Spectrum of neuropsychiatric symptoms in chronic post-stroke aphasia

Table 1 Demographic and clinical characteristics of persons with aphasia

Patient	Sex/handedness	Age (yr)	Education (yr)	Stroke duration (mo)	Barthel index1	Lesion volume (cm3)	Aphasia type2	Antidepressants
1	F/R	50	12	80	80	113.33	Conduction	Sertraline
2	M/R	61	14	103	90	163.02	Broca	Citalopram
3	M/R	49	17	61	90	210.38	Broca	No
4	M/R	42	11	45	100	99.31	Anomic	Citalopram
5	M/R	63	8	11	85	23.16	Conduction	No
6	F/R	58	12	126	95	188.76	Anomic	No
7	M/R	60	12	45	60	44.96	Anomic	No
8	M/R	54	14	44	90	66.97	Anomic	No
9	M/R	51	13	7	80	225.69	Anomic	Amitriptyline
10	M/R	54	10	19	90	282.59	Wernicke	No
11	F/R	58	15	66	95	98.84	Broca	No
12	F/R	61	12	17	45	4.47	Anomic	Sertraline
13	M/R	32	18	10	100	34.01	Wernicke	Sertraline
14	M/R	49	8	13	80	17.45	Anomic	No
15	F/R	28	8	6	100	51.26	Anomic	No
16	F/R	65	17	13	100	26.10	Wernicke	No
17	M/R	64	17	120	100	157.58	Anomic	No
18	F/R	65	17	13	75	158.25	Broca	No
19	M/R	58	8	17	100	69.66	Wernicke	No
20	M/R	63	17	10	100	50.43	Wernicke	Fluoxetine
Median		58	12.5	18	90	84.25

¹Barthel Index measures participant´s independence in activities of daily living;

²Type of aphasia was obtained from fluency, comprehension, and repetition subtest of the Western Aphasia Battery-Revised.

F: Female; M: Male; R: Right-handed.

Table 2 Incidence and composite score of neuropsychiatric symptoms based on the domain-general neuropsychiatric inventory evaluation

NPI symptom	No. of PWA with NPS (max. 20)	Percentage of PWA with NPS (%)	Composite NPI score1
Depression	15	75	4
Irritability	14	70	2
Agitation	14	70	2
Anxiety	13	65	2.5
Appetite/eating disorders	13	65	1
Apathy	10	50	4.5
Disinhibition	9	45	1
Sleep/nighttime disturbances	8	40	1.5
Euphoria	1	5	2
Aberrant motor behavior	1	5	2
Hallucinations	1	5	1
Delusions	0	0	0

¹Neuropsychiatric inventory scores were calculated based on positive cases.

Incidence of symptom was determined by the number of persons with aphasia with frequency scores of > 0 of the respective symptom. PWA: Persons with aphasia; NPI: Neuropsychiatric Inventory; NPS: Neuropsychiatric symptoms.

Table 3 Incidence and median score of neuropsychiatric diagnoses based on domain-specific scales

Domain-specific scale (range)	No. of PWA with diagnoses	Percentage of PWA with diagnosis (%)	Median score (range)
SADQ-10, depression (0-30)	6	30	15 (14-19)
SADQ-10, subthreshold depression (0-30)	9	45	14 (13-19)
SAS, apathy (0-42)	9	45	12 (1-35)
HADS, anxiety (0-21)	6	30	5 (0-12)
HADS, depression (0-21)	3	15	5.5 (1-14)

PWA: Persons with aphasia; SADQ-10: Stroke Aphasic Depression Questionnaire-version 10; SAS: Starkstein Apathy Scale; HADS: Hospital Anxiety and Depression Scale.

Table 4 Correlations between neuropsychiatric inventory-subdomains and domain-specific scales

Domain-specific scale	NPI-subdomains	Spearman correlation (rs)
SADQ-10	NPI-depression	0.67, P < 0.001a
	NPI-anxiety	0.60, P < 0.005a
	NPI-apathy	0.43, P = 0.540
	NPI-agitation	0.60, P < 0.005a
	NPI-irritability	0.63, P < 0.003a
HADS	NPI-depression	0.38, P = 0.820
	NPI-anxiety	0.27, P = 0.240
	NPI-apathy	0.27, P = 0.243
	NPI-agitation	0.14, P = 0.540
	NPI-irritability	0.11, P = 0.620
SAS	NPI-depression	0.50, P < 0.023b
	NPI-anxiety	0.30, P = 0.192
	NPI-apathy	0.58, P < 0.006a
	NPI-agitation	0.18, P = 0.440
	NPI-irritability	0.09, P = 0.700

^aP < 0.01;

^bP < 0.05.

NPI: Neuropsychiatric Inventory; SADQ-10: Stroke Aphasic Depression Questionnaire-version 10; SAS: Starkstein Apathy Scale; HADS: Hospital Anxiety and Depression Scale.