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Newman-Norlund RD, Gibson M, Johnson L, Teghipco A, Rorden C, Bonilha L, Fridriksson J. Cerebellar Atrophy and Language Processing in Chronic Left-Hemisphere Stroke. NEUROBIOLOGY OF LANGUAGE (CAMBRIDGE, MASS.) 2024; 5:722-735. [PMID: 39175791 PMCID: PMC11338304 DOI: 10.1162/nol_a_00120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/21/2023] [Indexed: 08/24/2024]
Abstract
Chronic stroke results in significant downstream changes at connected cortical sites. However, less is known about the impact of cortical stroke on cerebellar structure. Here, we examined the relationship between chronic stroke, cerebellar volume, cerebellar symmetry, language impairment, and treatment trajectories in a large cohort (N = 249) of chronic left hemisphere (LH) stroke patients with aphasia, using a healthy aging cohort (N = 244) as control data. Cerebellar gray matter volume was significantly reduced in chronic LH stroke relative to healthy control brains. Within the chronic LH stroke group, we observed a robust relationship between cerebellar volume, lesion size, and days post-stroke. Notably, the extent of cerebellar atrophy in chronic LH patients, particularly in the contralesional (right) cerebellar gray matter, explained significant variability in post-stroke aphasia severity, as measured by the Western Aphasia Battery-Revised, above and beyond traditional considerations such as cortical lesion size, days post-stroke, and demographic measures (age, race, sex). In a subset of participants that took part in language treatment studies, greater cerebellar gray matter volume was associated with greater treatment gains. These data support the importance of considering both cerebellar volume and symmetry in models of post-stroke aphasia severity and recovery.
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Affiliation(s)
| | - Makayla Gibson
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Lisa Johnson
- Department of Communication Sciences, University of South Carolina, Columbia, SC, USA
| | - Alex Teghipco
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Chris Rorden
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Leonardo Bonilha
- School of Medicine, University of South Carolina, Columbia, SC, USA
| | - Julius Fridriksson
- Department of Communication Sciences, University of South Carolina, Columbia, SC, USA
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2
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Walker GM, Fridriksson J, Hickok G. Assessing Relative Linguistic Impairment With Model-Based Item Selection. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:2600-2619. [PMID: 38995869 PMCID: PMC11305613 DOI: 10.1044/2024_jslhr-23-00439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 11/30/2023] [Accepted: 05/03/2024] [Indexed: 07/14/2024]
Abstract
PURPOSE A picture naming test is presented that reveals impairment to specific mechanisms involved in the naming process, using accuracy scores on curated item sets. A series of psychometric validation experiments are reported. METHOD Using a computational model that enables estimation of item difficulty at the lexical and sublexical stages of word retrieval, two complimentary sets of items were constructed that challenge the respective psycholinguistic levels of representation. The difference in accuracy between these item sets yields the relative linguistic impairment (RLI) score. In a cohort of 91 people with chronic left-hemisphere stroke who enrolled in a clinical trial for anomia, we assessed psychometric properties of the RLI score and then used the new scale to make predictions about other language behaviors, lesion distributions, and functional activation during naming. RESULTS RLI scores had adequate psychometric properties for clinical significance. RLI scores contained predictive information about spontaneous speech fluency, over and above accuracy. A dissociation was observed between performance on the RLI item sets and performance on the subtests of an independent language battery. Sublexical RLI was significantly associated with apraxia of speech and with lesions encompassing perisylvian regions, while lexical RLI was associated with lesions to deep white matter. The RLI construct was reflected in functional brain activity during naming, independent of overall accuracy, with a respective shift of activation between dorsal and ventral networks responsible for different aspects of word retrieval. CONCLUSION The RLI assessment satisfies the psychometric requirements to serve as a useful clinical measure.
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Affiliation(s)
- Grant M. Walker
- Department of Cognitive Sciences, University of California, Irvine
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia
| | - Gregory Hickok
- Department of Cognitive Sciences, University of California, Irvine
- Department of Language Science, University of California, Irvine
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Yu L, Dugan P, Doyle W, Devinsky O, Friedman D, Flinker A. A left-lateralized dorsolateral prefrontal network for naming. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.15.594403. [PMID: 38798614 PMCID: PMC11118423 DOI: 10.1101/2024.05.15.594403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
The ability to connect the form and meaning of a concept, known as word retrieval, is fundamental to human communication. While various input modalities could lead to identical word retrieval, the exact neural dynamics supporting this convergence relevant to daily auditory discourse remain poorly understood. Here, we leveraged neurosurgical electrocorticographic (ECoG) recordings from 48 patients and dissociated two key language networks that highly overlap in time and space integral to word retrieval. Using unsupervised temporal clustering techniques, we found a semantic processing network located in the middle and inferior frontal gyri. This network was distinct from an articulatory planning network in the inferior frontal and precentral gyri, which was agnostic to input modalities. Functionally, we confirmed that the semantic processing network encodes word surprisal during sentence perception. Our findings characterize how humans integrate ongoing auditory semantic information over time, a critical linguistic function from passive comprehension to daily discourse.
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Affiliation(s)
- Leyao Yu
- Department of Biomedical Engineering, New York University, New York, 10016, New York, the United States
- Department of Neurology, School of Medicine, New York University, New York, 10016, New York, the United States
| | - Patricia Dugan
- Department of Neurology, School of Medicine, New York University, New York, 10016, New York, the United States
| | - Werner Doyle
- Department of Neurosurgery, School of Medicine, New York University, New York, 10016, New York, the United States
| | - Orrin Devinsky
- Department of Neurology, School of Medicine, New York University, New York, 10016, New York, the United States
| | - Daniel Friedman
- Department of Neurology, School of Medicine, New York University, New York, 10016, New York, the United States
| | - Adeen Flinker
- Department of Biomedical Engineering, New York University, New York, 10016, New York, the United States
- Department of Neurology, School of Medicine, New York University, New York, 10016, New York, the United States
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Kram L, Neu B, Schroeder A, Wiestler B, Meyer B, Krieg SM, Ille S. Toward a systematic grading for the selection of patients to undergo awake surgery: identifying suitable predictor variables. Front Hum Neurosci 2024; 18:1365215. [PMID: 38756845 PMCID: PMC11096515 DOI: 10.3389/fnhum.2024.1365215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/11/2024] [Indexed: 05/18/2024] Open
Abstract
Background Awake craniotomy is the standard of care for treating language eloquent gliomas. However, depending on preoperative functionality, it is not feasible in each patient and selection criteria are highly heterogeneous. Thus, this study aimed to identify broadly applicable predictor variables allowing for a more systematic and objective patient selection. Methods We performed post-hoc analyses of preoperative language status, patient and tumor characteristics including language eloquence of 96 glioma patients treated in a single neurosurgical center between 05/2018 and 01/2021. Multinomial logistic regression and stepwise variable selection were applied to identify significant predictors of awake surgery feasibility. Results Stepwise backward selection confirmed that a higher number of paraphasias, lower age, and high language eloquence level were suitable indicators for an awake surgery in our cohort. Subsequent descriptive and ROC-analyses indicated a cut-off at ≤54 years and a language eloquence level of at least 6 for awake surgeries, which require further validation. A high language eloquence, lower age, preexisting semantic and phonological aphasic symptoms have shown to be suitable predictors. Conclusion The combination of these factors may act as a basis for a systematic and standardized grading of patients' suitability for an awake craniotomy which is easily integrable into the preoperative workflow across neurosurgical centers.
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Affiliation(s)
- Leonie Kram
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
- Department of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
| | - Beate Neu
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Axel Schroeder
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Benedikt Wiestler
- Section of Diagnostic and Interventional Neuroradiology, Department of Radiology, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Bernhard Meyer
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Sandro M. Krieg
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
- Department of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Sebastian Ille
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
- Department of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
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Upton E, Doogan C, Fleming V, Leyton PQ, Barbera D, Zeidman P, Hope T, Latham W, Coley-Fisher H, Price C, Crinion J, Leff A. Efficacy of a gamified digital therapy for speech production in people with chronic aphasia (iTalkBetter): behavioural and imaging outcomes of a phase II item-randomised clinical trial. EClinicalMedicine 2024; 70:102483. [PMID: 38685927 PMCID: PMC11056404 DOI: 10.1016/j.eclinm.2024.102483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/26/2024] [Accepted: 01/26/2024] [Indexed: 05/02/2024] Open
Abstract
Background Aphasia is among the most debilitating of symptoms affecting stroke survivors. Speech and language therapy (SLT) is effective, but many hours of practice are required to make clinically meaningful gains. One solution to this 'dosage' problem is to automate therapeutic approaches via self-supporting apps so people with aphasia (PWA) can amass practice as it suits them. However, response to therapy is variable and no clinical trial has yet identified the key brain regions required to engage with word-retrieval therapy. Methods Between Sep 7, 2020 and Mar 1, 2022 at University College London in the UK, we carried out a phase II, item-randomised clinical trial in 27 PWA using a novel, self-led app, 'iTalkBetter', which utilises confrontation naming therapy. Unlike previously reported apps, it has a real-time utterance verification system that drives its adaptive therapy algorithm. Therapy items were individually randomised to provide balanced lists of 'trained' and 'untrained' items matched on key psycholinguistic variables and baseline performance. PWA practised with iTalkBetter over a 6-week therapy block. Structural and functional MRI data were collected to identify therapy-related changes in brain states. A repeated-measures design was employed. The trial was registered at ClinicalTrials.gov (NCT04566081). Findings iTalkBetter significantly improved naming ability by 13% for trained items compared with no change for untrained items, an average increase of 29 words (SD = 26) per person; beneficial effects persisted at three months. PWA's propositional speech also significantly improved. iTalkBetter use was associated with brain volume increases in right auditory and left anterior prefrontal cortices. Task-based fMRI identified dose-related activity in the right temporoparietal junction. Interpretation Our findings suggested that iTalkBetter significantly improves PWAs' naming ability on trained items. The effect size is similar to a previous RCT of computerised therapy, but this is the first study to show transfer to a naturalistic speaking task. iTalkBetter usage and dose caused observable changes in brain structure and function to key parts of the surviving language perception, production and control networks. iTalkBetter is being rolled-out as an app for all PWA and anomia: https://www.ucl.ac.uk/icn/research/research-groups/neurotherapeutics/projects/digital-interventions-neuro-rehabilitation-0 so that they can increase their dosage of practice-based SLT. Funding National Institute for Health and Care Research, Wellcome Centre for Human Neuroimaging.
