Features of speech disorders in patients with acute ischemic stroke
- Authors: Kotov S.V.1, Shcherbakova M.M.1, Zenina V.A.1,2, Isakova E.V.1, Kotov A.S.1
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Affiliations:
- M.F. Vladimirsky Moscow Regional Research and Clinical Institute
- Ramenskoye Regional Hospital
- Issue: Vol 17, No 3 (2023)
- Pages: 13-20
- Section: Original articles
- URL: https://journals.rcsi.science/2075-5473/article/view/253950
- DOI: https://doi.org/10.54101/ACEN.2023.3.2
- ID: 253950
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Abstract
Introduction. Various speech disorders that lead to impaired communication occur in 30–50% of ischemic stroke (IS) survivors. Although most attention is traditionally paid to aphasia, speech disorders also include the following: dysarthria, dysphonia (isolated or in combination with dysarthria and/or dysphagia), fluency disorders, and non-specific speech disorders associated with the severity of condition and a cognitive disorder.
Objective: to study the variety of speech disorders and their features in patients with acute IS.
Materials and methods. We examined 69 right-handed patients with mild-to-moderate acute IS and NIHSS score of 4–12. The patients were enrolled in the study on days 1–7 of the IS.
Results. We found aphasia in 27/69 patients (39.1%), dysarthria in 21/69 patients (30.4%), dysphonia (isolated or in combination with dysarthria) in 17/69 patients (24.6%), fluency disorders in 19/69 patients (27.5%; 2 patients with tachylalia and 17 patients with bradylalia). In addition, 30 patients (43.5%) had dysphagia (isolated or in combination with dysarthria). At the initial examination, patients admitted within the 1–7 days of the acute IS onset presented with global or severe sensory and motor aphasia. At the same time, we discovered a pronounced positive dynamics in speech recovery thanks to speech therapy sessions. A significant remission in a speech disorder component led to the development of cortical aphasia affecting either anterior or posterior language areas at the end of the most acute IS period, while aphasia severity reduced to mild or moderate.
Conclusions. A fast reduction in aphasic disorders due to the speech therapy sessions suggests that the focal and connectional diaschisis are the basis for the severe speech disorders.
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##article.viewOnOriginalSite##About the authors
Sergey V. Kotov
M.F. Vladimirsky Moscow Regional Research and Clinical Institute
Email: kotovsv@yandex.ru
ORCID iD: 0000-0002-8706-7317
SPIN-code: 1798-0837
Scopus Author ID: 7005990035
ResearcherId: E-4451-2017
D. Sci. (Med.), Professor, Head, Department of neurology, Faculty of postgraduate medical education, chief researcher, Neurological department, M.F. Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia
Russian Federation, MoscowMaria M. Shcherbakova
M.F. Vladimirsky Moscow Regional Research and Clinical Institute
Email: kotovsv@yandex.ru
ORCID iD: 0000-0001-5923-5355
Cand. Sci. (Med.), speech therapist, psychologist, Neurological department, M.F. Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia
Russian Federation, MoscowValentina A. Zenina
M.F. Vladimirsky Moscow Regional Research and Clinical Institute; Ramenskoye Regional Hospital
Author for correspondence.
Email: kotovsv@yandex.ru
ORCID iD: 0000-0002-6864-0018
postgraduate student, Department of neurology, Faculty of postgraduate medical education, M.F. Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia; resident, Stroke unit, Ramenskoye Regional Hospital, Moscow region, Russia
Russian Federation, Moscow; Moscow regionElena V. Isakova
M.F. Vladimirsky Moscow Regional Research and Clinical Institute
Email: kotovsv@yandex.ru
ORCID iD: 0000-0002-0804-1128
D. Sci. (Med.), leading researcher, Neurological department, M.F. Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia
Russian Federation, MoscowAlexey S. Kotov
M.F. Vladimirsky Moscow Regional Research and Clinical Institute
Email: kotovsv@yandex.ru
ORCID iD: 0000-0003-2988-5706
D. Sci. (Med.), leading researcher, Neurological department, M.F. Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia
Russian Federation, MoscowReferences
- Клочихина О.А., Стаховская Л.В., Полунина Е.А. и др. Эпидемиология и прогноз уровня заболеваемости и смертности от инсульта в разных возрастных группах по данным территориально-популяционного регистра. Журнал неврологии и психиатрии им. С.С. Корсакова. Спецвыпуски. 2019;119(8-2):5–12. Klochikhina O.A., Stakhovskaya L.V., Polunina E.A. et al. Epidemiology and prognosis of the level of morbidity and mortality from stroke in different age groups according to the territorial-population register. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2019;119(8-2):5–12. doi: 10.17116/jnevro20191190825
