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White Matter Hyperintensities Predict Response to Language Treatment in Poststroke Aphasia

Background White matter hyperintensities (WMH) are a radiological marker of brain health that has been associated with language status in poststroke aphasia; however, its association with language treatment outcomes remains unknown. Objective To determine whether WMH in the right hemisphere (RH) predict response to language therapy independently from demographics and stroke lesion–related factors in poststroke aphasia. Methods We used the Fazekas scale to rate WMH in the RH in 30 patients with poststroke aphasia who received language treatment. We developed ordinal regression models to examine language treatment effects as a function of WMH severity after controlling for aphasia severity, stroke lesion volume, time post onset, age, and education level. We also evaluated associations between WMH severity and both pre-treatment naming ability and executive function. Results The severity of WMH in the RH predicted treatment response independently from demographic and stroke-related factors such that patients with less severe WMH exhibited better treatment outcome. WMH scores were not significantly correlated with pretreatment language scores, but they were significantly correlated with pretreatment scores of executive function. Conclusion We suggest that the severity of WMH in the RH is a clinically relevant predictor of treatment response in this population.