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Front. Neurol. | doi: 10.3389/fneur.2019.00776

Association of Lesion Location with Long-term Recovery in Post-stroke Aphasia and Language Deficits

Bomi Sul1,  Kyoung Bo Lee2, Bo Young Hong1,  Joon Sung Kim1, Jaewon Kim1, Woo Seop Hwang2 and  Seong Hoon Lim1*
  • 1College of Medicine, The Catholic University of Korea, South Korea
  • 2St. Vincent's Hospital, The Catholic University of Korea, South Korea

Background: Recovery from post-stroke aphasia is important for performing the activities of daily life, returning to work, and quality of life. We investigated the association between specific brain lesions and the long-term outcome of four dimensions of aphasia: fluency, comprehension, naming, and repetition 12 months after onset in patients with stroke.
Methods: Our retrospective cross-sectional observational study investigated the relationship between the Korean version of the Western Aphasia Battery scores in 31 stroke patients 1 year after the onset of stroke and stroke lesion location. Brain lesions were assessed using voxel-based lesion symptom mapping (VLSM) in conjunction with magnetic resonance imaging.
Results: Damage to the Rolandic cortex, Heschl’s gyrus, the posterior corona radiata, supramarginal cortex, superior longitudinal fasciculus, superior temporal gyrus, and insula was associated with a low total AQ score. Lesions in the inferior triangularis and inferior operculum of the frontal cortex, supramarginal cortex, and insula were associated with a poor fluency outcome. Damage to the parietal cortex, angular cortex, temporal middle cortex, sagittal stratum, and temporal superior cortex was associated with poor recovery of comprehension skills. Lesions in the angular cortex, supramarginal cortex, posterior corona radiata, superior longitudinal fasciculus, internal capsule, temporal superior cortex, and temporal middle cortex were associated with poor recovery of naming in patients with stroke. Damage to the superior temporal cortex, posterior corona radiata, and superior longitudinal fasciculus was associated with poor recovery of repetition component.
Conclusions: We identified specific brain lesions associated with long-term outcomes in four dimensions of aphasia, in patients with post-stroke aphasia. Our findings may be useful for advancing understanding for the pathophysiology of aphasia in stroke patients.

Keywords: Stroke, Aphasia, K-WAB, prognosis, Outcome, brain imaging, VLSM

Received: 17 Apr 2019; Accepted: 03 Jul 2019.

Edited by:

Lisa T. Connor, Washington University in St. Louis, United States

Reviewed by:

Carlo Cavaliere, Institute of Research and Medical Care (IRCCS) SDN, Italy
Alessandro Giustini, Consultant, Italy  

Copyright: © 2019 Sul, Lee, Hong, Kim, Kim, Hwang and Lim. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Mx. Seong Hoon Lim, College of Medicine, The Catholic University of Korea, Seoul, 06591, South Korea,