Predicting recovery in acute poststroke aphasia
Open accessAbstract
Objective: Many stroke patients show remarkable recovery of language after initial severe impairment, but it is difficult to predict which patients will show good recovery. We aimed to identify patient and lesion characteristics that together predict the best naming outcome in 4 studies. Methods: We report 2 longitudinal studies that identified 2 variables at onset that were strongly associated with good recovery of naming (the most common residual deficit in aphasia) in the first 6 months after stroke: damage to left posterior superior temporal gyrus (pSTG) and/or superior longitudinal fasciculus/arcuate fasciculus (SLF/AF), and selective serotonin reuptake inhibitor (SSRI) use. We then tested these variables in 2 independent cohorts of chronic left hemisphere stroke patients, using chi‐square tests and multivariate logistic regression for dichotomous outcomes and t tests for continuous outcomes. Results: Lesion load in left pSTG and SLF/AF was associated with poorer naming outcome. Preservation of these areas and use of SSRIs were associated with naming recovery, independent of lesion volume, time since stroke, and depression. Patients with damage to these critical areas showed better naming outcome if they took SSRIs for 3 months after stroke. Those with preservation of these critical areas achieved good recovery of naming regardless of SSRI use. Interpretation: Lesion load in left pSTG and SLF/AF at onset predicts later naming performance. Although based on a small number of patients, our preliminary results suggest outcome might be modulated by SSRIs, but these associations need to be confirmed in a larger randomized controlled trial. Ann Neurol 2018;83:612–622
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Hillis et al. demonstrated that the influence of lesion load on aphasia recovery may be influenced by SSRIs; for patients with superior temporal and/or SLF/AF lesions, SSRIs improved naming outcomes independent of depression, initial aphasia severity, or lesion volume.
“Hillis et al. [38] recently demonstrated that the influence of lesion load on aphasia recovery may be influenced by SSRIs. For patients with superior temporal and/or SLF/AF lesions, the use of SSRIs improved naming outcomes, independent of the presence of depression, initial aphasia severity, or lesion volume.”
From Aphasia Recovery: When, How and Who to Treat? (2018) · cites this paper as [38]
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“Likewise, with respect to language recovery, Hillis found that damage to left posterior superior temporal gyrus and fibers that included superior longitudinal fasciculus and arcuate fasciculus negatively influenced the degree of recovery of naming skills (33) in acute and chronic patients with aphasia, and these findi…”
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“Those with preservation of these critical areas achieved good recovery of naming regardless of the SSRI treatment (Hillis et al., 2018).”
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“[49] recently showed that stroke aphasic patients with damage in the left posterior superior temporal gyrus (pSTG) and/or superior longitudinal 6 Behavioural Neurology”
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“In recent studies, lesion-symptom mapping has been used to identify the neural substrates of particular cognitive functions,(8-10) or predict the prognosis of post-stroke functional deficits, such as aphasia.(11) It was also used to study the neural substrates of emotional disorders, such as post-stroke depression, an…”
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“or any combination of both, could explain severity, symptoms and prognosis of aphasia (28, 31, 32, 34, 50).”
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BackgroundResultInfluentialSelf-citationAphasia outcome: the interactions between initial severity, lesion size and location
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Right Hemispheric Homologous Language Pathways Negatively Predicts Poststroke Naming Recovery
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“Predicting language recovery after a stroke remains difficult, although imaging markers have provided some predictive information.(2,3) The neural mechanisms that support aphasia recovery are not yet fully understood.”
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Association of Lesion Location With Long-Term Recovery in Post-stroke Aphasia and Language Deficits
Sul, B., Lee, K. B., Hong, B. Y., Kim, J. S., Kim, J.-W., Hwang, W. S., & Lim, S. H. (2019) · Frontiers in Neurology · doi:10.3389/fneur.2019.00776 · Cited by 46 · see citing works
“The involvement of Broca’s area, the superior temporal gyrus, arcuate fasciculus, and superior longitudinal fasciculus are associated with a poor prognosis in patients with chronic post-stroke aphasia at 4–6 months after onset (5, 6, 8).”
