8203681 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Background and Purpose The severity of aphasic impairment in chronic stroke survivors is typically thought to be stable by 6 months postonset. However, a recent study showed that stroke survivors with aphasia experience language improvement or decline in the chronic phase, years beyond onset. Little is known about why some individuals improve whereas others remain stable or decline. Additionally, no study has tracked changes in aphasia from assessments completed at multiple time points across many years. The current study offers a comprehensive analysis of potential predictive demographic and health information to determine which factors predict dynamic changes in aphasia severity in chronic stroke. Methods Individuals in the chronic stage of a single-event, left-hemisphere ischemic stroke were identified from an archival database and included for study ( N = 39). Participants were included if they had undergone 2 or more standardized language assessments acquired at time points at least 6 months apart, with the 1st assessment at least 6 months postinjury. A linear mixed-effects model was used to determine the impact of treatment and a variety of demographic and health factors on language change. Results Over time, half of the participants improved (51%), whereas approximately a quarter (26%) decreased, and a quarter (23%) remained stable. A greater number of aphasia treatment hours significantly predicted language improvement ( p = .03), whereas older stroke age was associated with long-term decline ( p = .04). Two interactions were found to be significant in predicting improvement in individuals with diabetes: Increased exercise and younger age at stroke were significant in predicting outcomes ( p < .05). Conclusions Factors that significantly influence language recovery in chronic aphasia include stroke age and receiving aphasia treatment. For those with diabetes, increased exercise was shown to improve outcomes. Results from this study offer clinicians greater insight into the influence of patient factors on long-term recovery from stroke aphasia while suggesting a potential adjunct to language therapy: exercise. Supplemental Material https://doi.org/10.23641/asha.7849304.

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Association between aphasia severity and brain network alterations after stroke assessed using the electroencephalographic phase synchrony index.

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