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Accuracy of NIH Stroke Scale for diagnosing aphasia
Angelina Grönberg1,2, Ingrid Henriksson3, Arne Lindgren1,2
1Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden.
Acta Neurologica Scandinavica
|December 28, 2020
Summary
The National Institutes of Health Stroke Scale (NIHSS) can detect severe aphasia in stroke patients but may miss mild cases. Its 72% sensitivity means it should not solely guide stroke treatment decisions.
Area of Science:
- Neurology
- Speech-Language Pathology
Background:
- The National Institutes of Health Stroke Scale (NIHSS) is widely used for stroke assessment.
- Its utility in diagnosing aphasia in stroke patients requires validation.
Purpose of the Study:
- To evaluate the diagnostic accuracy of the NIHSS for detecting aphasia in patients with acute ischemic stroke.
- To compare NIHSS item 9 with a comprehensive language screening test (LAST).
Main Methods:
- Prospective study of 221 patients with acute ischemic stroke.
- NIHSS item 9 and LAST were administered by trained professionals.
- LAST served as the reference standard for aphasia diagnosis.
Main Results:
- Aphasia prevalence was 23% by NIHSS and 26% by LAST.
- NIHSS demonstrated a sensitivity of 72% and specificity of 95% for detecting aphasia.
- 16 false negatives and 8 false positives were identified using NIHSS.
Conclusions:
- NIHSS can identify severe aphasia in acute ischemic stroke patients.
- Mild aphasia cases may be misclassified by NIHSS.
- Absence of aphasia on NIHSS should not preclude further language assessment or influence treatment decisions.
