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Lu Y, Mao L, Wang P, Wang C, Hartwigsen G, Zhang Y. Aberrant neural oscillations in poststroke aphasia. Psychophysiology 2024; 61:e14655. [PMID: 39031971 DOI: 10.1111/psyp.14655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 06/21/2024] [Accepted: 07/08/2024] [Indexed: 07/22/2024]
Abstract
Neural oscillations are electrophysiological indicators of synchronous neuronal activity in the brain. Recent work suggests aberrant patterns of neuronal activity in patients with poststroke aphasia. Yet, there is a lack of systematic explorations of neural oscillations in poststroke aphasia. Investigating changes in the dynamics of neuronal activity after stroke may be helpful to identify neural markers of aphasia and language recovery and increase the current understanding of successful language rehabilitation. This review summarizes research on neural oscillations in poststroke aphasia and evaluates their potential as biomarkers for specific linguistic processes. We searched the literature through PubMed, Web of Science, and EBSCO, and selected 31 studies that met the inclusion criteria. Our analyses focused on neural oscillation activity in each frequency band, brain connectivity, and therapy-induced changes during language recovery. Our review highlights potential neurophysiological markers; however, the literature remains confounded, casting doubt on the reliability of these findings. Future research must address these confounds to confirm the robustness of cross-study findings on neural oscillations in poststroke aphasia.
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Affiliation(s)
- Yeyun Lu
- Centre for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Lin Mao
- Department of Physical Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Rehabilitation, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Peng Wang
- Centre for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
- Institute of Psychology, University of Greifswald, Greifswald, Germany
- Institute of Psychology, University of Regensberg, Regensberg, Germany
| | - Cuicui Wang
- Centre for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
- TMS Center, Deqing Hospital of Hangzhou Normal University, Huzhou, Zhejiang, China
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Gesa Hartwigsen
- Wilhelm Wundt Institute for Psychology, Leipzig University, Leipzig, Germany
- Lise Meitner Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Ye Zhang
- Centre for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
- TMS Center, Deqing Hospital of Hangzhou Normal University, Huzhou, Zhejiang, China
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2
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Billot A, Kiran S. Disentangling neuroplasticity mechanisms in post-stroke language recovery. BRAIN AND LANGUAGE 2024; 251:105381. [PMID: 38401381 PMCID: PMC10981555 DOI: 10.1016/j.bandl.2024.105381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/28/2023] [Accepted: 01/12/2024] [Indexed: 02/26/2024]
Abstract
A major objective in post-stroke aphasia research is to gain a deeper understanding of neuroplastic mechanisms that drive language recovery, with the ultimate goal of enhancing treatment outcomes. Subsequent to recent advances in neuroimaging techniques, we now have the ability to examine more closely how neural activity patterns change after a stroke. However, the way these neural activity changes relate to language impairments and language recovery is still debated. The aim of this review is to provide a theoretical framework to better investigate and interpret neuroplasticity mechanisms underlying language recovery in post-stroke aphasia. We detail two sets of neuroplasticity mechanisms observed at the synaptic level that may explain functional neuroimaging findings in post-stroke aphasia recovery at the network level: feedback-based homeostatic plasticity and associative Hebbian plasticity. In conjunction with these plasticity mechanisms, higher-order cognitive control processes dynamically modulate neural activity in other regions to meet communication demands, despite reduced neural resources. This work provides a network-level neurobiological framework for understanding neural changes observed in post-stroke aphasia and can be used to define guidelines for personalized treatment development.
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Affiliation(s)
- Anne Billot
- Center for Brain Recovery, Boston University, Boston, USA; Department of Psychology, Center for Brain Science, Harvard University, Cambridge, Massachusetts, USA; Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Swathi Kiran
- Center for Brain Recovery, Boston University, Boston, USA.
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3
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Santi GC, Conca F, Esposito V, Polito C, Caminiti SP, Boccalini C, Morinelli C, Berti V, Mazzeo S, Bessi V, Marcone A, Iannaccone S, Kim SK, Sorbi S, Perani D, Cappa SF, Catricalà E. Heterogeneity and overlap in the continuum of linguistic profile of logopenic and semantic variants of primary progressive aphasia: a Profile Analysis based on Multidimensional Scaling study. Alzheimers Res Ther 2024; 16:49. [PMID: 38448894 PMCID: PMC10918940 DOI: 10.1186/s13195-024-01403-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/29/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Primary progressive aphasia (PPA) diagnostic criteria underestimate the complex presentation of semantic (sv) and logopenic (lv) variants, in which symptoms partially overlap, and mixed clinical presentation (mixed-PPA) and heterogenous profile (lvPPA +) are frequent. Conceptualization of similarities and differences of these clinical conditions is still scarce. METHODS Lexical, semantic, phonological, and working memory errors from nine language tasks of sixty-seven PPA were analyzed using Profile Analysis based on Multidimensional Scaling, which allowed us to create a distributed representation of patients' linguistic performance in a shared space. Patients had been studied with [18F] FDG-PET. Correlations were performed between metabolic and behavioral data. RESULTS Patients' profiles were distributed across a continuum. All PPA, but two, presented a lexical retrieval impairment, in terms of reduced production of verbs and nouns. svPPA patients occupied a fairly clumped space along the continuum, showing a preponderant semantic deficit, which correlated to fusiform gyrus hypometabolism, while only few presented working memory deficits. Adjacently, lvPPA + presented a semantic impairment combined with phonological deficits, which correlated with metabolism in the anterior fusiform gyrus and posterior middle temporal gyrus. Starting from the shared phonological deficit side, a large portion of the space was occupied by all lvPPA, showing a combination of phonological, lexical, and working memory deficits, with the latter correlating with posterior temporo-parietal hypometabolism. Mixed PPA did not show unique profile, distributing across the space. DISCUSSION Different clinical PPA entities exist but overlaps are frequent. Identifying shared and unique clinical markers is critical for research and clinical practice. Further research is needed to identify the role of genetic and pathological factors in such distribution, including also higher sample size of less represented groups.
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Affiliation(s)
- Gaia Chiara Santi
- IUSS Cognitive Neuroscience (ICoN) Center, Scuola Universitaria Superiore IUSS, Pavia, Italy
| | | | | | | | | | | | - Carmen Morinelli
- Research and Innovation Centre for Dementia-CRIDEM, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Valentina Berti
- Department of Biomedical Experimental and Clinical Sciences, University of Florence, Florence, Italy
| | - Salvatore Mazzeo
- Research and Innovation Centre for Dementia-CRIDEM, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Valentina Bessi
- Research and Innovation Centre for Dementia-CRIDEM, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Alessandra Marcone
- Department of Rehabilitation and Functional Recovery, San Raffaele Hospital, Milan, Italy
| | - Sandro Iannaccone
- Department of Rehabilitation and Functional Recovery, San Raffaele Hospital, Milan, Italy
| | - Se-Kang Kim
- Department of Paediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Sandro Sorbi
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
- Research and Innovation Centre for Dementia-CRIDEM, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Daniela Perani
- Vita-Salute San Raffaele University, Milan, Italy
- Nuclear Medicine Unit, San Raffaele Hospital, Milan, Italy
| | - Stefano F Cappa
- IUSS Cognitive Neuroscience (ICoN) Center, Scuola Universitaria Superiore IUSS, Pavia, Italy.
- IRCCS Mondino Foundation, Pavia, Italy, Pavia, Italy.
| | - Eleonora Catricalà
- IUSS Cognitive Neuroscience (ICoN) Center, Scuola Universitaria Superiore IUSS, Pavia, Italy
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Lin X, Li Q, Sun X, Shi Q, Dan W, Zhan Y, Deng B, Xia Y, Xie Y, Jiang L. Effects of apolipoprotein E polymorphism on cerebral oxygen saturation, cerebral perfusion, and early prognosis after traumatic brain injury. Ann Clin Transl Neurol 2023; 10:1002-1011. [PMID: 37186447 PMCID: PMC10270252 DOI: 10.1002/acn3.51783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/13/2023] [Accepted: 04/14/2023] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVE To investigate the effects of the apolipoprotein E (APOE) gene on oxygen saturation and cerebral perfusion in the early stages of traumatic brain injury (TBI). METHODS This study included 136 consecutive TBI patients and 51 healthy individuals. The APOE genotypes of all subjects were determined using quantitative fluorescence polymerase chain reaction (QF-PCR). Regional cerebral oxygen saturation (rScO2) of patients with TBI and normal subjects was monitored using near-infrared spectroscopy (NIRS). Computed tomography (CT) perfusion was used to obtain cerebral perfusion in patients with TBI and normal subjects. RESULTS In the TBI group, the rScO2 of APOEε4 carriers (53.06 ± 6.87%) was significantly lower than that of non-carriers (58.19 ± 5.83%, p < 0.05). Meanwhile, the MTT of APOEε4 carriers (6.75 ± 1.30 s) was significantly longer than that of non-carriers (5.87 ± 1.00 s, p < 0.05). Furthermore, correlation analysis showed a negative correlation between rSCO2 and MTT in patients with TBI. Both the univariate and multifactorial logistic regression analyses revealed that APOE ε4, hypoxia, MTT >5.75 s, Marshall CT Class, and GCS were independent risk factors for early poor prognosis in patients with TBI. CONCLUSION Both cerebral perfusion and cerebral oxygen were significantly impaired after TBI, and low cerebral perfusion and hypoxia were related to poor prognosis of patients with TBI. Compared with APOE ε4 non-carriers, APOE ε4 carriers not only had poorer cerebral perfusion and cerebral oxygen metabolism but also worse prognosis in the early stages of TBI. Furthermore, a negative correlation was observed between the rSCO2 and MTT levels. In addition, both CT perfusion scanning (CTP) and NIRS are reliable for monitoring the condition of patients with TBI in the neurological intensive care unit (NICU).
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Affiliation(s)
- Xun Lin
- Department of Neurosurgerythe First Affiliated Hospital of Chongqing Medical UniversityChongqingPR China
| | - Qilin Li
- Department of NeurosurgeryYouyang HospitalChongqingPR China
| | - Xiaochuan Sun
- Department of Neurosurgerythe First Affiliated Hospital of Chongqing Medical UniversityChongqingPR China
| | - Quanhong Shi
- Department of Neurosurgerythe First Affiliated Hospital of Chongqing Medical UniversityChongqingPR China
| | - Wei Dan
- Department of Neurosurgerythe First Affiliated Hospital of Chongqing Medical UniversityChongqingPR China
| | - Yan Zhan
- Department of Neurosurgerythe First Affiliated Hospital of Chongqing Medical UniversityChongqingPR China
| | - Bo Deng
- Department of Neurosurgerythe First Affiliated Hospital of Chongqing Medical UniversityChongqingPR China
| | - Yulong Xia
- Department of Neurosurgerythe First Affiliated Hospital of Chongqing Medical UniversityChongqingPR China
| | - Yanfeng Xie
- Department of Neurosurgerythe First Affiliated Hospital of Chongqing Medical UniversityChongqingPR China
| | - Li Jiang
- Department of Neurosurgerythe First Affiliated Hospital of Chongqing Medical UniversityChongqingPR China
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5
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Schwen Blackett D, Varkey J, Wilmskoetter J, Roth R, Andrews K, Busby N, Gleichgerrcht E, Desai RH, Riccardi N, Basilakos A, Johnson LP, Kristinsson S, Johnson L, Rorden C, Spell LA, Fridriksson J, Bonilha L. Neural network bases of thematic semantic processing in language production. Cortex 2022; 156:126-143. [PMID: 36244204 PMCID: PMC10041939 DOI: 10.1016/j.cortex.2022.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/10/2022] [Accepted: 08/03/2022] [Indexed: 11/20/2022]
Abstract
Semantic processing is a central component of language and cognition. The anterior temporal lobe is postulated to be a key hub for semantic processing, but the posterior temporoparietal cortex is also involved in thematic associations during language. It is possible that these regions act in concert and depend on an anteroposterior network linking the temporal pole with posterior structures to support thematic semantic processing during language production. We employed connectome-based lesion-symptom mapping to examine the causal relationship between lesioned white matter pathways and thematic processing language deficits among individuals with post-stroke aphasia. Seventy-nine adults with chronic aphasia completed the Philadelphia Naming Test, and semantic errors were coded as either thematic or taxonomic to control for taxonomic errors. Controlling for nonverbal conceptual-semantic knowledge as measured by the Pyramids and Palm Trees Test, lesion size, and the taxonomic error rate, thematic error rate was associated with loss of white matter connections from the temporal pole traversing in peri-Sylvian regions to the posterior cingulate and the insula. These findings support the existence of a distributed network underlying thematic relationship processing in language as opposed to discrete cortical areas.
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Affiliation(s)
- Deena Schwen Blackett
- Department of Otolaryngology, College of Medicine, Medical University of South Carolina, Charleston, SC, USA; Division of Speech-Language Pathology, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.
| | - Jesse Varkey
- Department of Neurology, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Janina Wilmskoetter
- Division of Speech-Language Pathology, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.
| | - Rebecca Roth
- Department of Neurology, School of Medicine, Emory University, Atlanta, GA, USA.
| | - Keeghan Andrews
- Department of Neurology, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Natalie Busby
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA.
| | - Ezequiel Gleichgerrcht
- Department of Neurology, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Rutvik H Desai
- Department of Psychology, University of South Carolina, Barnwell College, Columbia, SC, USA.
| | - Nicholas Riccardi
- Department of Psychology, University of South Carolina, Barnwell College, Columbia, SC, USA.
| | - Alexandra Basilakos
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA.
| | - Lorelei P Johnson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA.
| | - Sigfus Kristinsson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA.
| | - Lisa Johnson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA.
| | - Chris Rorden
- Department of Psychology, University of South Carolina, Barnwell College, Columbia, SC, USA.
| | - Leigh A Spell
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA.
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA.
| | - Leonardo Bonilha
- Department of Neurology, School of Medicine, Emory University, Atlanta, GA, USA.
