Predictors of poststroke aphasia recovery: a systematic review-informed individual participant data meta-analysis

Myzoon Ali; Kathryn VandenBerg; Linda J. Williams; Louise R. Williams; Masahiro Abo; Frank Becker; Audrey Bowen; Caitlin  Brandenburg; Caterina Breitenstein; Stefanie Bruehl; David A. Copland; Tamara B. Cranfill; Marie di Pietro-Bachmann; Pamela  Enderby; Joanne Fillingham; Federica Lucia Galli; Marialuisa Gandolfi; Bertrand Glize; Erin Godecke; Neil Hawkins; Katerina Hilari; Jacqueline Hinckley; Simon Horton; David Howard; Petra Jaecks; Elizabeth Jefferies; Luis M.T.  Jesus; Maria Kambanaros; Eun Kyoung Kang; Eman M.  Khedr; Anthony Pak-Hin Kong; Tarja Kukkonen; Marina Laganaro; Matthew A.  Lambon Ralph; Ann Charlotte Laska; Béatrice  Leemann; Alexander P. Leff; Roxele R. Lima; Antje Lorenz; Brian MacWhinney; Rebecca Shisler Marshall; Flavia Mattioli; İlknur Maviş; Marcus Meinzer; Reza Nilipour; Enrique Noé; Nam-Jong Paik; Rebecca Palmer; Ilias Papathanasiou; Brigida F. Patricio; Isabel Pavão Martins; Cathy Price; Tatjana Prizl Jakovac; Elizabeth Rochon; Miranda L. Rose; Charlotte Rosso; Ilona Rubi-Fessen; Marina B. Ruiter; Claerwen  Snell; Benjamin Stahl; Jerzy P. Szaflarski; Shirley A. Thomas; Mieke van de Sandt-Koenderman; Ineke van der Meulen; Evy Visch-Brink; Linda Worrall; Heather Harris Wright; Marian C. Brady; The REhabilitation and recovery of peopLE with Aphasia after StrokE (RELEASE) Collaborators

doi:10.1161/STROKEAHA.120.031162

Predictors of poststroke aphasia recovery: a systematic review-informed individual participant data meta-analysis

Myzoon Ali, Kathryn VandenBerg, Linda J. Williams, Louise R. Williams, Masahiro Abo, Frank Becker, Audrey Bowen, Caitlin Brandenburg, Caterina Breitenstein, Stefanie Bruehl, David A. Copland, Tamara B. Cranfill, Marie di Pietro-Bachmann, Pamela Enderby, Joanne Fillingham, Federica Lucia Galli, Marialuisa Gandolfi, Bertrand Glize, Erin Godecke, Neil HawkinsKaterina Hilari, Jacqueline Hinckley, Simon Horton, David Howard, Petra Jaecks, Elizabeth Jefferies, Luis M.T. Jesus, Maria Kambanaros, Eun Kyoung Kang, Eman M. Khedr, Anthony Pak-Hin Kong, Tarja Kukkonen, Marina Laganaro, Matthew A. Lambon Ralph, Ann Charlotte Laska, Béatrice Leemann, Alexander P. Leff, Roxele R. Lima, Antje Lorenz, Brian MacWhinney, Rebecca Shisler Marshall, Flavia Mattioli, İlknur Maviş, Marcus Meinzer, Reza Nilipour, Enrique Noé, Nam-Jong Paik, Rebecca Palmer, Ilias Papathanasiou, Brigida F. Patricio, Isabel Pavão Martins, Cathy Price, Tatjana Prizl Jakovac, Elizabeth Rochon, Miranda L. Rose, Charlotte Rosso, Ilona Rubi-Fessen, Marina B. Ruiter, Claerwen Snell, Benjamin Stahl, Jerzy P. Szaflarski, Shirley A. Thomas, Mieke van de Sandt-Koenderman, Ineke van der Meulen, Evy Visch-Brink, Linda Worrall, Heather Harris Wright, Marian C. Brady^*, The REhabilitation and recovery of peopLE with Aphasia after StrokE (RELEASE) Collaborators

^*Corresponding author for this work

NMAHP

Research output: Contribution to journal › Article › peer-review

54 Citations (Scopus)

108 Downloads (Pure)

Abstract

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 (<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]; +0.8AAT Spontaneous-Speech Communication subscale points [CI, 0.5–1.0]) and enrollment <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.

