New metric predicts language recovery following stroke

NEW YORK (June 24, 2010) — A team of researchers led by NewYork-Presbyterian Hospital/Columbia University Medical Center has developed a method to predict post-stroke recovery of language by measuring the initial severity of impairment. Being able to predict recovery has important implications for stroke survivors and their families, as they plan for short and long-term treatment needs. Findings are reported online in the journal Stroke.

“These results indicate that if we know the extent of the initial impairment following stroke, then we can predict with remarkable accuracy how patients will function 90 days later,” said Ronald M. Lazar, Ph.D., professor of clinical neuropsychology in neurology and neurological surgery, Columbia University College of Physicians & Surgeons, and a neuropsychologist at NewYork-Presbyterian Hospital/Columbia University Medical Center. “We have established the first reliable metric of the current standard care for post-stroke language treatment, and a standard against which future treatments can be compared.”

For many years, it was thought that the size of the stroke, patient age and education, and specific characteristics of the type of language deficit were together predictive of recovery — but no reliable metric had been established.

Funded by the National Institutes of Health, the NewYork-Presbyterian Hospital/Columbia-led team used the Western Aphasia Battery (WAB) test to assess language function at 24 — 72 hours after stroke onset and then again at 90 days. They found that among patients with mild to moderate aphasia after acute stroke, recovery (defined as the change in WAB score between baseline and 90 days) improved to about 70 percent of their maximum potential recovery, as long as they received some aphasia therapy.

According to the National Institute of Neurological Disorders and Stroke, up to 25 percent of all stroke survivors experience language impairments involving the ability to speak, write, and understand spoken and written language. A stroke-induced injury to any of the brain’s language-control centers can severely impair verbal communication. There are more than one million Americans with aphasia, which is a disorder of language that occurs after brain injury; stroke is the most common injury causing aphasia.

This study involved patients in the Performance and Recovery in Stroke (PARIS) database, which is based at the Neurological Institute of Columbia University Medical Center and NewYork-Presbyterian/Columbia.

Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia’s College of Physicians and Surgeons was the first institution in the country to grant the M.D. degree and is now among the most selective medical schools in the country. Columbia University Medical Center is home to the most comprehensive medical research enterprise in New York City and State and one of the largest in the United States. Columbia University Medical Center is affiliated with NewYork-Presbyterian Hospital, the nation’s largest not-for-profit, non-sectarian hospital provider. For more information, please visit www.cumc.columbia.edu.

NewYork-Presbyterian Hospital, based in New York City, is the nation’s largest not-for-profit, non-sectarian hospital, with 2,353 beds. The Hospital has more than 1 million inpatient and outpatient visits in a year, including more than 220,000 visits to its emergency departments — more than any other area hospital. NewYork-Presbyterian provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, NewYork-Presbyterian/Morgan Stanley Children’s Hospital, NewYork-Presbyterian/The Allen Hospital and NewYork-Presbyterian Hospital/Westchester Division. One of the most comprehensive health care institutions in the world, the Hospital is committed to excellence in patient care, research, education and community service. NewYork-Presbyterian is the #1 hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S.News & World Report. The Hospital has academic affiliations with two of the nation’s leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons. For more information, visit www.nyp.org.


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