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Casilio M, Kasdan AV, Schneck SM, Entrup JL, Levy DF, Crouch K, Wilson SM. Situating word deafness within aphasia recovery: A case report. Cortex 2024; 173:96-119. [PMID: 38387377 PMCID: PMC11073474 DOI: 10.1016/j.cortex.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 10/02/2023] [Accepted: 12/26/2023] [Indexed: 02/24/2024]
Abstract
Word deafness is a rare neurological disorder often observed following bilateral damage to superior temporal cortex and canonically defined as an auditory modality-specific deficit in word comprehension. The extent to which word deafness is dissociable from aphasia remains unclear given its heterogeneous presentation, and some have consequently posited that word deafness instead represents a stage in recovery from aphasia, where auditory and linguistic processing are affected to varying degrees and improve at differing rates. Here, we report a case of an individual (Mr. C) with bilateral temporal lobe lesions whose presentation evolved from a severe aphasia to an atypical form of word deafness, where auditory linguistic processing was impaired at the sentence level and beyond. We first reconstructed in detail Mr. C's stroke recovery through medical record review and supplemental interviewing. Then, using behavioral testing and multimodal neuroimaging, we documented a predominant auditory linguistic deficit in sentence and narrative comprehension-with markedly reduced behavioral performance and absent brain activation in the language network in the spoken modality exclusively. In contrast, Mr. C displayed near-unimpaired behavioral performance and robust brain activations in the language network for the linguistic processing of words, irrespective of modality. We argue that these findings not only support the view of word deafness as a stage in aphasia recovery but also further instantiate the important role of left superior temporal cortex in auditory linguistic processing.
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Affiliation(s)
| | - Anna V Kasdan
- Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt Brain Institute, TN, USA
| | | | | | - Deborah F Levy
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kelly Crouch
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Stephen M Wilson
- Vanderbilt University Medical Center, Nashville, TN, USA; School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
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2
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Maloney TC, Dietz A, Vannest J, Wilkinson K, Szaflarski JP, Stall C, Mamlekar CR. Functional Magnetic Resonance Imaging Activation During Unscripted Discourse in People With Poststroke Aphasia. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4838-4848. [PMID: 37917918 PMCID: PMC11005021 DOI: 10.1044/2023_jslhr-23-00124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/14/2023] [Accepted: 09/03/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE The purpose of this project was to determine the feasibility of employing a functional magnetic resonance imaging (fMRI) task that captured activation associated with overt, unscripted (or free) discourse of people with aphasia (PWA), using a continuous scan paradigm. METHOD Seven participants (six females, ages 48-70 years) with chronic poststroke aphasia underwent two fMRI scanning sessions that included a discourse fMRI paradigm that consisted of five 1-min picture description tasks, using personally relevant photographs, interspersed with two 30-s control periods where participants looked at a fixation cross. Audio during the continuous fMRI scan was collected and marked with speaking times and coded for correct information units. Activation maps from the fMRI data were generated for the contrast between speaking and control conditions. In order to show the effects of the multi-echo data analysis, we compared it to a single-echo analysis by using only the middle echo (echo time of 30 ms). RESULTS Through the implementation of the free discourse fMRI task, we were able to elicit activation that included bilateral regions in the planum polare, central opercular cortex, precentral gyrus, superior temporal gyrus, middle temporal gyrus, superior temporal gyrus, Crus I of the cerebellum, as well as bilateral occipital regions. CONCLUSIONS We describe a new tool for assessing discourse recovery in PWA. By demonstrating the feasibility of a natural language paradigm in patients with chronic, poststroke aphasia, we open a new area for future research.
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Affiliation(s)
| | - Aimee Dietz
- Department of Communication Sciences and Disorders, Georgia State University, Atlanta
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
| | - Jennifer Vannest
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
| | - Krista Wilkinson
- Communication Sciences and Disorders, The Pennsylvania State University, State College
| | - Jerzy P. Szaflarski
- Departments of Neurology, Neurobiology, and Neurosurgery, University of Alabama at Birmingham Heersink School of Medicine
| | - Cassandra Stall
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
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3
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Bajracharya A, Peelle JE. A systematic review of neuroimaging approaches to mapping language in individuals. JOURNAL OF NEUROLINGUISTICS 2023; 68:101163. [PMID: 37637379 PMCID: PMC10449384 DOI: 10.1016/j.jneuroling.2023.101163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Although researchers often rely on group-level fMRI results to draw conclusions about the neurobiology of language, doing so without accounting for the complexities of individual brains may reduce the validity of our findings. Furthermore, understanding brain organization in individuals is critically important for both basic science and clinical translation. To assess the state of single-subject language localization in the functional neuroimaging literature, we carried out a systematic review of studies published through April 2020. Out of 977 papers identified through our search, 121 met our inclusion criteria for reporting single-subject fMRI results (fMRI studies of language in adults that report task-based single-subject statistics). Of these, 20 papers reported using a single-subject test-retest analysis to assess reliability. Thus, we found that a relatively modest number of papers reporting single-subject results quantified single-subject reliability. These varied substantially in acquisition parameters, task design, and reliability measures, creating significant challenges for making comparisons across studies. Future endeavors to optimize the localization of language networks in individuals will benefit from the standardization and broader reporting of reliability metrics for different tasks and acquisition parameters.
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Affiliation(s)
| | - Jonathan E Peelle
- Center for Cognitive and Brain Health, Department of Communication Sciences and Disorders, and Department of Psychology, Northeastern University
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4
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Brito AC, Levy DF, Schneck SM, Entrup JL, Onuscheck CF, Casilio M, de Riesthal M, Davis LT, Wilson SM. Leukoaraiosis Is Not Associated With Recovery From Aphasia in the First Year After Stroke. NEUROBIOLOGY OF LANGUAGE (CAMBRIDGE, MASS.) 2023; 4:536-549. [PMID: 37946731 PMCID: PMC10631799 DOI: 10.1162/nol_a_00115] [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: 10/14/2022] [Accepted: 06/28/2023] [Indexed: 11/12/2023]
Abstract
After a stroke, individuals with aphasia often recover to a certain extent over time. This recovery process may be dependent on the health of surviving brain regions. Leukoaraiosis (white matter hyperintensities on MRI reflecting cerebral small vessel disease) is one indication of compromised brain health and is associated with cognitive and motor impairment. Previous studies have suggested that leukoaraiosis may be a clinically relevant predictor of aphasia outcomes and recovery, although findings have been inconsistent. We investigated the relationship between leukoaraiosis and aphasia in the first year after stroke. We recruited 267 patients with acute left hemispheric stroke and coincident fluid attenuated inversion recovery MRI. Patients were evaluated for aphasia within 5 days of stroke, and 174 patients presented with aphasia acutely. Of these, 84 patients were evaluated at ∼3 months post-stroke or later to assess longer-term speech and language outcomes. Multivariable regression models were fit to the data to identify any relationships between leukoaraiosis and initial aphasia severity, extent of recovery, or longer-term aphasia severity. We found that leukoaraiosis was present to varying degrees in 90% of patients. However, leukoaraiosis did not predict initial aphasia severity, aphasia recovery, or longer-term aphasia severity. The lack of any relationship between leukoaraiosis severity and aphasia recovery may reflect the anatomical distribution of cerebral small vessel disease, which is largely medial to the white matter pathways that are critical for speech and language function.
