Schliep Megan E, Tilton-Bolowsky Victoria, Vallila-Rohter Sofia
School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston, Massachusetts, USA.
Top Stroke Rehabil. 2022 Mar;29(2):133-145. doi: 10.1080/10749357.2021.1886636. Epub 2021 Mar 24.
Prior research suggests that initial aphasia severity, lesion size, and lesion location are the most salient factors in predicting recovery outcomes. While these factors provide important prognostic information, information that is individualized and readily available to clinicians is limited. Deficits in naming are common to all aphasia types and are routinely targeted in aphasia assessment and treatment, with cues provided to facilitate lexical retrieval.
In this study, we examine aphasia recovery factors that are readily available to clinicians, examining whether a person's ability to improve naming with cues, indicating "stimulability," will be predictive of future word retrieval.
Ten participants with aphasia following a left-hemisphere stroke participated in initial assessment, seven of whom met criteria for longitudinal assessment. Stroke and early clinical recovery data were collected for all participants. At four timepoints over one year we evaluated longitudinal participants' naming ability and measured the proportion of successful lexical retrieval with the presentation of phonemic, feature, and sentence cues.
For all participants, multiple descriptive factors regarding recovery, including lesion information, information from the acute inpatient timeframe, and communication opportunities, were examined. For individuals followed longitudinally, naming stimulability did not consistently predict naming accuracy at the subsequent assessment timepoint. Individuals' attempts at naming emerged as a metric related to future naming performance warranting further evaluation.
Multiple factors related to recovery must be considered when providing prognostic information. Naming stimulability and attempts at naming provide some information regarding future performance, but are not consistently reliable across timepoints.
先前的研究表明，初始失语严重程度、病灶大小和病灶位置是预测恢复结果的最显著因素。虽然这些因素提供了重要的预后信息，但临床医生可获得的个性化且随时可用的信息有限。命名缺陷在所有失语类型中都很常见，并且在失语评估和治疗中通常是目标，会提供线索以促进词汇检索。
在本研究中，我们研究了临床医生可随时获得的失语恢复因素，考察一个人在有线索提示时改善命名的能力（即“可激发性”）是否能预测未来的词汇检索情况。
10名左半球中风后失语的参与者参加了初始评估，其中7人符合纵向评估标准。收集了所有参与者的中风和早期临床恢复数据。在一年中的四个时间点，我们评估了纵向参与者的命名能力，并测量了在呈现音素、特征和句子线索时成功词汇检索的比例。
对于所有参与者，研究了多个与恢复相关的描述性因素，包括病灶信息、急性住院期间的信息和交流机会。对于纵向随访的个体，命名可激发性在随后的评估时间点并不能一致地预测命名准确性。个体的命名尝试成为与未来命名表现相关的一个指标，值得进一步评估。
提供预后信息时必须考虑多个与恢复相关的因素。命名可激发性和命名尝试提供了一些关于未来表现的信息，但在各时间点并不始终可靠。
