Therapy-induced brain reorganization patterns in aphasia
Abstract
Both hemispheres are engaged in recovery from word production deficits in aphasia. Lexical therapy has been shown to induce brain reorganization even in patients with chronic aphasia. However, the interplay of factors influencing reorganization patterns still remains unresolved. We were especially interested in the relation between lesion site, therapy-induced recovery, and beneficial reorganization patterns. Thus, we applied intensive lexical therapy, which was evaluated with functional magnetic resonance imaging, to 14 chronic patients with aphasic word retrieval deficits. In a group study, we aimed to illuminate brain reorganization of the naming network in comparison with healthy controls. Moreover, we intended to analyse the data with joint independent component analysis to relate lesion sites to therapy-induced brain reorganization, and to correlate resulting components with therapy gain. As a result, we found peri-lesional and contralateral activations basically overlapping with premorbid naming networks observed in healthy subjects. Reduced activation patterns for patients compared to controls before training comprised damaged left hemisphere language areas, right precentral and superior temporal gyrus, as well as left caudate and anterior cingulate cortex. There were decreasing activations of bilateral visuo-cognitive, articulatory, attention, and language areas due to therapy, with stronger decreases for patients in right middle temporal gyrus/superior temporal sulcus, bilateral precuneus as well as left anterior cingulate cortex and caudate. The joint independent component analysis revealed three components indexing lesion subtypes that were associated with patient-specific recovery patterns. Activation decreases (i) of an extended frontal lesion disconnecting language pathways occurred in left inferior frontal gyrus; (ii) of a small frontal lesion were found in bilateral inferior frontal gyrus; and (iii) of a large temporo-parietal lesion occurred in bilateral inferior frontal gyrus and contralateral superior temporal gyrus. All components revealed increases in prefrontal areas. One component was negatively correlated with therapy gain. Therapy was associated exclusively with activation decreases, which could mainly be attributed to higher processing efficiency within the naming network. In our joint independent component analysis, all three lesion patterns disclosed involved deactivation of left inferior frontal gyrus. Moreover, we found evidence for increased demands on control processes. As expected, we saw partly differential reorganization profiles depending on lesion patterns. There was no compensatory deactivation for the large left inferior frontal lesion, with its less advantageous outcome probably being related to its disconnection from crucial language processing pathways.
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Abel et al. found decreased activity in left-hemisphere regions associated with treatment-induced naming improvements, suggesting increased efficiency of language-related networks.
“The notion that aphasia therapy decreases brain activity was also shown by Abel et al., [40] who found decreased activity in left-hemisphere regions that was associated with treatment induced naming improvements, suggesting increased efficiency of language-related networks.”
From Aphasia Recovery: When, How and Who to Treat? (2018) · cites this paper as [40]
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- Authors
- Abel, S., Weiller, C., Huber, W., Willmes, K., & Specht, K.
- Affiliations
- University of Manchester (GB)
- University Medical Center Freiburg (DE)
- Jülich Aachen Research Alliance (DE)
- Haukeland University Hospital (NO)
- Venue
- Brain
- Publisher
- Oxford University Press (OUP)
- Published
- 2015-02-14
- Volume
- 138
- Issue
- 4
- Pages
- 1097-1112
- ISSN
- 0006-8950 (ISSN-L)
- 1460-2156
- OpenAlex
- W2143844122
- Cited by
- 119
- References
- 74
- Citations by year
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- FWCI
- 8.02
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- journal article
- Language
- en
- Open access
- closed
- Locations
- Brain (publishedVersion)
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- Research Explorer (The University of Manchester) (publishedVersion)
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- Funders
- Deutsche Forschungsgemeinschaft (AB 282/2-1)
- Bundesministerium für Bildung und Forschung (01GW0662)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neurobiology of Language and Bilingualism
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hemispheric Asymmetry in Neuroscience
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Keywords
- aphasia, brain reorganization, chronic aphasia, lesion site, inferior frontal gyrus, language lateralization, joint independent component analysis, processing efficiency, control processes
- MeSH terms
- Adult, Aged, Aphasia, Brain, Humans, Magnetic Resonance Imaging, Middle Aged, Nerve Net, Neuronal Plasticity, Photic Stimulation, Reaction Time, Temporal Lobe, Recovery of Function
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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