Features of speech disorders in patients with acute ischemic stroke

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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.

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, Moscow

Maria 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, Moscow

Valentina 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 region

Elena 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, Moscow

Alexey 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, Moscow

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Copyright (c) 2023 Kotov S.V., Shcherbakova M.M., Zenina V.A., Isakova E.V., Kotov A.S.

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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