Abstract
Changes in brain connectivity during language therapy were examined among participants with aphasia (PWA), aiming to shed light on neural reorganization in the language network. Four PWA with anomia following left hemisphere stroke and eight healthy controls (HC) participated in the study. Two fMRI scans were administered to all participants with a 3.5-month interval. The fMRI scans included phonological and semantic tasks, each consisting of linguistic and perceptual matching conditions. Between the two fMRI scans, PWA underwent Phonological Components Analysis treatment. Changes in effective connectivity during the treatment were examined within right hemisphere (RH) architecture. The results illustrate that following the treatment, the averaged connectivity of PWA across all perceptual and linguistic conditions in both tasks increased resemblance to HC, reflecting the normalization of neural processes associated with silent object name retrieval. In contrast, connections that were specifically enhanced by the phonological condition in PWA decreased in their resemblance to HC, reflecting emerging compensatory reorganization in RH connectivity to support phonological processing. These findings suggest that both normalization and compensation play a role in neural language reorganization at the chronic stage, occurring simultaneously in the same brain.
Highlights
This study examines the effects of language therapy on brain functional connectivity among left hemisphere stroke patients with aphasia (PWA)
We explored changes in effective connectivity in right hemisphere (RH) language homologue regions among PWA, following phonological treatment, compared to a group of healthy controls (HC)
In the phonological linguistic condition, treatment-related changes decreased in resemblance to HC, indicating compensatory reorganization in RH connectivity
Summary
This study examines the effects of language therapy on brain functional connectivity among left hemisphere stroke patients with aphasia (PWA). While language recovery in the subacute phase after stroke is often related to the restoration of temporary dysfunctional perilesional regions, longer-term recovery is thought to reflect neuroplasticity through functional reorganization [4] Studies in this field are engaged in an ongoing discussion about the nature of the neural changes underlying recovery from left hemisphere damage [5,6,7,8]. Some studies emphasize the role of normalization of brain activation in language recovery, typically reflected in reactivation of perilesional regions in the left hemisphere [5,9,10,11,12,13] Holding this view, some studies suggest the left hemisphere damage leads to collateral and transcallosal disinhibition, resulting in inefficient increased activation of the right hemisphere during language processing [14]. Recent work by Kiran et al [26] suggests that spared tissue within the left hemisphere is critically engaged in language recovery, right hemisphere regions are involved in this process
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