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Affiliation(s)
| | - Deborah F. Levy
- 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
| | - Jillian L. Entrup
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Caitlin F. Onuscheck
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Marianne Casilio
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Michael de Riesthal
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - L. Taylor Davis
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Stephen M. Wilson
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
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Philips M, Schneck SM, Levy DF, Wilson SM. Modality-Specificity of the Neural Correlates of Linguistic and Non-Linguistic Demand. NEUROBIOLOGY OF LANGUAGE (CAMBRIDGE, MASS.) 2023; 4:516-535. [PMID: 37841966 PMCID: PMC10575553 DOI: 10.1162/nol_a_00114] [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: 12/15/2022] [Accepted: 06/28/2023] [Indexed: 10/17/2023]
Abstract
Imaging studies of language processing in clinical populations can be complicated to interpret for several reasons, one being the difficulty of matching the effortfulness of processing across individuals or tasks. To better understand how effortful linguistic processing is reflected in functional activity, we investigated the neural correlates of task difficulty in linguistic and non-linguistic contexts in the auditory modality and then compared our findings to a recent analogous experiment in the visual modality in a different cohort. Nineteen neurologically normal individuals were scanned with fMRI as they performed a linguistic task (semantic matching) and a non-linguistic task (melodic matching), each with two levels of difficulty. We found that left hemisphere frontal and temporal language regions, as well as the right inferior frontal gyrus, were modulated by linguistic demand and not by non-linguistic demand. This was broadly similar to what was previously observed in the visual modality. In contrast, the multiple demand (MD) network, a set of brain regions thought to support cognitive flexibility in many contexts, was modulated neither by linguistic demand nor by non-linguistic demand in the auditory modality. This finding was in striking contradistinction to what was previously observed in the visual modality, where the MD network was robustly modulated by both linguistic and non-linguistic demand. Our findings suggest that while the language network is modulated by linguistic demand irrespective of modality, modulation of the MD network by linguistic demand is not inherent to linguistic processing, but rather depends on specific task factors.
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Affiliation(s)
- Mackenzie Philips
- 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
| | - Deborah F. Levy
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Stephen M. Wilson
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
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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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7
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Shekari E, Nozari N. A narrative review of the anatomy and function of the white matter tracts in language production and comprehension. Front Hum Neurosci 2023; 17:1139292. [PMID: 37051488 PMCID: PMC10083342 DOI: 10.3389/fnhum.2023.1139292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/24/2023] [Indexed: 03/28/2023] Open
Abstract
Much is known about the role of cortical areas in language processing. The shift towards network approaches in recent years has highlighted the importance of uncovering the role of white matter in connecting these areas. However, despite a large body of research, many of these tracts' functions are not well-understood. We present a comprehensive review of the empirical evidence on the role of eight major tracts that are hypothesized to be involved in language processing (inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus, extreme capsule, middle longitudinal fasciculus, superior longitudinal fasciculus, arcuate fasciculus, and frontal aslant tract). For each tract, we hypothesize its role based on the function of the cortical regions it connects. We then evaluate these hypotheses with data from three sources: studies in neurotypical individuals, neuropsychological data, and intraoperative stimulation studies. Finally, we summarize the conclusions supported by the data and highlight the areas needing further investigation.
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Affiliation(s)
- Ehsan Shekari
- Department of Neuroscience, Iran University of Medical Sciences, Tehran, Iran
| | - Nazbanou Nozari
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, United States
- Center for the Neural Basis of Cognition (CNBC), Pittsburgh, PA, United States
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8
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Casilio M, Fergadiotis G, Salem AC, Gale RC, McKinney-Bock K, Bedrick S. ParAlg: A Paraphasia Algorithm for Multinomial Classification of Picture Naming Errors. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:966-986. [PMID: 36791263 PMCID: PMC10461785 DOI: 10.1044/2022_jslhr-22-00255] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/05/2022] [Accepted: 11/21/2022] [Indexed: 06/18/2023]
Abstract
PURPOSE A preliminary version of a paraphasia classification algorithm (henceforth called ParAlg) has previously been shown to be a viable method for coding picture naming errors. The purpose of this study is to present an updated version of ParAlg, which uses multinomial classification, and comprehensively evaluate its performance when using two different forms of transcribed input. METHOD A subset of 11,999 archival responses produced on the Philadelphia Naming Test were classified into six cardinal paraphasia types using ParAlg under two transcription configurations: (a) using phonemic transcriptions for responses exclusively (phonemic-only) and (b) using phonemic transcriptions for nonlexical responses and orthographic transcriptions for lexical responses (orthographic-lexical). Agreement was quantified by comparing ParAlg-generated paraphasia codes between configurations and relative to human-annotated codes using four metrics (positive predictive value, sensitivity, specificity, and F1 score). An item-level qualitative analysis of misclassifications under the best performing configuration was also completed to identify the source and nature of coding discrepancies. RESULTS Agreement between ParAlg-generated and human-annotated codes was high, although the orthographic-lexical configuration outperformed phonemic-only (weighted-average F1 scores of .78 and .87, respectively). A qualitative analysis of the orthographic-lexical configuration revealed a mix of human- and ParAlg-related misclassifications, the former of which were related primarily to phonological similarity judgments whereas the latter were due to semantic similarity assignment. CONCLUSIONS ParAlg is an accurate and efficient alternative to manual scoring of paraphasias, particularly when lexical responses are orthographically transcribed. With further development, it has the potential to be a useful software application for anomia assessment. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.22087763.
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Wilson SM, Entrup JL, Schneck SM, Onuscheck CF, Levy DF, Rahman M, Willey E, Casilio M, Yen M, Brito AC, Kam W, Davis LT, de Riesthal M, Kirshner HS. Recovery from aphasia in the first year after stroke. Brain 2023; 146:1021-1039. [PMID: 35388420 PMCID: PMC10169426 DOI: 10.1093/brain/awac129] [Citation(s) in RCA: 38] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/02/2022] [Accepted: 03/27/2022] [Indexed: 11/13/2022] Open
Abstract
Most individuals who experience aphasia after a stroke recover to some extent, with the majority of gains taking place in the first year. The nature and time course of this recovery process is only partially understood, especially its dependence on lesion location and extent, which are the most important determinants of outcome. The aim of this study was to provide a comprehensive description of patterns of recovery from aphasia in the first year after stroke. We recruited 334 patients with acute left hemisphere supratentorial ischaemic or haemorrhagic stroke and evaluated their speech and language function within 5 days using the Quick Aphasia Battery (QAB). At this initial time point, 218 patients presented with aphasia. Individuals with aphasia were followed longitudinally, with follow-up evaluations of speech and language at 1 month, 3 months, and 1 year post-stroke, wherever possible. Lesions were manually delineated based on acute clinical MRI or CT imaging. Patients with and without aphasia were divided into 13 groups of individuals with similar, commonly occurring patterns of brain damage. Trajectories of recovery were then investigated as a function of group (i.e. lesion location and extent) and speech/language domain (overall language function, word comprehension, sentence comprehension, word finding, grammatical construction, phonological encoding, speech motor programming, speech motor execution, and reading). We found that aphasia is dynamic, multidimensional, and gradated, with little explanatory role for aphasia subtypes or binary concepts such as fluency. Patients with circumscribed frontal lesions recovered well, consistent with some previous observations. More surprisingly, most patients with larger frontal lesions extending into the parietal or temporal lobes also recovered well, as did patients with relatively circumscribed temporal, temporoparietal, or parietal lesions. Persistent moderate or severe deficits were common only in patients with extensive damage throughout the middle cerebral artery distribution or extensive temporoparietal damage. There were striking differences between speech/language domains in their rates of recovery and relationships to overall language function, suggesting that specific domains differ in the extent to which they are redundantly represented throughout the language network, as opposed to depending on specialized cortical substrates. Our findings have an immediate clinical application in that they will enable clinicians to estimate the likely course of recovery for individual patients, as well as the uncertainty of these predictions, based on acutely observable neurological factors.
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Affiliation(s)
- Stephen M Wilson
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Jillian L Entrup
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Sarah M Schneck
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Caitlin F Onuscheck
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Deborah F Levy
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Maysaa Rahman
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Emma Willey
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Marianne Casilio
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Melodie Yen
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | | | - Wayneho Kam
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Vanderbilt Stroke and Cerebrovascular Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - L Taylor Davis
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Michael de Riesthal
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Howard S Kirshner
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Vanderbilt Stroke and Cerebrovascular Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA
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10
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Silva AB, Liu JR, Zhao L, Levy DF, Scott TL, Chang EF. A Neurosurgical Functional Dissection of the Middle Precentral Gyrus during Speech Production. J Neurosci 2022; 42:8416-8426. [PMID: 36351829 PMCID: PMC9665919 DOI: 10.1523/jneurosci.1614-22.2022] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
Classical models have traditionally focused on the left posterior inferior frontal gyrus (Broca's area) as a key region for motor planning of speech production. However, converging evidence suggests that it is not critical for either speech motor planning or execution. Alternative cortical areas supporting high-level speech motor planning have yet to be defined. In this review, we focus on the precentral gyrus, whose role in speech production is often thought to be limited to lower-level articulatory muscle control. In particular, we highlight neurosurgical investigations that have shed light on a cortical region anatomically located near the midpoint of the precentral gyrus, hence called the middle precentral gyrus (midPrCG). The midPrCG is functionally located between dorsal hand and ventral orofacial cortical representations and exhibits unique sensorimotor and multisensory functions relevant for speech processing. This includes motor control of the larynx, auditory processing, as well as a role in reading and writing. Furthermore, direct electrical stimulation of midPrCG can evoke complex movements, such as vocalization, and selective injury can cause deficits in verbal fluency, such as pure apraxia of speech. Based on these findings, we propose that midPrCG is essential to phonological-motoric aspects of speech production, especially syllabic-level speech sequencing, a role traditionally ascribed to Broca's area. The midPrCG is a cortical brain area that should be included in contemporary models of speech production with a unique role in speech motor planning and execution.
