A variety of language disturbances including aphasia have been described after subcortical stroke but less is known about the factors that influence the long-term recovery of stroke-induced language dysfunction. We prospectively examined the role of the affected hemisphere and the lesion site in the occurrence and recovery of language deficits in nonthalamic subcortical stroke. Forty patients with unilateral basal ganglia stroke underwent language assessment within 1 week, 3 months and 1 year after stroke. Disturbances in at least one language domain were observed in 35 patients during the first week post stroke including aphasia diagnosed in 11 patients. Importantly, the appearance of deficits after stroke onset and the improvement of language function were not determined by the site of subcortical lesion, but instead were critically influenced by the affected hemisphere. In fact, the language impairments following left and right basal ganglia stroke mirrored the language dysfunction observed after cortical lesions in the same hemisphere. A significant overall language improvement was observed at 3 months after stroke, although residual deficits in language executive function were the most commonly observed impairment at 1 year follow-up. Although a substantial improvement of language function can be expected after nonthalamic subcortical stroke, our findings suggest that language recovery may not be fully achieved at 1 year post stroke. © 2014 Elsevier Ltd.
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