Non-linguistic cognitive factors predict treatment-induced recovery in chronic post-stroke aphasia

Publication date: Available online 9 January 2019

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Natalie Gilmore, Erin L. Meier, Jeffrey P. Johnson, Swathi Kiran

Abstract

Objective

To determine if pre-treatment non-linguistic cognition predicted language treatment outcomes and if so, which specific non-linguistic cognitive subskills predicted naming therapy outcomes.

Design

Retrospective.

Setting

Research clinic.

Participants

Study 1 included data from 67 persons with aphasia who underwent language treatment and a pre-treatment cognitive-linguistic assessment battery. Study 2 included data from 27 Study 1 participants who completed additional pre-treatment non-linguistic cognitive assessments.

Interventions

120-minute sessions of sentence comprehension (n=26) or naming treatment (n= 41) 2x/week for up to 10-12 weeks

Main Outcome Measure(s)

Proportion of potential maximal gain (i.e. PMG; assessed immediately after treatment [10-12 weeks]; formula = mean post-treatment score – mean pre-treatment score/total number of trained items – mean pre-treatment score) and proportion of potential maximal gain maintained (i.e., PMGM; assessed 12 weeks after post-treatment [22-24 weeks]; formula = mean maintenance score – mean pre-treatment score/total number of trained items – mean pre-treatment score) as outcome variables; and pre-treatment assessment scores as predictor variables.

Results

In study 1, 37% participants demonstrated non-linguistic cognitive deficits. Principal component analyses reduced assessment data to two components: linguistic and non-linguistic cognition. Backward elimination regression revealed that higher linguistic and non-linguistic cognitive function significantly predicted higher PMG after language therapy. In study 2, principal component analysis of only the non-linguistic cognitive measures identified three components: executive function, verbal short-term memory and visual short-term memory. Controlling for pre-treatment apraxia of speech and auditory comprehension deficits, regression analyses revealed that higher executive function and visual short-term memory significantly predicted higher PMG and PMGM after naming therapy.

Conclusions

Pre-treatment non-linguistic cognitive function significantly influenced language treatment outcomes and maintenance of therapy gains.

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