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Affiliation(s)
- Emily Upton
- UCL Queen Square Institute of Neurology, University College London, UK
- Institute of Cognitive Neuroscience, University College London, UK
- Department of Psychology and Language Sciences, University College London, UK
| | - Catherine Doogan
- UCL Queen Square Institute of Neurology, University College London, UK
- Institute of Cognitive Neuroscience, University College London, UK
- St George’s, University of London, UK
| | - Victoria Fleming
- Department of Psychology and Language Sciences, University College London, UK
| | | | - David Barbera
- Institute of Cognitive Neuroscience, University College London, UK
| | - Peter Zeidman
- Wellcome Centre for Human Neuroimaging, University College London, UK
| | - Tom Hope
- Wellcome Centre for Human Neuroimaging, University College London, UK
- Department of Psychology and Social Science, John Cabot University, Rome, Italy
| | - William Latham
- Department of Computing, Goldsmiths, University of London, UK
| | | | - Cathy Price
- Wellcome Centre for Human Neuroimaging, University College London, UK
| | - Jennifer Crinion
- Institute of Cognitive Neuroscience, University College London, UK
- Department of Psychology and Language Sciences, University College London, UK
| | - Alex Leff
- UCL Queen Square Institute of Neurology, University College London, UK
- Institute of Cognitive Neuroscience, University College London, UK
- University College London Hospitals NHS Trust, UK
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6
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Meier EL, Sheppard SM, Sebastian R, Berube S, Goldberg EB, Shea J, Stein CM, Hillis AE. Resting state correlates of picture description informativeness in left vs. right hemisphere chronic stroke. Front Neurol 2023; 14:1288801. [PMID: 38145117 PMCID: PMC10744570 DOI: 10.3389/fneur.2023.1288801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/20/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction Despite a growing emphasis on discourse processing in clinical neuroscience, relatively little is known about the neurobiology of discourse production impairments. Individuals with a history of left or right hemisphere stroke can exhibit difficulty with communicating meaningful discourse content, which implies both cerebral hemispheres play a role in this skill. However, the extent to which successful production of discourse content relies on network connections within domain-specific vs. domain-general networks in either hemisphere is unknown. Methods In this study, 45 individuals with a history of either left or right hemisphere stroke completed resting state fMRI and the Cookie Theft picture description task. Results Participants did not differ in the total number of content units or the percentage of interpretative content units they produced. Stroke survivors with left hemisphere damage produced significantly fewer content units per second than individuals with right hemisphere stroke. Intrinsic connectivity of the left language network was significantly weaker in the left compared to the right hemisphere stroke group for specific connections. Greater efficiency of communication of picture scene content was associated with stronger left but weaker right frontotemporal connectivity of the language network in patients with a history of left hemisphere (but not right hemisphere) stroke. No significant relationships were found between picture description measures and connectivity of the dorsal attention, default mode, or salience networks or with connections between language and other network regions. Discussion These findings add to prior behavioral studies of picture description skills in stroke survivors and provide insight into the role of the language network vs. other intrinsic networks during discourse production.
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Affiliation(s)
- Erin L. Meier
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
| | - Shannon M. Sheppard
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
| | - Rajani Sebastian
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, United States
| | - Shauna Berube
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
| | - Emily B. Goldberg
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
| | - Jennifer Shea
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
| | - Colin M. Stein
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, United States
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, United States
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Thomas G, McMahon KL, Finch E, Copland DA. Interindividual variability and consistency of language mapping paradigms for presurgical use. BRAIN AND LANGUAGE 2023; 243:105299. [PMID: 37413742 DOI: 10.1016/j.bandl.2023.105299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 04/08/2023] [Accepted: 06/21/2023] [Indexed: 07/08/2023]
Abstract
Most functional MRI studies of language processing have focussed on group-level inference, but for clinical use, the aim is to predict outcomes at an individual patient level. This requires being able to identify atypical activation and understand how differences relate to language outcomes. A language mapping paradigm that selectively activates left hemisphere language regions in healthy individuals allows atypical activation in a patient to be more easily identified. We investigated the interindividual variability and consistency of language activation in 12 healthy participants using three tasks-verb generation, responsive naming, and sentence comprehension-for future presurgical use. Responsive naming produced the most consistent left-lateralised activation across participants in frontal and temporal regions that postsurgical voxel-based lesion-symptom mapping studies suggest are most critical for language outcomes. Studies with a long-term clinical aim of predicting language outcomes in neurosurgical patients and stroke patients should first establish paradigm validity at an individual level in healthy participants.
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Affiliation(s)
- Georgia Thomas
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia; Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
| | - Katie L McMahon
- School of Clinical Sciences, Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Australia; Herston Imaging Research Facility, The University of Queensland, Brisbane, Australia
| | - Emma Finch
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia; Research and Innovation, West Moreton Health, Ipswich, Australia; Speech Pathology Department, Princess Alexandra Hospital, Brisbane, Australia
| | - David A Copland
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia; Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia; Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Queensland, Australia
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8
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Avcu E, Hwang M, Brown KS, Gow DW. A tale of two lexica: Investigating computational pressures on word representation with neural networks. Front Artif Intell 2023; 6:1062230. [PMID: 37051161 PMCID: PMC10083378 DOI: 10.3389/frai.2023.1062230] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 03/10/2023] [Indexed: 03/28/2023] Open
Abstract
Introduction The notion of a single localized store of word representations has become increasingly less plausible as evidence has accumulated for the widely distributed neural representation of wordform grounded in motor, perceptual, and conceptual processes. Here, we attempt to combine machine learning methods and neurobiological frameworks to propose a computational model of brain systems potentially responsible for wordform representation. We tested the hypothesis that the functional specialization of word representation in the brain is driven partly by computational optimization. This hypothesis directly addresses the unique problem of mapping sound and articulation vs. mapping sound and meaning. Results We found that artificial neural networks trained on the mapping between sound and articulation performed poorly in recognizing the mapping between sound and meaning and vice versa. Moreover, a network trained on both tasks simultaneously could not discover the features required for efficient mapping between sound and higher-level cognitive states compared to the other two models. Furthermore, these networks developed internal representations reflecting specialized task-optimized functions without explicit training. Discussion Together, these findings demonstrate that different task-directed representations lead to more focused responses and better performance of a machine or algorithm and, hypothetically, the brain. Thus, we imply that the functional specialization of word representation mirrors a computational optimization strategy given the nature of the tasks that the human brain faces.
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Affiliation(s)
- Enes Avcu
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | | | - Kevin Scott Brown
- Department of Pharmaceutical Sciences and School of Chemical, Biological, and Environmental Engineering, Oregon State University, Corvallis, OR, United States
| | - David W. Gow
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- Athinoula A. Martinos Center for Biomedical Imaging Massachusetts General Hospital, Charlestown, MA, United States
- Department of Psychology, Salem State University, Salem, MA, United States
- Harvard-MIT Division of Health Sciences and Technology, Boston, MA, United States
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Ledwidge PS, Jones CM, Huston CA, Trenkamp M, Bator B, Laeng J. Electrophysiology reveals cognitive-linguistic alterations after concussion. BRAIN AND LANGUAGE 2022; 233:105166. [PMID: 35970083 DOI: 10.1016/j.bandl.2022.105166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 07/22/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023]
Abstract
Language deficits and alterations to the N400 ERP are commonly reported in aphasia and moderate-to-severe traumatic brain injury (TBI), but have seldomly been investigated after mild TBI, such as concussion. In the present study, the N400 was recorded from young adults within 1-month after concussion and matched controls during a sentence processing task. The N400 recorded to semantically incongruent sentence-final words was significantly more negative and with a more anterior distribution in the concussion group than control group. Among the concussion group, a weaker N400 was associated with more concussion symptoms, slower response time, and poorer executive functioning. Multiple regression results showed that concussion occurrence and male gender were independently associated with a more negative N400-effect, whereas symptoms were associated with a weaker N400. These findings provide novel evidence that alterations to lexical-semantic networks may occur after concussion and vary based on individual differences in post-concussion symptoms and cognitive function.
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Affiliation(s)
- Patrick S Ledwidge
- Department of Psychology, Baldwin Wallace University, 275 Eastland Rd., Berea, OH 44017, USA.
| | - Christa M Jones
- Department of Communication Sciences & Disorders, Baldwin Wallace University, 275 Eastland Rd., Berea, OH 44017, USA
| | - Chloe A Huston
- Department of Psychology, Baldwin Wallace University, 275 Eastland Rd., Berea, OH 44017, USA
| | - Madison Trenkamp
- Department of Psychology, Baldwin Wallace University, 275 Eastland Rd., Berea, OH 44017, USA
| | - Bryan Bator
- Department of Psychology, Baldwin Wallace University, 275 Eastland Rd., Berea, OH 44017, USA
| | - Jennie Laeng
- Cleveland Clinic, Taussig Cancer Institute, 9500 Euclid Avenue, Cleveland, OH 44195, USA
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10
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Pillay SB, Gross WL, Heffernan J, Book DS, Binder JR. Semantic network activation facilitates oral word reading in chronic aphasia. BRAIN AND LANGUAGE 2022; 233:105164. [PMID: 35933744 PMCID: PMC9948519 DOI: 10.1016/j.bandl.2022.105164] [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: 06/25/2021] [Revised: 03/22/2022] [Accepted: 07/24/2022] [Indexed: 06/15/2023]
Abstract
People with aphasia often show partial impairments on a given task. This trial-to-trial variability offers a potential window into understanding how damaged language networks function. We test the hypothesis that successful word reading in participants with phonological system damage reflects semantic system recruitment. Residual semantic and phonological networks were defined with fMRI in 21 stroke participants with phonological damage using semantic- and rhyme-matching tasks. Participants performed an oral word reading task, and activation was compared between correct and incorrect trials within the semantic and phonological networks. The results showed a significant interaction between hemisphere, network activation, and reading success. Activation in the left hemisphere semantic network was higher when participants successfully read words. Residual phonological regions showed no difference in activation between correct and incorrect trials on the word reading task. The results provide evidence that semantic processing supports successful phonological retrieval in participants with phonological impairment.
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Affiliation(s)
- Sara B Pillay
- Department of Neurology and the Center for Imaging Research, Medical College of Wisconsin, Milwaukee, WI 53226, United States.
| | - William L Gross
- Department of Neurology and the Center for Imaging Research, Medical College of Wisconsin, Milwaukee, WI 53226, United States; Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI 53226, United States
| | - Joseph Heffernan
- Department of Neurology and the Center for Imaging Research, Medical College of Wisconsin, Milwaukee, WI 53226, United States
| | - Diane S Book
- Department of Neurology and the Center for Imaging Research, Medical College of Wisconsin, Milwaukee, WI 53226, United States
| | - Jeffrey R Binder
- Department of Neurology and the Center for Imaging Research, Medical College of Wisconsin, Milwaukee, WI 53226, United States
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Li R, Mukadam N, Kiran S. Functional MRI evidence for reorganization of language networks after stroke. HANDBOOK OF CLINICAL NEUROLOGY 2022; 185:131-150. [PMID: 35078595 DOI: 10.1016/b978-0-12-823384-9.00007-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
In this chapter, we review fMRI evidence for language reorganization in individuals with poststroke aphasia. Several studies in the current literature have utilized fMRI as a tool to understand patterns of functional reorganization in poststroke aphasia. Consistent with previous models that have been proposed to explain the trajectory of language recovery, differential patterns of language processing and language recovery have been identified across individuals with poststroke aphasia in different stages of recovery. Overall, a global network breakdown typically occurs in the early stages of aphasia recovery, followed by normalization in "traditional" left hemisphere language networks. Depending on individual characteristics, right hemisphere regions and bilateral domain-general regions may be further recruited. The main takeaway of this chapter is that poststroke aphasia recovery does not depend on individual neural regions, but rather involves a complex interaction among regions in larger networks. Many of the unresolved issues and contrastive findings in the literature warrant further research with larger groups of participants and standard protocols of fMRI implementation.
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Affiliation(s)
- Ran Li
- Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA, United States
| | - Nishaat Mukadam
- Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA, United States
| | - Swathi Kiran
- Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA, United States.
