Enhanced estimations of post‐stroke aphasia severity using stacked multimodal predictions
Open accessAbstract
The severity of post‐stroke aphasia and the potential for recovery are highly variable and difficult to predict. Evidence suggests that optimal estimation of aphasia severity requires the integration of multiple neuroimaging modalities and the adoption of new methods that can detect multivariate brain‐behavior relationships. We created and tested a multimodal framework that relies on three information sources (lesion maps, structural connectivity, and functional connectivity) to create an array of unimodal predictions which are then fed into a final model that creates “stacked multimodal predictions” (STAMP). Crossvalidated predictions of four aphasia scores (picture naming, sentence repetition, sentence comprehension, and overall aphasia severity) were obtained from 53 left hemispheric chronic stroke patients (age: 57.1 ± 12.3 yrs, post‐stroke interval: 20 months, 25 female). Results showed accurate predictions for all four aphasia scores (correlation true vs. predicted: r = 0.79–0.88). The accuracy was slightly smaller but yet significant ( r = 0.66) in a full split crossvalidation with each patient considered as new. Critically, multimodal predictions produced more accurate results that any single modality alone. Topological maps of the brain regions involved in the prediction were recovered and compared with traditional voxel‐based lesion‐to‐symptom maps, revealing high spatial congruency. These results suggest that neuroimaging modalities carry complementary information potentially useful for the prediction of aphasia scores. More broadly, this study shows that the translation of neuroimaging findings into clinically useful tools calls for a shift in perspective from unimodal to multimodal neuroimaging, from univariate to multivariate methods, from linear to nonlinear models, and, conceptually, from inferential to predictive brain mapping. Hum Brain Mapp 38:5603–5615, 2017 . © 2017 Wiley Periodicals, Inc.
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“Seven studies (21, 23, 26, 31, 32, 35, 36) primarily relied on error metrics, such as root mean square error and mean absolute error, combined with indicators, such as the Pearson correlation coefficient and coefficient of determination, to provide a more comprehensive assessment.”
From Machine learning models in post-stroke aphasia: a scoping review (2026) · cites this paper as [36]
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Machine learning models in post-stroke aphasia: a scoping review
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“Seven studies (21, 23, 26, 31, 32, 35, 36) primarily relied on error metrics, such as root mean square error and mean absolute error, combined with indicators, such as the Pearson correlation coefficient and coefficient of determination, to provide a more comprehensive assessment.”
Influential
- Authors
- Pustina, D., Coslett, H. B., Ungar, L., Faseyitan, O. K., Medaglia, J. D., Avants, B., & Schwartz, M. F.
- Affiliations
- University of Pennsylvania (US)
- Moss Rehabilitation Hospital (US)
- ORCID
- Venue
- Human Brain Mapping
- Publisher
- Wiley
- Published
- 2017-08-07
- Volume
- 38
- Issue
- 11
- Pages
- 5603-5615
- ISSN
- 1065-9471 (ISSN-L)
- 1097-0193
- PMC
- PMC5765865
- OpenAlex
- W2744571415
- Cited by
- 86
- References
- 11
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 17 · 2023: 13 · 2022: 7 · 2021: 7 · 2020: 14 · 2019: 7 · 2018: 5 · 2017: 2
- FWCI
- 4.39
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Human Brain Mapping (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Deafness and Other Communication Disorders (RO1DC000191)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neurobiology of Language and Bilingualism
- Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Keywords
- post-stroke aphasia, structural connectivity, functional connectivity, chronic stroke, left hemisphere, picture naming, sentence imitation, sentence comprehension, voxel-based lesion-symptom mapping
- MeSH terms
- Aphasia, Brain, Cerebrovascular Circulation, Chronic Disease, Female, Humans, Language Tests, Magnetic Resonance Imaging, Male, Middle Aged, Oxygen, Rest, Severity of Illness Index, Multivariate Analysis, Linear Models, Nonlinear Dynamics, Stroke, Connectome, Multimodal Imaging
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