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6
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Sperber C, Griffis J, Kasties V. Indirect structural disconnection-symptom mapping. Brain Struct Funct 2022; 227:3129-3144. [PMID: 36048282 DOI: 10.1007/s00429-022-02559-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 08/24/2022] [Indexed: 01/01/2023]
Abstract
In vivo tracking of white matter fibres catalysed a modern perspective on the pivotal role of brain connectome disruption in neuropsychological deficits. However, the examination of white matter integrity in neurological patients by diffusion-weighted magnetic resonance imaging bears conceptual limitations and is not widely applicable, as it requires imaging-compatible patients and resources beyond the capabilities of many researchers. The indirect estimation of structural disconnection offers an elegant and economical alternative. For this approach, a patient's structural lesion information and normative connectome data are combined to estimate different measures of lesion-induced structural disconnection. Using one of several toolboxes, this method is relatively easy to implement and is even available to scientists without expertise in fibre tracking analyses. Nevertheless, the anatomo-behavioural statistical mapping of structural brain disconnection requires analysis steps that are not covered by these toolboxes. In this paper, we first review the current state of indirect lesion disconnection estimation, the different existing measures, and the available software. Second, we aim to fill the remaining methodological gap in statistical disconnection-symptom mapping by providing an overview and guide to disconnection data and the statistical mapping of their relationship to behavioural measurements using either univariate or multivariate statistical modelling. To assist in the practical implementation of statistical analyses, we have included software tutorials and analysis scripts.
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Affiliation(s)
- Christoph Sperber
- University of Tubingen: Eberhard Karls Universitat Tubingen, Tubingen, Germany.
| | - Joseph Griffis
- University of Tubingen: Eberhard Karls Universitat Tubingen, Tubingen, Germany
| | - Vanessa Kasties
- Centre of Neurology, Hertie-Institute for Clinical Brain Research, University of Tubingen, Tubingen, Germany
- Child Development Center, University Childrens Hospital Zurich, University of Zurich, Zurich, Switzerland
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7
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Firwana YMS, Zolkefley MKI, Mohamed Hatta HZ, Rowbin C, Che Mohd Nassir CMN, Hanafi MH, Abdullah MS, Keserci B, Lannin NA, Mustapha M. Regional cerebral blood perfusion changes in chronic stroke survivors as potential brain correlates of the functional outcome following gamified home-based rehabilitation (IntelliRehab)-a pilot study. J Neuroeng Rehabil 2022; 19:94. [PMID: 36002827 PMCID: PMC9404656 DOI: 10.1186/s12984-022-01072-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 08/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hospital-based stroke rehabilitation for stroke survivors in developing countries may be limited by staffing ratios and length of stay that could hamper recovery potential. Thus, a home-based, gamified rehabilitation system (i.e., IntelliRehab) was tested for its ability to increase cerebral blood flow (CBF), and the secondary impact of changes on the upper limb motor function and functional outcomes. OBJECTIVE To explore the effect of IntelliRehab on CBF in chronic stroke patients and its correlation with the upper limb motor function. METHODS Two-dimensional pulsed Arterial Spin Labelling (2D-pASL) was used to obtain CBF images of stable, chronic stroke subjects (n = 8) over 3-months intervention period. CBF alterations were mapped, and the detected differences were marked as regions of interest. Motor functions represented by Fugl-Meyer Upper Extremity Assessment (FMA) and Stroke Impact Scale (SIS) were used to assess the primary and secondary outcomes, respectively. RESULTS Regional CBF were significantly increased in right inferior temporal gyrus and left superior temporal white matter after 1-month (p = 0.044) and 3-months (p = 0.01) of rehabilitation, respectively. However, regional CBF in left middle fronto-orbital gyrus significantly declined after 1-month of rehabilitation (p = 0.012). Moreover, SIS-Q7 and FMA scores significantly increased after 1-month and 3-months of rehabilitation. There were no significant correlations, however, between CBF changes and upper limb motor function. CONCLUSIONS Participants demonstrated improved motor functions, supporting the benefit of using IntelliRehab as a tool for home-based rehabilitation. However, within-participant improvements may have limited potential that suggests the need for a timely administration of IntelliRehab to get the maximum capacity of improvement.
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Affiliation(s)
- Younis M S Firwana
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Mohd Khairul Izamil Zolkefley
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.,Faculty of Industrial Sciences and Technology, Universiti Malaysia Pahang, Kuantan, Malaysia
| | - Hasnetty Zuria Mohamed Hatta
- Rehabilitation Unit, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Christina Rowbin
- Rehabilitation Unit, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Che Mohd Nasril Che Mohd Nassir
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.,Kulliyyah of Islamic Revealed Knowledge and Human Sciences, International Islamic University Malaysia, Kuala Lumpur, Malaysia
| | - Muhammad Hafiz Hanafi
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.,Rehabilitation Unit, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Mohd Shafie Abdullah
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Bilgin Keserci
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Natasha A Lannin
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
| | - Muzaimi Mustapha
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
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8
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Meier EL, Kelly CR, Goldberg EB, Hillis AE. Executive control deficits and lesion correlates in acute left hemisphere stroke survivors with and without aphasia. Brain Imaging Behav 2022; 16:868-877. [PMID: 34647269 PMCID: PMC8514281 DOI: 10.1007/s11682-021-00580-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2021] [Indexed: 01/18/2023]
Abstract
In contrast to the traditional definition of the disorder, many individuals with aphasia exhibit non-linguistic cognitive impairments, including executive control deficits. Classic lesion studies cite frontal lobe damage in executive dysfunction, but more recent lesion symptom-mapping studies in chronic aphasia present mixed results. In this study, we compared executive control abilities of acute stroke survivors with and without aphasia and investigated lesion correlates of linguistic and non-linguistic cognitive tasks. Twenty-nine participants with acute left hemisphere stroke resulting in aphasia (n = 14) or no aphasia (n = 15) completed clinical MRI and testing, including three NIH Toolbox Cognition Batteries (Pattern Comparison Processing Speed, Flanker Inhibitory Control and Attention, and Dimensional Change Card Sort Tests) and the Boston Naming Test. We compared performance between groups using Wilcoxon rank sum tests. We used Least Absolute Shrinkage and Selection Operator Regression to identify neural markers (percent regional damage, hypoperfusion within vascular territories, and total lesion volume) of executive control deficits and anomia. Group performance was comparable on the Pattern Comparison Processing Speed Test, but people with aphasia had poorer standard scores, lower accuracy, and slower response times on the Dimensional Change Card Sort Test than people without aphasia. Damage to extrasylvian regions (dorsolateral prefrontal cortex, intraparietal sulcus) was related to executive control deficits, whereas language network damage (to inferior frontal and superior and posterior middle temporal gyri) was linked to naming impairments. These results suggest people with aphasia can exhibit comorbid executive control impairments linked to damage outside classic language network areas.
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Affiliation(s)
- Erin L Meier
- Department of Communication Sciences and Disorders, Northeastern University, 360 Huntington Avenue, 228C FR, Boston, MA, 02215, USA.
| | - Catherine R Kelly
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Emily B Goldberg
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA, USA
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, USA
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD, USA
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9
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Pasquini L, Di Napoli A, Rossi-Espagnet MC, Visconti E, Napolitano A, Romano A, Bozzao A, Peck KK, Holodny AI. Understanding Language Reorganization With Neuroimaging: How Language Adapts to Different Focal Lesions and Insights Into Clinical Applications. Front Hum Neurosci 2022; 16:747215. [PMID: 35250510 PMCID: PMC8895248 DOI: 10.3389/fnhum.2022.747215] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/18/2022] [Indexed: 12/13/2022] Open
Abstract
When the language-dominant hemisphere is damaged by a focal lesion, the brain may reorganize the language network through functional and structural changes known as adaptive plasticity. Adaptive plasticity is documented for triggers including ischemic, tumoral, and epileptic focal lesions, with effects in clinical practice. Many questions remain regarding language plasticity. Different lesions may induce different patterns of reorganization depending on pathologic features, location in the brain, and timing of onset. Neuroimaging provides insights into language plasticity due to its non-invasiveness, ability to image the whole brain, and large-scale implementation. This review provides an overview of language plasticity on MRI with insights for patient care. First, we describe the structural and functional language network as depicted by neuroimaging. Second, we explore language reorganization triggered by stroke, brain tumors, and epileptic lesions and analyze applications in clinical diagnosis and treatment planning. By comparing different focal lesions, we investigate determinants of language plasticity including lesion location and timing of onset, longitudinal evolution of reorganization, and the relationship between structural and functional changes.
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Affiliation(s)
- Luca Pasquini
- Neuroradiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Neuroradiology Unit, NESMOS Department, Sant’Andrea Hospital, La Sapienza University, Rome, Italy
| | - Alberto Di Napoli
- Neuroradiology Unit, NESMOS Department, Sant’Andrea Hospital, La Sapienza University, Rome, Italy
- Radiology Department, Castelli Hospital, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | | | - Emiliano Visconti
- Neuroradiology Unit, Cesena Surgery and Trauma Department, M. Bufalini Hospital, AUSL Romagna, Cesena, Italy
| | - Antonio Napolitano
- Medical Physics Department, Bambino Gesù Children’s Hospital, Rome, Italy
| | - Andrea Romano
- Neuroradiology Unit, NESMOS Department, Sant’Andrea Hospital, La Sapienza University, Rome, Italy
| | - Alessandro Bozzao
- Neuroradiology Unit, NESMOS Department, Sant’Andrea Hospital, La Sapienza University, Rome, Italy
| | - Kyung K. Peck
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Andrei I. Holodny
- Neuroradiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, United States
- Department of Neuroscience, Weill-Cornell Graduate School of the Medical Sciences, New York, NY, United States
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10
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Matchin W, Basilakos A, Ouden DBD, Stark BC, Hickok G, Fridriksson J. Functional differentiation in the language network revealed by lesion-symptom mapping. Neuroimage 2022; 247:118778. [PMID: 34896587 PMCID: PMC8830186 DOI: 10.1016/j.neuroimage.2021.118778] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 11/17/2021] [Accepted: 12/02/2021] [Indexed: 12/18/2022] Open
Abstract
Theories of language organization in the brain commonly posit that different regions underlie distinct linguistic mechanisms. However, such theories have been criticized on the grounds that many neuroimaging studies of language processing find similar effects across regions. Moreover, condition by region interaction effects, which provide the strongest evidence of functional differentiation between regions, have rarely been offered in support of these theories. Here we address this by using lesion-symptom mapping in three large, partially-overlapping groups of aphasia patients with left hemisphere brain damage due to stroke (N = 121, N = 92, N = 218). We identified multiple measure by region interaction effects, associating damage to the posterior middle temporal gyrus with syntactic comprehension deficits, damage to posterior inferior frontal gyrus with expressive agrammatism, and damage to inferior angular gyrus with semantic category word fluency deficits. Our results are inconsistent with recent hypotheses that regions of the language network are undifferentiated with respect to high-level linguistic processing.
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Affiliation(s)
- William Matchin
- Department of Communication Sciences and Disorders, University of South Carolina, Discovery 1, Room 202D, 915 Greene St., Columbia, SC 29208, United States.
| | - Alexandra Basilakos
- Department of Communication Sciences and Disorders, University of South Carolina, Discovery 1, Room 202D, 915 Greene St., Columbia, SC 29208, United States
| | - Dirk-Bart den Ouden
- Department of Communication Sciences and Disorders, University of South Carolina, Discovery 1, Room 202D, 915 Greene St., Columbia, SC 29208, United States
| | - Brielle C Stark
- Department of Speech and Hearing Sciences, Program in Neuroscience, Indiana University Bloomington, Bloomington, Indiana, United States
| | - Gregory Hickok
- Department of Cognitive Sciences, Department of Language Science, University of California, Irvine, California, United States
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Discovery 1, Room 202D, 915 Greene St., Columbia, SC 29208, United States
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11
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Sheppard SM, Meier EL, Kim KT, Breining BL, Keator LM, Tang B, Caffo BS, Hillis AE. Neural correlates of syntactic comprehension: A longitudinal study. BRAIN AND LANGUAGE 2022; 225:105068. [PMID: 34979477 PMCID: PMC9232253 DOI: 10.1016/j.bandl.2021.105068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 12/18/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
Broca's area is frequently implicated in sentence comprehension but its specific role is debated. Most lesion studies have investigated deficits at the chronic stage. We aimed (1) to use acute imaging to predict which left hemisphere stroke patients will recover sentence comprehension; and (2) to better understand the role of Broca's area in sentence comprehension by investigating acute deficits prior to functional reorganization. We assessed comprehension of canonical and noncanonical sentences in 15 patients with left hemisphere stroke at acute and chronic stages. LASSO regression was used to conduct lesion symptom mapping analyses. Patients with more severe word-level comprehension deficits and a greater proportion of damage to supramarginal gyrus and superior longitudinal fasciculus were likely to experience acute deficits prior to functional reorganization. Broca's area was only implicated in chronic deficits. We propose that when temporoparietal regions are damaged, intact Broca's area can support syntactic processing after functional reorganization occurs.
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Affiliation(s)
- Shannon M Sheppard
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States; Department of Communication Sciences & Disorders, Chapman University, Irvine, CA 92618, United States.
| | - Erin L Meier
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Kevin T Kim
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Bonnie L Breining
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Lynsey M Keator
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Bohao Tang
- Department of Biostatics, Johns Hopkins School of Public Health, Baltimore, MD 21287, United States
| | - Brian S Caffo
- Department of Biostatics, Johns Hopkins School of Public Health, Baltimore, MD 21287, United States
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States; Department of Cognitive Science, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD 21218, United States
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12
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Ubellacker DM, Hillis AE. The neural underpinnings of word comprehension and production: The critical roles of the temporal lobes. HANDBOOK OF CLINICAL NEUROLOGY 2022; 187:211-220. [PMID: 35964973 DOI: 10.1016/b978-0-12-823493-8.00013-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This chapter explores the involvement of the temporal lobes in distinct language functions. The examination of cases of localized damage to the temporal lobes and the resulting pattern of impairment across language tasks and types of errors made can reveal clear neural regions and associated networks essential for word comprehension, semantics, naming, reading, and spelling. Key regions implicated in these functions include left superior temporal gyrus posterior to the temporal pole in word comprehension, bilateral anterior temporal lobes in semantics, left posterior inferior temporal gyrus (pITG) in naming, and left pITG and fusiform cortex in reading and spelling. Results we review provide evidence that the temporal lobes have a critical role in many language tasks. Although various areas and associated white matter tracts work together in supporting language, damage to specific regions of the temporal lobes results in distinct and relatively predictable impairments of language functions.
