Changes in white matter microstructure related to non-linguistic cognitive impairment in post-stroke aphasia

Objects Post-stroke aphasia (PSA) often have non-linguistic cognitive impairment. We aimed to ascertain its characteristics of non-linguistic cognitive impairment and the corresponding changes in white matter microstructures. Methods Ten patients with PSA and 17 healthy controls (HCs) were enrolled. Loewenstein occupational therapy cognitive assessment (LOTCA) were used to assess non-linguistic cognitive function. Summary T-test was performed to compare the LOTCA scores between PSA and the Chinese norm. Tract-based spatial statistics (TBSS) was used to calculate fractional anisotropy (FA), mean diffusivity (MD), and radial diffusivity (RD) after collecting diffusion tensor imaging data. Correlation analysis was performed between these metrics and LOTCA scores. Results The days after stroke onset of PSA was 428.0 +/- 52.0. The total LOTCA score of PSA (78.20 +/- 22.63) was lower than the Chinese norm (97.65 +/- 16.24,P=0.003), as well as the scores of orientation, spatial perception (SP), motor praxis (MP), and attention (P<0.05). Lower FA and higher MD/RD in bilateral inferior fronto-occipital fasciculus (IFOF), inferior longitudinal fasciculus (ILF), and left superior longitudinal fasciculus (SLF) were found in PSA compared with HCs. The MD and RD of the right uncinate fasciculus (UF) was negatively correlated with SP and MP scores (r=-0.787,r=-0.733,r=-0.726;P<0.05). The FA of left UF was negatively correlated with orientation score (r=-0.690,P=0.04). Conclusion Patients with PSA have non-linguistic cognitive impairment. The integrity of the white matter microstructures can be extensively damaged. Impaired SP and MP in patients with PSA are related to UF damage.