Patterns of Recovery From Aphasia in the First 2 Weeks After Stroke

Stephen M Wilson, Dana K. Eriksson, Temre H. Brandt, Sarah M. Schneck, Jillian M. Lucanie, Annie S. Burchfield, Sara Charney, Ian A. Quillen, Michael de Riesthal, Howard S. Kirshner, Pelagie M Beeson, Leslie S Ritter, Stella Kidwell

Research output: Contribution to journalArticle

Abstract

Purpose Recovery from aphasia after stroke has a decelerating trajectory, with the greatest gains taking place early and the slope of change decreasing over time. Despite its importance, little is known regarding evolution of language function in the early postonset period. The goal of this study was to characterize the dynamics and nature of recovery of language function in the acute and early subacute phases of stroke. Method Twenty-one patients with aphasia were evaluated every 2-3 days for the first 15 days after onset of acute ischemic or hemorrhagic stroke. Language function was assessed at each time point with the Quick Aphasia Battery (Wilson, Eriksson, Schneck, & Lucanie, 2018), which yields an overall summary score and a multidimensional profile of 7 different language domains. Results On a 10-point scale, overall language function improved by a mean of 1.07 points per week, confidence interval [0.46, 1.71], with 19 of 21 patients showing positive changes. The trajectory of recovery was approximately linear over this time period. There was significant variability across patients, and patients with more impaired language function at Day 2 poststroke experienced greater improvements over the subsequent 2 weeks. Patterns of recovery differed across language domains, with consistent improvements in word finding, grammatical construction, repetition, and reading, but less consistent improvements in word comprehension and sentence comprehension. Conclusion Overall language function typically improves substantially and steadily during the first 2 weeks after stroke, driven mostly by recovery of expressive language. Information on the trajectory of early recovery will increase the accuracy of prognoses and establish baseline expectations against which to evaluate the efficacy of interventions. Supplemental Material https://doi.org/10.23641/asha.7811876.

Original languageEnglish (US)
Pages (from-to)723-732
Number of pages10
JournalJournal of speech, language, and hearing research : JSLHR
Volume62
Issue number3
DOIs
StatePublished - Mar 25 2019

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Aphasia
speech disorder
stroke
Language
Stroke
language
comprehension
Functions of Language
Recovery
Recovery of Function
Reading
confidence
Confidence Intervals
Trajectory

ASJC Scopus subject areas

  • Language and Linguistics
  • Linguistics and Language
  • Speech and Hearing

Cite this

Patterns of Recovery From Aphasia in the First 2 Weeks After Stroke. / Wilson, Stephen M; Eriksson, Dana K.; Brandt, Temre H.; Schneck, Sarah M.; Lucanie, Jillian M.; Burchfield, Annie S.; Charney, Sara; Quillen, Ian A.; de Riesthal, Michael; Kirshner, Howard S.; Beeson, Pelagie M; Ritter, Leslie S; Kidwell, Stella.

In: Journal of speech, language, and hearing research : JSLHR, Vol. 62, No. 3, 25.03.2019, p. 723-732.

Research output: Contribution to journalArticle

Wilson, SM, Eriksson, DK, Brandt, TH, Schneck, SM, Lucanie, JM, Burchfield, AS, Charney, S, Quillen, IA, de Riesthal, M, Kirshner, HS, Beeson, PM, Ritter, LS & Kidwell, S 2019, 'Patterns of Recovery From Aphasia in the First 2 Weeks After Stroke', Journal of speech, language, and hearing research : JSLHR, vol. 62, no. 3, pp. 723-732. https://doi.org/10.1044/2018_JSLHR-L-18-0254
Wilson, Stephen M ; Eriksson, Dana K. ; Brandt, Temre H. ; Schneck, Sarah M. ; Lucanie, Jillian M. ; Burchfield, Annie S. ; Charney, Sara ; Quillen, Ian A. ; de Riesthal, Michael ; Kirshner, Howard S. ; Beeson, Pelagie M ; Ritter, Leslie S ; Kidwell, Stella. / Patterns of Recovery From Aphasia in the First 2 Weeks After Stroke. In: Journal of speech, language, and hearing research : JSLHR. 2019 ; Vol. 62, No. 3. pp. 723-732.
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AU - Lucanie, Jillian M.

AU - Burchfield, Annie S.

AU - Charney, Sara

AU - Quillen, Ian A.

AU - de Riesthal, Michael

AU - Kirshner, Howard S.

AU - Beeson, Pelagie M

AU - Ritter, Leslie S

AU - Kidwell, Stella

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N2 - Purpose Recovery from aphasia after stroke has a decelerating trajectory, with the greatest gains taking place early and the slope of change decreasing over time. Despite its importance, little is known regarding evolution of language function in the early postonset period. The goal of this study was to characterize the dynamics and nature of recovery of language function in the acute and early subacute phases of stroke. Method Twenty-one patients with aphasia were evaluated every 2-3 days for the first 15 days after onset of acute ischemic or hemorrhagic stroke. Language function was assessed at each time point with the Quick Aphasia Battery (Wilson, Eriksson, Schneck, & Lucanie, 2018), which yields an overall summary score and a multidimensional profile of 7 different language domains. Results On a 10-point scale, overall language function improved by a mean of 1.07 points per week, confidence interval [0.46, 1.71], with 19 of 21 patients showing positive changes. The trajectory of recovery was approximately linear over this time period. There was significant variability across patients, and patients with more impaired language function at Day 2 poststroke experienced greater improvements over the subsequent 2 weeks. Patterns of recovery differed across language domains, with consistent improvements in word finding, grammatical construction, repetition, and reading, but less consistent improvements in word comprehension and sentence comprehension. Conclusion Overall language function typically improves substantially and steadily during the first 2 weeks after stroke, driven mostly by recovery of expressive language. Information on the trajectory of early recovery will increase the accuracy of prognoses and establish baseline expectations against which to evaluate the efficacy of interventions. Supplemental Material https://doi.org/10.23641/asha.7811876.

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