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Affiliation(s)
- Alexander B Silva
- Department of Neurological Surgery, University of California, San Francisco, California, 94158
- Weill Institute for Neurosciences, University of California, San Francisco, California, 94158
- Medical Scientist Training Program, University of California, San Francisco, California, 94158
- Graduate Program in Bioengineering, University of California, Berkeley, California 94720, & University of California, San Francisco, California, 94158
| | - Jessie R Liu
- Department of Neurological Surgery, University of California, San Francisco, California, 94158
- Weill Institute for Neurosciences, University of California, San Francisco, California, 94158
- Graduate Program in Bioengineering, University of California, Berkeley, California 94720, & University of California, San Francisco, California, 94158
| | - Lingyun Zhao
- Department of Neurological Surgery, University of California, San Francisco, California, 94158
- Weill Institute for Neurosciences, University of California, San Francisco, California, 94158
| | - Deborah F Levy
- Department of Neurological Surgery, University of California, San Francisco, California, 94158
- Weill Institute for Neurosciences, University of California, San Francisco, California, 94158
| | - Terri L Scott
- Department of Neurological Surgery, University of California, San Francisco, California, 94158
- Weill Institute for Neurosciences, University of California, San Francisco, California, 94158
| | - Edward F Chang
- Department of Neurological Surgery, University of California, San Francisco, California, 94158
- Weill Institute for Neurosciences, University of California, San Francisco, California, 94158
- Graduate Program in Bioengineering, University of California, Berkeley, California 94720, & University of California, San Francisco, California, 94158
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11
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Diachek E, Morgan VL, Wilson SM. Adaptive Language Mapping Paradigms for Presurgical Language Mapping. AJNR Am J Neuroradiol 2022; 43:1453-1459. [PMID: 36137653 PMCID: PMC9575518 DOI: 10.3174/ajnr.a7629] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 07/12/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND PURPOSE Functional MR imaging is widely used for preoperative language assessment in candidates for resective neurosurgery. Language mapping paradigms that are adaptive to participant performance have the potential to engage the language network more robustly and consistently, resulting in more accurate functional maps. The aim of the current study was to compare two adaptive paradigms with the recommended language mapping paradigms that constitute the current standard of care. MATERIALS AND METHODS Seventy-three patients undergoing fMRI for language lateralization and/or localization completed an adaptive semantic matching paradigm, an adaptive phonological judgment paradigm, and two standard paradigms: sentence completion and word generation. The paradigms were compared in terms of the degree to which they yielded lateralized language maps and the extent of activation in frontal, temporal, and parietal language regions. RESULTS The adaptive semantic paradigm resulted in the most strongly lateralized activation maps, the greatest extent of frontal and temporal activations, and the greatest proportion of overall satisfactory language maps. The adaptive phonological paradigm identified anterior inferior parietal phonological encoding regions in most patients, unlike any of the other paradigms. CONCLUSIONS The adaptive language mapping paradigms investigated have several psychometric advantages compared with currently recommended paradigms. Adoption of these paradigms could increase the likelihood of obtaining satisfactory language maps in each individual patient.
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Affiliation(s)
- E Diachek
- From the Departments of Psychology and Human Development (E.D., S.M.W.)
| | - V L Morgan
- Biomedical Engineering (V.L.M.), Vanderbilt University, Nashville, Tennessee
- Departments of Radiology and Radiological Sciences (V.L.M., S.M.W.)
- Neurological Surgery (V.L.M.)
| | - S M Wilson
- From the Departments of Psychology and Human Development (E.D., S.M.W.)
- Departments of Radiology and Radiological Sciences (V.L.M., S.M.W.)
- Hearing and Speech Sciences (S.M.W.), Vanderbilt University Medical Center, Nashville, Tennessee
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12
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Ketchabaw WT, DeMarco AT, Paul S, Dvorak E, van der Stelt C, Turkeltaub PE. The organization of individually mapped structural and functional semantic networks in aging adults. Brain Struct Funct 2022; 227:2513-2527. [PMID: 35925418 DOI: 10.1007/s00429-022-02544-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 07/18/2022] [Indexed: 01/27/2023]
Abstract
Language function in the brain, once thought to be highly localized, is now appreciated as relying on a connected but distributed network. The semantic system is of particular interest in the language domain because of its hypothesized integration of information across multiple cortical regions. Previous work in healthy individuals has focused on group-level functional connectivity (FC) analyses of the semantic system, which may obscure interindividual differences driving variance in performance. These studies also overlook the contributions of white matter networks to semantic function. Here, we identified semantic network nodes at the individual level with a semantic decision fMRI task in 53 typically aging adults, characterized network organization using structural connectivity (SC), and quantified the segregation and integration of the network using FC. Hub regions were identified in left inferior frontal gyrus. The individualized semantic network was composed of three interacting modules: (1) default-mode module characterized by bilateral medial prefrontal and posterior cingulate regions and also including right-hemisphere homotopes of language regions; (2) left frontal module extending dorsally from inferior frontal gyrus to pre-motor area; and (3) left temporoparietal module extending from temporal pole to inferior parietal lobule. FC within Module3 and integration of the entire network related to a semantic verbal fluency task, but not a matched phonological task. These results support and extend the tri-network semantic model (Xu in Front Psychol 8: 1538 1538, 2017) and the controlled semantic cognition model (Chiou in Cortex 103: 100 116, 2018) of semantic function.
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Affiliation(s)
- W Tyler Ketchabaw
- Center for Brain Plasticity and Recovery, Georgetown University Medical Center, Washington, DC, USA.
| | - Andrew T DeMarco
- Center for Brain Plasticity and Recovery, Georgetown University Medical Center, Washington, DC, USA
| | - Sachi Paul
- Center for Brain Plasticity and Recovery, Georgetown University Medical Center, Washington, DC, USA
| | - Elizabeth Dvorak
- Center for Brain Plasticity and Recovery, Georgetown University Medical Center, Washington, DC, USA
| | - Candace van der Stelt
- Center for Brain Plasticity and Recovery, Georgetown University Medical Center, Washington, DC, USA
| | - Peter E Turkeltaub
- Center for Brain Plasticity and Recovery, Georgetown University Medical Center, Washington, DC, USA.,Research Division, National Rehabilitation Hospital, Dublin, Ireland
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13
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Cirillo S, Battistella G, Castellano A, Sanvito F, Iadanza A, Bailo M, Barzaghi RL, Acerno S, Mortini P, Gorno-Tempini ML, Mandelli ML, Falini A. Comparison between inferior frontal gyrus intrinsic connectivity network and verb-generation task fMRI network for presurgical language mapping in healthy controls and in glioma patients. Brain Imaging Behav 2022; 16:2569-2585. [PMID: 35908147 DOI: 10.1007/s11682-022-00712-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 11/02/2022]
Abstract
Task-based functional MRI (tb-fMRI) represents an extremely valuable approach for the identification of language eloquent regions for presurgical mapping in patients with brain tumors. However, its routinely application is limited by patient-related factors, such as cognitive disability and difficulty in coping with long-time acquisitions, and by technical factors, such as lack of equipment availability for stimuli delivery. Resting-state fMRI (rs-fMRI) instead, allows the identification of distinct language networks in a 10-min acquisition without the need of performing active tasks and using specific equipment. Therefore, to test the feasibility of rs-fMRI as a preoperative mapping tool, we reconstructed a lexico-semantic intrinsic connectivity network (ICN) in healthy controls (HC) and in a case series of patients with gliomas and compared the organization of this language network with the one derived from tb-fMRI in the patient's group. We studied three patients with extra-frontal gliomas who underwent functional mapping with auditory verb-generation (AVG) task and rs-fMRI with a seed in the left inferior frontal gyrus (IFG). First, we identified the functional connected areas to the IFG in HC. We qualitatively compared these areas with those that showed functional activation in AVG task derived from Neurosynth meta-analysis. Last, in each patient we performed single-subject analyses both for rs- and tb-fMRI, and we evaluated the spatial overlap between the two approaches. In HC, the IFG-ICN network showed a predominant left fronto-temporal functional connectivity in regions overlapping with the AVG network derived from a meta-analysis. In two patients, rs- and tb-fMRI showed comparable patterns of activation in left fronto-temporal regions, with different levels of contralateral activations. The third patient could not accomplish the AVG task and thus it was not possible to make any comparison with the ICN. However, in this patient, task-free approach disclosed a consistent network of fronto-temporal regions as in HC, and additional parietal regions. Our preliminary findings support the value of rs-fMRI approach for presurgical mapping, particularly for identifying left fronto-temporal core language-related areas in glioma patients. In a preoperative setting, rs-fMRI approach could represent a powerful tool for the identification of eloquent language areas, especially in patients with language or cognitive impairments.
