Ann Rehabil Med.  2019 Dec;43(6):625-634. 10.5535/arm.2019.43.6.625.

Changes in Language Function and Recovery-Related Prognostic Factors in First-Ever Left Hemispheric Ischemic Stroke

• Kim KA
• Lee JS
• Chang WH
• Kim DY
• Shin YI
• Kim SY
• Kim YT
• Kang SH
• Choi JY
• Kim YH

• KMID: 2468689
• DOI: http://doi.org/10.5535/arm.2019.43.6.625

Abstract

OBJECTIVE
To investigate longitudinal changes in language function in left-hemispheric ischemic stroke patients as well as factors that influence language recovery until 1 year after stroke onset.
METHODS
We analyzed data from 235 patients with first-ever left-hemispheric ischemic stroke. All patients completed the Korean version of the Frenchay Aphasia Screening Test (K-FAST) at 7 days (T1), 3 months (T2), 6 months (T3), and 1 year (T4) after stroke onset. Repeated measures analysis of variance (ANOVA) was used to investigate changes in language function between time points. Subgroup analysis was performed according to the K-FAST scores at T1. Stroke lesion volume was assessed using diffusion tensor images, and involvement of language-related brain regions was examined. Multiple regression analysis was used to analyze factors influencing improvement of K-FAST score.
RESULTS
The K-FAST scores at T1, T2, T3, and T4 differed significantly (p < 0.05). In the subgroup analysis, only the severe group showed continuous significant improvement by 1 year. Factors that negatively influenced improvement of language function were the age at onset, initial National Institutes of Health Stroke Scale (NIHSS) score, and initial K-FAST score, whereas education level and stroke lesion volume positively affected recovery. Involvement of language-related brain regions did not significantly influence long-term language recovery after ischemic stroke.
CONCLUSION
Recovery of language function varied according to the severity of the initial language deficit. The age at stroke onset, education level, initial severity of aphasia, initial NIHSS score, and total stroke lesion volume were found to be important factors for recovery of language function.

Keyword

Stroke; Aphasia; Prognosis; Stroke volume; Rehabilitation

MeSH Terms

Age of Onset
Aphasia
Brain
Diffusion
Education
Humans
Mass Screening
National Institutes of Health (U.S.)
Prognosis
Rehabilitation
Stroke Volume
Stroke*

Figure

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  Fig. 1. CONSORT flow diagram for the study. KOSCO, Korean Stroke Cohort for Function and Rehabilitation; K-FAST, Korean version of the Frenchay Aphasia Screening Test ; MRI, magnetic resonance imaging.

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  Fig. 2. Magnetic resonance imaging mapping of aphasia-related regions of interest with MRIcro software.

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  Fig. 3. Changes in the Korean version of the Frenchay Aphasia Screening Test (K-FAST) scores over 12 months after stroke onset in all participants (A) and subgroups by initial severity (B). Significance of improvement in K-FAST scores among time points was analyzed by repeated measures ANOVA. Changes in K-FAST severity group distribution over 12 months after stroke onset (C). Significance of group shifting was analyzed by McNemar test. *p<0.05.

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