Osa García Alberto, Brambati Simona Maria, Brisebois Amélie, Désilets-Barnabé Marianne, Houzé Bérengère, Bedetti Christophe, Rochon Elizabeth, Leonard Carol, Desautels Alex, Marcotte Karine
Centre de Recherche du Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada.
École d'Orthophonie et d'Audiologie, Université de Montréal, Montreal, QC, Canada.
Front Neurol. 2020 Feb 21;11:120. doi: 10.3389/fneur.2020.00120. eCollection 2020.
The greatest degree of language recovery in post-stroke aphasia takes place within the first weeks. Aphasia severity and lesion measures have been shown to be good predictors of long-term outcomes. However, little is known about their implications in early spontaneous recovery. The present study sought to determine which factors better predict early language outcomes in individuals with post-stroke aphasia. Twenty individuals with post-stroke aphasia were assessed <72 h (acute) and 10-14 days (subacute) after stroke onset. We developed a composite score (CS) consisting of several linguistic sub-tests: repetition, oral comprehension and naming. Lesion volume, lesion load and diffusion measures [fractional anisotropy (FA) and axial diffusivity (AD)] from both arcuate fasciculi (AF) were also extracted using MRI scans performed at the same time points. A series of regression analyses were performed to predict the CS at the second assessment. Among the diffusion measures, only FA from right AF was found to be a significant predictor of early subacute aphasia outcome. However, when combined in two hierarchical models with FA, age and either lesion load or lesion size, the initial aphasia severity was found to account for most of the variance ( = 0.678), similarly to the complete models ( = 0.703 and = 0.73, respectively). Initial aphasia severity was the best predictor of early post-stroke aphasia outcome, whereas lesion measures, though highly correlated, show less influence on the prediction model. We suggest that factors predicting early recovery may differ from those involved in long-term recovery.
中风后失语症患者语言恢复的最大程度发生在最初几周内。失语症严重程度和病灶测量已被证明是长期预后的良好预测指标。然而，对于它们在早期自发恢复中的影响知之甚少。本研究旨在确定哪些因素能更好地预测中风后失语症患者的早期语言预后。20名中风后失语症患者在中风发作后<72小时（急性期）和10 - 14天（亚急性期）接受评估。我们制定了一个综合评分（CS），由几个语言子测试组成：复述、口语理解和命名。同时利用在相同时间点进行的MRI扫描提取双侧弓状束（AF）的病灶体积、病灶负荷和扩散测量指标[分数各向异性（FA）和轴向扩散率（AD）]。进行了一系列回归分析以预测第二次评估时的CS。在扩散测量指标中，仅发现右侧AF的FA是早期亚急性失语症预后的显著预测指标。然而，当在两个层次模型中将FA与年龄以及病灶负荷或病灶大小相结合时，发现初始失语症严重程度占大部分方差（分别为 = 0.678），与完整模型相似（分别为 = 0.703和 = 0.73）。初始失语症严重程度是中风后早期失语症预后的最佳预测指标，而病灶测量指标虽然高度相关，但对预测模型的影响较小。我们认为，预测早期恢复的因素可能与参与长期恢复的因素不同。
