Improvement in aphasia scores after stroke is well predicted by initial severity.
OBJECTIVE
Most improvement from poststroke aphasia occurs within the first 3 months, but there remains unexplained variability in recovery. Recently, we reported a strong correlation between initial impairment and change scores in motor recovery at 90 days. We wanted to determine whether aphasia recovery (defined as a change from baseline to 90 days) shows a comparably strong correlation and whether the relation was similar to that in motor recovery.


METHODS
Twenty-one stroke patients had aphasia scores on the Western Aphasia Battery (WAB) obtained on stroke admission (WAB(initial)) and at 90 days (WAB(3 mo)). The relation between actual change (Delta) scores (defined as WAB(3 mo)- WAB(initial)) and WAB(initial) was calculated in multiple-regression analysis.


RESULTS
Regression analysis demonstrated that WAB(initial) was highly correlated with DeltaWAB (R(2)=0.81, P<0.001) and that, in addition, the relation between WAB(initial) and DeltaWAB was proportional, such that patients recovered 0.73 of maximal potential recovery (WAB(maximum)-WAB(initial)).


CONCLUSIONS
We show that, like motor recovery, there is a highly predictable relation between aphasia recovery and initial impairment, which is also proportional in nature. The comparability of recovery from motor and language impairment suggests that common mechanisms may govern reduction of poststroke neurologic impairment across different functional domains and that they could be the focus of therapeutic intervention.
Lazar
Ronald M
RM
Stroke Division, Columbia University Medical Center, New York, NY, USA. ral22@columbia.edu
Minzer
Brandon
B
Antoniello
Daniel
D
Festa
Joanne R
JR
Krakauer
John W
JW
Marshall
Randolph S
RS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001037:Aphasia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007807:Language Tests / Q000592:standards; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D020127:Recovery of Function / Q000502:physiology*; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D016896:Treatment Outcome; D055815:Young Adult