Small Vessel Disease & Treatment Outcome in Aphasia

Predicting treatment-induced recovery in people with aphasia (PWA) is an essential goal of current rehabilitation research given the large outcome variability observed even across similar deficit profiles and the complex interplay between multiple factors modulating treatment response. Although stroke-related factors including lesion site and volume, and aphasia severity substantially predict aphasia recovery, general brain health markers may independently modulate individual response to language therapy. The aim of this project is to test the hypothesis that the overall health of the brain tissue in the right hemisphere may be associated with language treatment outcomes in PWA independently of aphasia severity and stroke-related factors (i.e. lesion volume and time post onset). To test this hypothesis, we examine the relationship between small vessel disease (SVD) and treatment outcome in chronic PWA.

Sporadic SVD is among the post prevalent known neurologic processes and contribute substantially to stroke, cognitive impairment, dementia, and other disabilities commonly seen in the elderly (including depression, motor and gait disturbances, urinary symptoms, and functional impairment). Previous studies have suggested a wide range of neuroimaging markers for SVD, including white matter hyperintensities (WMH), brain atrophy (BA) and lacunes on FLAIR imaging, acute small subcortical infarcts on diffusion-weighted images, enlarged perivascular spaces in cerebral white matter on T2-weighted imaging, and strictly lobar microbleeds and cortical superficial siderosis on susceptibility-weighted imaging (Charidimou et al. 2016). In this project all markers are taken into consideration and their effect on naming treatment outcome above and beyond aphasia severity, stroke-related factors (i.e. total lesion volume and time post onset) and PWA’s demographic characteristics (i.e. age, gender and educational level) is investigated.