Predictors of Poststroke Aphasia Recovery

Author:

,Ali Myzoon1,VandenBerg Kathryn1,Williams Linda J.2,Williams Louise R.1,Abo Masahiro3,Becker Frank4,Bowen Audrey5,Brandenburg Caitlin6,Breitenstein Caterina7,Bruehl Stefanie8,Copland David A.6,Cranfill Tamara B.9,Pietro-Bachmann Marie di10,Enderby Pamela11,Fillingham Joanne12,Lucia Galli Federica13,Gandolfi Marialuisa14,Glize Bertrand15,Godecke Erin16,Hawkins Neil17,Hilari Katerina18,Hinckley Jacqueline19,Horton Simon20,Howard David21,Jaecks Petra22,Jefferies Elizabeth23,Jesus Luis M.T.24,Kambanaros Maria25,Kyoung Kang Eun26,Khedr Eman M.27,Pak-Hin Kong Anthony28,Kukkonen Tarja29,Laganaro Marina30,Lambon Ralph Matthew A.31,Charlotte Laska Ann32,Leemann Béatrice33,Leff Alexander P.34,Lima Roxele R.35,Lorenz Antje36,Mac Whinney Brian37,Shisler Marshall Rebecca38,Mattioli Flavia39,Maviş İlknur40,Meinzer Marcus41,Nilipour Reza42,Noé Enrique43,Paik Nam-Jong44,Palmer Rebecca11,Papathanasiou Ilias45,Patricio Brigida F46,Pavão Martins Isabel47,Price Cathy48,Prizl Jakovac Tatjana49,Rochon Elizabeth50,Rose Miranda L51,Rosso Charlotte52,Rubi-Fessen Ilona53,Ruiter Marina B.54,Snell Claerwen55,Stahl Benjamin56,Szaflarski Jerzy P.57,Thomas Shirley A.58,van de Sandt-Koenderman Mieke59,van der Meulen Ineke59,Visch-Brink Evy60,Worrall Linda6,Harris Wright Heather61,Brady Marian C.62

Affiliation:

1. Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK

2. Usher Institute, University of Edinburgh, Edinburgh, UK

3. Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan

4. Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway, & Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway

5. Division of Neuroscience and Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK

6. School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia

7. Department of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany

8. St Mauritius Rehabilitation Centre, Meerbusch, Germany; Clinical and Cognitive Neurosciences, Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen, Germany; and Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK

9. Special Education, Eastern Kentucky University, Richmond, KY

10. Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospitals and University of Geneva, Geneva, Switzerland

11. School of Health and Related Research [ScHARR], University of Sheffield, Sheffield, UK

12. Nursing Directorate, NHS Improvement, London, UK

13. Neurorehabilitation Clinic, Neurological Sciences Department, Marche Polytechnic University, Ospedali Riuniti di Ancona, Ancona, Italy

14. Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy

15. Handicap Activity Cognition Health, University of Bordeaux, Bordeaux, France, & Department of Physical Medicine and Rehabilitation, Centre Hospitalier Universitaire [CHU] de Bordeaux, Bordeaux, France

16. School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia

17. Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK

18. Division of Language and Communication Science, City, University of London, London, UK

19. Nova Southeastern University, Fort Lauderdale, FL

20. School of Health Sciences, University of East Anglia, Norwich, UK

21. School of Education Communication and Language Sciences, Newcastle University, Newcastle Upon Tyne, UK

22. Faculty of Linguistics and Literary Studies, Bielefeld University, Bielefeld, Germany

23. Department of Psychology, University of York, York, UK

24. School of Health Sciences [ESSUA] and Institute of Electronics and Informatics Engineering of Aveiro [IEETA], University of Aveiro, Aveiro, Portugal

