Introduction
Materials and methods
Subjects
Neuropsychological assessment
Generation of lesion maps
Statistics
Results
Characteristics | Study cohort (n = 93) |
---|---|
Demographic characteristics | |
Age, mean (SD) | 59.5 (14.9) |
Male, n (%) | 53 (57) |
Education, median (range)a
| 5 (2–7) |
Hand preference, n (%)b
| |
Right | 82 (89) |
Left | 9 (10) |
Ambidexter | 1 (1) |
Neuropsychological examination | |
Time interval between stroke and NPE in days, mean (SD; range) | 7.5 (5.1; 1–30) |
No. words letter A (1 min) | 8.0 (4.3; 0–22) |
No. words letter N (1 min) | 7.7 (4.4; 0–20) |
No. animals (2 min) | 23.1 (10.4; 0–51) |
Lesion location, n (%) | Impaired semantic fluency | Impaired phonemic fluency | ||
---|---|---|---|---|
Yes (n = 18) | No (n = 75) | Yes (n = 29) | No (n = 64) | |
Left hemisphere (n = 34) | 11 (61 %) | 23 (31 %) | 16 (55 %) | 18 (28 %) |
Right hemisphere (n = 40) | 5 (28 %) | 35 (47 %) | 8 (28 %) | 32 (50 %) |
Infratentorial (n = 12) | 1 (6 %) | 11 (15 %) | 2 (7 %) | 10 (16 %) |
Multiple locations (n = 7) | 1 (6 %) | 6 (8 %) | 3 (10 %) | 4 (6 %) |
Phonemic fluency (N + A) | Semantic fluency (animal) | |
---|---|---|
Semantic fluency | 0.642 (p < 0.001) | – |
RAVLT total recall trial 1–5a
| 0.558 (p < 0.001) | 0.583 (p < 0.001) |
RAVLT recollectiona
| 0.493 (p < 0.001) | 0.517 (p < 0.001) |
RAVLT recognitiona
| 0.425 (p < 0.001) | 0.566 (p < 0.001) |
Delayed ROCFb
| 0.084 (p = 0.444) | 0.233 (p = 0.032) |
Boston Naming Testc
| 0.405 (p < 0.001) | 0.571 (p < 0.001) |
Token Testd
| 0.557 (p < 0.001) | 0.582 (p < 0.001) |
Voxel-based lesion-symptom mapping
Anatomical regions (AAL atlas) | Patients with lesion (n)* | Region size, voxels (n) | Tested voxels (n) | Significant voxels semantic [n (%)] | Significant voxels phonemic [n (%)] |
---|---|---|---|---|---|
Middle frontal gyrus L | 7 | 38,722 | 111 | 7 (6.3) | 111 (100) |
Inferior frontal gyrus operc L | 8 | 8271 | 2926 | 1776 (60.7) | 1832 (62.6) |
Inferior frontal gyrus triang L | 8 | 20,104 | 593 | 559 (94.3) | 581 (98.0) |
Rolandic operculum L | 11 | 7939 | 2670 | 682 (25.5) | 717 (26.9) |
Insula L | 17 | 15,025 | 5314 | 3158 (59.4) | 3485 (65.6 |
Precentral gyrus L | 13 | 28,174 | 766 | 340 (44.4) | 436 (56.9) |
Putamen L | 17 | 7942 | 1695 | 383 (22.6) | 297 (17.5) |
Hippocampus L | 8 | 7469 | 874 | 774 (88.6) | 0 |
Parahippocampal gyrus L | 4 | 7891 | 843 | 839 (99.5) | 0 |
Fusiform gyrus L | 8 | 18,333 | 3874 | 2615 (67.5) | 0 |
Inferior temporal gyrus L | 7 | 25,647 | 550 | 329 (59.8) | 0 |
Lingual gyrus L | 12 | 16,932 | 4543 | 156 (3.4) | 0 |
Inferior frontal gyrus operc R | 27 | 11,174 | 9340 | 107 (1.1) | 0 |
Inferior frontal gyrus triang R | 20 | 17,132 | 11,470 | 158 (1.4) | 0 |
Region-of-interest-based analyses
Model | Independent variables | Semantic fluency | Phonemic fluency | ||||
---|---|---|---|---|---|---|---|
R
2
|
p∆R
2
|
B (95 % CI) |
R
2
|
p∆R
2
|
B (95 % CI) | ||
1 | Age, sex, level of education | 0.057 | 0.155 | 0.095 | 0.031 | ||
Left frontal regions | |||||||
2a | Model 1 + IV L middle frontal gyrus | 0.064 | 0.424 | −0.05 (−0.19 to 0.08) | 0.155 | 0.014 | −0.15 (−0.27 to −0.03) |
2b | Model 1 + IV L inferior frontal gyrus opercular part | 0.163 | 0.001 | −0.35 (−0.56 to −0.14) | 0.200 | 0.001 | −0.33 (−0.52 to −0.14) |
2c | Model 1 + IV L inferior frontal gyrus triangular part | 0.142 | 0.004 | −0.37 (−0.62 to −0.12) | 0.181 | 0.003 | −0.35 (−0.58 to −0.12) |
2d | Model 1 + IV L rolandic operculum | 0.066 | 0.360 | −0.14 (−0.44 to 0.16) | 0.192 | 0.002 | −0.44 (−0.70 to −0.17) |
2e | Model 1 + IV L insula | 0.106 | 0.031 | −0.16 (−0.31 to −0.02) | 0.230 | <0.001 | −0.26 (−0.39 to −0.13) |
2f | Model 1 + IV L precentral gyrus | 0.065 | 0.388 | −0.08 (−0.26 to 0.10) | 0.110 | 0.215 | −0.10 (−0.27 to 0.06) |
2g | Model 1 + IV L putamen | 0.103 | 0.035 | −0.41 (−0.80 to −0.03) | 0.120 | 0.115 | −0.29 (−0.65 to 0.07) |
Right frontal regions | |||||||
2h | Model 1 + IV R inferior frontal gyrus opercular part | 0.130 | 0.008 | −0.13 (−0.22 to −0.04) | 0.096 | 0.709 | −0.02 (−0.11 to 0.07) |
2i | Model 1 + IV R inferior frontal gyrus triangular part | 0.128 | 0.009 | −0.11 (−0.19 to −0.03) | 0.096 | 0.730 | −0.01 (−0.09 to 0.07) |
Left temporal regions | |||||||
2j | Model 1 + IV L hippocampus | 0.144 | 0.004 | −0.45 (−0.74 to −0.15) | 0.119 | 0.123 | −0.22 (−0.51 to 0.06) |
2k | Model 1 + IV L parahippocampal gyrus | 0.145 | 0.003 | −0.45 (−0.75 to −0.15) | 0.121 | 0.110 | −0.23 (−0.52 to 0.05) |
2l | Model 1 + IV L fusiform gyrus | 0.136 | 0.006 | −0.15 (−0.26 to −0.05) | 0.115 | 0.162 | −0.07 (−0.17 to 0.03) |
2m | Model 1 + IV L Inferior temporal gyrus | 0.133 | 0.006 | −0.16 (−0.27 to −0.04) | 0.120 | 0.111 | −0.09 (−0.19 to 0.02) |
2n | Model 1 + IV L Lingual gyrus L | 0.106 | 0.030 | −0.13 (−0.26 to −0.01) | 0.108 | 0.249 | −0.07 (−0.18 to 0.05) |