Aphasia Neuroplasticity Review

Blasi et al. (2002)

Reference

AuthorsBlasi V, Young AC, Tansy AP, Petersen SE, Snyder AZ, Corbetta M
TitleWord retrieval learning modulates right frontal cortex in patients with left frontal damage
ReferenceNeuron 2002; 36: 159-170
PMID12367514
DOI10.1016/s0896-6273(02)00936-4

Participants

LanguageUS English
Inclusion criteriaL IFG, possibly extending to neighboring regions
Number of individuals with aphasia8
Number of control participants14
Were any of the participants included in any previous studies?No
Is age reported for patients and controls, and matched?No (mean 48.6 years; patients and controls not closely matched for age, unclear if difference significant)
Is sex reported for patients and controls, and matched?Yes (males: 2; females: 6)
Is handedness reported for patients and controls, and matched?Yes (right: 8; left: 0)
Is time post stroke onset reported and appropriate to the study design?No (> 6 months; actual TPO not stated)
To what extent is the nature of aphasia characterized?Comprehensive battery
Language evaluationWAB or BDAE
Aphasia severityAQ range 66.5-89.0 in 6 participants, BDAE aphasia severity of 4 in 1 participant, no formal evaluation in 1 participant
Aphasia type3 anomic, 3 transcortical motor, 1 Broca's, 1 not stated; most were Broca's or global acutely
First stroke only?Yes
Stroke typeIschemic only
To what extent is the lesion distribution characterized?Individual lesions
Lesion extentNot stated
Lesion locationL IFG and operculum, extending to adjacent cortex and white matter in several cases
Participants notes

Imaging

ModalityfMRI
Is the study cross-sectional or longitudinal?Cross-sectional
If longitudinal, at what time point(s) were imaging data acquired?
If longitudinal, was there any intervention between the time points?
Is the scanner described?Yes (Siemens Vision 1.5 Tesla)
Is the timing of stimulus presentation and image acquisition clearly described and appropriate?Yes
Design typeEvent-related
Total images acquired1024
Are the imaging acquisition parameters, including coverage, adequately described and appropriate?Yes (whole brain)
Is preprocessing and intrasubject coregistration adequately described and appropriate?Yes
Is first level model fitting adequately described and appropriate?Yes
Is intersubject normalization adequately described and appropriate?No (not described)
Imaging notes

Conditions

Are the conditions clearly described?Yes
ConditionResponse typeRepetitionsAll groups could do?All individuals could do?
word stem completion (novel items)Word (covert)196YesUnknown
word stem completion (repeated items)Word (covert)196YesUnknown
restNoneimplicit baselineN/AN/A
Conditions notesNovel items were presented in runs 1, 6, 7, and 8; repeated items were presented in runs 2, 3, 4, and 5; of the four repeated runs, only run 5 was analyzed.

Contrasts

Are the contrasts clearly described?Yes

Contrast 1: word stem completion (novel items) vs rest

Language conditionWord stem completion (novel items)
Control conditionRest
Are the conditions matched for visual demands?No
Are the conditions matched for auditory demands?Yes
Are the conditions matched for motor demands?Yes
Are the conditions matched for cognitive/executive demands?No
Is accuracy matched between the language and control tasks for all relevant groups?N/A, tasks not comparable
Is reaction time matched between the language and control tasks for all relevant groups?N/A, tasks not comparable
Behavioral data notes
Are control data reported in this paper or another that is referenced?Yes
Does the contrast selectively activate plausible relevant language regions in the control group?Somewhat
Are activations lateralized in the control data?Somewhat
Control activation notesActivation of language areas but also other areas; frontal activation is somewhat lateralized
Contrast notes

Contrast 2: word stem completion (novel items) vs word stem completion (repeated items)

Language conditionWord stem completion (novel items)
Control conditionWord stem completion (repeated items)
Are the conditions matched for visual demands?Yes
Are the conditions matched for auditory demands?Yes
Are the conditions matched for motor demands?Yes
Are the conditions matched for cognitive/executive demands?Yes
Is accuracy matched between the language and control tasks for all relevant groups?Yes, matched
Is reaction time matched between the language and control tasks for all relevant groups?No, different
Behavioral data notes
Are control data reported in this paper or another that is referenced?Somewhat
Does the contrast selectively activate plausible relevant language regions in the control group?Unknown
Are activations lateralized in the control data?Somewhat
Control activation notesNo whole brain analysis of this contrast, but somewhat lateralized in the sense that L but not R frontal areas showed a learning effect
Contrast notes

Analyses

Are the analyses clearly described?No** (major limitation) (see specific limitation(s) below)

Voxelwise analysis 1

First level contrastWord stem completion (novel items) vs rest
Analysis classCross-sectional aphasia vs control
Group(s)Aphasia vs control
Covariate
Is the second level contrast valid in terms of the group(s), time point(s), and measures involved?Yes
Is accuracy matched across the second level contrast?No, different
Is reaction time matched across the second level contrast?No, different
Behavioral data notesCovert task but overt data acquired separately; patients less accurate and slower than controls
Type of analysisVoxelwise
Search volumeWhole brain
Correction for multiple comparisonsUnclear or not stated
Softwarenot stated
Voxelwise p~.001 (z > 3)
Cluster extent45 voxels (size not stated)
Statistical detailsMonte Carlo analysis not described in detail; rather than fitting a HRF, the authors looked at the shape of the signal in the 8 volumes following each stimulus
Findings↑ R IFG pars opercularis
↑ R IFG pars triangularis
↑ R insula
↑ R ventral precentral/inferior frontal junction
↑ R dorsal precentral
↓ L IFG pars opercularis
↓ L ventral precentral/inferior frontal junction
Findings notesLabels based on coordinates reported

ROI analysis 1

First level contrastWord stem completion (novel items) vs word stem completion (repeated items)
Analysis classCross-sectional aphasia vs control
Group(s)Aphasia vs control
Covariate
Is the second level contrast valid in terms of the group(s), time point(s), and measures involved?Yes
Is accuracy matched across the second level contrast?Yes, matched
Is reaction time matched across the second level contrast?Yes, matched
Behavioral data notesCovert task but overt data acquired separately; no interaction of group by practice for accuracy or RT
Type of analysisRegions of interest (ROI)
ROI typeFunctional
How many ROIs are there?14
What are the ROI(s)?(1) L dorsal IFG; (2) L ventral IFG; (3) R MFG; (4) L anterior fusiform; (5) R anterior fusiform; (6) R posterior fusiform; (7) R lateral occipital; (8) R lateral cerebellum; (9) L SMA; (10) R dorsal IFG; (11) R posterior fusiform; (12) R lateral occipital; (13) R lingual; (14) L MTG
How are the ROI(s) defined?Regions that were active for the main effect of word stem completion (irrespective of practice) in either group and modulated by practice in that group
Correction for multiple comparisonsNo correction
Statistical detailsCircular because ROIs defined in one group or the other; the L ROIs showed repetition suppression in controls but not in patients, and this difference is interpreted by the authors, but not supported statistically
Findings↑ R ventral precentral/inferior frontal junction
↑ R posterior inferior temporal gyrus/fusiform gyrus
↓ L IFG
↓ L ventral precentral/inferior frontal junction
↓ L posterior inferior temporal gyrus/fusiform gyrus
Findings notesLabels based on coordinates reported

Notes

Excluded analyses(1) the ROI results were replicated in a whole brain SPM analysis, but that analysis is not reported; (2) the authors observe that patients with smaller L frontal lesions, and perilesional activation, performed better on word stem completion overall, but did not differ in rate of learning