SLPCohortNeurorehabilitation and neural repair2023

Early Subacute White Matter Hyperintensities and Recovery of Language After Stroke.

Veronika Vadinova, Aleksi J Sihvonen, Kimberley L Garden and 6 others

PMID 37083133

WHAT IT FOUND

Severe white matter hyperintensities seen on early subacute MRI predicted worse spoken language comprehension at both early and chronic stages, but not production.

These brain changes may explain why some stroke survivors struggle more with understanding speech than others.

Key findings

01Severe early subacute white matter hyperintensities were associated with lower spoken comprehension scores at the early subacute stage, independent of stroke lesion volume.

02Severe white matter hyperintensities also predicted poorer spoken comprehension at the chronic follow-up, adding significant explanatory power beyond lesion characteristics.

03White matter hyperintensities did not predict spoken language production scores at either timepoint.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The sample size was small (37 participants initially, 28 at follow-up), which limits the reliability of the findings. There was high correlation between WMH severity and age, so the study could not separate the independent effects of these two factors. The study only included patients with left hemisphere stroke, so results may not apply to right hemisphere strokes. The study design was retrospective and involved data from two different sources, which may introduce variability.

Declared interests

The authors declared no potential conflicts of interest. The research was supported by Australian government and NHMRC funding, as well as Finnish foundations.

The easy way to misread this

Do not assume that severe white matter hyperintensities cause aphasia or that they predict poor language production. The study found these brain changes specifically predicted worse comprehension scores, not production, and the effect was independent of the stroke lesion size. Also, remember that age and WMH severity were highly linked in this group, so the finding might partly reflect age-related decline.

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