Assessing the integrity of executive functioning in chronic aphasia

ABSTRACT

Background

Executive functioning (EF) deficits can commonly co-occur with language impairments in aphasia. Despite recognizing the role of EF in language and aphasia treatment outcomes, the integrity of EF in aphasia remains to be comprehensively studied.

Aims

The present study aimed to comprehensively examine the integrity of EF skills in individuals with different types and severities of aphasia. Accordingly, we sought to compare the performances of persons with aphasia (PWA) and healthy controls on a broad range of verbal and nonverbal EF skills using an extensive battery of assessments. To fully understand the nature of deficits in the aphasia population, we aimed to evaluate EF performances both quantitatively and qualitatively in addition to examining group- and individual-level differences.

Method

Persons with aphasia (PWA) and age- and education-matched healthy controls (HC) completed a battery of verbal and nonverbal EF assessments. Between-group comparisons were carried out using quantitative and qualitative EF task scores. Additionally, we conducted individual-level analyses to examine performances within the aphasia group. The influence of aphasia severity and type on EF task performances were also evaluated.

Results

PWA differed significantly from HC on most EF measures. Individual-level analyses revealed marked variability in performances within the aphasia group indicating that most but not all PWA demonstrated EF deficits. PWA performed significantly more poorly than HC on both verbal and nonverbal measures with greater difficulty on verbal EF tasks. No consistent relationship was found between aphasia variables and EF task performances.

Conclusion

Our findings indicate that many PWA demonstrate domain-general EF deficits that are not necessarily related to the degree of their language impairments. The present study emphasizes the importance of evaluating EF more routinely in clinical practice to improve rehabilitation success for PWA.

Acknowledgements

We would like to thank all our study participants for taking part in the study. We thank all the undergraduate and graduate students in the NEURAL Research Lab (IU) for their assistance with data scoring. We extend our sincere gratitude to Dr. Mary Gospel for her assistance with data collection, and to Dr. Karen Forrest and Dr. Arpita Bose for their valuable insights on the project.

Disclosure Statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported by the Indiana University Graduate School Grant-in-aid Doctoral Research Award and the Department of Speech, Language, and Hearing Sciences Research Support Grant (awarded to Manaswita Dutta).