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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. [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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“serotonin reuptake inhibitors (SSRIs), which elevate synaptic serotonin, might enhance recovery by augmenting synaptic plasticity.(13,14) SSRIs increase brain-derived neurotrophic factor,(15) which may be a critical modulator of recovery.”
Background
Flagged first, then by citations
1 of the 47 references couldn’t be matched to a known paper.
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Cited by
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Neuroplasticity of Language Networks in Aphasia: Advances, Updates, and Future Challenges
Kiran, S., & Thompson, C. K. (2019) · Frontiers in Neurology · doi:10.3389/fneur.2019.00295 · Cited by 250
“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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Fridriksson, J., & Hillis, A. E. (2021) · Journal of Stroke · doi:10.5853/jos.2020.05015 · Cited by 172
“Other factors have also been implicated such as the degree of damage to posterior superior temporal gyrus or arcuate fasciculus,(46,47) independently of lesion volume, and recovery in patients with damage to these critical areas may be influenced by medications.(46) Aphasia severity, a factor related to overall lesion…”
BackgroundSelf-citationRecovery from aphasia in the first year after stroke
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Sheppard, S. M., & Sebastian, R. (2020) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2020.1855976 · Cited by 166
Self-citation
Metadata
- 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
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