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Research Article |

Verbal Communication Disorders Following a First Stroke Event: Types, Evolutive Aspects and Psychological Experience in Patients in Brazzaville, Congo

Background: Stroke causes a variety of disorders. These include verbal communication disorders (VCDs), which often lead to psychological and social problems that have a negative impact on patients' quality of life. Objectives: To determine the frequencies of post-stroke VCDs in Brazzaville; to describe the evolutive aspects of VCDs following speech therapy; to explore patients' psychological experience of VCDs. Methods: This was an analytical longitudinal study conducted from April 1 to August 31, 2022. It took place in Brazzaville, in the physical medicine and rehabilitation department of the university hospital and the functional rehabilitation department of the Makelekele referral hospital. It focused on patients who suffered from a first stroke event. The Boston Diagnostic Aphasia Examination-Third Edition, the Clinical Assessment Battery for Dysarthria, the Diagnostic Instrumental for Apraxia of Speech and interviews were used to assess VCDs. Speech therapy was used to treat post-stroke VCD. The Hospital Anxiety and Depression Scale, the Rosenberg Self-Esteem Scale and a questionnaire were used to identify the feelings experienced by patients. Results: From a total of 138 patients, 74 (53.6%) had a VCD. From these, 63 agreed to take part in the study. Of these 63 patients, 32 (50.8%), 27 (42.9%) and 4 (6.3%) had, respectively, aphasia, dysarthria and apraxia of speech. At 30 speech therapy sessions (3 months of speech therapy after stroke), 2 (6.3% of cases) aphasic patients, 12 (44.4% of cases) dysarthric patients and 1 (25% of cases) apraxic patient had completely recovered speech. Patients' psychological experience of VCD was characterized by frustration (90.5%), anxiety (71.4%), depression (71.4%), anger (69%), low self-esteem (45.2%), bad luck (35.7%), overprotection (35.7%), divine punishment (28.6%) and fatality (26.2%). Conclusion: In our study population, aphasia and dysarthria are the dominant VCDs, followed by apraxia of speech. The therapeutic strategies used to treat aphasia and apraxia of speech have led to very low rates of patients having completely recovered speech, suggesting the implementation of improved therapeutic measures to increase the degree of speech recovery. VCDs cause psychological problems, four of which predominate: frustration, anxiety, depression and anger.

Stroke, Verbal Communication Disorders, Psychological Experience, Brazzaville

APA Style

Euberma Diatewa, J., Nevyl Dona Bakala, V., Happhia Boubayi Motoula-Latou, D., Mboungou, S., Kiakou, M., et al. (2023). Verbal Communication Disorders Following a First Stroke Event: Types, Evolutive Aspects and Psychological Experience in Patients in Brazzaville, Congo. Clinical Neurology and Neuroscience, 7(3), 65-76. https://doi.org/10.11648/j.cnn.20230703.14

ACS Style

Euberma Diatewa, J.; Nevyl Dona Bakala, V.; Happhia Boubayi Motoula-Latou, D.; Mboungou, S.; Kiakou, M., et al. Verbal Communication Disorders Following a First Stroke Event: Types, Evolutive Aspects and Psychological Experience in Patients in Brazzaville, Congo. Clin. Neurol. Neurosci. 2023, 7(3), 65-76. doi: 10.11648/j.cnn.20230703.14

AMA Style

Euberma Diatewa J, Nevyl Dona Bakala V, Happhia Boubayi Motoula-Latou D, Mboungou S, Kiakou M, et al. Verbal Communication Disorders Following a First Stroke Event: Types, Evolutive Aspects and Psychological Experience in Patients in Brazzaville, Congo. Clin Neurol Neurosci. 2023;7(3):65-76. doi: 10.11648/j.cnn.20230703.14

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Lajoie, C., Ferré, P. and Ska, B. (2010) L’impact de la nature des lésions sur les troubles de la communication consécutifs à une lésion cérébrale droite. Revista Neuropsicologia Latinoamericana, 2 (3), 12-20.
2. Haute Autorité de Santé (2022) Rééducation à la phase chronique de l’AVC de l’adulte: pertinence, indications et modalités. http://www.has-sante.fr
3. Wray, F., Clarke, D. and Forster, A. (2019) How do stroke survivors with communication difficulties manage life after stroke in the first year? A qualitative study. International Journal of Language & Communication Disorders, 54 (5), 814-827. doi: 10.1111/1460-6984.12487.
