Neural plasticity and treatment-induced recovery of sentence processing in agrammatism

This study examined patterns of neural activation associated with treatment-induced improvement of complex sentence production (and comprehension) in six individuals with stroke-induced agrammatic aphasia, taking into account possible alterations in blood flow often associated with stroke, including delayed time-to-peak of the hemodynamic response function (HRF) and hypoperfused tissue. Aphasic participants performed an auditory verification fMRI task, processing object cleft, subject cleft, and simple active sentences, prior to and following a course of Treatment of Underlying Forms (TUR; Thompson et al., 2003), a linguistically based approach for treating aphasic sentence deficits, which targeted objective relative clause constructions. The patients also were scanned in a long-trials task to examine HRFs, to account for any local deviations resulting from stroke, and perfusion images were obtained to evaluate regions of hypoperfused tissue. Region-of-interest (ROI) analyses were conducted (bilaterally), modeling participant-specific local HRFs in left hemisphere areas activated by 12 healthy age-matched volunteers performing the same task, including the middle and inferior frontal gyri, precentral gyrus, middle and superior temporal gyri, and insula, and additional regions associated with complex syntactic processing, including the posterior perisylvian and superior parietal cortices. Results showed that, despite individual variation in activation differences from pre- to post-treatment scans in the aphasic participants, main-effects analyses revealed a general shift from left superior temporal activation to more posterior temporoparietal areas, bilaterally. Time-to-peak of these responses correlated negatively with blood flow, as measured with perfusion imaging

Neural plasticity and treatment-induced recovery of sentence processing and production in agrammatism

Six agrammatic speakers were trained on production and processing of object-relative sentence structures, resulting in generalization to less complex sentence structures. The acquired structure-building process reflected by this generalization was shown to be supported by changes in neuronal activation patterns underlying syntactic task execution, as measured with pre and post training functional MRIs. The most prominent neuronal activity upregulation was seen in posterior temporoparietal cortical areas, outside of the core network activated in a group of healthy control subjects during complex syntactic processing