Published Online
on June 19, 2003

A more recent version of this article appeared on July 1, 2003

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Submitted on February 7, 2003
Accepted on March 5, 2003

Auditory Discrimination After Left-Hemisphere Stroke. A Mismatch Negativity Follow-Up Study

Titta-Maria Ilvonen MA; Teija Kujala PhD^*; Anita Kiesiläinen MA; Oili Salonen MD, PhD; Hesham Kozou MD; Eero Pekkonen MD, PhD; Risto O. Roine MD, PhD; Markku Kaste MD, PhD; and Risto Näätänen PhD

From the Cognitive Brain Research Unit (T.-M.I., T.K., H.K., E.P., R.N.), Department of Psychology, University of Helsinki; the Helsinki Brain Research Centre (T.-M.I., R.N.); the Helsinki Collegium for Advanced Studies (T.K.), University of Helsinki; and the Departments of Neurology (A.K., E.P., R.O.R., M.K.) and Radiology (O.S.), Helsinki University Central Hospital, Helsinki, Finland.

^* To whom correspondence should be addressed. E-mail: teija.m.kujala{at}helsinki.fi.

Background and Purpose--We sought to determine the recovery of cortical auditory discrimination in aphasic, left-hemisphere-stroke patients by using an electrophysiological response called mismatch negativity (MMN) and speech-comprehension tests.

Methods--MMN in 8 left-hemisphere stroke patients was recorded in response to duration and frequency changes in a repetitive, harmonically rich tone 4 and 10 days and again 3 and 6 months after their first unilateral stroke. Eight age-matched, healthy persons served as control subjects.

Results--At 4 days after stroke onset, patients' sound discrimination was impaired in their left hemisphere, as suggested by attenuated MMNs, especially to right-ear stimuli. At 3 months after stroke, however, MMN to the right-ear duration change had significantly increased and was of normal size. A significant change for the frequency MMN was found for left-ear stimuli between 3 and 6 months after stroke. During the follow-up period, progressive improvement in speech-comprehension tests was also observed. Furthermore, there was a significant correlation between the change in the duration MMN amplitude and the Boston Diagnostic Aphasia Examination speech-comprehension test from 10 days to 3 months after stroke.

Conclusions--These results suggest that the MMN can be used as an index of the recovery of auditory discrimination.

Key words: aphasia • hearing disorders • laterality • mismatch negativity • speech • stroke outcome

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