Objective Indices of Severity of Chronic Aphasia in Stroke Patients

Abstract

Standardized language tests of 78 stroke patients with chronic aphasia indicated: (1) All four language components were impaired in all 78 aphasics. (2) The severity of comprehension defect generally reflected the severity of overall language impairment. (3) In hemiplegics and nonhemiplegics, writing was more severely impaired than speech, comprehension, and reading. (4) Severity of language defects increased with advancing age. (5) Residual language functions in highly educated aphasics were greater than those in less educated aphasics. (6) Left-handed adults are less likely than dextrals to sustain chronic aphasia as a result of cerebrovascular lesions. (7) Patterns of associated language defects did not coincide with the traditional dichotomy of Broca’s “motor” vs Wernicke’s “sensory” and “conduction” aphasia as originally described. Marked impairment in visual ideational, spatial, and memory functions characteristic of deficits resulting from right posterior lesions was associated with severe comprehension defects. Since the same finding was consistently reported in several earlier studies, the results suggest that (1) cerebrovascular lesions resulting in chronic aphasia involve the nondominant as well as the left hemisphere more frequently than is commonly believed, and (2) the nondominant hemisphere plays a significant role in auditory comprehension and in recovery of language functions in aphasia.