City Research Online

Predictors of Poststroke Aphasia Recovery

Ali, M., VandenBerg, K., Williams, L., Williams, L., Abo, M., Becker, F., Bowen, A., Brandenburg, C., Breitenstein, C., Bruehl, S., Copland, D., Cranfill, T. B., Pietro-Bachmann, M. di, Enderby, P., Fillingham, J., Lucia Galli, F., Gandolfi, M., Glize, B., Godecke, E., Hawkins, N., Hilari, K. ORCID: 0000-0003-2091-4849, Hinckley, J., Horton, S., Howard, D., Jaecks, P., Jefferies, E., Jesus, L.M.T., Kambanaros, M., Kyoung Kang, E., Khedr, E. M., Pak-Hin Kong, A., Kukkonen, T., Laganaro, M., Lambon Ralph, M. A., Charlotte Laska, A., Leemann, B., Leff, A., Lima, R., Lorenz, A., Mac Whinney, B., Shisler Marshall, R., Mattioli, F., Mavis, I., Meinzer, M., Nilipour, R., Noe, E., Paik, N-J., Palmer, R., Papathanasiou, I., Patrício, B., Pavao Martins, I., Price, C., Prizl Jakovac, T., Rochon, E., Rose, M., Rosso, C., Rubi-Fessen, I., Ruiter, M. B., Snell, C., Stahl, B., Szaflarski, J. P., Thomas, S. A, van de Sandt-Koenderman, M., van der Meulen, I., Visch-Brink, E., Worrall, L., Harris Wright, H. and Brady, M. C. (2021). Predictors of Poststroke Aphasia Recovery. Stroke, 52(5), pp. 1778-1787. doi: 10.1161/strokeaha.120.031162

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 as 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.

Publication Type: Article
Additional Information: © 2021 The Authors. Stroke is published on behalf of the American Heart Association, Inc., by Wolters Kluwer Health, Inc. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited.
Publisher Keywords: aphasia, comprehension, demography, language, survivor
Subjects: P Language and Literature > P Philology. Linguistics
R Medicine > RC Internal medicine
Departments: School of Health Sciences > Language & Communication Science
Date available in CRO: 16 Mar 2021 13:18
Date deposited: 16 March 2021
Date of acceptance: 25 November 2020
Date of first online publication: 15 March 2021
URI: https://openaccess.city.ac.uk/id/eprint/25805
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