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Yang M, Liu Y, Yue Z, Yang G, Jiang X, Cai Y, Zhang Y, Yang X, Li D, Chen L. Transcranial photobiomodulation on the left inferior frontal gyrus enhances Mandarin Chinese L1 and L2 complex sentence processing performances. BRAIN AND LANGUAGE 2024; 256:105458. [PMID: 39197357 DOI: 10.1016/j.bandl.2024.105458] [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: 01/24/2024] [Revised: 07/09/2024] [Accepted: 08/21/2024] [Indexed: 09/01/2024]
Abstract
This study investigated the causal enhancing effect of transcranial photobiomodulation (tPBM) over the left inferior frontal gyrus (LIFG) on syntactically complex Mandarin Chinese first language (L1) and second language (L2) sentence processing performances. Two (L1 and L2) groups of participants (thirty per group) were recruited to receive the double-blind, sham-controlled tPBM intervention via LIFG, followed by the sentence processing, the verbal working memory (WM), and the visual WM tasks. Results revealed a consistent pattern for both groups: (a) tPBM enhanced sentence processing performance but not verbal WM for linear processing of unstructured sequences and visual WM performances; (b) Participants with lower sentence processing performances under sham tPBM benefited more from active tPBM. Taken together, the current study substantiated that tPBM enhanced L1 and L2 sentence processing, and would serve as a promising and cost-effective noninvasive brain stimulation (NIBS) tool for future applications on upregulating the human language faculty.
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Affiliation(s)
- Mingchuan Yang
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing 100875, China
| | - Yang Liu
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing 100875, China
| | - Zhaoqian Yue
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing 100875, China
| | - Guang Yang
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing 100875, China
| | - Xu Jiang
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing 100875, China
| | - Yimin Cai
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing 100875, China
| | - Yuqi Zhang
- School of Chinese as a Second Language, Peking University, Beijing 100871, China
| | - Xiujie Yang
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China.
| | - Dongwei Li
- Department of Psychology, Faculty of Arts and Sciences, Beijing Normal University, Zhuhai 519087, China; Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing 100875, China.
| | - Luyao Chen
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing 100875, China; Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Institute of Educational System Science, Beijing Normal University, Beijing 100875, China.
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2
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Billot A, Kiran S. Disentangling neuroplasticity mechanisms in post-stroke language recovery. BRAIN AND LANGUAGE 2024; 251:105381. [PMID: 38401381 PMCID: PMC10981555 DOI: 10.1016/j.bandl.2024.105381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/28/2023] [Accepted: 01/12/2024] [Indexed: 02/26/2024]
Abstract
A major objective in post-stroke aphasia research is to gain a deeper understanding of neuroplastic mechanisms that drive language recovery, with the ultimate goal of enhancing treatment outcomes. Subsequent to recent advances in neuroimaging techniques, we now have the ability to examine more closely how neural activity patterns change after a stroke. However, the way these neural activity changes relate to language impairments and language recovery is still debated. The aim of this review is to provide a theoretical framework to better investigate and interpret neuroplasticity mechanisms underlying language recovery in post-stroke aphasia. We detail two sets of neuroplasticity mechanisms observed at the synaptic level that may explain functional neuroimaging findings in post-stroke aphasia recovery at the network level: feedback-based homeostatic plasticity and associative Hebbian plasticity. In conjunction with these plasticity mechanisms, higher-order cognitive control processes dynamically modulate neural activity in other regions to meet communication demands, despite reduced neural resources. This work provides a network-level neurobiological framework for understanding neural changes observed in post-stroke aphasia and can be used to define guidelines for personalized treatment development.
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Affiliation(s)
- Anne Billot
- Center for Brain Recovery, Boston University, Boston, USA; Department of Psychology, Center for Brain Science, Harvard University, Cambridge, Massachusetts, USA; Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Swathi Kiran
- Center for Brain Recovery, Boston University, Boston, USA.
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3
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Gnedykh D, Tsvetova D, Mkrtychian N, Blagovechtchenski E, Kostromina S, Shtyrov Y. tDCS of right-hemispheric Wernicke's area homologue affects contextual learning of novel lexicon. Neurobiol Learn Mem 2024; 210:107905. [PMID: 38403010 DOI: 10.1016/j.nlm.2024.107905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 11/01/2023] [Accepted: 02/21/2024] [Indexed: 02/27/2024]
Abstract
Numerous studies have shown robust evidence of the right hemisphere's involvement in the language function, for instance in the processing of intonation, grammar, word meanings, metaphors, etc. However, its role in lexicon acquisition remains obscure. We applied transcranial direct current stimulation (tDCS) over the right-hemispheric homologue of Wernicke's area to assess its putative involvement in the processing of different types of novel semantics. After receiving 15 min of anodal, cathodal, or sham (placebo) tDCS, three groups of healthy participants learnt novel concrete and abstract words in the context of short stories. Learning outcomes were assessed using a battery of tests immediately after this contextual learning session and 24 h later. As a result, an inhibitory effect of cathodal tDCS and a facilitatory effect of anodal tDCS were found for abstract word acquisition only. We also found a significant drop in task performance on the second day of the assessment for both word types in all the stimulation groups, suggesting no significant influence of tDCS on the post-learning consolidation of new memory traces. The results suggest an involvement of Wernicke's right-hemispheric counterpart in initial encoding (but not consolidation) of abstract semantics, which may be explained either by the right hemispheres direct role in processing lexical semantics or by an indirect impact of tDCS on contralateral (left-hemispheric) cortical areas through cross-callosal connections.
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Affiliation(s)
- Daria Gnedykh
- Laboratory of Behavioural Neurodynamics, St. Petersburg State University, 199034 St. Petersburg, Russia; Department of Psychology, St. Petersburg State University, 199034 St. Petersburg, Russia.
| | - Diana Tsvetova
- Laboratory of Behavioural Neurodynamics, St. Petersburg State University, 199034 St. Petersburg, Russia
| | - Nadezhda Mkrtychian
- Laboratory of Behavioural Neurodynamics, St. Petersburg State University, 199034 St. Petersburg, Russia
| | - Evgeny Blagovechtchenski
- Laboratory of Behavioural Neurodynamics, St. Petersburg State University, 199034 St. Petersburg, Russia; Department of Psychology, St. Petersburg State University, 199034 St. Petersburg, Russia
| | - Svetlana Kostromina
- Laboratory of Behavioural Neurodynamics, St. Petersburg State University, 199034 St. Petersburg, Russia; Department of Psychology, St. Petersburg State University, 199034 St. Petersburg, Russia
| | - Yury Shtyrov
- Center of Functionally Integrative Neuroscience (CFIN), Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark
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4
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Barbieri E, Lukic S, Rogalski E, Weintraub S, Mesulam MM, Thompson CK. Neural mechanisms of sentence production: a volumetric study of primary progressive aphasia. Cereb Cortex 2024; 34:bhad470. [PMID: 38100360 PMCID: PMC10793577 DOI: 10.1093/cercor/bhad470] [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: 06/06/2023] [Revised: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 12/17/2023] Open
Abstract
Studies on the neural bases of sentence production have yielded mixed results, partly due to differences in tasks and participant types. In this study, 101 individuals with primary progressive aphasia (PPA) were evaluated using a test that required spoken production following an auditory prime (Northwestern Assessment of Verbs and Sentences-Sentence Production Priming Test, NAVS-SPPT), and one that required building a sentence by ordering word cards (Northwestern Anagram Test, NAT). Voxel-Based Morphometry revealed that gray matter (GM) volume in left inferior/middle frontal gyri (L IFG/MFG) was associated with sentence production accuracy on both tasks, more so for complex sentences, whereas, GM volume in left posterior temporal regions was exclusively associated with NAVS-SPPT performance and predicted by performance on a Digit Span Forward (DSF) task. Verb retrieval deficits partly mediated the relationship between L IFG/MFG and performance on the NAVS-SPPT. These findings underscore the importance of L IFG/MFG for sentence production and suggest that this relationship is partly accounted for by verb retrieval deficits, but not phonological loop integrity. In contrast, it is possible that the posterior temporal cortex is associated with auditory short-term memory ability, to the extent that DSF performance is a valid measure of this in aphasia.
