Orthographic Visualisation Induced Brain Activations in a Chronic Poststroke Global Aphasia with Dissociation between Oral and Written Expression

Jean-Marie Annoni,Michael Mouthon,Agnes Toscanelli,Jurgita Usinskiene,Chrisovalandou Martins Gaytanidis

doi:10.1155/2019/8425914

Jean-Marie Annoni, Michael Mouthon + Show 3 more

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https://doi.org/10.1155/2019/8425914

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Abstract

We propose a method of orthographic visualisation strategy in a poststroke severe aphasia person with dissociation between oral and written expression. fMRI results suggest that such strategy may induce the engagement of alternative nonlanguage networks and visual representations may help improving oral output. This choice of rehabilitation method can be based on the remaining capacities and, therefore, on written language. Most notably, no study so far addressed how orthographic visualisation strategy during speech rehabilitation might influence clinical outcomes in nonfluent aphasia and apraxia patients.

Highlights

While many studies have examined poststroke functional reorganization of language brain networks in aphasic patients with left hemispheric damage [1, 2], the behavioural and functional effects of teaching patients to implement new compensatory cognitive strategies in their language impairments remain underexplored [3]
The present study focuses on an 18-month rehabilitation program of patients’ ability to correctly name objects in a rare case of chronic severe nonfluent aphasia with severe apraxia of speech (AOS) following a large left hemisphere stroke
To investigate the functional consequences of this therapeutic approach, we recorded at the end of therapy fMRI the poststroke participant performing a task of naming objects from their pictures with success measured by correct application of the taught orthographic visualisation technique

Summary

Introduction

While many studies have examined poststroke functional reorganization of language brain networks in aphasic patients with left hemispheric damage [1, 2], the behavioural and functional effects of teaching patients to implement new compensatory cognitive strategies in their language impairments remain underexplored [3]. Speech and language therapeutic strategies shown to improve recovery of identifying an object or entity [5] may include teaching the patient to utilize visual recognition (access to structural description), use semantic representation, learn pronunciation (phonologic representation), and employ motor planning (articulation) [6]. It is typically as reported in chronic left hemispheric aphasic patients who correctly identify a subject involving left IFG, left TG, SMA, and right IFG [7, 8]. Identifying objects has been demonstrated to be mediated by a brain network independent of the classical network [9]

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