4. Gil, R. (2014). Abrégés de neuropsychologie (6e éd.). Paris: Elsevier Masson.
5. Darley, F. L., Brown, J. R. and Aronson, A. E. (1975) Motor Speech Disorders. Philadelphia PA: Saunders. doi: 10.3109/asl2.1975.3.issue-1.03.
6. Duffy JR. (2013) Motor speech disorders: substrates, differential diagnosis, and management. Third edition. St. Louis, Missouri: Elsevier.
7. Esmailzade Moghimi, S., Mohammadi, F., Yadegari, F., Dehghan, M., Hojjati, S. M. M., Saadat, P., Geraili, Z. and Alizadeh, M. (2021) Verbal and oral apraxia in patients with acute stroke: Frequency, relationship, and some risk factors. Applied Neuropsychology: Adult. doi: 10.1080/23279095.2021.1993225.
8. Dickson, S., Barbour, R. S., Brady, M., Clark, A. M. and Paton, G. (2008) Patients’ experiences of disruptions associated with post-stroke dysarthria. International Journal of Language & Communication Disorders, 43 (2), 135-153. doi: 10.1080/13682820701862228.
9. Brady, C., Dickson, A. M., Paton, S. and Barbour, R. S. (2011). The impact of stroke-related dysarthria on social participation and implications for rehabilitation. Disability and Rehabilitation, 33 (3), 178-186. https://doi.org/10.3109/09638288.2010.517897
10. Sinanovic, O., Mrkonjic, Z. and Zecic, S. (2012) Quality of life and post-stroke aphasic syndromes. Periodicum Biologorum, 114, 435–440.
11. Koleck, M., Gana, K., Lucot, C., Darrigrand, B., Mazaux, J.-M., and Glize, B. (2017) Quality of life in aphasic patients 1 year after a first stroke. Quality of Life Research, 26 (1), 45–54. http://www.jstor.org/stable/44853198
12. Bullier, B., Cassoudesalle, H., Villain, M., Cogné, M., Mollo, C., De Gabory, I., Dehail, P., Joseph, P. A., Sibon, I. and Glize, B. (2020) New factors that affect quality of life in patients with aphasia. Annals of Physical and Rehabilitation Medicine, 63 (1), 33-37. https://doi.org/10.1016/j.rehab.2019.06.015
13. Pedersen, P. M., Vinter, K. and Olsen, T. S. (2004) Aphasia after stroke: type, severity and prognosis. The Copenhagen aphasia study. Cerebrovascular Diseases, 17 (1), 35-43. doi: 10.1159/000073896.
14. Engelter, S. T., Gostynski, M., Papa, S., Frei, M., Born, C., Ajdacic-Gross, V., Gutzwiller, F. and Lyrer, P. A. (2006) Epidemiology of aphasia attributable to first ischemic stroke: incidence, severity, fluency, etiology, and thrombolysis. Stroke, 37 (6), 1379-1384. doi: 10.1161/01.STR.0000221815.64093.8c.
15. Vidović, M., Sinanović, O., Šabaškić, L., Hatičić, A. and Brkić E. (2011) Incidence and types of speech disorders in stroke patients. Acta Clinica Croatica, 50 (4), 491-494.
16. Flowers, H. L., Silver, F. L., Fang, J., Rochon, E. and Martino R. (2013) The incidence, co-occurrence and predictors of dysphagia, dysarthria and aphasia after first-ever acute ischemic stroke. Journal of Communication Disorders, 46 (3), 238-248. doi: 10.1016/j.jcomdis.2013.04.001.
17. Stipancic, K. L., Borders, J. C., Brates, D. and Thibeault, S. L. (2019) Prospective Investigation of Incidence and Co-Occurrence of Dysphagia, Dysarthria, and Aphasia Following Ischemic Stroke. American Journal of Speech-Language Pathology, 28 (1), 188–194. doi: 10.1044/2018_AJSLP-18-0136.
18. De Cock, E., Batens, K., Hemelsoet, D., Boon, P., Oostra, K. and De Herdt, V. (2020) Dysphagia, dysarthria and aphasia following a first acute ischaemic stroke: incidence and associated factors. European Journal of Neurology, 27 (10), 2014-2021. doi: 10.1111/ene.14385.
