The Relationship Between Set-Shifting Deficits and Language Difficulties in Persian-Speaking Post-Stroke Patients with Aphasia

Background: Post-stroke persons with aphasia (PWA) may suffer from deficits in executive function (EF). Cognitive flexibility, as an important element of EF, may be affected by PWA. As a task of cognitive flexibility, set-shifting can be measured by the Wisconsin Card Sorting Test (WCST). Assessing these EF basics may have important implications for cognitive-communicative rehabilitation of PWA. Objectives: The aim of the current study was to examine set-shifting skills and their correlation with language components of Persian-speaking PWA. Methods: Nineteen Persian-speaking, non-fluent PWA (13 males and six females; mean age was 54.26 ± 8.88 years, and age range was 32 to 69 years old) participated in this study. The bedside version of the Persian Western Aphasia Battery (P-WAB-1) and the WCST were performed to assess language and set-shifting abilities, respectively. The Spearman’s rank correlation coefficient test was used to examine the correlation between the variables. Statistical analyses were performed using the SPSS 18.0 software. Results: The results showed that the P-WAB-1 score was inversely correlated with perseverative errors index of WCST (r = -0.48, P < 0.05). Also, there was a significant correlation between the “fluency of spontaneous speech” subtest of P-WAB-1 and WCST indices, including number of categories completed (r = 0.54, P < 0.05), total number of correct responses (r = 0.61, P < 0.05), total number of errors (r = -0.60, P < 0.05), and non-perseverative errors (r = - 0.44, P < 0.05). Conclusions: Based on these results, it appears that decreased cognitive flexibility of PWA may coincide with decreased language ability. This study broadens current understanding of the complex relationship between language and EF by measuring set-shifting in a sample of non-fluent PWA. These results may be beneficial to cognitive-communicative rehabilitation programs for PWA.