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(Stroke. 2004;35:141.)
© 2004 American Heart Association, Inc.

Original Contributions

Effects of Semantic Treatment on Verbal Communication and Linguistic Processing in Aphasia After Stroke

A Randomized Controlled Trial

Suzanne J.C. Doesborgh, MA; Mieke W.E. van de Sandt-Koenderman, MA; Diederik W.J. Dippel, MD, PhD; Frans van Harskamp, MD; Peter J. Koudstaal, MD, PhD Evy G. Visch-Brink, MA, PhD

From Erasmus MC, Department of Neurology and Neuropsychology (S.J.C.D., D.W.J.D., F. van H., P.J.K., E.G.V.), and Rotterdam Aphasia Foundation/Rijndam Rehabilitation Center (W.M.E. van de S.), Rotterdam, the Netherlands.

Correspondence to E.G. Visch-Brink, Erasmus MC, Department of Neuropsychology, Room EE 2291, PO BOX 1738, 3000 DR Rotterdam, Netherlands. E-mail e.visch-brink{at}erasmusmc.nl

Background and Purpose— Semantic deficits, deficits in word meaning, have a large impact on aphasic patients’ verbal communication. We investigated the effects of semantic treatment on verbal communication in a randomized controlled trial.

Methods— Fifty-eight patients with a combined semantic and phonological deficit were randomized to receive either semantic treatment or the control treatment focused on word sound (phonology). Fifty-five patients completed pretreatment and posttreatment assessment of verbal communication (Amsterdam Nijmegen Everyday Language Test [ANELT]). In an on-treatment analysis (n=46), treatment-specific effects on semantic and phonological measures were explored.

Results— Both groups improved on the ANELT, with no difference between groups in overall score (difference, -1.1; 95% confidence interval [CI], -5.3 to 3.1). After semantic treatment, patients improved on a semantic measure (mean improvement, 2.9; 95% CI, 1.2 to 4.6), whereas after phonological treatment, patients improved on phonological measures (mean improvement, 3.0; 95% CI, 1.4 to 4.7, and 3.0; 95% CI, 1.2 to 4.7).

Conclusions— No differences in primary outcome were noted between the 2 treatments. Our findings challenge the current notion that semantic treatment is more effective than phonological treatment for patients with a combined semantic and phonological deficit. The selective gains on the semantic and phonological measures suggest that improved verbal communication was achieved in a different way for each treatment group.

Key Words: aphasia • linguistics • randomized controlled trials • rehabilitation • semantics

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