Examining the relationship between theory of mind deficits, aphasia severity, and brain health in individuals with post-stroke aphasia
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Abstract
Theory of Mind (ToM) deficits are well-documented in right-hemisphere stroke but understudied in post-stroke aphasia. This study examined ToM impairments in 44 people with aphasia (PWA) using nonverbal belief reasoning tasks and explored links to aphasia severity and brain health. Participants completed two tasks assessing spontaneous inference of another’s perspective, and self-perspective inhibition through short video clips, requiring them to locate a green object. Linear regression models examined the relationship between ToM performance, aphasia severity, as measured by the Western Aphasia Battery-Revised Aphasia Quotient (WAB-R AQ), and brain health, measured by cerebral small vessel disease (CSVD) markers from MRI scans. Using validated visual rating scales, established CSVD markers were evaluated, including white matter hyperintensities, cerebral microbleeds, enlarged perivascular spaces in the basal ganglia and centrum semiovale, and lacunes. Results indicated that ToM deficits were found in 22–36% of participants and these deficits were unrelated to aphasia severity. However, increased enlarged perivascular spaces in the basal ganglia (EPVS-BG) correlated with poorer ToM performance. These findings suggest ToM deficits in PWA may result from broader cerebrovascular pathology rather than language impairment alone. Recognizing these deficits early could improve rehabilitation outcomes and aid clinicians in identifying at-risk individuals, emphasizing the need for a multifactorial approach to aphasia treatment.
Description
2025