BackgroundMethodLeukoaraiosis is independently associated with naming outcome in poststroke aphasia
Wright, A. E., Tippett, D. C., Saxena, S., Sebastian, R., Breining, B. L., Faria, A. V., & Hillis, A. E. (2018) · Neurology · doi:10.1212/wnl.0000000000005945 · Cited by 42 · see citing works
“Results of this study also confirmed the importance of damage to the left STG in naming and overall language outcome, consistent with other studies.(2,21,22,45)”
ResultSelf-citationMoulton, E. J., Magno, S., Valabrègue, R., Sahli-Amor, M., Pires, C., Lehéricy, S., Léger, A., Samson, Y., & Rosso, C. (2019) · Stroke · doi:10.1161/strokeaha.119.024946 · Cited by 39 · see citing works
“superior temporal gyrus and the AF was highly predictive of improvement in object naming 6 months afterward.(31)”
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“…serotonin reuptake inhibitors – SSRI) improved more than untreated subjects in language tests (picture description and object/animal naming) (Hillis et al., 2018), global cognitive functioning (verbal and visual memory functions) (Jorge et al., 2010), functional independence measures…”
BackgroundBrain age predicts long-term recovery in post-stroke aphasia
Kristinsson, S., Busby, N., Rorden, C., Newman‐Norlund, R., den Ouden, D., Magnúsdóttir, S., Hjaltason, H., Thors, H., Hillis, A. E., Kjartansson, Ó., et al. (2022) · Brain Communications · doi:10.1093/braincomms/fcac252 · Cited by 35 · see citing works
Self-citationDisentangling neuroplasticity mechanisms in post-stroke language recovery
Billot, A., & Kiran, S. (2024) · Brain and Language · doi:10.1016/j.bandl.2024.105381 · Cited by 33 · see citing works
“…of acute post-stroke language impairments and the degree of language recovery across studies (Benghanem et al., 2019; Goldenberg & Spatt, 1994; Hillis et al., 2018; Hope et al., 2013; Kertesz et al., 1979, 1993; Mazzocchi & Vignolo, 1979; Naeser et al., 1987; Nakagawa et al., 2019; Ramsey et…”
Language and language disorders: neuroscience to clinical practice
O'Sullivan, M. J., Brownsett, S. L. E., & Copland, D. A. (2019) · Practical Neurology · doi:10.1136/practneurol-2018-001961 · Cited by 33 · see citing works
“41 To date, there is no convincing evidence for using stimulation strategies such as transcranial magnetic or direct current stimulation, 42 although recent studies have shown promising results when aphasia therapy is paired with stimulation of the motor cortex applied to preserved left temporal…”
BackgroundBreining, B. L., Faria, A. V., Caffo, B. S., Meier, E. L., Sheppard, S. M., Sebastian, R., Tippett, D. C., & Hillis, A. E. (2021) · Aphasiology · doi:10.1080/02687038.2021.1907291 · Cited by 32 · see citing works
Self-citationSerotonin Selective Reuptake Inhibitors (SSRIs) and Stroke
Chollet, F., Rigal, J., Marque, P., Barbieux-Guillot, M., Raposo, N., Fabry, V., Albucher, J., Pariente, J., & Loubinoux, I. (2018) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-018-0904-9 · Cited by 24 · see citing works
Newman‐Norlund, R., Newman-Norlund, S. E., Sayers, S., Nemati, S., Riccardi, N., Rorden, C., & Fridriksson, J. (2021) · Neuroimage Reports · doi:10.1016/j.ynirp.2021.100008 · Cited by 29 · see citing works
“Importantly, this processing stream has been used as the basis of analysis in multiple published papers by our group (William; W.; Fridriksson et al., 2015; Hickok et al., 2018; Hillis et al., 2018; Karnath et al., 2018; Matchin et al., 2020; Matchin et al., 2020; Yourganov et al., 2018).”
Self-citationStructural and functional brain correlates of theory of mind impairment post-stroke
D, J. F. D., Nott, Z. E., Horne, K., Prangley, T., Adams, A. G., Henry, J. D., & Molenberghs, P. (2019) · Cortex · doi:10.1016/j.cortex.2019.09.017 · Cited by 27 · see citing works
Lima, R. R., Rose, M. L., Lima, H. D. N., Cabral, N. L., Silveira, N. C., & Massi, G. A. D. A. (2019) · Topics in Stroke Rehabilitation · doi:10.1080/10749357.2019.1673593 · Cited by 28 · see citing works
“However, the NIHSS severity scale is widely used in many studies as an initial assessment of aphasia.(4,32,35) Second, the evaluation was performed by physicians and upon arrival at patient admission before any possibility of thrombolytic use.”