19. Ghoreyshi, Z., Nilipour, R., Bayat, N., Nejad, S. S., Mehrpour, M. and Azimi, T. (2022) The Incidence of Aphasia, Cognitive Deficits, Apraxia, Dysarthria, and Dysphagia in Acute Post Stroke Persian Speaking Adults. Indian Journal of Otolaryngology and Head & Neck Surgery, 74 (Suppl 3), 5685-5695. doi: 10.1007/s12070-021-03006-9.
20. Plowman, E., Hentz, B. and Ellis, C. Jr. (2012) Post-stroke aphasia prognosis: a review of patient-related and stroke-related factors. Journal of Evaluation in Clinical Practice, 18 (3), 689-694. doi: 10.1111/j.1365-2753.2011.01650.x.
21. Urban, P. P., Wicht, S., Vukurevic, G., Fitzek, C., Fitzek, S., Stoeter, P., Massinger, C., Hopf, H. C. H. (2001) Dysarthria in acute ischemic stroke. Lesion topography, clinicoradiologic correlation, and etiology. Neurology, 56 (8), 1021-1027. doi: 10.1212/WNL.56.8.1021.
22. Jodzio, K., Gasecki, D., Drumm, D. A., Lass, P. and Nyka, W. (2003) Neuroanatomical correlates of the post-stroke aphasias studied with cerebral blood flow SPECT scanning. Medical Science Monitor, 9 (3), MT32-41.
23. Yang, Z. H., Zhao, X. Q., Wang, C. X., Chen, H. Y. and Zhang, Y. M. (2008) Neuroanatomic correlation of the post-stroke aphasias studied with imaging. Neurological Research, 30 (4), 356-360. doi: 10.1179/174313208X300332.
24. Kang, E. K., Sohn, H. M., Han, M. K., Kim, W., Han, T. R. and Paik, N. J. (2010) Severity of post-stroke aphasia according to aphasia type and lesion location in Koreans. Journal of Korean Medical Science, 25 (1), 123-127. doi: 10.3346/jkms.2010.25.1.123.
25. Khedr, E. M., Abbass, M. A., Soliman, R. K., Zaki, A. F., Gamea, A., El-Fetoh, N. A. and Abdel-Aaal, MA. (2020) A hospital-based study of post-stroke aphasia: frequency, risk factors, and topographic representation. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 56, Article number: 2 (2020). https://doi.org/10.1186/s41983-019-0128-1
26. Lee, S., Na, Y., Tae, W. S. and Pyun, S. B. (2020) Clinical and neuroimaging factors associated with aphasia severity in stroke patients: diffusion tensor imaging study. Scientific Reports, 10, 12874 (2020). doi: 10.1038/s41598-020-69741-1.
27. Mitchell, C., Gittins, M., Tyson, S., Vail, A., Conroy, P., Paley, L. and Bowen, A. (2021) Prevalence of aphasia and dysarthria among inpatient stroke survivors: describing the population, therapy provision and outcomes on discharge. Aphasiology, 35 (7), 950-960. doi: 10.1080/02687038.2020.1759772.
28. West, C., Hesketh, A., Vail, A. and Bowen A. (2005) Interventions for apraxia of speech following stroke. Cochrane Database of Systematic Reviews, 4, CD004298. doi: 10.1002/14651858.CD004298.
29. Fridriksson, J. and Hillis, A. E. (2021) Current Approaches to the Treatment of Post-Stroke Aphasia. Journal of Stroke, 23 (2), 183-201. https://doi.org/10.5853/jos.2020.05015
30. Mitchell, C., Bowen, A., Tyson, S., Butterfint, Z. and Conroy, P. (2017) Interventions for dysarthria due to stroke and other adult-acquired, non-progressive brain injury. Cochrane Database of Systematic Reviews, 1 (1), CD002088. doi: 10.1002/14651858.CD002088.
31. Basilakos A. (2018) Contemporary Approaches to the Management of Post-stroke Apraxia of Speech. Seminars in Speech and Language, 39 (1), 25-36. doi: 10.1055/s-0037-1608853.