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12
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LaCroix AN, James E, Rogalsky C. Neural Resources Supporting Language Production vs. Comprehension in Chronic Post-stroke Aphasia: A Meta-Analysis Using Activation Likelihood Estimates. Front Hum Neurosci 2021; 15:680933. [PMID: 34759804 PMCID: PMC8572938 DOI: 10.3389/fnhum.2021.680933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 09/22/2021] [Indexed: 02/04/2023] Open
Abstract
In post-stroke aphasia, language tasks recruit a combination of residual regions within the canonical language network, as well as regions outside of it in the left and right hemispheres. However, there is a lack of consensus as to how the neural resources engaged by language production and comprehension following a left hemisphere stroke differ from one another and from controls. The present meta-analysis used activation likelihood estimates to aggregate across 44 published fMRI and PET studies to characterize the functional reorganization patterns for expressive and receptive language processes in persons with chronic post-stroke aphasia (PWA). Our results in part replicate previous meta-analyses: we find that PWA activate residual regions within the left lateralized language network, regardless of task. Our results extend this work to show differential recruitment of the left and right hemispheres during language production and comprehension in PWA. First, we find that PWA engage left perilesional regions during language comprehension, and that the extent of this activation is likely driven by stimulus type and domain-general cognitive resources needed for task completion. In contrast to comprehension, language production was associated with activation of the right frontal and temporal cortices. Further analyses linked right hemisphere regions involved in motor speech planning for language production with successful naming in PWA, while unsuccessful naming was associated with the engagement of the right inferior frontal gyrus, a region often implicated in domain-general cognitive processes. While the within-group findings indicate that the engagement of the right hemisphere during language tasks in post-stroke aphasia differs for expressive vs. receptive tasks, the overall lack of major between-group differences between PWA and controls implies that PWA rely on similar cognitive-linguistic resources for language as controls. However, more studies are needed that report coordinates for PWA and controls completing the same tasks in order for future meta-analyses to characterize how aphasia affects the neural resources engaged during language, particularly for specific tasks and as a function of behavioral performance.
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Affiliation(s)
- Arianna N LaCroix
- College of Health Sciences, Midwestern University, Glendale, AZ, United States
| | - Eltonnelle James
- College of Health Sciences, Midwestern University, Glendale, AZ, United States
| | - Corianne Rogalsky
- College of Health Solutions, Arizona State University, Tempe, AZ, United States
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13
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Wilson SM, Schneck SM. Neuroplasticity in post-stroke aphasia: A systematic review and meta-analysis of functional imaging studies of reorganization of language processing. NEUROBIOLOGY OF LANGUAGE (CAMBRIDGE, MASS.) 2020; 2:22-82. [PMID: 33884373 PMCID: PMC8057712 DOI: 10.1162/nol_a_00025] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 09/11/2020] [Indexed: 04/23/2023]
Abstract
Recovery from aphasia is thought to depend on neural plasticity, that is, functional reorganization of surviving brain regions such that they take on new or expanded roles in language processing. We carried out a systematic review and meta-analysis of all articles published between 1995 and early 2020 that have described functional imaging studies of six or more individuals with post-stroke aphasia, and have reported analyses bearing on neuroplasticity of language processing. Each study was characterized and appraised in detail, with particular attention to three critically important methodological issues: task performance confounds, contrast validity, and correction for multiple comparisons. We identified 86 studies describing a total of 561 relevant analyses. We found that methodological limitations related to task performance confounds, contrast validity, and correction for multiple comparisons have been pervasive. Only a few claims about language processing in individuals with aphasia are strongly supported by the extant literature: first, left hemisphere language regions are less activated in individuals with aphasia than neurologically normal controls, and second, in cohorts with aphasia, activity in left hemisphere language regions, and possibly a temporal lobe region in the right hemisphere, is positively correlated with language function. There is modest, equivocal evidence for the claim that individuals with aphasia differentially recruit right hemisphere homotopic regions, but no compelling evidence for differential recruitment of additional left hemisphere regions or domain-general networks. There is modest evidence that left hemisphere language regions return to function over time, but no compelling longitudinal evidence for dynamic reorganization of the language network.
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Affiliation(s)
- Stephen M. Wilson
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sarah M. Schneck
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
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Minkina I, Silkes JP, Bislick L, Madden EB, Lai V, Pompon RH, Torrence J, Zimmerman RM, Kendall DL. The Influence of Phonomotor Treatment on Word Retrieval: Insights From Naming Errors. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:4080-4104. [PMID: 31682780 DOI: 10.1044/2019_jslhr-l-19-0014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose An increasing number of anomia treatment studies have coupled traditional word retrieval accuracy outcome measures with more fine-grained analysis of word retrieval errors to allow for more comprehensive measurement of treatment-induced changes in word retrieval. The aim of this study was to examine changes in picture naming errors after phonomotor treatment. Method Twenty-eight individuals with aphasia received 60 hr of phonomotor treatment, an intensive, phoneme-based therapy for anomia. Confrontation naming was assessed pretreatment, immediately posttreatment, and 3 months posttreatment for trained and untrained nouns. Responses were scored for accuracy and coded for error type, and error proportions of each error type (e.g., semantic, phonological, omission) were compared: pre- versus posttreatment and pretreatment versus 3 months posttreatment. Results The group of treatment participants improved in whole-word naming accuracy on trained items and maintained their improvement. Treatment effects also generalized to untrained nouns at the maintenance testing phase. Additionally, participants demonstrated a decrease in proportions of omission and description errors on trained items immediately posttreatment. Conclusions Along with generalized improved whole-word naming accuracy, results of the error analysis suggest that a global (i.e., both lexical-semantic and phonological) change in lexical knowledge underlies the observed changes in confrontation naming accuracy following phonomotor treatment.
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Affiliation(s)
- Irene Minkina
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA
| | - JoAnn P Silkes
- School of Speech, Language, and Hearing Sciences, San Diego State University, CA
| | - Lauren Bislick
- School of Communication Sciences and Disorders, University of Central Florida, Orlando
| | | | - Victoria Lai
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Janaki Torrence
- Health Services Research & Development, Veterans Affairs Puget Sound Health Care System, Seattle, WA
| | - Reva M Zimmerman
- Department of Speech & Hearing Sciences, University of Washington, Seattle
| | - Diane L Kendall
- Department of Speech & Hearing Sciences, University of Washington, Seattle
- Veterans Affairs Puget Sound Health Care System, Seattle, WA
- University of Pretoria, South Africa
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15
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Kiran S, Meier EL, Johnson JP. Neuroplasticity in Aphasia: A Proposed Framework of Language Recovery. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:3973-3985. [PMID: 31756154 PMCID: PMC7203519 DOI: 10.1044/2019_jslhr-l-rsnp-19-0054] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 06/21/2019] [Accepted: 08/27/2019] [Indexed: 05/20/2023]
Abstract
Purpose Despite a tremendous amount of research in this topic, the precise neural mechanisms underlying language recovery remain unclear. Much of the evidence suggests that activation of remaining left-hemisphere tissue, including perilesional areas, is linked to the best treatment outcomes, yet recruitment of the right hemisphere for various language tasks has also been linked to favorable behavioral outcomes. In this review article, we propose a framework of language recovery that incorporates a network-based view of the brain regions involved in recovery. Method We review evidence from the extant literature and work from our own laboratory to identify findings consistent with our proposed framework and identify gaps in our current knowledge. Results Expanding on Heiss and Thiel's (2006) hierarchy of language recovery, we identify 4 emerging themes: (a) Several bilateral regions constitute a network engaged in language recovery; (b) spared left-hemisphere regions are important components of the network engaged in language recovery; (c) as damage increases in the left hemisphere, activation expands to the right hemisphere and domain-general regions; and (d) patients with efficient, control-like network topology show greater improvement than patients with abnormal topology. We propose a mechanistic model of language recovery that accounts for individual differences in behavior, network topology, and treatment responsiveness. Conclusion Continued work in this topic will lead us to a better understanding of the mechanisms underlying language recovery, biomarkers that influence recovery, and, consequently, more personalized treatment options for individual patients. Presentation Video https://doi.org/10.23641/asha.10257590.
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Affiliation(s)
- Swathi Kiran
- Department of Speech, Language & Hearing Sciences, College of Health & Rehabilitation Sciences: Sargent College, Boston University, MA
| | - Erin L. Meier
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Jeffrey P. Johnson
- Geriatric Research Education and Clinical Center, VA Pittsburgh Healthcare System, PA
- Audiology and Speech Pathology Program, VA Pittsburgh Healthcare System, PA
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16
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Johnson JP, Meier EL, Pan Y, Kiran S. Treatment-related changes in neural activation vary according to treatment response and extent of spared tissue in patients with chronic aphasia. Cortex 2019; 121:147-168. [PMID: 31627014 DOI: 10.1016/j.cortex.2019.08.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 06/21/2019] [Accepted: 08/23/2019] [Indexed: 11/25/2022]
Abstract
Neuroimaging studies of aphasia recovery have linked treatment-related improvements in language processing to changes in functional brain activation in left hemisphere language regions and their right hemisphere homologues. Although there is some consensus that better behavioral outcomes are achieved when activation is restored to the left hemisphere, the circumstances that dictate how and why regions in both hemispheres respond to naming therapy are still unclear. In this study, an fMRI picture-naming task was used to examine 16 regions of interest in 26 patients with chronic aphasia before and after 12 weeks of semantic naming treatment. Ten control patients who did not receive treatment and 17 healthy controls were also scanned. Naming therapy resulted in a significant increase in cortical activation, an effect that was largely driven by patients who responded most favorably to treatment, as patients who responded less favorably (as well as those who did not receive treatment) had little change in activation over time. Relative to healthy controls, patients had higher pre-treatment activation in the bilateral inferior frontal gyri (IFG) and lower activation in the bilateral angular gyri; after treatment, they had higher activation in bilateral IFG, as well as in the right middle frontal gyrus. These results suggest that the predominant effect of beneficial naming treatment was an upregulation of traditional language areas and their right hemisphere homologues and, in particular, regions associated with phonological and semantic/executive semantic processing, as well as broader domain general functions. Additionally, in some left hemisphere regions, post-treatment changes in activation were greater when there was more damage than when there was less damage, indicating that spared tissue in otherwise highly damaged regions can be modulated by treatment.
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Affiliation(s)
- Jeffrey P Johnson
- Aphasia Research Laboratory, Department of Speech, Language & Hearing Sciences, Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, MA, USA.
| | - Erin L Meier
- Aphasia Research Laboratory, Department of Speech, Language & Hearing Sciences, Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, MA, USA
| | - Yue Pan
- Aphasia Research Laboratory, Department of Speech, Language & Hearing Sciences, Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, MA, USA
| | - Swathi Kiran
- Aphasia Research Laboratory, Department of Speech, Language & Hearing Sciences, Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, MA, USA
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Torres-Prioris MJ, López-Barroso D, Roé-Vellvé N, Paredes-Pacheco J, Dávila G, Berthier ML. Repetitive verbal behaviors are not always harmful signs: Compensatory plasticity within the language network in aphasia. BRAIN AND LANGUAGE 2019; 190:16-30. [PMID: 30665003 DOI: 10.1016/j.bandl.2018.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 12/14/2018] [Accepted: 12/19/2018] [Indexed: 06/09/2023]
Abstract
Repetitive verbal behaviors such as conduite d'approche (CdA) and mitigated echolalia (ME) are well-known phenomena since early descriptions of aphasia. Nevertheless, there is no substantial fresh knowledge on their clinical features, neural correlates and treatment interventions. In the present study we take advantage of three index cases of chronic fluent aphasia showing CdA, ME or both symptoms to dissect their clinical and neural signatures. Using multimodal neuroimaging (structural magnetic resonance imaging and [18]-fluorodeoxyglucose positron emission tomography during resting state), we found that despite of the heterogeneous lesions in terms of etiology (stroke, traumatic brain injury), volume and location, CdA was present when the lesion affected in greater extent the left dorsal language pathway, while ME resulted from preferential damage to the left ventral stream. The coexistence of CdA and ME was associated with involvement of areas overlapping with the structural lesions and metabolic derangements described in the subjects who showed one of these symptoms (CdA or ME). These findings suggest that CdA and ME represent the clinical expression of plastic changes that occur within the spared language network and its interconnected areas in order to compensate for the linguistic functions that previously relied on the activity of the damaged pathway. We discuss the results in the light of this idea and consider alternative undamaged neural networks that may support CdA and ME.
