Stroke recurrence and language (Goldberg et al., 2021)

Purpose: Many factors influence poststroke language recovery, yet little is known about the influence of previous stroke(s) on language after left hemisphere stroke. In this prospective longitudinal study, we investigated the role of prior stroke on language abilities following an acute left hemisphere ischemic stroke, while controlling for demographic and stroke-related factors, and examined if earlier stroke impacted language recovery at a chronic time point.

Method: Participants (n = 122) with acute left hemisphere ischemic stroke completed language evaluation and clinical neuroimaging. They were divided into two groups: single stroke (SS; n = 79) or recurrent stroke (RS; n = 43). A subset of participants (n = 31) completed chronic-stage re-evaluation. Factors studied included age, education, diabetes and hypertension diagnoses, lesion volume and broad location, group status, aphasia prevalence, and language scores.

Results: Groups did not differ in language performance across time points. The only significant group differences were that participants with RS were older, had smaller acute lesions, and were less educated. Stroke group membership (SS vs. RS) was not associated with language performance at either time point. In patients with prior stroke, large acute lesion volumes were associated with acute language performance, whereas both large acute and chronic volumes influenced recovery.

Conclusions: History of prior stroke in itself may not significantly influence language impairment after an additional acute left hemisphere stroke, unless it contributes substantially to the total volume of infarcted brain tissue. Chronic and acute lesion volumes should be accounted for in studies investigating poststroke language performance and recovery.

Supplemental Material S1. Average performance of participants who completed the BDAE at the acute timepoint, differentiated by subtests across the SS, RS, and cumulative group.

Supplemental Material S2. Average performance of participants who completed the BDAE at the follow-up timepoint, differentiated by subtests across the SS, RS, and cumulative group.

Supplemental Material S3. Average performance of participants who completed the WAB at the acute timepoint, differentiated by subtests across the SS, RS, and cumulative group.

Supplemental Material S4. Average performance of participants who completed the WAB at the follow-up timepoint, differentiated by subtests across the SS, RS, and cumulative group.

Supplemental Material S5. Robust regression results of the linear regression model predicting acute language scores while controlling for demographic and stroke variables.

Supplemental Material S6. Robust regression results of the nested regression for the RS group predicting acute language scores from acute lesion volume only.

Supplemental Material S7. Robust regression results of the nested regression for the RS group predicting acute language scores from acute + chronic lesion volumes.

Supplemental Material S8. Robust regression results of the nested regression for the RS group predicting acute language scores from acute lesion volume + chronic lesion volume + chronic lesion classification.

Goldberg, E. B., Meier, E. L., Sheppard, S. M., Breining, B. L., & Hillis, A. E. (2021). Stroke recurrence and its relationship with language abilities. Journal of Speech, Language, and Hearing Research. Advance online publication. https://doi.org/10.1044/2021_JSLHR-20-00347