Aphasia profiles and trajectories in acute ischemic stroke: An observational study.

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Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_F74E8B6F50B8
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Aphasia profiles and trajectories in acute ischemic stroke: An observational study.
Journal
Journal of stroke and cerebrovascular diseases
Author(s)
Bill O., Lievens L., Lambrou D., Eskandari A., Beaud V., Michel P.
ISSN
1532-8511 (Electronic)
ISSN-L
1052-3057
Publication state
Published
Issued date
01/2025
Peer-reviewed
Oui
Volume
34
Number
1
Pages
108142
Language
english
Notes
Publication types: Journal Article ; Observational Study
Publication Status: ppublish
Abstract
In acute ischemic stroke (AIS), neuropsychological deficits and their long-term impact are insufficiently studied. We studied pure aphasic AIS patients, their short-term aphasiological course, predictors of persisting aphasia, and their outcome.
In the ASTRAL Registry, we assessed all pure aphasic AIS patients from 2003-2019, and reviewed their neuropsychological examination performed after 3-10 days. We identified factors associated with persistent significant aphasia in the subacute phase, and predictors of unfavourable functional outcome at 3 months (mRS≥ 2), using multivariate analyses (MVA).
Among 4513 consecutive AISs, 131 (2.9 %) had pure aphasia at admission. Eighty-one had a good quality neuropsychological examination and were analysed further (median age 76.3yrs; 44.4 % female; 6.2 % left-handed; 27.2 % treated by acute revascularization). Of these, 28.4 % still had significant aphasia in the subacute phase. Persistent aphasia was independently associated with cardioembolic (OR 13.6, 95 %CI 2.6-70.8) or atheromatous (OR 16.0, 95 %CI 1.9-132.1) stroke mechanisms, and with an executive function deficit on neuropsychological examination (OR 10.5, 95 %CI 2.0-54.4). At 3 months, female gender (OR 4.2, 95 %CI 1.2-15.3) and significant aphasia in the subacute phase (OR 12.0, 95 %CI 3.3-43.6) predicted an mRS≥2.
Pure aphasia was present in 2.9 % of all AIS patients and resolved in three-quarters in the subacute phase. Persistent aphasia was associated with embolic stroke mechanisms and concomitant executive function impairment, and poor 3 months outcome, with female gender and enduring subacute aphasia. These data may help with prognostication, management and rehabilitation planning.
Pure aphasic ischemic stroke is rare and most recover spontaneously within days, and persistent subacute aphasia is associated with defined embolic stroke mechanisms, and concomitant executive dysfunction. Unfavourable functional outcome at 3 months is present in women and if there is persistent subacute aphasia.
Keywords
Humans, Female, Male, Aphasia/etiology, Aphasia/diagnosis, Aphasia/physiopathology, Aphasia/psychology, Aged, Ischemic Stroke/diagnosis, Ischemic Stroke/therapy, Ischemic Stroke/physiopathology, Ischemic Stroke/complications, Aged, 80 and over, Registries, Time Factors, Risk Factors, Neuropsychological Tests, Middle Aged, Prognosis, Functional Status, Recovery of Function, Cognition, Executive Function, Disability Evaluation, Risk Assessment, Acute stroke, Aphasia, Rehabilitation, Women
Pubmed
Open Access
Yes
Create date
09/12/2024 15:10
Last modification date
18/01/2025 7:22
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