Late recovery of auditory comprehension in global aphasia. Improved recovery observed with subcortical temporal isthmus lesion vs Wernicke's cortical area lesion
M. A. Naeser, A. Gaddie, C. L. Palumbo and D. Stiassny-Eder
Department of Neurology, University School of Medicine, Boston, MA.
This study examined the relationship between recovery of auditory
comprehension in global aphasia patients after 1 year post onset, and
temporal lobe lesion in Wernicke's cortical area vs temporal lobe lesion in
the subcortical temporal isthmus area. Computed tomographic scans and
language behavior were examined in 14 right-handed globally aphasic stroke
patients with lesion in the left hemisphere. Nine patients had large
cortical/subcortical frontal, parietal, and temporal lobe lesion that
included more than half of Wernicke's cortical area (FPT cases). Five
patients had large cortical/subcortical frontal and parietal lobe lesion,
but only subcortical temporal lobe lesion, including the temporal isthmus
(FPTi cases). All patients were tested acutely at 1 to 4 months post onset
and again at 1 to 2 years post onset. There was a significantly greater
increase in the amount of recovery that had taken place after 1 to 2 years
post onset for the FPTi group vs the FPT group in the overall Boston
Diagnostic Aphasia Examination (BDAE) Auditory Comprehension Z score. In
four of the five FPTi cases, the late BDAE Auditory Comprehension Z scores
were above -0.5 (mild-to-moderate comprehension deficits). Most recovery
was in single-word comprehension. In eight of the nine FPT cases, the late
BDAE Auditory Comprehension Z-scores were below -0.5 (moderate-to-severe
comprehension deficits). There was no significant difference between the
two groups in recovery of spontaneous speech, repetition, or naming, where
severe deficits remained in most cases.(ABSTRACT TRUNCATED AT 250 WORDS)