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Affiliation(s)
- Sara Cirillo
- Neuroradiology Unit and CERMAC, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Giovanni Battistella
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Antonella Castellano
- Neuroradiology Unit and CERMAC, IRCCS Ospedale San Raffaele, Milan, Italy. .,Vita-Salute San Raffaele University, Milan, Italy.
| | | | - Antonella Iadanza
- Neuroradiology Unit and CERMAC, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Michele Bailo
- Vita-Salute San Raffaele University, Milan, Italy.,Neurosurgery and Gamma Knife Radiosurgery Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Stefania Acerno
- Neurosurgery and Gamma Knife Radiosurgery Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Pietro Mortini
- Vita-Salute San Raffaele University, Milan, Italy.,Neurosurgery and Gamma Knife Radiosurgery Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA.,Department of Psychiatry and Behavioral Science, and Weill Institute for Neurosciences, UCSF, San Francisco, CA, 94158, USA
| | - Maria Luisa Mandelli
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Andrea Falini
- Neuroradiology Unit and CERMAC, IRCCS Ospedale San Raffaele, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
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14
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DeMarco AT, van der Stelt C, Paul S, Dvorak E, Lacey E, Snider S, Turkeltaub PE. Absence of Perilesional Neuroplastic Recruitment in Chronic Poststroke Aphasia. Neurology 2022; 99:e119-e128. [PMID: 35508398 PMCID: PMC9280993 DOI: 10.1212/wnl.0000000000200382] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 02/25/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND AND OBJECTIVES A prominent theory proposes that neuroplastic recruitment of perilesional tissue supports aphasia recovery, especially when language-capable cortex is spared by smaller lesions. This theory has rarely been tested directly and findings have been inconclusive. We tested the perilesional plasticity hypothesis using 2 fMRI tasks in 2 groups of patients with previous aphasia diagnosis. METHODS Two cohorts totaling 82 patients with chronic left-hemisphere stroke with previous aphasia diagnosis and 82 control participants underwent fMRI using either a naming task or a reliable semantic decision task. Individualized perilesional tissue was defined by dilating anatomical lesions and language regions were defined using meta-analyses. Mixed modeling examined differences in activity between groups. Relationships with lesion size and aphasia severity were examined. RESULTS Patients exhibited reduced activity in perilesional language tissue relative to controls in both tasks. Although a few cortical regions exhibited greater activity irrespective of distance from the lesion, or only when distant from the lesion, no regions exhibited increased activity only when near the lesion. Larger lesions were associated with reduced language activity irrespective of distance from the lesion. Using the reliable fMRI task, reduced language activity was related to aphasia severity independent of lesion size. DISCUSSION We found no evidence for neuroplastic recruitment of perilesional tissue in aphasia beyond its typical role in language. Rather, our findings are consistent with alternative hypotheses that changes in left-hemisphere activation during recovery relate to normalization of language network dysfunction and possibly recruitment of alternate cortical processors. These findings clarify left-hemisphere neuroplastic mechanisms supporting language recovery after stroke.
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Affiliation(s)
- Andrew Tesla DeMarco
- From the Departments of Rehabilitation Medicine (A.T.D., P.E.T.) and Neurology (A.T.D., C.v.d.S., S.P., E.D., E.L., S.S., P.E.T.), Georgetown University; and MedStar National Rehabilitation Hospital (E.L., P.E.T.), Washington, DC
| | - Candace van der Stelt
- From the Departments of Rehabilitation Medicine (A.T.D., P.E.T.) and Neurology (A.T.D., C.v.d.S., S.P., E.D., E.L., S.S., P.E.T.), Georgetown University; and MedStar National Rehabilitation Hospital (E.L., P.E.T.), Washington, DC
| | - Sachi Paul
- From the Departments of Rehabilitation Medicine (A.T.D., P.E.T.) and Neurology (A.T.D., C.v.d.S., S.P., E.D., E.L., S.S., P.E.T.), Georgetown University; and MedStar National Rehabilitation Hospital (E.L., P.E.T.), Washington, DC
| | - Elizabeth Dvorak
- From the Departments of Rehabilitation Medicine (A.T.D., P.E.T.) and Neurology (A.T.D., C.v.d.S., S.P., E.D., E.L., S.S., P.E.T.), Georgetown University; and MedStar National Rehabilitation Hospital (E.L., P.E.T.), Washington, DC
| | - Elizabeth Lacey
- From the Departments of Rehabilitation Medicine (A.T.D., P.E.T.) and Neurology (A.T.D., C.v.d.S., S.P., E.D., E.L., S.S., P.E.T.), Georgetown University; and MedStar National Rehabilitation Hospital (E.L., P.E.T.), Washington, DC
| | - Sarah Snider
- From the Departments of Rehabilitation Medicine (A.T.D., P.E.T.) and Neurology (A.T.D., C.v.d.S., S.P., E.D., E.L., S.S., P.E.T.), Georgetown University; and MedStar National Rehabilitation Hospital (E.L., P.E.T.), Washington, DC
| | - Peter E Turkeltaub
- From the Departments of Rehabilitation Medicine (A.T.D., P.E.T.) and Neurology (A.T.D., C.v.d.S., S.P., E.D., E.L., S.S., P.E.T.), Georgetown University; and MedStar National Rehabilitation Hospital (E.L., P.E.T.), Washington, DC.
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15
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Larson C, Rivera-Figueroa K, Thomas HR, Fein D, Stevens MC, Eigsti IM. Structural language impairment in Autism Spectrum Disorder versus Loss of Autism Diagnosis: Behavioral and neural characteristics. Neuroimage Clin 2022; 34:103043. [PMID: 35567947 PMCID: PMC9112023 DOI: 10.1016/j.nicl.2022.103043] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/14/2022] [Accepted: 05/08/2022] [Indexed: 02/02/2023]
Abstract
This study probed for structural language impairment using behavioral and functional neuroimaging methods in individuals with Autism Spectrum Disorder (ASD) and those diagnosed with ASD in childhood who no longer meet criteria for ASD, referred to as Loss of Autism Diagnosis (LAD1). Participants were drawn from Fein et al. (2013): ASD (n = 35), LAD (n = 31), and Neurotypical (NT; n = 34). Criteria for structural language impairment were: Scores ≤ 82 on Clinical Evaluation of Language Fundamentals-4 (CELF) Core Language, an omnibus measure of language; and scores ≤ 7 on CELF Recalling Sentences, a clinical marker of structural language impairment. Task-based fMRI examined lateralization of significantly activated language-related brain regions in groups with structural language impairment (LI2) versus normal-range language (LN3), collapsed across ASD, LAD1, and NT status. Results showed no ASD versus LAD group differences in the proportion of participants with structural language impairment according to either metric (Recalling Sentences or Core Language). Functional MRI results indicated greater left hemisphere lateralization within significantly activated regions in the LI2 group. Structural language abilities were not meaningfully associated with either social abilities or lifetime ADHD symptoms in LI2 subgroups, further suggesting the presence of structural language impairment. Findings indicate the presence of persistent structural language difficulty even in the absence of ASD symptoms in some individuals within the LAD1 group and unique patterns of language-related neural specialization for language function in LI2 relative to LN3.
