Evidence map›Paper›PMID 40276856›Full record

ArticleStroke2025

White Matter Hyperintensity Load Independent From the Stroke Lesion Is Associated With Chronic Aphasia Severity and Treatment Outcome.

Natalie Busby, Sigfus Kristinsson, Lisa Johnson, Rebecca W Roth, Argye E Hillis, Roger Newman-Norlund, Chris Rorden, Julius Fridriksson, Leonardo Bonilha

Abstract read
In one paragraph

Article in Stroke, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. The Influence of Contralesional Brain Age Gradients on Chronic Stroke Aphasia Severity and Treatment Response.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2026
    Article
  2. Review
  3. Accelerated brain aging and anterior white matter hyperintensity burden in chronic post-stroke aphasia: a lesion-aware MRI analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Natalie BusbyDepartment of Communication Sciences and Disorders (N.B., S.K., L.J., J.F.), University of South Carolina, Columbia.ORCID 0000-0001-7117-7899
Sigfus KristinssonDepartment of Communication Sciences and Disorders (N.B., S.K., L.J., J.F.), University of South Carolina, Columbia.
Lisa JohnsonDepartment of Communication Sciences and Disorders (N.B., S.K., L.J., J.F.), University of South Carolina, Columbia.ORCID 0000-0002-8727-7269
Rebecca W RothDepartment of Neurology, Emory University, Atlanta, GA (R.W.R.).
Argye E HillisDepartment of Neurology and Physical Medicine and Rehabilitation (A.E.H.), Johns Hopkins School of Medicine, Baltimore, MA.ORCID 0000-0002-5192-1171
Roger Newman-NorlundDepartment of Psychology (R.N.-N., C.R.), University of South Carolina, Columbia.ORCID 0000-0002-0966-1070
Chris RordenDepartment of Psychology (R.N.-N., C.R.), University of South Carolina, Columbia.ORCID 0000-0002-7554-6142
Julius FridrikssonDepartment of Communication Sciences and Disorders (N.B., S.K., L.J., J.F.), University of South Carolina, Columbia.
Leonardo BonilhaSchool of Medicine (L.B.), University of South Carolina, Columbia.ORCID 0000-0002-6153-8942

Funding

Telerehab for Aphasia (TERRA)P50DC014664 · NIDCD · UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA · PI HICKOK, GREGORY · 2016 to 2025
$25.0M
Cortical and Subcortical Organization of Language-Related Semantic Processing in Alzheimer's DiseaseR01DC014021 · NIDCD · UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA · PI BONILHA, LEONARDO F · 2014 to 2023
$4.7M
NIDCD NIH HHS P50 DC014664NIDCD NIH HHS R01 DC014021
6 · The paper itself

Abstract

backgroundAlthough many studies have suggested that white matter hyperintensity (WMH) severity predicts naming and aphasia severity in chronic poststroke aphasia, there are inconsistencies in the literature. WMHs are typically symmetrical in neurotypical controls, and measuring WMH in the contralateral hemisphere is likely the best option to estimate brain health independently from the stroke lesion and avoid measurement contamination from stroke-related gliosis. In this study, we aimed to clarify the discrepancies in the literature by testing whether WMH rating methods are related to clinical outcomes.

methodsNinety-five participants with chronic aphasia at least 12 months after their left-hemisphere stroke completed a baseline Western Aphasia Battery and the Philadelphia Naming Test. All participants then underwent 6 weeks of phonological and semantic naming treatments focused on improving lexical processing, and the Philadelphia Naming Test was readministered immediately following treatment. Using the Fazekas scale, WMH severity was independently rated on the whole brain and the right hemisphere only. Their relationship of WMH behavior was calculated by accounting for age, lesion volume, time poststroke, years of education, and sex.

resultsThere were significant positive correlations between whole-brain and right-hemisphere ratings of WMH, but Wilcoxon signed-rank tests revealed that whole-brain ratings were consistently higher (whole brain M=3.337, right hemisphere M=2.899;

conclusionsGiven the regional effect of the stroke lesion, whole-brain ratings can overestimate the WMH burden and thus reduce the accuracy in evaluating small vessel disease effects on stroke recovery and aphasia severity, particularly therapy-related neuroplasticity. This is an important detail that should be considered in mechanistic studies of small vessel disease, brain health, and stroke recovery.

Indexed as

AphasiaStrokeWhite MatterAgedAged, 80 and overBrainChronic DiseaseFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedSeverity of Illness IndexTreatment Outcomeaphasiabrainneuronal plasticitystrokewhite matter

Identifiers

PMID40276856
PMCPMC13643712

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.