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Prat CS, Gallée J, Yamasaki BL. Getting language right: Relating individual differences in right hemisphere contributions to language learning and relearning. BRAIN AND LANGUAGE 2023; 239:105242. [PMID: 36931111 DOI: 10.1016/j.bandl.2023.105242] [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: 04/15/2022] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 05/10/2023]
Abstract
Language, or the diverse set of dynamic processes through which symbolic, perceptual codes are linked to meaning representations in memory, has long been assumed to be lateralized to the left hemisphere (LH). However, after over 150 years of investigation, we still lack a unifying account of when, and for whom, a particular linguistic process relies upon LH or right hemisphere (RH) computations, or both. With a focus on individual differences, this article integrates existing theories of hemispheric contributions to language and cognition into a novel proposed framework for understanding how, when, and for whom the RH contributes to linguistic processes. We use evidence from first and second language learning and language relearning following focal brain damage to highlight the critical contributions of the RH.
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Affiliation(s)
- Chantel S Prat
- Department of Psychology, Institute for Learning and Brain Sciences, University of Washington, Seattle, WA, USA.
| | - Jeanne Gallée
- Department of Psychology, Institute for Learning and Brain Sciences, University of Washington, Seattle, WA, USA
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2
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An H, Bashir S, Cha E, Lee J, Ohn SH, Jung KI, Yoo WK. Continuous theta-burst stimulation over the left posterior inferior frontal gyrus induced compensatory plasticity in the language network. Front Neurol 2022; 13:950718. [PMID: 36188373 PMCID: PMC9518904 DOI: 10.3389/fneur.2022.950718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/17/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction Continuous theta-burst stimulation (cTBS) has been used as an effective tool in inducing inhibitory aftereffect within a short time periods in the motor cortex; this has been demonstrated in the language network to a limited degree with controversial effect. In this study, we aimed to delineate the offline effect of cTBS-induced changes to the left posterior inferior frontal gyrus (pIFG) in healthy subjects using functional magnetic resonance imaging (fMRI). Methods Twenty healthy, normal subjects (mean age: 30.84 years) were recruited. They all were right-handed and had no contra-indications for fMRI or cTBS. They were randomly assigned into the treatment group or the sham control group. Results ANOVA showed that cTBS had a significant main effect only when the sham treatment was subtracted from the real stimulation in left superior temporal, left inferior frontal gyrus, thalamus, and right insular cortex (uncorrected p < 0.002). The subjects' post-cTBS condition differed significantly from their pre-cTBS condition in the left pIFG (uncorrected p < 0.002). There were interactions in the pIFG, bilateral superior parietal lobules, left superior temporal, left supramarginal, and left cuneus areas. The application of cTBS induced increased BOLD signals in language-related networks by stimulating the left pIFG (BA 44). This implies that inhibiting the pIFG led to increased use of language network resources. Conclusion This study demonstrated cTBS-induced changes in the language network caused by stimulation of the left pIFG. Based on these findings, future studies on the therapeutic effects of cTBS on the right Broca's homolog area are warranted.
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Affiliation(s)
- HyunJung An
- Hallym Institute for Interdisciplinary Program Molecular Medicine, Hallym University College of Medicine, Chunchon, South Korea
| | - Shahid Bashir
- Neuroscience Center, King Fahad Specialist Hospital Dammam, Dammam, Saudi Arabia
| | - Eunsil Cha
- Department of Physical Medicine and Rehabilitation, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Jeongeun Lee
- Department of Physical Medicine and Rehabilitation, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Suk Hoon Ohn
- Department of Physical Medicine and Rehabilitation, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Kwang-Ik Jung
- Department of Physical Medicine and Rehabilitation, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Woo-Kyoung Yoo
- Hallym Institute for Interdisciplinary Program Molecular Medicine, Hallym University College of Medicine, Chunchon, South Korea
- Department of Physical Medicine and Rehabilitation, Hallym University Sacred Heart Hospital, Anyang, South Korea
- *Correspondence: Woo-Kyoung Yoo ;
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3
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Wang T, Zhang Y, Zhang X, Chen L, Zheng MQ, Zhang J, Brust P, Deuther-Conrad W, Huang Y, Jia H. Synthesis and characterization of the two enantiomers of a chiral sigma-1 receptor radioligand: (S)-(+)- and (R)-(-)-[18F]FBFP. CHINESE CHEM LETT 2022. [DOI: 10.1016/j.cclet.2022.03.099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Pasquini L, Di Napoli A, Rossi-Espagnet MC, Visconti E, Napolitano A, Romano A, Bozzao A, Peck KK, Holodny AI. Understanding Language Reorganization With Neuroimaging: How Language Adapts to Different Focal Lesions and Insights Into Clinical Applications. Front Hum Neurosci 2022; 16:747215. [PMID: 35250510 PMCID: PMC8895248 DOI: 10.3389/fnhum.2022.747215] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/18/2022] [Indexed: 12/13/2022] Open
Abstract
When the language-dominant hemisphere is damaged by a focal lesion, the brain may reorganize the language network through functional and structural changes known as adaptive plasticity. Adaptive plasticity is documented for triggers including ischemic, tumoral, and epileptic focal lesions, with effects in clinical practice. Many questions remain regarding language plasticity. Different lesions may induce different patterns of reorganization depending on pathologic features, location in the brain, and timing of onset. Neuroimaging provides insights into language plasticity due to its non-invasiveness, ability to image the whole brain, and large-scale implementation. This review provides an overview of language plasticity on MRI with insights for patient care. First, we describe the structural and functional language network as depicted by neuroimaging. Second, we explore language reorganization triggered by stroke, brain tumors, and epileptic lesions and analyze applications in clinical diagnosis and treatment planning. By comparing different focal lesions, we investigate determinants of language plasticity including lesion location and timing of onset, longitudinal evolution of reorganization, and the relationship between structural and functional changes.
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Affiliation(s)
- Luca Pasquini
- Neuroradiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Neuroradiology Unit, NESMOS Department, Sant’Andrea Hospital, La Sapienza University, Rome, Italy
| | - Alberto Di Napoli
- Neuroradiology Unit, NESMOS Department, Sant’Andrea Hospital, La Sapienza University, Rome, Italy
- Radiology Department, Castelli Hospital, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | | | - Emiliano Visconti
- Neuroradiology Unit, Cesena Surgery and Trauma Department, M. Bufalini Hospital, AUSL Romagna, Cesena, Italy
| | - Antonio Napolitano
- Medical Physics Department, Bambino Gesù Children’s Hospital, Rome, Italy
| | - Andrea Romano
- Neuroradiology Unit, NESMOS Department, Sant’Andrea Hospital, La Sapienza University, Rome, Italy
| | - Alessandro Bozzao
- Neuroradiology Unit, NESMOS Department, Sant’Andrea Hospital, La Sapienza University, Rome, Italy
| | - Kyung K. Peck
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Andrei I. Holodny
- Neuroradiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, United States
- Department of Neuroscience, Weill-Cornell Graduate School of the Medical Sciences, New York, NY, United States
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5
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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: 2] [Impact Index Per Article: 1.0] [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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6
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Fan R, Gao Y, Zhang H, Xin X, Sang F, Tan Z, Zhang B, Li X, Huang X, Li S, Chang J. Lesion Distribution and Early Changes of Right Hemisphere in Chinese Patients With Post-stroke Aphasia. Front Aging Neurosci 2022; 13:632217. [PMID: 34987373 PMCID: PMC8722470 DOI: 10.3389/fnagi.2021.632217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 11/16/2021] [Indexed: 11/30/2022] Open
Abstract
The role of the right hemisphere (RH) in post-stroke aphasia (PSA) has not been completely understood. In general, the language alterations in PSA are normally evaluated from the perspective of the language processing models developed from Western languages such as English. However, the successful application of the models for assessing Chinese-language functions in patients with PSA has not been reported. In this study, the features of specific language-related lesion distribution and early variations of structure in RH in Chinese patients with PSA were investigated. Forty-two aphasic patients (female: 13, male: 29, mean age: 58 ± 12 years) with left hemisphere (LH) injury between 1 and 6 months after stroke were included. The morphological characteristics, both at the levels of gray matter (GM) and white matter (WM), were quantified by 3T multiparametric brain MRI. The Fridriksson et al.’s dual-stream model was used to compare language-related lesion regions. Voxel-based lesion-symptom mapping (VLSM) analysis has been performed. Our results showed that lesions in the precentral, superior frontal, middle frontal, and postcentral gyri were responsible for both the production and comprehension dysfunction of Chinese patients with PSA and were quite different from the lesions described by using the dual-stream model of Fridriksson et al. Furthermore, gray matter volume (GMV) was found significantly decreased in RH, and WM integrity was disturbed in RH after LH injury in Chinese patients with PSA. The different lesion patterns between Chinese patients with PSA and English-speaking patients with PSA may indicate that the dual-stream model of Fridriksson et al. is not suitable for the assessment of Chinese-language functions in Chinese patients with PSA in subacute phase of recovery. Moreover, decreased structural integrity in RH was found in Chinese patients with PSA.
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Affiliation(s)
- Ruiwen Fan
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Ying Gao
- Key Laboratory of Encephalopathy Treatment of Chinese Medicine, State Administration of Traditional Chinese Medicine of the People's Republic of China, Beijing, China
| | - Hua Zhang
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xiyan Xin
- TCM Department of Peking University Third Hospital, Peking University, Beijing, China
| | - Feng Sang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Zhongjian Tan
- Key Laboratory of Encephalopathy Treatment of Chinese Medicine, State Administration of Traditional Chinese Medicine of the People's Republic of China, Beijing, China
| | - Binlong Zhang
- 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
| | - 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
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7
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Meier EL. The role of disrupted functional connectivity in aphasia. HANDBOOK OF CLINICAL NEUROLOGY 2022; 185:99-119. [PMID: 35078613 DOI: 10.1016/b978-0-12-823384-9.00005-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Language is one of the most complex and specialized higher cognitive processes. Brain damage to the distributed, primarily left-lateralized language network can result in aphasia, a neurologic disorder characterized by receptive and/or expressive deficits in spoken and/or written language. Most often, aphasia is the consequence of stroke-termed poststroke aphasia (PSA)-yet, aphasia can also manifest due to neurodegenerative disease, specifically, a disorder called primary progressive aphasia (PPA). In recent years, functional connectivity neuroimaging studies have provided emerging evidence supporting theories regarding the relationships between language impairments, structural brain damage, and functional network properties in these two disorders. This chapter reviews the current evidence for the "network phenotype of stroke injury" hypothesis (Siegel et al., 2016) as it pertains to PSA and the "network degeneration hypothesis" (Seeley et al., 2009) as it pertains to PPA. Methodologic considerations for functional connectivity studies, limitations of the current functional connectivity literature in aphasia, and future directions are also discussed.
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Affiliation(s)
- Erin L Meier
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA, United States.