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Affiliation(s)
- Caroline Larson
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA,CT Institute for the Brain and Cognitive Sciences, Storrs, CT, USA,Corresponding author at: Department of Psychological Sciences, Unit 1020, 406 Babbidge Rd, Storrs, CT 06269, USA.
| | | | - Hannah R. Thomas
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Deborah Fein
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA,Department of Pediatrics, University of Connecticut, Farmington, CT, USA
| | - Michael C. Stevens
- Olin Neuropsychiatry Research Center at the Institute of Living, Hartford, CT, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Inge-Marie Eigsti
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA,CT Institute for the Brain and Cognitive Sciences, Storrs, CT, USA
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16
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Task effects on functional connectivity measures after stroke. Exp Brain Res 2021; 240:575-590. [PMID: 34860257 DOI: 10.1007/s00221-021-06261-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 10/28/2021] [Indexed: 10/19/2022]
Abstract
Understanding the effect of task compared to rest on detecting stroke-related network abnormalities will inform efforts to optimize detection of such abnormalities. The goal of this work was to determine whether connectivity measures obtained during an overt task are more effective than connectivity obtained during a "resting" state for detecting stroke-related changes in network function of the brain. This study examined working memory, discrete pedaling, continuous pedaling and language tasks. Functional magnetic resonance imaging was used to examine regional and inter-regional brain network function in 14 stroke and 16 control participants. Independent component analysis was used to identify 149 regions of interest (ROI). Using the inter-regional connectivity measurements, the weighted sum was calculated across only regions associated with a given task. Both inter-regional connectivity and regional connectivity were greater during each of the tasks as compared to the resting state. The working memory and discrete pedaling tasks allowed for detection of stroke-related decreases in inter-regional connectivity, while the continuous pedaling and language tasks allowed for detection of stroke-related enhancements in regional connectivity. These observations illustrate that task-based functional connectivity allows for detection of stroke-related changes not seen during resting states. In addition, this work provides evidence that tasks emphasizing different cognitive domains reveal different aspects of stroke-related reorganization. We also illustrate that within the motor domain, different tasks can reveal inter-regional or regional stroke-related changes, in this case suggesting that discrete pedaling required more central drive than continuous pedaling.
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17
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Gilmore N, Yücel MA, Li X, Boas DA, Kiran S. Investigating Language and Domain-General Processing in Neurotypicals and Individuals With Aphasia - A Functional Near-Infrared Spectroscopy Pilot Study. Front Hum Neurosci 2021; 15:728151. [PMID: 34602997 PMCID: PMC8484538 DOI: 10.3389/fnhum.2021.728151] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/25/2021] [Indexed: 11/29/2022] Open
Abstract
Brain reorganization patterns associated with language recovery after stroke have long been debated. Studying mechanisms of spontaneous and treatment-induced language recovery in post-stroke aphasia requires a network-based approach given the potential for recruitment of perilesional left hemisphere language regions, homologous right hemisphere language regions, and/or spared bilateral domain-general regions. Recent hardware, software, and methodological advances in functional near-infrared spectroscopy (fNIRS) make it well-suited to examine this question. fNIRS is cost-effective with minimal contraindications, making it a robust option to monitor treatment-related brain activation changes over time. Establishing clear activation patterns in neurotypical adults during language and domain-general cognitive processes via fNIRS is an important first step. Some fNIRS studies have investigated key language processes in healthy adults, yet findings are challenging to interpret in the context of methodological limitations. This pilot study used fNIRS to capture brain activation during language and domain-general processing in neurotypicals and individuals with aphasia. These findings will serve as a reference when interpreting treatment-related changes in brain activation patterns in post-stroke aphasia in the future. Twenty-four young healthy controls, seventeen older healthy controls, and six individuals with left hemisphere stroke-induced aphasia completed two language tasks (i.e., semantic feature, picture naming) and one domain-general cognitive task (i.e., arithmetic) twice during fNIRS. The probe covered bilateral frontal, parietal, and temporal lobes and included short-separation detectors for scalp signal nuisance regression. Younger and older healthy controls activated core language regions during semantic feature processing (e.g., left inferior frontal gyrus pars opercularis) and lexical retrieval (e.g., left inferior frontal gyrus pars triangularis) and domain-general regions (e.g., bilateral middle frontal gyri) during hard versus easy arithmetic as expected. Consistent with theories of post-stroke language recovery, individuals with aphasia activated areas outside the traditional networks: left superior frontal gyrus and left supramarginal gyrus during semantic feature judgment; left superior frontal gyrus and right precentral gyrus during picture naming; and left inferior frontal gyrus pars opercularis during arithmetic processing. The preliminary findings in the stroke group highlight the utility of using fNIRS to study language and domain-general processing in aphasia.
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Affiliation(s)
- Natalie Gilmore
- Department of Speech Language & Hearing Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, United States
| | - Meryem Ayse Yücel
- Neurophotonics Center, Biomedical Engineering, Boston University, Boston, MA, United States
| | - Xinge Li
- Neurophotonics Center, Biomedical Engineering, Boston University, Boston, MA, United States.,Department of Psychology, College of Liberal Arts and Social Sciences, University of Houston, Houston, TX, United States
| | - David A Boas
- Neurophotonics Center, Biomedical Engineering, Boston University, Boston, MA, United States
| | - Swathi Kiran
- Department of Speech Language & Hearing Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, United States
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18
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Borghesani V, Wang C, Miller C, Mandelli M, Shapiro K, Miller Z, Fox C, Dronkers N, Gorno-Tempini M, Watson C. The resilience of the developing reading system: multi-modal evidence of incident and recovery after a pediatric stroke. Neurocase 2021; 27:338-348. [PMID: 34503393 PMCID: PMC8814732 DOI: 10.1080/13554794.2021.1957119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 07/12/2021] [Indexed: 10/20/2022]
Abstract
Decades of neuroscientific findings have elucidated the highly specialized brain areas involved in reading, especially along the ventral occipitotemporal stream where the critical step of recognizing words occurs. We report on a 14-year-old female with temporary dyslexia after a left ventral occipitotemporal ischemic stroke. Our longitudinal multimodal findings show that the resolution of the reading impairment was associated with heightened activity in the left posterior superior and inferior temporal gyri. Our findings highlight the role of the left inferior temporal gyrus in reading and the importance of perilesional and ipsilateral cortical areas for functional recovery after childhood stroke.
