Navigating the Complexity of Bilingual Aphasia: Current Insights and Future Directions

Abstract

Bilingual aphasia is shaped by a dynamic interplay of neural, cognitive, linguistic, and experiential factors that influence both impairment and recovery. This review synthesizes current evidence on bilingual language organization, assessment, and treatment, emphasizing how individual language histories and cognitive systems contribute to variability in outcomes. We highlight the challenges of estimating pre-stroke proficiency, evaluating impairment across languages, and interpreting recovery patterns. Finally, we explore emerging technological directions while emphasizing that advances in machine learning, automated assessment, and neurotechnology must be developed with explicit attention to cultural responsiveness and equity to ensure benefits reach diverse multilingual populations.