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Affiliation(s)
- Delaney M Ubellacker
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
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13
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Reinartz M, Gabel S, Schaeverbeke J, Meersmans K, Adamczuk K, Luckett ES, De Meyer S, Van Laere K, Sunaert S, Dupont P, Vandenberghe R. Changes in the language system as amyloid-β accumulates. Brain 2021; 144:3756-3768. [PMID: 34534284 PMCID: PMC8719839 DOI: 10.1093/brain/awab335] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/08/2021] [Accepted: 08/12/2021] [Indexed: 11/17/2022] Open
Abstract
Language dysfunction is common in Alzheimer's disease. There is increasing interest in the preclinical or asymptomatic phase of Alzheimer's disease. Here we examined in 35 cognitively intact older adults (age range 52-78 years at baseline, 17 male) in a longitudinal study design the association between accumulation of amyloid over a 5-6-year period, measured using PET, and functional changes in the language network measured over the same time period using task-related functional MRI. In the same participants, we also determined the association between the longitudinal functional MRI changes and a cross-sectional measure of tau load as measured with 18F-AV1451 PET. As predicted, the principal change occurred in posterior temporal cortex. In the cortex surrounding the right superior temporal sulcus, the response amplitude during the associative-semantic versus visuo-perceptual task increased over time as amyloid load accumulated (Pcorrected = 0.008). In a whole-brain voxel-wise analysis, amyloid accumulation was also associated with a decrease in response amplitude in the left inferior frontal sulcus (Pcorrected = 0.009) and the right dorsomedial prefrontal cortex (Pcorrected = 0.005). In cognitively intact older adults, cross-sectional tau load was not associated with longitudinal changes in functional MRI response amplitude. Our findings confirm the central role of the neocortex surrounding the posterior superior temporal sulcus as the area of predilection within the language network in the earliest stages of Alzheimer's disease. Amyloid accumulation has an impact on cognitive brain circuitry in the asymptomatic phase of Alzheimer's disease.
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Affiliation(s)
- Mariska Reinartz
- Laboratory for Cognitive Neurology, Department of Neurosciences, Leuven Brain Institute, KU Leuven, 3000 Leuven, Belgium
| | - Silvy Gabel
- Laboratory for Cognitive Neurology, Department of Neurosciences, Leuven Brain Institute, KU Leuven, 3000 Leuven, Belgium
| | - Jolien Schaeverbeke
- Laboratory for Cognitive Neurology, Department of Neurosciences, Leuven Brain Institute, KU Leuven, 3000 Leuven, Belgium
| | - Karen Meersmans
- Laboratory for Cognitive Neurology, Department of Neurosciences, Leuven Brain Institute, KU Leuven, 3000 Leuven, Belgium
| | | | - Emma Susanne Luckett
- Laboratory for Cognitive Neurology, Department of Neurosciences, Leuven Brain Institute, KU Leuven, 3000 Leuven, Belgium
| | - Steffi De Meyer
- Laboratory for Cognitive Neurology, Department of Neurosciences, Leuven Brain Institute, KU Leuven, 3000 Leuven, Belgium
| | - Koen Van Laere
- Division of Nuclear Medicine, UZ Leuven, 3000 Leuven, Belgium
- Nuclear Medicine and Molecular Imaging, Department of Imaging and Pathology, KU Leuven, 3000 Leuven, Belgium
| | | | - Patrick Dupont
- Laboratory for Cognitive Neurology, Department of Neurosciences, Leuven Brain Institute, KU Leuven, 3000 Leuven, Belgium
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, Leuven Brain Institute, KU Leuven, 3000 Leuven, Belgium
- Alzheimer Research Centre KU Leuven, Leuven Brain Institute, 3000 Leuven, Belgium
- Neurology Department, University Hospitals Leuven, 3000 Leuven, Belgium
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14
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Meier EL, Sheppard SM, Goldberg EB, Kelly CR, Walker A, Ubellacker DM, Vitti E, Ruch K, Hillis AE. Dysfunctional Tissue Correlates of Unrelated Naming Errors in Acute Left Hemisphere Stroke. LANGUAGE, COGNITION AND NEUROSCIENCE 2021; 37:330-347. [PMID: 35665076 PMCID: PMC9159539 DOI: 10.1080/23273798.2021.1980593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 08/31/2021] [Indexed: 06/15/2023]
Abstract
Most naming error lesion-symptom mapping (LSM) studies have focused on semantic and/or phonological errors. Anomic individuals also produce unrelated word errors, which may be linked to semantic or modality-independent lexical deficits. To investigate the neural underpinnings of rarely-studied unrelated errors, we conducted LSM analyses in 100 individuals hospitalized with a left hemisphere stroke who completed imaging protocols and language assessments. We used least absolute shrinkage and selection operator regression to capture relationships between naming errors and dysfunctional brain tissue metrics (regional damage or hypoperfusion in vascular territories) in two groups: participants with and without impaired single-word auditory comprehension. Hypoperfusion-particularly within the parietal lobe-was an important error predictor, especially for the unimpaired group. In both groups, higher unrelated error proportions were associated with primarily ventral stream damage, the language route critical for processing meaning. Nonetheless, brain metrics implicated in unrelated errors were distinct from semantic error correlates.
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Affiliation(s)
- Erin L. Meier
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Shannon M. Sheppard
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Communication Sciences and Disorders, Chapman University, Irvine, CA
| | - Emily B. Goldberg
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Catherine R. Kelly
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Alexandra Walker
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Emilia Vitti
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Kristina Ruch
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD
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15
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Durfee AZ, Sheppard SM, Blake ML, Hillis AE. Lesion loci of impaired affective prosody: A systematic review of evidence from stroke. Brain Cogn 2021; 152:105759. [PMID: 34118500 PMCID: PMC8324538 DOI: 10.1016/j.bandc.2021.105759] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 05/06/2021] [Accepted: 05/24/2021] [Indexed: 02/06/2023]
Abstract
Affective prosody, or the changes in rate, rhythm, pitch, and loudness that convey emotion, has long been implicated as a function of the right hemisphere (RH), yet there is a dearth of literature identifying the specific neural regions associated with its processing. The current systematic review aimed to evaluate the evidence on affective prosody localization in the RH. One hundred and ninety articles from 1970 to February 2020 investigating affective prosody comprehension and production in patients with focal brain damage were identified via database searches. Eleven articles met inclusion criteria, passed quality reviews, and were analyzed for affective prosody localization. Acute, subacute, and chronic lesions demonstrated similar profile characteristics. Localized right antero-superior (i.e., dorsal stream) regions contributed to affective prosody production impairments, whereas damage to more postero-lateral (i.e., ventral stream) regions resulted in affective prosody comprehension deficits. This review provides support that distinct RH regions are vital for affective prosody comprehension and production, aligning with literature reporting RH activation for affective prosody processing in healthy adults as well. The impact of study design on resulting interpretations is discussed.
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Affiliation(s)
- Alexandra Zezinka Durfee
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States.
| | - Shannon M Sheppard
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States; Department of Communication Sciences and Disorders, Chapman University Crean College of Health and Behavioral Sciences, Irvine, CA 92618, United States
| | - Margaret L Blake
- Department of Communication Sciences and Disorders, University of Houston College of Liberal Arts and Social Sciences, Houston, TX 77204, United States
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States; Department of Cognitive Science, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD 21218, United States
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16
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Durfee AZ, Sheppard SM, Meier EL, Bunker L, Cui E, Crainiceanu C, Hillis AE. Explicit Training to Improve Affective Prosody Recognition in Adults with Acute Right Hemisphere Stroke. Brain Sci 2021; 11:brainsci11050667. [PMID: 34065453 PMCID: PMC8161405 DOI: 10.3390/brainsci11050667] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/15/2021] [Accepted: 05/18/2021] [Indexed: 11/16/2022] Open
Abstract
Difficulty recognizing affective prosody (receptive aprosodia) can occur following right hemisphere damage (RHD). Not all individuals spontaneously recover their ability to recognize affective prosody, warranting behavioral intervention. However, there is a dearth of evidence-based receptive aprosodia treatment research in this clinical population. The purpose of the current study was to investigate an explicit training protocol targeting affective prosody recognition in adults with RHD and receptive aprosodia. Eighteen adults with receptive aprosodia due to acute RHD completed affective prosody recognition before and after a short training session that targeted proposed underlying perceptual and conceptual processes. Behavioral impairment and lesion characteristics were investigated as possible influences on training effectiveness. Affective prosody recognition improved following training, and recognition accuracy was higher for pseudo- vs. real-word sentences. Perceptual deficits were associated with the most posterior infarcts, conceptual deficits were associated with frontal infarcts, and a combination of perceptual-conceptual deficits were related to temporoparietal and subcortical infarcts. Several right hemisphere ventral stream regions and pathways along with frontal and parietal hypoperfusion predicted training effectiveness. Explicit acoustic-prosodic-emotion training improves affective prosody recognition, but it may not be appropriate for everyone. Factors such as linguistic context and lesion location should be considered when planning prosody training.
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Affiliation(s)
- Alexandra Zezinka Durfee
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; (A.Z.D.); (E.L.M.); (L.B.)
| | - Shannon M. Sheppard
- Department of Communication Sciences and Disorders, Chapman University, Irvine, CA 92618, USA;
| | - Erin L. Meier
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; (A.Z.D.); (E.L.M.); (L.B.)
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MD 02115, USA
| | - Lisa Bunker
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; (A.Z.D.); (E.L.M.); (L.B.)
| | - Erjia Cui
- Department of Biostatistics, Johns Hopkins University, Baltimore, MD 21205, USA; (E.C.); (C.C.)
| | - Ciprian Crainiceanu
- Department of Biostatistics, Johns Hopkins University, Baltimore, MD 21205, USA; (E.C.); (C.C.)
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; (A.Z.D.); (E.L.M.); (L.B.)
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD 21287, USA
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD 21218, USA
- Correspondence:
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17
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Sheppard SM, Meier EL, Zezinka Durfee A, Walker A, Shea J, Hillis AE. Characterizing subtypes and neural correlates of receptive aprosodia in acute right hemisphere stroke. Cortex 2021; 141:36-54. [PMID: 34029857 DOI: 10.1016/j.cortex.2021.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 03/20/2021] [Accepted: 04/09/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Speakers naturally produce prosodic variations depending on their emotional state. Receptive prosody has several processing stages. We aimed to conduct lesion-symptom mapping to determine whether damage (core infarct or hypoperfusion) to specific brain areas was associated with receptive aprosodia or with impairment at different processing stages in individuals with acute right hemisphere stroke. We also aimed to determine whether different subtypes of receptive aprosodia exist that are characterized by distinctive behavioral performance patterns. METHODS Twenty patients with receptive aprosodia following right hemisphere ischemic stroke were enrolled within five days of stroke; clinical imaging was acquired. Participants completed tests of receptive emotional prosody, and tests of each stage of prosodic processing (Stage 1: acoustic analysis; Stage 2: analyzing abstract representations of acoustic characteristics that convey emotion; Stage 3: semantic processing). Emotional facial recognition was also assessed. LASSO regression was used to identify predictors of performance on each behavioral task. Predictors entered into each model included 14 right hemisphere regions, hypoperfusion in four vascular territories as measured using FLAIR hyperintense vessel ratings, lesion volume, age, and education. A k-medoid cluster analysis was used to identify different subtypes of receptive aprosodia based on performance on the behavioral tasks. RESULTS Impaired receptive emotional prosody and impaired emotional facial expression recognition were both predicted by greater percent damage to the caudate. The k-medoid cluster analysis identified three different subtypes of aprosodia. One group was primarily impaired on Stage 1 processing and primarily had frontotemporal lesions. The second group had a domain-general emotion recognition impairment and maximal lesion overlap in subcortical areas. Finally, the third group was characterized by a Stage 2 processing deficit and had lesion overlap in posterior regions. CONCLUSIONS Subcortical structures, particularly the caudate, play an important role in emotional prosody comprehension. Receptive aprosodia can result from impairments at different processing stages.
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Affiliation(s)
- Shannon M Sheppard
- Department of Communication Sciences & Disorders, Chapman University, Irvine, CA, USA; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Erin L Meier
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Alex Walker
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jennifer Shea
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Cognitive Science, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD, USA
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18
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Meier EL, Sheppard SM, Goldberg EB, Head CR, Ubellacker DM, Walker A, Hillis AE. Naming errors and dysfunctional tissue metrics predict language recovery after acute left hemisphere stroke. Neuropsychologia 2020; 148:107651. [PMID: 33045231 PMCID: PMC7546715 DOI: 10.1016/j.neuropsychologia.2020.107651] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/29/2020] [Accepted: 10/02/2020] [Indexed: 12/11/2022]
Abstract
Language recovery following acute left hemisphere (LH) stroke is notoriously difficult to predict. Global language measures (e.g., overall aphasia severity) and gross lesion metrics (e.g., size) provide incomplete recovery predictions. In this study, we test the hypothesis that the types of naming errors patients produce, combined with dysfunctional brain tissue metrics, can provide additional insight into recovery following acute LH stroke. One hundred forty-eight individuals who were hospitalized with a new LH stroke completed clinical neuroimaging and assessments of naming and global language skills. A subset of participants again completed language testing at subacute, early (5-7 months post-stroke), and late (≥11 months post-stroke) chronic phases. At each time point, we coded naming errors into four types (semantic, phonological, mixed and unrelated) and determined error type totals and proportions. Dysfunctional tissue measures included the percentage of damage to language network regions and hypoperfusion in vascular territories. A higher proportion of semantic errors was associated with better acute naming, but higher proportions of other error types was related to poorer accuracy. Naming and global language skills significantly improved over time , but naming error profiles did not change. Fewer acute unrelated errors and less damage to left angular gyrus resulted in optimal naming and language recovery by the final testing time point, yet patients with more acute errors and damage to left middle temporal gyrus demonstrated the greatest increases in language over time. These results illustrate that naming error profiles, particularly unrelated errors, add power to predictions of language recovery after stroke.