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Affiliation(s)
- María José Torres-Prioris
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Malaga, Spain; Area of Psychobiology, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain; Research Laboratory on the Neuroscience of Language, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain.
| | - Diana López-Barroso
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Malaga, Spain; Area of Psychobiology, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain; Research Laboratory on the Neuroscience of Language, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain.
| | - Núria Roé-Vellvé
- Molecular Imaging Unit, Centro de Investigaciones Médico-Sanitarias, General Foundation of the University of Malaga, Malaga, Spain; Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain
| | - José Paredes-Pacheco
- Molecular Imaging Unit, Centro de Investigaciones Médico-Sanitarias, General Foundation of the University of Malaga, Malaga, Spain; Molecular Imaging and Medical Physics Group, Department of Psychiatry, Radiology and Public Health, University of Compostela, Galicia, Spain
| | - Guadalupe Dávila
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Malaga, Spain; Area of Psychobiology, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain; Research Laboratory on the Neuroscience of Language, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - Marcelo L Berthier
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Malaga, Spain; Research Laboratory on the Neuroscience of Language, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
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18
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Chu R, Meltzer JA, Bitan T. Interhemispheric interactions during sentence comprehension in patients with aphasia. Cortex 2018; 109:74-91. [PMID: 30312780 DOI: 10.1016/j.cortex.2018.08.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 05/03/2018] [Accepted: 08/28/2018] [Indexed: 02/06/2023]
Abstract
Right-hemisphere involvement in language processing following left-hemisphere damage may reflect either compensatory processes, or a release from homotopic transcallosal inhibition, resulting in excessive right-to-left suppression that is maladaptive for language performance. Using fMRI, we assessed inter-hemispheric effective connectivity in fifteen patients with post-stroke aphasia, along with age-matched and younger controls during a sentence comprehension task. Dynamic Causal Modeling was used with four bilateral regions including inferior frontal gyri (IFG) and primary auditory cortices (A1). Despite the presence of lesions, satisfactory model fit was obtained in 9/15 patients. In young controls, the only significant homotopic connection (RA1-LA1), was excitatory, while inhibitory connections emanated from LIFG to both left and right A1's. Interestingly, these connections were also correlated with language comprehension scores in patients. The results for homotopic connections show that excitatory connectivity from RA1-to-LA1 and inhibitory connectivity from LA1-to-RA1 are associated with general auditory verbal comprehension. Moreover, negative correlations were found between sentence comprehension and top-down coupling for both heterotopic (LIFG-to-RA1) and intra-hemispheric (LIFG-to-LA1) connections. These results do not show an emergence of a new compensatory right to left excitation in patients nor do they support the existence of left to right transcallosal suppression in controls. Nevertheless, the correlations with performance in patients are consistent with some aspects of both the compensation model, and the transcallosal suppression account for the role of the RH. Altogether our results suggest that changes to both excitatory and inhibitory homotopic and heterotopic connections due to LH damage may be maladaptive, as they disrupt the normal inter-hemispheric coordination and communication.
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Affiliation(s)
- Ronald Chu
- Baycrest Health Sciences, Rotman Research Institute, Toronto, ON, Canada; University of Toronto, Department of Psychology, Toronto, ON, Canada.
| | - Jed A Meltzer
- Baycrest Health Sciences, Rotman Research Institute, Toronto, ON, Canada; University of Toronto, Department of Psychology, Toronto, ON, Canada; University of Toronto, Department of Speech-Language Pathology, Toronto, ON, Canada; Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada
| | - Tali Bitan
- University of Toronto, Department of Speech-Language Pathology, Toronto, ON, Canada; University of Haifa, Department of Psychology and IIPDM, Haifa, Israel
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19
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Wilson SM, Yen M, Eriksson DK. An adaptive semantic matching paradigm for reliable and valid language mapping in individuals with aphasia. Hum Brain Mapp 2018; 39:3285-3307. [PMID: 29665223 PMCID: PMC6045968 DOI: 10.1002/hbm.24077] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 03/26/2018] [Accepted: 03/30/2018] [Indexed: 11/08/2022] Open
Abstract
Research on neuroplasticity in recovery from aphasia depends on the ability to identify language areas of the brain in individuals with aphasia. However, tasks commonly used to engage language processing in people with aphasia, such as narrative comprehension and picture naming, are limited in terms of reliability (test-retest reproducibility) and validity (identification of language regions, and not other regions). On the other hand, paradigms such as semantic decision that are effective in identifying language regions in people without aphasia can be prohibitively challenging for people with aphasia. This paper describes a new semantic matching paradigm that uses an adaptive staircase procedure to present individuals with stimuli that are challenging yet within their competence, so that language processing can be fully engaged in people with and without language impairments. The feasibility, reliability and validity of the adaptive semantic matching paradigm were investigated in sixteen individuals with chronic post-stroke aphasia and fourteen neurologically normal participants, in comparison to narrative comprehension and picture naming paradigms. All participants succeeded in learning and performing the semantic paradigm. Test-retest reproducibility of the semantic paradigm in people with aphasia was good (Dice coefficient = 0.66), and was superior to the other two paradigms. The semantic paradigm revealed known features of typical language organization (lateralization; frontal and temporal regions) more consistently in neurologically normal individuals than the other two paradigms, constituting evidence for validity. In sum, the adaptive semantic matching paradigm is a feasible, reliable and valid method for mapping language regions in people with aphasia.
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Affiliation(s)
- Stephen M. Wilson
- Department of Hearing and Speech SciencesVanderbilt University Medical CenterNashvilleTennessee
| | - Melodie Yen
- Department of Hearing and Speech SciencesVanderbilt University Medical CenterNashvilleTennessee
| | - Dana K. Eriksson
- Department of SpeechLanguage, and Hearing Sciences, University of ArizonaTucsonArizona
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20
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Pillay SB, Gross WL, Graves WW, Humphries C, Book DS, Binder JR. The Neural Basis of Successful Word Reading in Aphasia. J Cogn Neurosci 2018; 30:514-525. [PMID: 29211656 PMCID: PMC9926535 DOI: 10.1162/jocn_a_01214] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Understanding the neural basis of recovery from stroke is a major research goal. Many functional neuroimaging studies have identified changes in brain activity in people with aphasia, but it is unclear whether these changes truly support successful performance or merely reflect increased task difficulty. We addressed this problem by examining differences in brain activity associated with correct and incorrect responses on an overt reading task. On the basis of previous proposals that semantic retrieval can assist pronunciation of written words, we hypothesized that recruitment of semantic areas would be greater on successful trials. Participants were 21 patients with left-hemisphere stroke with phonologic retrieval deficits. They read words aloud during an event-related fMRI paradigm. BOLD signals obtained during correct and incorrect trials were contrasted to highlight brain activity specific to successful trials. Successful word reading was associated with higher BOLD signal in the left angular gyrus. In contrast, BOLD signal in bilateral posterior inferior frontal cortex, SMA, and anterior cingulate cortex was greater on incorrect trials. These data show for the first time the brain regions where neural activity is correlated specifically with successful performance in people with aphasia. The angular gyrus is a key node in the semantic network, consistent with the hypothesis that additional recruitment of the semantic system contributes to successful word production when phonologic retrieval is impaired. Higher activity in other brain regions during incorrect trials likely reflects secondary engagement of attention, working memory, and error monitoring processes when phonologic retrieval is unsuccessful.
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21
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Alferova VV, Mayorova LA, Ivanova EG, Guekht AB, Shklovskij VM. [Functional neuroimaging of the brain structures associated with language in healthy individuals and patients with post-stroke aphasia]. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117:71-78. [PMID: 28665373 DOI: 10.17116/jnevro20171173271-78] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The introduction of non-invasive functional neuroimaging techniques such as functional magnetic resonance imaging (fMRI), in the practice of scientific and clinical research can increase our knowledge about the organization of cognitive processes, including language, in normal and reorganization of these cognitive functions in post-stroke aphasia. The article discusses the results of fMRI studies of functional organization of the cortex of a healthy adult's brain in the processing of various voice information as well as the main types of speech reorganization after post-stroke aphasia in different stroke periods. The concepts of 'effective' and 'ineffective' brain plasticity in post-stroke aphasia were considered. It was concluded that there was an urgent need for further comprehensive studies, including neuropsychological testing and several complementary methods of functional neuroimaging, to develop a phased treatment plan and neurorehabilitation of patients with post-stroke aphasia.
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Affiliation(s)
- V V Alferova
- Center for Speech Pathology and Neurorehabilitation, Moscow, Russia; Pirogov Russian National Research Medical University, Moscow, Russia
| | - L A Mayorova
- Center for Speech Pathology and Neurorehabilitation, Moscow, Russia; Institute of Higher Nervous Activity of RAS, Moscow, Russia
| | - E G Ivanova
- Center for Speech Pathology and Neurorehabilitation, Moscow, Russia; Pirogov Russian National Research Medical University, Moscow, Russia
| | - A B Guekht
- Pirogov Russian National Research Medical University, Moscow, Russia; The Solovyov Scientific and Practical Centre of neuropsychiatric, Moscow, Russia
| | - V M Shklovskij
- Center for Speech Pathology and Neurorehabilitation, Moscow, Russia; The Serbsky State Scientific Center for Psychiatry and Narcology, Moscow, Russia
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22
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Wortman-Jutt S, Edwards DJ. Transcranial Direct Current Stimulation in Poststroke Aphasia Recovery. Stroke 2017; 48:820-826. [PMID: 28174328 DOI: 10.1161/strokeaha.116.015626] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 11/17/2016] [Accepted: 12/15/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Susan Wortman-Jutt
- From the Burke Rehabilitation Hospital, White Plains, NY (S.W.-J.); Neuromodulation and Human Motor Control Laboratory, Burke Medical Research Institute, White Plains, NY (D.J.E.); Department of Neurology, Weill-Cornell Medical College, New York, NY (D.J.E.); School of Medical and Health Sciences, Edith Cowan University, Western Australia (D.J.E.); and Beth-Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.J.E.).
| | - Dylan J Edwards
- From the Burke Rehabilitation Hospital, White Plains, NY (S.W.-J.); Neuromodulation and Human Motor Control Laboratory, Burke Medical Research Institute, White Plains, NY (D.J.E.); Department of Neurology, Weill-Cornell Medical College, New York, NY (D.J.E.); School of Medical and Health Sciences, Edith Cowan University, Western Australia (D.J.E.); and Beth-Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.J.E.)