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8
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Agha H, McCurdy CR. In vitro and in vivo sigma 1 receptor imaging studies in different disease states. RSC Med Chem 2021; 12:154-177. [PMID: 34046607 PMCID: PMC8127618 DOI: 10.1039/d0md00186d] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 09/02/2020] [Indexed: 12/11/2022] Open
Abstract
The sigma receptor system has been classified into two distinct subtypes, sigma 1 (σ1R) and sigma 2 (σ2R). Sigma 1 receptors (σ1Rs) are involved in many neurodegenerative diseases and different central nervous system disorders such as Alzheimer's disease, Parkinson's disease, schizophrenia, and drug addiction, and pain. This makes them attractive targets for developing radioligands as tools to gain a better understanding of disease pathophysiology and clinical diagnosis. Over the years, several σ1R radioligands have been developed to image the changes in σ1R distribution and density providing insights into their role in disease development. Moreover, the involvement of both σ1Rs and σ2Rs with cancer make these ligands, especially those that are σ2R selective, great tools for imaging different types of tumors. This review will discuss the principles of molecular imaging using PET and SPECT, known σ1R radioligands and their applications for labelling σ1Rs under different disease conditions. Furthermore, this review will highlight σ1R radioligands that have demonstrated considerable potential as biomarkers, and an opportunity to fulfill the ultimate goal of better healthcare outcomes and improving human health.
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Affiliation(s)
- Hebaalla Agha
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida Gainesville FL 32610 USA +(352) 273 7705 +1 (352) 294 8691
| | - Christopher R McCurdy
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida Gainesville FL 32610 USA +(352) 273 7705 +1 (352) 294 8691
- UF Translational Drug Development Core, University of Florida Gainesville FL 32610 USA
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High definition transcranial direct current stimulation modulates abnormal neurophysiological activity in post-stroke aphasia. Sci Rep 2020; 10:19625. [PMID: 33184382 PMCID: PMC7665190 DOI: 10.1038/s41598-020-76533-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 10/23/2020] [Indexed: 12/20/2022] Open
Abstract
Recent findings indicate that measures derived from resting-state magnetoencephalography (rsMEG) are sensitive to cortical dysfunction in post-stroke aphasia. Spectral power and multiscale entropy (MSE) measures show that left-hemispheric areas surrounding the stroke lesion (perilesional) exhibit pathological oscillatory slowing and alterations in signal complexity. In the current study, we tested whether individually-targeted high-definition transcranial direct current stimulation (HD-tDCS) can reduce MEG abnormalities and transiently improve language performance. In eleven chronic aphasia survivors, we devised a method to localize perilesional areas exhibiting peak MSE abnormalities, and subsequently targeted these areas with excitatory/anodal-tDCS, or targeted the contralateral homolog areas with inhibitory/cathodal-tDCS, based on prominent theories of stroke recovery. Pathological MEG slowing in these patients was correlated with aphasia severity. Sentence/phrase repetition accuracy was assessed before and after tDCS. A delayed word reading task was administered inside MEG to assess tDCS-induced neurophysiological changes in relative power and MSE computed on the pre-stimulus and delay task time windows. Results indicated increases in repetition accuracy, decreases in contralateral theta (4–7 Hz) and coarse-scale MSE (slow activity), and increases in perilesional low-gamma (25–50 Hz) and fine-scale MSE (fast activity) after anodal-tDCS, indicating reversal of pathological abnormalities. RsMEG may be a sensitive measure for guiding therapeutic tDCS.
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10
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Tscherpel C, Grefkes C. Funktionserholung nach Schlaganfall und die therapeutische Rolle der nicht-invasiven Hirnstimulation. KLIN NEUROPHYSIOL 2020. [DOI: 10.1055/a-1272-9435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
ZusammenfassungIm Bereich der non-invasiven Hirnstimulation stellen die transkranielle Magnetstimulation (engl. transcranial magnetic stimulation, TMS) sowie die transkranielle Gleichstromstimulation (engl. transcranial direct current stimulation, tDCS) bis heute die wichtigsten Techniken zur Modulation kortikaler Erregbarkeit dar. Beide Verfahren induzieren Nacheffekte, welche die Zeit der reinen Stimulation überdauern, und ebnen damit den Weg für ihren therapeutischen Einsatz beim Schlaganfall. In diesem Übersichtsartikel diskutieren wir die aktuelle Datenlage TMS- und tDCS-vermittelter Therapien für die häufigsten schlaganfallbedingten Defizite wie Hemiparese, Aphasie und Neglect. Darüber hinaus adressieren wir mögliche Einschränkungen der gegenwärtigen Ansätze und zeigen Ansatzpunkte auf, um Neuromodulation nach Schlaganfall effektiver zu gestalten und damit das Outcome der Patienten zu verbessern.
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Affiliation(s)
- Caroline Tscherpel
- Klinik und Poliklinik für Neurologie, Universitätsklinik Köln
- Institut für Neurowissenschaften und Medizin (INM-3), Forschungszentrum Jülich
| | - Christian Grefkes
- Klinik und Poliklinik für Neurologie, Universitätsklinik Köln
- Institut für Neurowissenschaften und Medizin (INM-3), Forschungszentrum Jülich
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Abstract
BACKGROUND Language and communication are fundamental to the human experience, and, traditionally, spoken language is studied as an isolated skill. However, before propositional language (i.e., spontaneous, voluntary, novel speech) can be produced, propositional content or 'ideas' must be formulated. OBJECTIVE This review highlights the role of broader cognitive processes, particularly 'executive attention', in the formulation of propositional content (i.e., 'ideas') for propositional language production. CONCLUSIONS Several key lines of evidence converge to suggest that the formulation of ideas for propositional language production draws on executive attentional processes. Larger-scale clinical research has demonstrated a link between attentional processes and language, while detailed case studies of neurological patients have elucidated specific idea formulation mechanisms relating to the generation, selection and sequencing of ideas for expression. Furthermore, executive attentional processes have been implicated in the generation of ideas for propositional language production. Finally, neuroimaging studies suggest that a widely distributed network of brain regions, including parts of the prefrontal and parietal cortices, supports propositional language production. IMPLICATIONS Theoretically driven experimental research studies investigating mechanisms involved in the formulation of ideas are lacking. We suggest that novel experimental approaches are needed to define the contribution of executive attentional processes to idea formulation, from which comprehensive models of spoken language production can be developed. Clinically, propositional language impairments should be considered in the context of broader executive attentional deficits.
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12
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Dressing A, Kaller CP, Nitschke K, Beume LA, Kuemmerer D, Schmidt CS, Bormann T, Umarova RM, Egger K, Rijntjes M, Weiller C, Martin M. Neural correlates of acute apraxia: Evidence from lesion data and functional MRI in stroke patients. Cortex 2019; 120:1-21. [DOI: 10.1016/j.cortex.2019.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 02/28/2019] [Accepted: 05/07/2019] [Indexed: 10/26/2022]
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13
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Naeser MA, Ho MD, Martin PI, Hamblin MR, Koo BB. Increased Functional Connectivity Within Intrinsic Neural Networks in Chronic Stroke Following Treatment with Red/Near-Infrared Transcranial Photobiomodulation: Case Series with Improved Naming in Aphasia. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 38:115-131. [PMID: 31621498 DOI: 10.1089/photob.2019.4630] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective: To examine effects of four different transcranial, red/near-infrared (NIR), light-emitting diode (tLED) protocols on naming ability in persons with aphasia (PWA) due to left hemisphere (LH) stroke. This is the first study to report beneficial effects from tLED therapy in chronic stroke, and parallel changes on functional magnetic resonance imaging (fMRI). Materials and methods: Six PWA, 2-18 years poststroke, in whom 18 tLED treatments were applied (3 × /week, 6 weeks) using LED cluster heads: 500 mW, red (633 nm) and NIR (870 nm), 22.48 cm2, 22.2 mW/cm2. Results: After Protocol A with bilateral LED placements, including midline, at scalp vertex over left and right supplementary motor areas (L and R SMAs), picture naming was not improved. P1 underwent pre-/postovert, picture-naming task-fMRI scans; P2 could not. After Protocol A, P1 showed increased activation in LH and right hemisphere, including L and R SMAs. After Protocol B with LEDs only on ipsilesional, LH side, naming ability significantly improved for P1 and P2; the fMRI scans for P1 then showed activation only on the ipsilesional LH side. After Protocol C with LED placements on ipsilesional LH side, plus one midline placement over mesial prefrontal cortex (mPFC) at front hairline, a cortical node of the default mode network (DMN), P3 and P4 had only moderate/poor response, and no increase in functional connectivity on resting-state functional-connectivity MRI. After Protocol D, however, with LED placements on ipsilesional LH side, plus over two midline nodes of DMN, mPFC, and precuneus (high parietal) simultaneously, P5 and P6 each had good response with significant increase in functional connectivity within DMN, p < 0.0005; salience network, p < 0.0005; and central executive network, p < 0.05. Conclusions: NIR photons can affect surface brain cortex areas subjacent to where LEDs are applied on the scalp. Improved naming ability was present with optimal Protocol D. Transcranial photobiomodulation may be an additional noninvasive therapy for stroke.
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Affiliation(s)
- Margaret A Naeser
- VA Boston Healthcare System (12-A), Boston, Massachusetts.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
| | - Michael D Ho
- VA Boston Healthcare System (12-A), Boston, Massachusetts
| | - Paula I Martin
- VA Boston Healthcare System (12-A), Boston, Massachusetts.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
| | - Michael R Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts.,Department of Dermatology, Harvard Medical School, Boston, Massachusetts.,Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts
| | - Bang-Bon Koo
- Brain-Imaging and Informatics Lab (BIL), Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts
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14
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Meier EL, Johnson JP, Pan Y, Kiran S. A lesion and connectivity-based hierarchical model of chronic aphasia recovery dissociates patients and healthy controls. NEUROIMAGE-CLINICAL 2019; 23:101919. [PMID: 31491828 PMCID: PMC6702239 DOI: 10.1016/j.nicl.2019.101919] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 06/05/2019] [Accepted: 06/30/2019] [Indexed: 12/28/2022]
Abstract
Traditional models of left hemisphere stroke recovery propose that reactivation of remaining ipsilesional tissue is optimal for language processing whereas reliance on contralesional right hemisphere homologues is less beneficial or possibly maladaptive in the chronic recovery stage. However, neuroimaging evidence for this proposal is mixed. This study aimed to elucidate patterns of effective connectivity in patients with chronic aphasia in light of healthy control connectivity patterns and in relation to damaged tissue within left hemisphere regions of interest and according to performance on a semantic decision task. Using fMRI and dynamic causal modeling, biologically-plausible models within four model families were created to correspond to potential neural recovery patterns, including Family A: Left-lateralized connectivity (i.e., no/minimal damage), Family B: Bilateral anterior-weighted connectivity (i.e., posterior damage), Family C: Bilateral posterior-weighted connectivity (i.e., anterior damage) and Family D: Right-lateralized connectivity (i.e., extensive damage). Controls exhibited a strong preference for left-lateralized network models (Family A) whereas patients demonstrated a split preference for Families A and C. At the level of connections, controls exhibited stronger left intrahemispheric task-modulated connections than did patients. Within the patient group, damage to left superior frontal structures resulted in greater right intrahemispheric connectivity whereas damage to left ventral structures resulted in heightened modulation of left frontal regions. Lesion metrics best predicted accuracy on the fMRI task and aphasia severity whereas left intrahemispheric connectivity predicted fMRI task reaction times. These results are discussed within the context of the hierarchical recovery model of chronic aphasia. The semantic network in neurologically-intact, healthy controls was characterized by left-lateralized connectivity. Patient connectivity was split between left-lateralized and bilateral, posterior-weighted (i.e., anterior damage) models. Controls solely recruited LITG-driven connections whereas patients recruited a distributed network of connections. Within the patient group, intra- and inter-hemispheric connections were related to lesion site and/or size. Lesion size predicted aphasia severity and fMRI task accuracy, and effective connectivity predicted task reaction times.