MethodNeurocognitive Recovery of Sentence Processing in Aphasia
Thompson, C. K. (2019) · Journal of Speech Language and Hearing Research · doi:10.1044/2019_jslhr-l-rsnp-19-0219 · Cited by 28 · see citing works
“Hillis et al. found that damage to the left posterior STG and fibers within the superior longitudinal and arcuate fasciculi negatively influence the recovery of naming in both acute and chronic patients with aphasia, and these findings were independent of total lesion volume (Hillis et al., 2018).”
BackgroundKeser, Z., Meier, E. L., Stockbridge, M. D., & Hillis, A. E. (2020) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2020.105078 · Cited by 27 · see citing works
Self-citationBerthier, M. L., Edelkraut, L., López‐González, F. J., López-Barroso, D., Mohr, B., Friedemann Pulvermüller, A., STARKSTEIN, S. E., Jorge, R. E., Torres‐Prioris, M. J., & Dávila, G. (2022) · Brain and Language · doi:10.1016/j.bandl.2022.105205 · Cited by 27 · see citing works
“, serotonin transporter gene polymorphisms, location of the injury) that would predict the response of depressed PWA to treatment with antidepressants alone (Fridriksson & Hillis, 2021; Hillis et al., 2018; Lee et al., 2018; Stockbridge et al., 2021) and combined with acetylcholinesterase inhibitors.”
Factors predicting long-term recovery from post-stroke aphasia
Harvey, D. Y., Parchure, S., & Hamilton, R. H. (2021) · Aphasiology · doi:10.1080/02687038.2021.1966374 · Cited by 27 · see citing works
“To our knowledge, no study has examined the impact of lesion location on long-term aphasia recovery in the same people with aphasia assessed at different time points in the chronic stage (see Hillis et al., 2018 for evidence from a cross-sectional study).”
BackgroundHan, Y., Jing, Y., Shi, Y., Mo, H., Wan, Y., Zhou, H.-W., & Deng, F. (2024) · Journal of Neurology · doi:10.1007/s00415-024-12358-5 · Cited by 26 · see citing works
“Moreover, the initial lesion load of the left SLF/AF has been shown to predict naming performance within the first 6 months after stroke [180].”
Pharmacological Enhancement of Stroke Recovery
Kumar, A., & Kitago, T. (2019) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-019-0959-2 · Cited by 26 · see citing works
Schneider, C., Majewska, A. K., Busza, A. C., Williams, Z. R., Mahon, B. Z., & Sahin, B. (2019) · Journal of Neurology · doi:10.1007/s00415-019-09480-0 · Cited by 24 · see citing works
Right hemispheric structural connectivity and poststroke language recovery
Sihvonen, A. J., Vadinova, V., Garden, K. L., Meinzer, M., Roxbury, T., O’Brien, K. M., Copland, D. A., McMahon, K. L., & Brownsett, S. L. E. (2023) · Human Brain Mapping · doi:10.1002/hbm.26252 · Cited by 25 · see citing works
“A body of research has shown that greater lesion load in the left arcuate fasciculus predicts poor language outcome in aphasia (Alyahya et al., 2020; Fridriksson et al., 2013; Hillis et al., 2018; Marchina et al., 2011).”
BackgroundKeser, Z., Meier, E. L., Stockbridge, M. D., Breining, B. L., Sebastian, R., & Hillis, A. E. (2021) · Brain Connectivity · doi:10.1089/brain.2020.0831 · Cited by 24 · see citing works
“In addition to excluding subjects with thalamic infarcts and removing the lesions from the tracts with thresholding, we also controlled our analyses for overall lesion load as the lesioned tissues were previously found to predict poor outcome (Hillis et al., 2018).”