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Affiliation(s)
- V. Borghesani
- Memory and Aging Center, Department of Neurology, University of California San Francisco
- Department of Neurology, University of California, San Francisco, CA
| | - C. Wang
- Memory and Aging Center, Department of Neurology, University of California San Francisco
- Department of Neurology, University of California, San Francisco, CA
| | - C. Miller
- Memory and Aging Center, Department of Neurology, University of California San Francisco
- Department of Neurology, University of California, San Francisco, CA
| | - M.L. Mandelli
- Memory and Aging Center, Department of Neurology, University of California San Francisco
- Department of Neurology, University of California, San Francisco, CA
| | - K. Shapiro
- Memory and Aging Center, Department of Neurology, University of California San Francisco
- Department of Neurology, University of California, San Francisco, CA
| | - Z. Miller
- Memory and Aging Center, Department of Neurology, University of California San Francisco
- Department of Neurology, University of California, San Francisco, CA
| | - C. Fox
- Department of Neurology, University of California, San Francisco, CA
| | - N.F. Dronkers
- Department of Psychology, University of California, Berkeley, CA
- Department of Neurology, University of California, Davis, CA3
| | - M.L. Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California San Francisco
- Department of Neurology, University of California, San Francisco, CA
- Dyslexia Center, University of California, San Francisco, CA
| | - C Watson
- Memory and Aging Center, Department of Neurology, University of California San Francisco
- Department of Neurology, University of California, San Francisco, CA
- Dyslexia Center, University of California, San Francisco, CA
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19
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Borghesani V, Dale CL, Lukic S, Hinkley LBN, Lauricella M, Shwe W, Mizuiri D, Honma S, Miller Z, Miller B, Houde JF, Gorno-Tempini ML, Nagarajan SS. Neural dynamics of semantic categorization in semantic variant of primary progressive aphasia. eLife 2021; 10:e63905. [PMID: 34155973 PMCID: PMC8241439 DOI: 10.7554/elife.63905] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 06/21/2021] [Indexed: 12/28/2022] Open
Abstract
Semantic representations are processed along a posterior-to-anterior gradient reflecting a shift from perceptual (e.g., it has eight legs) to conceptual (e.g., venomous spiders are rare) information. One critical region is the anterior temporal lobe (ATL): patients with semantic variant primary progressive aphasia (svPPA), a clinical syndrome associated with ATL neurodegeneration, manifest a deep loss of semantic knowledge. We test the hypothesis that svPPA patients perform semantic tasks by over-recruiting areas implicated in perceptual processing. We compared MEG recordings of svPPA patients and healthy controls during a categorization task. While behavioral performance did not differ, svPPA patients showed indications of greater activation over bilateral occipital cortices and superior temporal gyrus, and inconsistent engagement of frontal regions. These findings suggest a pervasive reorganization of brain networks in response to ATL neurodegeneration: the loss of this critical hub leads to a dysregulated (semantic) control system, and defective semantic representations are seemingly compensated via enhanced perceptual processing.
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Affiliation(s)
- V Borghesani
- Memory and Aging Center, Department of Neurology, University of California, San FranciscoSan FranciscoUnited States
| | - CL Dale
- Department of Radiology and Biomedical Imaging, University of California, San FranciscoSan FranciscoUnited States
| | - S Lukic
- Memory and Aging Center, Department of Neurology, University of California, San FranciscoSan FranciscoUnited States
| | - LBN Hinkley
- Department of Radiology and Biomedical Imaging, University of California, San FranciscoSan FranciscoUnited States
| | - M Lauricella
- Memory and Aging Center, Department of Neurology, University of California, San FranciscoSan FranciscoUnited States
| | - W Shwe
- Memory and Aging Center, Department of Neurology, University of California, San FranciscoSan FranciscoUnited States
| | - D Mizuiri
- Department of Radiology and Biomedical Imaging, University of California, San FranciscoSan FranciscoUnited States
| | - S Honma
- Department of Radiology and Biomedical Imaging, University of California, San FranciscoSan FranciscoUnited States
| | - Z Miller
- Memory and Aging Center, Department of Neurology, University of California, San FranciscoSan FranciscoUnited States
| | - B Miller
- Memory and Aging Center, Department of Neurology, University of California, San FranciscoSan FranciscoUnited States
| | - JF Houde
- Department of Otolaryngology, University of California, San FranciscoSan FranciscoUnited States
| | - ML Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California, San FranciscoSan FranciscoUnited States
- Department of Neurology, Dyslexia Center University of California, San FranciscoSan FranciscoUnited States
| | - SS Nagarajan
- Department of Radiology and Biomedical Imaging, University of California, San FranciscoSan FranciscoUnited States
- Department of Otolaryngology, University of California, San FranciscoSan FranciscoUnited States
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20
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Stefaniak JD, Alyahya RSW, Lambon Ralph MA. Language networks in aphasia and health: A 1000 participant activation likelihood estimation meta-analysis. Neuroimage 2021; 233:117960. [PMID: 33744459 DOI: 10.1016/j.neuroimage.2021.117960] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/28/2021] [Accepted: 03/08/2021] [Indexed: 12/20/2022] Open
Abstract
Aphasia recovery post-stroke is classically and most commonly hypothesised to rely on regions that were not involved in language premorbidly, through 'neurocomputational invasion' or engagement of 'quiescent homologues'. Contemporary accounts have suggested, instead, that recovery might be supported by under-utilised areas of the premorbid language network, which are downregulated in health to save neural resources ('variable neurodisplacement'). Despite the importance of understanding the neural bases of language recovery clinically and theoretically, there is no consensus as to which specific regions are more likely to be activated in post-stroke aphasia (PSA) than healthy individuals. Accordingly, we performed an Activation Likelihood Estimation (ALE) meta-analysis of language functional neuroimaging studies in PSA. We obtained coordinate-based functional neuroimaging data for 481 individuals with aphasia following left-hemisphere stroke and 530 linked controls from 33 studies that met predefined inclusion criteria. ALE identified regions of consistent, above-chance spatial convergence of activation, as well as regions of significantly different activation likelihood, between participant groups and language tasks. Overall, these findings dispute the prevailing theory that aphasia recovery involves recruitment of novel right hemisphere territory into the language network post-stroke. Instead, multiple regions throughout both hemispheres were consistently activated during language tasks in both PSA and controls. Regions of the right anterior insula, frontal operculum and inferior frontal gyrus (IFG) pars opercularis were more likely to be activated across all language tasks in PSA than controls. Similar regions were more likely to be activated during higher than lower demand comprehension or production tasks, consistent with them representing enhanced utilisation of spare capacity within right hemisphere executive-control related regions. This provides novel evidence that 'variable neurodisplacement' underlies language network changes that occur post-stroke. Conversely, multiple undamaged regions were less likely to be activated across all language tasks in PSA than controls, including domain-general regions of medial superior frontal and paracingulate cortex, right IFG pars triangularis and temporal pole. These changes might represent functional diaschisis, and demonstrate that there is not global, undifferentiated upregulation of all domain-general neural resources during language in PSA. Such knowledge is essential if we are to design neurobiologically-informed therapeutic interventions to facilitate language recovery.
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Affiliation(s)
- James D Stefaniak
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK; Department of Psychiatry, University of Cambridge, Cambridge, UK; Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK.
| | - Reem S W Alyahya
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK; King Fahad Medical City, Riyadh, Saudi Arabia; Alfaisal University, Riyadh, Saudi Arabia
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21
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Schneck SM, Entrup JL, Duff MC, Wilson SM. Unexpected absence of aphasia following left temporal hemorrhage: a case study with functional neuroimaging to characterize the nature of atypical language localization. Neurocase 2021; 27:97-105. [PMID: 33666124 PMCID: PMC8026574 DOI: 10.1080/13554794.2021.1886309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Unexpected absence of aphasia after left-hemisphere perisylvian damage is often assumed to reflect right-hemisphere language lateralization, but other potential explanations include bilateral language representation, or sparing of critical left-hemisphere regions due to individual variability. We describe the case of a left-handed gentleman who presented with no aphasia after a left temporal hemorrhage. We used functional neuroimaging to determine how his language network had been spared. In this case, we observed unequivocal right-hemisphere lateralization of language function, explaining his lack of aphasia. We discuss the variability of language organization and highlight outstanding questions about the implications of damage in different scenarios.
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Affiliation(s)
- Sarah M Schneck
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jillian L Entrup
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Melissa C Duff
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Stephen M Wilson
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
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22
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Dial HR, Gnanateja GN, Tessmer RS, Gorno-Tempini ML, Chandrasekaran B, Henry ML. Cortical Tracking of the Speech Envelope in Logopenic Variant Primary Progressive Aphasia. Front Hum Neurosci 2021; 14:597694. [PMID: 33488371 PMCID: PMC7815818 DOI: 10.3389/fnhum.2020.597694] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 11/19/2020] [Indexed: 11/13/2022] Open
Abstract
Logopenic variant primary progressive aphasia (lvPPA) is a neurodegenerative language disorder primarily characterized by impaired phonological processing. Sentence repetition and comprehension deficits are observed in lvPPA and linked to impaired phonological working memory, but recent evidence also implicates impaired speech perception. Currently, neural encoding of the speech envelope, which forms the scaffolding for perception, is not clearly understood in lvPPA. We leveraged recent analytical advances in electrophysiology to examine speech envelope encoding in lvPPA. We assessed cortical tracking of the speech envelope and in-task comprehension of two spoken narratives in individuals with lvPPA (n = 10) and age-matched (n = 10) controls. Despite markedly reduced narrative comprehension relative to controls, individuals with lvPPA had increased cortical tracking of the speech envelope in theta oscillations, which track low-level features (e.g., syllables), but not delta oscillations, which track speech units that unfold across a longer time scale (e.g., words, phrases, prosody). This neural signature was highly correlated across narratives. Results indicate an increased reliance on acoustic cues during speech encoding. This may reflect inefficient encoding of bottom-up speech cues, likely as a consequence of dysfunctional temporoparietal cortex.
