Aphasia Neuroplasticity Review

Dietz et al. (2018)

Reference

AuthorsDietz A, Vannest J, Maloney T, Altaye M, Holland S, Szaflarski JP
TitleThe feasibility of improving discourse in people with aphasia through AAC: clinical and functional MRI correlates
ReferenceAphasiology 2018; 32: 693-719
PMIDN/A
DOI10.1080/02687038.2018.1447641

Participants

LanguageUS English
Inclusion criteria
Number of individuals with aphasia12 (plus 2 excluded: 1 for illness; 1 for MRI contraindication or personal conflict (inconsistent information provided))
Number of control participants0
Were any of the participants included in any previous studies?Yes (same data as Dietz et al. (2016), which is a methodological paper)
Is age reported for patients and controls, and matched?Yes (AAC group: range 39-63 years; usual care group: range 47-71 years)
Is sex reported for patients and controls, and matched?Yes (males: 5; females: 7)
Is handedness reported for patients and controls, and matched?Yes (right: 11; left: 1)
Is time post stroke onset reported and appropriate to the study design?Yes (AAC group: range 16-170 months; usual care group: range 38-105 months)
To what extent is the nature of aphasia characterized?Severity and type
Language evaluationWAB, Reading Comprehension Battery for Aphasia
Aphasia severityAAC group: AQ range 37.6-82.4; usual care group: AQ range 36.7-89.2
Aphasia typeAAC group: 2 Broca's, 1 anomic, 1 conduction, 1 global, 1 Wernicke's; usual care group: 2 anomic, 2 Broca's, 1 conduction, 1 Wernicke's
First stroke only?Yes
Stroke typeIschemic only
To what extent is the lesion distribution characterized?Individual lesions
Lesion extentAAC group: range 7849-30570 voxels; usual care group: 1583-30110 voxels (voxel size not stated)
Lesion locationL MCA
Participants notes

Imaging

ModalityfMRI
Is the study cross-sectional or longitudinal?Longitudinal—chronic treatment
If longitudinal, at what time point(s) were imaging data acquired?T1: pre-treatment/chronic; T2: post-treatment, ~4 weeks later
If longitudinal, was there any intervention between the time points?AAC group: treatment aimed at teaching participants how to utilize AAC to facilitate discourse; usual care group: traditional SLT, not focused on discourse or AAC specifically
Is the scanner described?Yes (Philips Achieva 3 Tesla)
Is the timing of stimulus presentation and image acquisition clearly described and appropriate?Yes
Design typeEvent-related
Total images acquired135
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?No (no description of HRF model, which is important given sparse sampling design)
Is intersubject normalization adequately described and appropriate?No (lesion impact not addressed)
Imaging notesadditional methodological details in Dietz et al. (2016)

Conditions

Are the conditions clearly described?Yes
ConditionResponse typeRepetitionsAll groups could do?All individuals could do?
verb generation (covert)Multiple words (covert)15UnknownUnknown
verb generation (overt)Multiple words (overt)15YesUnknown
noun repetitionMultiple words (overt)15YesUnknown
Conditions notesEvidence for task performance from Dietz et al. (2016)

Contrasts

Are the contrasts clearly described?Yes

Contrast 1: verb generation (overt) vs noun repetition

Language conditionVerb generation (overt)
Control conditionNoun repetition
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?No
Is accuracy matched between the language and control tasks for all relevant groups?Unknown, not reported
Is reaction time matched between the language and control tasks for all relevant groups?Unknown, not reported
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 notesControl data in Allendorfer et al. (2012); somewhat L-lateralized frontal, temporal and parietal activations, but also extensive midline activation
Contrast notes

Analyses

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

ROI analysis 1

First level contrastVerb generation (overt) vs noun repetition
Analysis classCross-sectional between two groups with aphasia
Group(s)Aphasia with AAC treatment (n = 6) T2 vs usual care T2 (n = 6)
Covariate
Is the second level contrast valid in terms of the group(s), time point(s), and measures involved?Somewhat (marginal treatment effect)
Is accuracy matched across the second level contrast?Unknown, not reported
Is reaction time matched across the second level contrast?Unknown, not reported
Behavioral data notes
Type of analysisRegion of interest (ROI)
ROI typeLaterality indi(ces)
How many ROIs are there?1
What are the ROI(s)?Frontal LI
How are the ROI(s) defined?
Correction for multiple comparisonsOne only
Statistical detailsTemporal LI calculated but not reported
FindingsNone
Findings notes

ROI analysis 2

First level contrastVerb generation (overt) vs noun repetition
Analysis classLongitudinal correlation with language or other measure
Group(s)Aphasia (both groups) T2 vs T1
CovariateΔ WAB AQ
Is the second level contrast valid in terms of the group(s), time point(s), and measures involved?Somewhat (gain in AQ not tested for significance)
Is accuracy matched across the second level contrast?Unknown, not reported
Is reaction time matched across the second level contrast?Unknown, not reported
Behavioral data notes
Type of analysisRegion of interest (ROI)
ROI typeLaterality indi(ces)
How many ROIs are there?1
What are the ROI(s)?Frontal LI
How are the ROI(s) defined?
Correction for multiple comparisonsOne only
Statistical detailsTemporal LI calculated but not reported
Findings↑ LI (frontal)
Findings notes

Notes

Excluded analyses(1) pre-treatment comparison between treated and untreated groups; (2) several other analyses based on LI in different ROIs, because there were no inferential statistics