Changes in white matter microstructure related to non-linguistic cognitive impairment in post-stroke aphasia

ABSTRACT

Objects

Post-stroke aphasia (PSA) often have non-linguistic cognitive impairment. We aimed to ascertain its characteristics of non-linguistic cognitive impairment and the corresponding changes in white matter microstructures.

Methods

Ten patients with PSA and 17 healthy controls (HCs) were enrolled. Loewenstein occupational therapy cognitive assessment (LOTCA) were used to assess non-linguistic cognitive function. Summary T-test was performed to compare the LOTCA scores between PSA and the Chinese norm. Tract-based spatial statistics (TBSS) was used to calculate fractional anisotropy (FA), mean diffusivity (MD), and radial diffusivity (RD) after collecting diffusion tensor imaging data. Correlation analysis was performed between these metrics and LOTCA scores.

Results

The days after stroke onset of PSA was 428.0±52.0. The total LOTCA score of PSA (78.20±22.63) was lower than the Chinese norm (97.65±16.24, P=0.003), as well as the scores of orientation, spatial perception (SP), motor praxis (MP), and attention (P<0.05). Lower FA and higher MD/RD in bilateral inferior fronto-occipital fasciculus (IFOF), inferior longitudinal fasciculus (ILF), and left superior longitudinal fasciculus (SLF) were found in PSA compared with HCs. The MD and RD of the right uncinate fasciculus (UF) was negatively correlated with SP and MP scores (r=-0.787, r=-0.733, r=-0.726; P<0.05). The FA of left UF was negatively correlated with orientation score (r=-0.690, P=0.04).

Conclusion

Patients with PSA have non-linguistic cognitive impairment. The integrity of the white matter microstructures can be extensively damaged. Impaired SP and MP in patients with PSA are related to UF damage.

KEYWORDS:

• PSA
• non-linguistic cognition
• DTI
• TBSS
• white matter microstructure

Acknowledgments

We acknowledge all the participants, colleagues, nurses, and imaging technicians.

Author contributions

Conception and design of the present study: Jingfan Yao and Yumei Zhang. Acquisition of LOTCA/WAB data: Jingfan Yao and Xiao Lu. Analysis of data: Jingfan Yao and Xinxin Liu. Collection and interpretation of imaging data: Hongyan Chen and Cheng Xu. Preparation of manuscript: Jingfan Yao. Supervision: Yumei Zhang.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was granted by National Natural Science Foundation of China [81972144]; Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support [ZYLX201836]; and National Key R&D Program of China [2018YFC2002300, 2018YFC2002302].

Notes on contributors

Jingfan Yao

Jingfan Yao, Resident doctor specialized in aphasia and cerebrovascular disease. M.D. in Neurology at Beijing Tiantan Hospital, Capital Medical University.

Xinxin Liu

Xinxin Liu, Resident doctor specialized in aphasia and cerebrovascular disease. M.M. in Neurology at Beijing Tiantan Hospital, Capital Medical University.

Xiao Lu

Xiao Lu, Speech therapist at Department of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University.

Cheng Xu

Cheng Xu, Imaging technician at Department of Radiology, Beijing Tiantan Hospital, Capital Medical University.

Hongyan Chen

Hongyan Chen, Radiologist specialized in neurological disease. M.D. in Neuroimaging at Department of Radiology, Beijing Tiantan Hospital, Capital Medical University.

Yumei Zhang

Yumei Zhang, Neurologist specialized in aphasia, cognitive impairment and cerebrovascular disease. M.D. in Neurology at Beijing Tiantan Hospital, Capital Medical University.