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. 2024 Jan;45(1):e26568.
doi: 10.1002/hbm.26568.

The volume and the distribution of premorbid white matter hyperintensities: Impact on post-stroke aphasia

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The volume and the distribution of premorbid white matter hyperintensities: Impact on post-stroke aphasia

Veronika Vadinova et al. Hum Brain Mapp. 2024 Jan.

Abstract

White matter hyperintensities (WMH) are a radiological manifestation of progressive white matter integrity loss. The total volume and distribution of WMH within the corpus callosum have been associated with pathological cognitive ageing processes but have not been considered in relation to post-stroke aphasia outcomes. We investigated the contribution of both the total volume of WMH, and the extent of WMH lesion load in the corpus callosum to the recovery of language after first-ever stroke. Behavioural and neuroimaging data from individuals (N = 37) with a left-hemisphere stroke were included at the early subacute stage of recovery. Spoken language comprehension and production abilities were assessed using word and sentence-level tasks. Neuroimaging data was used to derive stroke lesion variables (volume and lesion load to language critical regions) and WMH variables (WMH volume and lesion load to three callosal segments). WMH volume did not predict variance in language measures, when considered together with stroke lesion and demographic variables. However, WMH lesion load in the forceps minor segment of the corpus callosum explained variance in early subacute comprehension abilities (t = -2.59, p = .01) together with corrected stroke lesion volume and socio-demographic variables. Premorbid WMH lesions in the forceps minor were negatively associated with early subacute language comprehension after aphasic stroke. This negative impact of callosal WMH on language is consistent with converging evidence from pathological ageing suggesting that callosal WMH disrupt the neural networks supporting a range of cognitive functions.

Keywords: aphasia; corpus callosum; language comprehension; stroke; white matter hyperintensities.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Stroke lesion overlay at the early subacute stage (N = 37). Warmer colours indicate greater areas of lesion overlap. Z plane coordinates (mm) are reported in MNI space.
FIGURE 2
FIGURE 2
WMH lesion overlay at the early subacute stage (N = 37). Warmer colours indicate greater areas of lesion overlap. Z plane coordinates (mm) are reported in MNI space.
FIGURE 3
FIGURE 3
Transformed stroke lesion load across cortical ROIs and transformed WMH lesion load across callosal ROIs. AG + SMG, angular gyrus + supramarginal gyrus; CC‐Body, corpus callosum body; CC‐Fmaj, corpus callosum forceps major; CC‐Fmin, corpus callosum forceps minor; sqrt, square root; STG, superior temporal gyrus; WMH, white matter hyperintensities.

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