What do we learn from recovery from aphasia?
1. Recovery rates are different from outcome measures, and therefore paradoxically positive correlation between the recovery of comprehension and lesion size can be found particularly in Broca's aphasia or in populations that are skewed toward nonfluent aphasics. 2. Outcome, in terms of recovery from aphasia, correlates significantly with lesion size in the expected direction regardless of initial severity for the total aphasic group, but not as much in Wernicke's aphasia. 3. Outcome correlates well with initial test scores, but, particularly in Broca's aphasics, lesion size is as good a predictor as initial severity. 4. The rate of recovery differs in different types of aphasia, and Broca's aphasics recover most. 5. The initial recovery period between 0 and 3 months is significantly steeper than subsequent periods, but it does not correlate as well as outcome with lesion size. 6. Cerebral asymmetry or torque may be less typical in more recovered Broca's aphasics, but this failed to reach statistical significance and seems not be a factor for Wernicke's aphasics. 7. Age and gender are not as significant as lesion size and location. 8. Surrounding intact ipsilateral structures are more important for the recovery of some of the language functions, such as motor output and phonemic assembly, than homologous contralateral structures. Comprehension and semantic processing may have more contralateral or right hemisphere compensation than other language functions.
Kertesz
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Research Institute, St. Joseph's Hospital, University of Western Ontario, London, Canada.
D001037:Aphasia / Q000503:physiopathology / Q000534:rehabilitation*; D001921:Brain / Q000033:anatomy & histology / Q000503:physiopathology*; D005500:Follow-Up Studies; D007839:Functional Laterality; D006801:Humans; D014956:Writing