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Brain Sciences
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Diagnosis and Treatment of Post-Stroke and Progressive Aphasias
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Diagnosis and Treatment of Post-Stroke and Progressive Aphasias

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurolinguistics".

Deadline for manuscript submissions: 31 July 2026 | Viewed by 3648

Special Issue Editors

Dr. Sigfus Kristinsson

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Guest Editor
Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
Interests: aphasia; aphasia treatment; neuroimaging; cognitive science
Dr. Sladjana Lukic

E-Mail Website
Guest Editor
FSU College of Communication and Information, School of Communication Science and Disorders, Florida State University, Tallahassee, FL, USA
Interests: cognitive neuroscience; aphasia; neuroimaging; neurolinguistics

Special Issue Information

Dear Colleagues,

Aphasia is a common language disorder caused by neurological diseases. The scientific history of aphasia began over 100 years ago, during the “golden age” of neurology, with Broca’s discoveries, raising interest in the more precise localization of brain disorders. Significant clinical contributions and notable advances in theoretical formulation were made during the first few decades of the 19th century, followed by the 20th century advances in neuroimaging and the most recent data-driven approaches to deliver better classification and lesion-based predictions in post-stroke patients. Lately, the study of aphasia has expanded to include a newly discovered clinical entity, primary progressive aphasia (PPA), which, although broadening our knowledge about aphasia phenotypes, extended the discrepancy between clinical impressions and classification systems among language disorders. Although a huge number of individuals with post-stroke aphasia can have improved outcomes with behavioral therapy, there is a need to develop new and emerging technologies to improve the quality of life for patients who suffer from both stroke-induced and primary progressive aphasia, and to facilitate early diagnoses and focusing on slowing down the progression in PPA.

This Special Issue will primarily address (i) the clinical categorization of patients with aphasia, (ii) highlight advances in the diagnosis and treatment of aphasia, and finally (iii) define the best modalities to include imaging techniques and machine-learning approaches to facilitate and predict outcomes. The aims of this Special Issue are to offer more personalized and granular predictive modeling of rehabilitation, understand the hidden neural markers of vulnerability and disease, and characterize the anatomical substrate of aphasia.

Dr. Sigfus Kristinsson
Dr. Sladjana Lukic
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • post-stroke aphasia
  • primary progressive aphasia
  • lesion–symptom mapping
  • neuroimaging
  • speech and language treatment
  • neural markers

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Published Papers (3 papers)

