Stroke is the leading cause of disability for adults. Handicap assessment is required to improve follow-up and for clinical trials. The modified Rankin scale is a "best-seller" which has contributed to prove efficacy of thrombolysis. This global score of disability is simple and patient-oriented. It seems interesting to developp such global scoring for aphasia. Our aim was to validate a simple and reproductible tool for handicap due to every type of aphasia. Aphasia Handicap Score (AHS) was developped in the Stoke Unit of Salpetriere Hospital (Paris, France). It leads to 5 grades of aphasia severity mainly based on the persistence of a communicative language. We assessed the inter-rater reproductibility in 71 acute-stroke cases. We correlated these AHS data with the "Echelle de Communication Verbale de Bordeaux" (ECVB) and verbal fluency obtained from 84 patients suffering from post-stroke chronic aphasia. In th e caute pahse of stroke, we observed a good reproductibilty (k=0.71). During the follow-up, AHS was correlated to ECVB (R=-0.89) and to verbal fluency (R=-0.67). We shown significant threshold of ECVB and fluency corresponding to the 5 grades of initial AHS. Conclusion: AHS is an patient-oriented tool to assess handicap due to aphasia. It is as simple as the Rankin scale. It has a good reproductibility for acute phase assessment and is well correlated to the chronic communcation handicap. Thus, AHS would be an interesting tool for aphasia follow-up notably in clinical trials.