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Affiliation(s)
- Erin L Meier
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Shannon M Sheppard
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Communication Sciences and Disorders, Chapman University, Irvine, CA, USA
| | - Emily B Goldberg
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Catherine R Head
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Delaney M Ubellacker
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alexandra Walker
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, USA
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19
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Bowyer SM, Zillgitt A, Greenwald M, Lajiness-O'Neill R. Language Mapping With Magnetoencephalography: An Update on the Current State of Clinical Research and Practice With Considerations for Clinical Practice Guidelines. J Clin Neurophysiol 2020; 37:554-563. [DOI: 10.1097/wnp.0000000000000489] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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20
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Catricalà E, Polito C, Presotto L, Esposito V, Sala A, Conca F, Gasparri C, Berti V, Filippi M, Pupi A, Sorbi S, Iannaccone S, Magnani G, Cappa SF, Perani D. Neural correlates of naming errors across different neurodegenerative diseases: An FDG-PET study. Neurology 2020; 95:e2816-e2830. [PMID: 33004608 DOI: 10.1212/wnl.0000000000010967] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 07/23/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To investigate the types of errors produced in a picture naming task by patients with neurodegenerative dementia due to different etiologies and their neural correlates. METHODS The same standardized picture naming test was administered to a consecutive sample of patients (n = 148) who had been studied with [18F] FDG-PET. The errors were analyzed in 3 categories (visual, semantic, and phonologic). The PET data were analyzed using an optimized single-subject procedure, and the statistical parametric mapping multiple regression design was used to explore the correlation between each type of error and brain hypometabolism in the whole group. Metabolic connectivity analyses were run at the group level on 7 left hemisphere cortical areas corresponding to an a priori defined naming network. RESULTS Semantic errors were predominant in most patients, independent of clinical diagnosis. In the whole group analysis, visual errors correlated with hypometabolism in the right inferior occipital lobe and in the left middle occipital lobe. Semantic errors correlated with hypometabolism in the left fusiform gyrus, the inferior and middle temporal gyri, and the temporal pole. Phonologic errors were associated with hypometabolism in the left superior and middle temporal gyri. Both positive (occipital-posterior fusiform) and negative (anterior fusiform gyrus and the superior anterior temporal lobe) connectivity changes were associated with semantic errors. CONCLUSIONS Naming errors reflect the dysfunction of separate stages of the naming process and are specific markers for different patterns of brain involvement. These correlations are not limited to primary progressive aphasia but extend to other neurodegenerative dementias.
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Affiliation(s)
- Eleonora Catricalà
- From the Faculty of Psychology (E.C., F.C., C.G., S.F.C.), Institute for Advanced Studies, IUSS, Pavia; Nuclear Medicine Unit (C.P., V.B., A.P.), Department of Experimental and Clinical Biomedical Sciences, and NEUROFARBA, Department of Neuroscience, Psychology, Drug Research and Child Health (S.S.), University of Florence; Nuclear Medicine Unit (L.P., A.S., D.P.), IRCCS San Raffaele Hospital, Milan; Faculty of Psychology (V.E., A.S., D.P.), Vita-Salute San Raffaele University, Milan; Department of Neurology and INSPE (M.F., G.M.), San Raffaele Scientific Institute, Milan; Clinical Neuroscience Department (S.I.), San Raffaele Turro Hospital, Milan; IRCCS Fondazione Don Carlo Gnocchi (S.S.), Florence, and IRCCS Fondazione Istituto Neurologico Casimiro Mondino (S.F.C.), Pavia, Italy
| | - Cristina Polito
- From the Faculty of Psychology (E.C., F.C., C.G., S.F.C.), Institute for Advanced Studies, IUSS, Pavia; Nuclear Medicine Unit (C.P., V.B., A.P.), Department of Experimental and Clinical Biomedical Sciences, and NEUROFARBA, Department of Neuroscience, Psychology, Drug Research and Child Health (S.S.), University of Florence; Nuclear Medicine Unit (L.P., A.S., D.P.), IRCCS San Raffaele Hospital, Milan; Faculty of Psychology (V.E., A.S., D.P.), Vita-Salute San Raffaele University, Milan; Department of Neurology and INSPE (M.F., G.M.), San Raffaele Scientific Institute, Milan; Clinical Neuroscience Department (S.I.), San Raffaele Turro Hospital, Milan; IRCCS Fondazione Don Carlo Gnocchi (S.S.), Florence, and IRCCS Fondazione Istituto Neurologico Casimiro Mondino (S.F.C.), Pavia, Italy
| | - Luca Presotto
- From the Faculty of Psychology (E.C., F.C., C.G., S.F.C.), Institute for Advanced Studies, IUSS, Pavia; Nuclear Medicine Unit (C.P., V.B., A.P.), Department of Experimental and Clinical Biomedical Sciences, and NEUROFARBA, Department of Neuroscience, Psychology, Drug Research and Child Health (S.S.), University of Florence; Nuclear Medicine Unit (L.P., A.S., D.P.), IRCCS San Raffaele Hospital, Milan; Faculty of Psychology (V.E., A.S., D.P.), Vita-Salute San Raffaele University, Milan; Department of Neurology and INSPE (M.F., G.M.), San Raffaele Scientific Institute, Milan; Clinical Neuroscience Department (S.I.), San Raffaele Turro Hospital, Milan; IRCCS Fondazione Don Carlo Gnocchi (S.S.), Florence, and IRCCS Fondazione Istituto Neurologico Casimiro Mondino (S.F.C.), Pavia, Italy
| | - Valentina Esposito
- From the Faculty of Psychology (E.C., F.C., C.G., S.F.C.), Institute for Advanced Studies, IUSS, Pavia; Nuclear Medicine Unit (C.P., V.B., A.P.), Department of Experimental and Clinical Biomedical Sciences, and NEUROFARBA, Department of Neuroscience, Psychology, Drug Research and Child Health (S.S.), University of Florence; Nuclear Medicine Unit (L.P., A.S., D.P.), IRCCS San Raffaele Hospital, Milan; Faculty of Psychology (V.E., A.S., D.P.), Vita-Salute San Raffaele University, Milan; Department of Neurology and INSPE (M.F., G.M.), San Raffaele Scientific Institute, Milan; Clinical Neuroscience Department (S.I.), San Raffaele Turro Hospital, Milan; IRCCS Fondazione Don Carlo Gnocchi (S.S.), Florence, and IRCCS Fondazione Istituto Neurologico Casimiro Mondino (S.F.C.), Pavia, Italy
| | - Arianna Sala
- From the Faculty of Psychology (E.C., F.C., C.G., S.F.C.), Institute for Advanced Studies, IUSS, Pavia; Nuclear Medicine Unit (C.P., V.B., A.P.), Department of Experimental and Clinical Biomedical Sciences, and NEUROFARBA, Department of Neuroscience, Psychology, Drug Research and Child Health (S.S.), University of Florence; Nuclear Medicine Unit (L.P., A.S., D.P.), IRCCS San Raffaele Hospital, Milan; Faculty of Psychology (V.E., A.S., D.P.), Vita-Salute San Raffaele University, Milan; Department of Neurology and INSPE (M.F., G.M.), San Raffaele Scientific Institute, Milan; Clinical Neuroscience Department (S.I.), San Raffaele Turro Hospital, Milan; IRCCS Fondazione Don Carlo Gnocchi (S.S.), Florence, and IRCCS Fondazione Istituto Neurologico Casimiro Mondino (S.F.C.), Pavia, Italy
| | - Francesca Conca
- From the Faculty of Psychology (E.C., F.C., C.G., S.F.C.), Institute for Advanced Studies, IUSS, Pavia; Nuclear Medicine Unit (C.P., V.B., A.P.), Department of Experimental and Clinical Biomedical Sciences, and NEUROFARBA, Department of Neuroscience, Psychology, Drug Research and Child Health (S.S.), University of Florence; Nuclear Medicine Unit (L.P., A.S., D.P.), IRCCS San Raffaele Hospital, Milan; Faculty of Psychology (V.E., A.S., D.P.), Vita-Salute San Raffaele University, Milan; Department of Neurology and INSPE (M.F., G.M.), San Raffaele Scientific Institute, Milan; Clinical Neuroscience Department (S.I.), San Raffaele Turro Hospital, Milan; IRCCS Fondazione Don Carlo Gnocchi (S.S.), Florence, and IRCCS Fondazione Istituto Neurologico Casimiro Mondino (S.F.C.), Pavia, Italy
| | - Celeste Gasparri
- From the Faculty of Psychology (E.C., F.C., C.G., S.F.C.), Institute for Advanced Studies, IUSS, Pavia; Nuclear Medicine Unit (C.P., V.B., A.P.), Department of Experimental and Clinical Biomedical Sciences, and NEUROFARBA, Department of Neuroscience, Psychology, Drug Research and Child Health (S.S.), University of Florence; Nuclear Medicine Unit (L.P., A.S., D.P.), IRCCS San Raffaele Hospital, Milan; Faculty of Psychology (V.E., A.S., D.P.), Vita-Salute San Raffaele University, Milan; Department of Neurology and INSPE (M.F., G.M.), San Raffaele Scientific Institute, Milan; Clinical Neuroscience Department (S.I.), San Raffaele Turro Hospital, Milan; IRCCS Fondazione Don Carlo Gnocchi (S.S.), Florence, and IRCCS Fondazione Istituto Neurologico Casimiro Mondino (S.F.C.), Pavia, Italy
| | - Valentina Berti
- From the Faculty of Psychology (E.C., F.C., C.G., S.F.C.), Institute for Advanced Studies, IUSS, Pavia; Nuclear Medicine Unit (C.P., V.B., A.P.), Department of Experimental and Clinical Biomedical Sciences, and NEUROFARBA, Department of Neuroscience, Psychology, Drug Research and Child Health (S.S.), University of Florence; Nuclear Medicine Unit (L.P., A.S., D.P.), IRCCS San Raffaele Hospital, Milan; Faculty of Psychology (V.E., A.S., D.P.), Vita-Salute San Raffaele University, Milan; Department of Neurology and INSPE (M.F., G.M.), San Raffaele Scientific Institute, Milan; Clinical Neuroscience Department (S.I.), San Raffaele Turro Hospital, Milan; IRCCS Fondazione Don Carlo Gnocchi (S.S.), Florence, and IRCCS Fondazione Istituto Neurologico Casimiro Mondino (S.F.C.), Pavia, Italy
| | - Massimo Filippi
- From the Faculty of Psychology (E.C., F.C., C.G., S.F.C.), Institute for Advanced Studies, IUSS, Pavia; Nuclear Medicine Unit (C.P., V.B., A.P.), Department of Experimental and Clinical Biomedical Sciences, and NEUROFARBA, Department of Neuroscience, Psychology, Drug Research and Child Health (S.S.), University of Florence; Nuclear Medicine Unit (L.P., A.S., D.P.), IRCCS San Raffaele Hospital, Milan; Faculty of Psychology (V.E., A.S., D.P.), Vita-Salute San Raffaele University, Milan; Department of Neurology and INSPE (M.F., G.M.), San Raffaele Scientific Institute, Milan; Clinical Neuroscience Department (S.I.), San Raffaele Turro Hospital, Milan; IRCCS Fondazione Don Carlo Gnocchi (S.S.), Florence, and IRCCS Fondazione Istituto Neurologico Casimiro Mondino (S.F.C.), Pavia, Italy
| | - Alberto Pupi
- From the Faculty of Psychology (E.C., F.C., C.G., S.F.C.), Institute for Advanced Studies, IUSS, Pavia; Nuclear Medicine Unit (C.P., V.B., A.P.), Department of Experimental and Clinical Biomedical Sciences, and NEUROFARBA, Department of Neuroscience, Psychology, Drug Research and Child Health (S.S.), University of Florence; Nuclear Medicine Unit (L.P., A.S., D.P.), IRCCS San Raffaele Hospital, Milan; Faculty of Psychology (V.E., A.S., D.P.), Vita-Salute San Raffaele University, Milan; Department of Neurology and INSPE (M.F., G.M.), San Raffaele Scientific Institute, Milan; Clinical Neuroscience Department (S.I.), San Raffaele Turro Hospital, Milan; IRCCS Fondazione Don Carlo Gnocchi (S.S.), Florence, and IRCCS Fondazione Istituto Neurologico Casimiro Mondino (S.F.C.), Pavia, Italy
| | - Sandro Sorbi
- From the Faculty of Psychology (E.C., F.C., C.G., S.F.C.), Institute for Advanced Studies, IUSS, Pavia; Nuclear Medicine Unit (C.P., V.B., A.P.), Department of Experimental and Clinical Biomedical Sciences, and NEUROFARBA, Department of Neuroscience, Psychology, Drug Research and Child Health (S.S.), University of Florence; Nuclear Medicine Unit (L.P., A.S., D.P.), IRCCS San Raffaele Hospital, Milan; Faculty of Psychology (V.E., A.S., D.P.), Vita-Salute San Raffaele University, Milan; Department of Neurology and INSPE (M.F., G.M.), San Raffaele Scientific Institute, Milan; Clinical Neuroscience Department (S.I.), San Raffaele Turro Hospital, Milan; IRCCS Fondazione Don Carlo Gnocchi (S.S.), Florence, and IRCCS Fondazione Istituto Neurologico Casimiro Mondino (S.F.C.), Pavia, Italy
| | - Sandro Iannaccone
- From the Faculty of Psychology (E.C., F.C., C.G., S.F.C.), Institute for Advanced Studies, IUSS, Pavia; Nuclear Medicine Unit (C.P., V.B., A.P.), Department of Experimental and Clinical Biomedical Sciences, and NEUROFARBA, Department of Neuroscience, Psychology, Drug Research and Child Health (S.S.), University of Florence; Nuclear Medicine Unit (L.P., A.S., D.P.), IRCCS San Raffaele Hospital, Milan; Faculty of Psychology (V.E., A.S., D.P.), Vita-Salute San Raffaele University, Milan; Department of Neurology and INSPE (M.F., G.M.), San Raffaele Scientific Institute, Milan; Clinical Neuroscience Department (S.I.), San Raffaele Turro Hospital, Milan; IRCCS Fondazione Don Carlo Gnocchi (S.S.), Florence, and IRCCS Fondazione Istituto Neurologico Casimiro Mondino (S.F.C.), Pavia, Italy
| | - Giuseppe Magnani
- From the Faculty of Psychology (E.C., F.C., C.G., S.F.C.), Institute for Advanced Studies, IUSS, Pavia; Nuclear Medicine Unit (C.P., V.B., A.P.), Department of Experimental and Clinical Biomedical Sciences, and NEUROFARBA, Department of Neuroscience, Psychology, Drug Research and Child Health (S.S.), University of Florence; Nuclear Medicine Unit (L.P., A.S., D.P.), IRCCS San Raffaele Hospital, Milan; Faculty of Psychology (V.E., A.S., D.P.), Vita-Salute San Raffaele University, Milan; Department of Neurology and INSPE (M.F., G.M.), San Raffaele Scientific Institute, Milan; Clinical Neuroscience Department (S.I.), San Raffaele Turro Hospital, Milan; IRCCS Fondazione Don Carlo Gnocchi (S.S.), Florence, and IRCCS Fondazione Istituto Neurologico Casimiro Mondino (S.F.C.), Pavia, Italy
| | - Stefano F Cappa
- From the Faculty of Psychology (E.C., F.C., C.G., S.F.C.), Institute for Advanced Studies, IUSS, Pavia; Nuclear Medicine Unit (C.P., V.B., A.P.), Department of Experimental and Clinical Biomedical Sciences, and NEUROFARBA, Department of Neuroscience, Psychology, Drug Research and Child Health (S.S.), University of Florence; Nuclear Medicine Unit (L.P., A.S., D.P.), IRCCS San Raffaele Hospital, Milan; Faculty of Psychology (V.E., A.S., D.P.), Vita-Salute San Raffaele University, Milan; Department of Neurology and INSPE (M.F., G.M.), San Raffaele Scientific Institute, Milan; Clinical Neuroscience Department (S.I.), San Raffaele Turro Hospital, Milan; IRCCS Fondazione Don Carlo Gnocchi (S.S.), Florence, and IRCCS Fondazione Istituto Neurologico Casimiro Mondino (S.F.C.), Pavia, Italy.
