Characteristics and prognosis of language impairment in subcortical aphasia of acute stroke patients
BackgroundSubcortical aphasia, caused by lesions in deep brain structures such as the basal ganglia, thalamus, and periventricular white matter, remains poorly understood due to its heterogeneous clinical presentations and disputed neural mechanisms. Unlike classical cortical aphasia syndromes, subc...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1630365/full |
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| author | Zinan Yuan Siqi Li Xinya Chen Yang Liu Anji Zheng Liqun Gao Zaizhu Han Yumei Zhang |
| author_facet | Zinan Yuan Siqi Li Xinya Chen Yang Liu Anji Zheng Liqun Gao Zaizhu Han Yumei Zhang |
| author_sort | Zinan Yuan |
| collection | DOAJ |
| description | BackgroundSubcortical aphasia, caused by lesions in deep brain structures such as the basal ganglia, thalamus, and periventricular white matter, remains poorly understood due to its heterogeneous clinical presentations and disputed neural mechanisms. Unlike classical cortical aphasia syndromes, subcortical aphasia often involves subtle deficits in lexical, semantic, and phonological processing, which may be underestimated by standard assessments.ObjectiveThis study aimed to comprehensively characterize the language profiles of patients with subcortical aphasia using a multidimensional assessment approach, and to explore the underlying components of language impairment and their relationship to aphasia severity.MethodsThirty-four right-handed, native Chinese-speaking patients with first-ever, MRI-confirmed subcortical stroke and aphasia were enrolled within 4 weeks post-stroke. Standardized assessments included the Chinese version of the Western Aphasia Battery (WAB), the Aphasia Severity Rating Scale (ASRS), the Chinese Aphasia Fluency Characteristic Scale, and the naming battery of Chinese Aphasia Language Battery (CALB-nb). Principal component analysis (PCA) and correlation analyses were used to identify key dimensions of language impairment, with correlation coefficients calculated to quantify patient performance across linguistic domains. A one-year follow-up assessment was conducted using the ASRS to evaluate prognostic outcomes of the enrolled patients.ResultsMost patients exhibited mild to moderate aphasia, with anomic aphasia being the most prevalent subtype (47.1%). CALB naming battery results revealed high accuracy in tone decoding but lower performance in low-frequency word performance and semantic association. Strong correlations were found between phonological output and both auditory perception and phonemic decoding, as well as between auditory lexical comprehension and multiple semantic tasks. PCA identified two components—lexical-semantic and phonological-auditory, which together explained 77.3% of the variance. A composite PCA score significantly predicted aphasia severity (R2 = 0.31, p < 0.001). At one-year follow-up, 73.6% of patients achieved functional language recovery (ASRS 4–5), and five patients resumed their pre-stroke occupations.ConclusionMultidimensional assessments reveal distinct but interrelated components of lexical-semantic and phonological processing, which are closely linked to functional recovery. These findings underscore the necessity for sensitive and domain-specific language evaluations to inform prognosis and guide individualized rehabilitation strategies for subcortical aphasia. |
| format | Article |
| id | doaj-art-4b03e67d492240b1b33c3d76d5f1126a |
| institution | Kabale University |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj-art-4b03e67d492240b1b33c3d76d5f1126a2025-08-20T03:27:52ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-07-011610.3389/fneur.2025.16303651630365Characteristics and prognosis of language impairment in subcortical aphasia of acute stroke patientsZinan Yuan0Siqi Li1Xinya Chen2Yang Liu3Anji Zheng4Liqun Gao5Zaizhu Han6Yumei Zhang7Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaThe Rehabilitation Department, Beijing Xiaotangshan Hospital, Beijing, ChinaDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaBeijing Language and Culture University, Beijing, ChinaState Key Laboratory of Cognitive Neuroscience, Beijing Normal University, Beijing, ChinaDepartment of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaBackgroundSubcortical aphasia, caused by lesions in deep brain structures such as the basal ganglia, thalamus, and periventricular white matter, remains poorly understood due to its heterogeneous clinical presentations and disputed neural mechanisms. Unlike classical cortical aphasia syndromes, subcortical aphasia often involves subtle deficits in lexical, semantic, and phonological processing, which may be underestimated by standard assessments.ObjectiveThis study aimed to comprehensively characterize the language profiles of patients with subcortical aphasia using a multidimensional assessment approach, and to explore the underlying components of language impairment and their relationship to aphasia severity.MethodsThirty-four right-handed, native Chinese-speaking patients with first-ever, MRI-confirmed subcortical stroke and aphasia were enrolled within 4 weeks post-stroke. Standardized assessments included the Chinese version of the Western Aphasia Battery (WAB), the Aphasia Severity Rating Scale (ASRS), the Chinese Aphasia Fluency Characteristic Scale, and the naming battery of Chinese Aphasia Language Battery (CALB-nb). Principal component analysis (PCA) and correlation analyses were used to identify key dimensions of language impairment, with correlation coefficients calculated to quantify patient performance across linguistic domains. A one-year follow-up assessment was conducted using the ASRS to evaluate prognostic outcomes of the enrolled patients.ResultsMost patients exhibited mild to moderate aphasia, with anomic aphasia being the most prevalent subtype (47.1%). CALB naming battery results revealed high accuracy in tone decoding but lower performance in low-frequency word performance and semantic association. Strong correlations were found between phonological output and both auditory perception and phonemic decoding, as well as between auditory lexical comprehension and multiple semantic tasks. PCA identified two components—lexical-semantic and phonological-auditory, which together explained 77.3% of the variance. A composite PCA score significantly predicted aphasia severity (R2 = 0.31, p < 0.001). At one-year follow-up, 73.6% of patients achieved functional language recovery (ASRS 4–5), and five patients resumed their pre-stroke occupations.ConclusionMultidimensional assessments reveal distinct but interrelated components of lexical-semantic and phonological processing, which are closely linked to functional recovery. These findings underscore the necessity for sensitive and domain-specific language evaluations to inform prognosis and guide individualized rehabilitation strategies for subcortical aphasia.https://www.frontiersin.org/articles/10.3389/fneur.2025.1630365/fullsubcortical aphasialexical-semantic processingphonological processinglanguage recoveryChinese Aphasia Language Batteryprincipal component analysis |
| spellingShingle | Zinan Yuan Siqi Li Xinya Chen Yang Liu Anji Zheng Liqun Gao Zaizhu Han Yumei Zhang Characteristics and prognosis of language impairment in subcortical aphasia of acute stroke patients Frontiers in Neurology subcortical aphasia lexical-semantic processing phonological processing language recovery Chinese Aphasia Language Battery principal component analysis |
| title | Characteristics and prognosis of language impairment in subcortical aphasia of acute stroke patients |
| title_full | Characteristics and prognosis of language impairment in subcortical aphasia of acute stroke patients |
| title_fullStr | Characteristics and prognosis of language impairment in subcortical aphasia of acute stroke patients |
| title_full_unstemmed | Characteristics and prognosis of language impairment in subcortical aphasia of acute stroke patients |
| title_short | Characteristics and prognosis of language impairment in subcortical aphasia of acute stroke patients |
| title_sort | characteristics and prognosis of language impairment in subcortical aphasia of acute stroke patients |
| topic | subcortical aphasia lexical-semantic processing phonological processing language recovery Chinese Aphasia Language Battery principal component analysis |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1630365/full |
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