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23
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Lee YS, Zreik JT, Hamilton RH. Patterns of neural activity predict picture-naming performance of a patient with chronic aphasia. Neuropsychologia 2016; 94:52-60. [PMID: 27864027 DOI: 10.1016/j.neuropsychologia.2016.11.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 10/06/2016] [Accepted: 11/13/2016] [Indexed: 10/20/2022]
Abstract
Naming objects represents a substantial challenge for patients with chronic aphasia. This could be in part because the reorganized compensatory language networks of persons with aphasia may be less stable than the intact language systems of healthy individuals. Here, we hypothesized that the degree of stability would be instantiated by spatially differential neural patterns rather than either increased or diminished amplitudes of neural activity within a putative compensatory language system. We recruited a chronic aphasic patient (KL; 66 year-old male) who exhibited a semantic deficit (e.g., often said "milk" for "cow" and "pillow" for "blanket"). Over the course of four behavioral sessions involving a naming task performed in a mock scanner, we identified visual objects that yielded an approximately 50% success rate. We then conducted two fMRI sessions in which the patient performed a naming task for multiple exemplars of those objects. Multivoxel pattern analysis (MVPA) searchlight revealed differential activity patterns associated with correct and incorrect trials throughout intact brain regions. The most robust and largest cluster was found in the right occipito-temporal cortex encompassing fusiform cortex, lateral occipital cortex (LOC), and middle occipital cortex, which may account for the patient's propensity for semantic naming errors. None of these areas were found by a conventional univariate analysis. By using an alternative approach, we extend current evidence for compensatory naming processes that operate through spatially differential patterns within the reorganized language system.
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Affiliation(s)
- Yune Sang Lee
- Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, USA.
| | - Jihad T Zreik
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Roy H Hamilton
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA.
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Carlson HL, Jadavji Z, Mineyko A, Damji O, Hodge J, Saunders J, Hererro M, Nowak M, Patzelt R, Mazur-Mosiewicz A, MacMaster FP, Kirton A. Treatment of dysphasia with rTMS and language therapy after childhood stroke: Multimodal imaging of plastic change. BRAIN AND LANGUAGE 2016; 159:23-34. [PMID: 27262774 DOI: 10.1016/j.bandl.2016.05.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 02/18/2016] [Accepted: 05/11/2016] [Indexed: 06/05/2023]
Abstract
Expressive dysphasia accompanies left inferior frontal gyrus (IFG/Broca) injury. Recovery may relate to interhemispheric balance with homologous, contralesional IFG but is unexplored in children. We evaluated effects of inhibitory rTMS to contralesional IFG combined with intensive speech therapy (SLT). A 15year-old, right-handed male incurred a left middle cerebral artery stroke. After 30months, severe non-fluent dysphasia impacted quality of life. Language networks, neuronal metabolism and white matter pathways were explored using MRI. Language function was measured longitudinally. An intensive SLT program was combined with contralesional inhibitory rTMS of right pars triangularis. Procedures were well tolerated. Language function improved persisting to four months. Post-treatment fMRI demonstrated increased left perilesional IFG activations and connectivity at rest. Bilateral changes in inositol and glutamate metabolism were observed. Contralesional, inhibitory rTMS appears safe in childhood stroke-induced dysphasia. We observed clinically significant improvements after SLT coupled with rTMS. Advanced neuroimaging can evaluate intervention-induced plasticity.
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Affiliation(s)
- Helen L Carlson
- Calgary Pediatric Stroke Program, Alberta Children's Hospital, Calgary, AB, Canada; Alberta Children's Hospital Research Institute (ACHRI), Calgary, AB, Canada; Department of Neurosciences, Alberta Children's Hospital, Calgary, AB, Canada.
| | - Zeanna Jadavji
- Calgary Pediatric Stroke Program, Alberta Children's Hospital, Calgary, AB, Canada
| | - Aleksandra Mineyko
- Calgary Pediatric Stroke Program, Alberta Children's Hospital, Calgary, AB, Canada; Alberta Children's Hospital Research Institute (ACHRI), Calgary, AB, Canada; Department of Neurosciences, Alberta Children's Hospital, Calgary, AB, Canada; Department of Pediatrics, University of Calgary, Calgary, AB, Canada; Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Omar Damji
- Calgary Pediatric Stroke Program, Alberta Children's Hospital, Calgary, AB, Canada; Department of Neurosciences, Alberta Children's Hospital, Calgary, AB, Canada
| | - Jacquie Hodge
- Calgary Pediatric Stroke Program, Alberta Children's Hospital, Calgary, AB, Canada
| | - Jenny Saunders
- Calgary Pediatric Stroke Program, Alberta Children's Hospital, Calgary, AB, Canada
| | - Mia Hererro
- Calgary Pediatric Stroke Program, Alberta Children's Hospital, Calgary, AB, Canada; Department of Neurosciences, Alberta Children's Hospital, Calgary, AB, Canada
| | - Michele Nowak
- Department of Neurosciences, Alberta Children's Hospital, Calgary, AB, Canada
| | - Rebecca Patzelt
- Department of Neurosciences, Alberta Children's Hospital, Calgary, AB, Canada
| | - Anya Mazur-Mosiewicz
- Department of Clinical Psychology, Chicago School of Professional Psychology, Chicago, IL, USA
| | - Frank P MacMaster
- Alberta Children's Hospital Research Institute (ACHRI), Calgary, AB, Canada; Department of Pediatrics, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada; Department of Psychiatry, University of Calgary, AB, Canada; The Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, AB, Canada; Child and Adolescent Imaging Research (CAIR) Programs, Alberta Children's Hospital, Calgary, AB, Canada
| | - Adam Kirton
- Calgary Pediatric Stroke Program, Alberta Children's Hospital, Calgary, AB, Canada; Alberta Children's Hospital Research Institute (ACHRI), Calgary, AB, Canada; Department of Neurosciences, Alberta Children's Hospital, Calgary, AB, Canada; Department of Pediatrics, University of Calgary, Calgary, AB, Canada; Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
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25
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Maladaptive Plasticity in Aphasia: Brain Activation Maps Underlying Verb Retrieval Errors. Neural Plast 2016; 2016:4806492. [PMID: 27429808 PMCID: PMC4939358 DOI: 10.1155/2016/4806492] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 04/25/2016] [Accepted: 05/05/2016] [Indexed: 11/18/2022] Open
Abstract
Anomia, or impaired word retrieval, is the most widespread symptom of aphasia, an acquired language impairment secondary to brain damage. In the last decades, functional neuroimaging techniques have enabled studying the neural basis underlying anomia and its recovery. The present study aimed to explore maladaptive plasticity in persistent verb anomia, in three male participants with chronic nonfluent aphasia. Brain activation maps associated with semantic verb paraphasia occurring within an oral picture-naming task were identified with an event-related fMRI paradigm. These maps were compared with those obtained in our previous study examining adaptive plasticity (i.e., successful verb naming) in the same participants. The results show that activation patterns related to semantic verb paraphasia and successful verb naming comprise a number of common areas, contributing to both maladaptive and adaptive neuroplasticity mechanisms. This finding suggests that the segregation of brain areas provides only a partial view of the neural basis of verb anomia and successful verb naming. Therefore, it indicates the importance of network approaches which may better capture the complexity of maladaptive and adaptive neuroplasticity mechanisms in anomia recovery.
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Validity and reliability of four language mapping paradigms. NEUROIMAGE-CLINICAL 2016; 16:399-408. [PMID: 28879081 PMCID: PMC5574842 DOI: 10.1016/j.nicl.2016.03.015] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 03/01/2016] [Accepted: 03/20/2016] [Indexed: 11/22/2022]
Abstract
Language areas of the brain can be mapped in individual participants with functional MRI. We investigated the validity and reliability of four language mapping paradigms that may be appropriate for individuals with acquired aphasia: sentence completion, picture naming, naturalistic comprehension, and narrative comprehension. Five neurologically normal older adults were scanned on each of the four paradigms on four separate occasions. Validity was assessed in terms of whether activation patterns reflected the known typical organization of language regions, that is, lateralization to the left hemisphere, and involvement of the left inferior frontal gyrus and the left middle and/or superior temporal gyri. Reliability (test-retest reproducibility) was quantified in terms of the Dice coefficient of similarity, which measures overlap of activations across time points. We explored the impact of different absolute and relative voxelwise thresholds, a range of cluster size cutoffs, and limitation of analyses to a priori potential language regions. We found that the narrative comprehension and sentence completion paradigms offered the best balance of validity and reliability. However, even with optimal combinations of analysis parameters, there were many scans on which known features of typical language organization were not demonstrated, and test-retest reproducibility was only moderate for realistic parameter choices. These limitations in terms of validity and reliability may constitute significant limitations for many clinical or research applications that depend on identifying language regions in individual participants. Validity and reliability were investigated for four language mapping paradigms. Narrative comprehension and sentence completion paradigms performed best. Lateralization to the left hemisphere was not always apparent. Test-retest reproducibility was only moderate.
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27
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Heath S, McMahon KL, Nickels LA, Angwin A, MacDonald AD, van Hees S, McKinnon E, Johnson K, Copland DA. An fMRI investigation of the effects of attempted naming on word retrieval in aphasia. Front Hum Neurosci 2015; 9:291. [PMID: 26074801 PMCID: PMC4443028 DOI: 10.3389/fnhum.2015.00291] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 05/06/2015] [Indexed: 11/13/2022] Open
Abstract
In healthy controls, picture naming performance can be facilitated by a single prior exposure to the same picture (“priming”). This priming phenomenon is utilized in the treatment of aphasia, which often includes repeated picture naming as part of a therapeutic task. The current study sought to determine whether single and/or multiple exposures facilitate subsequent naming in aphasia and whether such facilitatory effects act through normal priming mechanisms. A functional magnetic resonance imaging paradigm was employed to explore the beneficial effects of attempted naming in two individuals with aphasia and a control group. The timing and number of prior exposures was manipulated, with investigation of both short-term effects (single prior exposure over a period of minutes) and long-term effects (multiple presentations over a period of days). Following attempted naming, both short-term and long-term facilitated items showed improvement for controls, while only the long-term condition showed benefits at a behavioral level for the participants with aphasia. At a neural level, effects of long-term facilitation were noted in the left precuneus for one participant with aphasia, a result also identified for the equivalent contrast in controls. It appears that multiple attempts are required to improve naming performance in the presence of anomia and that for some individuals with aphasia the source of facilitation may be similar to unimpaired mechanisms engaged outside the language network.
