Applied Evidence

Aphasia severity mediates the relationship between attention and sentence comprehension.

Aphasiology · 2026 · Other · SLP

Emily J Lenz, Arianna N LaCroix

PMID 42232106

Attention does not directly drive sentence comprehension in aphasia.

In 58 stroke survivors, the link between attention and sentence processing ran through overall aphasia severity. More severe aphasia meant worse ability to shift attention and more difficulty resisting distraction.

Key findings

1The direct effects of all three attention networks (alerting, orienting, executive control) on sentence comprehension were non-significant. For orienting, the relationship with sentence comprehension was fully accounted for by aphasia severity.

2Between-group differences in attention tracked with aphasia severity: the severe group showed poorer orienting and executive control than all other groups, while alerting did not differ across groups.

3The indirect effect of orienting on sentence comprehension through severity was significant for both canonical and non-canonical sentences. Executive control showed only trend-level indirect effects, and alerting showed no significant paths in the model.

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What it does not show

Small severity subgroups: only 3 severe and 8 latent participants, limiting power for group comparisons and making the severe-group findings fragile Cross-sectional design: cannot determine whether attention affects language, language affects attention, or both arise from shared neural damage Pooled data from two studies with minor procedural differences (different fixation jitter intervals, different numbers of experimental trials), accounted for by a site covariate but not eliminated No neuroimaging: attentional differences cannot be linked to specific lesion locations or network disruption Aphasia subtype was clustered within severity groups (moderate and severe mostly Broca's and conduction; mild mostly anomic), so severity effects may partly reflect subtype differences in grammatical processing

Declared interests

The authors declare no financial or non-financial conflicts of interest.

The easy way to misread this

Do not read this as evidence that attention training will improve sentence comprehension. The study is cross-sectional: it shows attention and language co-vary through severity, not that improving one will improve the other. The data cannot determine whether attention affects language, language affects attention, or both arise from shared neural damage.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →