Event Abstract

Back to Event

Dynamic Recovery of Language Comprehension from Acute Wernicke’s Aphasia

Holly Robson1*, Timothy D. Griffiths2, Manon Grube2, 3 and Anna M. Woollams4
  • 1 University of Reading, United Kingdom
  • 2 University of Newcastle, Institute of Neuroscience, United Kingdom
  • 3 Technische Universität, Germany
  • 4 University of Manchester, Psychological Sciences, United Kingdom

Introduction: The language comprehension impairment of the Wernicke’s aphasia (WA) type is pervasive and difficult to treat if it persists into the chronic stage (e.g. Woolf, Panton et al., 2014). However, it is estimated that 75% of individuals with acute WA sufficiently recover their comprehension and fall outside the WA classification by the chronic phase (Pedersen, Vinter et al., 2004). Recent work with chronic WA has found a strong relationship between acoustic-phonological processing and language comprehension (Robson, Grube et al., 2013), with a more limited contribution of semantic processing (Robson, Keidel et al., 2012). This prospective longitudinal study explored the neuropsychological profile associated with subacute WA and factors associated with recovery of auditory language comprehension. Methods: Twelve individuals with subacute WA and ten individuals with chronic WA were recruited. Individuals recruited at the subacute stage underwent neuropsychological testing at three time points: 2.5, 5 and 9 months post-stroke onset (mpo). Individuals with chronic WA were recruited and assessed within a range of 1-12 years post-stroke. The psychoacoustic and neuropsychological battery included the following: - Basic Auditory Processing: pure tone discrimination, frequency modulation detection (2 & 40 Hz sinusoidal modulation of 500-Hz carrier), dynamic modulation detection (1cycle/octave, 4cycles/second). - Phonological Processing: non-word and word phonological discrimination - Semantic processing: picture semantic association - Language Comprehension: Boston Diagnostic Aphasia Examination (BDAE), in-house spoken & written word-to-picture matching tests (swpm/wwpm). Analysis & Results: All but one participant recruited at the subacute stage displayed an improvement in comprehension on the BDAE from 2.5 to 9mpo and this improvement was highly significant at the group level (F(2,20)=22.2, p<0.001). At 9mpo half the subacute group fell outside the BDAE WA classification. Compared to the chronic group, the subacute group (2.5mpo) showed no difference in auditory comprehension (BDAE: t(16.4)=0.09, p=0.92 – unequal variances; swpm: t(16.5)=0.9, p=0.38 – unequal variances) but significantly better performance on phonological word discrimination (t(21)=2.2, p=0.042) and dynamic modulation detection (t(21)=2.5, p=0.02) . sWPM accuracy correlated with nonverbal semantics at 2.5mpo (r=.73, p=.01); word discrimination at 5mpo (r=.78, p=.003) and non-verbal auditory processing (frequency modulation detection) at 9mpo (r=.82, p=.002), Figure 1. Partial cross-lagged correlations were performed controlling for comprehension severity measured by the BDAE at 2.5mpo. Non-verbal semantic processing at 2.5mpo correlated with swpm at 5mpo (r=.66, p=.038) and word discrimination, but not non-verbal semantics, at 5mpo correlated with swpm at 9mpo (r=.90, p<.001), Figure 1. Finally, discriminant function analysis indicated that only digit span at 2.5mpo was a successful predictor of which participants in the subacute group were classified as WA at 9mpo. Discussion: This study indicates the dynamic nature of WA-type comprehension impairments post stroke. Auditory comprehension was significantly associated with semantic processing integrity at an early stage post stroke, with a transition toward a more prominent influence of early auditory processing at chronic stages. WA which persisted into the chronic stage was associated with poor digit span at the subacute phase – a skill associated with left posterior superior temporal gyrus (“Wernicke’s Area”) function (Leff, Schofield et al., 2009).

Figure 1
Image

Acknowledgements

This research was funded by a Stroke Association, UK, Senior Research Training Fellowship awarded to HR (TSA SRTF 2012/02)

References

Leff, A. P., Schofield, T. M., Crinion, J. T., Seghier, M. L., Grogan, A., Green, D. W., & Price, C. J. (2009). The left superior temporal gyrus is a shared substrate for auditory short-term memory and speech comprehension: evidence from 210 patients with stroke. Brain, 132, 3401-3410.
Pedersen, P. M., Vinter, K., & Olsen, T. S. (2004). Aphasia after stroke: Type, severity and prognosis - The Copenhagen aphasia study. Cerebrovascular Diseases, 17, 35-43.
Robson, H., Grube, M., Lambon Ralph, M. A., Griffiths, T. D., & Sage, K. (2013). Fundamental deficits of auditory perception in Wernicke's aphasia. Cortex, 49(7), 1808-1822.
Robson, H., Keidel, J. L., Lambon Ralph, M. A., & Sage, K. (2012). Revealing and quantifying the impaired phonological analysis underpinning impaired comprehension in Wernicke's aphasia. Neuropsychologia, 50(2), 276-288.
Woolf, C., Panton, A., Rosen, S., Best, W., & Marshall, J. (2014). Therapy for auditory processing impairment in aphasia: An evaluation of two approaches. Aphasiology, 28(12), 1481-1505.

Keywords: Wernicke’s aphasia, Auditory comprehension, auditory processing, semantic association, Aphasia

Conference: 54th Annual Academy of Aphasia Meeting, Llandudno, United Kingdom, 16 Oct - 18 Oct, 2016.

Presentation Type: Platform Sessions

Topic: Academy of Aphasia

Citation: Robson H, Griffiths TD, Grube M and Woollams AM (2016). Dynamic Recovery of Language Comprehension from Acute Wernicke’s Aphasia. Front. Psychol. Conference Abstract: 54th Annual Academy of Aphasia Meeting. doi: 10.3389/conf.fpsyg.2016.68.00049

Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters.

The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated.

Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed.

For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions.

Received: 27 Apr 2016; Published Online: 15 Aug 2016.

* Correspondence: Dr. Holly Robson, University of Reading, Reading, United Kingdom, h.v.robson@reading.ac.uk