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Affiliation(s)
- Shiree Heath
- ARC Centre of Excellence in Cognition and its Disorders, Department of Cognitive Science, Macquarie University, Sydney NSW, Australia ; Language Neuroscience Laboratory, University of Queensland Centre for Clinical Research, St Lucia QLD, Australia
| | - Katie L McMahon
- Centre for Advanced Imaging, University of Queensland, St Lucia QLD, Australia
| | - Lyndsey A Nickels
- ARC Centre of Excellence in Cognition and its Disorders, Department of Cognitive Science, Macquarie University, Sydney NSW, Australia ; NHMRC Centre for Clinical Research Excellence in Aphasia Rehabilitation, St Lucia QLD, Australia
| | - Anthony Angwin
- NHMRC Centre for Clinical Research Excellence in Aphasia Rehabilitation, St Lucia QLD, Australia ; School of Health and Rehabilitation Sciences, University of Queensland, St Lucia QLD, Australia
| | - Anna D MacDonald
- Language Neuroscience Laboratory, University of Queensland Centre for Clinical Research, St Lucia QLD, Australia ; NHMRC Centre for Clinical Research Excellence in Aphasia Rehabilitation, St Lucia QLD, Australia
| | - Sophia van Hees
- Language Neuroscience Laboratory, University of Queensland Centre for Clinical Research, St Lucia QLD, Australia ; NHMRC Centre for Clinical Research Excellence in Aphasia Rehabilitation, St Lucia QLD, Australia
| | - Eril McKinnon
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia QLD, Australia
| | - Kori Johnson
- Centre for Advanced Imaging, University of Queensland, St Lucia QLD, Australia
| | - David A Copland
- Language Neuroscience Laboratory, University of Queensland Centre for Clinical Research, St Lucia QLD, Australia ; NHMRC Centre for Clinical Research Excellence in Aphasia Rehabilitation, St Lucia QLD, Australia ; School of Health and Rehabilitation Sciences, University of Queensland, St Lucia QLD, Australia
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28
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de Aguiar V, Paolazzi CL, Miceli G. tDCS in post-stroke aphasia: The role of stimulation parameters, behavioral treatment and patient characteristics. Cortex 2015; 63:296-316. [PMID: 25460496 DOI: 10.1016/j.cortex.2014.08.015] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Revised: 07/30/2014] [Accepted: 08/10/2014] [Indexed: 10/24/2022]
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29
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Sandberg C, Kiran S. Analysis of abstract and concrete word processing in persons with aphasia and age-matched neurologically healthy adults using fMRI. Neurocase 2014; 20:361-88. [PMID: 23548150 PMCID: PMC3713118 DOI: 10.1080/13554794.2013.770881] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The concreteness effect occurs in both normal and language-disordered populations. Research suggests that abstract and concrete concepts elicit differing neural activation patterns in healthy young adults, but this is undocumented in persons with aphasia (PWA). Three PWA and three age-matched controls were scanned using fMRI while processing abstract and concrete words. Consistent with current theories of abstract and concrete word processing, abstract words elicited activation in verbal areas, whereas concrete words additionally activated multimodal association areas. PWA show greater differences in neural activation than age-matched controls between abstract and concrete words, possibly due to an exaggerated concreteness effect.
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Affiliation(s)
- Chaleece Sandberg
- a Speech, Language, and Hearing Sciences, Sargent College of Health and Rehabilitation Sciences , Boston University , Boston , MA , USA
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30
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Neural underpinnings for model-oriented therapy of aphasic word production. Neuropsychologia 2014; 57:154-65. [DOI: 10.1016/j.neuropsychologia.2014.03.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 03/03/2014] [Accepted: 03/20/2014] [Indexed: 11/23/2022]
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31
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Schönberger E, Heim S, Meffert E, Pieperhoff P, da Costa Avelar P, Huber W, Binkofski F, Grande M. The neural correlates of agrammatism: Evidence from aphasic and healthy speakers performing an overt picture description task. Front Psychol 2014; 5:246. [PMID: 24711802 PMCID: PMC3968764 DOI: 10.3389/fpsyg.2014.00246] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Accepted: 03/05/2014] [Indexed: 11/22/2022] Open
Abstract
Functional brain imaging studies have improved our knowledge of the neural localization of language functions and the functional reorganization after a lesion. However, the neural correlates of agrammatic symptoms in aphasia remain largely unknown. The present fMRI study examined the neural correlates of morpho-syntactic encoding and agrammatic errors in continuous language production by combining three approaches. First, the neural mechanisms underlying natural morpho-syntactic processing in a picture description task were analyzed in 15 healthy speakers. Second, agrammatic-like speech behavior was induced in the same group of healthy speakers to study the underlying functional processes by limiting the utterance length. In a third approach, five agrammatic participants performed the picture description task to gain insights in the neural correlates of agrammatism and the functional reorganization of language processing after stroke. In all approaches, utterances were analyzed for syntactic completeness, complexity, and morphology. Event-related data analysis was conducted by defining every clause-like unit (CLU) as an event with its onset-time and duration. Agrammatic and correct CLUs were contrasted. Due to the small sample size as well as heterogeneous lesion sizes and sites with lesion foci in the insula lobe, inferior frontal, superior temporal and inferior parietal areas the activation patterns in the agrammatic speakers were analyzed on a single subject level. In the group of healthy speakers, posterior temporal and inferior parietal areas were associated with greater morpho-syntactic demands in complete and complex CLUs. The intentional manipulation of morpho-syntactic structures and the omission of function words were associated with additional inferior frontal activation. Overall, the results revealed that the investigation of the neural correlates of agrammatic language production can be reasonably conducted with an overt language production paradigm.
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Affiliation(s)
- Eva Schönberger
- Section Neurological Cognition Research, Department of Neurology, Uniklinik RWTH Aachen Aachen, Germany
| | - Stefan Heim
- Section Neurological Cognition Research, Department of Neurology, Uniklinik RWTH Aachen Aachen, Germany ; Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen Aachen, Germany ; Research Centre Juelich, Institute of Neuroscience and Medicine (INM-1) Juelich, Germany
| | - Elisabeth Meffert
- Section Neurological Cognition Research, Department of Neurology, Uniklinik RWTH Aachen Aachen, Germany ; Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen Aachen, Germany
| | - Peter Pieperhoff
- Research Centre Juelich, Institute of Neuroscience and Medicine (INM-1) Juelich, Germany
| | - Patricia da Costa Avelar
- Section Neurological Cognition Research, Department of Neurology, Uniklinik RWTH Aachen Aachen, Germany
| | - Walter Huber
- Section Neurological Cognition Research, Department of Neurology, Uniklinik RWTH Aachen Aachen, Germany
| | - Ferdinand Binkofski
- Section Neurological Cognition Research, Department of Neurology, Uniklinik RWTH Aachen Aachen, Germany
| | - Marion Grande
- Section Neurological Cognition Research, Department of Neurology, Uniklinik RWTH Aachen Aachen, Germany
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32
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Mattioli F, Ambrosi C, Mascaro L, Scarpazza C, Pasquali P, Frugoni M, Magoni M, Biagi L, Gasparotti R. Early Aphasia Rehabilitation Is Associated With Functional Reactivation of the Left Inferior Frontal Gyrus. Stroke 2014; 45:545-52. [DOI: 10.1161/strokeaha.113.003192] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Flavia Mattioli
- From Neuropsychology Unit (F.M., C.S., P.P., M.F.), Department of Diagnostic Imaging, Medical Physics Unit (L.M.), and Stroke Unit (M.M.), Spedali Civili di Brescia, Brescia, Italy; Department of Diagnostic Imaging, Neuroradiology Unit, University of Brescia, Brescia, Italy (C.A., R.G.); and IRCCS Stella Maris Foundation, Pisa, Italy (L.B.)
| | - Claudia Ambrosi
- From Neuropsychology Unit (F.M., C.S., P.P., M.F.), Department of Diagnostic Imaging, Medical Physics Unit (L.M.), and Stroke Unit (M.M.), Spedali Civili di Brescia, Brescia, Italy; Department of Diagnostic Imaging, Neuroradiology Unit, University of Brescia, Brescia, Italy (C.A., R.G.); and IRCCS Stella Maris Foundation, Pisa, Italy (L.B.)
| | - Lorella Mascaro
- From Neuropsychology Unit (F.M., C.S., P.P., M.F.), Department of Diagnostic Imaging, Medical Physics Unit (L.M.), and Stroke Unit (M.M.), Spedali Civili di Brescia, Brescia, Italy; Department of Diagnostic Imaging, Neuroradiology Unit, University of Brescia, Brescia, Italy (C.A., R.G.); and IRCCS Stella Maris Foundation, Pisa, Italy (L.B.)
| | - Cristina Scarpazza
- From Neuropsychology Unit (F.M., C.S., P.P., M.F.), Department of Diagnostic Imaging, Medical Physics Unit (L.M.), and Stroke Unit (M.M.), Spedali Civili di Brescia, Brescia, Italy; Department of Diagnostic Imaging, Neuroradiology Unit, University of Brescia, Brescia, Italy (C.A., R.G.); and IRCCS Stella Maris Foundation, Pisa, Italy (L.B.)
| | - Patrizia Pasquali
- From Neuropsychology Unit (F.M., C.S., P.P., M.F.), Department of Diagnostic Imaging, Medical Physics Unit (L.M.), and Stroke Unit (M.M.), Spedali Civili di Brescia, Brescia, Italy; Department of Diagnostic Imaging, Neuroradiology Unit, University of Brescia, Brescia, Italy (C.A., R.G.); and IRCCS Stella Maris Foundation, Pisa, Italy (L.B.)
| | - Marina Frugoni
- From Neuropsychology Unit (F.M., C.S., P.P., M.F.), Department of Diagnostic Imaging, Medical Physics Unit (L.M.), and Stroke Unit (M.M.), Spedali Civili di Brescia, Brescia, Italy; Department of Diagnostic Imaging, Neuroradiology Unit, University of Brescia, Brescia, Italy (C.A., R.G.); and IRCCS Stella Maris Foundation, Pisa, Italy (L.B.)
| | - Mauro Magoni
- From Neuropsychology Unit (F.M., C.S., P.P., M.F.), Department of Diagnostic Imaging, Medical Physics Unit (L.M.), and Stroke Unit (M.M.), Spedali Civili di Brescia, Brescia, Italy; Department of Diagnostic Imaging, Neuroradiology Unit, University of Brescia, Brescia, Italy (C.A., R.G.); and IRCCS Stella Maris Foundation, Pisa, Italy (L.B.)
| | - Laura Biagi
- From Neuropsychology Unit (F.M., C.S., P.P., M.F.), Department of Diagnostic Imaging, Medical Physics Unit (L.M.), and Stroke Unit (M.M.), Spedali Civili di Brescia, Brescia, Italy; Department of Diagnostic Imaging, Neuroradiology Unit, University of Brescia, Brescia, Italy (C.A., R.G.); and IRCCS Stella Maris Foundation, Pisa, Italy (L.B.)
| | - Roberto Gasparotti
- From Neuropsychology Unit (F.M., C.S., P.P., M.F.), Department of Diagnostic Imaging, Medical Physics Unit (L.M.), and Stroke Unit (M.M.), Spedali Civili di Brescia, Brescia, Italy; Department of Diagnostic Imaging, Neuroradiology Unit, University of Brescia, Brescia, Italy (C.A., R.G.); and IRCCS Stella Maris Foundation, Pisa, Italy (L.B.)
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33
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van Hees S, McMahon K, Angwin A, de Zubicaray G, Copland DA. Neural activity associated with semantic versus phonological anomia treatments in aphasia. BRAIN AND LANGUAGE 2014; 129:47-57. [PMID: 24556337 DOI: 10.1016/j.bandl.2013.12.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 12/20/2013] [Accepted: 12/30/2013] [Indexed: 06/03/2023]
Abstract
Naming impairments in aphasia are typically targeted using semantic and/or phonologically based tasks. However, it is not known whether these treatments have different neural mechanisms. Eight participants with aphasia received twelve treatment sessions using an alternating treatment design, with fMRI scans pre- and post-treatment. Half the sessions employed Phonological Components Analysis (PCA), and half the sessions employed Semantic Feature Analysis (SFA). Pre-treatment activity in the left caudate correlated with greater immediate treatment success for items treated with SFA, whereas recruitment of the left supramarginal gyrus and right precuneus post-treatment correlated with greater immediate treatment success for items treated with PCA. The results support previous studies that have found greater treatment outcome to be associated with activity in predominantly left hemisphere regions, and suggest that different mechanisms may be engaged dependent on the type of treatment employed.
