Executive control deficits and lesion correlates in acute left hemisphere stroke survivors with and without aphasia

Purpose The purpose of this study was to compare the utility of two automated indices of lexical diversity, the Moving-Average Type–Token Ratio (MATTR) and the Word Information Measure (WIM), in predicting aphasia diagnosis and responding to differences in severity and aphasia subtype. Method Transcripts of a single discourse task were analyzed for 478 speakers, 225 of whom had aphasia per an aphasia battery. We calculated the MATTR and the WIM for each participant. We compared the group means among speakers with aphasia, neurotypical controls, and left-hemisphere stroke survivors with mild aphasia not detected by an aphasia battery. We examined whether each measure distinguished levels of aphasia severity and subtypes of aphasia. We used each measure to classify aphasia versus neurotypical control and compared the areas under the curve. Results The WIM and the MATTR differentiated among people with aphasia, neurotypical controls, and people with mild aphasia. Both measures demonstrated moderately high predictive accuracy in classifying aphasia. The WIM demonstrated greater sensitivity to aphasia severity and subtype compared to the MATTR. Conclusions The WIM and the MATTR are promising measures that quantify lexical diversity in different and complementary ways. The WIM may be more useful for quantifying the effect of treatment or disease progression, whereas the MATTR may be more useful for discriminating discourse produced by people with very mild aphasia from discourse produced by neurotypical controls. Further validation is required.

Download Full-text

Communication Outcome 12 Months Following Left-Hemisphere Stroke in the Elderly

Brain Impairment ◽

10.1375/brim.9.2.170 ◽

2008 ◽

Vol 9 (2) ◽

pp. 170-178 ◽

Cited By ~ 3

Author(s):

Margaret Macrae ◽

Jacinta M. Douglas

Keyword(s):

Left Hemisphere ◽

Residential Care ◽

Recurrent Stroke ◽

Preliminary Investigation ◽

Speech Pathology ◽

Stroke Survivors ◽

Age Related ◽

Left Hemisphere Stroke ◽

The Impact ◽

Communication Outcome

AbstractWith increasing life expectancy and the changing age structure of the population, the health sector is experiencing increased demands on services associated with age-related diseases including stroke and Alzheimer's disease. The communication needs of older Australians in these disease groups need to be understood to enable adequate provision of speech pathology services. In this project we set out to make a preliminary investigation of 12-month communication outcome and discharge destination of aphasic stroke survivors over age 65 at onset of first ever in a lifetime stroke (FELS). The recruitment timeframe was a 6-month period of stroke admissions to a large metropolitan health network. Nearly 70% of stroke admissions were aged 65 years and over and 34% were ascertained retrospectively from medical records as having aphasia. Within this group, there was a 20% mortality rate. Sixteen left-hemisphere stroke survivors with aphasia were followed up at 12 months. More than half were living in residential care. Excluding the impact of recurrent stroke, 12-month reassessment of language demonstrated substantial improvement could occur in the old-very old stroke survivor. These findings highlight the need to develop systematic review and follow-up speech pathology services that operate effectively in residential care environments.

Download Full-text

Mapping lesion, structural disconnection, and functional disconnection to symptoms in semantic aphasia

10.1101/2021.12.01.470605 ◽

2021 ◽

Author(s):

Nicholas E. Souter ◽

Xiuyi Wang ◽

Hannah Thompson ◽

Katya Krieger-Redwood ◽

Ajay D. Halai ◽

...

Keyword(s):

Cognitive Control ◽

Left Hemisphere ◽

Executive Control ◽

Inferior Frontal Gyrus ◽

Temporal Cortex ◽

Executive Dysfunction ◽

Semantic Retrieval ◽

Semantic Cognition ◽

Left Hemisphere Stroke ◽

Executive Impairment

AbstractPatients with semantic aphasia have impaired control of semantic retrieval, often accompanied by executive dysfunction following left hemisphere stroke. Many but not all of these patients have damage to the left inferior frontal gyrus, important for semantic and cognitive control. Yet semantic and cognitive control networks are highly distributed, including posterior as well as anterior components. Accordingly, semantic aphasia might not only reflect local damage but also white matter structural and functional disconnection. Here we characterise the lesions and predicted patterns of structural and functional disconnection in individuals with semantic aphasia and relate these effects to semantic and executive impairment. Impaired semantic cognition was associated with infarction in distributed left- hemisphere regions, including in the left anterior inferior frontal and posterior temporal cortex. Lesions were associated with executive dysfunction within a set of adjacent but distinct left frontoparietal clusters. Performance on executive tasks was also associated with interhemispheric structural disconnection across the corpus callosum. Poor semantic cognition was associated with small left-lateralized structurally disconnected clusters, including in the left posterior temporal cortex. These results demonstrate that while left- lateralized semantic and executive control regions are often damaged together in stroke aphasia, these deficits are associated with distinct patterns of structural disconnection, consistent with the bilateral nature of executive control and the left-lateralized yet distributed semantic control network.

