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• W2912851924 abstract "Event Abstract Back to Event Influence of Antidepressants on Aphasia Recovery Amy Wright1, Sadhvi Saxena1, Donna C. Tippett1, Bonnie L. Breining1, Rajani Sebastian1 and Argye E. Hillis1* 1 Johns Hopkins University School of Medicine, Neurology, United States Problem: Most studies of aphasia recovery after stroke have evaluated people at different times post-stroke and identified variables associated with recovery. There have been some longitudinal studies of recovery, but none have evaluated the influence of antidepressants. Clinical trials showed that use of selective serotonin reuptake inhibitors (SSRIs) in the first 90 days after stroke was associated with better motor recovery compared to placebo (Chollet et al., 2011) and more improvement on cognitive tests (Jorge, Acion, Moser, Adams, & Robinson, 2010). We tested the hypothesis that SSRI use is associated with better improvement on language tests. Methods: We studied 24 patients from the first 48 hours after stroke through 6 months on picture descriptions and the Boston Naming Test (BNT; Kaplan, Goodglass, Weintraub, Segal, & van Loon-Vervoorn, 2001). Picture descriptions were quantitatively analyzed for the number of Content Units (CU; concepts mentioned by healthy controls in describing the same picture (Agis et al., 2016; Yorkston & Beukelman, 1980). All aphasic patients received language therapy; we did not evaluate the effects of language rehabilitation. We evaluated other variables associated with improvement, after controlling for initial severity. We evaluated the influence of antidepressants during the first 6 months after stroke on improvement (measured by change in CU and BNT score, divided by initial performance on each measure). Depression was measured with the Patient Health Questionnaire-9 (PHQ-9; Löwe, Kroenke, Herzog, & Gräfe, 2004). We evaluated associations between dichotomously defined improvement and use of antidepressants and demographics using chi squared tests and logistic regression. We compared groups using t-tests. Results The lowest quartile of change on language tests were negative values (decline); the next lowest was little or no change. Good improvement was defined as the upper 50th percentile. SSRI use was associated with both good improvement in BNT score (chi squared = 5.1; p=0.02) and good improvement in total correct CU (chi squared = 6.9; p=0.009). In contrast, bupropion use was associated with lack of improvement on both BNT (chi squared p=0.024) and CU (chi squared = 5.9; p=0.016.) There were too few participants who used other anti-depressants (e.g. MAO inhibitors) to evaluate associations with outcomes. SSRI users showed a greater mean improvement in BNT score than non-users (10.7 versus -0.5; p=0.016) and a trend toward greater mean improvement in CU (7.2 versus 3; p=0.086). SSRI users were non-significantly more depressed than non-users (mean PHQ-9 of 6.7 vs. 4.1; p=0.44); but bupropion users were significantly more depressed than non-users (mean PHQ-9 of 15 vs. 3.4; p=0.0091). Together, SSRI use, age, and education were associated with improvement in BNT (Pseudo r2=0.47; p=0.019), but only SSRI use was associated with good improvement (p=0.030) independently of the other variables. Conclusions Use of SSRIs early after stroke was associated with greater improvement in naming and content of picture descriptions, independently of age and education. Lower depression could not explain the positive effects of SSRIs. However, the observed association between bupropion and poorer recovery might be explained by the more severe depression in bupropion users (or the fact that these participants were not taking SSRIs). These results provide support for clinical trials of SSRI use in early aphasia recovery. Acknowledgements This research was supported by R01 DC05375. References Agis, D., Goggins, M. B., Oishi, K., Oishi, K., Davis, C., Wright, A., . . . Hillis, A. E. (2016). Picturing the size and site of stroke with an expanded national institutes of health stroke scale. Stroke; a Journal of Cerebral Circulation, 47(6), 1459-1465. doi:10.1161/STROKEAHA.115.012324 [doi] Chollet, F., Tardy, J., Albucher, J., Thalamas, C., Berard, E., Lamy, C., . . . Niclot, P. (2011). Fluoxetine for motor recovery after acute ischaemic stroke (FLAME): A randomised placebo-controlled trial. The Lancet Neurology, 10(2), 123-130. Jorge, R. E., Acion, L., Moser, D., Adams, H. P., & Robinson, R. G. (2010). Escitalopram and enhancement of cognitive recovery following stroke. Archives of General Psychiatry, 67(2), 187-196. Kaplan, E., Goodglass, H., Weintraub, S., Segal, O., & van Loon-Vervoorn, A. (2001). Boston naming test Pro-ed. Löwe, B., Kroenke, K., Herzog, W., & Gräfe, K. (2004). Measuring depression outcome with a brief self-report instrument: Sensitivity to change of the patient health questionnaire (PHQ-9). Journal of Affective Disorders, 81(1), 61-66. Yorkston, K. M., & Beukelman, D. R. (1980). An analysis of connected speech samples of aphasic and normal speakers. Journal of Speech and Hearing Disorders, 45(1), 27-36. Keywords: Seratonin, Antidepressants, Depression, Aphasia, Recovery of Function Conference: Academy of Aphasia 55th Annual Meeting , Baltimore, United States, 5 Nov - 7 Nov, 2017. Presentation Type: poster or oral Topic: Aphasia Citation: Wright A, Saxena S, Tippett DC, Breining BL, Sebastian R and Hillis AE (2019). Influence of Antidepressants on Aphasia Recovery. Conference Abstract: Academy of Aphasia 55th Annual Meeting . doi: 10.3389/conf.fnhum.2017.223.00118 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 18 Apr 2017; Published Online: 25 Jan 2019. * Correspondence: Dr. Argye E Hillis, Johns Hopkins University School of Medicine, Neurology, Baltimore, MD, 21287, United States, argye@jhmi.edu Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Amy Wright Sadhvi Saxena Donna C Tippett Bonnie L Breining Rajani Sebastian Argye E Hillis Google Amy Wright Sadhvi Saxena Donna C Tippett Bonnie L Breining Rajani Sebastian Argye E Hillis Google Scholar Amy Wright Sadhvi Saxena Donna C Tippett Bonnie L Breining Rajani Sebastian Argye E Hillis PubMed Amy Wright Sadhvi Saxena Donna C Tippett Bonnie L Breining Rajani Sebastian Argye E Hillis Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page." @default.
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