Recovered vs. not-recovered from post-stroke aphasia: the contributions from the dominant and non-dominant hemispheres.


PURPOSE Several adult studies have documented the importance of the peri-stroke areas to aphasia recovery. But, studies examining the differences in patterns of cortical participation in language comprehension in patients who have (LMCA-R) or have not recovered (LMCA-NR) from left middle cerebral artery infarction have not been performed up to date. METHODS In this study, we compare cortical correlates of language comprehension using fMRI and semantic decision/tone decision task in 9 LMCA-R and 18 LMCA-NR patients matched at the time of stroke for age and handedness. We examine the cortical correlates of language performance by correlating intra- and extra-scanner measures of linguistic performance with fMRI activation and stroke volumes. RESULTS Our analyses show that LMCA-R at least 1 year after stroke show a return to typical fMRI language activation patterns and that there is a compensatory reorganization of language function in LMCA-NR patients with shifts to the right hemispheric brain regions. Further, with increasing strength of the left-hemispheric fMRI signal shift there are associated improvements in performance as tested with standardized linguistic measures. A negative correlation between the size of the stroke and performance on some of the linguistic tests is also observed. CONCLUSIONS This right-hemispheric shift as a mechanism of post-stroke recovery in adults appears to be an ineffective mode of language function recovery with increasing right-hemispheric shift associated with lower language performance. Thus, normalization of the post-stroke language activation patterns is needed for better language performance while shifts of the activation patterns to the non-dominant (right) hemisphere and/or large stroke size are associated with decreased linguistic abilities after stroke.

DOI: 10.3233/RNN-120267

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@article{Szaflarski2013RecoveredVN, title={Recovered vs. not-recovered from post-stroke aphasia: the contributions from the dominant and non-dominant hemispheres.}, author={Jerzy P. Szaflarski and Jane B. Allendorfer and Christi Banks and Jennifer Vannest and Scott Holland}, journal={Restorative neurology and neuroscience}, year={2013}, volume={31 4}, pages={347-60} }