Self-citationDevelopments in treating the nonmotor symptoms of stroke
Hillis, A. E. (2020) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2020.1763173 · Cited by 21 · see citing works
Self-citationSelective Serotonin Reuptake Inhibitors
Belagaje, S. R., Brahmbhatt, D., & Abramoff, B. A. (2024) · Springer eBooks · doi:10.1007/978-3-031-49963-0_23 · Cited by 21 · see citing works
Early white matter connectivity and plasticity in post stroke aphasia recovery
Schevenels, K., Gerrits, R., Lemmens, R., Smedt, B. D., Zink, I., & Vandermosten, M. (2022) · NeuroImage: Clinical · doi:10.1016/j.nicl.2022.103271 · Cited by 22 · see citing works
Strategies for feature extraction from structural brain imaging in lesion‐deficit modelling
Kasties, V., Karnath, H., & Sperber, C. (2021) · Human Brain Mapping · doi:10.1002/hbm.25629 · Cited by 17 · see citing works
Boucher, J., Marcotte, K., Brisebois, A., Courson, M., Houzé, B., Désautels, A., Léonard, C., Rochon, E. A., & Brambati, S. M. (2020) · The Clinical Neuropsychologist · doi:10.1080/13854046.2020.1817563 · Cited by 19 · see citing works
“Hillis et al. (2018) had reported a similar relationship (r ¼ .72) between performance on a confrontation naming task and number of content units conveyed in a picture description task in a cohort of 19 individuals with various types of aphasia, within 48 hours and 6months after stroke onset.”
BackgroundMethodA longitudinal study of narrative discourse in post-stroke aphasia
Brisebois, A., Brambati, S. M., Boucher, J., Rochon, E. A., Léonard, C., Désilets-Barnabé, M., Désautels, A., & Marcotte, K. (2021) · Aphasiology · doi:10.1080/02687038.2021.1907295 · Cited by 18 · see citing works
“Also, most longitudinal studies that did not specifically investigated the effect of therapy have not investigated the effect of treatment on longitudinal changes (e.g., Hillis et al., 2018; Stockbridge et al., 2019).”
BackgroundCore lexicon in aphasia: A longitudinal study
Kim, H. H., Berube, S. K., & Hillis, A. E. (2022) · Aphasiology · doi:10.1080/02687038.2022.2121598 · Cited by 18 · see citing works
“; Fergadiotis & Wright, 2016; Hillis et al., 2018; Mayer & Murray, 2003; Pashek & Tompkins, 2002; Richardson et al., 2018).”
Self-citationMeier, E. L., Kelly, C. R., & Hillis, A. E. (2022) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2022.108270 · Cited by 17 · see citing works
Self-citationStockbridge, M. D. (2022) · Handbook of clinical neurology · doi:10.1016/b978-0-12-823384-9.00013-x · Cited by 17 · see citing works
Georgiou, A. M., & Kambanaros, M. (2023) · Medicina · doi:10.3390/medicina59091674 · Cited by 17 · see citing works
“Drugs that show moderately positive outcomes include acetylcholinesterase inhibitors and dextroamphetamine sulfate [9], while selective serotonin reuptake inhibitors may also help aphasia recovery [10].”
BackgroundPredictive role of subcomponents of the left arcuate fasciculus in prognosis of aphasia after stroke
Yu, Q., Wang, H., Li, S., & Dai, Y. (2019) · Medicine · doi:10.1097/md.0000000000015775 · Cited by 16 · see citing works
“Recently, Hillis et al([55]) reported that the lesion load in the left AF was associated with poorer naming outcome, indicating that recovery of naming could be negatively influenced by lesion load of the left AF in acute poststroke aphasia.”
Meier, E. L., Sheppard, S. M., Goldberg, E. B., Head, C. R., Ubellacker, D. M., Walker, A., & Hillis, A. E. (2020) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2020.107651 · Cited by 17 · see citing works
Self-citationHodological organization of spoken language production and singing in the human brain
Pitkäniemi, A., Särkämö, T., Siponkoski, S., Brownsett, S. L. E., Copland, D. A., Sairanen, V., & Sihvonen, A. J. (2023) · Communications Biology · doi:10.1038/s42003-023-05152-y · Cited by 15 · see citing works
“…of damage to the left arcuate fasciculus, a major dorsal white matter pathway, historically associated with repetition tasks, has most commonly been linked to both long-term spoken language production outcomes in aphasia 9 , and anomia, the most common residual language de fi cit in aphasia 10 .”
Stroke Recurrence and Its Relationship With Language Abilities
Goldberg, E. B., Meier, E. L., Sheppard, S. M., Breining, B. L., & Hillis, A. E. (2021) · Journal of Speech Language and Hearing Research · doi:10.1044/2021_jslhr-20-00347 · Cited by 14 · see citing works
“Lesion-related factors include lesion location and size (Goldenberg & Spatt, 1994; Hillis et al., 2018; Kertesz et al., 1979; Pedersen et al., 1995).”
