The Neurobiology of Language Recovery in Aphasia

Thompson, Cynthia K.

doi:10.1006/brln.1999.2260

Cited by 29 publications

(15 citation statements)

References 14 publications

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“…This cortical area reorganization related to language (temporal chain pre-existing frontal), consists in the activation of not injured areas in both hemispheres, but particularly the right hemisphere, that may be decisive for the recovery of the language function 11,[22][23][24][25] . In this sample only 15 patients were under speech treatment, different from what happens in the United States, where most of the patients who have language disturbs achieve specific treatment to improve the maximum recovery 26 . In Brazil we still have difficulties in referring how important the speech treatment is for the reduction of recovery time.…”

Section: Discussionmentioning

confidence: 97%

Verbal language spontaneous recovery after ischemic stroke

Remesso

Chiappetta

Aguiar

et al. 2009

Arq. Neuro-Psiquiatr.

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-Objective: To analyze the spontaneous recovery of the verbal language on patients who have had an ischemic stroke. Method: Retrospective analysis of 513 medical records. We characterize referring aspects for data identification, language deficit, spontaneous recovery and speech therapy. Results: The average age was 62.2 years old (SD= ±12.3), the average time of academic experience was 4.5 years (SD=±3.9), 245 (47.7%) patients presented language disturbance, 166 (54.0%) presented spontaneous recovery, from which 145 (47.2%) had expression deficit (p=0.001); 12 (3.9%) had comprehension deficit and 9 (2.9%) had both expression and comprehension deficit. Speech therapy was carried with 15 patients (4.8%) (p=0.001). Conclusion: The verbal language spontaneous recovery occurred in most of the patients being taken care of at the stroke out clinic, and expression disturbance was the most identified alteration. As expected, the left hemisphere was associated with the deficit and smoking and pregressive stroke were the language alteration primary associated factors.KEY WORDS: aphasia, language, stroke, neuronal plasticity. Recuperação espontânea da linguagem verbal após acidente cerebrovascular isquêmicoResumo -Objetivo: Analisar a recuperação espontânea da linguagem verbal em pacientes que sofreram acidente cerebrovascular isquêmico (AVCI). Método: Análise retrospectiva de 513 prontuários. Caracterizamos aspectos referentes aos dados de identificação, déficit de linguagem, recuperação espontânea, realização de tratamento fonoaudiológico. Resultados: A média de idade foi 62,2 anos (DP=±12,3), o nível de escolaridade teve média de 4,5 anos (DP=±3,9), 245 (47,7%) pacientes apresentaram alteração de linguagem, 166 (54,0%) apresentaram recuperação espontânea sendo 145 (47,2%) do déficit de expressão (p=0,001), 12 (3,9%) de compreensão e 9 (2,9%) misto. A realização de tratamento fonoaudiológico foi encontrada em 15 (4,8%) (p=0,001). Conclusão: A recuperação espontânea da linguagem verbal ocorreu na maioria dos pacientes atendidos no ambulatório de AVCI e a alteração mais encontrada foi de expressão. Como esperado o hemisfério esquerdo associou-se ao déficit, sendo o tabagismo e AVC pregresso fatores preditores de alteração de linguagem. Cerebrovascular disease is responsible for one third of adult's deaths in Brazil, about 125,000 Brazilians suffer a new stroke or present a new recurrent condition every year. It occurs more frequently on individuals above 85 years of age and the occurrence on people below 45 years of age comprises around 10% to 20% of the cases [1][2][3][4] . Among the most frequent stroke aftermath, there is the aphasia, characterized by language disturbance that causes a loss of expression and/or oral and written comprehension, varying from type, level and lesion extension. It occurs in 20% to 30% of the stroke cases and it brings the patient and his caregiver great suffering, resulting from the alterations that affect the communication and life style 5,6 . The aphasias are sorted in expressive, ...

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Section: Discussionmentioning

confidence: 97%

Verbal language spontaneous recovery after ischemic stroke

Remesso

Chiappetta

Aguiar

et al. 2009

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

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“…The mechanisms of spontaneous recovery are likely to be different from those of training-induced recovery (cf. Johansson, 2000;Thompson, 2000). As regards cortical correlates of aphasia treatment, only a few studies have been published thus far (Musso et al, 1999;Small et al, 1998;Belin et al, 1996).…”