| | - Daniela Perani
- From the Faculty of Psychology (E.C., F.C., C.G., S.F.C.), Institute for Advanced Studies, IUSS, Pavia; Nuclear Medicine Unit (C.P., V.B., A.P.), Department of Experimental and Clinical Biomedical Sciences, and NEUROFARBA, Department of Neuroscience, Psychology, Drug Research and Child Health (S.S.), University of Florence; Nuclear Medicine Unit (L.P., A.S., D.P.), IRCCS San Raffaele Hospital, Milan; Faculty of Psychology (V.E., A.S., D.P.), Vita-Salute San Raffaele University, Milan; Department of Neurology and INSPE (M.F., G.M.), San Raffaele Scientific Institute, Milan; Clinical Neuroscience Department (S.I.), San Raffaele Turro Hospital, Milan; IRCCS Fondazione Don Carlo Gnocchi (S.S.), Florence, and IRCCS Fondazione Istituto Neurologico Casimiro Mondino (S.F.C.), Pavia, Italy
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21
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Bowyer SM, Pang EW, Huang M, Papanicolaou AC, Lee RR. Presurgical Functional Mapping with Magnetoencephalography. Neuroimaging Clin N Am 2020; 30:159-174. [DOI: 10.1016/j.nic.2020.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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22
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DeMarco AT, Turkeltaub PE. Functional anomaly mapping reveals local and distant dysfunction caused by brain lesions. Neuroimage 2020; 215:116806. [PMID: 32278896 DOI: 10.1016/j.neuroimage.2020.116806] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/16/2020] [Accepted: 03/21/2020] [Indexed: 01/28/2023] Open
Abstract
The lesion method has been important for understanding brain-behavior relationships in humans, but has previously used maps based on structural damage. Lesion measurement based on structural damage may label partly damaged but functional tissue as abnormal, and moreover, ignores distant dysfunction in structurally intact tissue caused by deafferentation, diaschisis, and other processes. A reliable method to map functional integrity of tissue throughout the brain would provide a valuable new approach to measuring lesions. Here, we use machine learning on four dimensional resting state fMRI data obtained from left-hemisphere stroke survivors in the chronic period of recovery and control subjects to generate graded maps of functional anomaly throughout the brain in individual patients. These functional anomaly maps identify areas of obvious structural lesions and are stable across multiple measurements taken months and even years apart. Moreover, the maps identify functionally anomalous regions in structurally intact tissue, providing a direct measure of remote effects of lesions on the function of distant brain structures. Multivariate lesion-behavior mapping using functional anomaly maps replicates classic behavioral localization, identifying inferior frontal regions related to speech fluency, lateral temporal regions related to auditory comprehension, parietal regions related to phonology, and the hand area of motor cortex and descending corticospinal pathways for hand motor function. Further, this approach identifies relationships between tissue function and behavior distant from the structural lesions, including right premotor dysfunction related to ipsilateral hand movement, and right cerebellar regions known to contribute to speech fluency. Brain-wide maps of the functional effects of focal lesions could have wide implications for lesion-behavior association studies and studies of recovery after brain injury.
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Affiliation(s)
- Andrew T DeMarco
- Department of Neurology, Georgetown University, Washington, DC, 20057, United States.
| | - Peter E Turkeltaub
- Department of Neurology, Georgetown University, Washington, DC, 20057, United States; MedStar National Rehabilitation Hospital, Washington, DC, 20010, United States
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23
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Kristinsson S, Thors H, Yourganov G, Magnusdottir S, Hjaltason H, Stark BC, Basilakos A, den Ouden DB, Bonilha L, Rorden C, Hickok G, Hillis A, Fridriksson J. Brain Damage Associated with Impaired Sentence Processing in Acute Aphasia. J Cogn Neurosci 2020; 32:256-271. [PMID: 31596169 PMCID: PMC7132331 DOI: 10.1162/jocn_a_01478] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Left-hemisphere brain damage commonly affects patients' abilities to produce and comprehend syntactic structures, a condition typically referred to as "agrammatism." The neural correlates of agrammatism remain disputed in the literature, and distributed areas have been implicated as important predictors of performance, for example, Broca's area, anterior temporal areas, and temporo-parietal areas. We examined the association between damage to specific language-related ROIs and impaired syntactic processing in acute aphasia. We hypothesized that damage to the posterior middle temporal gyrus, and not Broca's area, would predict syntactic processing abilities. One hundred four individuals with acute aphasia (<20 days poststroke) were included in the study. Structural MRI scans were obtained, and all participants completed a 45-item sentence-picture matching task. We performed an ROI-based stepwise regression analyses to examine the relation between cortical brain damage and impaired comprehension of canonical and noncanonical sentences. Damage to the posterior middle temporal gyrus was the strongest predictor for overall task performance and performance on noncanonical sentences. Damage to the angular gyrus was the strongest predictor for performance on canonical sentences, and damage to the posterior superior temporal gyrus predicted noncanonical scores when performance on canonical sentences was included as a cofactor. Overall, our models showed that damage to temporo-parietal and posterior temporal areas was associated with impaired syntactic comprehension. Our results indicate that the temporo-parietal area is crucially implicated in complex syntactic processing, whereas the role of Broca's area may be complementary.
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24
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Kim K, Adams L, Keator LM, Sheppard SM, Breining BL, Rorden C, Fridriksson J, Bonilha L, Rogalsky C, Love T, Hickok G, Hillis AE. Neural processing critical for distinguishing between speech sounds. BRAIN AND LANGUAGE 2019; 197:104677. [PMID: 31442633 PMCID: PMC6726570 DOI: 10.1016/j.bandl.2019.104677] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 06/29/2019] [Accepted: 08/04/2019] [Indexed: 06/10/2023]
Abstract
We aimed to identify neural regions where ischemia acutely after stroke is associated with impairment in phoneme discrimination, and to determine whether such deficits are associated with impairment of spoken word comprehension. We evaluated 33 patients within 48 h of left hemisphere ischemic stroke onset with tests of phoneme discrimination and word-picture matching. We identified Pearson correlations between accuracy in phoneme discrimination and accuracy of word comprehension and identified areas where the percentage of infarcted tissue was associated with severity of phoneme discrimination deficit. We found that 54% had deficits in phoneme discrimination relative to healthy controls. Accuracy in phoneme discrimination correlated with accuracy on word comprehension tests. Damage to left intraparietal sulcus and hypoperfusion and/or infarct of left superior temporal gyrus were associated with phoneme discrimination deficits acutely, although patients with these lesions showed improvement or resolution of the deficit by six months.
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Affiliation(s)
- Kevin Kim
- Department of Neurology, Johns Hopkins University School of Medicine, United States
| | - Luke Adams
- Department of Neurology, Johns Hopkins University School of Medicine, United States.
| | - Lynsey M Keator
- Department of Neurology, Johns Hopkins University School of Medicine, United States
| | - Shannon M Sheppard
- Department of Neurology, Johns Hopkins University School of Medicine, United States
| | - Bonnie L Breining
- Department of Neurology, Johns Hopkins University School of Medicine, United States
| | - Chris Rorden
- Department of Psychology, University of South Carolina, United States
| | - Julius Fridriksson
- Department of Communication Disorders, University of South Carolina, United States
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, United States
| | - Corianne Rogalsky
- Department of Speech & Hearing Science, Arizona State University, United States
| | - Tracy Love
- University of California San Diego, United States; San Diego State University, United States
| | - Gregory Hickok
- Departments of Cognitive Sciences & Language Science, University of California, Irvine, United States
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, United States
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25
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Fridriksson J, den Ouden DB, Hillis AE, Hickok G, Rorden C, Basilakos A, Yourganov G, Bonilha L. Anatomy of aphasia revisited. Brain 2019; 141:848-862. [PMID: 29360947 DOI: 10.1093/brain/awx363] [Citation(s) in RCA: 182] [Impact Index Per Article: 36.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 11/08/2017] [Indexed: 12/31/2022] Open
Abstract
In most cases, aphasia is caused by strokes involving the left hemisphere, with more extensive damage typically being associated with more severe aphasia. The classical model of aphasia commonly adhered to in the Western world is the Wernicke-Lichtheim model. The model has been in existence for over a century, and classification of aphasic symptomatology continues to rely on it. However, far more detailed models of speech and language localization in the brain have been formulated. In this regard, the dual stream model of cortical brain organization proposed by Hickok and Poeppel is particularly influential. Their model describes two processing routes, a dorsal stream and a ventral stream, that roughly support speech production and speech comprehension, respectively, in normal subjects. Despite the strong influence of the dual stream model in current neuropsychological research, there has been relatively limited focus on explaining aphasic symptoms in the context of this model. Given that the dual stream model represents a more nuanced picture of cortical speech and language organization, cortical damage that causes aphasic impairment should map clearly onto the dual processing streams. Here, we present a follow-up study to our previous work that used lesion data to reveal the anatomical boundaries of the dorsal and ventral streams supporting speech and language processing. Specifically, by emphasizing clinical measures, we examine the effect of cortical damage and disconnection involving the dorsal and ventral streams on aphasic impairment. The results reveal that measures of motor speech impairment mostly involve damage to the dorsal stream, whereas measures of impaired speech comprehension are more strongly associated with ventral stream involvement. Equally important, many clinical tests that target behaviours such as naming, speech repetition, or grammatical processing rely on interactions between the two streams. This latter finding explains why patients with seemingly disparate lesion locations often experience similar impairments on given subtests. Namely, these individuals' cortical damage, although dissimilar, affects a broad cortical network that plays a role in carrying out a given speech or language task. The current data suggest this is a more accurate characterization than ascribing specific lesion locations as responsible for specific language deficits.5705668782001awx363media15705668782001.
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Affiliation(s)
- Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, USA
| | - Dirk-Bart den Ouden
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, USA
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine; Department of Cognitive Science, Johns Hopkins University, Baltimore, USA.,Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine; Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, USA
| | - Gregory Hickok
- Cognitive Sciences, School of Social Sciences, University of California, Irvine, USA
| | - Chris Rorden
- Department of Psychology, University of South Carolina, Columbia, USA
| | - Alexandra Basilakos
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, USA
| | - Grigori Yourganov
- Department of Psychology, University of South Carolina, Columbia, USA
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
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26
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Kiran S, Thompson CK. Neuroplasticity of Language Networks in Aphasia: Advances, Updates, and Future Challenges. Front Neurol 2019; 10:295. [PMID: 31001187 PMCID: PMC6454116 DOI: 10.3389/fneur.2019.00295] [Citation(s) in RCA: 116] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 03/06/2019] [Indexed: 11/13/2022] Open
Abstract
Researchers have sought to understand how language is processed in the brain, how brain damage affects language abilities, and what can be expected during the recovery period since the early 19th century. In this review, we first discuss mechanisms of damage and plasticity in the post-stroke brain, both in the acute and the chronic phase of recovery. We then review factors that are associated with recovery. First, we review organism intrinsic variables such as age, lesion volume and location and structural integrity that influence language recovery. Next, we review organism extrinsic factors such as treatment that influence language recovery. Here, we discuss recent advances in our understanding of language recovery and highlight recent work that emphasizes a network perspective of language recovery. Finally, we propose our interpretation of the principles of neuroplasticity, originally proposed by Kleim and Jones (1) in the context of extant literature in aphasia recovery and rehabilitation. Ultimately, we encourage researchers to propose sophisticated intervention studies that bring us closer to the goal of providing precision treatment for patients with aphasia and a better understanding of the neural mechanisms that underlie successful neuroplasticity.
