Ischemia in broca area is associated with broca aphasia more reliably in acute than in chronic stroke
Open accessAbstract
BACKGROUND AND PURPOSE: We aimed to determine if ischemia involving Broca area predicts Broca aphasia more reliably in acute or chronic stroke. METHODS: We included consecutive right-hand-dominant patients with left hemisphere ischemic stroke (<48 hours from onset for acute stroke or >6 months after stroke for chronic stroke). MRI scans were analyzed for ischemic lesions or hypoperfusion in Broca area (Brodmann areas 44 and 45). Patients were scored on the Western Aphasia Battery to classify aphasia syndromes; chi(2) tests were used to identify significant associations. RESULTS: The presence of infarct involving any part of Broca area and the presence of Broca or global aphasia was much stronger in acute (chi(2)=38.1; df1; P<0.0001) than in chronic stroke (chi(2)=0.54; df1; P=0.46; not significant). The association between infarct or hypoperfusion covering all of Broca area and the presence of Broca or global aphasia was much stronger in acute (chi(2)=35.8; df1; P<0.0001) than in chronic stroke (chi(2)=1.2; df1; p=0.27; not significant). In a subset of 20 patients studied longitudinally, the associations were significant only acutely, not chronically (chi(2)=20; df1; P<0.0001 vs. chi(2)=0; df1; p=1; not significant for ischemia involving part of Broca area, and chi(2)=16.4; df1; P<0.0001 vs chi(2)=3.2; df1; p=0.08; not significant for ischemia covering all of Broca area). CONCLUSIONS: Broca aphasia is more reliably associated with infarct/ hypoperfusion of Broca area in acute stroke. Many chronic stroke patients with damage to part or all of Broca area had neither Broca nor global aphasia. Broca or global aphasia was sometimes present initially in these patients but resolved by 6 months. Our results indicate that the acute aphasia syndrome may allow the clinician to predict the compromised vascular territory, even when structural imaging shows only a small (or no) infarct.
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Broca's area damage is associated with short-term speech production impairments.
“the association of Broca’s area damage with short-term speech production impairments (Ochfeld et al., 2010) should be re-evaluated after controlling for damage to aAF.”
From Damage to Broca’s area does not contribute to long-term speech production outcome after stroke (2021) · cites this paper as Ochfeld et al., 2010
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Carragher, M. (2013) · Research Explorer (The University of Manchester)
- Authors
- Ochfeld, E., Newhart, M., Molitoris, J., Leigh, R., Cloutman, L., Davis, C., Crinion, J., & Hillis, A. E.
- Affiliations
- Johns Hopkins University (US)
- From Departments of Neurology (E.O., M.N., J.M., R.L., L.C., C.D., J.C., A.E.H.) and Physical Medicine and Rehabilitation (A.E.H.), Johns Hopkins Cognitive Science (A.E.H.), Johns Hopkins University School of Medicine, Baltimore, Md; Institute of Cognitive Neuroscience (J.C.), University College London, London, UK.
- Venue
- Stroke
- Published
- 2010-02
- Volume
- 41
- Issue
- 2
- Pages
- 325-330
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- PMC
- PMC2828050
- OpenAlex
- W2005847696
- Cited by
- 71
- References
- 16
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 5 · 2023: 4 · 2022: 6 · 2021: 5 · 2020: 4 · 2019: 3 · 2018: 1 · 2017: 7 · 2016: 3 · 2015: 7 · 2014: 3 · 2013: 6 · 2012: 3
- FWCI
- 2.87
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Research Explorer (The University of Manchester) (submittedVersion, other-oa)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Institutes of Health
- National Institute on Deafness and Other Communication Disorders (R01DC005375)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neurobiology of Language and Bilingualism
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Neurological and metabolic disorders
- Keywords
- Broca's aphasia, Broca's area, ischemic stroke, acute stroke, chronic stroke, cerebral infarction, cerebral hypoperfusion, global aphasia, vascular territories, longitudinal follow-up
- MeSH terms
- Acute Disease, Adult, Aged, Aged, 80 and over, Aphasia, Broca, Brain Mapping, Brain Ischemia, Chronic Disease, Dominance, Cerebral, Female, Frontal Lobe, Humans, Language Tests, Magnetic Resonance Imaging, Male, Middle Aged, Predictive Value of Tests, Prognosis, Severity of Illness Index, Reproducibility of Results, Comorbidity, Disease Progression, Stroke, Young Adult
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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