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Affiliation(s)
- Elena Barbieri
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Department of Neurology, Northwestern University, 300 E Superior Street, Chicago, IL 60611, United States
| | - Sladjana Lukic
- Department of Communication Sciences and Disorders, Adelphi University, 158 Cambridge Avenue, Garden City, NY 11530, United States
| | - Emily Rogalski
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Department of Neurology, Northwestern University, 300 E Superior Street, Chicago, IL 60611, United States
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Department of Neurology, Northwestern University, 300 E Superior Street, Chicago, IL 60611, United States
- Department of Psychiatry and Behavioral Sciences, Northwestern University, 676 N Saint Clair Street, Chicago, IL 60611, United States
| | - Marek-Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Department of Neurology, Northwestern University, 300 E Superior Street, Chicago, IL 60611, United States
- Department of Neurology, Northwestern University, 300 E Superior Street, Chicago, IL 60611, United States
| | - Cynthia K Thompson
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Department of Neurology, Northwestern University, 300 E Superior Street, Chicago, IL 60611, United States
- Department of Neurology, Northwestern University, 300 E Superior Street, Chicago, IL 60611, United States
- Department of Communication Sciences and Disorders, Northwestern University, 2240 Campus Drive, Evanston, IL 60208, United States
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Meier EL, Sheppard SM, Sebastian R, Berube S, Goldberg EB, Shea J, Stein CM, Hillis AE. Resting state correlates of picture description informativeness in left vs. right hemisphere chronic stroke. Front Neurol 2023; 14:1288801. [PMID: 38145117 PMCID: PMC10744570 DOI: 10.3389/fneur.2023.1288801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/20/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction Despite a growing emphasis on discourse processing in clinical neuroscience, relatively little is known about the neurobiology of discourse production impairments. Individuals with a history of left or right hemisphere stroke can exhibit difficulty with communicating meaningful discourse content, which implies both cerebral hemispheres play a role in this skill. However, the extent to which successful production of discourse content relies on network connections within domain-specific vs. domain-general networks in either hemisphere is unknown. Methods In this study, 45 individuals with a history of either left or right hemisphere stroke completed resting state fMRI and the Cookie Theft picture description task. Results Participants did not differ in the total number of content units or the percentage of interpretative content units they produced. Stroke survivors with left hemisphere damage produced significantly fewer content units per second than individuals with right hemisphere stroke. Intrinsic connectivity of the left language network was significantly weaker in the left compared to the right hemisphere stroke group for specific connections. Greater efficiency of communication of picture scene content was associated with stronger left but weaker right frontotemporal connectivity of the language network in patients with a history of left hemisphere (but not right hemisphere) stroke. No significant relationships were found between picture description measures and connectivity of the dorsal attention, default mode, or salience networks or with connections between language and other network regions. Discussion These findings add to prior behavioral studies of picture description skills in stroke survivors and provide insight into the role of the language network vs. other intrinsic networks during discourse production.
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Affiliation(s)
- Erin L. Meier
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
| | - Shannon M. Sheppard
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
| | - Rajani Sebastian
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, United States
| | - Shauna Berube
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
| | - Emily B. Goldberg
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
| | - Jennifer Shea
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
| | - Colin M. Stein
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, United States
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, United States
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Georgiou AM, Kambanaros M. Therapies and Challenges in the Post-Stroke Aphasia Rehabilitation Arena: Current and Future Prospects. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1674. [PMID: 37763793 PMCID: PMC10537631 DOI: 10.3390/medicina59091674] [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: 08/17/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023]
Abstract
Aphasia is a serious consequence of stroke that results in a breakdown in communication. The course of aphasia recovery differs between afflicted individuals, and responsiveness to treatment cannot be predicted. Aphasiologists continue to investigate numerous behavioral treatment protocols that have shifted their focus to complimentary rehabilitation strategies. The aim of this study is threefold. First, to summarize the different categories of aphasia interventions post-stroke, considering their respective protocols, and present available evidence on the effectiveness of those protocols. Second, to document the challenges regarding the prediction of aphasia treatment response post-stroke in individual patients. Third, to report the challenges faced by researchers in recruiting people with aphasia (PWA) for treatment studies, and provide recommendations on how to increase participant recruitment and retention. This study provides up-to-date information on (i) effective therapies and aphasia recovery processes, and (ii) research recruitment hurdles together with potential strategies for overcoming them.
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Affiliation(s)
- Anastasios M. Georgiou
- The Brain and Neurorehabilitation Lab, Department of Rehabilitation Sciences, Cyprus University of Technology, 3041 Limassol, Cyprus;
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Townsend SAM, Marcotte K, Brisebois A, Smidarle AD, Schneider F, Loureiro F, Soder RB, Franco ADR, Marrone LCP, Hübner LC. Neuroanatomical correlates of macrostructural receptive abilities in narrative discourse in unilateral left hemisphere stroke: A behavioural and voxel-based morphometry study. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:826-847. [PMID: 36448625 DOI: 10.1111/1460-6984.12825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 10/29/2022] [Indexed: 05/12/2023]
Abstract
BACKGROUND Little is known about story retelling and comprehension abilities in groups with lower levels of education and socio-economic status (SES). A growing body of evidence suggests the role of an extended network supporting narrative comprehension, but few studies have been conducted in clinical populations, even less in developing countries. AIMS To extend our knowledge of the impact of a stroke on macrostructural aspects of discourse processes, namely main and complementary information, in individuals with middle-low to low SES and low levels of education. Relationships were tested between the performance in story retell and comprehension and reading and writing habits (RWH). Also, the associations between retelling and comprehension measures and their structural grey matter (GM) correlates were explored. METHODS & PROCEDURES A total of 17 adults with unilateral left hemisphere (LH) chronic ischaemic stroke without the presence of significant aphasia and 10 matched (age, education and SES) healthy controls (HC) participated in the study. Retell and comprehension tasks were performed after listening or reading narrative stories. Voxel-based morphometry (VBM) analysis was conducted on a subgroup of nine individuals with LH stroke and the 10 matched controls using structural magnetic resonance imaging (MRI). OUTCOMES & RESULTS Retelling and comprehension abilities were not significantly different between LH and HC, nonetheless quantitively lower in LH. Exploratory correlations showed that retelling and comprehension abilities in both written and auditory modalities were correlated with naming abilities. At the neural level, written comprehension positively correlated with GM density of the LH, including areas in the temporal pole, superior and middle temporal gyrus as well as the orbitofrontal cortex, precentral and postcentral gyri. Auditory narrative comprehension was associated with GM density of the lingual gyrus in the right hemisphere. CONCLUSIONS & IMPLICATIONS The present results suggest that retelling and comprehension of auditory and written narratives are relatively well-preserved in individuals with a LH stroke without significant aphasia, but poorer than in HC. The findings replicate previous studies conducted in groups with higher levels of education and SES both at the behavioural and neural levels. Considering that naming seems to be associated with narrative retell and comprehension in individuals with lower SES and education, this research provides evidence on the importance of pursuing further studies including larger samples with and without aphasia as well as with various SES and education levels. WHAT THIS PAPER ADDS What is already known on this subject Story retell and comprehension of auditory and written discourse have been shown to be affected after stroke, but most studies have been conducted on individuals with middle to high SES and high educational levels. What this paper adds to existing knowledge The study reports on narrative retell and comprehension in both auditory and written modalities in groups of HC and individuals with LH brain damage, with low-to-middle SES and lower levels of education. What are the potential or actual clinical implications of this work? This study highlights the importance of taking into consideration the sociodemographic and RWH of patients when assessing discourse retell and comprehension in both auditory and written modalities. It also underlines the importance of including patients without significant aphasia following LH stroke to look at the effect of both stroke and aphasia on narrative comprehension and story retelling.