BackgroundSelf-citationAnatomo-functional profile of white matter tracts in relevance to language: A systematic review
Kargar, Y., & Jalilian, M. (2023) · Journal of Neurolinguistics · doi:10.1016/j.jneuroling.2023.101175 · Cited by 13 · see citing works
How Does Aphasia Affect Quality of Life? Preliminary Reports
Filipska, K., Zielińska, J., Zieliński, M., Wiśniewski, A., & Ślusarz, R. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12247687 · Cited by 13 · see citing works
Schliep, M. E., Kasparian, L., Kaminski, O., Tierney‐Hendricks, C., Ayuk, E., Wagner, L. B., Koymen, S., & Rohter, S. V. (2020) · Frontiers in Neurology · doi:10.3389/fneur.2020.00412 · Cited by 13 · see citing works
Even when right is all that's left: There are still more options for recovery from aphasia
Gottfried Schlaug, A. (2018) · Annals of Neurology · doi:10.1002/ana.25217 · Cited by 12 · see citing works
A machine learning approach for predicting post-stroke aphasia recovery
Gu, Y., Bahrani, M., Billot, A., Lai, S., Braun, E. J., Varkanitsa, M., Bighetto, J., Rapp, B. C., Parrish, T. B., Caplan, D. N., et al. (2020) · International Conference on PErvasive Technologies Related to Assistive Environments (PETRA) · doi:10.1145/3389189.3389204 · Cited by 12 · see citing works
“Until recently, most prediction analyses focused on brain-behavior relationships using simple correlations or regressions between damaged areas of interest and cognitive scores, as well as mass-univariate voxel-based lesion symptom mapping [6–14].”
BackgroundMultivariate lesion symptom mapping for predicting trajectories of recovery from aphasia
Levy, D. F., Entrup, J. L., Schneck, S. M., Onuscheck, C. F., Rahman, M., Kasdan, A. V., Casilio, M., Willey, E., Davis, L. T., de Riesthal, M. R., et al. (2023) · Brain Communications · doi:10.1093/braincomms/fcae024 · Cited by 13 · see citing works
Stockbridge, M. D., Fridriksson, J., Sen, S., Bonilha, L., & Hillis, A. E. (2021) · PLoS ONE · doi:10.1371/journal.pone.0261474 · Cited by 11 · see citing works
Self-citationStructural brain networks correlating with poststroke cognition
Brownsett, S. L. E., Carey, L. M., Copland, D. A., Walsh, A., & Sihvonen, A. J. (2024) · Human Brain Mapping · doi:10.1002/hbm.26665 · Cited by 9 · see citing works
“The inferior fronto-occipital and superior longitudinal fasciculi, and to a certain extent, the inferior longitudinal fasciculus, have been consistently associated with language production (Catani et al., 2007; Forkel & Catani, 2018; Hillis et al., 2018; Saur et al., 2010).”
BackgroundFeng, J., Lv, M., Ma, X., Li, T., Xu, M., Yang, J., Su, F., Hu, R., Li, J., Qiu, Y., et al. (2024) · European Journal of Neuroscience · doi:10.1111/ejn.16436 · Cited by 9 · see citing works
“Spontaneous recovery usually lasts for 3 to 6 months and gradually improves (Fama & Turkeltaub, 2014; Hillis et al., 2018), while improvements after CC7 can be detected immediately within 1-week after the surgery.”
Functional MRI evidence for reorganization of language networks after stroke
Li, R., Mukadam, N., & Kiran, S. (2022) · Handbook of clinical neurology · doi:10.1016/b978-0-12-823384-9.00007-4 · Cited by 9 · see citing works
Predicting language function post-stroke: a model-based structural connectivity approach
Hildesheim, F. E., Ophey, A., Zumbansen, A., Funck, T., Schuster, T., Jamison, K. W., Kuceyeski, A., & Thiel, A. (2024) · Neurorehabilitation and Neural Repair · doi:10.1177/15459683241245410 · Cited by 8 · see citing works
“15 and others reporting Time since stroke onset strongly predicted sVF at BL, with more days passed since stroke predicting a higher sVF score.”