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Affiliation(s)
- Erin L Meier
- Department of Speech, Language, & Hearing Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Room 326, Boston, MA 02215, United States of America.
| | - Jeffrey P Johnson
- Department of Speech, Language, & Hearing Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Room 326, Boston, MA 02215, United States of America
| | - Yue Pan
- Department of Speech, Language, & Hearing Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Room 326, Boston, MA 02215, United States of America
| | - Swathi Kiran
- Department of Speech, Language, & Hearing Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Room 326, Boston, MA 02215, United States of America
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15
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Phonemic fluency improved after inhibitory transcranial magnetic stimulation in a case of chronic aphasia. Int J Rehabil Res 2019; 42:92-95. [PMID: 30300167 PMCID: PMC6382039 DOI: 10.1097/mrr.0000000000000322] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Twenty-six months after a left hemispheric ischemic stroke an aphasic patient showed a significant improvement in verbal fluency following ten daily sessions of inhibitory 1 Hz repetitive transcranial magnetic stimulation over the right cortex homologous to the Broca's area.No improvement was observed for other linguistic functions or for executive ones. Results confirm the segregation of neural circuitries subtending phonemic and semantic fluency and suggest a selective usefulness of the repetitive transcranial magnetic stimulation treatment.
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Nenert R, Allendorfer JB, Martin AM, Banks C, Vannest J, Holland SK, Hart KW, Lindsell CJ, Szaflarski JP. Longitudinal fMRI study of language recovery after a left hemispheric ischemic stroke. Restor Neurol Neurosci 2018; 36:359-385. [PMID: 29782329 DOI: 10.3233/rnn-170767] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Recovery from stroke-induced aphasia is typically protracted and involves complex functional reorganization. The relative contributions of the lesioned and non-lesioned hemispheres to this process have been examined in several cross-sectional studies but longitudinal studies involving several time-points and large numbers of subjects are scarce. OBJECTIVE The aim of this study was to address the gaps in the literature by longitudinally studying the evolution of post-stroke lateralization and localization of language-related fMRI activation in the first year after single left hemispheric ischemic stroke. METHOD Seventeen patients with stroke-induced aphasia were enrolled to undergo detailed behavioral testing and fMRI at 2, 6, 12, 26, and 52 weeks post-stroke. Matched for age, handedness and sex participants were also enrolled to visualize canonical language regions. RESULTS Behavioral results showed improvements over time for all but one of the behavioral scores (Semantic Fluency Test). FMRI results showed that the left temporal area participates in compensation for language deficits in the first year after stroke, that there is a correlation between behavioral improvement and the left cerebellar activation over time, and that there is a shift towards stronger frontal left-lateralization of the fMRI activation over the first year post-stroke. Temporary compensation observed in the initial phases of post-stroke recovery that involves the non-lesioned hemisphere may not be as important as previously postulated, since in this study the recovery was driven by activations in the left fronto-temporal regions. CONCLUSION Language recovery after left hemispheric ischemic stroke is likely driven by the previously involved in language and attention left hemispheric networks.
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Affiliation(s)
- Rodolphe Nenert
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jane B Allendorfer
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Amber M Martin
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Christi Banks
- Department of Neurology, University of Cincinnati Academic Health Center, Cincinnati, OH, USA
| | - Jennifer Vannest
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Scott K Holland
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Kimberly W Hart
- Department of Emergency Medicine, University of Cincinnati Academic Health Center, Cincinnati, OH, USA
| | - Christopher J Lindsell
- Department of Emergency Medicine, University of Cincinnati Academic Health Center, Cincinnati, OH, USA.,currently at Department of Biostatistics, Vanderbilt University, Department of Biostatistics, Nashville, TN, USA
| | - Jerzy P Szaflarski
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Neurology, University of Cincinnati Academic Health Center, Cincinnati, OH, USA
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Van Lancker Sidtis D, Sidtis JJ. Cortical-subcortical production of formulaic language: A review of linguistic, brain disorder, and functional imaging studies leading to a production model. Brain Cogn 2018; 126:53-64. [PMID: 30176549 PMCID: PMC6310163 DOI: 10.1016/j.bandc.2018.08.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 08/23/2018] [Accepted: 08/26/2018] [Indexed: 11/27/2022]
Abstract
Formulaic language forms about one-fourth of everyday talk. Formulaic (fixed expressions) and novel (grammatical language) differ in important characteristics. The features of idioms, slang, expletives, proverbs, aphorisms, conversational speech formulas, and other fixed expressions include ranges of length, flexible cohesion, memory storage, nonliteral and situation meaning, and affective content. Neurolinguistic observations in persons with focal brain damage or progressive neurological disease suggest that producing formulaic expressions can be achieved by interactions between the right hemisphere and subcortical structures. The known functional characteristics of these structures form a compatible substrate for production of formulaic expressions. Functional imaging using a performance-based analysis supported a right hemisphere involvement in producing conversational speech formulas, while indicating that the pause fillers, uh and um, engage the left hemisphere and function like lexical items. Together these findings support a dual-process model of language, whereby formulaic and grammatical language are modulated by different cerebral structures.
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Affiliation(s)
- Diana Van Lancker Sidtis
- Department of Communicative Sciences and Disorders, New York University Steinhardt School, New York, NY, USA; Brain and Behavior Laboratory, The Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA.
| | - John J Sidtis
- Brain and Behavior Laboratory, The Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Department of Psychiatry, New York University Langone School of Medicine, New York, NY, USA
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Chu R, Meltzer JA, Bitan T. Interhemispheric interactions during sentence comprehension in patients with aphasia. Cortex 2018; 109:74-91. [PMID: 30312780 DOI: 10.1016/j.cortex.2018.08.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 05/03/2018] [Accepted: 08/28/2018] [Indexed: 02/06/2023]
Abstract
Right-hemisphere involvement in language processing following left-hemisphere damage may reflect either compensatory processes, or a release from homotopic transcallosal inhibition, resulting in excessive right-to-left suppression that is maladaptive for language performance. Using fMRI, we assessed inter-hemispheric effective connectivity in fifteen patients with post-stroke aphasia, along with age-matched and younger controls during a sentence comprehension task. Dynamic Causal Modeling was used with four bilateral regions including inferior frontal gyri (IFG) and primary auditory cortices (A1). Despite the presence of lesions, satisfactory model fit was obtained in 9/15 patients. In young controls, the only significant homotopic connection (RA1-LA1), was excitatory, while inhibitory connections emanated from LIFG to both left and right A1's. Interestingly, these connections were also correlated with language comprehension scores in patients. The results for homotopic connections show that excitatory connectivity from RA1-to-LA1 and inhibitory connectivity from LA1-to-RA1 are associated with general auditory verbal comprehension. Moreover, negative correlations were found between sentence comprehension and top-down coupling for both heterotopic (LIFG-to-RA1) and intra-hemispheric (LIFG-to-LA1) connections. These results do not show an emergence of a new compensatory right to left excitation in patients nor do they support the existence of left to right transcallosal suppression in controls. Nevertheless, the correlations with performance in patients are consistent with some aspects of both the compensation model, and the transcallosal suppression account for the role of the RH. Altogether our results suggest that changes to both excitatory and inhibitory homotopic and heterotopic connections due to LH damage may be maladaptive, as they disrupt the normal inter-hemispheric coordination and communication.
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Affiliation(s)
- Ronald Chu
- Baycrest Health Sciences, Rotman Research Institute, Toronto, ON, Canada; University of Toronto, Department of Psychology, Toronto, ON, Canada.
| | - Jed A Meltzer
- Baycrest Health Sciences, Rotman Research Institute, Toronto, ON, Canada; University of Toronto, Department of Psychology, Toronto, ON, Canada; University of Toronto, Department of Speech-Language Pathology, Toronto, ON, Canada; Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada
| | - Tali Bitan
- University of Toronto, Department of Speech-Language Pathology, Toronto, ON, Canada; University of Haifa, Department of Psychology and IIPDM, Haifa, Israel
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León Ruiz M, Rodríguez Sarasa M, Sanjuán Rodríguez L, Benito-León J, García-Albea Ristol E, Arce Arce S. Evidencias actuales sobre la estimulación magnética transcraneal y su utilidad potencial en la neurorrehabilitación postictus: Ampliando horizontes en el tratamiento de la enfermedad cerebrovascular. Neurologia 2018; 33:459-472. [DOI: 10.1016/j.nrl.2016.03.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 03/07/2016] [Accepted: 03/08/2016] [Indexed: 12/17/2022] Open
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20
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León Ruiz M, Rodríguez Sarasa M, Sanjuán Rodríguez L, Benito-León J, García-Albea Ristol E, Arce Arce S. Current evidence on transcranial magnetic stimulation and its potential usefulness in post-stroke neurorehabilitation: Opening new doors to the treatment of cerebrovascular disease. NEUROLOGÍA (ENGLISH EDITION) 2018. [DOI: 10.1016/j.nrleng.2016.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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21
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Silva FRD, Mac-Kay APMG, Chao JC, Santos MDD, Gagliadi RJ. Transcranial direct current stimulation: a study on naming performance in aphasic individuals. Codas 2018; 30:e20170242. [PMID: 30184007 DOI: 10.1590/2317-1782/20182017242] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 03/24/2018] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Compare the results in naming tasks of after-stroke aphasic individuals divided into active and placebo groups pre- and post-transcranial direct current stimulation. METHODS A double-blind, randomized, controlled study conducted with 14 individuals. Patients underwent five 20-min sessions with stimulation of 2mA's on consecutive days. The cathode was placed over the Broca's homologous area and the anode was placed over the supraorbital region of the left hemisphere. Boston and Snodgrass naming tasks were assessed before and after the stimulation sessions and the results were compared between the groups. RESULTS No significant results were observed for sequences 1 and 2 in the Snodgrass test. The Boston test results indicated significant difference related to mean time for correct responses with strategy. CONCLUSION The results suggest that simultaneous transcranial direct current stimulation (anodic and cathodic) is a method that can improve the rehabilitation of patients with anomic and Broca's aphasia after stroke, and that language strategies should be considered in the analysis of naming task responses.