Section: Introductionmentioning

confidence: 99%

Adult Brain Plasticity Elicited by Anomia Treatment

Cornelissen¹,

Laine

Tarkiainen³

et al. 2003

Journal of Cognitive Neuroscience

151

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Abstract& We describe a study where a specific treatment method for word-finding difficulty (so-called contextual priming technique, which combines massive repetition priming with semantic priming) was applied with three chronic left hemispheredamaged aphasics. Both before and after treatment, which focused on naming of a series of pictures, naming-related brain activity was measured by magnetoencephalography (MEG). Due to its excellent temporal resolution and good spatial resolution, we were able to track treatment-induced changes in cortical activity. All three subjects showed improved naming of the trained items. In all subjects, a single source area, located in the left inferior parietal lobe, close to the lesioned area, displayed statistically significant training-induced changes. This effect was of long latency as it started 300 -600 msec after picture presentation. The change in activation was specific to training, as it could not be accounted for by variation of cortical dynamics associated with increased proportion of correct answers. Our interpretation is that the training effect reflects more effective phonological encoding and storage of the trained items through the engagement of a left hemispheric word-learning system. This is in line with recent functional imaging studies, which have linked left inferior parietal lobe activity to the phonological storage component of the verbal working memory, as well as with theoretical arguments stating that the primary role of the phonological loop is to acquire new words. Finally, the MEG results showed no evidence of increased right hemisphere participation following training, supporting the view that restoration of language-related networks in the damaged left hemisphere is crucial for anomia recovery. &

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“…Evidence from patient data also supports this 'map extension' (Thompson, 2000a) with reports of renewed language impairments in people with aphasia with previously recovered language function, but who go on to experience a second left hemisphere stroke (Basso, Gardelli, Grassi, & Mariotti, 1989). Neuroimaging studies have also demonstrated activation of perilesional tissue adjacent to the lesioned area in response to language processing (Heiss, Kessler, Thiel, Ghaemi, & Karbe, 1999;Kurland et al, 2004;Warburton, Price, Swinburn, & Wise, 1999).…”

Section: Stages Of Recoverysupporting

confidence: 62%

“…It should be noted that these mechanisms have not been examined as predictors of chronic recovery, but instead have explained changes or between subject differences in behaviour at the acute stage. (Lazar & Antoniello, 2008;Thompson, 2000a). These two mechanisms have been at the centre of the debate on language recovery for the past 100 years and the emergence of new noninvasive neuroimaging techniques has prompted a renewed interest in determining whether recruitment of residual left hemisphere language regions or contralateral homologues mediates recovery (Muñoz-Cespedes et al, 2005).…”

Section: Stages Of Recoverymentioning

confidence: 99%

Neurophysiological Markers of Language Recovery in Subacute Stroke

Roxbury¹

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Most patients with aphasia recover language function to some degree, but there is significant variability in the speed, nature, and extent of language recovery that occurs in the months following a stroke. Currently, there is no effective method available to predict how an individual with aphasia will recover. The most accurate predictors of recovery to date rely on global outcome measures which do not provide relevant information regarding recovery of symptoms that are targeted in therapy. The overall goal of this thesis was to examine whether language-related brain activity predicted recovery of specific symptoms in aphasia. The first aim was to gain a clearer understanding of the neural mechanisms which underpin word processing in healthy individuals.Brain activity associated with spoken word processing was investigated firstly in a group of healthy young adults, then in a healthy older cohort in order to ascertain whether task performance was preserved in ageing and if so, whether a preserved performance was underpinned by age-related changes in the neural mechanisms. The second main aim was to investigate the neural substrates which underpin language processing in the subacute (2-6 weeks) and chronic (6 months) phases of aphasia recovery and to determine whether the timing and extent to which these mechanisms are recruited contributes to a good or poor language outcome. An auditory lexical decision task with a novel pseudoword condition was employed to investigate language recovery mechanisms and was selected to ensure that patients with aphasia in the subacute stage would be able to perform the task with sufficient accuracy. The real word stimuli consisted of concrete and abstract items. The stimuli were presented in an event-related fMRI task to young healthy controls, older healthy controls, and patients with aphasia during the subacute and chronic phases post-stroke. A range of behavioural language measures was administered to all three cohorts and at both time points for patients with aphasia.In the healthy young group, concrete words elicited increased activity in a widely distributed network of brain regions including bilateral angular gyrus (AG), left posterior cingulate and left dorsolateral prefrontal cortex, compared to abstract words. Meanwhile, no region showed increased activity for abstract compared to concrete words, rather differences were only observed in bilateral AG when abstract words were contrasted with pseudowords. In the healthy older group, region of interest (ROI) results identified that a preserved performance was associated with an altered pattern of left hemisphere activity in the inferior and middle frontal regions, the AG and the fusiform gyrus.Differences between the healthy older and healthy young group were identified in key language regions, with the left inferior frontal gyrus (IFG) showing increased activity for abstract and pseudowords compared to concrete words while increased activity in the left AG was observed in the younger group only.ii In patients with a...

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The Neurobiology of Language Recovery in Aphasia

Cited by 29 publications

References 14 publications

Verbal language spontaneous recovery after ischemic stroke

Verbal language spontaneous recovery after ischemic stroke

Adult Brain Plasticity Elicited by Anomia Treatment

Neurophysiological Markers of Language Recovery in Subacute Stroke

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