32. Cichon, N., Wlodarczyk, L., Saluk-Bijak, J., Bijak, M., Redlicka, J., Gorniak, L. and Miller, E. (2021) Novel. Advances to Post-Stroke Aphasia Pharmacology and Rehabilitation. Journal of Clinical Medicine, 10 (17), 3778. https://doi.org/10.3390/jcm10173778
33. Haldin, C., Lœvenbruck, H., Hueber, T., Marcon, V., Piscicelli, C., Perrier, P., Chrispin, A., Pérennou, D. and Baciu, M. (2021) Speech rehabilitation in post-stroke aphasia using visual illustration of speech articulators. A case report study. Clinical Linguistics and Phonetics, 35 (3), 253-276. doi: 10.1080/02699206.2020.1780473.
34. Palmer, R. and Pauranik, A. (2021) Rehabilitation of Communication Disorders. In: Platz, T., Ed., Clinical Pathways in Stroke Rehabilitation. Evidence-based Clinical Practice Recommendations. Switzerland: Springer, 175-190. https://doi.org/10.1007/978-3-030-58505-1_10
35. Carr, P., Moser, D., Williamson, S., Robinson, G. and Kintz, S. (2022) Improving Functional Communication Outcomes in Post-Stroke Aphasia via Telepractice: An Alternative Service Delivery Model for Underserved Populations. International Journal of Telerehabilitation, 14 (2), Fall 2022. https://doi.org/10.5195/ijt.2022.6531.
36. Yang, X., Shi, L., Ran, D., Li, M., Qin, C. and An, Z. (2022) The treatment of post-stroke dysarthria with a combination of different acupuncture types and language rehabilitation training: a systematic review and network meta-analysis. Annals of Translational Medicine, 10 (23), 1281. doi: 10.21037/atm-22-5583.
37. Wade, D. T., Hewer, R. L., David, R. M. and Enderby, P. M. (1986) Aphasia after stroke: natural history and associated deficits. Journal of Neurology, Neurosurgery & Psychiatry, 49 (1), 11-16. doi: 10.1136/jnnp.49.1.11.
38. Pashek, G. V. and Holland, A. L. (1988) Evolution of aphasia in the first year post-onset. Cortex, 24, 411-423. doi: 10.1016/s0010-9452(88)80004-2.
39. El Hachioui, H., Van de Sandt-Koenderman, M., Dippel, D., Koudstaal, P. and Visch-Brink, E. (2011). A 3-year evolution of linguistic disorders in aphasia after stroke. International Journal of Rehabilitation Research, 34 (3), 215-221. doi: 10.1097/MRR.0b013e3283460e65.
40. Ali, M., Lyden, P., Brady, M. and VISTA Collaboration. (2015) Aphasia and Dysarthria in Acute Stroke: Recovery and Functional Outcome. International Journal of Stroke, 10 (3), 400-406. doi: 10.1111/ijs.12067.
41. Gerstenecker, A. and Lazar, R. M. (2019) Language recovery following stroke. The Clinical Neuropsychologist, 33 (5), 928-947. doi: 10.1080/13854046.2018.1562093.
42. Osa, G. A., Brambati, S. M., Brisebois, A., Désilets-Barnabé, M., Houzé, B., Bedetti, C., Rochon, E., Leonard, C., Desautels, A. and Marcotte, K. (2020) Predicting Early Post-stroke Aphasia Outcome From Initial Aphasia Severity. Frontiers in Neurology, 11, 120. doi: 10.3389/fneur.2020.00120.
43. Billot, A., Lai, S., Varkanitsa, M., Braun, E. J., Rapp, B., Parrish, T. B., Higgins, J., Kurani, A. S., Caplan, D., Thompson, C. K., Ishwar, P., Betke, M. and Kiran, S. (2022) Multimodal Neural and Behavioral Data Predict Response to Rehabilitation in Chronic Poststroke Aphasia. Stroke, 53 (5), 1606-1614. doi: 10.1161/STROKEAHA.121.036749.
44. Stefaniak, J. D., Geranmayeh, F. and Lambon Ralph, M. A. (2022) The multidimensional nature of aphasia recovery post-stroke, Brain, 145 (4), 1354-1367. doi: 10.1093/brain/awab377.
45. Ossou-Nguiet, P. M., Gnonlonfoun, D., Bandzouzi-Ndamba, B., Mouanga, A. M., Assogba, K. and Matali, E. (2012) Qualité de vie des aphasiques post-AVC à Brazzaville. African Journal of Neurological Sciences, 31 (1), 34-40.