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Affiliation(s)
| | | | - John ChiiTyng Chao
- Faculdade de Ciências Médicas da Santa Casa de São Paulo - São Paulo (SP), Brasil
| | | | - Rubens José Gagliadi
- Faculdade de Ciências Médicas da Santa Casa de São Paulo - São Paulo (SP), Brasil
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Pillay SB, Gross WL, Graves WW, Humphries C, Book DS, Binder JR. The Neural Basis of Successful Word Reading in Aphasia. J Cogn Neurosci 2018; 30:514-525. [PMID: 29211656 PMCID: PMC9926535 DOI: 10.1162/jocn_a_01214] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Understanding the neural basis of recovery from stroke is a major research goal. Many functional neuroimaging studies have identified changes in brain activity in people with aphasia, but it is unclear whether these changes truly support successful performance or merely reflect increased task difficulty. We addressed this problem by examining differences in brain activity associated with correct and incorrect responses on an overt reading task. On the basis of previous proposals that semantic retrieval can assist pronunciation of written words, we hypothesized that recruitment of semantic areas would be greater on successful trials. Participants were 21 patients with left-hemisphere stroke with phonologic retrieval deficits. They read words aloud during an event-related fMRI paradigm. BOLD signals obtained during correct and incorrect trials were contrasted to highlight brain activity specific to successful trials. Successful word reading was associated with higher BOLD signal in the left angular gyrus. In contrast, BOLD signal in bilateral posterior inferior frontal cortex, SMA, and anterior cingulate cortex was greater on incorrect trials. These data show for the first time the brain regions where neural activity is correlated specifically with successful performance in people with aphasia. The angular gyrus is a key node in the semantic network, consistent with the hypothesis that additional recruitment of the semantic system contributes to successful word production when phonologic retrieval is impaired. Higher activity in other brain regions during incorrect trials likely reflects secondary engagement of attention, working memory, and error monitoring processes when phonologic retrieval is unsuccessful.
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Changes in Resting-State Connectivity following Melody-Based Therapy in a Patient with Aphasia. Neural Plast 2018; 2018:6214095. [PMID: 29796017 PMCID: PMC5896238 DOI: 10.1155/2018/6214095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 12/19/2017] [Accepted: 01/24/2018] [Indexed: 11/17/2022] Open
Abstract
Melody-based treatments for patients with aphasia rely on the notion of preserved musical abilities in the RH, following left hemisphere damage. However, despite evidence for their effectiveness, the role of the RH is still an open question. We measured changes in resting-state functional connectivity following melody-based intervention, to identify lateralization of treatment-related changes. A patient with aphasia due to left frontal and temporal hemorrhages following traumatic brain injuries (TBI) more than three years earlier received 48 sessions of melody-based intervention. Behavioral measures improved and were maintained at the 8-week posttreatment follow-up. Resting-state fMRI data collected before and after treatment showed an increase in connectivity between motor speech control areas (bilateral supplementary motor areas and insulae) and RH language areas (inferior frontal gyrus pars triangularis and pars opercularis). This change, which was specific for the RH, was greater than changes in a baseline interval measured before treatment. No changes in RH connectivity were found in a matched control TBI patient scanned at the same intervals. These results are compatible with a compensatory role for RH language areas following melody-based intervention. They further suggest that this therapy intervenes at the level of the interface between language areas and speech motor control areas necessary for language production.
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24
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Baker CM, Burks JD, Briggs RG, Smitherman AD, Glenn CA, Conner AK, Wu DH, Sughrue ME. The crossed frontal aslant tract: A possible pathway involved in the recovery of supplementary motor area syndrome. Brain Behav 2018; 8:e00926. [PMID: 29541539 PMCID: PMC5840439 DOI: 10.1002/brb3.926] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Supplementary motor area (SMA) syndrome is a constellation of temporary symptoms that may occur following tumors of the frontal lobe. Affected patients develop akinesia and mutism but often recover within weeks to months. With our own case examples and with correlations to fiber tracking validated by gross anatomical dissection as ground truth, we describe a white matter pathway through which recovery may occur. METHODS Diffusion spectrum imaging from the Human Connectome Project was used for tractography analysis. SMA outflow tracts were mapped in both hemispheres using a predefined seeding region. Postmortem dissections of 10 cadaveric brains were performed using a modified Klingler technique to verify the tractography results. RESULTS Two cases were identified in our clinical records in which patients sustained permanent SMA syndrome after complete disconnection of the SMA and corpus callosum (CC). After investigating the postoperative anatomy of these resections, we identified a pattern of nonhomologous connections through the CC connecting the premotor area to the contralateral premotor and SMAs. The transcallosal fibers have projections from the previously described frontal aslant tract (FAT) and thus, we have termed this path the "crossed FAT." CONCLUSIONS We hypothesize that this newly described tract may facilitate recovery from SMA syndrome by maintaining interhemispheric connectivity through the supplementary motor and premotor areas.
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Affiliation(s)
- Cordell M Baker
- Department of Neurosurgery University of Oklahoma Health Sciences Center Oklahoma City OK USA
| | - Joshua D Burks
- Department of Neurosurgery University of Oklahoma Health Sciences Center Oklahoma City OK USA
| | - Robert G Briggs
- Department of Neurosurgery University of Oklahoma Health Sciences Center Oklahoma City OK USA
| | - Adam D Smitherman
- Department of Neurosurgery University of Oklahoma Health Sciences Center Oklahoma City OK USA
| | - Chad A Glenn
- Department of Neurosurgery University of Oklahoma Health Sciences Center Oklahoma City OK USA
| | - Andrew K Conner
- Department of Neurosurgery University of Oklahoma Health Sciences Center Oklahoma City OK USA
| | - Dee H Wu
- Department of Radiological Sciences University of Oklahoma Health Sciences Center Oklahoma City OK USA
| | - Michael E Sughrue
- Department of Neurosurgery University of Oklahoma Health Sciences Center Oklahoma City OK USA
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25
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Kielar A, Deschamps T, Jokel R, Meltzer JA. Abnormal language-related oscillatory responses in primary progressive aphasia. NEUROIMAGE-CLINICAL 2018; 18:560-574. [PMID: 29845004 PMCID: PMC5964832 DOI: 10.1016/j.nicl.2018.02.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 02/09/2018] [Accepted: 02/27/2018] [Indexed: 11/24/2022]
Abstract
Patients with Primary Progressive Aphasia (PPA) may react to linguistic stimuli differently than healthy controls, reflecting degeneration of language networks and engagement of compensatory mechanisms. We used magnetoencephalography (MEG) to evaluate oscillatory neural responses in sentence comprehension, in patients with PPA and age-matched controls. Participants viewed sentences containing semantically and syntactically anomalous words that evoke distinct oscillatory responses. For age-matched controls, semantic anomalies elicited left-lateralized 8–30 Hz power decreases distributed along ventral brain regions, whereas syntactic anomalies elicited bilateral power decreases in both ventral and dorsal regions. In comparison to controls, patients with PPA showed altered patterns of induced oscillations, characterized by delayed latencies and attenuated amplitude, which were correlated with linguistic impairment measured offline. The recruitment of right hemisphere temporo-parietal areas (also found in controls) was correlated with preserved semantic processing abilities, indicating that preserved neural activity in these regions was able to support successful semantic processing. In contrast, syntactic processing was more consistently impaired in PPA, regardless of neural activity patterns, suggesting that this domain of language is particularly vulnerable to the neuronal loss. In addition, we found that delayed peak latencies of oscillatory responses were associated with lower accuracy for detecting semantic anomalies, suggesting that language deficits observed in PPA may be linked to delayed or slowed information processing. Evaluated induced oscillations in patients with PPA using MEG. PPA patients showed delayed latencies and attenuated amplitude of responses. Preserved right hemisphere regions support semantic processing. Delayed latencies of oscillatory responses associated with impaired performance. Language deficits in PPA linked to delayed or slowed information processing.
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Affiliation(s)
- A Kielar
- Rotman Research Institute, Baycrest Health Sciences Toronto, Ontario, Canada; Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada.
| | - T Deschamps
- Rotman Research Institute, Baycrest Health Sciences Toronto, Ontario, Canada
| | - R Jokel
- Rotman Research Institute, Baycrest Health Sciences Toronto, Ontario, Canada; Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada
| | - J A Meltzer
- Rotman Research Institute, Baycrest Health Sciences Toronto, Ontario, Canada; Department of Psychology University of Toronto, Toronto, Ontario, Canada; Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada; Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada.
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26
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Hartwigsen G, Saur D. Neuroimaging of stroke recovery from aphasia - Insights into plasticity of the human language network. Neuroimage 2017; 190:14-31. [PMID: 29175498 DOI: 10.1016/j.neuroimage.2017.11.056] [Citation(s) in RCA: 130] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 11/02/2017] [Accepted: 11/22/2017] [Indexed: 12/15/2022] Open
Abstract
The role of left and right hemisphere brain regions in language recovery after stroke-induced aphasia remains controversial. Here, we summarize how neuroimaging studies increase the current understanding of functional interactions, reorganization and plasticity in the language network. We first discuss the temporal dynamics across the time course of language recovery, with a main focus on longitudinal studies from the acute to the chronic phase after stroke. These studies show that the functional contribution of perilesional and spared left hemisphere as well as contralesional right hemisphere regions to language recovery changes over time. The second section introduces critical variables and recent advances on early prediction of subsequent outcome. In the third section, we outline how multi-method approaches that combine neuroimaging techniques with non-invasive brain stimulation elucidate mechanisms of plasticity and reorganization in the language network. These approaches provide novel insights into general mechanisms of plasticity in the language network and might ultimately support recovery processes during speech and language therapy. Finally, the neurobiological correlates of therapy-induced plasticity are discussed. We argue that future studies should integrate individualized approaches that might vary the combination of language therapy with specific non-invasive brain stimulation protocols across the time course of recovery. The way forward will include the combination of such approaches with large data sets obtained from multicentre studies.
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Affiliation(s)
- Gesa Hartwigsen
- Research Group Modulation of Language Networks, Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
| | - Dorothee Saur
- Language & Aphasia Laboratory, Department of Neurology, University of Leipzig, Germany.
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27
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Nenert R, Allendorfer JB, Martin AM, Banks C, Ball A, Vannest J, Dietz AR, Szaflarski JP. Neuroimaging Correlates of Post-Stroke Aphasia Rehabilitation in a Pilot Randomized Trial of Constraint-Induced Aphasia Therapy. Med Sci Monit 2017; 23:3489-3507. [PMID: 28719572 PMCID: PMC5529460 DOI: 10.12659/msm.902301] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background Recovery from post-stroke aphasia is a long and complex process with an uncertain outcome. Various interventions have been proposed to augment the recovery, including constraint-induced aphasia therapy (CIAT). CIAT has been applied to patients suffering from post-stroke aphasia in several unblinded studies to show mild-to-moderate linguistic gains. The aim of the present study was to evaluate the neuroimaging correlates of CIAT in patients with chronic aphasia related to left middle cerebral artery stroke. Material/Methods Out of 24 patients recruited in a pilot randomized blinded trial of CIAT, 19 patients received fMRI of language. Eleven of them received CIAT (trained) and eight served as a control group (untrained). Each patient participated in three fMRI sessions (before training, after training, and 3 months later) that included semantic decision and verb generation fMRI tasks, and a battery of language tests. Matching healthy control participants were also included (N=38; matching based on age, handedness, and sex). Results Language testing showed significantly improved performance on Boston Naming Test (BNT; p<0.001) in both stroke groups over time and fMRI showed differences in the distribution of the areas involved in language production between groups that were not present at baseline. Further, regression analysis with BNT indicated changes in brain regions correlated with behavioral performance (temporal gyrus, postcentral gyrus, precentral gyrus, thalamus, left middle and superior frontal gyri). Conclusions Overall, our results suggest the possibility of language-related cortical plasticity following stroke-induced aphasia with no specific effect from CIAT training.