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Affiliation(s)
- Heather R. Dial
- Aphasia Research and Treatment Lab, Department of Speech, Language, and Hearing Sciences, University of Texas at Austin, Austin, TX, United States
| | - G. Nike Gnanateja
- SoundBrain Lab, Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA, United States
| | - Rachel S. Tessmer
- Aphasia Research and Treatment Lab, Department of Speech, Language, and Hearing Sciences, University of Texas at Austin, Austin, TX, United States
| | - Maria Luisa Gorno-Tempini
- Language Neurobiology Laboratory, Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Bharath Chandrasekaran
- SoundBrain Lab, Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA, United States
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States
| | - Maya L. Henry
- Aphasia Research and Treatment Lab, Department of Speech, Language, and Hearing Sciences, University of Texas at Austin, Austin, TX, United States
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, United States
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23
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Quillen IA, Yen M, Wilson SM. Distinct neural correlates of linguistic demand and non-linguistic demand. NEUROBIOLOGY OF LANGUAGE (CAMBRIDGE, MASS.) 2021; 2:202-225. [PMID: 34585141 PMCID: PMC8475781 DOI: 10.1162/nol_a_00031] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
In this study, we investigated how the brain responds to task difficulty in linguistic and non-linguistic contexts. This is important for the interpretation of functional imaging studies of neuroplasticity in post-stroke aphasia, because of the inherent difficulty of matching or controlling task difficulty in studies with neurological populations. Twenty neurologically normal individuals were scanned with fMRI as they performed a linguistic task and a non-linguistic task, each of which had two levels of difficulty. Critically, the tasks were matched across domains (linguistic, non-linguistic) for accuracy and reaction time, such that the differences between the easy and difficult conditions were equivalent across domains. We found that non-linguistic demand modulated the same set of multiple demand (MD) regions that have been identified in many prior studies. In contrast, linguistic demand modulated MD regions to a much lesser extent, especially nodes belonging to the dorsal attention network. Linguistic demand modulated a subset of language regions, with the left inferior frontal gyrus most strongly modulated. The right hemisphere region homotopic to Broca's area was also modulated by linguistic but not non-linguistic demand. When linguistic demand was mapped relative to non-linguistic demand, we also observed domain by difficulty interactions in temporal language regions as well as a widespread bilateral semantic network. In sum, linguistic and non-linguistic demand have strikingly different neural correlates. These findings can be used to better interpret studies of patients recovering from aphasia. Some reported activations in these studies may reflect task performance differences, while others can be more confidently attributed to neuroplasticity.
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Affiliation(s)
- Ian A Quillen
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Melodie Yen
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Stephen M Wilson
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
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24
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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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25
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Copland DA. Elizabeth Usher Memorial Lecture: Lost in Translation? Challenges and future prospects for a neurobiological approach to aphasia rehabilitation. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 22:270-280. [PMID: 32686593 DOI: 10.1080/17549507.2020.1768287] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
While there has been considerable progress in conducting trials of aphasia therapy, there is no consistent evidence for long-term benefits of aphasia treatment, suggesting the need to reconsider current approaches. There are also no accurate methods for determining the amount, type and timing of aphasia therapy that should be provided for an individual. At the same time, there has been increasing interest in applying various principles of neuroplasticity to aphasia treatment and using measures of brain structure and function to predict recovery. This article will consider the potential of neuroplasticity principles and neurobiological predictors to improve our current approach to aphasia rehabilitation and optimise outcomes. Reviewing these principles highlights some of the challenges of translating animal model-based principles and emphases the need to also consider relevant theories of human learning. While considerable progress has been made in considering neurobiological principles and using measures of brain structure and function to predict recovery, there is significant work required to achieve the full potential of this neurobiological approach to aphasia management.
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Affiliation(s)
- David A Copland
- School of Health and Rehabilitation Sciences, Centre for Clinical Research, Queensland Aphasia Rehabilitation Centre, The University of Queensland, St Lucia, Australia
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26
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Higgins J, Barbieri E, Wang X, Mack J, Caplan D, Kiran S, Rapp B, Thompson C, Zinbarg R, Parrish T. Reliability of BOLD signals in chronic stroke-induced aphasia. Eur J Neurosci 2020; 52:3963-3978. [PMID: 32282965 DOI: 10.1111/ejn.14739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 11/30/2022]
Abstract
Investigating the neurobiology of language impairment and treatment in chronic stroke aphasia using fMRI requires an understanding of measurement variability within and between participants. In this multicenter study, we evaluated the scan-rescan reliability of an auditory and visual (written) story comprehension paradigm in stroke participants with aphasia (N = 65) and healthy controls (N = 22). The multi-modal task was conducted twice (~1 week apart) on separate visits upon study enrolment and twice again at completion three months later. A non-language visuomotor task was studied in the aphasia group only, which was conducted once per time point (3 months apart). While participants were asked to make responses during the comprehension task, these in-scanner responses were not recorded. Reliability was assessed using intraclass correlation coefficient (ICC) at both group and individual participant levels. The visual story comprehension condition had higher reliability than the auditory condition in both groups, with participants with aphasia exhibiting lower reliability than controls in both conditions (stroke ICC = .43, healthy ICC = .81). Differences in reliability within the group of participants with aphasia were found to be partially explained by overall language impairment as well as greater head motion. In the participants with aphasia, the visuomotor paradigm was found to have greater reliability than the story comprehension task at equivalent interscan intervals (visuomotor = 0.50, comprehension = 0.34), and its reliability was not associated with language impairment. This work highlights the importance of considering the reliability of fMRI tasks in aphasia research, provides strategies to improve reliability and has potential implications for the field of clinical neuroimaging in general.
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Affiliation(s)
- James Higgins
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL, USA.,Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Elena Barbieri
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL, USA.,Department of Communication Sciences and Disorders, School of Communication, Northwestern University, Evanston, IL, USA
| | - Xue Wang
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL, USA.,Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Jennifer Mack
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL, USA.,Department of Communication Sciences and Disorders, School of Communication, Northwestern University, Evanston, IL, USA
| | - David Caplan
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL, USA.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Swathi Kiran
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL, USA.,Department of Speech, Language, and Hearing, College of Health & Rehabilitation, Boston University, Boston, MA, USA
| | - Brenda Rapp
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL, USA.,Department of Cognitive Science, Krieger School of Arts & Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Cynthia Thompson
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL, USA.,Department of Communication Sciences and Disorders, School of Communication, Northwestern University, Evanston, IL, USA.,Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Richard Zinbarg
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL, USA.,Department of Psychology, Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, USA.,The Family Institute at Northwestern University, Evanston, IL, USA
| | - Todd Parrish
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL, USA.,Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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27
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Abstract
Syntax, the structure of sentences, enables humans to express an infinite range of meanings through finite means. The neurobiology of syntax has been intensely studied but with little consensus. Two main candidate regions have been identified: the posterior inferior frontal gyrus (pIFG) and the posterior middle temporal gyrus (pMTG). Integrating research in linguistics, psycholinguistics, and neuroscience, we propose a neuroanatomical framework for syntax that attributes distinct syntactic computations to these regions in a unified model. The key theoretical advances are adopting a modern lexicalized view of syntax in which the lexicon and syntactic rules are intertwined, and recognizing a computational asymmetry in the role of syntax during comprehension and production. Our model postulates a hierarchical lexical-syntactic function to the pMTG, which interconnects previously identified speech perception and conceptual-semantic systems in the temporal and inferior parietal lobes, crucial for both sentence production and comprehension. These relational hierarchies are transformed via the pIFG into morpho-syntactic sequences, primarily tied to production. We show how this architecture provides a better account of the full range of data and is consistent with recent proposals regarding the organization of phonological processes in the brain.
