Variability in language recovery after first-time Stroke
- Ronald M Lazar (ral22{at}columbia.edu)
- Allison E Speizer (allisongeller{at}gmail.com)
- Joanne R Festa (jfesta{at}neuro.columbia.edu)
- John W Krakauer (tropiques{at}aol.com)
Abstract
Background:Predicting aphasia recovery after stroke has been difficult because of substantial variability in outcomes. Few studies have characterized the nature and extent of recovery, beginning with baselines at 24-72 hours after stroke onset.
Aim:To characterize the course of language recovery after first-time stroke.
Methods:Using our Performance and Recovery in Stroke Study (PARIS) database, we evaluated consecutive first-time stroke patients with aphasia and DWI-positive lesions on admission and at 90 days.
Results:Twenty-two of 91 patients had language disorders. Initial syndrome scores were positively correlated with 90-days scores (r = .60) and negatively correlated with the change score from baseline to follow-up ( r = -.66). Neither lesion size, age nor education correlated with initial syndrome severity or with performance at 90 days. Level of education was not associated with degree of recovery. A multiple regression model that combined lesion size, age and initial syndrome was significant (p = .03) but only explained 29% of the variance. Patients with severe deficits at baseline in individual language domains could recover, improve to a less severe deficit, or not improve at all.
Conclusion:There was significant variability in language recovery after first-time stroke, even in more severe, initial syndromes. Traditional predictors of post-stroke language outcomes did not reliably predict function at 90 days. These data suggest other factors have not yet been identified that account for functional stroke recovery.
