Defining Hypoperfusion in Chronic Aphasia: An Individualized Thresholding Approach

Abbott, Noelle T.; Baker, Carolyn; Chen, Conan; Liu, Thomas T.; Love, Tracy

doi:10.3390/brainsci11040491

Cited by 9 publications

(34 citation statements)

References 54 publications

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“…Within the left hemisphere as well, tissue closer to the lesion was reduced in perfusion relative to more distant areas—for the 0–6 mm ring compared to the 6–12 mm ring, and for 6–12 mm vs. 12–18 mm. This is again consistent with prior findings ( Abbott et al, 2021 ; Boukrina et al, 2019 ; Fridriksson et al, 2012 ; Thompson et al, 2017 ), but is most consistent with one prior study that reports a similar gradient across successive 3 mm rings ( Fridriksson et al, 2012 ).…”

Section: Methodssupporting

confidence: 92%

“…However, what constitutes a “perilesional” region has never been precisely defined ( Thompson et al, 2017 ), and some authors refer to perilesional regions strictly in terms of rings of tissue surrounding the lesion. Here we focus on studies examining such perilesional rings in chronic aphasia, where the extent of the rings identified as perilesional have varied across reports, from 6.88 (left/right, anterior/posterior) or 13.88 mm (inferior/superior) depending on direction ( Brumm et al, 2010 ), to 3–8 mm ( Richardson et al, 2011 ), 3–15 mm ( Fridriksson et al, 2012 ), 0–6 mm ( Thompson et al, 2017 ), 0–5 mm ( Boukrina et al, 2019 ), and 0–3 mm ( Abbott et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

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Perilesional Perfusion in Chronic Stroke-Induced Aphasia and Its Response to Behavioral Treatment Interventions

Walenski

Chen

Litcofsky

et al. 2022

Neurobiology of Language

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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 (pCASL) in 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 homolog. 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 who were 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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Section: Methodssupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Perilesional Perfusion in Chronic Stroke-Induced Aphasia and Its Response to Behavioral Treatment Interventions

Walenski

Chen

Litcofsky

et al. 2022

Neurobiology of Language

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“…Beneath the brain function changes, adequate cerebral blood flow perfusion provides the metabolism supports for the neural activities [ 27 ]. Researches focused on the cerebral blood of poststroke aphasia patients found worse perfusion in regions around the core lesions [ 86 ].…”

Section: Discussionmentioning

confidence: 99%

“…Clinical researches showed multiform language function impairments and the aphasia recovery process [ 26 ]. Apart from the relationship based on the structure-function hypothesis, evidence has been found in the variation of cerebral blood perfusion, brain functional connection, and neural activity, which enriched the mechanism of aphasia recovery [ 27 – 29 ]. Taking advantage of multidisciplinary combinations such as neuroimaging technology, researchers can explore the aphasia recovery mechanism in detail.…”

Section: Introductionmentioning

confidence: 99%

Revealing the Neuroimaging Mechanism of Acupuncture for Poststroke Aphasia: A Systematic Review

Deng

Sang

et al. 2022

Neural Plasticity

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Background. Aphasia is a common symptom in stroke patients, presenting with the impairment of spontaneous speech, repetition, naming, auditory comprehension, reading, and writing function. Multiple rehabilitation methods have been suggested for the recovery of poststroke aphasia, including medication treatment, behavioral therapy, and stimulation approach. Acupuncture has been proven to have a beneficial effect on improving speech functions in repetition, oral speech, reading, comprehension, and writing ability. Neuroimaging technology provides a visualized way to explore cerebral neural activity, which helps reveal the therapeutic effect of acupuncture therapy. In this systematic review, we aim to reveal and summarize the neuroimaging mechanism of acupuncture therapy on poststroke aphasia to provide the foundation for further study. Methods. Seven electronic databases were searched including PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, the Wanfang databases, and the Chinese Scientific Journal Database. After screening the studies according to the inclusion and exclusion criteria, we summarized the neuroimaging mechanism of acupuncture on poststroke aphasia, as well as the utilization of acupuncture therapy and the methodological characteristics. Result. After searching, 885 articles were retrieved. After removing the literature studies, animal studies, and case reports, 16 studies were included in the final analysis. For the acupuncture type, 10 studies used manual acupuncture and 5 studies used electroacupuncture, while body acupuncture (10 studies), scalp acupuncture (7 studies), and tongue acupuncture (8 studies) were applied for poststroke aphasia patients. Based on blood oxygen level-dependent (BOLD) and diffusion tensor imaging (DTI) technologies, 4 neuroimaging analysis methods were used including amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), seed-based analysis, and independent component analysis (ICA). Two studies reported the instant acupuncture effect, and 14 studies reported the constant acupuncture’s effect on poststroke aphasia patients. 5 studies analyzed the correlation between the neuroimaging outcomes and the clinical language scales. Conclusion. In this systematic review, we found that the mechanism of acupuncture’s effect might be associated with the activation and functional connectivity of language-related brain areas, such as brain areas around Broca’s area and Wernicke’s area in the left inferior temporal gyrus, supramarginal gyrus, middle frontal gyrus, and inferior frontal gyrus. However, these studies were still in the preliminary stage. Multicenter randomized controlled trials (RCT) with large sample sizes were needed to verify current evidence, as well as to explore deeply the neuroimaging mechanisms of acupuncture’s effects.

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“…To identify a new model which investigates the functional integrity of brain regions in chronic aphasia, Abbott and coworkers, in their paper “Defining Hypoperfusion in Chronic Aphasia: An Individualized Thresholding Approach” [ 7 ], examine how an individualized thresholding approach might quantify the extent of hypoperfused tissue in the perilesional regions. The authors investigate the relationship between the amount of hypoperfusion in language areas and the language behaviors of six individuals with aphasia post-stroke.…”

mentioning

confidence: 99%

Editorial: New Perspectives and Methodologies in the Diagnosis and Rehabilitation of Aphasia

Pisano

Marangolo

2021

Brain Sciences

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Defining Hypoperfusion in Chronic Aphasia: An Individualized Thresholding Approach

Cited by 9 publications

References 54 publications

Perilesional Perfusion in Chronic Stroke-Induced Aphasia and Its Response to Behavioral Treatment Interventions

Perilesional Perfusion in Chronic Stroke-Induced Aphasia and Its Response to Behavioral Treatment Interventions

Revealing the Neuroimaging Mechanism of Acupuncture for Poststroke Aphasia: A Systematic Review

Editorial: New Perspectives and Methodologies in the Diagnosis and Rehabilitation of Aphasia

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