Language deficits and cognitive profile on different stages of cerebrovascular disease
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1
University of Hong Kong, Hong Kong, SAR China
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2
Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Australia
Background. Stroke by definition is a consequence of blood circulation disturbance caused by the ischemia or a hemorrhage in a specific brain area (Sacco, et al., 2013). At least, one-third of the patients with CVD suffer from communicative disorders accompanied by other cognitive disruptions (Kauhanen, et al, 2000). However, there is no clinically homogenous pattern of cognitive symptoms or established course of cerebrovascular disease (CVD) from initial to terminal stages. The aim of the present study is to determine if there is a specific cognitive profile associated with language deficits on two different stages of CVD - small vessel disease (SVD) and chronic stroke representing the contrasting CVD phases.
Procedures. 205 stroke patients and 42 patients with SVD (18-88 years old, 85 women, 8.4 months post onset in average) were assessed with the newly validated Russian version of the Oxford Cognitive Screen (Rus-OCS; Shendyapina et al., 2017), the Russian version of the Montreal Cognitive Assessment (Rus-MoCA), the Luria Neuropsychological Battery, and Star Cancellation Test. The scores on attention, memory, praxis, language and number processing domains have been obtained. Lesion lateralization was assessed by use of structural MRI scans. Patients with left hemisphere stroke (LH, n = 41) or right hemisphere stroke (RH, n = 46) were then compared to a group with bilateral lesions (BL, n = 118). The Kruskal-Wallis test was applied to check for differences between these clinical groups performance on all Rus-OCS subtests. Chi-square test was used to check for equality of impairments proportions between clinical groups.
Results. The SVD group demonstrated a mild level of verbal and non-verbal cognitive impairment mostly in the verbal memory domain. Over 29% of participants had deficits on verbal recall, and a further 24% on the Orientation task. Visual attention (24%) and praxis (19%) were also affected. The stroke cohort revealed impairments on language, memory, visuospatial and numerical domains with specific deficits in verbal recall (81%), verbal recognition (68%), task switching and number writing (52%). Additional analysis on patients with different lesion localisations showed that left hemisphere stroke survivors are likely to have the highest rate of language functions deficit (verbal recall - 95%, verbal recognition - 80%, oral reading - 61%, object naming - 37%). Statistical analysis of the impairment ratios within each group confirmed these results.
Conclusions. Cognitive profiles of patients with initial and chronic CVD stages were compared. The observed differences could be explained by the functional language decline following the loss of intact brain tissue in the left hemispheric region.
Acknowledgements
We would like to acknowledge the contribution of Mr Sergey Kazymaev and Dr Ekaterina Kuzmina who made the Rus-OCS project possible.
References
Kauhanen, M. L., Korpelainen, J. T., Hiltunen, P., Määttä, R., Mononen, H., Brusin, E., ... & Myllylä, V. V. (2000). Aphasia, depression, and non-verbal cognitive impairment in ischaemic stroke. Cerebrovascular Diseases, 10(6), 455-461.
Sacco, R. L., Kasner, S. E., Broderick, J. P., Caplan, L. R., Culebras, A., Elkind, M. S., ... & Janis, L. S. (2013). An updated definition of stroke for the 21st century. Stroke, 44(7), 2064-2089
Shendyapina M, Kuzmina E, Kazymaev S, Petrova A, Riddoch J, Humphreys G and Weekes BS (2017). The Russian version of the Oxford Cognitive Screen: validation with stroke survivors. Frontiers in Human Neuroscience. Conference Abstract: Academy of Aphasia 55th Annual Meeting. doi: 10.3389/conf.fnhum.2017.223.00028
Keywords:
Stroke,
Cerebrovascular Disorders,
Language Disorders,
cognitive assessment,
Oxford Cognitive Screen,
Russian
Conference:
Academy of Aphasia 56th Annual Meeting, Montreal, Canada, 21 Oct - 23 Oct, 2018.
Presentation Type:
oral presentation
Topic:
Eligible for a student award
Citation:
Shendyapina
M and
Weekes
B
(2019). Language deficits and cognitive profile on different stages of cerebrovascular disease.
Conference Abstract:
Academy of Aphasia 56th Annual Meeting.
doi: 10.3389/conf.fnhum.2018.228.00108
Copyright:
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Received:
28 Mar 2018;
Published Online:
22 Jan 2019.
*
Correspondence:
Ms. Maria Shendyapina, University of Hong Kong, Pokfulam, Hong Kong, SAR China, mshend@hku.hk