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Mechanisms of Verbal Fluency Impairment in Stroke: Insights From "Strategic Indices" Derived From a Study of 337 Patients.

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Title: Mechanisms of Verbal Fluency Impairment in Stroke: Insights From "Strategic Indices" Derived From a Study of 337 Patients.
Authors: Dorchies, Flore (AUTHOR), Aarabi, Ardalan (AUTHOR), Kassir, Rania (AUTHOR), Wannepain, Sandrine (AUTHOR), Leclercq, Claire (AUTHOR), Godefroy, Olivier (AUTHOR), Roussel, Martine (AUTHOR), Barbay, Mélanie (AUTHOR), Canaple, Sandrine (AUTHOR), Lamy, Chantal (AUTHOR), Courselle‐Arnoux, Audrey (AUTHOR), Despretz‐Wannepain, Sandrine (AUTHOR), Despretz, Pascal (AUTHOR), Berrissoul, Hassan (AUTHOR), Picard, Carl (AUTHOR), Diouf, Momar (AUTHOR), Loas, Gwénolé (AUTHOR), Deramond, Hervé (AUTHOR), Taillia, Hervé (AUTHOR), Ardisson, Anne‐Emmanuelle (AUTHOR)
Source: European Journal of Neuroscience. Mar2025, Vol. 61 Issue 5, p1-15. 15p.
Subjects: Stroke, Language disorders, Brain imaging, Decision making, Verbal behavior testing, Rehabilitation, Brain anatomy
Abstract: Verbal fluency provides a unique index of the functional architecture of control functions because it reflects the interactions between executive processes and lower‐level language processes. However, an evaluation of the number of correct words alone does not enable one to determine precisely which processes are impaired. This study investigates post‐stroke fluency impairments, focusing on previously unexplored indices and their neuroanatomical correlates using voxel‐based lesion symptom mapping (VLSM). In total, 337 patients and 851 controls performed letter and semantic fluency tests. Analyses included overall performance (correct responses) and strategic indices (errors, time course, frequency, switches, and cluster size). Stroke patients produced fewer correct responses, more rule‐breaking errors, fewer words after 15″, fewer infrequent words, fewer switches, and smaller clusters in letter fluency. Switching was strongly associated with letter fluency, while clustering was more related to semantic fluency. VLSM identified left‐hemisphere structures, particularly frontal tracts (e.g., anterior thalamic and frontostriatal tracts), associated with switching, and a smaller set of left‐hemisphere structures linked to clustering. Conceptually, the findings suggest stroke‐related fluency disorders primarily arise from impairments in executive strategic search, as indicated by switching impairments, with weaker impairment on lexicosemantic abilities. The rarity of rule‐breaking and perseverative errors indicates that inhibition and working memory deficits do not significantly contribute to poor fluency. The patients' production of infrequent words and fluency worsened over time, although the precise contributions of the three core processes to these additional changes require further investigation. Our results highlight the importance of detailed fluency evaluations in stroke patients for optimized rehabilitation. [ABSTRACT FROM AUTHOR]
Copyright of European Journal of Neuroscience is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Mechanisms of Verbal Fluency Impairment in Stroke: Insights From "Strategic Indices" Derived From a Study of 337 Patients.
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  Data: <searchLink fieldCode="AR" term="%22Dorchies%2C+Flore%22">Dorchies, Flore</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Aarabi%2C+Ardalan%22">Aarabi, Ardalan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kassir%2C+Rania%22">Kassir, Rania</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wannepain%2C+Sandrine%22">Wannepain, Sandrine</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Leclercq%2C+Claire%22">Leclercq, Claire</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Godefroy%2C+Olivier%22">Godefroy, Olivier</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Roussel%2C+Martine%22">Roussel, Martine</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Barbay%2C+Mélanie%22">Barbay, Mélanie</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Canaple%2C+Sandrine%22">Canaple, Sandrine</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lamy%2C+Chantal%22">Lamy, Chantal</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Courselle‐Arnoux%2C+Audrey%22">Courselle‐Arnoux, Audrey</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Despretz‐Wannepain%2C+Sandrine%22">Despretz‐Wannepain, Sandrine</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Despretz%2C+Pascal%22">Despretz, Pascal</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Berrissoul%2C+Hassan%22">Berrissoul, Hassan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Picard%2C+Carl%22">Picard, Carl</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Diouf%2C+Momar%22">Diouf, Momar</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Loas%2C+Gwénolé%22">Loas, Gwénolé</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Deramond%2C+Hervé%22">Deramond, Hervé</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Taillia%2C+Hervé%22">Taillia, Hervé</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ardisson%2C+Anne‐Emmanuelle%22">Ardisson, Anne‐Emmanuelle</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Neuroscience%22">European Journal of Neuroscience</searchLink>. Mar2025, Vol. 61 Issue 5, p1-15. 15p.
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  Data: <searchLink fieldCode="DE" term="%22Stroke%22">Stroke</searchLink><br /><searchLink fieldCode="DE" term="%22Language+disorders%22">Language disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Brain+imaging%22">Brain imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Decision+making%22">Decision making</searchLink><br /><searchLink fieldCode="DE" term="%22Verbal+behavior+testing%22">Verbal behavior testing</searchLink><br /><searchLink fieldCode="DE" term="%22Rehabilitation%22">Rehabilitation</searchLink><br /><searchLink fieldCode="DE" term="%22Brain+anatomy%22">Brain anatomy</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Verbal fluency provides a unique index of the functional architecture of control functions because it reflects the interactions between executive processes and lower‐level language processes. However, an evaluation of the number of correct words alone does not enable one to determine precisely which processes are impaired. This study investigates post‐stroke fluency impairments, focusing on previously unexplored indices and their neuroanatomical correlates using voxel‐based lesion symptom mapping (VLSM). In total, 337 patients and 851 controls performed letter and semantic fluency tests. Analyses included overall performance (correct responses) and strategic indices (errors, time course, frequency, switches, and cluster size). Stroke patients produced fewer correct responses, more rule‐breaking errors, fewer words after 15″, fewer infrequent words, fewer switches, and smaller clusters in letter fluency. Switching was strongly associated with letter fluency, while clustering was more related to semantic fluency. VLSM identified left‐hemisphere structures, particularly frontal tracts (e.g., anterior thalamic and frontostriatal tracts), associated with switching, and a smaller set of left‐hemisphere structures linked to clustering. Conceptually, the findings suggest stroke‐related fluency disorders primarily arise from impairments in executive strategic search, as indicated by switching impairments, with weaker impairment on lexicosemantic abilities. The rarity of rule‐breaking and perseverative errors indicates that inhibition and working memory deficits do not significantly contribute to poor fluency. The patients' production of infrequent words and fluency worsened over time, although the precise contributions of the three core processes to these additional changes require further investigation. Our results highlight the importance of detailed fluency evaluations in stroke patients for optimized rehabilitation. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of European Journal of Neuroscience is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=183688356
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        Value: 10.1111/ejn.70022
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        Text: English
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      – SubjectFull: Stroke
        Type: general
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              Text: Mar2025
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