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Affiliation(s)
- Sabrine Amaral Martins Townsend
- School of Humanities (Linguistics Department), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
- University of Santa Cruz do Sul (UNISC), Postdoctoral Program in Linguistics-Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Karine Marcotte
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, QC, Canada
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Montréal, QC, Canada
| | - Amelie Brisebois
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, QC, Canada
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Montréal, QC, Canada
| | - Anderson Dick Smidarle
- School of Humanities (Linguistics Department), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Fernanda Schneider
- Federal Institute of Education, Science and Technology of Rio Grande do Sul (IFRS-Ibirubá), Bento Goncalves, Rio Grande do Sul, Brazil
| | - Fernanda Loureiro
- Institut of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Ricardo Bernardi Soder
- Brain Institute (InsCer), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Alexandre da Rosa Franco
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
- Center for Biomedical Imaging and Neuromodulation, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
- Center for the Developing Brain, Child Mind Institute, New York, NY, USA
| | - Luiz Carlos Porcello Marrone
- Brain Institute (InsCer), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Neurology Center, Hospital São Lucas at Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
- Medicine School, Luteran University of Brazil (ULBRA), Porto Alegre, Rio Grande do Sul, Brazil
- Morphology Sciences Department, ICBS, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Lilian Cristine Hübner
- School of Humanities (Linguistics Department), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
- National Council for Scientific and Technological Development (CNPq), Federal Capital, Brasília, Brazil
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Stockbridge MD, Elm J, Breining BL, Tippett DC, Sebastian R, Cassarly C, Teklehaimanot A, Spell LA, Sheppard SM, Vitti E, Ruch K, Goldberg EB, Kelly C, Keator LM, Fridriksson J, Hillis AE. Transcranial Direct-Current Stimulation in Subacute Aphasia: A Randomized Controlled Trial. Stroke 2023; 54:912-920. [PMID: 36912144 PMCID: PMC10050116 DOI: 10.1161/strokeaha.122.041557] [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: 10/06/2022] [Accepted: 02/10/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Transcranial direct-current stimulation (tDCS) is a promising adjunct to therapy for chronic aphasia. METHODS This single-center, randomized, double-blind, sham-controlled efficacy trial tested the hypothesis that anodal tDCS augments language therapy in subacute aphasia. Secondarily, we compared the effect of tDCS on discourse measures and quality of life and compared the effects on naming to previous findings in chronic stroke. Right-handed English speakers with aphasia <3 months after left hemisphere ischemic stroke were included, unless they had prior neurological or psychiatric disease or injury or were taking certain medications (34 excluded; final sample, 58). Participants were randomized 1:1, controlling for age, aphasia type, and severity, to receive 20 minutes of tDCS (1 mA) or sham-tDCS in addition to fifteen 45-minute sessions of naming treatment (plus standard care). The primary outcome variable was change in naming accuracy of untrained pictures pretreatment to 1-week posttreatment. RESULTS Baseline characteristics were similar between the tDCS (N=30) and sham (N=28) groups: patients were 65 years old, 53% male, and 2 months from stroke onset on average. In intent-to-treat analysis, the adjusted mean change from baseline to 1-week posttreatment in picture naming was 22.3 (95% CI, 13.5-31.2) for tDCS and 18.5 (9.6-27.4) for sham and was not significantly different. Content and efficiency of picture description improved more with tDCS than sham. Groups did not differ in quality of life improvement. No patients were withdrawn due to adverse events. CONCLUSIONS tDCS did not improve recovery of picture naming but did improve recovery of discourse. Discourse skills are critical to participation. Future research should examine tDCS in a larger sample with richer functional outcomes. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT02674490.
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Affiliation(s)
- Melissa D. Stockbridge
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Jordan Elm
- Department of Public Health Science, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Bonnie L. Breining
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Donna C. Tippett
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Rajani Sebastian
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Christy Cassarly
- Department of Public Health Science, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Abeba Teklehaimanot
- Department of Public Health Science, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Leigh Ann Spell
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29208, United States
| | - Shannon M. Sheppard
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
- Department of Communication Sciences & Disorders, Chapman University, Orange, CA 92866, United States
| | - Emilia Vitti
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Kristina Ruch
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Emily B. Goldberg
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Catherine Kelly
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Lynsey M. Keator
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29208, United States
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29208, United States
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
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9
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Barbieri E, Thompson CK, Higgins J, Caplan D, Kiran S, Rapp B, Parrish T. Treatment-induced neural reorganization in aphasia is language-domain specific: Evidence from a large-scale fMRI study. Cortex 2023; 159:75-100. [PMID: 36610109 PMCID: PMC9931666 DOI: 10.1016/j.cortex.2022.11.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 08/14/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022]
Abstract
Studies investigating the effects of language intervention on the re-organization of language networks in chronic aphasia have resulted in mixed findings, likely related to-among other factors-the language function targeted during treatment. The present study investigated the effects of the type of treatment provided on neural reorganization. Seventy individuals with chronic stroke-induced aphasia, recruited from three research laboratories and meeting criteria for agrammatism, anomia or dysgraphia were assigned to either treatment (N = 51) or control (N = 19) groups. Participants in the treatment group received 12-weeks of language intervention targeting sentence comprehension/production, naming, or spelling. At baseline and post-testing, all participants performed an fMRI story comprehension task, with blocks of auditorily-presented stories alternated with blocks of reversed speech. Participants in the treatment, but not control, group significantly improved in the treated language domain. FMRI region-of-interest (ROI) analyses, conducted within regions that were either active (or homologous to active) regions in a group of 22 healthy participants on the story comprehension task, revealed a significant increase in activation from pre-to post-treatment in right-hemisphere homologues of these regions for participants in the sentence and spelling, but not naming, treatment groups, not predicted by left-hemisphere lesion size. For the sentence (but not the spelling) treatment group, activation changes within right-hemisphere homologues of language regions were positively associated with changes in measures of verb and sentence comprehension. These findings support previous research pointing to recruitment of right hemisphere tissue as a viable route for language recovery and suggest that sentence-level treatment may promote greater neuroplasticity on naturalistic, language comprehension tasks, compared to word-level treatment.
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Affiliation(s)
- Elena Barbieri
- Center for the Neurobiology of Language Recovery, Northwestern University, 2240 Campus Drive, Evanston, IL 60208, USA; Department of Communication Sciences and Disorders, School of Communication, Northwestern University, 70 Arts Circle Drive, Evanston, IL 60208, USA.
| | - Cynthia K Thompson
- Center for the Neurobiology of Language Recovery, Northwestern University, 2240 Campus Drive, Evanston, IL 60208, USA; Department of Communication Sciences and Disorders, School of Communication, Northwestern University, 70 Arts Circle Drive, Evanston, IL 60208, USA; Department of Neurology, Feinberg School of Medicine, Northwestern University, 303 East Chicago Avenue, Chicago, IL 60611, USA
| | - James Higgins
- Center for the Neurobiology of Language Recovery, Northwestern University, 2240 Campus Drive, Evanston, IL 60208, USA; Department of Radiology, Feinberg School of Medicine, Northwestern University, 737 N Michigan Avenue, Chicago, IL 60611, USA
| | - David Caplan
- Center for the Neurobiology of Language Recovery, Northwestern University, 2240 Campus Drive, Evanston, IL 60208, USA; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, 15 Parkman Street, Boston, MA 02114, USA
| | - Swathi Kiran
- Center for the Neurobiology of Language Recovery, Northwestern University, 2240 Campus Drive, Evanston, IL 60208, USA; Department of Speech, Language, And Hearing, College of Health & Rehabilitation, Boston University, 635 Commonwealth Avenue, Boston, MA 02215, USA
| | - Brenda Rapp
- Center for the Neurobiology of Language Recovery, Northwestern University, 2240 Campus Drive, Evanston, IL 60208, USA; Department of Cognitive Science, Krieger School of Arts & Sciences, Johns Hopkins Univeristy, 3400 N Charles Street, Baltimore, MD 21218, USA
| | - Todd Parrish
- Center for the Neurobiology of Language Recovery, Northwestern University, 2240 Campus Drive, Evanston, IL 60208, USA; Department of Radiology, Feinberg School of Medicine, Northwestern University, 737 N Michigan Avenue, Chicago, IL 60611, USA
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10
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Abstract
Although language deficits are the primary area of weakness, people with poststroke aphasia often experience challenges with nonlinguistic cognitive skills, including attention processing. The purpose of this review is to synthesize the evidence for the relationship between attention deficits and language deficits in people with poststroke aphasia. Three different types of studies are reviewed: (1) studies exploring whether people with poststroke aphasia exhibit concomitant attention and language deficits, (2) studies explicitly exploring the relationship between attention and language deficits in people with poststroke aphasia, and (3) either language or attention (or both) treatment studies exploring whether treatment gains in one domain generalize to the other. In the last section, we briefly review research evidence for the neural basis of the attention-language relationship in aphasia.