BackgroundA Review of Poststroke Aphasia Recovery and Treatment Options
Tilton-Bolowsky, V. E., & Hillis, A. E. (2023) · Physical Medicine and Rehabilitation Clinics of North America · doi:10.1016/j.pmr.2023.06.010 · Cited by 8 · see citing works
Self-citationInvestigating Aphasia Recovery: Demographic and Clinical Factors
Papageorgiou, G., Kasselimis, D. S., Angelopoulou, G., Laskaris, N., Tsolakopoulos, D., Velonakis, G., Tountopoulou, A., Vassilopoulou, S., & Potagas, C. M. (2023) · Brain Sciences · doi:10.3390/brainsci14010007 · Cited by 8 · see citing works
“Hillis and colleagues [6] have reported that damage to the left posterior part of the superior temporal gyrus may negatively affect the degree of recovery of naming skills in acute and chronic patients with aphasia.”
BackgroundAnterior connectivity critical for recovery of connected speech after stroke
Ding, J., & Schnur, T. T. (2022) · Brain Communications · doi:10.1093/braincomms/fcac266 · Cited by 9 · see citing works
Comparing the brain–behaviour relationship in acute and chronic stroke aphasia
Busby, N., Hillis, A. E., Bunker, L. D., Rorden, C., Newman‐Norlund, R., Bonilha, L., Meier, E. L., Goldberg, E. B., Hickok, G. S., Yourganov, G., et al. (2023) · Brain Communications · doi:10.1093/braincomms/fcad014 · Cited by 9 · see citing works
Self-citationSupporting Post-Stroke Language and Cognition with Pharmacotherapy: Tools for Each Phase of Care
Stockbridge, M. D., & Keser, Z. (2023) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-023-01273-3 · Cited by 8 · see citing works
“Continuous SSRI use for the first three months following stroke also has been associated with greater frequency of improved picture naming and inclusion of more elaborate content when describing a picture than those with similar initial aphasia severity, levels of depressive symptoms, lesion volume, and percentage of…”
BackgroundIntegrity of arcuate fasciculus is a good predictor of language impairment after subcortical stroke
Noh, J. S., Lee, S., Na, Y., Cho, M., Hwang, Y. M., Tae, W., & Pyun, S. (2020) · Journal of Neurolinguistics · doi:10.1016/j.jneuroling.2020.100968 · Cited by 8 · see citing works
Cerebello-Cerebral Resting-State Functional Connectivity in Poststroke Aphasia
Stilling, J., Kim, J. H., Cust, S., Keser, Z., Murter, J. L., Tippett, D. C., Hillis, A. E., & Sebastian, R. (2024) · Brain Connectivity · doi:10.1089/brain.2023.0087 · Cited by 7 · see citing works
“These fi ndings are consistent with other studies indicating that the left STG and the right MTG are critical to naming and naming recovery (Baldo et al., 2013; Hillis et al., 2018; Hope et al., 2017; Xing et al., 2016).”
Self-citationStockbridge, M. D., Keser, Z., Bonilha, L., & Hillis, A. E. (2024) · Brain Structure and Function · doi:10.1007/s00429-024-02826-z · Cited by 7 · see citing works
“Null findings also were reported previously by our group when examining tracts related to recovery of picture naming recovery, and this is in line with previous studies showing SLF and AF associated with poorer picture naming functions and recovery (Hillis et al. 2018; Lee et al. 2020).”
Self-citationDøli, H., Helland, W. A., Helland, T., Næss, H., Hofstad, H., & Specht, K. (2021) · Aphasiology · doi:10.1080/02687038.2021.2013430 · Cited by 6 · see citing works
“, 2012), and the posterior divisions of the STG (Hillis et al., 2018) as ROIs.”
BackgroundMethodInfluentialPredictors of functional communication in people with aphasia after stroke
Fernandes, A., Fraga-Maia, H., Maso, I., Matos, I. G., Gomes, L., Matos, M., Santana, A. S. R., Filho, J. O., de Jesus, P. A. P., & Pinto, E. B. (2022) · Arquivos de Neuro-Psiquiatria · doi:10.1055/s-0042-1755267 · Cited by 6 · see citing works
Pharmacotherapy for post-stroke aphasia: what are the options?
Berthier, M. L., & Dávila, G. (2023) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2023.2221382 · Cited by 5 · see citing works
“Preliminary evidence suggests that people with PSA associated or not to depression may improve language with antidepressants [89,90].”
