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Lesion site and therapy time predict responses to a therapy for anomia after stroke: a prognostic model development study

Hope, T., Nardo, D., Holland, R. ORCID: 0000-0001-9865-0121, Ondobaka, S., Akkad, H., Price, C. J., Leff, A. and Crinion, J. (2021). Lesion site and therapy time predict responses to a therapy for anomia after stroke: a prognostic model development study. Scientific Reports, 11(1), 18572. doi: 10.1038/s41598-021-97916-x

Abstract

Stroke is a leading cause of disability, and language impairments (aphasia) after stroke are both common and particularly feared. Most stroke survivors with aphasia exhibit anomia (difficulties with naming common objects), but while many therapeutic interventions for anomia have been proposed, treatment effects are typically much larger in some patients than others. Here, we asked whether that variation might be more systematic, and even predictable, than previously thought. 18 patients, each at least 6 months after left hemisphere stroke, engaged in a computerised treatment for their anomia over a 6-week period. Using only: (a) the patients' initial accuracy when naming (to-be) trained items; (b) the hours of therapy that they devoted to the therapy; and (c) whole-brain lesion location data, derived from structural MRI; we developed Partial Least Squares regression models to predict the patients' improvements on treated items, and tested them in cross-validation. Somewhat surprisingly, the best model included only lesion location data and the hours of therapy undertaken. In cross-validation, this model significantly out-performed the null model, in which the prediction for each patient was simply the mean treatment effect of the group. This model also made promisingly accurate predictions in absolute terms: the correlation between empirical and predicted treatment response was 0.62 (95% CI 0.27, 0.95). Our results indicate that individuals' variation in response to anomia treatment are, at least somewhat, systematic and predictable, from the interaction between where and how much lesion damage they have suffered, and the time they devoted to the therapy.

Publication Type: Article
Additional Information: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Te images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. © The Author(s) 2021.
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: 28 Sep 2021 10:47
Date deposited: 28 September 2021
Date of acceptance: 14 July 2021
Date of first online publication: 17 September 2021
URI: https://openaccess.city.ac.uk/id/eprint/26830
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