Faculty from the Communication Sciences and Disorders Department, East Carolina University, have published a review of selected peer-reviewed materials since 1980 to update understandings of patterns and circumstances of long-term recovery from aphasia pursuant to stroke. Prior to 1980, most speech-language pathologists held that significant improvements in post-stroke aphasia were associated primarily with the period of spontaneous recovery (6-12 mo.), after which significant improvements were not generally expected, nor often reported. Over the past several decades, those views have been changing owing to a variety of factors, and the current article attempts to summarize best current understandings.

The authors analyze a sample of 33 studies drawn from scientific journals (e.g., Aphasiology, Cortex) and elsewhere (e.g., Aphasia Access’s White Paper). The sample covers the spectrum of study types in aphasia – e.g., some discuss changes following individual courses of therapy, while others document changes in subjects not actively enrolled in intervention studies. Their subjects are drawn from most aphasia diagnostic categories – e.g., Broca’s, Wernicke’s, global, anomic, conduction, transcortical motor, etc. – and the methodologies include both group- and case-studies. The authors summarize what sorts of changes are noted, in which subject groups, in which modalities, and under what circumstances; and they then seek to generalize across the article selection.

Their findings reveal, over the past thirty-one years, widespread reports of significant changes in persons with post-stroke aphasia presented well beyond the period of spontaneous recovery. For example, a study that was published in 1990 by M Naeser, A. Gaddie and colleagues describes 14 persons with global aphasia whose improvement in single-word auditory comprehension was associated with a relative sparing of the cortical regions of Wernicke’s area. A later report, published in 1997 by Aftonomos, Steele, and Wertz reports significant improvements in 23 subjects across a range of communicative modalities and severity levels, following participation in a computer-based therapy program. And a case series study in 2020 by Jungblut and colleagues found sequential significant improvements in three subjects in the chronic stage of aphasia who came in for annual evaluations for several years.

The authors conclude that persons with aphasia can show continuing improvements in both receptive and expressive language, though the underlying causes are not well understood. The latter will require targeted research.

For further reading:  F. Jebahi, C. Ellis.  2021. Long-term recovery of post-stroke aphasia.  Current Trends in Neurology, pp. 1-12.  Available from corresponding author, Prof. Charles Ellis, Jr., Department of Communication Sciences and Disorders, East Carolina University, ellisc14@ecu.edu

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