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(Stroke. 2003;34:1746.)
© 2003 American Heart Association, Inc.

Original Contributions

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 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.

Correspondence to Teija Kujala, Helsinki Collegium for Advanced Studies, PO Box 4, FIN-00014, University of Helsinki, Helsinki, Finland. 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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