Cerebral Small Vessel Disease Burden: a Biomarker for Post-Stroke Aphasia Recovery

EasyChair Preprint 6540

Abstract

This study systematically assessed the clinical significance of the global burden of cerebral small vessels disease (cSVD) through a neuroimaging evaluation of white matter hyperintensities (WMH), enlarged perivascular spaces (EPVS), lacunes and global cortical atrophy (GCA) in people with aphasia (PWA) that underwent language therapy. Thirty chronic PWA due to single left hemisphere stroke completed up to 12 weeks of semantic feature analysis treatment for word retrieval deficits. Baseline T1- and T2–FLAIR-weighted MRI scans were rated for four major cSVD biomarkers, including WMH, EPVS, lacunes and GCA, using validated visual rating scales. Total cSVD burden was rated on an ordinal 0-4 scale, by counting the presence and severity of each of the four biomarkers. To determine the role of cSVD burden on treatment-induced aphasia recovery, we used mixed effects logistic regression with binary naming accuracy as the predicted variable. Our main predictor was the interaction between total cSVD score and session, WAB-R AQ, stroke lesion volume, months post onset and age were included in the model as covariates, and participant and item were included as random factors. Our participants presented with various degrees of brain changes associated with cSVD. The regression model showed a significant interaction among total cSVD burden and session. Follow up analyses showed that the predicted probability of accurate naming increased over time more for participants with less severe cSVD. This interaction was significant after controlling for aphasia severity, an also significant predictor, and stroke related factors, including total lesion volume and months post onset. This work indicates that the severity of cSVD may be used as a prognostic biomarker for treatment-induced aphasia recovery.

Keyphrases: Cerebral small vessel disease, aphasia, aphasia recovery, brain resilience

@booklet{EasyChair:6540,
  author    = {Maria Varkanitsa and Claudia Peñaloza and Andreas Charidimou and David Caplan and Swathi Kiran},
  title     = {Cerebral Small Vessel Disease Burden: a Biomarker for Post-Stroke Aphasia Recovery},
  howpublished = {EasyChair Preprint 6540},
  year      = {EasyChair, 2021}}