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Affiliation(s)
- Sophia van Hees
- University of Queensland Centre for Clinical Research, Herston, QLD 4029, Australia; School of Health and Rehabilitation Sciences, University of Queensland, St. Lucia, QLD 4072, Australia; Centre for Advanced Imaging, University of Queensland, St. Lucia, QLD 4072, Australia.
| | - Katie McMahon
- Centre for Advanced Imaging, University of Queensland, St. Lucia, QLD 4072, Australia; Wesley Hospital, Auchenflower, QLD 4066, Australia.
| | - Anthony Angwin
- School of Health and Rehabilitation Sciences, University of Queensland, St. Lucia, QLD 4072, Australia.
| | - Greig de Zubicaray
- School of Psychology, University of Queensland, St. Lucia, QLD 4072, Australia.
| | - David A Copland
- University of Queensland Centre for Clinical Research, Herston, QLD 4029, Australia; School of Health and Rehabilitation Sciences, University of Queensland, St. Lucia, QLD 4072, Australia; Clinical Centre for Research Excellence in Aphasia Rehabilitation, Australia.
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34
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Basso G, Magon S, Reggiani F, Capasso R, Monittola G, Yang FJ, Miceli G. Distinguishable neurofunctional effects of task practice and item practice in picture naming: a BOLD fMRI study in healthy subjects. BRAIN AND LANGUAGE 2013; 126:302-313. [PMID: 23933470 DOI: 10.1016/j.bandl.2013.07.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 07/03/2013] [Accepted: 07/08/2013] [Indexed: 06/02/2023]
Abstract
Practice of language tasks results in improved performance and BOLD signal changes. We distinguish changes correlated with repeated exposure to a picture naming task, from changes associated with naming specific items trained during practice. Task practice affected trained and untrained items, yielding left-sided BOLD deactivations in extrastriate, prefrontal and superior temporal areas (consistent with their putative role in perceptual priming, articulatory planning and phonological lexical retrieval, respectively). Item practice effects were restricted to trained words. There was deactivation in left posterior fusiform (supporting its role in accessing structural object representations), anterior cingulate and left insular/inferior frontal cortices (consistent with their role in processing low-frequency words). Central precuneus and posterior cingulate were hyperactivated (consistent with their putative role in episodic memory for trained items, probably due to functional connections with language areas). In healthy subjects, naming practice modifies stored linguistic representations, but mostly affects ease of access to trained words.
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Affiliation(s)
- Gianpaolo Basso
- DiPSCo (Department of Psychology and Cognitive Sciences), Università di Trento, Rovereto, TN, Italy
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35
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Meinzer M, Beeson PM, Cappa S, Crinion J, Kiran S, Saur D, Parrish T, Crosson B, Thompson CK. Neuroimaging in aphasia treatment research: consensus and practical guidelines for data analysis. Neuroimage 2013. [PMID: 22387474 DOI: 10.1016/j.neuroimage.2012.02.058,pii:s1053-8119(12)00236-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023] Open
Abstract
Functional magnetic resonance imaging is the most widely used imaging technique to study treatment-induced recovery in post-stroke aphasia. The longitudinal design of such studies adds to the challenges researchers face when studying patient populations with brain damage in cross-sectional settings. The present review focuses on issues specifically relevant to neuroimaging data analysis in aphasia treatment research identified in discussions among international researchers at the Neuroimaging in Aphasia Treatment Research Workshop held at Northwestern University (Evanston, Illinois, USA). In particular, we aim to provide the reader with a critical review of unique problems related to the pre-processing, statistical modeling and interpretation of such data sets. Despite the fact that data analysis procedures critically depend on specific design features of a given study, we aim to discuss and communicate a basic set of practical guidelines that should be applicable to a wide range of studies and useful as a reference for researchers pursuing this line of research.
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Affiliation(s)
- Marcus Meinzer
- Charite Universitätsmedizin, Department of Neurology, Center for Stroke Research Berlin & Cluster of Excellence NeuroCure, Berlin, Germany.
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36
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Meinzer M, Beeson PM, Cappa S, Crinion J, Kiran S, Saur D, Parrish T, Crosson B, Thompson CK. Neuroimaging in aphasia treatment research: consensus and practical guidelines for data analysis. Neuroimage 2013; 73:215-24. [PMID: 22387474 PMCID: PMC3416913 DOI: 10.1016/j.neuroimage.2012.02.058] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Accepted: 02/19/2012] [Indexed: 11/19/2022] Open
Abstract
Functional magnetic resonance imaging is the most widely used imaging technique to study treatment-induced recovery in post-stroke aphasia. The longitudinal design of such studies adds to the challenges researchers face when studying patient populations with brain damage in cross-sectional settings. The present review focuses on issues specifically relevant to neuroimaging data analysis in aphasia treatment research identified in discussions among international researchers at the Neuroimaging in Aphasia Treatment Research Workshop held at Northwestern University (Evanston, Illinois, USA). In particular, we aim to provide the reader with a critical review of unique problems related to the pre-processing, statistical modeling and interpretation of such data sets. Despite the fact that data analysis procedures critically depend on specific design features of a given study, we aim to discuss and communicate a basic set of practical guidelines that should be applicable to a wide range of studies and useful as a reference for researchers pursuing this line of research.
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Affiliation(s)
- Marcus Meinzer
- Charite Universitätsmedizin, Department of Neurology, Center for Stroke Research Berlin & Cluster of Excellence NeuroCure, Berlin, Germany.
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37
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Pagliarin KC, Oliveira CRD, Silva BMD, Calvette LDF, Fonseca RP. Instrumentos para avaliação da linguagem pós-lesão cerebrovascular esquerda. REVISTA CEFAC 2013. [DOI: 10.1590/s1516-18462013005000015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
O tema deste estudo é a avaliação padronizada da linguagem em pacientes com lesão cerebrovascular esquerda (LHE) que pode ser muito útil no estabelecimento do diagnóstico, prognóstico e plano terapêutico, complementando observação, entrevistas e tarefas clínicas. Este estudo teve como objetivo identificar quais instrumentos de investigação de linguagem têm sido utilizados para avaliação de quadros neurológicos súbitos envolvendo o hemisfério esquerdo (HE) e analisar quais componentes linguísticos são os mais avaliados. Foi possível identificar nove instrumentos utilizados internacionalmente que avaliam diferentes componentes linguísticos em pacientes com LHE; no contexto nacional, porém, foram encontradas apenas duas baterias para avaliação dessa população, ficando evidente a necessidade da construção e/ou de adaptação de instrumentos para a população brasileira. Os componentes linguísticos mais investigados foram nomeação e compreensão oral, respectivamente. A avaliação da linguagem torna-se essencial nos quadros envolvendo o HE, pois déficits linguísticos podem acarretar prejuízos sociais, ocupacionais e familiares.
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Schwartz MF, Faseyitan O, Kim J, Coslett HB. The dorsal stream contribution to phonological retrieval in object naming. Brain 2012; 135:3799-814. [PMID: 23171662 DOI: 10.1093/brain/aws300] [Citation(s) in RCA: 143] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Meaningful speech, as exemplified in object naming, calls on knowledge of the mappings between word meanings and phonological forms. Phonological errors in naming (e.g. GHOST named as 'goath') are commonly seen in persisting post-stroke aphasia and are thought to signal impairment in retrieval of phonological form information. We performed a voxel-based lesion-symptom mapping analysis of 1718 phonological naming errors collected from 106 individuals with diverse profiles of aphasia. Voxels in which lesion status correlated with phonological error rates localized to dorsal stream areas, in keeping with classical and contemporary brain-language models. Within the dorsal stream, the critical voxels were concentrated in premotor cortex, pre- and postcentral gyri and supramarginal gyrus with minimal extension into auditory-related posterior temporal and temporo-parietal cortices. This challenges the popular notion that error-free phonological retrieval requires guidance from sensory traces stored in posterior auditory regions and points instead to sensory-motor processes located further anterior in the dorsal stream. In a separate analysis, we compared the lesion maps for phonological and semantic errors and determined that there was no spatial overlap, demonstrating that the brain segregates phonological and semantic retrieval operations in word production.
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Affiliation(s)
- Myrna F Schwartz
- Moss Rehabilitation Research Institute, 50 Township Line Road, Elkins Park, PA 19027, USA.
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Medina J, Norise C, Faseyitan O, Coslett HB, Turkeltaub PE, Hamilton RH. Finding the Right Words: Transcranial Magnetic Stimulation Improves Discourse Productivity in Non-fluent Aphasia After Stroke. APHASIOLOGY 2012; 26:1153-1168. [PMID: 23280015 PMCID: PMC3532848 DOI: 10.1080/02687038.2012.710316] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND: Loss of fluency is a significant source of functional impairment in many individuals with aphasia. Repetitive transcranial magnetic stimulation (rTMS) administered to the right inferior frontal gyrus (IFG) has been shown to facilitate naming in persons with chronic left hemisphere stroke and non-fluent aphasia. However, changes in fluency in aphasic subjects receiving rTMS have not been adequately explored. AIMS: To determine whether rTMS improves fluency in individuals with chronic nonfluent aphasia, and to identify aspects of fluency that are modulated in persons who respond to rTMS. METHODS #ENTITYSTARTX00026; PROCEDURES: Ten individuals with left hemisphere MCA strokes and mild to moderate non-fluent aphasia participated in the study. Before treatment, subjects were asked to describe the Cookie Theft picture in three separate sessions. During treatment, all subjects received 1200 pulses of 1 Hz rTMS daily in 10 sessions over two weeks at a site that had previously been shown to improve naming. Subjects repeated the Cookie Theft description two months after treatment. Five subjects initially received sham stimulation instead of real TMS. Two months after sham treatment, these individuals received real rTMS. Performance both at baseline and after stimulation was coded using Quantitative Production Analysis (Saffran, Berndt & Schwartz, 1989) and Correct Information Unit (Nicholas & Brookshire, 1993) analysis. OUTCOMES #ENTITYSTARTX00026; RESULTS: Across all subjects (n=10), real rTMS treatment resulted in a significant increase in multiple measures of discourse productivity compared to baseline performance. There was no significant increase in measures of sentence productivity or grammatical accuracy. There was no significant increase from baseline in the sham condition (n=5) on any study measures. CONCLUSIONS: Stimulation of the right IFG in patients with chronic non-fluent aphasia facilitates discourse production. We posit that this effect may be attributable to improved lexical-semantic access.