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Affiliation(s)
- Swathi Kiran
- Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, United States
| | - Cynthia K. Thompson
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
- Department of Neurology, The Cognitive Neurology and Alzheimer's Disease Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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27
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Resting-state functional connectivity: An emerging method for the study of language networks in post-stroke aphasia. Brain Cogn 2019; 131:22-33. [DOI: 10.1016/j.bandc.2017.08.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 08/11/2017] [Accepted: 08/12/2017] [Indexed: 12/15/2022]
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28
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Karnath HO, Sperber C, Rorden C. Reprint of: Mapping human brain lesions and their functional consequences. Neuroimage 2019; 190:4-13. [PMID: 30686616 DOI: 10.1016/j.neuroimage.2019.01.044] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 10/10/2017] [Accepted: 10/13/2017] [Indexed: 12/17/2022] Open
Abstract
Neuroscience has a long history of inferring brain function by examining the relationship between brain injury and subsequent behavioral impairments. The primary advantage of this method over correlative methods is that it can tell us if a certain brain region is necessary for a given cognitive function. In addition, lesion-based analyses provide unique insights into clinical deficits. In the last decade, statistical voxel-based lesion behavior mapping (VLBM) emerged as a powerful method for understanding the architecture of the human brain. This review illustrates how VLBM improves our knowledge of functional brain architecture, as well as how it is inherently limited by its mass-univariate approach. A wide array of recently developed methods appear to supplement traditional VLBM. This paper provides an overview of these new methods, including the use of specialized imaging modalities, the combination of structural imaging with normative connectome data, as well as multivariate analyses of structural imaging data. We see these new methods as complementing rather than replacing traditional VLBM, providing synergistic tools to answer related questions. Finally, we discuss the potential for these methods to become established in cognitive neuroscience and in clinical applications.
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Affiliation(s)
- Hans-Otto Karnath
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany; Department of Psychology, University of South Carolina, Columbia, SC 29208, USA.
| | - Christoph Sperber
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Christopher Rorden
- Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
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29
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Yu M, Wu Z, Luan M, Wang X, Song Y, Liu J. Neural correlates of semantic and phonological processing revealed by functional connectivity patterns in the language network. Neuropsychologia 2018; 121:47-57. [PMID: 30391566 DOI: 10.1016/j.neuropsychologia.2018.10.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 10/19/2018] [Accepted: 10/29/2018] [Indexed: 01/26/2023]
Abstract
Semantics and phonology are fundamental components of language. Neuroimaging studies have identified a language network (LN) that is distributed through multiple regions and exhibits preferential responses to semantic and phonological information. However, it is unclear how these regions work collaboratively to support the processing of these components. In the present study, we first defined the LN as voxels that responded more to sentences than to strings of Chinese pseudo-characters. We subsequently used a voxel-based global brain connectivity method based on resting-state functional connectivity (FC) to characterize the neural correlates of semantic and phonological processing. We specifically correlated the within-network connectivity (WNC) of each voxel in the LN with the participants' scores on the semantic and phonological components extracted from a battery of reading tests via principal component analysis. We found that individuals with stronger WNC in the left posterior superior temporal gyrus (lpSTG) and anterior superior temporal gyrus (laSTG) were better at semantic and phonological processing, respectively. Furthermore, the FC of the lpSTG with the laSTG and bilateral fusiform gyrus mainly contributed to semantic processing, whereas the FC of the laSTG with the left posterior middle temporal gyrus and inferior frontal gyrus largely contributed to phonological processing. Importantly, the semantic and phonological subnetworks overlapped in the laSTG, the WNC of which correlated with the participants' performances during semantic-phonological interactions. Our study revealed the hub and subnetwork for semantic and phonological processing, respectively, and highlighted the role of the laSTG in semantic-phonological interactions.
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Affiliation(s)
- Mengxia Yu
- Beijing Key Laboratory of Applied Experimental Psychology & National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Zhe Wu
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Mengkai Luan
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Xu Wang
- Beijing University of Chinese Medicine, Beijing 100029, China
| | - Yiying Song
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Jia Liu
- Beijing Key Laboratory of Applied Experimental Psychology & National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing 100875, China.
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30
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Boyd LA, Hayward KS, Ward NS, Stinear CM, Rosso C, Fisher RJ, Carter AR, Leff AP, Copland DA, Carey LM, Cohen LG, Basso DM, Maguire JM, Cramer SC. Biomarkers of Stroke Recovery: Consensus-Based Core Recommendations from the Stroke Recovery and Rehabilitation Roundtable. Neurorehabil Neural Repair 2018; 31:864-876. [PMID: 29233071 DOI: 10.1177/1545968317732680] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The most difficult clinical questions in stroke rehabilitation are "What is this patient's potential for recovery?" and "What is the best rehabilitation strategy for this person, given her/his clinical profile?" Without answers to these questions, clinicians struggle to make decisions regarding the content and focus of therapy, and researchers design studies that inadvertently mix participants who have a high likelihood of responding with those who do not. Developing and implementing biomarkers that distinguish patient subgroups will help address these issues and unravel the factors important to the recovery process. The goal of the present paper is to provide a consensus statement regarding the current state of the evidence for stroke recovery biomarkers. Biomarkers of motor, somatosensory, cognitive and language domains across the recovery timeline post-stroke are considered; with focus on brain structure and function, and exclusion of blood markers and genetics. We provide evidence for biomarkers that are considered ready to be included in clinical trials, as well as others that are promising but not ready and so represent a developmental priority. We conclude with an example that illustrates the utility of biomarkers in recovery and rehabilitation research, demonstrating how the inclusion of a biomarker may enhance future clinical trials. In this way, we propose a way forward for when and where we can include biomarkers to advance the efficacy of the practice of, and research into, rehabilitation and recovery after stroke.
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Affiliation(s)
- Lara A Boyd
- 1 Department of Physical Therapy & the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Kathryn S Hayward
- 2 Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Nick S Ward
- 3 Sobell Department of Motor Neuroscience, UCL Institute of Neurology, Queen Square, London, UK
| | - Cathy M Stinear
- 4 Department of Medicine and Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Charlotte Rosso
- 5 Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, France; AP-HP, Stroke Unit, Pitié-Salpêtrière Hospital, France
| | - Rebecca J Fisher
- 6 Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
| | - Alexandre R Carter
- 7 Department of Neurology, Washington University in Saint Louis, St Louis, MO, USA
| | - Alex P Leff
- 8 Department of Brain Repair and Rehabilitation, Institute of Neurology & Institute of Cognitive Neuroscience, University College London, Queens Square, London, UK
| | - David A Copland
- 9 School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, Australia; and University of Queensland Centre for Clinical Research, Brisbane, Australia
| | - Leeanne M Carey
- 10 School of Allied Health, College of Science, Health and Engineering, La Trobe, University, Bundoora, Australia; and Neurorehabilitation and Recovery, Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Leonardo G Cohen
- 11 Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA
| | - D Michele Basso
- 12 School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Jane M Maguire
- 13 Faculty of Health, University of Technology Sydney, Ultimo, Sydney, Australia
| | - Steven C Cramer
- 14 University of California, Irvine, CA, USA; Depts. Neurology, Anatomy & Neurobiology, and Physical Medicine & Rehabilitation, Irvine, CA, USA
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31
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Forkel SJ, Catani M. Lesion mapping in acute stroke aphasia and its implications for recovery. Neuropsychologia 2018; 115:88-100. [PMID: 29605593 PMCID: PMC6018610 DOI: 10.1016/j.neuropsychologia.2018.03.036] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 03/21/2018] [Accepted: 03/27/2018] [Indexed: 12/24/2022]
Abstract
Patients with stroke offer a unique window into understanding human brain function. Mapping stroke lesions poses several challenges due to the complexity of the lesion anatomy and the mechanisms causing local and remote disruption on brain networks. In this prospective longitudinal study, we compare standard and advanced approaches to white matter lesion mapping applied to acute stroke patients with aphasia. Eighteen patients with acute left hemisphere stroke were recruited and scanned within two weeks from symptom onset. Aphasia assessment was performed at baseline and six-month follow-up. Structural and diffusion MRI contrasts indicated an area of maximum overlap in the anterior external/extreme capsule with diffusion images showing a larger overlap extending into posterior perisylvian regions. Anatomical predictors of recovery included damage to ipsilesional tracts (as shown by both structural and diffusion images) and contralesional tracts (as shown by diffusion images only). These findings indicate converging results from structural and diffusion lesion mapping methods but also clear differences between the two approaches in their ability to identify predictors of recovery outside the lesioned regions.
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Affiliation(s)
- Stephanie J Forkel
- Natbrainlab, King's College London, Department of Neuroimaging, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), De Crespigny Park, London SE5 8AF, United Kingdom; Natbrainlab, Department of Forensic and Neurodevelopmental Sciences and Sackler Institute of Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London De Crespigny Park, London SE5 8AF, United Kingdom.
| | - Marco Catani
- Natbrainlab, King's College London, Department of Neuroimaging, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), De Crespigny Park, London SE5 8AF, United Kingdom; Natbrainlab, Department of Forensic and Neurodevelopmental Sciences and Sackler Institute of Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London De Crespigny Park, London SE5 8AF, United Kingdom.
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32
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Boyd LA, Hayward KS, Ward NS, Stinear CM, Rosso C, Fisher RJ, Carter AR, Leff AP, Copland DA, Carey LM, Cohen LG, Basso DM, Maguire JM, Cramer SC. Biomarkers of stroke recovery: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable. Int J Stroke 2018; 12:480-493. [PMID: 28697711 DOI: 10.1177/1747493017714176] [Citation(s) in RCA: 234] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The most difficult clinical questions in stroke rehabilitation are "What is this patient's potential for recovery?" and "What is the best rehabilitation strategy for this person, given her/his clinical profile?" Without answers to these questions, clinicians struggle to make decisions regarding the content and focus of therapy, and researchers design studies that inadvertently mix participants who have a high likelihood of responding with those who do not. Developing and implementing biomarkers that distinguish patient subgroups will help address these issues and unravel the factors important to the recovery process. The goal of the present paper is to provide a consensus statement regarding the current state of the evidence for stroke recovery biomarkers. Biomarkers of motor, somatosensory, cognitive and language domains across the recovery timeline post-stroke are considered; with focus on brain structure and function, and exclusion of blood markers and genetics. We provide evidence for biomarkers that are considered ready to be included in clinical trials, as well as others that are promising but not ready and so represent a developmental priority. We conclude with an example that illustrates the utility of biomarkers in recovery and rehabilitation research, demonstrating how the inclusion of a biomarker may enhance future clinical trials. In this way, we propose a way forward for when and where we can include biomarkers to advance the efficacy of the practice of, and research into, rehabilitation and recovery after stroke.
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Affiliation(s)
- Lara A Boyd
- 1 Department of Physical Therapy & the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Kathryn S Hayward
- 2 Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Nick S Ward
- 3 Sobell Department of Motor Neuroscience, UCL Institute of Neurology, Queen Square, London, UK
| | - Cathy M Stinear
- 4 Department of Medicine and Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Charlotte Rosso
- 5 Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.,6 AP-HP, Urgences Cérébro-Vasculaires, Hôpital Pitié-Salpêtrière, Paris, France
| | - Rebecca J Fisher
- 7 Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
| | - Alexandre R Carter
- 8 Department of Neurology, Washington University in Saint Louis, St Louis, MO, USA
| | - Alex P Leff
- 9 Department of Brain Repair and Rehabilitation, Institute of Neurology & Institute of Cognitive Neuroscience, University College London, Queens Square, London, UK
| | - David A Copland
- 10 School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, Australia; and University of Queensland Centre for Clinical Research, Brisbane, Australia
| | - Leeanne M Carey
- 11 School of Allied Health, College of Science, Health and Engineering, La Trobe, University, Bundoora, Australia; and Neurorehabilitation and Recovery, Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Leonardo G Cohen
- 12 Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA
| | - D Michele Basso
- 13 School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Jane M Maguire
- 14 Faculty of Health, University of Technology, Ultimo, Sydney, Australia
| | - Steven C Cramer
- 15 University of California, Irvine, CA, USA; Depts. Neurology, Anatomy & Neurobiology, and Physical Medicine & Rehabilitation, Irvine, CA, USA
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33
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Left-lateralization of resting state functional connectivity between the presupplementary motor area and primary language areas. Neuroreport 2018; 28:545-550. [PMID: 28538516 DOI: 10.1097/wnr.0000000000000783] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
An abundance of evidence points to the role of a presupplementary motor area (pre-SMA) in human language. This study explores the pre-SMA resting state connectivity network and the nature of its connections to known language areas. We tested the hypothesis that by seeding the pre-SMA, one would be able to establish language laterality to known cortical and subcortical language areas. We analyzed data from 30 right-handed healthy controls and performed the resting state functional MRI. A seed-based analysis using a manually drawn pre-SMA region of interest template was applied. Time-course signals in the pre-SMA region of interest were averaged and cross-correlated to every voxel in the brain. Results show that the pre-SMA has significant left-lateralized functional connectivity to the pars opercularis within Broca's area. Among cortical regions, pre-SMA functional connectivity is strongest to the pars opercularis In addition, pre-SMA connectivity was shown to exist to other cortical language-association regions, including Wernicke's Area, supramarginal gyri, angular gyri, and middle frontal gyri. Among subcortical areas, considerable left-lateralized functional connectivity occurs to the caudate and thalamus, whereas cerebellar subregions show right lateralization. The current study shows that the pre-SMA most strongly connects to the pars opercularis within Broca's area and that cortical connections to language areas are left lateralized among a sample of right-handed patients. We provide resting state functional MRI evidence that the functional connectivity of the pre-SMA is involved in semantic language processing and that this identification may be useful for establishing language laterality in preoperative neurosurgical planning.
