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White Matter Hyperintensities Predict Response to Language Treatment in Poststroke Aphasia
Neurorehabilitation and Neural Repair ( IF 3.7 ) Pub Date : 2020-09-13 , DOI: 10.1177/1545968320952809
Maria Varkanitsa 1, 2 , Claudia Peñaloza 1 , Andreas Charidimou 2 , David Caplan 2 , Swathi Kiran 1
Affiliation  

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.

中文翻译:

白质高信号预测卒中后失语症患者对语言治疗的反应

背景 白质高信号 (WMH) 是大脑健康的放射学标志,与中风后失语症的语言状态有关。然而,它与语言治疗结果的关联仍然未知。目的 确定右半球 (RH) 的 WMH 是否独立于人口统计学和卒中后失语症的卒中病变相关因素预测对语言治疗的反应。方法 我们使用 Fazekas 量表对 30 名接受语言治疗的卒中后失语患者的 RH 中的 WMH 进行评分。我们开发了有序回归模型,在控制失语症严重程度、中风病变体积、发病时间、年龄和教育水平后,检查作为 WMH 严重程度函数的语言治疗效果。我们还评估了 WMH 严重程度与治疗前命名能力和执行功能之间的关联。结果 RH 中 WMH 的严重程度独立于人口统计学和中风相关因素预测治疗反应,因此 WMH 较轻的患者表现出更好的治疗结果。WMH评分与治疗前语言评分无显着相关,但与治疗前执行功能评分显着相关。结论 我们认为 RH 中 WMH 的严重程度是该人群治疗反应的临床相关预测因子。WMH评分与治疗前语言评分无显着相关,但与治疗前执行功能评分显着相关。结论 我们认为 RH 中 WMH 的严重程度是该人群治疗反应的临床相关预测因子。WMH 评分与治疗前语言评分无显着相关,但与治疗前执行功能评分显着相关。结论 我们认为 RH 中 WMH 的严重程度是该人群治疗反应的临床相关预测因子。
更新日期:2020-09-13
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