Concomitant Cognitive Impairment in Aphasia

ABSTRACT INTRODUCTION. Aphasia is observed in 30-40% of patients who have suffered a stroke, and the prognosis for the restoration of speech functions in severe aphasia is unfavorable. To date, there has been no assessment of the severity of cognitive impairment in various clinical forms of aphasia. The aim is analysis of cognitive impairment in various forms of aphasia. MATERIAL AND METHODS. 572 patients with severe and moderate post-stroke aphasia, 103 with dynamic aphasia, 89 with afferent motor aphasia, 100 with efferent motor aphasia, 98 with acoustic-gnostic aphasia, 94 with acoustic-mnestic aphasia, 88 patients — with semantic aphasia. RESULTS AND DISCUSSION. The presence of violations of non-verbal cognitive domains was revealed, and the specificity of pathology was different for each form of aphasia. All examined patients showed a decrease in mental activity, fatigue, exhaustion, most pronounced with dynamic aphasia and acoustic-gnostic aphasia. Memory loss was noted in all, most pronounced in acoustic-mnestic aphasia (p < 0,001), slightly in patients with dynamic aphasia (p = 0,08). The decrease in level of attention was most pronounced in patients with acoustic–gnostic aphasia (p < 0,001), insignificant — with efferent motor aphasia (p = 0,15). Intellectual disabilities and decreased executive functions were most pronounced in dynamic aphasia and semantic aphasia (p < 0,001). Violations of praxis were characteristic of dynamic aphasia, afferent motor aphasia and efferent motor aphasia (p < 0,001), and gnosis, including visual–spatial, for acoustic-mnestic aphasia and semantic aphasia (p = 0,001–0,002). CONCLUSION. It can be assumed that rehabilitation of patients with aphasia should include, along with speech exercises, practice aimed at restoring non-speech cognitive functions, which will increase the effectiveness of rehabilitation. KEYWORDS: aphasia, cognitive impairment, executive functions, visual-spatial functions, praxis, gnosis