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Affiliation(s)
- Maria Varkanitsa
- Aphasia Research Laboratory, Department of Speech, Language & Hearing Sciences, Sargent College of Health and Rehabilitation, Boston, MA, USA
| | - Erin Godecke
- Edith Cowan University and Sir Charles Gairdner Hospital, Perth, Australia
| | - Swathi Kiran
- Aphasia Research Laboratory, Department of Speech, Language & Hearing Sciences, Sargent College of Health and Rehabilitation, Boston, MA, USA
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11
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Zhu Y, Zeng Y, Ren J, Zhang L, Chen C, Fernandez G, Qin S. Emotional learning retroactively promotes memory integration through rapid neural reactivation and reorganization. eLife 2022; 11:e60190. [PMID: 36476501 PMCID: PMC9815824 DOI: 10.7554/elife.60190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
Neutral events preceding emotional experiences can be better remembered, likely by assigning them as significant to guide possible use in future. Yet, the neurobiological mechanisms of how emotional learning enhances memory for past mundane events remain unclear. By two behavioral studies and one functional magnetic resonance imaging study with an adapted sensory preconditioning paradigm, we show rapid neural reactivation and connectivity changes underlying emotion-charged retroactive memory enhancement. Behaviorally, emotional learning retroactively enhanced initial memory for neutral associations across the three studies. Neurally, emotional learning potentiated trial-specific reactivation of overlapping neural traces in the hippocampus and stimulus-relevant neocortex. It further induced rapid hippocampal-neocortical functional reorganization supporting such retroactive memory benefit, as characterized by enhanced hippocampal-neocortical coupling modulated by the amygdala during emotional learning, and a shift of hippocampal connectivity from stimulus-relevant neocortex to distributed transmodal prefrontal-parietal areas at post-learning rests. Together, emotional learning retroactively promotes memory integration for past neutral events through stimulating trial-specific reactivation of overlapping representations and reorganization of associated memories into an integrated network to foster its priority for future use.
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Affiliation(s)
- Yannan Zhu
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal UniversityBeijingChina
- Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal UniversityBeijingChina
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical CenterNijmegenNetherlands
| | - Yimeng Zeng
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal UniversityBeijingChina
- Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal UniversityBeijingChina
| | - Jingyuan Ren
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical CenterNijmegenNetherlands
| | - Lingke Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal UniversityBeijingChina
- Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal UniversityBeijingChina
| | - Changming Chen
- School of Education, Chongqing Normal UniversityChongqingChina
| | - Guillen Fernandez
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical CenterNijmegenNetherlands
| | - Shaozheng Qin
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal UniversityBeijingChina
- Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal UniversityBeijingChina
- Chinese Institute for Brain ResearchBeijingChina
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12
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Xu M, Gao Y, Zhang H, Zhang B, Lyu T, Tan Z, Li C, Li X, Huang X, Kong Q, Xiao J, Kranz GS, Li S, Chang J. Modulations of static and dynamic functional connectivity among brain networks by electroacupuncture in post-stroke aphasia. Front Neurol 2022; 13:956931. [PMID: 36530615 PMCID: PMC9751703 DOI: 10.3389/fneur.2022.956931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 10/10/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Post-stroke aphasia (PSA) is a language disorder caused by left hemisphere stroke. Electroacupuncture (EA) is a minimally invasive therapeutic option for PSA treatment. Tongli (HT5) and Xuanzhong (GB39), two important language-associated acupoints, are frequently used in the rehabilitation of patients with PSA. Preliminary evidence indicated functional activation in distributed cortical areas upon HT5 and GB39 stimulation. However, research on the modulation of dynamic and static functional connectivity (FC) in the brain by EA in PSA is lacking. Method This study aimed to investigate the PSA-related effects of EA stimulation at HT5 and GB39 on neural processing. Thirty-five participants were recruited, including 19 patients with PSA and 16 healthy controls (HCs). The BOLD signal was analyzed by static independent component analysis, generalized psychophysiological interactions, and dynamic independent component analysis, considering variables such as age, sex, and years of education. Results The results revealed that PSA showed activated clusters in the left putamen, left postcentral gyrus (PostCG), and left angular gyrus in the salience network (SN) compared to the HC group. The interaction effect on temporal properties of networks showed higher variability of SN (F = 2.23, positive false discovery rate [pFDR] = 0.017). The interaction effect on static FC showed increased functional coupling between the right calcarine and right lingual gyrus (F = 3.16, pFDR = 0.043). For the dynamic FC, at the region level, the interaction effect showed lower variability and higher frequencies of circuit 3, with the strongest connections between the supramarginal gyrus and posterior cingulum (F = 5.42, pFDR = 0.03), middle cingulum and PostCG (F = 5.27, pFDR = 0.036), and triangle inferior frontal and lingual gyrus (F = 5.57, pFDR = 0.026). At the network level, the interaction effect showed higher variability in occipital network-language network (LN) and cerebellar network (CN) coupling, with stronger connections between the LN and CN (F = 4.29, pFDR = 0.042). Dynamic FC values between the triangle inferior frontal and lingual gyri were anticorrelated with transcribing, describing, and dictating scores in the Chinese Rehabilitation Research Center for Chinese Standard Aphasia Examination. Discussion These findings suggest that EA stimulation may improve language function, as it significantly modulated the nodes of regions/networks involved in the LN, SN, CN, occipital cortex, somatosensory regions, and cerebral limbic system.
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Affiliation(s)
- Minjie Xu
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China,Key Laboratory of Chinese Internal Medicine Ministry of Education, Beijing University of Chinese Medicine, Beijing, China
| | - Ying Gao
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China,Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China,Ying Gao
| | - Hua Zhang
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Binlong Zhang
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Tianli Lyu
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhongjian Tan
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Changming Li
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaolin Li
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xing Huang
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Qiao Kong
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Juan Xiao
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Georg S. Kranz
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China,Department of Psychiatry and Psychotherapy, Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Shuren Li
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Jingling Chang
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China,Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China,*Correspondence: Jingling Chang
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13
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Pregla D, Vasishth S, Lissón P, Stadie N, Burchert F. Can the resource reduction hypothesis explain sentence processing in aphasia? A visual world study in German. BRAIN AND LANGUAGE 2022; 235:105204. [PMID: 36435153 DOI: 10.1016/j.bandl.2022.105204] [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: 04/29/2022] [Revised: 10/21/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
Resource limitation has often been invoked as a key driver of sentence comprehension difficulty, in both theories of language-unimpaired and language-impaired populations. In the field of aphasia, one such influential theory is Caplan's resource reduction hypothesis (RRH). In this large investigation of online processing in aphasia in German, we evaluated three key predictions of the RRH in 21 individuals with aphasia and 22 control pparticipants. Measures of online processing were obtained by combining a sentence-picture matching task with the visual world paradigm. Four sentence types were used to investigate the generality of the findings, and two test phases were used to investigate RRH's predictions regarding variability in aphasia. The processing patterns were consistent with two of the three predictions of the RRH. Overall, our investigation shows that the RRH can account for important aspects of sentence processing in aphasia.
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14
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Walenski M, Chen Y, Litcofsky KA, Caplan D, Kiran S, Rapp B, Parrish TB, Thompson CK. Perilesional Perfusion in Chronic Stroke-Induced Aphasia and Its Response to Behavioral Treatment Interventions. NEUROBIOLOGY OF LANGUAGE (CAMBRIDGE, MASS.) 2022; 3:345-363. [PMID: 35685084 PMCID: PMC9169892 DOI: 10.1162/nol_a_00068] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/02/2022] [Indexed: 05/28/2023]
Abstract
Stroke-induced alterations in cerebral blood flow (perfusion) may contribute to functional language impairments in chronic aphasia, particularly in perilesional tissue. Abnormal perfusion in this region may also serve as a biomarker for predicting functional improvements with behavioral treatment interventions. Using pseudo-continuous arterial spin labeling in magnetic resonance imaging (MRI), we examined perfusion in chronic aphasia, in perilesional rings in the left hemisphere and their right hemisphere homologues. In the left hemisphere we found a gradient pattern of decreasing perfusion closer to the lesion. The opposite pattern was found in the right hemisphere, with significantly increased perfusion close to the lesion homologue. Perfusion was also increased in the right hemisphere lesion homologue region relative to the surrounding tissue. We next examined changes in perfusion in two groups: one group who underwent MRI scanning before and after three months of a behavioral treatment intervention that led to significant language gains, and a second group who was scanned twice at a three-month interval without a treatment intervention. For both groups, there was no difference in perfusion over time in either the left or the right hemisphere. Moreover, within the treatment group pre-treatment perfusion scores did not predict treatment response; neither did pre-treatment perfusion predict post-treatment language performance. These results indicate that perfusion is chronically abnormal in both hemispheres, but chronically abnormal perfusion did not change in response to our behavioral treatment interventions, and did not predict responsiveness to language treatment.
