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Mary’s book and big shoes: Production of noun-modifier phrases in individuals with acute post-stroke aphasia
Poster D36 in Poster Session D, Wednesday, October 25, 4:45 - 6:30 pm CEST, Espace Vieux-Port
Melissa Stockbridge1, William Matchin2, Massoud Sharif1, Julius Fridriksson2, Andreia V Faria1, Argye E Hillis1; 1Johns Hopkins University School of Medicine, 2University of South Carolina Arnold School of Public Health
Introduction: Acute post-stroke aphasia typically is assessed by examining patients’ understanding and use of simple sentences and nouns. However, modifiers and bound morphemes can be the subject of considerable difficulty for individuals with aphasia. The recently developed Morphosyntactic Generation (MorGen) test has been used in individuals with post-stroke (Matchin et al., 2021; Stockbridge, Walker, et al., 2021) and progressive (Stockbridge, Matchin, et al., 2021) aphasia to target noun, modifier, and bound inflectional morpheme production in two-word phrases. Here, we report on the first examination of the MorGen in hyperacute-acute aphasia. We aim to (1) examine the MorGen’s concurrent validity with other common tests of aphasia; (2) describe MorGen performance in people with acute aphasia; and (3) associate MorGen performance with the extent of lesioned vascular territories in acute stroke. Methods: Sixty-two adult English speakers within the first 14 days of left hemisphere ischemic stroke and 61 healthy control participants completed the MorGen. The MorGen produces constituent accuracy scores for patients’ use of nouns, proper names, color, number, size, and bound morphemes marking the plural and genitive in two-word phrases. Patients also were tested using the Western Aphasia Battery (WAB), Boston Naming Test (BNT), and Hopkins Action Naming Assessment. Clinical MRIs were analyzed for the extent of lesion in the vascular territory of left anterior, middle, and posterior cerebral, posterior choroidal and thalamoperforator arteries. We used repeated measures multivariable analysis of variance to compare groups and multivariable logistic regression to identify associations between lesions and accuracy. Results: Performance on the MorGen demonstrated consistently high, significant positive correlations with that on the WAB, BNT, and Hopkins Action Naming Assessment (p<0.001). Individuals with a recent stroke performed more poorly than healthy individuals across all capacities targeted by the MorGen when controlling for differences in education, F(3.6)=2.73, p=0.04, ηP2=0.03. Exploratory follow-up analyses suggested that patients with fluent aphasia performed significantly better than those with non-fluent aphasia in their use of nouns, modifiers, and plural marking, but not proper names or genitive marking. Patients who scored within functional limits on the WAB were distinguishable from controls, particularly in variability of performance on modifiers. Lesions in the territory of the temporal branch of the posterior cerebral artery (PCA) were associated with poorer accuracy for nouns, size, and color. Lesions in anterior cerebral artery (ACA) territory were associated with poorer accuracy for numbers (R2=0.36, F(4)=3.42, p < 0.008). When divisions of the middle cerebral artery (MCA) were considered together as a single predictor with ACA, PCA, and posterior choroidal artery, the model significantly predicted plural performance (R2=0.40, F(4)=7.40, p < 0.001). Both the MCA and ACA were significant independent predictors of plural performance. The same predictors resulted in a model that predicted possessive marking (R2=0.27, F(4)=4.25, p=0.005), but no single region was a significant independent predictor. Conclusions: This work highlights the value of the MorGen as a tool for post-stroke language evaluation that complements the skills captured in more widely-used assessments such as the WAB and BNT.
Topic Areas: Disorders: Acquired, Morphology