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34
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Sebastian R, Breining BL. Contributions of Neuroimaging to Understanding Language Deficits in Acute Stroke. Semin Speech Lang 2018; 39:66-78. [PMID: 29359306 PMCID: PMC5840876 DOI: 10.1055/s-0037-1608854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Advances in structural and functional imaging techniques have provided new insights into our understanding of brain and language relationships. In this article, we review the various structural and functional imaging methods currently used to study language deficits in acute stroke. We also discuss the advantages and the limitations of each imaging modality and the applications of each modality in the clinical and research settings in the study of language deficits.
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Affiliation(s)
- Rajani Sebastian
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Bonnie L Breining
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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35
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Shahid H, Sebastian R, Tippett DC, Saxena S, Wright A, Hanayik T, Breining B, Bonilha L, Fridriksson J, Rorden C, Hillis AE. Regional Brain Dysfunction Associated with Semantic Errors in Comprehension. Semin Speech Lang 2018; 39:79-86. [PMID: 29359307 DOI: 10.1055/s-0037-1608858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Here we illustrate how investigation of individuals acutely after stroke, before structure/function reorganization through recovery or rehabilitation, can be helpful in answering questions about the role of specific brain regions in language functions. Although there is converging evidence from a variety of sources that the left posterior-superior temporal gyrus plays some role in spoken word comprehension, its precise role in this function has not been established. We hypothesized that this region is essential for distinguishing between semantically related words, because it is critical for linking the spoken word to the complete semantic representation. We tested this hypothesis in 127 individuals with 48 hours of acute ischemic stroke, before the opportunity for reorganization or recovery. We identified tissue dysfunction (acute infarct and/or hypoperfusion) in gray and white matter parcels of the left hemisphere, and we evaluated the association between rate of semantic errors in a word-picture verification tasks and extent of tissue dysfunction in each region. We found that after correcting for lesion volume and multiple comparisons, the rate of semantic errors correlated with the extent of tissue dysfunction in left posterior-superior temporal gyrus and retrolenticular white matter.
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Affiliation(s)
- Hinna Shahid
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Rajani Sebastian
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Donna C Tippett
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sadhvi Saxena
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Amy Wright
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Bonnie Breining
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, Columbia, South Carolina
| | | | - Chris Rorden
- University of South Carolina, Columbia, South Carolina
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Cognitive Science, Johns Hopkins University, Baltimore, Maryland
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36
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Basilakos A. Contemporary Approaches to the Management of Post-stroke Apraxia of Speech. Semin Speech Lang 2018; 39:25-36. [PMID: 29359303 DOI: 10.1055/s-0037-1608853] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Apraxia of speech (AOS) is a motor speech disorder that disrupts the planning and programming of speech motor movements. In the acute stage of stroke recovery, AOS following unilateral (typically) left hemisphere stroke can occur alongside dysarthria, an impairment in speech execution and control, and/or aphasia, a higher-level impairment in language function. At this time, perceptual evaluation (the systematic, although subjective, description of speech and voice characteristics) is perhaps the only "gold standard" for differential diagnosis when it comes to motor speech disorders. This poses a challenge for speech-language pathologists charged with the evaluation of poststroke communication abilities, as distinguishing production impairments associated with AOS from those that can occur in aphasia and/or dysarthria can be difficult, especially when more than one deficit is present. Given the need for more objective, reliable methods to identify and diagnose AOS, several studies have turned to acoustic evaluation and neuroimaging to supplement clinical assessment. This article focuses on these recent advances. Studies investigating acoustic evaluation of AOS will be reviewed, as well as those that have considered the extent that neuroimaging can guide clinical decision making. Developments in the treatment of AOS will also be discussed. Although more research is needed regarding the use of these methods in everyday clinical practice, the studies reviewed here show promise as emerging tools for the management of AOS.
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Affiliation(s)
- Alexandra Basilakos
- Arnold School of Public Health, Department of Communication Sciences and Disorders, University of South Carolina, Columbia, South Carolina
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37
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Karnath HO, Sperber C, Rorden C. Mapping human brain lesions and their functional consequences. Neuroimage 2018; 165:180-189. [PMID: 29042216 PMCID: PMC5777219 DOI: 10.1016/j.neuroimage.2017.10.028] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 10/10/2017] [Accepted: 10/13/2017] [Indexed: 11/24/2022] Open
Abstract
Neuroscience has a long history of inferring brain function by examining the relationship between brain injury and subsequent behavioral impairments. The primary advantage of this method over correlative methods is that it can tell us if a certain brain region is necessary for a given cognitive function. In addition, lesion-based analyses provide unique insights into clinical deficits. In the last decade, statistical voxel-based lesion behavior mapping (VLBM) emerged as a powerful method for understanding the architecture of the human brain. This review illustrates how VLBM improves our knowledge of functional brain architecture, as well as how it is inherently limited by its mass-univariate approach. A wide array of recently developed methods appear to supplement traditional VLBM. This paper provides an overview of these new methods, including the use of specialized imaging modalities, the combination of structural imaging with normative connectome data, as well as multivariate analyses of structural imaging data. We see these new methods as complementing rather than replacing traditional VLBM, providing synergistic tools to answer related questions. Finally, we discuss the potential for these methods to become established in cognitive neuroscience and in clinical applications.
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Affiliation(s)
- Hans-Otto Karnath
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany; Department of Psychology, University of South Carolina, Columbia, SC 29208, USA.
| | - Christoph Sperber
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Christopher Rorden
- Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
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38
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Hartwigsen G, Saur D. Neuroimaging of stroke recovery from aphasia - Insights into plasticity of the human language network. Neuroimage 2017; 190:14-31. [PMID: 29175498 DOI: 10.1016/j.neuroimage.2017.11.056] [Citation(s) in RCA: 147] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 11/02/2017] [Accepted: 11/22/2017] [Indexed: 12/15/2022] Open
Abstract
The role of left and right hemisphere brain regions in language recovery after stroke-induced aphasia remains controversial. Here, we summarize how neuroimaging studies increase the current understanding of functional interactions, reorganization and plasticity in the language network. We first discuss the temporal dynamics across the time course of language recovery, with a main focus on longitudinal studies from the acute to the chronic phase after stroke. These studies show that the functional contribution of perilesional and spared left hemisphere as well as contralesional right hemisphere regions to language recovery changes over time. The second section introduces critical variables and recent advances on early prediction of subsequent outcome. In the third section, we outline how multi-method approaches that combine neuroimaging techniques with non-invasive brain stimulation elucidate mechanisms of plasticity and reorganization in the language network. These approaches provide novel insights into general mechanisms of plasticity in the language network and might ultimately support recovery processes during speech and language therapy. Finally, the neurobiological correlates of therapy-induced plasticity are discussed. We argue that future studies should integrate individualized approaches that might vary the combination of language therapy with specific non-invasive brain stimulation protocols across the time course of recovery. The way forward will include the combination of such approaches with large data sets obtained from multicentre studies.
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Affiliation(s)
- Gesa Hartwigsen
- Research Group Modulation of Language Networks, Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
| | - Dorothee Saur
- Language & Aphasia Laboratory, Department of Neurology, University of Leipzig, Germany.
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39
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A hitchhiker's guide to lesion-behaviour mapping. Neuropsychologia 2017; 115:5-16. [PMID: 29066325 DOI: 10.1016/j.neuropsychologia.2017.10.021] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 10/16/2017] [Accepted: 10/17/2017] [Indexed: 01/09/2023]
Abstract
Lesion-behaviour mapping is an influential and popular approach to anatomically localise cognitive brain functions in the human brain. Multiple considerations, ranging from patient selection, assessment of lesion location and patient behaviour, spatial normalisation, statistical testing, to the anatomical interpretation of obtained results, are necessary to optimize a lesion-behaviour mapping study and arrive at meaningful conclusions. Here, we provide a hitchhiker's guide, giving practical guidelines and references for each step of the typical lesion-behaviour mapping study pipeline.
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40
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Sperber C, Karnath HO. On the validity of lesion-behaviour mapping methods. Neuropsychologia 2017; 115:17-24. [PMID: 28782546 DOI: 10.1016/j.neuropsychologia.2017.07.035] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/11/2017] [Accepted: 07/30/2017] [Indexed: 01/13/2023]
Abstract
Brain lesion studies have been criticised for producing partly heterogeneous results; especially the validity of statistical voxel-based lesion-behaviour mapping has been discussed. In fact, planning a lesion-behaviour mapping study is associated with many methodological degrees of freedom. In the present review, we argue that not the lesion-behaviour mapping method itself produces heterogeneous results, but rather its heterogeneous or even erroneous application. We outline which methodological pitfalls and trade-offs can affect the results of lesion analyses, addressing behavioural assessment, recruitment of patients, statistical analysis, neuroimaging, and interpretation with brain atlases. Further, we discuss several methods to actually test the validity of lesion-behaviour mapping. Each of these approaches has specific advantages and disadvantages. In combination, they provide valuable tools to answer most empirical questions related to the validity of lesion-behaviour mapping.
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Affiliation(s)
- Christoph Sperber
- Center of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Hans-Otto Karnath
- Center of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany; Department of Psychology, University of South Carolina, Columbia, USA.
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41
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Pulvermüller F. Neural reuse of action perception circuits for language, concepts and communication. Prog Neurobiol 2017; 160:1-44. [PMID: 28734837 DOI: 10.1016/j.pneurobio.2017.07.001] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 05/12/2017] [Accepted: 07/13/2017] [Indexed: 10/19/2022]
Abstract
Neurocognitive and neurolinguistics theories make explicit statements relating specialized cognitive and linguistic processes to specific brain loci. These linking hypotheses are in need of neurobiological justification and explanation. Recent mathematical models of human language mechanisms constrained by fundamental neuroscience principles and established knowledge about comparative neuroanatomy offer explanations for where, when and how language is processed in the human brain. In these models, network structure and connectivity along with action- and perception-induced correlation of neuronal activity co-determine neurocognitive mechanisms. Language learning leads to the formation of action perception circuits (APCs) with specific distributions across cortical areas. Cognitive and linguistic processes such as speech production, comprehension, verbal working memory and prediction are modelled by activity dynamics in these APCs, and combinatorial and communicative-interactive knowledge is organized in the dynamics within, and connections between APCs. The network models and, in particular, the concept of distributionally-specific circuits, can account for some previously not well understood facts about the cortical 'hubs' for semantic processing and the motor system's role in language understanding and speech sound recognition. A review of experimental data evaluates predictions of the APC model and alternative theories, also providing detailed discussion of some seemingly contradictory findings. Throughout, recent disputes about the role of mirror neurons and grounded cognition in language and communication are assessed critically.
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Affiliation(s)
- Friedemann Pulvermüller
- Brain Language Laboratory, Department of Philosophy & Humanities, WE4, Freie Universität Berlin, 14195 Berlin, Germany; Berlin School of Mind and Brain, Humboldt Universität zu Berlin, 10099 Berlin, Germany; Einstein Center for Neurosciences, Berlin 10117 Berlin, Germany.
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42
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Jiao Y, Lin F, Wu J, Li H, Chen X, Li Z, Ma J, Cao Y, Wang S, Zhao J. Brain Arteriovenous Malformations Located in Language Area: Surgical Outcomes and Risk Factors for Postoperative Language Deficits. World Neurosurg 2017; 105:478-491. [PMID: 28602661 DOI: 10.1016/j.wneu.2017.05.159] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 05/25/2017] [Accepted: 05/26/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Case selection for surgical treatment of language-area brain arteriovenous malformations (L-BAVMs) remains difficult. This study aimed to determine the surgical outcomes and risk factors for postoperative language deficits (LDs) in patients with L-BAVMs. METHODS Patients with L-BAVMs who underwent microsurgical resection between September 2012 and June 2016 were reviewed. All patients had undergone preoperative functional magnetic resonance imaging and diffusion tensor imaging. Both functional and angioarchitectural factors were analyzed regarding the postoperative LD. Functional factors included the eloquence involved, the side of blood-oxygenation level-dependent signal activation and the white-matter fibers (anterior segment, long segment [LS], and posterior segment of arcuate fasciculus, and the inferior fronto-occipital fasciculus) involved. RESULTS Sixty-nine patients with L-BAVMs were reviewed. Postoperative short- and long-term LD was found in 32 (46.4%) and 14 (20.3%) patients, respectively. Twelve of the 14 patients with Geschwind's territory L-BAVMs (85.7%) had short-term LD, compared with 10 (34.5%) in Wernicke's and 10 (38.5%) in Broca's area. LS involvement (P = 0.001) and larger nidus size (P = 0.017) were independent risk factors for the short-term LD. Meanwhile, nidus size (P = 0.007), preoperative LD (P = 0.008), and LS involvement (P = 0.028) were independent risk factors for long-term LD. CONCLUSIONS L-BAVMs located in Geschwind's territory can cause a high incidence of LD. LS involvement and larger nidus size are risk factors for postoperative short- and long-term LD, and preoperative LD is a risk factor for postoperative, long-term LD.
