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Lesion Correlates of Language, Communication, and Depression in Chronic Poststroke Aphasia: A Multi- Domain Lesion Symptom Mapping Study
Poster Session C, Thursday, October 1, 10:45 am - 12:45 pm, Wangari Maathai
Anna-Thekla Jäger1, Effrosyni Ntemou2, Valmira Xharavina1, Milena Osterloh1, Anna Sadlon1, Johanna Knechtges1, Marcelo Berthier3, Bettina Mohr4, Friedemann Pulvermüller1; 1Freie Universität Berlin, 2Heinrich Heine University Düsseldorf, 3University of Malaga, 4Center for Neuropsychology and Intensive Language Therapy
Chronic aphasia affects language, communication, as well as emotional well-being. Traditionally, aphasia is defined by impaired language comprehension and production however this language-centred focus obscures the fact that communication, the goal-directed, pragmatic use of language in social interactions - can diverge from structured language abilities and may rely on different neural systems. Similarly, mood changes, such as post-stroke depression are understudied in aphasia research due to the frequent exclusion of individuals with language impairment. These considerations motivate a multimodal lesion-based approach to identify both domain-specific and cross-domain lesion sites with direct relevance for integrated, multidomain functional rehabilitation. In this cross-sectional study, we analysed data from 49 individuals with chronic post-stroke aphasia (22 female; mean age = 60.7 years, SD = 10.4), each with a single left-hemispheric infarct. Assessments included the Aachen Aphasia Test (AAT) for language, the Action Communication Test (ACT) for communication, and the Beck Depression Inventory (BDI) and Montgomery–Åsberg Depression Rating Scale (MADRS) for depression, which differ in their linguistic demands. Voxel-based support vector regression lesion–symptom mapping (SVR–LSM) was used to identify lesion–behaviour associations (5,000 permutations, FWE- corrected p < 0.05). We examined atlas-based shared and distinct lesion correlates of (i) language and communication, (ii) across depression measures, and (iii) regions jointly implicated across language, communication, and depression. Language and communication impairments showed overlapping lesion correlates in the left perisylvian cortex, including the inferior frontal gyrus, angular gyrus, and superior temporal cortex. Dissociable patterns were also evident: temporal regions were more strongly associated with language deficits, whereas postcentral, supramarginal, and insular cortices were more strongly associated with impaired functional communication. Depressive symptoms, assessed across both measures, were linked to lesions in the left inferior frontal, dorsolateral prefrontal, and sensorimotor cortices. A multi-domain overlap analysis identified the postcentral gyrus and inferior frontal gyrus as jointly implicated across language, communication, and depression. These findings provide supporting evidence that language and functional communication rely on partially dissociable neural systems. They further demonstrate that depressive symptoms can be meaningfully assessed and mapped in individuals with aphasia. By identifying lesion sites shared across domains, this study highlights neural hubs of multidomain vulnerability and provides anatomical targets for integrated, multidomain rehabilitation.
Topic Areas: Disorders: Acquired, Speech-Language Treatment