Communication through language is central to the human experience. The essential role of linguistic interaction in daily function drives interpersonal connections key to health-related quality of life. Interest in the study of language and its rehabilitation, is fueled by the considerable impact of aphasia on both public and personal health and by societal costs. Recent estimates are that there are more than 795,000 strokes per year in the US [1] the major source of aphasia incidence. Between 1997 and 2006, the number of individuals with aphasia grew by approximately 100,000 per year [2]. Aphasia is present in 21–38% of acute strokes and associates with higher mortality, morbidity and healthcare resources consumed [3]. Costs for stroke-related healthcare exceeded $25 billion in 2007 [1]. On an individual level, reintegration into school, work and family life may be unattainable given human dependence on the spoken word. Social isolation is a devastating and all too common consequence of aphasia [4]. Norman Geschwind wrote that “every behavior has an anatomy” [3,5]. Language is no exception. Though complex in its underpinnings, the study of the structural and physiological basis of aphasia has been a major focus of neurological investigation since the mid-nineteenth century. However, we are now witnessing a revolution in the understanding of language and its disorders. Recent advances in neuroimaging contribute to a combined understanding of the structural and functional correlates of language. In fact, in the morphometry and the dynamic functioning measured with neuroimaging have emerged highly refined models of the neurobiological organization of language. Extensive research has focused on the functional neuroanatomy of language, with current models modifying the neurological model of language and promoting a dorsal-ventral stream framework [e.g., (Association ash. aphasia treatment; [6-8]. Similarly, advances in the study of treatment of aphasia have resulted in adaptation of evidence based and person-centered approaches to rehabilitation e.g., (www.calculator.net) as well as methods of delivering cortical brain stimulation to modulate cortical excitability, such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) [9].

The purpose of this research is to determine the frequency of aphasia in stroke patients. A cross sectional survey design was selected for this purpose. Simple random sampling was done. The stroke patients were selected from the neurology department of Medicine, Govt. Medical College, Amritsar during 2018 to 2019. Estimated stroke population is close to 250 per 100,000 populations. Based on stroke population in Pakistan, with 95% confidence level and 5% confidence interval Sample size of 162 stroke patients was taken [8]. They were selected on the basis of inclusion criteria. An inclusion criterion of the study was equal male and female gender of age ranges between 25-70 years having acute stroke.

A questionnaire developed from literature review and expert’s opinion was used from Assessment in speech language pathology a resource manual (www.calculator.net). It includes medical history and aphasia symptoms. On the basis of data collected analysis was done with SPSS 16 to determine the frequency of aphasia in stroke patients.

This observational study was based on 6 months’ time period and 162 patients of stroke were studied. A questionnaire was used for each patient, which was filled out based on history and clinical observation.

The percentage and frequency of aphasia in 162 patients of stroke is 88 (54.3%) had aphasia and 74 (45.7%) had no aphasia (Table 1).

Table 1: Frequency Distribution of Aphasia in Stroke Patients (n=30)

Table 2 shows the cross tabulation between age and diagnosis. The 22 (40.7%) aphasia patients had age ranges between 25-40 years, 26 (48.1%) patients had age ranges between 40-55 years and 40 (74.0%) patients had age ranges between 55-70 years.

The 162 stroke patients are included in study from OPD of GMC, Amritsar. Most female stroke patients are aphasic. Most common symptoms of aphasia are anomia, impaired repetition, grammaticism, writing problems and disfluency. Mostly people were having problem in naming. A research was conducted by Brust in 2001, on aphasia in acute stroke and its relation to outcome. The degree and type of aphasia are also assessed. Results showed that about one third stroke patients had aphasia [9]. A research by Brust correlate with the results of this study which showed that 54.3% stroke patients had aphasia.

Table 2: cross tabulation between age and diagnosis

Another study conducted on relationship between the presence of aphasia and the severity of the stroke also supported the results of this study. The relationship between aphasia and severity of the stroke is assessed by other measures such as loss of functional independence. Findings indicated as aphasia occurred in about one quarter of conscious patients soon after stroke [10]. A prospective study is conducted on incidence of aphasia in acute stroke and its recovery. Assessment of aphasia was done at the time of admission, weekly and after 6 months. Results showed that Fifty four percent had aphasia at the time of admission and 38% had aphasia at the time of discharge [11]. The prospective study also supported the results of this study which showed that 54.3% stroke patients had aphasia. A prospective study conducted by Kenneth in 2002 on relationship between stroke and aphasia. The most common symptom of aphasia seen after stroke is anomia. The second most common symptom is impaired repetition [12,13]. This prospective study supports the results of this study which showed that most common symptom of aphasia is anomia [14].

It was concluded from the study that aphasia was present in half of the sample population. Aphasia is more in female than male. It is more common in age group of 55-70 years.

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6. Inatomi, Y. et al. "Aphasia during the acute phase in ischemic stroke." Cerebrovascular Diseases, vol. 25, no. 4, 2008, pp. 316–323.

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8. Kertesz, A. Aphasia and Associated Disorders: Taxonomy, Localization and Recovery. Holt Rinehart & Winston, 1979.

9. Pedersen, P.M. et al. "Aphasia in acute stroke: incidence, determinants and recovery." Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society, vol. 38, no. 4, 1995, pp. 659–666.

10. Pedersen, P.M. et al. "Aphasia after stroke: Type, severity and prognosis." Cerebrovascular Diseases, vol. 17, no. 1, 2004, pp. 35–43.

11. Stephen, E. and L.J.R. Nadeau. Aphasia and Language: Theory to Practice. Guilford, 2000.

12. Wade, D.T. et al. "Aphasia after stroke: Natural history and associated deficits." Journal of Neurology, Neurosurgery & Psychiatry, vol. 49, no. 1, 1986, pp. 11–16.

13. Weisenburg, T.H. and K.E. McBride. Aphasia, a Clinical and Psychological Study. Hafner Pub. Co., 1964.

14. "Sample size calculator." Calculator.net. http://www.calculator.net/sample-size-calculator.html.