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Affiliation(s)
- Yuming Jiao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China; China National Clinical Research Center for Neurological Diseases, Beijing, P. R. China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, P. R. China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, P. R. China
| | - Fuxin Lin
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fujian Medical University, Fujian Province, P. R. China
| | - Jun Wu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China; China National Clinical Research Center for Neurological Diseases, Beijing, P. R. China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, P. R. China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, P. R. China
| | - Hao Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China; China National Clinical Research Center for Neurological Diseases, Beijing, P. R. China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, P. R. China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, P. R. China
| | - Xin Chen
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China; China National Clinical Research Center for Neurological Diseases, Beijing, P. R. China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, P. R. China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, P. R. China
| | - Zhicen Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China; China National Clinical Research Center for Neurological Diseases, Beijing, P. R. China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, P. R. China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, P. R. China
| | - Ji Ma
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China; China National Clinical Research Center for Neurological Diseases, Beijing, P. R. China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, P. R. China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, P. R. China
| | - Yong Cao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China; China National Clinical Research Center for Neurological Diseases, Beijing, P. R. China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, P. R. China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, P. R. China.
| | - Shuo Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China; China National Clinical Research Center for Neurological Diseases, Beijing, P. R. China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, P. R. China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, P. R. China
| | - Jizong Zhao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China; China National Clinical Research Center for Neurological Diseases, Beijing, P. R. China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, P. R. China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, P. R. China
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Hillis AE, Rorden C, Fridriksson J. Brain regions essential for word comprehension: Drawing inferences from patients. Ann Neurol 2017; 81:759-768. [PMID: 28445916 DOI: 10.1002/ana.24941] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 04/22/2017] [Accepted: 04/22/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Argye E Hillis
- Departments of Neurology, Physical Medicine & Rehabilitation, and Cognitive Science, Johns Hopkins University, Baltimore, MD
| | | | - Julius Fridriksson
- Department of Communication Sciences & Disorders, University of South Carolina, Columbia, SC
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Shahid H, Sebastian R, Schnur TT, Hanayik T, Wright A, Tippett DC, Fridriksson J, Rorden C, Hillis AE. Important considerations in lesion-symptom mapping: Illustrations from studies of word comprehension. Hum Brain Mapp 2017; 38:2990-3000. [PMID: 28317276 PMCID: PMC5426992 DOI: 10.1002/hbm.23567] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 03/02/2017] [Accepted: 03/06/2017] [Indexed: 11/06/2022] Open
Abstract
Lesion-symptom mapping is an important method of identifying networks of brain regions critical for functions. However, results might be influenced substantially by the imaging modality and timing of assessment. We tested the hypothesis that brain regions found to be associated with acute language deficits depend on (1) timing of behavioral measurement, (2) imaging sequences utilized to define the "lesion" (structural abnormality only or structural plus perfusion abnormality), and (3) power of the study. We studied 191 individuals with acute left hemisphere stroke with MRI and language testing to identify areas critical for spoken word comprehension. We use the data from this study to examine the potential impact of these three variables on lesion-symptom mapping. We found that only the combination of structural and perfusion imaging within 48 h of onset identified areas where more abnormal voxels was associated with more severe acute deficits, after controlling for lesion volume and multiple comparisons. The critical area identified with this methodology was the left posterior superior temporal gyrus, consistent with other methods that have identified an important role of this area in spoken word comprehension. Results have implications for interpretation of other lesion-symptom mapping studies, as well as for understanding areas critical for auditory word comprehension in the healthy brain. We propose that lesion-symptom mapping at the acute stage of stroke addresses a different sort of question about brain-behavior relationships than lesion-symptom mapping at the chronic stage, but that timing of behavioral measurement and imaging modalities should be considered in either case. Hum Brain Mapp 38:2990-3000, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Hinna Shahid
- Department of NeurologyJohns Hopkins University School of MedicineBaltimoreMaryland21287
| | - Rajani Sebastian
- Department of NeurologyJohns Hopkins University School of MedicineBaltimoreMaryland21287
| | - Tatiana T. Schnur
- Department of NeurosurgeryBaylor College of MedicineHoustonTexas77030
| | | | - Amy Wright
- Department of NeurologyJohns Hopkins University School of MedicineBaltimoreMaryland21287
| | - Donna C. Tippett
- Department of NeurologyJohns Hopkins University School of MedicineBaltimoreMaryland21287
- Department of Physical Medicine & RehabilitationJohns Hopkins University School of MedicineBaltimoreMaryland21287
- Department of Otolaryngology & Head & Neck SurgeryJohns Hopkins University School of MedicineBaltimoreMaryland21287
| | | | - Chris Rorden
- University of South CarolinaColumbiaSouth Carolina29208
| | - Argye E. Hillis
- Department of NeurologyJohns Hopkins University School of MedicineBaltimoreMaryland21287
- Department of Physical Medicine & RehabilitationJohns Hopkins University School of MedicineBaltimoreMaryland21287
- Department of Cognitive ScienceJohns Hopkins UniversityBaltimoreMaryland21218
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45
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Language Representation Following Left MCA Stroke in Children and Adults: An fMRI Study. Can J Neurol Sci 2017; 44:483-497. [PMID: 28468691 DOI: 10.1017/cjn.2017.44] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND In this case series, functional magnetic resonance imaging was used to examine brain networks that mediate different aspects of language function in 4 young adults (17-22 years) with a history of left middle cerebral artery (MCA) stroke in childhood (40 years of age). Although it is widely believed that altered lateralization patterns are more likely to occur following early brain injuries compared with later brain injuries, the presumed plasticity of the young brain has been challenged in recent years, particularly in the domain of language. METHODS We explored this issue by contrasting the brain activation patterns of individuals with childhood left MCA stroke and adult left MCA stroke while performing two language tasks: verb generation and picture-word matching. Importantly, both groups showed significant recovery of language function, based on standard clinical indicators. RESULTS Controls showed left lateralized activation for both tasks, although much more pronounced for verb generation. Adult stroke patients also showed left lateralization for both tasks, though somewhat weaker than controls. Childhood stroke patients exhibited significantly weaker lateralization than the adult group for verb generation, but there was no significant group difference for picture-word matching. CONCLUSIONS These preliminary findings suggest that successful reorganization of language function is more likely to involve bilateral recruitment following left MCA stroke in childhood than in adulthood. Of importance, although childhood stroke patients had primarily subcortical lesions, there were substantial alterations in cortical activation patterns.
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Faulkner J, Stoner L, Grigg R, Fryer S, Stone K, Lambrick D. Acute effects of exercise posture on executive function in transient ischemic attack patients. Psychophysiology 2017; 54:1239-1248. [DOI: 10.1111/psyp.12868] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 03/03/2017] [Accepted: 03/03/2017] [Indexed: 11/30/2022]
Affiliation(s)
- James Faulkner
- Department of Sport and Exercise; University of Winchester; Winchester United Kingdom
| | - Lee Stoner
- School of Sport and Exercise; Massey University; Wellington New Zealand
- Department of Exercise and Sport Science; University of North Carolina at Chapel Hill; Chapel Hill North Carolina
| | - Rebecca Grigg
- School of Sport and Exercise; Massey University; Wellington New Zealand
| | - Simon Fryer
- School of Sport and Exercise; University of Gloucestershire; Gloucester United Kingdom
| | - Keeron Stone
- School of Sport and Exercise; University of Gloucestershire; Gloucester United Kingdom
| | - Danielle Lambrick
- School of Health and Life Sciences; University of Southampton; Southampton United Kingdom
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Revisiting Current Golden Rules in Managing Acute Ischemic Stroke: Evaluation of New Strategies to Further Improve Treatment Selection and Outcome. AJR Am J Roentgenol 2017; 208:32-41. [DOI: 10.2214/ajr.16.16557] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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48
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Robson H, Specht K, Beaumont H, Parkes LM, Sage K, Lambon Ralph MA, Zahn R. Arterial spin labelling shows functional depression of non-lesion tissue in chronic Wernicke's aphasia. Cortex 2016; 92:249-260. [PMID: 28525836 PMCID: PMC5480775 DOI: 10.1016/j.cortex.2016.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 08/15/2016] [Accepted: 11/02/2016] [Indexed: 11/23/2022]
Abstract
Behavioural impairment post-stroke is a consequence of structural damage and altered functional network dynamics. Hypoperfusion of intact neural tissue is frequently observed in acute stroke, indicating reduced functional capacity of regions outside the lesion. However, cerebral blood flow (CBF) is rarely investigated in chronic stroke. This study investigated CBF in individuals with chronic Wernicke's aphasia (WA) and examined the relationship between lesion, CBF and neuropsychological impairment. Arterial spin labelling CBF imaging and structural MRIs were collected in 12 individuals with chronic WA and 13 age-matched control participants. Joint independent component analysis (jICA) investigated the relationship between structural lesion and hypoperfusion. Partial correlations explored the relationship between lesion, hypoperfusion and language measures. Joint ICA revealed significant differences between the control and WA groups reflecting a large area of structural lesion in the left posterior hemisphere and an associated area of hypoperfusion extending into grey matter surrounding the lesion. Small regions of remote cortical hypoperfusion were observed, ipsilateral and contralateral to the lesion. Significant correlations were observed between the neuropsychological measures (naming, repetition, reading and semantic association) and the jICA component of interest in the WA group. Additional ROI analyses found a relationship between perfusion surrounding the core lesion and the same neuropsychological measures. This study found that core language impairments in chronic WA are associated with a combination of structural lesion and abnormal perfusion in non-lesioned tissue. This indicates that post-stroke impairments are due to a wider disruption of neural function than observable on structural T1w MRI.
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Affiliation(s)
- Holly Robson
- Department of Psychology and Clinical Language Sciences, University of Reading, UK.
| | - Karsten Specht
- Department of Biological and Medical Psychology, University of Bergen, Norway; Department of Clinical Engineering, Haukeland University Hospital, Bergen, Norway
| | | | - Laura M Parkes
- Centre for Imaging Science, Institute of Population Health, University of Manchester, UK
| | - Karen Sage
- Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK
| | - Matthew A Lambon Ralph
- Neuroscience and Aphasia Research Unit, School Psychological Sciences, University of Manchester, UK
| | - Roland Zahn
- Department of Psychological Medicine, Kings College London, UK
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49
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Wright AE, Davis C, Gomez Y, Posner J, Rorden C, Hillis AE, Tippett DC. Acute Ischemic Lesions Associated with Impairments in Expression and Recognition of Affective Prosody. ACTA ACUST UNITED AC 2016. [PMID: 28626799 DOI: 10.1044/persp1.sig2.82] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE We aimed to: (a) review existing data on the neural basis of affective prosody;(b) test the hypothesis that there are double dissociations in impairments of expression and recognition of affective prosody; and (c) identify areas of infarct associated with impaired expression and/or recognition of affective prosody after acute right hemisphere (RH) ischemic stroke. METHODS Participants were tested on recognition of emotional prosody in content-neutral sentences. Expression was evaluated by measuring variability in fundamental frequency. Voxel-based symptom mapping was used to identify areas associated with severity of expressive deficits. RESULTS We found that 9/23 patients had expressive prosody impairments; 5/9 of these patients also had impaired recognition of affective prosody; 2/9 had selective deficits in expressive prosody; recognition was not tested in 2/9. Another 6/23 patients had selective impairment in recognition of affective prosody. Severity of expressive deficits was associated with lesions in right temporal pole; patients with temporal pole lesions had deficits in expression and recognition. CONCLUSIONS Expression and recognition of prosody can be selectively impaired. Damage to right anterior temporal pole is associated with impairment of both, indicating a role of this structure in a mechanism shared by expression and production of affective prosody.
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Affiliation(s)
- Amy E Wright
- Department of Neurology, Johns Hopkins University, School of Medicine, Baltimore, MD
| | - Cameron Davis
- Department of Neurology, Johns Hopkins University, School of Medicine, Baltimore, MD
| | - Yessenia Gomez
- Department of Neurology, Johns Hopkins University, School of Medicine, Baltimore, MD
| | - Joseph Posner
- Department of Neurology, Johns Hopkins University, School of Medicine, Baltimore, MD
| | - Christopher Rorden
- Center for Aphasia Research and Rehabilitation, University of South Carolina, Columbia, SC
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University, School of Medicine, Baltimore, MD. Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD. Department of Cognitive Science, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD
| | - Donna C Tippett
- Department of Neurology, Johns Hopkins University, School of Medicine, Baltimore, MD. Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD. Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
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Kielar A, Deschamps T, Chu RKO, Jokel R, Khatamian YB, Chen JJ, Meltzer JA. Identifying Dysfunctional Cortex: Dissociable Effects of Stroke and Aging on Resting State Dynamics in MEG and fMRI. Front Aging Neurosci 2016; 8:40. [PMID: 26973515 PMCID: PMC4776400 DOI: 10.3389/fnagi.2016.00040] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 02/15/2016] [Indexed: 11/13/2022] Open
Abstract
Spontaneous signals in neuroimaging data may provide information on cortical health in disease and aging, but the relative sensitivity of different approaches is unknown. In the present study, we compared different but complementary indicators of neural dynamics in resting-state MEG and BOLD fMRI, and their relationship with blood flow. Participants included patients with post-stroke aphasia, age-matched controls, and young adults. The complexity of brain activity at rest was quantified in MEG using spectral analysis and multiscale entropy (MSE) measures, whereas BOLD variability was quantified as the standard deviation (SDBOLD), mean squared successive difference (MSSD), and sample entropy of the BOLD time series. We sought to assess the utility of signal variability and complexity measures as markers of age-related changes in healthy adults and perilesional dysfunction in chronic stroke. The results indicate that reduced BOLD variability is a robust finding in aging, whereas MEG measures are more sensitive to the cortical abnormalities associated with stroke. Furthermore, reduced complexity of MEG signals in perilesional tissue were correlated with hypoperfusion as assessed with arterial spin labeling (ASL), while no such relationship was apparent with BOLD variability. These findings suggest that MEG signal complexity offers a sensitive index of neural dysfunction in perilesional tissue in chronic stroke, and that these effects are clearly distinguishable from those associated with healthy aging.
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Affiliation(s)
- Aneta Kielar
- Rotman Research Institute, Baycrest Health SciencesToronto, ON, Canada
| | - Tiffany Deschamps
- Rotman Research Institute, Baycrest Health SciencesToronto, ON, Canada
| | - Ron K. O. Chu
- Rotman Research Institute, Baycrest Health SciencesToronto, ON, Canada
- Department of Psychology, University of TorontoToronto, ON, Canada
| | - Regina Jokel
- Rotman Research Institute, Baycrest Health SciencesToronto, ON, Canada
- Department of Speech-Language Pathology, University of TorontoToronto, ON, Canada
| | | | - Jean J. Chen
- Rotman Research Institute, Baycrest Health SciencesToronto, ON, Canada
- Department of Medical Biophysics, University of TorontoToronto, ON, Canada
- Canadian Partnership for Stroke RecoveryOttawa, ON, Canada
| | - Jed A. Meltzer
- Rotman Research Institute, Baycrest Health SciencesToronto, ON, Canada
- Department of Psychology, University of TorontoToronto, ON, Canada
- Department of Speech-Language Pathology, University of TorontoToronto, ON, Canada
- Canadian Partnership for Stroke RecoveryOttawa, ON, Canada
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