Abstract
Semantics, phonology, and syntax are essential elements of aphasia diagnosis and treatment. Until now, these linguistic components have not been specifically addressed in follow-up studies of aphasia recovery after stroke. The aim of this observational prospective follow-up study was to investigate semantic, phonological, and syntactic recovery in aphasic stroke patients. In addition, we investigated the recovery of verbal communication and of aphasia severity. We assessed 147 aphasic patients at 1, 2, and 6 weeks, 3 and 6 months, and 1 year after stroke with the ScreeLing, a screening test for detecting deficits on the three main linguistic components, the aphasia severity rating scale (ASRS), a measure of verbal communication, and the Token test, a measure of aphasia severity. We investigated the differences in scores between the six time points with mixed models. Semantics and syntax improved up to 6 weeks (p < 0.001) after stroke, and phonology up to 3 months (p ≤ 0.001). ASRS improved up to 6 months (p < 0.05) and the Token test up to 3 months (p < 0.001). We conclude that in aphasia after stroke, various linguistic components have a different recovery pattern, with phonology showing the longest period of recovery that paralleled aphasia severity, as measured with the Token test. The improvement of verbal communication continues after the stabilization of the recovery of the linguistic components.
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Acknowledgments
This research was supported by the Netherlands Organization for Scientific Research (NWO) (Grant number 017.002.083). We thank the speech-language therapists who included and/or tested the patients of the following centers: Hospitals Bronovo, Canisius-Wilhelmina, Deventer, Gelre Zutphen, HagaZiekenhuis, Kennemer Gasthuis, Clara, MCH, St. Elisabeth, Tergooiziekenhuizen, TweeSteden Tilburg, UMC St. Radboud, Bernhoven, Rijnstate, Zevenaar, Diaconessenhuis Meppel. Rehabilitation centers Trappenberg, Leijpark, Tolbrug, RMC Groot Klimmendaal, Sint Maartenskliniek, Sophia Den Haag, Sutfene Warnsveld. Nursing homes Amaris Gooizicht, Regina Pacis and Gelders Hof, Watersteeg Veghel, Zevenaar, Den Ooiman, Hazelaar, Tilburg, Sint Jacob, Boerhaave, Cortenbergh, Zuiderhout, Reggersoord, Sint Jozef, Deventer, Waelwick, Bieslandhof, Irene Dekkerswald and Margriet. Private practices Bonnier-Baars. We also wish to thank Annemarie Rausch, Eline Dogterom, Sandra Op het Veld, and Willeke de Louw for helping collecting data and Siri Siepel for scoring all the spontaneous speech samples.
Conflicts of interest
El Hachioui has received research support from the Netherlands Organization for Scientific Research (NWO) (Grant number 017.002.083) and receives royalties from the publication of the test ScreeLing. Van de Sandt-Koenderman and Visch-Brink receive royalties from the publication of the test ScreeLing. The publisher has had no influence on the data collection, methods, the interpretation of data, and the final conclusions. Koudstaal receives royalties from the publication of Textbook of Neurology. Lingsma and Dippel report no disclosures.
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El Hachioui, H., Lingsma, H.F., van de Sandt-Koenderman, M.E. et al. Recovery of aphasia after stroke: a 1-year follow-up study. J Neurol 260, 166–171 (2013). https://doi.org/10.1007/s00415-012-6607-2
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DOI: https://doi.org/10.1007/s00415-012-6607-2