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Affiliation(s)
- Matthew Walenski
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL
| | - Yufen Chen
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Evanston, IL
| | - Kaitlyn A. Litcofsky
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL
- Department of Communication Sciences and Disorders, School of Communication, Northwestern University, Evanston, IL
| | - David Caplan
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL
- Massachusetts General Hospital, Department of Neurology, Harvard Medical School, Boston, MA
| | - Swathi Kiran
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL
- Department of Speech, Language, and Hearing, College of Health & Rehabilitation, Boston University, Boston, MA
| | - Brenda Rapp
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL
- Department of Cognitive Science, Krieger School of Arts & Sciences, Johns Hopkins University, Baltimore, MD
| | - Todd B. Parrish
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Evanston, IL
| | - Cynthia K. Thompson
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL
- Department of Communication Sciences and Disorders, School of Communication, Northwestern University, Evanston, IL
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Evanston, IL
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15
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Kristinsson S, den Ouden DB, Rorden C, Newman-Norlund R, Neils-Strunjas J, Fridriksson J. Predictors of Therapy Response in Chronic Aphasia: Building a Foundation for Personalized Aphasia Therapy. J Stroke 2022; 24:189-206. [PMID: 35677975 PMCID: PMC9194549 DOI: 10.5853/jos.2022.01102] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 11/12/2022] Open
Abstract
Chronic aphasia, a devastating impairment of language, affects up to a third of stroke survivors. Speech and language therapy has consistently been shown to improve language function in prior clinical trials, but few clinicially applicable predictors of individual therapy response have been identified to date. Consequently, clinicians struggle substantially with prognostication in the clinical management of aphasia. A rising prevalence of aphasia, in particular in younger populations, has emphasized the increasing demand for a personalized approach to aphasia therapy, that is, therapy aimed at maximizing language recovery of each individual with reference to evidence-based clinical recommendations. In this narrative review, we discuss the current state of the literature with respect to commonly studied predictors of therapy response in aphasia. In particular, we focus our discussion on biographical, neuropsychological, and neurobiological predictors, and emphasize limitations of the literature, summarize consistent findings, and consider how the research field can better support the development of personalized aphasia therapy. In conclusion, a review of the literature indicates that future research efforts should aim to recruit larger samples of people with aphasia, including by establishing multisite aphasia research centers.
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Affiliation(s)
- Sigfus Kristinsson
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia, SC, USA
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Dirk B. den Ouden
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia, SC, USA
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Chris Rorden
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia, SC, USA
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Roger Newman-Norlund
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia, SC, USA
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Jean Neils-Strunjas
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Julius Fridriksson
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia, SC, USA
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16
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Sheppard SM, Meier EL, Kim KT, Breining BL, Keator LM, Tang B, Caffo BS, Hillis AE. Neural correlates of syntactic comprehension: A longitudinal study. BRAIN AND LANGUAGE 2022; 225:105068. [PMID: 34979477 PMCID: PMC9232253 DOI: 10.1016/j.bandl.2021.105068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 12/18/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
Broca's area is frequently implicated in sentence comprehension but its specific role is debated. Most lesion studies have investigated deficits at the chronic stage. We aimed (1) to use acute imaging to predict which left hemisphere stroke patients will recover sentence comprehension; and (2) to better understand the role of Broca's area in sentence comprehension by investigating acute deficits prior to functional reorganization. We assessed comprehension of canonical and noncanonical sentences in 15 patients with left hemisphere stroke at acute and chronic stages. LASSO regression was used to conduct lesion symptom mapping analyses. Patients with more severe word-level comprehension deficits and a greater proportion of damage to supramarginal gyrus and superior longitudinal fasciculus were likely to experience acute deficits prior to functional reorganization. Broca's area was only implicated in chronic deficits. We propose that when temporoparietal regions are damaged, intact Broca's area can support syntactic processing after functional reorganization occurs.
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Affiliation(s)
- Shannon M Sheppard
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States; Department of Communication Sciences & Disorders, Chapman University, Irvine, CA 92618, United States.
| | - Erin L Meier
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Kevin T Kim
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Bonnie L Breining
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Lynsey M Keator
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Bohao Tang
- Department of Biostatics, Johns Hopkins School of Public Health, Baltimore, MD 21287, United States
| | - Brian S Caffo
- Department of Biostatics, Johns Hopkins School of Public Health, Baltimore, MD 21287, United States
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States; Department of Cognitive Science, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD 21218, United States
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17
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Li R, Mukadam N, Kiran S. Functional MRI evidence for reorganization of language networks after stroke. HANDBOOK OF CLINICAL NEUROLOGY 2022; 185:131-150. [PMID: 35078595 DOI: 10.1016/b978-0-12-823384-9.00007-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
In this chapter, we review fMRI evidence for language reorganization in individuals with poststroke aphasia. Several studies in the current literature have utilized fMRI as a tool to understand patterns of functional reorganization in poststroke aphasia. Consistent with previous models that have been proposed to explain the trajectory of language recovery, differential patterns of language processing and language recovery have been identified across individuals with poststroke aphasia in different stages of recovery. Overall, a global network breakdown typically occurs in the early stages of aphasia recovery, followed by normalization in "traditional" left hemisphere language networks. Depending on individual characteristics, right hemisphere regions and bilateral domain-general regions may be further recruited. The main takeaway of this chapter is that poststroke aphasia recovery does not depend on individual neural regions, but rather involves a complex interaction among regions in larger networks. Many of the unresolved issues and contrastive findings in the literature warrant further research with larger groups of participants and standard protocols of fMRI implementation.
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Affiliation(s)
- Ran Li
- Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA, United States
| | - Nishaat Mukadam
- Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA, United States
| | - Swathi Kiran
- Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA, United States.
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18
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Cherney LR, Carpenter J. Behavioral interventions for poststroke aphasia. HANDBOOK OF CLINICAL NEUROLOGY 2022; 185:197-220. [PMID: 35078599 DOI: 10.1016/b978-0-12-823384-9.00010-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
There is a long history of behavioral interventions for poststroke aphasia with hundreds of studies supporting the benefits of aphasia treatment. However, interventions for aphasia are complex with many interacting components, and no one treatment is appropriate for all persons with aphasia. We present a novel, simple framework for classifying aphasia interventions. The framework is incorporated within the overarching International Classification of Functioning, Disability, and Health (ICF) model and is consistent with the commonly-held definition that aphasia is a multimodality disorder that impairs, in varying degrees, the understanding and expression of both oral and written language modalities. Furthermore, within the language impairment level, it distinguishes between the linguistic areas of phonology, semantics, and syntax that may be impaired individually or in combination. We define the terminology of the proposed framework and then categorize some common examples of behavioral interventions for post-stroke aphasia. We describe some of these interventions in greater detail to illustrate the extensive toolbox of evidence-based treatments for aphasia. We address some key issues that clinicians, usually speech-language pathologists, consider when selecting interventions for their specific patients with aphasia, including dose. Finally, we address various models of service delivery for persons with aphasia such as Intensive Comprehensive Aphasia Programs (ICAPs) and Aphasia Centers.
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Affiliation(s)
- Leora R Cherney
- Center for Aphasia Research and Treatment, Shirley Ryan AbilityLab, Chicago, IL, United States; Department of Physical Medicine & Rehabilitation, Northwestern University, Chicago, IL, United States; Department of Communication Sciences & Disorders, Northwestern University, Chicago, IL, United States.
| | - Julia Carpenter
- Center for Aphasia Research and Treatment, Shirley Ryan AbilityLab, Chicago, IL, United States
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19
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Billot A, Lai S, Varkanitsa M, Braun EJ, Rapp B, Parrish TB, Higgins J, Kurani AS, Caplan D, Thompson CK, Ishwar P, Betke M, Kiran S. Multimodal Neural and Behavioral Data Predict Response to Rehabilitation in Chronic Poststroke Aphasia. Stroke 2022; 53:1606-1614. [PMID: 35078348 PMCID: PMC9022691 DOI: 10.1161/strokeaha.121.036749] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Poststroke recovery depends on multiple factors and varies greatly across individuals. Using machine learning models, this study investigated the independent and complementary prognostic role of different patient-related factors in predicting response to language rehabilitation after a stroke. METHODS Fifty-five individuals with chronic poststroke aphasia underwent a battery of standardized assessments and structural and functional magnetic resonance imaging scans, and received 12 weeks of language treatment. Support vector machine and random forest models were constructed to predict responsiveness to treatment using pretreatment behavioral, demographic, and structural and functional neuroimaging data. RESULTS The best prediction performance was achieved by a support vector machine model trained on aphasia severity, demographics, measures of anatomic integrity and resting-state functional connectivity (F1=0.94). This model resulted in a significantly superior prediction performance compared with support vector machine models trained on all feature sets (F1=0.82, P<0.001) or a single feature set (F1 range=0.68-0.84, P<0.001). Across random forest models, training on resting-state functional magnetic resonance imaging connectivity data yielded the best F1 score (F1=0.87). CONCLUSIONS While behavioral, multimodal neuroimaging data and demographic information carry complementary information in predicting response to rehabilitation in chronic poststroke aphasia, functional connectivity of the brain at rest after stroke is a particularly important predictor of responsiveness to treatment, both alone and combined with other patient-related factors.