Original language	English
Pages (from-to)	1778-1787
Number of pages	10
Journal	Stroke
Volume	52
Issue number	5
Early online date	15 Mar 2021
DOIs	https://doi.org/10.1161/STROKEAHA.120.031162
Publication status	Published - May 2021

Keywords

aphasia
recovery
predictors
language
severity
naming
functional-communication
demography
comprehension
survivor

ASJC Scopus subject areas

Clinical Neurology
Cardiology and Cardiovascular Medicine
Advanced and Specialised Nursing

Documents and Links

10.1161/STROKEAHA.120.031162

Predictors of post-stroke aphasia recovery: a systematic review-informed individual participant data (IPD) meta-analysis
© 2021 The Authors. Stroke is published on behalf of the American Heart Association, Inc., by Wolters Kluwer Health, Inc. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited.
Final published version, 992 KBLicence: CC BY

Cite this

Ali, M., VandenBerg, K., Williams, L. J., Williams, L. R., Abo, M., Becker, F., Bowen, A., Brandenburg, C., Breitenstein, C., Bruehl, S., Copland, D. A., Cranfill, T. B., di Pietro-Bachmann, M., Enderby, P., Fillingham, J., Galli, F. L., Gandolfi, M., Glize, B., Godecke, E., ... The REhabilitation and recovery of peopLE with Aphasia after StrokE (RELEASE) Collaborators (2021). Predictors of poststroke aphasia recovery: a systematic review-informed individual participant data meta-analysis. Stroke, 52(5), 1778-1787. https://doi.org/10.1161/STROKEAHA.120.031162

@article{0412db2daf904d329450f840da4320ee,

title = "Predictors of poststroke aphasia recovery: a systematic review-informed individual participant data meta-analysis",

abstract = "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{\textquoteright} 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 (<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]; +0.8AAT Spontaneous-Speech Communication subscale points [CI, 0.5–1.0]) and enrollment <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.",

keywords = "aphasia, recovery, predictors, language, severity, naming, functional-communication, demography, comprehension, survivor",

author = "Myzoon Ali and Kathryn VandenBerg and Williams, {Linda J.} and Williams, {Louise R.} and Masahiro Abo and Frank Becker and Audrey Bowen and Caitlin Brandenburg and Caterina Breitenstein and Stefanie Bruehl and Copland, {David A.} and Cranfill, {Tamara B.} and {di Pietro-Bachmann}, Marie and Pamela Enderby and Joanne Fillingham and Galli, {Federica Lucia} and Marialuisa Gandolfi and Bertrand Glize and Erin Godecke and Neil Hawkins and Katerina Hilari and Jacqueline Hinckley and Simon Horton and David Howard and Petra Jaecks and Elizabeth Jefferies and Jesus, {Luis M.T.} and Maria Kambanaros and {Kyoung Kang}, Eun and Khedr, {Eman M.} and {Pak-Hin Kong}, Anthony and Tarja Kukkonen and Marina Laganaro and {Lambon Ralph}, {Matthew A.} and Laska, {Ann Charlotte} and B{\'e}atrice Leemann and Leff, {Alexander P.} and Lima, {Roxele R.} and Antje Lorenz and Brian MacWhinney and {Shisler Marshall}, Rebecca and Flavia Mattioli and İlknur Mavi{\c s} and Marcus Meinzer and Reza Nilipour and Enrique No{\'e} and Nam-Jong Paik and Rebecca Palmer and Ilias Papathanasiou and Patricio, {Brigida F.} and {Pav{\~a}o Martins}, Isabel and Cathy Price and {Prizl Jakovac}, Tatjana and Elizabeth Rochon and Rose, {Miranda L.} and Charlotte Rosso and Ilona Rubi-Fessen and Ruiter, {Marina B.} and Claerwen Snell and Benjamin Stahl and Szaflarski, {Jerzy P.} and Thomas, {Shirley A.} and {van de Sandt-Koenderman}, Mieke and {van der Meulen}, Ineke and Evy Visch-Brink and Linda Worrall and {Harris Wright}, Heather and Brady, {Marian C.} and {The REhabilitation and recovery of peopLE with Aphasia after StrokE (RELEASE) Collaborators}",

note = "Acceptance in SAN AAM: no embargo ^Update: published OA. Replaced AAM with VoR, retained SI file as this looks the same as SI on the publisher website. ET 19/3/21 ",

