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    Cerebral perfusion and diffusion in stroke: Association with aphasia severity in the early phases of recovery

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    Author
    Fridriksson, Julius
    Issue Date
    2002
    Keywords
    Health Sciences, Speech Pathology.
    Advisor
    Holland, Audrey L.
    
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    Publisher
    The University of Arizona.
    Rights
    Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
    Abstract
    The purpose of this study was to investigate the relationship between aphasia severity and cerebral perfusion and lesion size in stroke. Nine subjects with acute ischemic stroke were examined within 24 hours of symptom onset and six were reexamined at one-month post-stroke. Examination included aphasia testing, testing of face discrimination ability, administration of the National Institutes of Health Stroke Scale, and perfusion MRI (PI), diffusion MRI (DWI), and T2-weighted MRI (T2-MRI). Subjects with a variety of aphasia types and a large range of aphasia severity participated in the study. MR images were visually inspected to verify perfusion and diffusion abnormalities. Perfusion abnormality was quantified by calculating a perfusion signal ratio of the affected hemisphere over the whole image (left/whole = ratio). Lesion volume was calculated from the DWI and T2-MRI. A perfusion abnormality larger than a DWI lesion was observed in 8 of 9 subjects. Minimal lesions were observed on DWI in three of the subjects while their PI revealed significant perfusion abnormality. Correlation coefficients (Spearman) between aphasia severity and hypoperfusion were significant in the acute stage and again at one-month post-stroke. Five of six subjects that were reexamined at one-month post-stroke experienced significant aphasia recovery. Visual inspection of their PI scans suggests that aphasia recovery was accompanied by increase in cerebral perfusion. The correlation between aphasia severity and lesion size was not statistically significant in the acute stage or at one-month post-stroke. Consequently, it is probable that cerebral hypoperfusion is a better predictor of aphasia severity and recovery in early stroke than lesion volume.
    Type
    text
    Dissertation-Reproduction (electronic)
    Degree Name
    Ph.D.
    Degree Level
    doctoral
    Degree Program
    Graduate College
    Speech and Hearing Sciences
    Degree Grantor
    University of Arizona
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