- Feigin V.L., Krishnamurthi R.V., Parmar .P et al, Update on the global burden of ischemic and hemorrhagic stroke in 1990-2013: The GBD 2013 Study. Neuroepidemiology. 2015;45(3):161–176. doi: 10.1159/000441085
- Zhelev Z., Walker G., Henschke N. et al. Prehospital stroke scales as screening tools for early identification of stroke and transient ischemic attack. Cochrane Database Syst. Rev. 2019;4(4):CD011427. doi: 10.1002/14651858.CD011427.pub2
- Brady M.C., Kelly H., Godwin J. et al. Speech and language therapy for aphasia following stroke. Cochrane Database Syst. Rev. 2016;2016(6):CD000425. doi: 10.1002/14651858.CD000425.pub4
- Rohde A., Worrall L., Godecke E. et al. Diagnosis of aphasia in stroke populations: A systematic review of language tests. PLoS One. 2018;13(3):e0194143. doi: 10.1371/journal.pone.0194143
- De Cock E., Oostra K., Bliki L. et al. Dysarthria following acute ischemic stroke: Prospective evaluation of characteristics, type and severity. Int. J. Lang. Commun. Disord. 2021;56(3):549–557. doi: 10.1111/1460-6984.12607
- Lazar R.M., Boehme A.K. Aphasia as a predictor of stroke outcome. Curr. Neurol. Neurosci. Rep. 2017;17(11):83. doi: 10.1007/s11910-017-0797-z
- Fernandes A., Fraga-Maia H., Maso I. et al. Preditores de comunicação funcional em pessoas com afasia após acidente vascular cerebral. Arquivos de neuro-psiquiatria. 2022;80(7):681–688. doi: 10.1055/s-0042-1755267
- Котов С.В., Белова Ю.А., Щербакова М.М. и др. Восстановление речевых функций у больных с афазией в раннем реабилитационном периоде ишемического инсульта. Журнал неврологии и психиатрии им. С.С. Корсакова. 2017;117(2):38–41. Kotov S.V., Belova Yu.A., Scherbakova M.M. et al. Restoring of the speech functions in patients with aphasia in the early rehabilitation period of ischemic stroke. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2017;117(2):38–41. doi: 10.17116/jnevro20171172138-41
- Щербакова М.М. Синдром афазии. Клинические проявления истинной и ложной афазии. Consilium Medicum. Неврология и ревматология. 2019;1:41–48. Scherbakova M.M. The aphasia syndrome. Clinical manifestations of true and false aphasia. Consilium Medicum. Neurology and Rheumatology. 2019;1:41–48. doi: 10.26442/2414357X.2019.1.190423
- Hillis A.E., Wityk R.J., Barker P.B. et al. Subcortical aphasia and neglect in acute stroke: the role of cortical hypoperfusion. Brain. 2002;125(Pt 5):1094–1104. doi: 10.1093/brain/awf113
- Brownsett S.L., Warren J.E., Geranmayeh F. et al. Cognitive control and its impact on recovery from aphasic stroke. Brain. 2014;137(Pt 1):242–254. doi: 10.1093/brain/awt289
- Yourganov G., Fridriksson J., Rorden C. et al. Multivariate connectome-based symptom mapping in post-stroke patients: networks supporting language and speech. J. Neurosci. 2016;36(25):6668–6679. doi: 10.1523/JNEUROSCI.4396-15.2016
- Davis S.W., Cabeza R. Cross-hemispheric collaboration and segregation associated with task difficulty as revealed by structural and functional connectivity. J. Neurosci. 2015;35(21):8191–8200. doi: 10.1523/JNEUROSCI.0464-15.2015
- Hartwigsen G., Saur D. Neuroimaging of stroke recovery from aphasia — Insights into plasticity of the human language network. Neuroimage. 2019;190:14–31. doi: 10.1016/j.neuroimage.2017.11.056
- Ali M., Lyden P., Brady M.; VISTA Collaboration. Aphasia and dysarthria in acute stroke: recovery and functional outcome. Int. J. Stroke. 2015;10(3):400–406. doi: 10.1111/ijs.12067
- REhabilitation and recovery of peopLE with Aphasia after StrokE (RELEASE) Collaborators. Predictors of poststroke aphasia recovery: a systematic review-informed individual participant data meta-analysis. Stroke. 2021;52(5):1778–1787. doi: 10.1161/STROKEAHA.120.031162
- Godecke E., Armstrong E., Rai T. et al. A randomized control trial of intensive aphasia therapy after acute stroke: the Very Early Rehabilitation for SpEech (VERSE) study. Int. J. Stroke. 2021;16(5):556–572. doi: 10.1177/1747493020961926
- Shahid H., Sebastian R., Schnur T.T. et al. Important considerations in lesion-symptom mapping: Illustrations from studies of word comprehension. Hum. Brain Mapp. 2017;38(6):2990–3000. doi: 10.1002/hbm.23567
- Siegel J.S., Ramsey L.E., Snyder A.Z. et al. Disruptions of network connectivity predict impairment in multiple behavioral domains after stroke. Proc. Natl. Acad. Sci. U S A. 2016;113(30):E4367–E4376. doi: 10.1073/pnas.1521083113
- Geranmayeh F., Chau T.W., Wise R.J.S. et al. Domain-general subregions of the medial prefrontal cortex contribute to recovery of language after stroke. Brain. 2017;140(7):1947–1958. doi: 10.1093/brain/awx134
- Price C.J., Friston K.J. Degeneracy and cognitive anatomy. Trends Cogn. Sci. 2002;6(10):416–421. doi: 10.1016/s1364-6613(02)01976-9
- Nudo R.J. Neural bases of recovery after brain injury. J. Commun. Disord. 2011;44(5):515–520. doi: 10.1016/j.jcomdis.2011.04.004
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