Abstract T P112: Independent Contributions of Education, Anti-Depressants, and Other Factors in Aphasia Recovery
BACKGROUND AND PURPOSE: The greatest aphasia recovery after stroke occurs in the first 3 months, and the degree of recovery is fairly predictable by initial severity. Degree of recovery of after 3 months is highly variable. We sought to determine factors (age, education, time post onset (TPO), infarct volume, medications) that influence language recovery after 3 months.
METHODS: We tested 45 chronic, left-hemisphere stroke patients (mean age 54.9 years; education of 14.7 years; TPO 35.4 months; volume of lesion of 126 cc) on the WAB. Comprehension, repetition, and naming summary scores and total of these scores were used as outcome variables. “Spontaneous speech” scores were omitted because of lower reliably in scoring. Infarct volume was measured on MRI FLAIR sequences. Multivariable linear regression analyses were used to identify predictors of recovery.
RESULTS: WAB total score beyond 3 months was independently predicted only by education (for model including education, age, TPO, infarct volume: r2 = 0.32; p=0.004). Repetition was also predicted only by education (p=0.007). However, naming was also predicted by age (p=.003). For those not on antidepressants, naming was significantly influenced by age, education, TPO, and volume of lesion, independently of each other (r2 for this model = 0.66; p<0.0001). For those on antidepressants, naming was predicted only by education (p=0.03). There were no differences between patients who had never taken antidepressants and those currently taking antidepressants in age, education, TPO, volume of lesion, total WAB score (mean 23.7 vs 28.3), comprehension (8.3/10 vs. 9.9/10), or naming (7.5/10 vs. 8.8/10), but patients who had never taken anti-depressants tended to have lower repetition scores (mean 8.1/10 vs. 9.6/10; p=0.05).
CONCLUSION: Education may provide a “cognitive reserve” for stroke patients; higher education is robustly associated with better recovery of language scores, even after controlling for age, lesion volume, and TPO. Younger age, longer TPO, and small infarcts are all independently associated with better recovery of naming. Anti-depressants may be associated with better short-term memory and concentration, and therefore associated with a tendency for better recovery of repetition.
Author Disclosures: A. Suneja: None. M. Fernandez: None. A. Hillis: None.
- © 2014 by American Heart Association, Inc.