46. Goodglass, H., Kaplan, E. and Barresi, B. (2000) Assessment of aphasia and related disorders-Third edition. Philadelphia: Lippincott Williams & Wilkins.
47. Auzou, P. and Rolland-Monnoury, V. (2019). BECD-Batterie d’Evaluation Clinique de la Dysarthrie. Isbergues: Ortho Editions.
48. Jonkers, R., Feiken, J., and Stuive, I. (2017). Diagnosing Apraxia of Speech on the Basis of Eight Distinctive Signs. Canadian Journal of Speech-Language Pathology and Audiology, 41 (3), 303-319.
49. Zigmond, A. S., & Snaith, R. P. (1983). Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67 (6), 361-370. doi: 10.1111/j.1600-0447.1983.tb09716.x.
50. Rosenberg, M. (1986) Conceiving the Self. Krieger Publ, Malabar (Fla.).
51. Rousseau, T., Auzou P., Rolland, V., Lambert, J., Chokron, S., Joyeux, N., Aubin, G., Allain, P and Eyoum, I. (2004). Les approches thérapeutiques en orthophonie. Tome 4 - Prise en charge orthophonique d'origine neurologique. Ortho Editions, Isbergues.
52. González-Fernández, M., Brodsky, M. B. and Palmer, J. B. (2015) Poststroke Communication Disorders and Dysphagia. Physical Medicine and Rehabilitation Clinics of North America, 26 (4), 657-670. doi: 10.1016/j.pmr.2015.06.005.
53. Ballard, K. J., Wambaugh, J. L., Duffy, J. R., Layfield, C., Maas, E., Mauszycki, S. and McNeil, M. R. (2015) Treatment for Acquired Apraxia of Speech: A Systematic Review of Intervention Research between 2004 and 2012. American Journal of Speech-Language Pathology, 24 (2), 316-337. doi: 10.1044/2015_AJSLP-14-0118.
54. Kim, G., Min, D., Lee, E.-0., Eun Kyoung Kang, E. K. (2016) Impact of Co-occurring Dysarthria and Aphasia on Functional Recovery in Post-stroke Patients. Annals of Rehabilitation Medicine, 40 (6), 1010-1017. doi: 10.5535/arm.2016.40.6.1010.
55. de Goulart, B. N. G., de Almeida, C. P. G., da Silva, M. W., Oenning, N. S. X. and Verlaine Balzan Lagni, V. B. (2016) Characterization of stroke with a focus on oral communication disorders in inpatients of a regional hospital. Audiology Communication Research, 21, e1603. doi: 10.1590/2317-6431-2015-1603.
56. Kpadonou, G. T., Alagnidé, E., Niama-Natta, D., Houngbédji, G. and Adjaka, N. (2013) Verbal communication disorders in brain damaged post-stroke patients in Benin. Annals of Physical and Rehabilitation Medicine, 56 (9-10), 663-672. doi: 10.1016/j.rehab.2013.08.004.
57. Arauz, A., Rodríguez-Agudelo, Y., Sosa, A. L., Chávez, M., Paz, F., González, M., Coral, J., Díaz-Olavarrieta, C. and Román, G. C. (2014) Vascular cognitive disorders and depression after first-ever stroke: the Fogarty-Mexico Stroke Cohort. Cerebrovascular Diseases, 38 (4), 284-289. doi: 10.1159/000366471.
58. Mackenzie, C. (2011) Dysarthria in stroke: A narrative review of its description and the outcome of intervention. International Journal of Speech-Language Pathology, 13 (2), 125-136. doi: 10.3109/17549507.2011.524940.
59. Araki, K., Hirano, Y., Kozono, M., Fujitani, J. and Shimizu, E. (2022) The Screening Test for Aphasia and Dysarthria (STAD) for Patients with Neurological Communicative Disorders: A Large-Scale, Multicenter Validation Study in Japan. Folia phoniatrica et logopaedica, 74 (3), 195-208. doi: 10.1159/000519381.
60. Weiss, P., Ubben, S., Kaesberg, S., Kalbe, E., Kessler, J., Liebig, T. and Fink, G. (2016) Where language meets meaningful action: a combined behaviour and lesion analysis of aphasia and apraxia. Brain Structure and Function, 221 (1), 563–576. http, 221i.org/10.1007/s00429-014-0925-3
61. Koberskaya, N. N. (2018) Treatment of the post-stroke speech disorders in the patients with cardiac and cerebrovascular pathology. Journal of Neurology & Stroke, 8 (3), 155‒161. doi: 10.15406/jnsk.2018.08.00301.
