Language recovery following stroke

Objective: To review the research literature pertaining to post-stroke language recovery, and to discuss neurocognitive assessment in patients in the context of aphasia, time course of language recovery, factors associated with language recovery, and therapeutic techniques designed to facilitate language recovery. Method: Articles were identified through PubMed, MEDLINE, PsychINFO, and Google Scholar searches. Examples of utilized keywords include "post-stroke aphasia," "post-stroke language recovery," "post-stroke neurocognitive assessment," and "neuropsychology and aphasia." Results: Most language recovery occurs in the first few weeks following stroke, but residual recovery may occur for many years. Although initial aphasia severity is the single largest determinant of post-stroke language recovery, a number of other variables also contribute. Several techniques have been developed to aid in the recovery process including speech-language therapy and noninvasive brain stimulation, although the effectiveness of acute and subacute treatment remains unclear. Some degree of valid neurocognitive assessment is possible in patients with aphasia, and the information gained from such an evaluation can aid the rehabilitative process Conclusions: Significant recovery of language function is possible following a stroke, but prediction of level of recovery in an individual patient is difficult. Information about initial aphasia severity and the integrity of cognitive domains other than language can help guide the rehabilitation team, as well as manage expectations for recovery.