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Research

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15 pages, 31200 KB  
Article
Your Mileage May Vary: Individuals with Primary Progressive Aphasia Differ Widely in Their Utilization of Congruent Prosodic and Visual Information During Sentence Comprehension
by Mathew Chaves, Marco A. Lambert, Lindsey Kelly, Isidora Diaz-Carr, Voss Neal, Argye E. Hillis and Melissa D. Stockbridge
Brain Sci. 2026, 16(2), 149; https://doi.org/10.3390/brainsci16020149 - 29 Jan 2026
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Abstract
Background/Objectives: Primary progressive aphasia (PPA) is a clinical syndrome associated with gradual language impairment caused by neurodegenerative disease. While people with post-stroke aphasia often depend on visual and prosodic cues to facilitate language, we hypothesized that people with PPA may have difficulty using [...] Read more.
Background/Objectives: Primary progressive aphasia (PPA) is a clinical syndrome associated with gradual language impairment caused by neurodegenerative disease. While people with post-stroke aphasia often depend on visual and prosodic cues to facilitate language, we hypothesized that people with PPA may have difficulty using such cues due to degeneration in the right hemisphere (albeit less than in the left hemisphere) in PPA. Methods: Eighty-eight outpatients diagnosed with PPA received the Hopkins Auditory Comprehension with Context Assessment (HACCA), a recently developed instrument that systematically titrates both acoustic (prosody) and visual (speaker image) cues in a four-item forced-choice sentence picture matching paradigm assessing comprehension. Patients were grouped based on the effects of cues on accuracy and were examined both by the PPA variant and individually. Results: There was a significant difference between performance classifications across the three cueing conditions as a function of PPA variant (p = 0.014). When individuals with distinct complementary profiles of performance across conditions were examined separately, a small number with logopenic PPA uniquely benefitted from the inclusion of video, while certain patients performed more poorly given any additional cues. HACCA performance across cueing conditions had a strong positive association with other concurrent measures of communication and cognition. Conclusions: Individual patterns of response to prosodic and visual cues provide important insights valuable in refining therapeutic approaches that target the retention of function and support a more robust understanding of the individual variability among patients with this uncommon neurodegenerative syndrome. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Post-Stroke and Progressive Aphasias)
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17 pages, 1991 KB  
Article
Lesion-Symptom Mapping of Acute Speech Deficits After Left vs. Right Hemisphere Stroke: A Retrospective Analysis of NIHSS Best Language Scores and Clinical Neuroimaging
by Nilofar Sherzad, Roger Newman-Norlund, John Absher, Leonardo Bonilha, Christopher Rorden, Julius Fridriksson and Sigfus Kristinsson
Brain Sci. 2025, 15(12), 1329; https://doi.org/10.3390/brainsci15121329 - 13 Dec 2025
Viewed by 1707
Abstract
Background: Recent research suggests that damage to right hemisphere regions homotopic to the left hemisphere language network affects language abilities to a greater extent than previously thought. However, few studies have investigated acute disruption of language after lesion to the right hemisphere. [...] Read more.
Background: Recent research suggests that damage to right hemisphere regions homotopic to the left hemisphere language network affects language abilities to a greater extent than previously thought. However, few studies have investigated acute disruption of language after lesion to the right hemisphere. Here, we examined lesion correlates of acute speech deficits following left and right hemisphere ischemic stroke to clarify the neural architecture underlying early language dysfunction. Methods: We retrospectively analyzed 410 patients (225 left, 185 right hemisphere lesions) from the Stroke Outcome Optimization Project dataset. Presence and severity of speech deficits was measured using the National Institute of Health Stroke Scale Best Language subscore within 48 h of onset. Manual lesion masks were derived from clinical MRI scans and normalized to MNI space. Lesion-symptom mapping was conducted using voxelwise and region-of-interest analyses with permutation correction (5000 iterations; p < 0.05), controlling for total lesion volume. Results: Speech deficits were observed in 53.7% of the cohort (58.2% left, 48.1% right hemisphere lesions). In the full sample, the presence of speech deficits was associated with bilateral subcortical and perisylvian damage, including the external and internal capsules, insula, putamen, and superior fronto-occipital fasciculus. Severity of speech deficits localized predominantly to left hemisphere structures, with peak associations in the external capsule (Z = 6.39), posterior insula (Z = 5.64), and inferior fronto-occipital fasciculus (Z = 5.43). In the right hemisphere cohort, the presence and severity of speech deficits were linked to homologous regions, including the posterior insula (Z = 3.70) and external capsule (Z = 3.63), although with smaller effect sizes relative to the left hemisphere cohort. Right hemisphere lesions resulted in milder deficits despite larger lesion volumes compared with left hemisphere lesions. Conclusions: Acute speech impairment following right hemisphere stroke is associated with damage to a homotopic network encompassing perisylvian cortical and subcortical regions analogous to the dominant left hemisphere language network. These findings demonstrate that damage to the right hemisphere consistently results in acute speech deficits, challenging the traditional left-centric view of post-stroke speech impairment. These results have important implications for models of bilateral language representation and the neuroplastic mechanisms supporting language recovery. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Post-Stroke and Progressive Aphasias)
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Other

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20 pages, 2476 KB  
Case Report
Improving Lexicosemantic Impairments in Post-Stroke Aphasia Using rTMS Targeting the Right Anterior Temporal Lobe
by Sophie Arheix-Parras, Sophia R. Moore and Rutvik H. Desai
Brain Sci. 2026, 16(1), 117; https://doi.org/10.3390/brainsci16010117 - 22 Jan 2026
Viewed by 604
Abstract
Background/Objectives: Repetitive Transcranial Magnetic Stimulation (rTMS) can enhance post-stroke aphasia recovery. The right Inferior Frontal Gyrus is the most common target in rTMS studies for inhibitory stimulation. However, lexicosemantic processes involve a large brain network including the Anterior Temporal Lobe (ATL). We [...] Read more.
Background/Objectives: Repetitive Transcranial Magnetic Stimulation (rTMS) can enhance post-stroke aphasia recovery. The right Inferior Frontal Gyrus is the most common target in rTMS studies for inhibitory stimulation. However, lexicosemantic processes involve a large brain network including the Anterior Temporal Lobe (ATL). We hypothesize that rTMS targeting the ATL will improve lexicosemantic impairments in people with post-stroke aphasia. Methods: In a Single-Case Experimental Design, three people with post-stroke aphasia with lexicosemantic impairments performed Picture and Auditory Naming and Semantic Decision tasks five times a week for one or two weeks to establish baseline scores. Then, each participant received continuous inhibitory Theta Burst Stimulation targeting the right ATL, five times a week for two weeks. After each rTMS session, participants performed all linguistic tasks. A follow-up measurement was performed one month after the end of the study. Results: All participants showed significant improvement in the Picture Naming task, while only P1 improved in Auditory Naming accuracy. In the Semantic Decision task, only P2 showed improvement in both accuracy and RT, while P1 showed improvement in RT alone and P3 showed no improvement. Conclusions: The results suggest that ATL could be a potential target for future brain stimulation studies in aphasia involving lexicosemantic impairments. RTMS targeting the ATL may modulate the connected ventral semantic stream, leading to improvements in lexical access. This preliminary study highlights the possibility of selecting the cortical target for rTMS based on the clinical profile of the participant, an approach that will need further investigation in larger sham-controlled studies. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Post-Stroke and Progressive Aphasias)
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