BackgroundResultUnraveling the Thread of Aphasia Rehabilitation: A Translational Cognitive Perspective
Papageorgiou, G., Kasselimis, D. S., Laskaris, N., & Potagas, C. M. (2023) · Biomedicines · doi:10.3390/biomedicines11102856 · Cited by 5 · see citing works
“Hillis and colleagues [59] have reported significantly better semantic and comprehension performance following naming rehabilitation, although there are ap-Biomedicines proaches which doubt the methodological processes that lead to generalization gains [60].”
BackgroundEmbracing virtual reality in rehabilitation of post-stroke aphasia
Kljajević, V. (2024) · Digital Health · doi:10.1177/20552076241271823 · Cited by 5 · see citing works
“…as recently recommended, 8 while retaining the conventional way of treatment delivery, (ii) combining SLT with pharmacological interventions 56 or with brain stimulation techniques, 57 and (iii) the use of technological solutions, such as VR, 48 but in more innovative ways, such as…”
BackgroundLiu, N., Ye, T.-F., & Yu, Q. (2024) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2024.111866 · Cited by 4 · see citing works
Pisano, F., Rizzo, G., D’Angelo, L., & Bilotta, F. (2025) · Stroke · doi:10.1161/strokeaha.125.052606 · Cited by 4 · see citing works
Diffusion tensor imaging of dorsal stream language areas in patients with post-stroke aphasia
Elmongui, A., Razek, A. A. K. A., Abou-Elsaad, T. S., Belal, T. M. I., Ibrahim, N., & Alnaghy, E. (2022) · The Egyptian Journal of Radiology and Nuclear Medicine · doi:10.1186/s43055-021-00690-z · Cited by 4 · see citing works
Varkanitsa, M., & Kiran, S. (2023) · Cortex · doi:10.1016/j.cortex.2023.12.002 · Cited by 4 · see citing works
日本脳卒中学会 (2024) · Nosotchu · doi:10.3995/jstroke.11206 · Cited by 4 · see citing works
Regional brain aging: premature aging of the domain general system predicts aphasia severity
Busby, N., Newman-Norlund, S. E., Sayers, S., Rorden, C., Newman‐Norlund, R., Wilmskoetter, J., Roth, R., Wilson, S. C., Blackett, D. S., Kristinsson, S., et al. (2024) · Communications Biology · doi:10.1038/s42003-024-06211-8 · Cited by 4 · see citing works
Self-citationPredicting individual long-term prognosis of spatial neglect based on acute stroke patient data
Röhrig, L., Wiesen, D., Li, D., Rorden, C., & Karnath, H. (2024) · Brain Communications · doi:10.1093/braincomms/fcaf047 · Cited by 4 · see citing works
“Previous studies predicting the recovery of cognitive deficits after stroke represent an inconsistency in how to deal with control patients, that is, whether to include 15,40,41 or not to include 10,42,43 patients without a behaviour/deficit of interest.”
Self-citationSpeech disorders and anxiety: interaction mechanisms and therapy potential
Васенина, Е. Е., & Levin, O. S. (2020) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro2020120041136 · Cited by 4 · see citing works
Cho, M. J., & Jang, S. H. (2021) · Journal of Integrative Neuroscience · doi:10.31083/j.jin2003072 · Cited by 4 · see citing works
Desjardins, M.-È., Marcotte, K., Bedetti, C., Houzé, B., Brisebois, A., Descoteaux, M., Désautels, A., & Brambati, S. M. (2026) · Cortex · doi:10.1016/j.cortex.2026.01.004 · Cited by 3 · see citing works
Takato, M., Nanto, T., Kanamori, M., Nakao, Y., Horikawa, K., Eimoto, K., Toyota, K., Marumoto, K., Kaku, S., Uchiyama, Y., et al. (2022) · Progress in Rehabilitation Medicine · doi:10.2490/prm.20220060 · Cited by 3 · see citing works
Neural correlates of verbal fluency revealed by longitudinal T1, T2 and FLAIR imaging in stroke
Xiong, Y., Khlif, M. S., Egorova, N., Brodtmann, A. G., & Stark, B. C. (2023) · NeuroImage Clinical · doi:10.1016/j.nicl.2023.103406 · Cited by 3 · see citing works
“Stroke patients may develop various language abnormalities as a function of lesions in cortical, subcortical and white matter (WM) regions (Hillis et al., 2018; Kuljic‐Obradovic, 2003).”