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Affiliation(s)
- Anne Billot
- Sargent College of Health and Rehabilitation Sciences (A.B., M.V., E.J.B., S.K.), Boston University, MA
- School of Medicine (A.B.), Boston University, MA
| | - Sha Lai
- Department of Computer Science (S.L., P.I., M.B.), Boston University, MA
| | - Maria Varkanitsa
- Sargent College of Health and Rehabilitation Sciences (A.B., M.V., E.J.B., S.K.), Boston University, MA
| | - Emily J. Braun
- Sargent College of Health and Rehabilitation Sciences (A.B., M.V., E.J.B., S.K.), Boston University, MA
| | - Brenda Rapp
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD (B.R.)
| | - Todd B. Parrish
- Department of Radiology (T.B.P., J.H.), Northwestern University, Chicago, IL
| | - James Higgins
- Department of Radiology (T.B.P., J.H.), Northwestern University, Chicago, IL
| | - Ajay S. Kurani
- Department of Neurology (A.S.K.), Northwestern University, Chicago, IL
| | - David Caplan
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (D.C.)
| | - Cynthia K. Thompson
- Feinberg School of Medicine and Department of Communication Sciences and Disorders (C.K.T.), Northwestern University, Chicago, IL
| | - Prakash Ishwar
- Department of Computer Science (S.L., P.I., M.B.), Boston University, MA
| | - Margrit Betke
- Department of Computer Science (S.L., P.I., M.B.), Boston University, MA
| | - Swathi Kiran
- Sargent College of Health and Rehabilitation Sciences (A.B., M.V., E.J.B., S.K.), Boston University, MA
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20
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Swiderski AM, Quique YM, Dickey MW, Hula WD. Treatment of Underlying Forms: A Bayesian Meta-Analysis of the Effects of Treatment and Person-Related Variables on Treatment Response. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:4308-4328. [PMID: 34694908 DOI: 10.1044/2021_jslhr-21-00131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose This meta-analysis synthesizes published studies using "treatment of underlying forms" (TUF) for sentence-level deficits in people with aphasia (PWA). The study aims were to examine group-level evidence for TUF efficacy, to characterize the effects of treatment-related variables (sentence structural family and complexity; treatment dose) in relation to the Complexity Account of Treatment Efficacy (CATE) hypothesis, and to examine the effects of person-level variables (aphasia severity, sentence comprehension impairment, and time postonset of aphasia) on TUF response. Method Data from 13 single-subject, multiple-baseline TUF studies, including 46 PWA, were analyzed. Bayesian generalized linear mixed-effects interrupted time series models were used to assess the effect of treatment-related variables on probe accuracy during baseline and treatment. The moderating influence of person-level variables on TUF response was also investigated. Results The results provide group-level evidence for TUF efficacy demonstrating increased probe accuracy during treatment compared with baseline phases. Greater amounts of TUF were associated with larger increases in accuracy, with greater gains for treated than untreated sentences. The findings revealed generalization effects for sentences that were of the same family but less complex than treated sentences. Aphasia severity may moderate TUF response, with people with milder aphasia demonstrating greater gains compared with people with more severe aphasia. Sentence comprehension performance did not moderate TUF response. Greater time postonset of aphasia was associated with smaller improvements for treated sentences but not for untreated sentences. Conclusions Our results provide generalizable group-level evidence of TUF efficacy. Treatment and generalization responses were consistent with the CATE hypothesis. Model results also identified person-level moderators of TUF (aphasia severity, time postonset of aphasia) and preliminary estimates of the effects of varying amounts of TUF for treated and untreated sentences. Taken together, these findings add to the TUF evidence and may guide future TUF treatment-candidate selection. Supplemental Material https://doi.org/10.23641/asha.16828630.
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Affiliation(s)
- Alexander M Swiderski
- University of Pittsburgh, PA
- Center for Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, PA
- VA Healthcare System, Pittsburgh, PA
| | - Yina M Quique
- Center for Education in Health Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Michael Walsh Dickey
- University of Pittsburgh, PA
- Center for Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, PA
- VA Healthcare System, Pittsburgh, PA
| | - William D Hula
- University of Pittsburgh, PA
- VA Healthcare System, Pittsburgh, PA
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21
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Fridriksson J, Hillis AE. Current Approaches to the Treatment of Post-Stroke Aphasia. J Stroke 2021; 23:183-201. [PMID: 34102754 PMCID: PMC8189855 DOI: 10.5853/jos.2020.05015] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/21/2021] [Accepted: 04/30/2021] [Indexed: 12/16/2022] Open
Abstract
Aphasia, impairment of language after stroke or other neurological insult, is a common and often devastating condition that affects nearly every social activity and interaction. Behavioral speech and language therapy is the mainstay of treatment, although other interventions have been introduced to augment the effects of the behavioral therapy. In this narrative review, we discuss advances in aphasia therapy in the last 5 years and focus primarily on properly powered, randomized, controlled trials of both behavioral therapies and interventions to augment therapy for post-stroke aphasia. These trials include evaluation of behavioral therapies and computer-delivered language therapies. We also discuss outcome prediction trials as well as interventional trials that have employed noninvasive brain stimulation, or medications to augment language therapy. Supported by evidence from Phase III trials and large meta-analyses, it is now generally accepted that aphasia therapy can improve language processing for many patients. Not all patients respond similarly to aphasia therapy with the most severe patients being the least likely responders. Nevertheless, it is imperative that all patients, regardless of severity, receive aphasia management focused on direct therapy of language deficits, counseling, or both. Emerging evidence from Phase II trials suggests transcranial brain stimulation is a promising method to boost aphasia therapy outcomes.
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Affiliation(s)
- Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Argye Elizabeth Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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22
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German Language Adaptation of the NAVS (NAVS-G) and of the NAT (NAT-G): Testing Grammar in Aphasia. Brain Sci 2021; 11:brainsci11040474. [PMID: 33918022 PMCID: PMC8069474 DOI: 10.3390/brainsci11040474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/02/2021] [Accepted: 04/04/2021] [Indexed: 11/17/2022] Open
Abstract
Grammar provides the framework for understanding and producing language. In aphasia, an acquired language disorder, grammatical deficits are diversified and widespread. However, the few assessments for testing grammar in the German language do not consider current linguistic, psycholinguistic, and functional imaging data, which have been shown to be crucial for effective treatment. This study developed German language versions of the Northwestern Assessment of Verbs and Sentences (NAVS-G) and the Northwestern Anagram Test (NAT-G) to examine comprehension and production of verbs, controlling for the number and optionality of verb arguments, and sentences with increasing syntactic complexity. The NAVS-G and NAT-G were tested in 27 healthy participants, 15 right hemispheric stroke patients without aphasia, and 15 stroke patients with mild to residual aphasia. Participants without aphasia showed near-perfect performance, with the exception of (object) relative sentences, where accuracy was associated with educational level. In each patient with aphasia, deficits in more than one subtest were observed. The within and between population-groups logistic mixed regression analyses identified significant impairments in processing syntactic complexity at the verb and sentence levels. These findings indicate that the NAVS-G and NAT-G have potential for testing grammatical competence in (German) stroke patients.