62. Godefroy, O., Dubois, C., Debachy, B., Leclerc, M., Kreisler, A. and Lille Stroke Program. (2002) Vascular aphasias: main characteristics of patients hospitalized in acute stroke units. Stroke, 33 (3), 702-705. doi: 10.1161/hs0302.103653.
63. Hoffmann, M and Chen, R. (2013) The spectrum of aphasia subtypes and etiology in subacute stroke. Journal of Stroke & Cerebrovascular Diseases, 22 (8), 1385-1392. doi: 10.1016/j.jstrokecerebrovasdis.2013.04.017.
64. Gnonlonfoun, D., Adjien, C., Ossou-Nguiet, P. M., Mapoure, Y., Sissoko, A., Wouton, G., Kpadonou, T., Houinato, D. and Avode, D. G. (2017) Facteurs associés à la qualité de vie des aphasiques post accident vasculaire cérébral en milieu hospitalier à Cotonou, Benin. Mali Médical, 32 (2), 27-34.
65. Brkić, E., Sinanović, O., Vidović, M., Smajlović, D. (2009) Ucestalost i klinicka fenomenologija afazickih poremećaja nakon mozdanog udara [Incidence and clinical phenomenology of aphasic disorders after stroke]. Medical Archives, 63 (4), 197-199.
66. Brust, J. C., Shafer, S. Q., Richter, R. W. and Bruun, B. (1976) Aphasia in acute stroke. Stroke, 7 (2), 167-174. doi: 10.1161/01.str.7.2.167.
67. Chand-Mall, R. and Vanaja, C. S. (2017). Speech Profile of Individuals with Dysarthria Following First Ever Stroke. International Journal of Medical Research & Health Sciences, 6 (9), 86-95.
68. Berthier, M. L. (2005) Poststroke aphasia: epidemiology, pathophysiology and treatment. Drugs Aging, 22 (2), 163-182. doi: 10.2165/00002512-200522020-00006.
69. Urban, P. P., Rolke, R., Wicht, S., Keilmann, A., Stoeter, P., Hopf, H. C. and Dieterich, M. (2006) Left-hemispheric dominance for articulation: a prospective study on acute ischaemic dysarthria at different localizations. Brain, 129 (Pt 3), 767-777. doi: 10.1093/brain/awh708.
70. Fonville, S., van der Worp, H. B., Maat, P., Aldenhoven, M., Algra, A. and van Gijn, J. (2008) Accuracy and inter-observer variation in the classification of dysarthria from speech recordings. Journal of Neurology, 255 (10), 1545-1548. doi: 10.1007/s00415-008-0978-4.
71. Van der Graaff, M., Kuiper, T., Zwinderman, A., Van de Warrenburg, B., Poels, P., Offeringa, A., Van der Kooi, A., Speelman, H. and De Visser, M. (2009) Clinical identification of dysarthria types among neurologists, residents in neurology and speech therapists. European Neurology, 61 (5), 295-300. doi: 10.1159/000206855.
72. Sène Diouf, F., Mapoure, Y., Ndiaye, M., Touré, K., Diagne, N. S., Thiam, A., Diop, A. G., Ndiaye, M. M. and Ndiaye, I. P. (2008) Aphasies vasculaires: aspects cliniques, epidemiologiques et evolutifs [Vascular aphasias: clinical, epidemiologicaland evolutionary aspects]. Dakar Medical, 53 (1), 68-75.
73. Lemmetyinen, S., Hokkanen, L. and Klippi, A. (2020). Long-term recovery from apraxia and its relation to severe apraxic-aphasic disorder in left hemisphere stroke - a systematic review. Aphasiology, 34 (6), 735-756. doi: 10.1080/02687038.2019.1636932.
74. Kumral, E., Celebisoy, M., Celebisoy, N., Canbaz, D. H. and Calli, C. (2007) Dysarthria due to supratentorial and infratentorial ischemic stroke: a diffusion-weighted imaging study. Cerebrovascular Diseases, 23 (5-6), 331-338. doi: 10.1159/000099131.