BackgroundAphasia outcome: the role of diffusion tensor tractography in patients with acute ischemic stroke
Alloush, T. K., Emara, T., Mahmoud, M. K. R., Abdulghani, K. O., Alloush, A. T., & El-Sudany, A. H. (2024) · The Egyptian Journal of Neurology Psychiatry and Neurosurgery · doi:10.1186/s41983-024-00881-1 · Cited by 3 · see citing works
“…this bidirectional transfer of signals and information, the AF could also play a role in more domain-specific language functions [26, 27], and injury to the AF could cause various types of language dysfunction, including deficits in speech production, comprehension and speech repetition [14, 28].”
BackgroundStockbridge, M. D., Keser, Z., Bunker, L. D., & Hillis, A. E. (2022) · PLoS ONE · doi:10.1371/journal.pone.0270135 · Cited by 3 · see citing works
“Recently there has been more interest in studying potential beneficial pharmaceuticals such as serotonergic drugs [12] and neuro-stimulants [34, 35] in a controlled clinical trial setting to promote post-stroke recovery.”
BackgroundSelf-citationEarly considerations of genetics in aphasia rehabilitation: a narrative review
Harnish, S. M., Diedrichs, V. A., & Bartlett, C. W. (2022) · Aphasiology · doi:10.1080/02687038.2022.2043234 · Cited by 3 · see citing works
“SSRIs have been especially promising when used to treat individuals in the subacute phase of aphasia who had damage to posterior superior temporal gyrus and the superior longitudinal fasciculus/arcuate fasciculus (Hillis et al., 2018).”
BackgroundCharting the Course of Aphasia Recovery: Factors, Trajectories, and Outcomes
Marte, M. J., Russell-Meill, M., Carvalho, N., & Kiran, S. (2024) · Annual Review of Linguistics · doi:10.1146/annurev-linguistics-011724-121245 · Cited by 5 · see citing works
Aphasia rehabilitation: a narrative review of adjuvant techniques
Harnish, S. M., Jewell, C. C., Freitag, N. G., Terry, G. E., & Anderson, G. I. (2025) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2025.1554147 · Cited by 2 · see citing works
Bhattarai, B., & Mohapatra, B. (2026) · Journal of Speech Language and Hearing Research · doi:10.1044/2025_jslhr-25-00176 · Cited by 2 · see citing works
- Authors
- Hillis, A. E., Beh, Y. Y., Sebastian, R., Breining, B., Tippett, D. C., Wright, A., Saxena, S., Rorden, C., Bonilha, L., Basilakos, A., Yourganov, G., & Fridriksson, J.
- Affiliations
- Johns Hopkins University (US)
- Medical University of South Carolina (US)
- University of South Carolina (US)
- Corresponding author
- Hillis, Argye E.
- Beh, Yuan Ye
- Sebastian, Rajani
- Breining, Bonnie
- Tippett, Donna C.
- Wright, Amy
- Saxena, Sadhvi
- Rorden, Chris
- Bonilha, Leonardo
- Basilakos, Alexandra
- Yourganov, Grigori
- Fridriksson, Julius
- ORCID
- Venue
- Annals of Neurology
- Publisher
- Wiley
- Published
- 2018-03
- Volume
- 83
- Issue
- 3
- Pages
- 612-622
- ISSN
- 0364-5134 (ISSN-L)
- 1531-8249
- PMC
- PMC5867273
- OpenAlex
- W2791952209
- Cited by
- 142
- References
- 47
- Citations by year
- 2026: 17 · 2025: 8 · 2024: 21 · 2023: 19 · 2022: 21 · 2021: 15 · 2020: 15 · 2019: 21 · 2018: 4
- FWCI
- 8.12
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annals of Neurology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NIH (R01 DC05375, T32 DC014435, P50 DC014664)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neurobiology of Language and Bilingualism
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hemispheric Asymmetry in Neuroscience
- Keywords
- post-stroke aphasia, posterior superior temporal gyrus, superior longitudinal fasciculus, arcuate fasciculus, selective serotonin reuptake inhibitors, lesion load, left hemisphere stroke, chronic stroke
- MeSH terms
- Acute Disease, Adult, Aged, Aphasia, Brain Mapping, Female, Humans, Functional Laterality, Male, Middle Aged, Neural Pathways, Recovery of Function, Stroke, Cerebrum, Diffusion Tensor Imaging
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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