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Affiliation(s)
- Rodolphe Nenert
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jane B Allendorfer
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Amber M Martin
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Christi Banks
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Jennifer Vannest
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Jerzy P Szaflarski
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Neurology, University of Cincinnati Academic Health Center, Cincinnati, OH, USA
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Modulating phonemic fluency performance in healthy subjects with transcranial magnetic stimulation over the left or right lateral frontal cortex. Neuropsychologia 2017; 102:109-115. [DOI: 10.1016/j.neuropsychologia.2017.06.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 06/06/2017] [Accepted: 06/09/2017] [Indexed: 11/30/2022]
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29
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Alferova VV, Mayorova LA, Ivanova EG, Guekht AB, Shklovskij VM. [Functional neuroimaging of the brain structures associated with language in healthy individuals and patients with post-stroke aphasia]. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117:71-78. [PMID: 28665373 DOI: 10.17116/jnevro20171173271-78] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The introduction of non-invasive functional neuroimaging techniques such as functional magnetic resonance imaging (fMRI), in the practice of scientific and clinical research can increase our knowledge about the organization of cognitive processes, including language, in normal and reorganization of these cognitive functions in post-stroke aphasia. The article discusses the results of fMRI studies of functional organization of the cortex of a healthy adult's brain in the processing of various voice information as well as the main types of speech reorganization after post-stroke aphasia in different stroke periods. The concepts of 'effective' and 'ineffective' brain plasticity in post-stroke aphasia were considered. It was concluded that there was an urgent need for further comprehensive studies, including neuropsychological testing and several complementary methods of functional neuroimaging, to develop a phased treatment plan and neurorehabilitation of patients with post-stroke aphasia.
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Affiliation(s)
- V V Alferova
- Center for Speech Pathology and Neurorehabilitation, Moscow, Russia; Pirogov Russian National Research Medical University, Moscow, Russia
| | - L A Mayorova
- Center for Speech Pathology and Neurorehabilitation, Moscow, Russia; Institute of Higher Nervous Activity of RAS, Moscow, Russia
| | - E G Ivanova
- Center for Speech Pathology and Neurorehabilitation, Moscow, Russia; Pirogov Russian National Research Medical University, Moscow, Russia
| | - A B Guekht
- Pirogov Russian National Research Medical University, Moscow, Russia; The Solovyov Scientific and Practical Centre of neuropsychiatric, Moscow, Russia
| | - V M Shklovskij
- Center for Speech Pathology and Neurorehabilitation, Moscow, Russia; The Serbsky State Scientific Center for Psychiatry and Narcology, Moscow, Russia
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Geranmayeh F, Chau TW, Wise RJS, Leech R, Hampshire A. Domain-general subregions of the medial prefrontal cortex contribute to recovery of language after stroke. Brain 2017; 140:1947-1958. [PMID: 29177494 PMCID: PMC5903407 DOI: 10.1093/brain/awx134] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 04/11/2017] [Accepted: 04/14/2017] [Indexed: 01/09/2023] Open
Abstract
We hypothesized that the recovery of speech production after left hemisphere stroke not only depends on the integrity of language-specialized brain systems, but also on 'domain-general' brain systems that have much broader functional roles. The presupplementary motor area/dorsal anterior cingulate forms part of the cingular-opercular network, which has a broad role in cognition and learning. Consequently, we have previously suggested that variability in the recovery of speech production after aphasic stroke may relate in part to differences in patients' abilities to engage this domain-general brain region. To test our hypothesis, 27 patients (aged 59 ± 11 years) with a left hemisphere stroke performed behavioural assessments and event-related functional magnetic resonance imaging tasks at two time points; first in the early phase (∼2 weeks) and then ∼4 months after the ictus. The functional magnetic resonance imaging tasks were designed to differentiate between activation related to language production (sentential overt speech production-Speech task) and activation related to cognitive processing (non-verbal decision making). Simple rest and counting conditions were also included in the design. Task-evoked regional brain activations during the early and late phases were compared with a longitudinal measure of recovery of language production. In accordance with a role in cognitive processing, substantial activity was observed within the presupplementary motor area/dorsal anterior cingulate during the decision-making task. Critically, the level of activation within this region during speech production correlated positively with the longitudinal recovery of speech production across the two time points (as measured by the in-scanner performance in the Speech task). This relationship was observed for activation in both the early phase (r = 0.363, P = 0.03 one-tailed) and the late phase (r = 0.538, P = 0.004). Furthermore, presupplementary motor area/dorsal anterior cingulate activity was a predictor of both language recovery over time and language outcome at ∼4 months, over and above that predicted by lesion volume, age and the initial language impairment (general linear model overall significant at P < 0.0001; ExpB 1.01, P = 0.02). The particularly prominent relationship of the presupplementary motor area/dorsal anterior cingulate region with recovery of language was confirmed in voxel-wise correlation analysis, conducted unconstrained for the whole brain volume. These results accord with the hypothesis that the functionality of the presupplementary motor area/dorsal anterior cingulate contributes to language recovery after stroke. Given that this brain region is often spared in aphasic stroke, we propose that it is a sensible target for future research into rehabilitative treatments. More broadly, baseline assessment of domain-general systems could help provide a better prediction of language recovery.
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Affiliation(s)
- Fatemeh Geranmayeh
- Computational Cognitive and Clinical Neuroimaging Laboratory, Imperial College, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Tsz Wing Chau
- Computational Cognitive and Clinical Neuroimaging Laboratory, Imperial College, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Richard J. S. Wise
- Computational Cognitive and Clinical Neuroimaging Laboratory, Imperial College, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Robert Leech
- Computational Cognitive and Clinical Neuroimaging Laboratory, Imperial College, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Adam Hampshire
- Computational Cognitive and Clinical Neuroimaging Laboratory, Imperial College, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
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He Y, Xie F, Ye J, Deuther-Conrad W, Cui B, Wang L, Lu J, Steinbach J, Brust P, Huang Y, Lu J, Jia H. 1-(4-[ 18F]Fluorobenzyl)-4-[(tetrahydrofuran-2-yl)methyl]piperazine: A Novel Suitable Radioligand with Low Lipophilicity for Imaging σ 1 Receptors in the Brain. J Med Chem 2017; 60:4161-4172. [PMID: 28409931 DOI: 10.1021/acs.jmedchem.6b01723] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
We have designed and synthesized novel piperazine compounds with low lipophilicity as σ1 receptor ligands. 1-(4-Fluorobenzyl)-4-[(tetrahydrofuran-2-yl)methyl]piperazine (10) possessed a low nanomolar σ1 receptor affinity and a high selectivity toward the vesicular acetylcholine transporter (>2000-fold), σ2 receptors (52-fold), and adenosine A2A, adrenergic α2, cannabinoid CB1, dopamine D1, D2L, γ-aminobutyric acid A (GABAA), NMDA, melatonin MT1, MT2, and serotonin 5-HT1 receptors. The corresponding radiotracer [18F]10 demonstrated high brain uptake and extremely high brain-to-blood ratios in biodistribution studies in mice. Pretreatment with the selective σ1 receptor agonist SA4503 significantly reduced the level of accumulation of the radiotracer in the brain. No radiometabolite of [18F]10 was observed to enter the brain. Positron emission tomography and magnetic resonance imaging confirmed suitable kinetics and a high specific binding of [18F]10 to σ1 receptors in rat brain. Ex vivo autoradiography showed a reduced level of binding of [18F]10 in the cortex and hippocampus of the senescence-accelerated prone (SAMP8) compared to that of the senescence-accelerated resistant (SAMR1) mice, indicating the potential dysfunction of σ1 receptors in Alzheimer's disease.
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Affiliation(s)
- Yingfang He
- Key Laboratory of Radiopharmaceuticals (Beijing Normal University), Ministry of Education, College of Chemistry, Beijing Normal University , Beijing, China
| | - Fang Xie
- Key Laboratory of Radiopharmaceuticals (Beijing Normal University), Ministry of Education, College of Chemistry, Beijing Normal University , Beijing, China
| | - Jiajun Ye
- Key Laboratory of Radiopharmaceuticals (Beijing Normal University), Ministry of Education, College of Chemistry, Beijing Normal University , Beijing, China
| | - Winnie Deuther-Conrad
- Helmholtz-Zentrum Dresden-Rossendorf , Institute of Radiopharmaceutical Cancer Research, Department of Neuroradiopharmaceuticals, 04318 Leipzig, Germany
| | - Bixiao Cui
- Department of Nuclear Medicine, Xuanwu Hospital Capital Medical University , Beijing, China
| | - Liang Wang
- Key Laboratory of Radiopharmaceuticals (Beijing Normal University), Ministry of Education, College of Chemistry, Beijing Normal University , Beijing, China
| | - Jie Lu
- Key Laboratory of Radiopharmaceuticals (Beijing Normal University), Ministry of Education, College of Chemistry, Beijing Normal University , Beijing, China
| | - Jörg Steinbach
- Helmholtz-Zentrum Dresden-Rossendorf , Institute of Radiopharmaceutical Cancer Research, Department of Neuroradiopharmaceuticals, 04318 Leipzig, Germany
| | - Peter Brust
- Helmholtz-Zentrum Dresden-Rossendorf , Institute of Radiopharmaceutical Cancer Research, Department of Neuroradiopharmaceuticals, 04318 Leipzig, Germany
| | - Yiyun Huang
- Yale PET Center, Department of Radiology and Biomedical Imaging, Yale University School of Medicine , New Haven, Connecticut 06520-8048, United States
| | - Jie Lu
- Department of Nuclear Medicine, Xuanwu Hospital Capital Medical University , Beijing, China
| | - Hongmei Jia
- Key Laboratory of Radiopharmaceuticals (Beijing Normal University), Ministry of Education, College of Chemistry, Beijing Normal University , Beijing, China
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Chiral resolution of serial potent and selective σ 1 ligands and biological evaluation of (-)-[ 18F]TZ3108 in rodent and the nonhuman primate brain. Bioorg Med Chem 2017; 25:1533-1542. [PMID: 28129990 DOI: 10.1016/j.bmc.2017.01.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/11/2017] [Accepted: 01/13/2017] [Indexed: 11/24/2022]
Abstract
Twelve optically pure enantiomers were obtained using either crystallization or chiral high performance liquid chromatography (HPLC) separation methodologies to resolve six racemic sigma-1 (σ1) receptor ligands. The in vitro binding affinities of each enantiomer for σ1, σ2 receptors and vesicular acetylcholine transporter (VAChT) were determined. Out of the 12 optically pure enantiomers, five displayed very high affinities for σ1 (Ki<2nM) and high selectivity for σ1 versus σ2 and VAChT (>100-fold). The minus enantiomer, (-)-14a ((-)-TZ3108) (Ki-σ1=1.8±0.4nM, Ki-σ2=6960±810nM, Ki-VAChT=980±87nM), was chosen for radiolabeling and further in vivo evaluation in rodents and nonhuman primates (NHPs). A biodistribution study in Sprague Dawley rats showed brain uptake (%ID/gram) of (-)-[18F]TZ3108 reached 1.285±0.062 at 5min and 0.802±0.129 at 120min. NHP microPET imaging studies revealed higher brain uptake of (-)-[18F]TZ3108 and more favorable pharmacokinetics compared to its racemic counterpart. Pretreatment of the animal using two structurally different σ1 ligands significantly decreased accumulation of (-)-[18F]TZ3108 in the brain. Together, our in vivo evaluation results suggest that (-)-[18F]TZ3108 is a promising positron emission tomography (PET) tracer for quantifying σ1 receptor in the brain.
