Less is more: neural mechanisms underlying anomia treatment in chronic aphasic patients
Open accessAbstract
See Thompson and Woollams (doi:10.1093/brain/awx264) for a scientific commentary on this article. Previous research with aphasic patients has shown that picture naming can be facilitated by concurrent phonemic cueing [e.g. initial phoneme(s) of the word that the patient is trying to retrieve], both as an immediate word retrieval technique, and when practiced repeatedly over time as a long-term anomia treatment. Here, to investigate the neural mechanisms supporting word retrieval, we adopted—for the first time—a functional magnetic resonance imaging task using the same naming procedure as it occurs during the anomia treatment process. Before and directly after a 6-week anomia treatment programme, 18 chronic aphasic stroke patients completed our functional magnetic resonance imaging protocol—a picture naming task aided by three different types of phonemic cues (whole words, initial phonemes, final phonemes) and a noise-control condition. Patients completed a naming task based on the training materials, and a more general comprehensive battery of language tests both before and after the anomia treatment, to determine the effectiveness and specificity of the therapy. Our results demonstrate that the anomia treatment was effective and specific to speech production, significantly improving both patients’ naming accuracy and reaction time immediately post-treatment (unstandardized effect size: 29% and 17%, respectively; Cohen’s d: 3.45 and 1.83). Longer term gains in naming were maintained 3 months later. Functional imaging results showed that both immediate and long-term facilitation of naming involved a largely overlapping bilateral frontal network including the right anterior insula, inferior frontal and dorsal anterior cingulate cortices, and the left premotor cortex. These areas were associated with a neural priming effect (i.e. reduced blood oxygen level-dependent signal) during both immediate (phonemically-cued versus control-cue conditions), and long-term facilitation of naming (i.e. treated versus untreated items). Of note is that different brain regions were sensitive to different phonemic cue types. Processing of whole word cues was associated with increased activity in the right angular gyrus; whereas partial word cues (initial and final phonemes) recruited the left supplementary motor area, and right anterior insula, inferior frontal cortex, and basal ganglia. The recruitment of multiple and bilateral areas may help explain why phonemic cueing is such a successful behavioural facilitation tool for anomia treatment. Our results have important implications for optimizing current anomia treatment approaches, developing new treatments, and improving speech outcome for aphasic patients.
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Age influences inter-individual variability in treated language improvement in post-stroke aphasia.
“It is well established that inter-individual variability in TLI in post-stroke aphasia is influenced by an array of factors, including, but not limited to, age12–15, education16–19, aphasia severity11,14,15,20,21, baseline cognitive abilities13,22,23, and, specific to bPWA, bilingual language experience and language of treatment (e.g., whether therapy is delivered in L1 or L2)24,25.”
From Machine Learning Predictions of Recovery in Bilingual Poststroke Aphasia: Aligning Insights With Clinical Evidence (2025) · cites this paper as [12]
The Results (Experiment 1: Free-naming; page unavailable) explicitly state that no treatment-outcome measure correlated with age in this study. The paper therefore does not support the attributed claim that age influenced differences between patients in treated language improvement. (LLM, conf=0.90)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredNardo et al. showed that different therapeutic cues for word retrieval had a neural priming effect (reduced activity) in different regions within bilateral frontal networks.
“Nardo et al. [39] highlighted the complexity of this issue by showing that even different therapeutic cues for word retrieval had a neural priming effect (reduced activity) in different regions within bilateral frontal networks.”
From Aphasia Recovery: When, How and Who to Treat? (2018) · cites this paper as [39]
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Aphasia Recovery: When, How and Who to Treat?
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- Authors
- Nardo, D., Holland, R., Leff, A. P., Price, C. J., & Crinion, J. T.
- Affiliations
- University College London (GB)
- City, University of London (GB)
- Wellcome Centre for Human Neuroimaging (GB)
- Institute of Cognitive Neuroscience, University College London, London, UK
- Corresponding author
- Nardo, Davide
- Venue
- Brain
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-09-27
- Volume
- 140
- Issue
- 11
- Pages
- 3039-3054
- ISSN
- 0006-8950 (ISSN-L)
- 1460-2156
- PMC
- PMC5808641
- OpenAlex
- W2759893279
- Cited by
- 80
- References
- 83
- Citations by year
- 2026: 8 · 2025: 11 · 2024: 5 · 2023: 9 · 2022: 6 · 2021: 12 · 2020: 13 · 2019: 10 · 2018: 4 · 2017: 2
- FWCI
- 4.55
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Brain (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- City Research Online (City University London) (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Iris (Roma Tre University) (submittedVersion)
- Funders
- National Institutes of Health
- Wellcome Trust
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neurobiology of Language and Bilingualism
- Social Sciences › Psychology › Developmental and Educational Psychology › Language Development and Disorders
- Social Sciences › Psychology › Developmental and Educational Psychology › Reading and Literacy Development
- Keywords
- anomia, chronic aphasia, picture naming, word retrieval, aphasia rehabilitation, stroke, neural priming, anterior insula, inferior frontal cortex, supplementary motor area, angular gyrus, basal ganglia, frontal network, speech production
- MeSH terms
- Adult, Aged, Anomia, Aphasia, Chronic Disease, Cues, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Photic Stimulation, Reaction Time, Treatment Outcome, Stroke, Young Adult
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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