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23
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Sharma S, Kim H, Harris H, Haberstroh A, Wright HH, Rothermich K. Eye Tracking Measures for Studying Language Comprehension Deficits in Aphasia: A Systematic Search and Scoping Review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:1008-1022. [PMID: 33606952 DOI: 10.1044/2020_jslhr-20-00287] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Aim The aim of this scoping review is to identify the eye tracking paradigms and eye movement measures used to investigate auditory and reading comprehension deficits in persons with aphasia (PWA). Method MEDLINE via PubMed, Cochrane, CINAHL, Embase, PsycINFO, OTseeker, Scopus, Google Scholar, Grey Literature Database, and ProQuest Search (Dissertations & Theses) were searched for relevant studies. The Covidence software was used to manage the initial and full-text screening process for the search. Results and Discussion From a total of 1,803 studies, 68 studies were included for full-text screening. In addition, 418 records from gray literature were also screened. After full-text screening, 16 studies were included for this review-12 studies for auditory comprehension in PWA and four studies for reading comprehension in PWA. The review highlights the use of common eye tracking paradigms used to study language comprehension in PWA. We also discusse eye movement measures and how they help in assessing auditory and reading comprehension. Methodological challenges of using eye tracking are discussed. Conclusion The studies summarized in this scoping review provide evidence that the eye tracking methods are beneficial for studying auditory and reading comprehension in PWA.
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Affiliation(s)
- Saryu Sharma
- Department of Communication Sciences & Disorders, College of Allied Health Sciences, East Carolina University, Greenville, NC
| | - Hana Kim
- Department of Communication Sciences & Disorders, College of Allied Health Sciences, East Carolina University, Greenville, NC
| | - Havan Harris
- Department of Communication Sciences & Disorders, College of Allied Health Sciences, East Carolina University, Greenville, NC
| | | | - Heather Harris Wright
- Department of Communication Sciences & Disorders, College of Allied Health Sciences, East Carolina University, Greenville, NC
| | - Kathrin Rothermich
- Department of Communication Sciences & Disorders, College of Allied Health Sciences, East Carolina University, Greenville, NC
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24
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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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25
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Thompson CK, Barbieri E, Mack JE, Wilkins A, Xie KY. Plasticity of sentence processing networks: evidence from a patient with agrammatic variant of primary progressive aphasia (PPA). Neurocase 2021; 27:39-56. [PMID: 33378229 PMCID: PMC8026534 DOI: 10.1080/13554794.2020.1862241] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 12/04/2020] [Indexed: 10/22/2022]
Abstract
This study reports the results of a longitudinal study examining the effects of treatment for sentence processing deficits for a 70-year-old gentleman (DK) with the agrammatic variant of Primary Progressive Aphasia (PPA). On entry into the study, he presented with a 2-year history of impaired verb and sentence processing and concomitant neural atrophy in primarily subcortical regions. Spanning an 18-month period, treatment focused on improving comprehension and production of syntactically complex, passive and object cleft, structures, consecutively. Results, derived from extensive behavioral and neurocognitive testing, showed not only improved ability to comprehend and produce both trained and untrained, less complex, linguistically related structures in offline tasks, but also improved online sentence processing strategies as revealed by partially normalized eye movements in online comprehension (i.e., emergence of thematic prediction and thematic integration) and production (i.e., use of incremental processing) tasks. Changes in neural activation from pre- to post-treatment of both structures also were found, with upregulation of tissue in both the left and right hemispheres, overlapping with regions recruited by neurotypical adults performing the same task. These findings indicate that Treatment of Underlying Forms (TUF) is effective for treatment of patients with the agrammatic variant of PPA (as it is for those with stroke-induced agrammatism), and show that unaffected neural tissue in patients with PPA is malleable and may be recruited to support language, providing evidence of experience-based plasticity in neurodegenerative disease.
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Affiliation(s)
- Cynthia K. Thompson
- Aphasia and Neurolinguistics Research Laboratory, Center for the Neurobiology of Language Recovery, Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
- Department of Neurology, Northwestern University, Chicago, IL, United States
- Cognitive Neurology and Alzheimer’s Disease Center, Northwestern University, Chicago, IL, United States
| | - Elena Barbieri
- Aphasia and Neurolinguistics Research Laboratory, Center for the Neurobiology of Language Recovery, Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
| | - Jennifer E. Mack
- Aphasia and Neurolinguistics Research Laboratory, Center for the Neurobiology of Language Recovery, Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
| | - Aaron Wilkins
- Center for Audiology, Speech, Language, and Learning, Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
| | - Kathy Y. Xie
- Aphasia and Neurolinguistics Research Laboratory, Center for the Neurobiology of Language Recovery, Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
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26
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Lukic S, Thompson CK, Barbieri E, Chiappetta B, Bonakdarpour B, Kiran S, Rapp B, Parrish TB, Caplan D. Common and distinct neural substrates of sentence production and comprehension. Neuroimage 2021; 224:117374. [PMID: 32949711 PMCID: PMC10134242 DOI: 10.1016/j.neuroimage.2020.117374] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 09/08/2020] [Accepted: 09/12/2020] [Indexed: 01/08/2023] Open
Abstract
Functional neuroimaging and lesion-symptom mapping investigations implicate a left frontal-temporal-parietal network for sentence processing. The majority of studies have focused on sentence comprehension, with fewer in the domain of sentence production, which have not fully elucidated overlapping and/or unique brain structures associated with the two domains, particularly for sentences with noncanonical word order. Using voxel-based lesion symptom mapping (VLSM) we examined the relationship between lesions within the left hemisphere language network and both sentence comprehension and production of simple and complex syntactic structures in 76 participants with chronic stroke-induced aphasia. Results revealed shared regions across domains in the anterior and posterior superior temporal gyri (aSTG, pSTG), and the temporal pole (adjusted for verb production/comprehension). Additionally, comprehension was associated with lesions in the anterior and posterior middle temporal gyri (aMTG, pMTG), the MTG temporooccipital regions, SMG/AG, central and parietal operculum, and the insula. Subsequent VLSM analyses (production versus comprehension) revealed critical regions associated with each domain: anterior temporal lesions were associated with production; posterior temporo-parietal lesions were associated with comprehension, implicating important roles for regions within the ventral and dorsal stream processing routes, respectively. Processing of syntactically complex, noncanonical (adjusted for canonical), sentences was associated with damage to the pSTG across domains, with additional damage to the pMTG and IPL associated with impaired sentence comprehension, suggesting that the pSTG is crucial for computing noncanonical sentences across domains and that the pMTG, and IPL are necessary for re-analysis of thematic roles as required for resolution of long-distance dependencies. These findings converge with previous studies and extend our knowledge of the neural mechanisms of sentence comprehension to production, highlighting critical regions associated with both domains, and further address the mechanism engaged for syntactic computation, controlled for the contribution of verb processing.
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27
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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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28
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Ionta S, Costantini M, Ferretti A, Galati G, Romani GL, Aglioti SM. Visual similarity and psychological closeness are neurally dissociable in the brain response to vicarious pain. Cortex 2020; 133:295-308. [PMID: 33160159 DOI: 10.1016/j.cortex.2020.09.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/13/2020] [Accepted: 09/28/2020] [Indexed: 12/30/2022]
Abstract
Personal and vicarious experience of pain activate partially overlapping brain networks. This brain activity is further modulated by low- and high-order factors, e.g., the perceived intensity of the model's pain and the model's similarity with the onlooker, respectively. We investigated which specific aspect of similarity modulates such empathic reactivity, focusing on the potential differentiation between visual similarity and psychological closeness between the onlooker and different types of models. To this aim, we recorded fMRI data in neurotypical participants who observed painful and tactile stimuli delivered to an adult human hand, a baby human hand, a puppy dog paw, and an anthropomorphic robotic hand. The interaction between type of vicarious experience (pain, touch) and nature of model (adult, baby, dog, robot) showed that the right supramarginal gyrus (rSMG) was selectively active for visual similarity (more active during vicarious pain for the adult and baby models), while the anterior cingulate cortex (ACC) was more sensitive to psychological closeness (specifically linked to vicarious pain for the baby model). These findings indicate that visual similarity and psychological closeness between onlooker and model differentially affect the activity of brain regions specifically implied in encoding interindividual sharing of sensorimotor and affective aspects of vicarious pain, respectively.
