Success rates of intensive aphasia therapy: real-world data from 448 patients between 2003 and 2020

Journal of Neurology, vol. 271, pp. 7169–7183

Abstract

BACKGROUND: Aphasia is a devastating consequence after stroke, affecting millions of patients each year. Studies have shown that intensive speech and language therapy (SLT) is effective in the chronic phase of aphasia. Leveraging a large single-center cohort of persons with aphasia (PWA) including patients also in the subacute phase, we assessed treatment effects of intensive aphasia therapy in a real-world setting. METHODS: Data were collected at the Aachen aphasia ward in Germany between 2003 and 2020. Immediate treatment responses across different language domains were assessed with the Aachen Aphasia Test (AAT) using single-case psychometrics, conducted before and after 6-7 weeks of intensive SLT (10 h per week, median (IQR) dosage = 68 (61-76)). We adjusted for spontaneous recovery in subacute patients. Differential treatment effects between subgroups of chronicity and predictors of therapy response were investigated. RESULTS: A total of 448 PWA were included (29% female, median (IQR) age = 54 (46-62) years, median (IQR) time post-onset = 11 (6-20) months) with 12% in the early subacute, 15% in the late subacute and 74% in the chronic phase of aphasia. The immediate responder rate was 59%. Significant improvements in all AAT subtests und subscales were observed hinting at broad effectiveness across language domains. The degree of therapy-induced improvement did not differ between the chronicity groups. Time post-onset, dosage of therapy and aphasia severity at the beginning of treatment were predictors of immediate treatment response. DISCUSSION: Intensive therapy protocols for aphasia after stroke are yielding substantial responder rates in a routine clinical setting including a wide range of patients.

Authors 11

1. Dorothea Peitz Aachen Department of Neurology, Medical Faculty

   RWTH Aachen University

   Affiliation as printed

   Department of Neurology, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany

2. Beate Schumann‐Werner Aachen Department of Neurology, Medical Faculty

   RWTH Aachen University · Otto-von-Guericke-Universität Magdeburg

   Affiliation as printed

   Department of Neurology, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany

   Institute of Cognitive Neurology and Dementia Research, Otto-Von-Guericke-University, Magdeburg, Germany

3. Katja Hußmann Aachen Department of Neurology, Medical Faculty

   RWTH Aachen University

   Affiliation as printed

   Department of Neurology, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany

4. João Pinho Aachen Department of Neurology, Medical Faculty

   RWTH Aachen University

   Affiliation as printed

   Department of Neurology, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany

5. Ferdinand Binkofski Aachen Department of Neurology, Medical Faculty Section Clinical Cognitive Sciences

   RWTH Aachen University

   Affiliation as printed

   Section Clinical Cognitive Sciences, Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen, Germany

6. Walter Huber Aachen Department of Neurology, Medical Faculty

   RWTH Aachen University

   Affiliation as printed

   Department of Neurology, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany

7. Klaus Willmes Aachen Department of Neurology, Medical Faculty

   RWTH Aachen University

   Affiliation as printed

   Department of Neurology, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany

8. Stefan Heim Aachen Department of Psychiatry, Psychotherapy and Psychosomatics Medical Faculty Department of Neurology, Medical Faculty

   RWTH Aachen University · Forschungszentrum Jülich

   Affiliation as printed

   Department of Neurology, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany

   Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany

   Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany

9. Jörg Bernhard Schulz Aachen JARA Brain Institute Molecular Neuroscience and Neuroimaging (INM-11) Department of Neurology, Medical Faculty

   RWTH Aachen University · Forschungszentrum Jülich · Jülich Aachen Research Alliance

   Affiliation as printed

   Department of Neurology, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany

   JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, RWTH Aachen University, Aachen, Germany

   JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Research Centre Jülich GmbH, Jülich, Germany

10. Bruno Fimm Aachen Department of Neurology, Medical Faculty

    RWTH Aachen University

    Affiliation as printed

    Department of Neurology, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany

11. Cornelius Johannes Werner corresponding Aachen Department of Neurology, Medical Faculty Department of Neurology and Geriatrics

    RWTH Aachen University

    Affiliation as printed

    Department of Neurology and Geriatrics, Johanniter Hospital Stendal, Hansestadt Stendal, Germany. cornelius.werner@rwth-aachen.de

    Department of Neurology, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany. cornelius.werner@rwth-aachen.de