75. Canbaz, D. H., Celebisoy, M., Ozdemirkiran, T. and Tokucoglu, F. (2019) Dysarthria in Acute Ischemic Stroke: Localization and Prognosis. Journal of Neurological Sciences, 27 (1), 22, 020-027. http://www.jns.dergisi.org/text.php3?id=334
76. Latarnik, S., Stahl, J., Vossel, S., Grefkes, C., Fink, G. R. and Weiss, P. H. (2022) The impact of apraxia and neglect on early rehabilitation outcome after stroke. Neurology Research and Practice, 4, Article number: 46 (2022). doi: 10.1186/s42466-022-00211-x.
77. Demeurisse, G., Demol, O., Derouck, M., de Beuckelaer, R., Coekaerts, M. J. and Capon, A. (1980) Quantitative study of the rate of recovery from aphasia due to ischemic stroke. Stroke, 11 (5), 455-458. doi: 10.1161/01.str.11.5.455.
78. Laska, A. C., Hellblom, A., Murray, V., Kahan, T. and Von Arbin, M. (2001) Aphasia in acute stroke and relation to outcome. Journal of Internal Medicine, 249 (5), 413-22. doi: 10.1046/j.1365-2796.2001.00812.x.
79. Sinanović, O., Mrkonjić, Z., Zukić, S., Vidović, M. and Imamović, K. (2011) Post-stroke language disorders. Acta Clinica Croatica, 50 (1), 79-94.
80. Robey RR. (1998) A meta-analysis of clinical outcomes in the treatment of aphasia. Journal of Speech, Language, and Hearing Research, 41 (1), 172–187. doi: 10.1044/jslhr.4101.172.
81. Lazar, R. M., Minzer, B., Antoniello, D., Festa, J. R., Krakauer, J. W. and Marshall, R. S. (2010) Improvement in aphasia scores after stroke is well predicted by initial severity. Stroke, 41 (7), 1485-1488. doi: 10.1161/STROKEAHA.109.577338.
82. Donkervoort, M., Dekker, J., Deelman, B. (2006) The course of apraxia and ADL functioning in left hemisphere stroke patients treated in rehabilitation centres and nursing homes. Clinical Rehabilitation, 20 (12), 1085-1093. doi: 10.1177/0269215506071257.
83. Katz, W. F., McNeil, M. R. and Garst, D. M. (2010) Treating apraxia of speech (AOS) with EMA-supplied visual augmented feedback. Aphasiology, 24 (6), 826-837. doi: 10.1080/02687030903518176.
84. Hurkmans, J., Jonkers, R., de Bruijn, M., Boonstra, A. M., Hartman, P. P., Arendzen, H. and Reinders-Messelink, H. A. (2015) The effectiveness of Speech–Music Therapy for Aphasia (SMTA) in five speakers with Apraxia of Speech and aphasia. Aphasiology, 29 (8), 939-964. doi: 10.1080/02687038.2015.1006565.
85. Mackenzie, C., Kelly, S., Paton, G., Brady, M. and Muir, M. (2013) The Living with Dysarthria group for post-stroke dysarthria: the participant voice. International journal of language & communication disorders, 48 (4), 402-420. doi: 10.1111/1460-6984.12017.
86. Parr, S. (2004) Living with severe aphasia: The experiences of communication impairment after stroke. Brighton: Pavilion Publishing.
87. Wray, F. and Clarke, D. (2017) Longer-term needs of stroke survivors with communication difficulties living in the community: a systematic review and thematic synthesis of qualitative studies. BMJ Open, 7 (10), e017944. doi: 10.1136/bmjopen-2017-017944.
88. Hilari, K., Needle, J. J. & Harrison, K. L. (2012). What are the important factors inhealth-related quality of life for people with aphasia? A systematic review. Archives of Physical Medicine and Rehabilitation, 93 (1 Suppl), S86-S95. doi: 10.1016/j.apmr.2011.05.028.
89. Shehata, G. A., El Mistikawi, T., Al Sayed, K. R. and Hassan, H. S. (2015) The effect of aphasia upon personality traits, depression and anxiety among stroke patients. Journal of affective disorders, 172, 312-314. https://doi.org/10.1016/j.jad.2014.10.027
90. Vuković, M. (2018) Communication Related Quality of Life in Patients with Different Types of Aphasia Following a Stroke: Preliminary Insights. International Archives of Communication Disorder, 1 (1), 1: 004. doi.org/10.23937/iacod-2017/1710004