25. Department of Rehabilitation Sciences, Cyprus University of Technology, Limassol, Cyprus

26. Department of Rehabilitation Medicine, Kangwon National University Hospital, Gangwon-do, Republic of Korea

27. Department of Neurology, Assiut University Hospital, Assiut, Egypt

28. School of Communication Sciences and Disorders, University of Central Florida, Orlando, FL

29. Ear, Nose and Throat [ENT]/Department of Phoniatry, Tampere University Hospital, Tampere, Finland

30. Faculty of Psychology and Educational Science, University of Geneva, Geneva, Switzerland

31. Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK

32. Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden

33. Neurorééducation, Département des Neurosciences Cliniques, Hôpitaux Universitaires de Genève, Geneva, Switzerland

34. Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, UK

35. Department of Speech Language Pathology, Educational Association Bom Jesus – IELUSC, Santa Catarina, Brazil

36. Institut für Psychologie, Humboldt University Berlin, Berlin, Germany

37. Department of Psychology, Carnegie Mellon University, Pittsburgh, PA

38. Department of Communication Sciences and Special Education, University of Georgia, Athens, GA

39. Neuropsychology Unit, Azienda Socio Sanitaria Territoriale [ASST] Spedali Civili of Brescia, Brescia, Italy

40. Department of Speech and Language Therapy, Anadolu University, Eskişehir, Turkey

41. UQ Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia

42. Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran

43. NEURORHB-Hospitales Vithas, Valencia, Spain

44. Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea

45. Department of Speech and Language Therapy, Technological Educational Institute of Western Greece, Patras, Greece

46. Speech Therapy Department of Health School of Polytechnic Institute of Porto, Porto, Portugal

47. Laboratório de Estudos de Linguagem, Faculdade de Medicina de Lisboa, Universidade de Lisboa, Lisbon, Portugal

48. Wellcome Centre for Human Neuroimaging, University College London, London, UK

49. Department of Speech and Language Pathology, Faculty of Education and Rehabilitation Sciences, University of Zagreb, Zagreb, Croatia

50. Department of Speech–Language Pathology and Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada & Toronto Rehabilitation Institute, Toronto, ON, Canada

51. School of Allied Health, La Trobe University, Melbourne, VIC, Australia

52. Institut du Cerveau et del la Moelle épinière, Sorbonne University, Paris, France & APHP, Urgences Cérébro- Vasculaires, Hôpital de la Pitié Salpêtrière, Paris, France

53. RehaNova Rehabilitation Hospital and Department of Special Education and Rehabilitation, University of Cologne, Cologne, Germany

54. Sint Maartenskliniek, Rehabilitation Centre and Centre for Language Studies, Radboud University, Nijmegen, the Netherlands

55. Warrington Hospital, Warrington and Halton NHS Foundation Trust, Warrington, UK

56. Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany

57. UAB Epilepsy Centre, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL

58. Division of Rehabilitation, Ageing and Wellbeing, School of Medicine, University of Nottingham, Nottingham, UK

59. Rijndam Rehabilitation, Rotterdam, the Netherlands; Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands

60. Department of Neurology and Neurosurgery, Erasmus University Medical Center, Rotterdam, the Netherlands

61. College of Allied Health Sciences, North Carolina University, Greenville, SC

62. Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian Un University, Glasgow, UK

Abstract

Background and Purpose: The factors associated with recovery of language domains after stroke remain uncertain. We described recovery of overall-language-ability, auditory comprehension, naming, and functional-communication across participants’ age, sex, and aphasia chronicity in a large, multilingual, international aphasia dataset. Methods: Individual participant data meta-analysis of systematically sourced aphasia datasets described overall-language ability using the Western Aphasia Battery Aphasia-Quotient; auditory comprehension by Aachen Aphasia Test (AAT) Token Test; naming by Boston Naming Test and functional-communication by AAT Spontaneous-Speech Communication subscale. Multivariable analyses regressed absolute score-changes from baseline across language domains onto covariates identified a priori in randomized controlled trials and all study types. Change-from-baseline scores were presented as estimates of means and 95% CIs. Heterogeneity was described using relative variance. Risk of bias was considered at dataset and meta-analysis level. Results: Assessments at baseline (median=43.6 weeks poststroke; interquartile range [4–165.1]) and first-follow-up (median=10 weeks from baseline; interquartile range [3–26]) were available for n=943 on overall-language ability, n=1056 on auditory comprehension, n=791 on naming and n=974 on functional-communication. Younger age (<55 years, +15.4 Western Aphasia Battery Aphasia-Quotient points [CI, 10.0–20.9], +6.1 correct on AAT Token Test [CI, 3.2–8.9]; +9.3 Boston Naming Test points [CI, 4.7–13.9]; +0.8 AAT Spontaneous-Speech Communication subscale points [CI, 0.5–1.0]) and enrollment <1 month post-onset (+19.1 Western Aphasia Battery Aphasia-Quotient points [CI, 13.9–24.4]; +5.3 correct on AAT Token Test [CI, 1.7–8.8]; +11.1 Boston Naming Test points [CI, 5.7–16.5]; and +1.1 AAT Spontaneous-Speech Communication subscale point [CI, 0.7–1.4]) conferred the greatest absolute change-from-baseline across each language domain. Improvements in language scores from baseline diminished with increasing age and aphasia chronicity. Data exhibited no significant statistical heterogeneity. Risk-of-bias was low to moderate-low. Conclusions: Earlier intervention for poststroke aphasia was crucial to maximize language recovery across a range of language domains, although recovery continued to be observed to a lesser extent beyond 6 months poststroke.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialised Nursing,Cardiology and Cardiovascular Medicine,Clinical Neurology

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