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Qiu WH, Wu HX, Yang QL, Kang Z, Chen ZC, Li K, Qiu GR, Xie CQ, Wan GF, Chen SQ. Evidence of cortical reorganization of language networks after stroke with subacute Broca's aphasia: a blood oxygenation level dependent-functional magnetic resonance imaging study. Neural Regen Res 2017; 12:109-117. [PMID: 28250756 PMCID: PMC5319215 DOI: 10.4103/1673-5374.198996] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aphasia is an acquired language disorder that is a common consequence of stroke. The pathogenesis of the disease is not fully understood, and as a result, current treatment options are not satisfactory. Here, we used blood oxygenation level-dependent functional magnetic resonance imaging to evaluate the activation of bilateral cortices in patients with Broca's aphasia 1 to 3 months after stroke. Our results showed that language expression was associated with multiple brain regions in which the right hemisphere participated in the generation of language. The activation areas in the left hemisphere of aphasia patients were significantly smaller compared with those in healthy adults. The activation frequency, volumes, and intensity in the regions related to language, such as the left inferior frontal gyrus (Broca's area), the left superior temporal gyrus, and the right inferior frontal gyrus (the mirror region of Broca's area), were lower in patients compared with healthy adults. In contrast, activation in the right superior temporal gyrus, the bilateral superior parietal lobule, and the left inferior temporal gyrus was stronger in patients compared with healthy controls. These results suggest that the right inferior frontal gyrus plays a role in the recovery of language function in the subacute stage of stroke-related aphasia by increasing the engagement of related brain areas.
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Affiliation(s)
- Wei-Hong Qiu
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Hui-Xiang Wu
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Qing-Lu Yang
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Zhuang Kang
- Department of Radiology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Zhao-Cong Chen
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Kui Li
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Guo-Rong Qiu
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Chun-Qing Xie
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Gui-Fang Wan
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Shao-Qiong Chen
- Department of Radiology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
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Balaev V, Petrushevsky A, Martynova O. Changes in Functional Connectivity of Default Mode Network with Auditory and Right Frontoparietal Networks in Poststroke Aphasia. Brain Connect 2016; 6:714-723. [DOI: 10.1089/brain.2016.0419] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Affiliation(s)
- Vladislav Balaev
- Institute of Higher Nervous Activity and Neurophysiology Russian Academy of Sciences, Moscow, Russian Federation
| | - Alexey Petrushevsky
- Center for Speech Pathology and Neurorehabilitation, Moscow, Russian Federation
| | - Olga Martynova
- Institute of Higher Nervous Activity and Neurophysiology Russian Academy of Sciences, Moscow, Russian Federation
- Centre for Cognition and Decision Making, National Research University Higher School of Economics, Moscow, Russian Federation
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35
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Ye J, Wang X, Deuther-Conrad W, Zhang J, Li J, Zhang X, Wang L, Steinbach J, Brust P, Jia H. Synthesis and evaluation of a18F-labeled 4-phenylpiperidine-4-carbonitrile radioligand for σ1receptor imaging. J Labelled Comp Radiopharm 2016; 59:332-9. [DOI: 10.1002/jlcr.3408] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 03/10/2016] [Accepted: 05/03/2016] [Indexed: 11/10/2022]
Affiliation(s)
- Jiajun Ye
- Key Laboratory of Radiopharmaceuticals (Beijing Normal University), Ministry of Education, College of Chemistry; Beijing Normal University; Beijing 100875 China
| | - Xia Wang
- Key Laboratory of Radiopharmaceuticals (Beijing Normal University), Ministry of Education, College of Chemistry; Beijing Normal University; Beijing 100875 China
| | - Winnie Deuther-Conrad
- Helmholtz-Zentrum Dresden-Rossendorf, Department of Neuroradiopharmaceuticals; Institute of Radiopharmaceutical Cancer Research; 04318 Leipzig Germany
| | - Jinming Zhang
- Nuclear Medicine Department; Chinese PLA General Hospital; Beijing 100853 China
| | - Jianzhou Li
- Key Laboratory of Radiopharmaceuticals (Beijing Normal University), Ministry of Education, College of Chemistry; Beijing Normal University; Beijing 100875 China
| | - Xiaojun Zhang
- Nuclear Medicine Department; Chinese PLA General Hospital; Beijing 100853 China
| | - Liang Wang
- Key Laboratory of Radiopharmaceuticals (Beijing Normal University), Ministry of Education, College of Chemistry; Beijing Normal University; Beijing 100875 China
| | - Jörg Steinbach
- Helmholtz-Zentrum Dresden-Rossendorf, Department of Neuroradiopharmaceuticals; Institute of Radiopharmaceutical Cancer Research; 04318 Leipzig Germany
| | - Peter Brust
- Helmholtz-Zentrum Dresden-Rossendorf, Department of Neuroradiopharmaceuticals; Institute of Radiopharmaceutical Cancer Research; 04318 Leipzig Germany
| | - Hongmei Jia
- Key Laboratory of Radiopharmaceuticals (Beijing Normal University), Ministry of Education, College of Chemistry; Beijing Normal University; Beijing 100875 China
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Sandars M, Cloutman L, Woollams AM. Taking Sides: An Integrative Review of the Impact of Laterality and Polarity on Efficacy of Therapeutic Transcranial Direct Current Stimulation for Anomia in Chronic Poststroke Aphasia. Neural Plast 2015; 2016:8428256. [PMID: 26819777 PMCID: PMC4706968 DOI: 10.1155/2016/8428256] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 08/10/2015] [Accepted: 08/24/2015] [Indexed: 11/18/2022] Open
Abstract
Anomia is a frequent and persistent symptom of poststroke aphasia, resulting from damage to areas of the brain involved in language production. Cortical neuroplasticity plays a significant role in language recovery following stroke and can be facilitated by behavioral speech and language therapy. Recent research suggests that complementing therapy with neurostimulation techniques may enhance functional gains, even amongst those with chronic aphasia. The current review focuses on the use of transcranial Direct Current Stimulation (tDCS) as an adjunct to naming therapy for individuals with chronic poststroke aphasia. Our survey of the literature indicates that combining therapy with anodal (excitatory) stimulation to the left hemisphere and/or cathodal (inhibitory) stimulation to the right hemisphere can increase both naming accuracy and speed when compared to the effects of therapy alone. However, the benefits of tDCS as a complement to therapy have not been yet systematically investigated with respect to site and polarity of stimulation. Recommendations for future research to help determine optimal protocols for combined therapy and tDCS are outlined.
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Affiliation(s)
- Margaret Sandars
- Neuroscience and Aphasia Research Unit, School of Psychological Sciences, 3rd Floor, Zochonis Building, University of Manchester, Brunswick Street, Manchester M13 9PL, UK
| | - Lauren Cloutman
- Neuroscience and Aphasia Research Unit, School of Psychological Sciences, 3rd Floor, Zochonis Building, University of Manchester, Brunswick Street, Manchester M13 9PL, UK
| | - Anna M. Woollams
- Neuroscience and Aphasia Research Unit, School of Psychological Sciences, 3rd Floor, Zochonis Building, University of Manchester, Brunswick Street, Manchester M13 9PL, UK
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37
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Geva S, Correia MM, Warburton EA. Contributions of bilateral white matter to chronic aphasia symptoms as assessed by diffusion tensor MRI. BRAIN AND LANGUAGE 2015; 150:117-28. [PMID: 26401977 PMCID: PMC4669306 DOI: 10.1016/j.bandl.2015.09.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 06/09/2015] [Accepted: 09/01/2015] [Indexed: 06/05/2023]
Abstract
Language reorganisation following stroke has been studied widely. However, while studies of brain activation and grey matter examined both hemispheres, studies of white matter changes have mostly focused on the left hemisphere. Here we examined the relationship between bilateral hemispheric white matter and aphasia symptoms. 15 chronic stroke patients with aphasia and 18 healthy adults were studied using Diffusion Weighted Imaging data. By applying histogram analysis, Tract-Based Spatial Statistics, tractography and lesion-tract overlap methods, it was found that damage to the left hemisphere in general, and to the arcuate fasciculus in particular, correlated with impairments on word repetition, object naming, sentence comprehension and homophone and rhyme judgement. However, no such relationship was found in the right hemisphere. It is suggested that while some language function in aphasia can be explained by damage to the left arcuate fasciculus, it cannot be explained by looking at the contra-lesional tract.
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Affiliation(s)
- Sharon Geva
- Department of Clinical Neurosciences, University of Cambridge, United Kingdom; Cognitive Neuroscience and Neuropsychiatry Section, UCL Institute of Child Health, United Kingdom.
| | - Marta M Correia
- MRC Cognition and Brain Sciences Unit, Cambridge, United Kingdom
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Cortese MD, Riganello F, Arcuri F, Pignataro LM, Buglione I. Rehabilitation of aphasia: application of melodic-rhythmic therapy to Italian language. Front Hum Neurosci 2015; 9:520. [PMID: 26441615 PMCID: PMC4585219 DOI: 10.3389/fnhum.2015.00520] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 09/07/2015] [Indexed: 11/13/2022] Open
Abstract
Aphasia is a complex disorder, frequent after stroke (with an incidence of 38%), with a detailed pathophysiological characterization. Effective approaches are crucial for devising an efficient rehabilitative strategy, in order to address the everyday life and professional disability. Several rehabilitative procedures are based on psycholinguistic, cognitive, psychosocial or pragmatic approaches, including amongst those with a neurobehavioral approach the Melodic Intonation Therapy (MIT). Van Eeckhout's adaptation of MIT to French language (Melodic-Rhythmic Therapy: MRT) has implemented the training strategy by adding a rhythmic structure reproducing French prosody. The purpose of this study was to adapt MRT rehabilitation procedures to Italian language and to verify its efficacy in a group of six chronic patients (five males) with severe non-fluent aphasia and without specific aphasic treatments during the previous 9 months. The patients were treated 4 days a week for 16 weeks, with sessions of 30-40 min. They were assessed 6 months after the end of the treatment (follow-up). The patients showed a significant improvement at the Aachener Aphasie Test (AAT) in different fields of spontaneous speech, with superimposable results at the follow-up. Albeit preliminary, these findings support the use of MRT in the rehabilitation after stroke. Specifically, MRT seems to benefit from its stronger structure than the available stimulation-facilitation procedures and allows a better quantification of the rehabilitation efficacy.
