Predictors of Poststroke Aphasia Recovery: A Systematic Review-Informed Individual Participant Data Meta-Analysis
Creators: name: Ali, Myzoon
name: VandenBerg, Kathryn
name: Williams, Linda J
name: Williams, Louise R
name: Abo, Masahiro
name: Becker, Frank
name: Bowen, Audrey
name: Brandenburg, Caitlin
name: Breitenstein, Caterina
name: Bruehl, Stefanie
name: Copland, David A
name: Cranfill, Tamara B
name: Di Pietro-Bachmann, Marie
name: Enderby, Pamela
name: Fillingham, Joanne
name: Galli, Federica Lucia
name: Gandolfi, Marialuisa
name: Glize, Bertrand
name: Godecke, Erin
name: Hawkins, Neil
name: Hilari, Katerina
name: Hinckley, Jacqueline
name: Horton, Simon
name: Howard, David
name: Jaecks, Petra
name: Jefferies, Elizabeth
name: Jesus, Luis MT
name: Kambanaros, Maria
name: Kang, Eun Kyoung
name: Khedr, Eman M
name: Kong, Anthony Pak-Hin
name: Kukkonen, Tarja
name: Laganaro, Marina
name: Ralph, Matthew A Lambon
name: Laska, Ann Charlotte
name: Leemann, Beatrice
name: Leff, Alexander P
name: Lima, Roxele R
name: Lorenz, Antje
name: Whinney, Brian Mac
name: Marshall, Rebecca Shisler
name: Meinzer, Marcus
name: Nilipour, Reza
name: Noe, Enrique
name: Paik, Nam-Jong
name: Palmer, Rebecca
name: Papathanasiou, Ilias
name: Patricio, Brigida F
name: Martins, Isabel Pavao
name: Price, Cathy
name: Jakovac, Tatjana Prizl
name: Rochon, Elizabeth
name: Rose, Miranda
name: Rosso, Charlotte
name: Rubi-Fessen, Ilona
name: Ruiter, Marina B
name: Snell, Claerwen
name: Stahl, Benjamin
name: Szaflarski, Jerzy P
name: Thomas, Shirley A
name: Van De Sandt-Koenderman, Mieke
name: van der Meulen, Ineke
name: Visch-Brink, Evy
name: Worrall, Linda
name: Wright, Heather Harris
name: Brady, Marian C
Publisher: name: La Trobe
Year: 2021
Subjects: Uncategorized

description: Background and Purpose: The factors associated with recovery of language domains after stroke remain uncertain. We described recovery of overall-language-ability, auditory comprehension, naming, and functional-communication across participants’ age, sex, and aphasia chronicity in a large, multilingual, international aphasia dataset. Methods: Individual participant data meta-analysis of systematically sourced aphasia datasets described overall-language ability using the Western Aphasia Battery Aphasia-Quotient; auditory comprehension by Aachen Aphasia Test (AAT) Token Test; naming by Boston Naming Test and functional-communication by AAT Spontaneous-Speech Communication subscale. Multivariable analyses regressed absolute score-changes from baseline across language domains onto covariates identified a priori in randomized controlled trials and all study types. Change-from-baseline scores were presented as estimates of means and 95% CIs. Heterogeneity was described using relative variance. Risk of bias was considered at dataset and meta-analysis level. Results: Assessments at baseline (median=43.6 weeks poststroke; interquartile range [4–165.1]) and first-follow-up (median=10 weeks from baseline; interquartile range [3–26]) were available for n=943 on overall-language ability, n=1056 on auditory comprehension, n=791 on naming and n=974 on functional-communication. Younger age (&lt;55 years, +15.4 Western Aphasia Battery Aphasia-Quotient points [CI, 10.0–20.9], +6.1 correct on AAT Token Test [CI, 3.2–8.9]; +9.3 Boston Naming Test points [CI, 4.7–13.9]; +0.8 AAT Spontaneous-Speech Communication subscale points [CI, 0.5–1.0]) and enrollment &lt;1 month post-onset (+19.1 Western Aphasia Battery Aphasia-Quotient points [CI, 13.9–24.4]; +5.3 correct on AAT Token Test [CI, 1.7–8.8]; +11.1 Boston Naming Test points [CI, 5.7–16.5]; and +1.1 AAT Spontaneous-Speech Communication subscale point [CI, 0.7–1.4]) conferred the greatest absolute change-from-baseline across each language domain. Improvements in language scores from baseline diminished with increasing age and aphasia chronicity. Data exhibited no significant statistical heterogeneity. Risk-of-bias was low to moderate-low. Conclusions: Earlier intervention for poststroke aphasia was crucial to maximize language recovery across a range of language domains, although recovery continued to be observed to a lesser extent beyond 6 months poststroke.