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Affiliation(s)
- Jared Medina
- Department of Neurology, University of Pennsylvania
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Heath S, McMahon KL, Nickels L, Angwin A, Macdonald AD, van Hees S, Johnson K, McKinnon E, Copland DA. Neural mechanisms underlying the facilitation of naming in aphasia using a semantic task: an fMRI study. BMC Neurosci 2012; 13:98. [PMID: 22882806 PMCID: PMC3477078 DOI: 10.1186/1471-2202-13-98] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Accepted: 08/01/2012] [Indexed: 11/10/2022] Open
Abstract
Background Previous attempts to investigate the effects of semantic tasks on picture naming in both healthy controls and people with aphasia have typically been confounded by inclusion of the phonological word form of the target item. As a result, it is difficult to isolate any facilitatory effects of a semantically-focused task to either lexical-semantic or phonological processing. This functional magnetic resonance imaging (fMRI) study examined the neurological mechanisms underlying short-term (within minutes) and long-term (within days) facilitation of naming from a semantic task that did not include the phonological word form, in both participants with aphasia and age-matched controls. Results Behavioral results showed that a semantic task that did not include the phonological word form can successfully facilitate subsequent picture naming in both healthy controls and individuals with aphasia. The whole brain neuroimaging results for control participants identified a repetition enhancement effect in the short-term, with modulation of activity found in regions that have not traditionally been associated with semantic processing, such as the right lingual gyrus (extending to the precuneus) and the left inferior occipital gyrus (extending to the fusiform gyrus). In contrast, the participants with aphasia showed significant differences in activation over both the short- and the long-term for facilitated items, predominantly within either left hemisphere regions linked to semantic processing or their right hemisphere homologues. Conclusions For control participants in this study, the short-lived facilitation effects of a prior semantic task that did not include the phonological word form were primarily driven by object priming and episodic memory mechanisms. However, facilitation effects appeared to engage a predominantly semantic network in participants with aphasia over both the short- and the long-term. The findings of the present study also suggest that right hemisphere involvement may be supportive rather than maladaptive, and that a large distributed perisylvian network in both cerebral hemispheres supports the facilitation of naming in individuals with aphasia.
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Affiliation(s)
- Shiree Heath
- University of Queensland, Language Neuroscience Laboratory, Centre for Clinical Research, Brisbane, Queensland, Australia.
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Marcotte K, Adrover-Roig D, Damien B, de Préaumont M, Généreux S, Hubert M, Ansaldo AI. Therapy-induced neuroplasticity in chronic aphasia. Neuropsychologia 2012; 50:1776-86. [DOI: 10.1016/j.neuropsychologia.2012.04.001] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Revised: 03/20/2012] [Accepted: 04/04/2012] [Indexed: 11/25/2022]
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Fridriksson J, Richardson JD, Fillmore P, Cai B. Left hemisphere plasticity and aphasia recovery. Neuroimage 2012; 60:854-63. [PMID: 22227052 PMCID: PMC3313653 DOI: 10.1016/j.neuroimage.2011.12.057] [Citation(s) in RCA: 138] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Revised: 12/14/2011] [Accepted: 12/15/2011] [Indexed: 10/14/2022] Open
Abstract
A recent study by our group revealed a strong relationship between functional brain changes in the left hemisphere and anomia treatment outcome in chronic stroke patients (N=26) with aphasia (Fridriksson, 2010). The current research represents a continuation of this work in which we have refined our methods and added data from four more patients (for a total sample size of 30) to assess where in the left hemisphere treatment-related brain changes occur. Unlike Fridriksson (2010) which only focused on changes in correct naming as a marker of treatment outcome, the current study examined the relationship between changes in left hemisphere activity and changes in correct naming, semantic paraphasias, and phonemic paraphasias following treatment. We also expanded on the work by Fridriksson by examining whether neurophysiological measures taken at baseline (defined henceforth as the time-point before the start of anomia treatment) predict treatment outcome. Our analyses revealed that changes in activation in perilesional areas predicted treatment-related increases in correct naming in individuals with chronic aphasia. This relationship was most easily observed in the left frontal lobe. A decrease in the number of semantic and phonemic paraphasias was predicted by an activation change in the temporal lobe involving cortical areas that were shown to be active during picture naming in 14 normal subjects. In contrast, a far less certain relationship was found between baseline neurophysiological measures and anomia treatment outcome. Our findings suggest that improved naming associated with behavioral anomia treatment in aphasia is associated with modulation of the left frontal lobe whereas a reduction in naming errors is mediated by left posterior regions that classically are thought to be involved in language processing.
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Affiliation(s)
- Julius Fridriksson
- Department of Communication Sciences & Disorders, University of South Carolina, Columbia, South Carolina, USA.
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Harnish S, Meinzer M, Trinastic J, Fitzgerald D, Page S. Language changes coincide with motor and fMRI changes following upper extremity motor therapy for hemiparesis: a brief report. Brain Imaging Behav 2011; 8:370-7. [DOI: 10.1007/s11682-011-9139-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Meinzer M, Harnish S, Conway T, Crosson B. Recent developments in functional and structural imaging of aphasia recovery after stroke. APHASIOLOGY 2011; 25:271-290. [PMID: 21532927 PMCID: PMC3083028 DOI: 10.1080/02687038.2010.530672] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND: Functional and structural neuroimaging techniques can increase our knowledge about the neural processes underlying recovery from post-stroke language impairments (aphasia). AIMS: In the present review we highlight recent developments in neuroimaging research of aphasia recovery. MAIN CONTRIBUTION: We review (a) cross-sectional findings in aphasia with regard to local brain functions and functional connectivity, (b) structural and functional imaging findings using longitudinal (intervention) paradigms, (c) new adjunct treatments that are guided by functional imaging techniques (e.g., electrical brain stimulation) and (d) studies related to the prognosis of language recovery and treatment responsiveness after stroke. CONCLUSIONS: More recent developments in data acquisition and analysis foster better understanding and more realistic modelling of the neural substrates of language recovery after stroke. Moreover, the combination of different neuroimaging protocols can provide converging evidence for neuroplastic brain remodelling during spontaneous and treatment-induced recovery. Researchers are also beginning to use sophisticated imaging analyses to improve accuracy of prognosis, which may eventually improve patient care by allowing for more efficient treatment planning. Brain stimulation techniques offer a new and exciting way to improve the recovery potential after stroke.
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Affiliation(s)
- Marcus Meinzer
- Department of Neurology, Center for Stroke Research Berlin & Cluster of Excellence NeuroCure, Charite, Universitätsmedizin Berlin, Berlin, Germany
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL, USA
| | - Stacy Harnish
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA
- Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Tim Conway
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL, USA
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA
| | - Bruce Crosson
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL, USA
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA
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Mohr J, Binder JR. Posterior Cerebral Artery Disease. Stroke 2011. [DOI: 10.1016/b978-1-4160-5478-8.10025-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Preservation and modulation of specific left hemisphere regions is vital for treated recovery from anomia in stroke. J Neurosci 2010; 30:11558-64. [PMID: 20810877 DOI: 10.1523/jneurosci.2227-10.2010] [Citation(s) in RCA: 128] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The location and extent of brain changes that support recovery in chronic stroke is probably related to the structural integrity of the remaining cortex. However, little is known about the specifics of this relationship and how it influences treatment outcome in chronic stroke. To examine this issue, the current study examined frank brain damage and changes in cortical activation as predictors of language-treatment outcome in patients with chronic aphasia caused by stroke. Twenty-six patients received multiple MRI sessions before and after 30 h of aphasia treatment targeting anomia, an impairment in the ability to name common objects. Improved naming was associated with increased brain activation in the anterior and posterior regions of the left hemisphere, whereas damage to the posterior portion of the left middle temporal lobe and the temporal-occipital junction had a particularly negative effect on treatment outcome. Specifically, patients whose brain damage included regions commonly associated with lexical retrieval and phonological processing (e.g., Brodmann's areas 37 and 39) were less likely to show treatment-related improvement in correct naming compared with cases where the same areas were intact. These findings suggest that brain changes associated with improved naming ability in chronic aphasia rely on preservation and recruitment of eloquent cortex in the left hemisphere. In general, it seems likely that a similar relationship between cortical preservation and recruitment may also pertain to recovery from other functional impairments in chronic stroke.
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Baker JM, Rorden C, Fridriksson J. Using transcranial direct-current stimulation to treat stroke patients with aphasia. Stroke 2010; 41:1229-36. [PMID: 20395612 DOI: 10.1161/strokeaha.109.576785] [Citation(s) in RCA: 341] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Recent research suggests that increased left hemisphere cortical activity, primarily of the left frontal cortex, is associated with improved naming performance in stroke patients with aphasia. Our aim was to determine whether anodal transcranial direct-current stimulation (tDCS), a method thought to increase cortical excitability, would improve naming accuracy in stroke patients with aphasia when applied to the scalp overlying the left frontal cortex. METHODS Ten patients with chronic stroke-induced aphasia received 5 days of anodal tDCS (1 mA for 20 minutes) and 5 days of sham tDCS (for 20 minutes, order randomized) while performing a computerized anomia treatment. tDCS positioning was guided by a priori functional magnetic resonance imaging results for each individual during an overt naming task to ensure that the active electrode was placed over structurally intact cortex. RESULTS Results revealed significantly improved naming accuracy of treated items (F[1,9]=5.72, P<0.040) after anodal tDCS compared with sham tDCS. Patients who demonstrated the most improvement were those with perilesional areas closest to the stimulation site. Crucially, this treatment effect persisted at least 1 week after treatment. CONCLUSIONS Our findings suggest that anodal tDCS over the left frontal cortex can lead to enhanced naming accuracy in stroke patients with aphasia and, if proved to be effective in larger studies, may provide a supplementary treatment approach for anomia.
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Affiliation(s)
- Julie M Baker
- Department of Communication Sciences and Disorders, Williams Brice Building, 1621 Greene St, University of South Carolina, Columbia, SC 29208, USA.
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Fridriksson J, Bonilha L, Baker JM, Moser D, Rorden C. Activity in preserved left hemisphere regions predicts anomia severity in aphasia. Cereb Cortex 2009; 20:1013-9. [PMID: 19687294 DOI: 10.1093/cercor/bhp160] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Understanding the neural mechanism that supports preserved language processing in aphasia has implications for both basic and applied science. This study examined brain activation associated with correct picture naming in 15 patients with aphasia. We contrasted each patient's activation to the activation observed in a neurologically healthy control group, allowing us to identify regions with unusual activity patterns. The results revealed that increased activation in preserved left hemisphere areas is associated with better naming performance in aphasia. This relationship was linear in nature; progressively less cortical activation was associated with greater severity of anomia. These findings are consistent with others who suggests that residual language function following stroke relies on preserved cortical areas in the left hemisphere.
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Affiliation(s)
- Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29208, USA.
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Where (in the brain) do semantic errors come from? Cortex 2008; 45:641-9. [PMID: 19084219 DOI: 10.1016/j.cortex.2008.05.013] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2007] [Revised: 02/11/2008] [Accepted: 05/22/2008] [Indexed: 11/22/2022]
Abstract
BACKGROUND Semantic errors result from the disruption of access either to semantics or to lexical representations. One way to determine the origins of these errors is to evaluate comprehension of words that elicit semantic errors in naming. We hypothesized that in acute stroke there are different brain regions where dysfunction results in semantic errors in both naming and comprehension versus those with semantic errors in oral naming alone. METHODS A consecutive series of 196 patients with acute left hemispheric stroke who met inclusion criteria were evaluated with oral naming and spoken word/picture verification tasks and magnetic resonance imaging within 48 h of stroke onset. We evaluated the relationship between tissue dysfunction in 10 pre-specified Brodmann's areas (BA) and the production of coordinate semantic errors resulting from (1) semantic deficits or (2) lexical access deficits. RESULTS Semantic errors arising from semantic deficits were most associated with tissue dysfunction/infarct of left BA 22. Semantic errors resulting from lexical access deficits were associated with hypoperfusion/infarct of left BA 37. CONCLUSION Our study shows that semantic errors arising from damage to distinct cognitive processes reflect dysfunction of different brain regions.
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