year = "2021",

month = may,

doi = "10.1161/STROKEAHA.120.031162",

language = "English",

volume = "52",

pages = "1778--1787",

journal = "Stroke",

issn = "0039-2499",

publisher = "Wolters Kluwer Health",

number = "5",

}

Ali, M , VandenBerg, K, Williams, LJ, Williams, LR, Abo, M, Becker, F, Bowen, A, Brandenburg, C, Breitenstein, C, Bruehl, S, Copland, DA, Cranfill, TB, di Pietro-Bachmann, M, Enderby, P, Fillingham, J, Galli, FL, Gandolfi, M, Glize, B, Godecke, E, Hawkins, N, Hilari, K, Hinckley, J, Horton, S, Howard, D, Jaecks, P, Jefferies, E, Jesus, LMT, Kambanaros, M, Kyoung Kang, E, Khedr, EM, Pak-Hin Kong, A, Kukkonen, T, Laganaro, M, Lambon Ralph, MA, Laska, AC, Leemann, B, Leff, AP, Lima, RR, Lorenz, A, MacWhinney, B, Shisler Marshall, R, Mattioli, F, Maviş, İ, Meinzer, M, Nilipour, R, Noé, E, Paik, N-J, Palmer, R, Papathanasiou, I, Patricio, BF, Pavão Martins, I, Price, C, Prizl Jakovac, T, Rochon, E, Rose, ML, Rosso, C, Rubi-Fessen, I, Ruiter, MB, Snell, C, Stahl, B, Szaflarski, JP, Thomas, SA, van de Sandt-Koenderman, M, van der Meulen, I, Visch-Brink, E, Worrall, L, Harris Wright, H, Brady, MC & The REhabilitation and recovery of peopLE with Aphasia after StrokE (RELEASE) Collaborators 2021, 'Predictors of poststroke aphasia recovery: a systematic review-informed individual participant data meta-analysis', Stroke, vol. 52, no. 5, pp. 1778-1787. https://doi.org/10.1161/STROKEAHA.120.031162

TY - JOUR

T1 - Predictors of poststroke aphasia recovery: a systematic review-informed individual participant data meta-analysis

AU - Ali, Myzoon

AU - VandenBerg, Kathryn

AU - Williams, Linda J.

AU - Williams, Louise R.

AU - Abo, Masahiro

AU - Becker, Frank

AU - Bowen, Audrey

AU - Brandenburg, Caitlin

AU - Breitenstein, Caterina

AU - Bruehl, Stefanie

AU - Copland, David A.

AU - Cranfill, Tamara B.

AU - di Pietro-Bachmann, Marie

AU - Enderby, Pamela

AU - Fillingham, Joanne

AU - Galli, Federica Lucia

AU - Gandolfi, Marialuisa

AU - Glize, Bertrand

AU - Godecke, Erin

AU - Hawkins, Neil

AU - Hilari, Katerina

AU - Hinckley, Jacqueline

AU - Horton, Simon

AU - Howard, David

AU - Jaecks, Petra

AU - Jefferies, Elizabeth

AU - Jesus, Luis M.T.

AU - Kambanaros, Maria

AU - Kyoung Kang, Eun

AU - Khedr, Eman M.

AU - Pak-Hin Kong, Anthony

AU - Kukkonen, Tarja

AU - Laganaro, Marina

AU - Lambon Ralph, Matthew A.

AU - Laska, Ann Charlotte

AU - Leemann, Béatrice

AU - Leff, Alexander P.

AU - Lima, Roxele R.

AU - Lorenz, Antje

AU - MacWhinney, Brian

AU - Shisler Marshall, Rebecca

AU - Mattioli, Flavia

AU - Maviş, İlknur

AU - Meinzer, Marcus

AU - Nilipour, Reza

AU - Noé, Enrique

AU - Paik, Nam-Jong

AU - Palmer, Rebecca

AU - Papathanasiou, Ilias

AU - Patricio, Brigida F.

AU - Pavão Martins, Isabel

AU - Price, Cathy

AU - Prizl Jakovac, Tatjana

AU - Rochon, Elizabeth

AU - Rose, Miranda L.

AU - Rosso, Charlotte

AU - Rubi-Fessen, Ilona

AU - Ruiter, Marina B.

AU - Snell, Claerwen

AU - Stahl, Benjamin

AU - Szaflarski, Jerzy P.

AU - Thomas, Shirley A.

AU - van de Sandt-Koenderman, Mieke

AU - van der Meulen, Ineke

AU - Visch-Brink, Evy

AU - Worrall, Linda

AU - Harris Wright, Heather

AU - Brady, Marian C.

AU - The REhabilitation and recovery of peopLE with Aphasia after StrokE (RELEASE) Collaborators

N1 - Acceptance in SAN AAM: no embargo ^Update: published OA. Replaced AAM with VoR, retained SI file as this looks the same as SI on the publisher website. ET 19/3/21

PY - 2021/5

Y1 - 2021/5

N2 - 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 (<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]; +0.8AAT Spontaneous-Speech Communication subscale points [CI, 0.5–1.0]) and enrollment <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.

AB - 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 (<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]; +0.8AAT Spontaneous-Speech Communication subscale points [CI, 0.5–1.0]) and enrollment <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.

KW - aphasia

KW - recovery

KW - predictors

KW - language

KW - severity

KW - naming

KW - functional-communication

KW - demography

KW - comprehension

KW - survivor

U2 - 10.1161/STROKEAHA.120.031162

DO - 10.1161/STROKEAHA.120.031162

M3 - Article

C2 - 33719515

SN - 0039-2499

VL - 52

SP - 1778

EP - 1787

JO - Stroke

JF - Stroke

IS - 5

ER -

Predictors of poststroke aphasia recovery: a systematic review-informed individual participant data meta-analysis

Abstract

Keywords

ASJC Scopus subject areas

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Precision rehabilitation for aphasia by patient age, sex, aphasia severity, and time since stroke? A prespecified, systematic review based, individual participant data network subgroup meta-analysis

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