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Affiliation(s)
- William Matchin
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, 29208, USA
| | - Gregory Hickok
- Department of Cognitive Sciences, University of California, Irvine, Irvine, CA, 92697, USA
- Department of Language Science, University of California, Irvine, Irvine, CA, 92697, USA
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28
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Matchin W, Basilakos A, Stark BC, den Ouden DB, Fridriksson J, Hickok G. Agrammatism and Paragrammatism: A Cortical Double Dissociation Revealed by Lesion-Symptom Mapping. NEUROBIOLOGY OF LANGUAGE (CAMBRIDGE, MASS.) 2020; 1:208-225. [PMID: 34296193 PMCID: PMC8293792 DOI: 10.1162/nol_a_00010] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 03/27/2020] [Indexed: 05/21/2023]
Abstract
The fundamental distinction of grammatical deficits in aphasia, agrammatism and paragrammatism, was made over a century ago. However, the extent to which the agrammatism/paragrammatism distinction exists independently of differences in speech fluency has not clearly been investigated. Despite much research on agrammatism, the lesion correlates of paragrammatism are essentially unknown. Lesion-symptom mapping was used to investigate the degree to which the lesion correlates of agrammatism and paragrammatism overlap or dissociate. Four expert raters assessed videos of 53 right-handed patients with aphasia following chronic left-hemisphere stroke retelling the Cinderella story. Consensus discussion determined each subject's classification with respect to grammatical deficits as Agrammatic, Paragrammatic, Both, or No Grammatical Deficit. Each subject's lesion was manually drawn on a high-resolution MRI and warped to standard space for group analyses. Lesion-symptom mapping analyses were performed in NiiStat including lesion volume as a covariate. Secondary analyses included speech rate (words per minute) as an additional covariate. Region of interest analyses identified a double dissociation between these syndromes: damage to Broca's area was significantly associated with agrammatism, p = 0.001 (but not paragrammatism, p = 0.930), while damage to the left posterior superior and middle temporal gyri was significantly associated with paragrammatism, p < 0.001 (but not agrammatism, p = 0.873). The same results obtained when regressing out the effect of speech rate, and nonoverlapping lesion distributions between the syndromes were confirmed by uncorrected whole brain analyses. Our results support a fundamental distinction between agrammatism and paragrammatism.
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Affiliation(s)
| | - Alexandra Basilakos
- Department of Communication Sciences and Disorders, University of South Carolina
| | - Brielle C. Stark
- ISpeech and Hearing Sciences Department and Program in Neuroscience Faculty, Indiana University Bloomington
| | - Dirk-Bart den Ouden
- Department of Communication Sciences and Disorders, University of South Carolina
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina
| | - Gregory Hickok
- Department of Cognitive Sciences, Department of Language Sciences, University of California, Irvine
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29
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Turkeltaub PE. A Taxonomy of Brain-Behavior Relationships After Stroke. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:3907-3922. [PMID: 31756155 PMCID: PMC7203524 DOI: 10.1044/2019_jslhr-l-rsnp-19-0032] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Purpose Understanding the brain basis of language and cognitive outcomes is a major goal of aphasia research. Prior studies have not often considered the many ways that brain features can relate to behavioral outcomes or the mechanisms underlying these relationships. The purpose of this review article is to provide a new framework for understanding the ways that brain features may relate to language and cognitive outcomes from stroke. Method Brain-behavior relationships that may be important for aphasia outcomes are organized into a taxonomy, including features of the lesion and features of brain tissue spared by the lesion. Features of spared brain tissue are categorized into those that change after stroke and those that do not. Features that change are further subdivided, and multiple mechanisms of brain change after stroke are discussed. Results Features of the stroke, including size, location, and white matter damage, relate to many behavioral outcomes and likely account for most of the variance in outcomes. Features of the spared brain tissue that are unchanged by stroke, such as prior ischemic disease in the white matter, contribute to outcomes. Many different neurobiological and behavioral mechanisms may drive changes in the brain after stroke in association with behavioral recovery. Changes primarily driven by neurobiology are likely to occur in brain regions with a systematic relationship to the stroke distribution. Changes primarily driven by behavior are likely to occur in brain networks related to the behavior driving the change. Conclusions Organizing the various hypothesized brain-behavior relationships according to this framework and considering the mechanisms that drive these relationships may help investigators develop specific experimental designs and more complete statistical models to explain language and cognitive abilities after stroke. Eight main recommendations for future research are provided. Presentation Video https://doi.org/10.23641/asha.10257578.
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Affiliation(s)
- Peter E Turkeltaub
- Department of Neurology, Georgetown University Medical Center, Washington, DC
- Center for Brain Plasticity and Recovery, Georgetown University Medical Center, Washington, DC
- Research Division, MedStar National Rehabilitation Hospital, Washington, DC
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30
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Wilson SM, Eriksson DK, Yen M, Demarco AT, Schneck SM, Lucanie JM. Language Mapping in Aphasia. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:3937-3946. [PMID: 31756153 PMCID: PMC7203526 DOI: 10.1044/2019_jslhr-l-rsnp-19-0031] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Purpose 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. To make progress in characterizing the nature of this process, we need feasible, reliable, and valid methods for identifying language regions of the brain in individuals with aphasia. This article reviews 3 recent studies from our lab in which we have developed and validated several novel functional magnetic resonance imaging paradigms for language mapping in aphasia. Method In the 1st study, we investigated the reliability and validity of 4 language mapping paradigms in neurologically normal older adults. In the 2nd study, we developed a novel adaptive semantic matching paradigm and assessed its feasibility, reliability, and validity in individuals with and without aphasia. In the 3rd study, we developed and evaluated 2 additional adaptive paradigms-rhyme judgment and syllable counting-for mapping phonological encoding regions. Results We found that the adaptive semantic matching paradigm could be performed by most individuals with aphasia and yielded reliable and valid maps of core perisylvian language regions in each individual participant. The psychometric properties of this paradigm were superior to those of other commonly used paradigms such as narrative comprehension and picture naming. The adaptive rhyme judgment paradigm was capable of identifying fronto-parietal phonological encoding regions in individual participants. Conclusion Adaptive language mapping paradigms offer a promising approach for future research on the neural basis of recovery from aphasia. Presentation Video https://doi.org/10.23641/asha.10257584.
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Affiliation(s)
- Stephen M. Wilson
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Dana K. Eriksson
- Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson
| | - Melodie Yen
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | | | - Sarah M. Schneck
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Jillian M. Lucanie
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
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31
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Yen M, DeMarco AT, Wilson SM. Adaptive paradigms for mapping phonological regions in individual participants. Neuroimage 2019; 189:368-379. [PMID: 30665008 DOI: 10.1016/j.neuroimage.2019.01.040] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 12/03/2018] [Accepted: 01/15/2019] [Indexed: 11/19/2022] Open
Abstract
Phonological encoding depends on left-lateralized regions in the supramarginal gyrus and the ventral precentral gyrus. Localization of these phonological regions in individual participants-including individuals with language impairments-is important in several research and clinical contexts. To localize these regions, we developed two paradigms that load on phonological encoding: a rhyme judgment task and a syllable counting task. Both paradigms relied on an adaptive staircase design to ensure that each individual performed each task at a similarly challenging level. The goal of this study was to assess the validity and reliability of the two paradigms, in terms of their ability to consistently produce left-lateralized activations of the supramarginal gyrus and ventral precentral gyrus in neurologically normal individuals with presumptively normal language localization. Sixteen participants were scanned with fMRI as they performed the rhyme judgment paradigm, the syllable counting paradigm, and an adaptive semantic paradigm that we have described previously. We found that the rhyme and syllable paradigms both yielded left-lateralized supramarginal and ventral precentral activations in the majority of participants. The rhyme paradigm produced more lateralized and more reliable activations, and so should be favored in future applications. In contrast, the semantic paradigm did not reveal supramarginal or precentral activations in most participants, suggesting that the recruitment of these regions is indeed driven by phonological encoding, not language processing in general. In sum, the adaptive rhyme judgment paradigm was effective in localizing left-lateralized phonological encoding regions in individual participants, and, in conjunction with the adaptive semantic paradigm, can be used to map individual language networks.
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Affiliation(s)
- Melodie Yen
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Andrew T DeMarco
- Department of Neurology, Georgetown University Medical Center, Washington, DC, USA
| | - Stephen M Wilson
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
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32
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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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