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Affiliation(s)
- Maria Daniela Cortese
- Intensive Care Unit, S. Anna Institute and Research in Advanced Neurorehabilitation Crotone, Italy
| | - Francesco Riganello
- Intensive Care Unit, S. Anna Institute and Research in Advanced Neurorehabilitation Crotone, Italy
| | - Francesco Arcuri
- Intensive Care Unit, S. Anna Institute and Research in Advanced Neurorehabilitation Crotone, Italy
| | - Luigina Maria Pignataro
- Intensive Care Unit, S. Anna Institute and Research in Advanced Neurorehabilitation Crotone, Italy
| | - Iolanda Buglione
- Casa di Cura Villa Margherita, San Giuseppe Moscati Institute Benevento, Italy
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Huertas Hoyas E, Pedrero Pérez EJ, Águila Maturana AM, García López-Alberca S, González Alted C. Functionality predictors in acquired brain damage. Neurologia 2015; 30:339-46. [PMID: 24560472 DOI: 10.1016/j.nrl.2014.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 01/09/2014] [Accepted: 01/16/2014] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION Most individuals who have survived an acquired brain injury present consequences affecting the sensorimotor, cognitive, affective or behavioural components. These deficits affect the proper performance of daily living activities. The aim of this study is to identify functional differences between individuals with unilateral acquired brain injury using functional independence, capacity, and performance of daily activities. METHOD Descriptive cross-sectional design with a sample of 58 people, with right-sided injury (n=14 TBI; n=15 stroke) or left-sided injury (n = 14 TBI, n = 15 stroke), right handed, and with a mean age of 47 years and time since onset of 4 ± 3.65 years. The functional assessment/functional independence measure (FIM/FAM) and the International Classification of Functioning (ICF) were used for the study. RESULTS The data showed significant differences (P<.000), and a large size effect (dr=0.78) in the cross-sectional estimates, and point to fewer restrictions for patients with a lesion on their right side. The major differences were in the variables 'speaking' and 'receiving spoken messages' (ICF variables), and 'Expression', 'Writing' and 'intelligible speech' (FIM/FAM variables). In the linear regression analysis, the results showed that only 4 FIM/FAM variables, taken together, predict 44% of the ICF variance, which measures the ability of the individual, and up to 52% of the ICF, which measures the individual's performance. Gait alone predicts a 28% of the variance. CONCLUSIONS It seems that individuals with acquired brain injury in the left hemisphere display important differences regarding functional and communication variables. The motor aspects are an important prognostic factor in functional rehabilitation.
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Affiliation(s)
- E Huertas Hoyas
- Universidad Rey Juan Carlos, Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Alcorcón, Madrid, España.
| | - E J Pedrero Pérez
- Instituto de Adicciones de Madrid, Ayuntamiento de Madrid, Madrid, España
| | - A M Águila Maturana
- Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Alcorcón, Madrid, España
| | - S García López-Alberca
- Centro de Rehabilitación integral a personas con daño cerebral adquirido, POLIBEA, Madrid, España
| | - C González Alted
- Centro de Referencia Estatal de Atención al Daño Cerebral Adquirido, CEADAC, Madrid, España
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40
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Huertas Hoyas E, Pedrero Pérez E, Águila Maturana A, García López-Alberca S, González Alted C. Functionality predictors in acquired brain damage. NEUROLOGÍA (ENGLISH EDITION) 2015. [DOI: 10.1016/j.nrleng.2015.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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41
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Anglade C, Thiel A, Ansaldo AI. The complementary role of the cerebral hemispheres in recovery from aphasia after stroke: a critical review of literature. Brain Inj 2014; 28:138-45. [PMID: 24456053 DOI: 10.3109/02699052.2013.859734] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To review the literature on the specific role of the right cerebral hemisphere during recovery from aphasia in order to address the lack of consensus among authors. To derive a theoretical model reconciling the controversial findings in the literature. METHODS Initial PubMed, MEDLINE (1946 to 5 May 2012) and PsycINFO (1806 to first week June 2012) searches on recovery mechanisms from aphasia, whether treatment-related or not, retrieved a total of 35 English language articles. Articles, cross-referenced in this initial set were also reviewed if they met the inclusion criteria, thus resulting in a total of 42 articles included in this review. MAIN OUTCOMES Recruitment of the right hemisphere during recovery from aphasia can be effective if it occurs during a critical time window post-stroke. The recruitment's effectiveness will depend on the lesion's location, extent and permanence. Preservation of core language processing areas will generate minimal right hemisphere recruitment and vice versa. Some experimental studies seem to suggest that the improvement linked to a particular hemisphere can be modulated by specific therapy methods. CONCLUSION The specific conditions in which effective right recruitment takes place may have important implications for rehabilitation treatment. These findings could lead to improved recovery in people suffering from aphasia. However, more research with non-invasive brain stimulation is needed.
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Affiliation(s)
- Carole Anglade
- Jewish General Hospital and Lady Davis Institute , Montréal, Quebec , Canada
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42
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Geranmayeh F, Brownsett SLE, Wise RJS. Task-induced brain activity in aphasic stroke patients: what is driving recovery? Brain 2014; 137:2632-48. [PMID: 24974382 PMCID: PMC4163030 DOI: 10.1093/brain/awu163] [Citation(s) in RCA: 150] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 04/03/2014] [Accepted: 04/27/2014] [Indexed: 12/24/2022] Open
Abstract
The estimated prevalence of aphasia in the UK and the USA is 250 000 and 1 000 000, respectively. The commonest aetiology is stroke. The impairment may improve with behavioural therapy, and trials using cortical stimulation or pharmacotherapy are undergoing proof-of-principle investigation, but with mixed results. Aphasia is a heterogeneous syndrome, and the simple classifications according to the Broca-Wernicke-Lichtheim model inadequately describe the diverse communication difficulties with which patients may present. Greater knowledge of how intact neural networks promote recovery after aphasic stroke, either spontaneously or in response to interventions, will result in clearer hypotheses about how to improve the treatment of aphasia. Twenty-five years ago, a pioneering study on healthy participants heralded the introduction of functional neuroimaging to the study of mechanisms of recovery from aphasia. Over the ensuing decades, such studies have been interpreted as supporting one of three hypotheses, which are not mutually exclusive. The first two predate the introduction of functional neuroimaging: that recovery is the consequence of the reconstitution of domain-specific language systems in tissue around the lesion (the 'perilesional' hypothesis), or by homotopic cortex in the contralateral hemisphere (the 'laterality-shift' hypothesis). The third is that loss of transcallosal inhibition to contralateral homotopic cortex hinders recovery (the 'disinhibition' hypothesis). These different hypotheses at times give conflicting views about rehabilitative intervention; for example, should one attempt to activate or inhibit a contralateral homotopic region with cortical stimulation techniques to promote recovery? This review proposes that although the functional imaging data are statistically valid in most cases, their interpretation has often favoured one explanation while ignoring plausible alternatives. In our view, this is particularly evident when recovery is attributed to activity in 'language networks' occupying sites not observed in healthy participants. In this review we will argue that much of the distribution of what has often been interpreted as language-specific activity, particularly in midline and contralateral cortical regions, is an upregulation of activity in intact domain-general systems for cognitive control and attention, responding in a task-dependent manner to the increased 'effort' when damaged downstream domain-specific language networks are impaired. We further propose that it is an inability fully to activate these systems that may result in sub optimal recovery in some patients. Interpretation of the data in terms of activity in domain-general networks affords insights into novel approaches to rehabilitation.
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Affiliation(s)
- Fatemeh Geranmayeh
- Computational Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, W12 0NN, UK
| | - Sonia L E Brownsett
- Computational Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, W12 0NN, UK
| | - Richard J S Wise
- Computational Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, W12 0NN, UK
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Chen YY, Wang X, Zhang JM, Deuther-Conrad W, Zhang XJ, Huang Y, Li Y, Ye JJ, Cui MC, Steinbach J, Brust P, Liu BL, Jia HM. Synthesis and evaluation of a 18F-labeled spirocyclic piperidine derivative as promising σ1 receptor imaging agent. Bioorg Med Chem 2014; 22:5270-8. [DOI: 10.1016/j.bmc.2014.08.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 07/18/2014] [Accepted: 08/05/2014] [Indexed: 12/16/2022]
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Development of (18)F-labeled radiotracers for neuroreceptor imaging with positron emission tomography. Neurosci Bull 2014; 30:777-811. [PMID: 25172118 DOI: 10.1007/s12264-014-1460-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Accepted: 06/02/2014] [Indexed: 12/14/2022] Open
Abstract
Positron emission tomography (PET) is an in vivo molecular imaging tool which is widely used in nuclear medicine for early diagnosis and treatment follow-up of many brain diseases. PET uses biomolecules as probes which are labeled with radionuclides of short half-lives, synthesized prior to the imaging studies. These probes are called radiotracers. Fluorine-18 is a radionuclide routinely used in the radiolabeling of neuroreceptor ligands for PET because of its favorable half-life of 109.8 min. The delivery of such radiotracers into the brain provides images of transport, metabolic, and neurotransmission processes on the molecular level. After a short introduction into the principles of PET, this review mainly focuses on the strategy of radiotracer development bridging from basic science to biomedical application. Successful radiotracer design as described here provides molecular probes which not only are useful for imaging of human brain diseases, but also allow molecular neuroreceptor imaging studies in various small-animal models of disease, including genetically-engineered animals. Furthermore, they provide a powerful tool for in vivo pharmacology during the process of pre-clinical drug development to identify new drug targets, to investigate pathophysiology, to discover potential drug candidates, and to evaluate the pharmacokinetics and pharmacodynamics of drugs in vivo.
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Merrett DL, Peretz I, Wilson SJ. Neurobiological, cognitive, and emotional mechanisms in melodic intonation therapy. Front Hum Neurosci 2014; 8:401. [PMID: 24917811 PMCID: PMC4040885 DOI: 10.3389/fnhum.2014.00401] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 05/19/2014] [Indexed: 11/13/2022] Open
Abstract
Singing has been used in language rehabilitation for decades, yet controversy remains over its effectiveness and mechanisms of action. Melodic Intonation Therapy (MIT) is the most well-known singing-based therapy; however, speculation surrounds when and how it might improve outcomes in aphasia and other language disorders. While positive treatment effects have been variously attributed to different MIT components, including melody, rhythm, hand-tapping, and the choral nature of the singing, there is uncertainty about the components that are truly necessary and beneficial. Moreover, the mechanisms by which the components operate are not well understood. Within the literature to date, proposed mechanisms can be broadly grouped into four categories: (1) neuroplastic reorganization of language function, (2) activation of the mirror neuron system and multimodal integration, (3) utilization of shared or specific features of music and language, and (4) motivation and mood. In this paper, we review available evidence for each mechanism and propose that these mechanisms are not mutually exclusive, but rather represent different levels of explanation, reflecting the neurobiological, cognitive, and emotional effects of MIT. Thus, instead of competing, each of these mechanisms may contribute to language rehabilitation, with a better understanding of their relative roles and interactions allowing the design of protocols that maximize the effectiveness of singing therapy for aphasia.
