QuALiCoMe Questionnaire: the Possible Role of Cognitive and Linguistic Reserve in the Recovery from Post-Stroke Aphasia

Introduction: By extending the concept of Cognitive Reserve (CR) to the domains of linguistic, communicative and metalinguistic competence, we suppose that the wide variability of recovery among post-stroke aphasic patients with similar initial clinical and demographic characteristics, as well as comparable therapeutic intervention, may be at least partly due to a sort of linguistic subset of CR, namely a “Linguistic Reserve”, which may influence a patient's brain plasticity and neural language networks implied in recovery processes.To investigate this hypothesis we developed an informant-based instrument, named QuALiCoMe (Questionario su Attitudine Linguistica, Comunicativa e Metalinguistica), aimed at providing an estimate of premorbid linguistic abilities in patients with post-stroke aphasia. Methods and Results: The QuALiCoMe was drafted in the framework of a wider research aimed at studying language recovery of post-stroke aphasic patients, assessed since acute phase of stroke. The initial pool of items was submitted to classical test theory and factorial analysis. The resulting questionnaire addresses educational attainment, major lifetime occupation, reading abilities and habits, writing abilities and use of widely available technology. It has been tested on a sample of healthy subjects in terms of applicability, internal consistency, reliability, external validity and informativeness. It has also been used in a pilot study on post-stroke aphasic patients to evaluate its applicability and possible prognostic implications. Conclusions: We report the final version of the questionnaire after a preliminary validity evaluation and application on post-stroke patients. It shows good properties and appears a promising tool to estimate premorbid linguistic reserve in post-stroke aphasic subjects. Disclosure: The present research is performed under a grant from the Ente Cassa di Risparmio di Firenze, a no-profit banking foundation pursuing social goals.