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Affiliation(s)
- Silvio Ionta
- Sensory-Motor Lab (SeMoLa), Department of Ophthalmology-University of Lausanne, Jules Gonin Eye Hospital-Fondation Asile des Aveugles, Lausanne, Switzerland; Department of Neuroscience, Imaging and Clinical Science, University G. D'Annunzio, Chieti, Italy; Institute of Advanced Biomedical Technologies, University G. D'Annunzio, Chieti, Italy; CNLS@Sapienza, Istituto Italiano di Tecnologia, Sapienza University of Rome, Italy.
| | - Marcello Costantini
- Department of Psychological, Health and Territorial Sciences, University G. D'Annunzio, Chieti-Pescara, Italy
| | - Antonio Ferretti
- Department of Neuroscience, Imaging and Clinical Science, University G. D'Annunzio, Chieti, Italy; Institute of Advanced Biomedical Technologies, University G. D'Annunzio, Chieti, Italy
| | - Gaspare Galati
- Department of Psychology, University of Rome "La Sapienza", Italy; IRCCS "Fondazione Santa Lucia", Rome, Italy
| | - Gian Luca Romani
- Institute of Advanced Biomedical Technologies, University G. D'Annunzio, Chieti, Italy
| | - Salvatore M Aglioti
- CNLS@Sapienza, Istituto Italiano di Tecnologia, Sapienza University of Rome, Italy; IRCCS "Fondazione Santa Lucia", Rome, Italy.
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29
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Fromm D, MacWhinney B, Thompson CK. Automation of the Northwestern Narrative Language Analysis System. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:1835-1844. [PMID: 32464070 PMCID: PMC7839033 DOI: 10.1044/2020_jslhr-19-00267] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 01/29/2020] [Accepted: 02/26/2020] [Indexed: 05/06/2023]
Abstract
Purpose Analysis of spontaneous speech samples is important for determining patterns of language production in people with aphasia. To accomplish this, researchers and clinicians can use either hand coding or computer-automated methods. In a comparison of the two methods using the hand-coding NNLA (Northwestern Narrative Language Analysis) and automatic transcript analysis by CLAN (Computerized Language Analysis), Hsu and Thompson (2018) found good agreement for 32 of 51 linguistic variables. The comparison showed little difference between the two methods for coding most general (i.e., utterance length, rate of speech production), lexical, and morphological measures. However, the NNLA system coded grammatical measures (i.e., sentence and verb argument structure) that CLAN did not. Because of the importance of quantifying these aspects of language, the current study sought to implement a new, single, composite CLAN command for the full set of 51 NNLA codes and to evaluate its reliability for coding aphasic language samples. Method Eighteen manually coded NNLA transcripts from eight people with aphasia and 10 controls were converted into CHAT (Codes for the Human Analysis of Talk) files for compatibility with CLAN commands. Rules from the NNLA manual were translated into programmed rules for CLAN computation of lexical, morphological, utterance-level, sentence-level, and verb argument structure measures. Results The new C-NNLA (CLAN command to compute the full set of NNLA measures) program automatically computes 50 of the 51 NNLA measures and generates the results in a summary spreadsheet. The only measure it does not compute is the number of verb particles. Statistical tests revealed no significant difference between C-NNLA results and those generated by manual coding for 44 of the 50 measures. C-NNLA results were not comparable to manual coding for the six verb argument measures. Conclusion Clinicians and researchers can use the automatic C-NNLA to analyze important variables required for quantification of grammatical deficits in aphasia in a way that is fast, replicable, and accessible without extensive linguistic knowledge and training.
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Affiliation(s)
- Davida Fromm
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA
| | - Brian MacWhinney
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA
| | - Cynthia K. Thompson
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
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30
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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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31
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Thompson CK. Neurocognitive Recovery of Sentence Processing in Aphasia. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:3947-3972. [PMID: 31756151 PMCID: PMC7203523 DOI: 10.1044/2019_jslhr-l-rsnp-19-0219] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 08/20/2019] [Accepted: 09/09/2019] [Indexed: 05/04/2023]
Abstract
Purpose Reorganization of language networks in aphasia takes advantage of the facts that (a) the brain is an organ of plasticity, with neuronal changes occurring throughout the life span, including following brain damage; (b) plasticity is highly experience dependent; and (c) as with any learning system, language reorganization involves a synergistic interplay between organism-intrinsic (i.e., cognitive and brain) and organism-extrinsic (i.e., environmental) variables. A major goal for clinical treatment of aphasia is to be able to prescribe treatment and predict its outcome based on the neurocognitive deficit profiles of individual patients. This review article summarizes the results of research examining the neurocognitive effects of psycholinguistically based treatment (i.e., Treatment of Underlying Forms; Thompson & Shapiro, 2005) for sentence processing impairments in individuals with chronic agrammatic aphasia resulting from stroke and primary progressive aphasia and addresses both behavioral and brain variables related to successful treatment outcomes. The influences of lesion volume and location, perfusion (blood flow), and resting-state neural activity on language recovery are also discussed as related to recovery of agrammatism and other language impairments. Based on these and other data, principles for promoting neuroplasticity of language networks are presented. Conclusions Sentence processing treatment results in improved comprehension and production of complex syntactic structures in chronic agrammatism and generalization to less complex, linguistically related structures in chronic agrammatism. Patients also show treatment-induced shifts toward normal-like online sentence processing routines (based on eye movement data) and changes in neural recruitment patterns (based on functional neuroimaging), with posttreatment activation of regions overlapping with those within sentence processing and dorsal attention networks engaged by neurotypical adults performing the same task. These findings provide compelling evidence that treatment focused on principles of neuroplasticity promotes neurocognitive recovery in chronic agrammatic aphasia. Presentation Videohttps://doi.org/10.23641/asha.10257587.
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Affiliation(s)
- Cynthia K. Thompson
- Department of Communication Sciences and Disorders, Department of Neurology and Mesulam Cognitive Neurology and Alzheimer's Disease Center, Northwestern University, Evanston/Chicago, IL
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32
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Mack JE, Mesulam MM, Rogalski EJ, Thompson CK. Verb-argument integration in primary progressive aphasia: Real-time argument access and selection. Neuropsychologia 2019; 134:107192. [PMID: 31521633 DOI: 10.1016/j.neuropsychologia.2019.107192] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 07/30/2019] [Accepted: 09/09/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Impaired sentence comprehension is observed in the three major subtypes of PPA, with distinct performance patterns relating to impairments in comprehending complex sentences in the agrammatic (PPA-G) and logopenic (PPA-L) variants and word comprehension in the semantic subtype (PPA-S). However, little is known about basic combinatory processes during sentence comprehension in PPA, such the integration of verbs with their subject and object(s) (verb-argument integration). METHODS The present study used visual-world eye-tracking to examine real-time verb-argument integration in individuals with PPA (12 with PPA-G, 10 with PPA-L, and 6 with PPA-S) and neurotypical older adults (15). Two baseline experiments probed eye movement control, using a non-linguistic task, and noun comprehension, respectively. Two verb-argument integration experiments examined the effects of verb meaning on (a) lexical access of the verb's direct object (argument access) and (b) selection of a semantically-appropriate direct object (argument selection), respectively. Eye movement analyses were conducted only for trials with correct behavioral responses, allowing us to distinguish accuracy and online processing. RESULTS The eye movement control experiment revealed no significant impairments in PPA, whereas the noun comprehension experiment revealed reduced accuracy and eye-movement latencies in PPA-S, and to a lesser extent PPA-G. In the argument access experiment, verb meaning facilitated argument access normally in PPA-G and PPA-L; in PPA-S, verb-meaning effects emerged on an atypical time course. In the argument selection experiment, significant impairments in accuracy were observed only in PPA-G, accompanied by markedly atypical eye movement patterns. CONCLUSION This study revealed two distinct patterns of impaired verb-argument integration in PPA. In PPA-S, impaired verb-argument integration was observed in the argument access experiment, indicating impairments in basic semantic combinatory processes which likely relate to damage in ventral language pathways. In contrast, listeners with PPA-G showed marked impairments of argument selection, likely relating to damage to left inferior frontal regions.
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Affiliation(s)
- Jennifer E Mack
- Roxelyn & Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, USA.
| | - M-Marsel Mesulam
- Mesulam Cognitive Neurology and Alzheimer's Disease Center, Northwestern University, USA; Ken & Ruth Davee Department of Neurology, Northwestern University, USA
| | - Emily J Rogalski
- Mesulam Cognitive Neurology and Alzheimer's Disease Center, Northwestern University, USA; Department of Psychiatry and Behavioral Sciences, Northwestern University, USA
| | - Cynthia K Thompson
- Roxelyn & Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, USA; Mesulam Cognitive Neurology and Alzheimer's Disease Center, Northwestern University, USA; Ken & Ruth Davee Department of Neurology, Northwestern University, USA
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