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Affiliation(s)
- Dawn L. Merrett
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Isabelle Peretz
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Sarah J. Wilson
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
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Jungblut M, Huber W, Mais C, Schnitker R. Paving the way for speech: voice-training-induced plasticity in chronic aphasia and apraxia of speech--three single cases. Neural Plast 2014; 2014:841982. [PMID: 24977055 PMCID: PMC4058170 DOI: 10.1155/2014/841982] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 05/03/2014] [Accepted: 05/03/2014] [Indexed: 11/18/2022] Open
Abstract
Difficulties with temporal coordination or sequencing of speech movements are frequently reported in aphasia patients with concomitant apraxia of speech (AOS). Our major objective was to investigate the effects of specific rhythmic-melodic voice training on brain activation of those patients. Three patients with severe chronic nonfluent aphasia and AOS were included in this study. Before and after therapy, patients underwent the same fMRI procedure as 30 healthy control subjects in our prestudy, which investigated the neural substrates of sung vowel changes in untrained rhythm sequences. A main finding was that post-minus pretreatment imaging data yielded significant perilesional activations in all patients for example, in the left superior temporal gyrus, whereas the reverse subtraction revealed either no significant activation or right hemisphere activation. Likewise, pre- and posttreatment assessments of patients' vocal rhythm production, language, and speech motor performance yielded significant improvements for all patients. Our results suggest that changes in brain activation due to the applied training might indicate specific processes of reorganization, for example, improved temporal sequencing of sublexical speech components. In this context, a training that focuses on rhythmic singing with differently demanding complexity levels as concerns motor and cognitive capabilities seems to support paving the way for speech.
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Affiliation(s)
- Monika Jungblut
- Interdisciplinary Institute for Music- and Speech-Therapy, Am Lipkamp 14, 47269 Duisburg, Germany
| | - Walter Huber
- Clinical Cognition Research, University Hospital Aachen University, RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Christiane Mais
- Interdisciplinary Institute for Music- and Speech-Therapy, Am Lipkamp 14, 47269 Duisburg, Germany
- Aphasia Center North Rhine Westphalia, Laarmannstraße 21, 45359 Essen, Germany
| | - Ralph Schnitker
- Interdisciplinary Centre for Clinical Research—Neurofunctional Imaging Lab, University Hospital Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
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Okada N, Sasaguri K, Otsuka T, Fujita A, Ito H, Noguchi T, Jinbu Y, Kusama M. Effect of articulatory rehabilitation after oral cancer surgery on higher brain activation. Int J Oral Maxillofac Surg 2014; 43:933-40. [PMID: 24679850 DOI: 10.1016/j.ijom.2014.02.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 02/22/2014] [Accepted: 02/25/2014] [Indexed: 11/17/2022]
Abstract
The present study aimed to verify the importance of postoperative articulatory rehabilitation in patients with oral cancer and to clarify the neurological changes underlying articulatory functional recovery. A longitudinal assessment of oral function and accompanying brain activity was performed using non-invasive functional magnetic resonance imaging (fMRI). We assessed 13 patients with cancers of the tongue and oral floor before and after ablative surgery. Articulatory function was assessed preoperatively and postoperatively using a conversation intelligibility test and the Assessment of Motor Speech for Dysarthria test. Patients also performed a verbal task during fMRI scans. The assessments were then repeated after the patients had undergone 4-6 months of articulatory rehabilitation therapy. Compared to pretreatment levels, articulatory rehabilitation resulted in a significant increase in activation in the supplementary motor cortex, thalamus, and cingulate cortex. The present study offers a quantitative assessment of the effects of speech rehabilitation by investigating changes in brain activation sites.
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Affiliation(s)
- N Okada
- Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, Tochigi, Japan.
| | - K Sasaguri
- Department of Craniofacial Growth and Development Dentistry, Kanagawa Dental College, Kanagawa, Japan
| | - T Otsuka
- Department of Craniofacial Growth and Development Dentistry, Kanagawa Dental College, Kanagawa, Japan
| | - A Fujita
- Department of Radiology, Jichi Medical University, Tochigi, Japan
| | - H Ito
- Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, Tochigi, Japan
| | - T Noguchi
- Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, Tochigi, Japan
| | - Y Jinbu
- Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, Tochigi, Japan
| | - M Kusama
- Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, Tochigi, Japan
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Schönberger E, Heim S, Meffert E, Pieperhoff P, da Costa Avelar P, Huber W, Binkofski F, Grande M. The neural correlates of agrammatism: Evidence from aphasic and healthy speakers performing an overt picture description task. Front Psychol 2014; 5:246. [PMID: 24711802 PMCID: PMC3968764 DOI: 10.3389/fpsyg.2014.00246] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Accepted: 03/05/2014] [Indexed: 11/22/2022] Open
Abstract
Functional brain imaging studies have improved our knowledge of the neural localization of language functions and the functional reorganization after a lesion. However, the neural correlates of agrammatic symptoms in aphasia remain largely unknown. The present fMRI study examined the neural correlates of morpho-syntactic encoding and agrammatic errors in continuous language production by combining three approaches. First, the neural mechanisms underlying natural morpho-syntactic processing in a picture description task were analyzed in 15 healthy speakers. Second, agrammatic-like speech behavior was induced in the same group of healthy speakers to study the underlying functional processes by limiting the utterance length. In a third approach, five agrammatic participants performed the picture description task to gain insights in the neural correlates of agrammatism and the functional reorganization of language processing after stroke. In all approaches, utterances were analyzed for syntactic completeness, complexity, and morphology. Event-related data analysis was conducted by defining every clause-like unit (CLU) as an event with its onset-time and duration. Agrammatic and correct CLUs were contrasted. Due to the small sample size as well as heterogeneous lesion sizes and sites with lesion foci in the insula lobe, inferior frontal, superior temporal and inferior parietal areas the activation patterns in the agrammatic speakers were analyzed on a single subject level. In the group of healthy speakers, posterior temporal and inferior parietal areas were associated with greater morpho-syntactic demands in complete and complex CLUs. The intentional manipulation of morpho-syntactic structures and the omission of function words were associated with additional inferior frontal activation. Overall, the results revealed that the investigation of the neural correlates of agrammatic language production can be reasonably conducted with an overt language production paradigm.
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Affiliation(s)
- Eva Schönberger
- Section Neurological Cognition Research, Department of Neurology, Uniklinik RWTH Aachen Aachen, Germany
| | - Stefan Heim
- Section Neurological Cognition Research, Department of Neurology, Uniklinik RWTH Aachen Aachen, Germany ; Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen Aachen, Germany ; Research Centre Juelich, Institute of Neuroscience and Medicine (INM-1) Juelich, Germany
| | - Elisabeth Meffert
- Section Neurological Cognition Research, Department of Neurology, Uniklinik RWTH Aachen Aachen, Germany ; Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen Aachen, Germany
| | - Peter Pieperhoff
- Research Centre Juelich, Institute of Neuroscience and Medicine (INM-1) Juelich, Germany
| | - Patricia da Costa Avelar
- Section Neurological Cognition Research, Department of Neurology, Uniklinik RWTH Aachen Aachen, Germany
| | - Walter Huber
- Section Neurological Cognition Research, Department of Neurology, Uniklinik RWTH Aachen Aachen, Germany
| | - Ferdinand Binkofski
- Section Neurological Cognition Research, Department of Neurology, Uniklinik RWTH Aachen Aachen, Germany
| | - Marion Grande
- Section Neurological Cognition Research, Department of Neurology, Uniklinik RWTH Aachen Aachen, Germany
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Shah PP, Szaflarski JP, Allendorfer J, Hamilton RH. Induction of neuroplasticity and recovery in post-stroke aphasia by non-invasive brain stimulation. Front Hum Neurosci 2013; 7:888. [PMID: 24399952 PMCID: PMC3870921 DOI: 10.3389/fnhum.2013.00888] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Accepted: 12/05/2013] [Indexed: 11/13/2022] Open
Abstract
Stroke victims tend to prioritize speaking, writing, and walking as the three most important rehabilitation goals. Of note is that two of these goals involve communication. This underscores the significance of developing successful approaches to aphasia treatment for the several hundred thousand new aphasia patients each year and over 1 million stroke survivors with chronic aphasia in the U.S. alone. After several years of growth as a research tool, non-invasive brain stimulation (NBS) is gradually entering the arena of clinical aphasiology. In this review, we first examine the current state of knowledge of post-stroke language recovery including the contributions from the dominant and non-dominant hemispheres. Next, we briefly discuss the methods and the physiologic basis of the use of inhibitory and excitatory repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) as research tools in patients who experience post-stroke aphasia. Finally, we provide a critical review of the most influential evidence behind the potential use of these two brain stimulation methods as clinical rehabilitative tools.
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Affiliation(s)
- Priyanka P Shah
- Department of Neurology, University of Pennsylvania Philadelphia, PA, USA ; Laboratory for Cognition and Neural Stimulation, Center for Cognitive Neuroscience, University of Pennsylvania Philadelphia, PA, USA
| | - Jerzy P Szaflarski
- Department of Neurology, University of Alabama at Birmingham Birmingham, AL, USA
| | - Jane Allendorfer
- Department of Neurology, University of Alabama at Birmingham Birmingham, AL, USA
| | - Roy H Hamilton
- Department of Neurology, University of Pennsylvania Philadelphia, PA, USA ; Laboratory for Cognition and Neural Stimulation, Center for Cognitive Neuroscience, University of Pennsylvania Philadelphia, PA, USA
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Brownsett SLE, Warren JE, Geranmayeh F, Woodhead Z, Leech R, Wise RJS. Cognitive control and its impact on recovery from aphasic stroke. ACTA ACUST UNITED AC 2013; 137:242-54. [PMID: 24163248 PMCID: PMC3891442 DOI: 10.1093/brain/awt289] [Citation(s) in RCA: 165] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Aphasic deficits are usually only interpreted in terms of domain-specific language processes. However, effective human communication and tests that probe this complex cognitive skill are also dependent on domain-general processes. In the clinical context, it is a pragmatic observation that impaired attention and executive functions interfere with the rehabilitation of aphasia. One system that is important in cognitive control is the salience network, which includes dorsal anterior cingulate cortex and adjacent cortex in the superior frontal gyrus (midline frontal cortex). This functional imaging study assessed domain-general activity in the midline frontal cortex, which was remote from the infarct, in relation to performance on a standard test of spoken language in 16 chronic aphasic patients both before and after a rehabilitation programme. During scanning, participants heard simple sentences, with each listening trial followed immediately by a trial in which they repeated back the previous sentence. Listening to sentences in the context of a listen–repeat task was expected to activate regions involved in both language-specific processes (speech perception and comprehension, verbal working memory and pre-articulatory rehearsal) and a number of task-specific processes (including attention to utterances and attempts to overcome pre-response conflict and decision uncertainty during impaired speech perception). To visualize the same system in healthy participants, sentences were presented to them as three-channel noise-vocoded speech, thereby impairing speech perception and assessing whether this evokes domain general cognitive systems. As expected, contrasting the more difficult task of perceiving and preparing to repeat noise-vocoded speech with the same task on clear speech demonstrated increased activity in the midline frontal cortex in the healthy participants. The same region was activated in the aphasic patients as they listened to standard (undistorted) sentences. Using a region of interest defined from the data on the healthy participants, data from the midline frontal cortex was obtained from the patients. Across the group and across different scanning sessions, activity correlated significantly with the patients’ communicative abilities. This correlation was not influenced by the sizes of the lesion or the patients’ chronological ages. This is the first study that has directly correlated activity in a domain general system, specifically the salience network, with residual language performance in post-stroke aphasia. It provides direct evidence in support of the clinical intuition that domain-general cognitive control is an essential factor contributing to the potential for recovery from aphasic stroke.
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Affiliation(s)
- Sonia L E Brownsett
- 1 Cognitive, Clinical and Computational Neuroimaging Group, Imperial College, Hammersmith Hospital, London, W12 0NN, UK
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