Download Full-text

Auditory Attention following a Left Hemisphere Stroke: Comparisons of Alerting, Orienting, and Executive Control Performance Using an Auditory Attention Network Test

Auditory Perception & Cognition ◽

10.1080/25742442.2021.1922988 ◽

2021 ◽

pp. 1-14

Author(s):

Arianna N. LaCroix ◽

Leslie C. Baxter ◽

Corianne Rogalsky

Keyword(s):

Left Hemisphere ◽

Executive Control ◽

Auditory Attention ◽

Attention Network Test ◽

Control Performance ◽

Attention Network ◽

Left Hemisphere Stroke

Download Full-text

Distinguishing Semantic Control and Phonological Control And Their Role in Aphasic Deficits: A Task Switching Investigation

10.31234/osf.io/sbazh ◽

2021 ◽

Author(s):

Joshua McCall ◽

Candace M. van der Stelt ◽

Andrew DeMarco ◽

J. Vivian Dickens ◽

Elizabeth Dvorak ◽

...

Keyword(s):

Cognitive Control ◽

Left Hemisphere ◽

Task Switching ◽

Daily Life ◽

Stroke Survivors ◽

Semantic Representations ◽

Phonological Representations ◽

Left Hemisphere Stroke ◽

Switching Task

People use cognitive control across many contexts in daily life, yet it remains unclear how cognitive control is used in contexts involving language. Distinguishing language-specific cognitive control components may be critical to understanding aphasia, which can co-occur with cognitive control deficits. For example, deficits in control of semantic representations (i.e., semantic control), are thought to contribute to semantic deficits in aphasia. Conversely, little is known about control of phonological representations (i.e., phonological control) in aphasia. We developed a switching task to investigate semantic and phonological control in 32 left hemisphere stroke survivors with aphasia and 37 matched controls. We found that phonological and semantic control were related, but dissociate in the presence of switching demands. People with aphasia exhibited group-wise impairment at phonological control, although individual impairments were subtle. Several individuals with aphasia exhibited frank semantic control impairments, and these individuals had relative deficits on other semantic tasks. The present findings distinguish semantic control from phonological control, and confirm that semantic control impairments contribute to semantic deficits in aphasia.

Download Full-text

Domains of Health-Related Quality of Life Are Associated With Specific Deficits and Lesion Locations in Chronic Aphasia

Neurorehabilitation and Neural Repair ◽

10.1177/15459683211017507 ◽

2021 ◽

pp. 154596832110175

Author(s):

Elizabeth L. Dvorak ◽

Davetrina S. Gadson ◽

Elizabeth H. Lacey ◽

Andrew T. DeMarco ◽

Peter E. Turkeltaub

Keyword(s):

Quality Of Life ◽

Language Production ◽

Depression Symptoms ◽

Stroke Survivors ◽

Factor Scores ◽

Lesion Location ◽

Related Quality ◽

Health Related ◽

Left Hemisphere Stroke

Background Health-related quality of life (HRQL) in stroke survivors is related to numerous factors, but more research is needed to delineate factors related to HRQL in people with aphasia. Objective To examine the relationship between HRQL and demographic factors, impairment-based measures, and lesion characteristics in chronic aphasia. Methods A total of 41 left-hemisphere stroke survivors with aphasia underwent cognitive testing and magnetic resonance imaging. To address relationships with demographic and impairment-based measures, test scores were entered into a principal component analysis (PCA) and multiple linear regression was performed for overall and domain (physical, communication, psychosocial) scores of the Stroke and Aphasia Quality of Life Scale (SAQOL-39g). Independent variables included factor scores from the PCA, motricity, lesion volume, depressed mood, and demographic variables. To address relationships with lesion location, multivariate support vector regression lesion-symptom mapping (SVR-LSM) was used to localize lesions associated with SAQOL-39g scores. Results The PCA yielded 3 factors, which were labeled Language Production, Nonlinguistic Cognition, and Language Comprehension. Multiple linear regression revealed that depression symptoms predicted lower SAQOL-39g average and domain scores. Lower motricity scores predicted lower SAQOL-39g average and physical scores, and lower Language Production factor scores predicted lower communication scores. SVR-LSM demonstrated that basal ganglia lesions were associated with lower physical scores, and inferior frontal lesions were associated with lower psychosocial scores. Conclusions HRQL in chronic left-hemisphere stroke survivors with aphasia relates to lesion location, depression symptoms, and impairment-based measures. This information may help identify individuals at risk for specific aspects of low HRQL and facilitate targeted interventions to improve well-being.

Download Full-text