Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
Pt 6
pubmed:dateCreated
2006-6-1
pubmed:abstractText
Previous functional imaging studies of chronic stroke patients with aphasia suggest that recovery of language occurs in a pre-existing, bilateral network with an upregulation of undamaged areas and a recruitment of perilesional tissue and homologue right language areas. The present study aimed at identifying the dynamics of reorganization in the language system by repeated functional MRI (fMRI) examinations with parallel language testing from the acute to the chronic stage. We examined 14 patients with aphasia due to an infarction of the left middle cerebral artery territory and an age-matched control group with an auditory comprehension task in an event-related design. Control subjects were scanned once, whereas patients were scanned repeatedly at three consecutive dates. All patients recovered clinically as shown by a set of aphasia tests. In the acute phase [mean: 1.8 days post-stroke (dps)], patients' group analysis showed little early activation of non-infarcted left-hemispheric language structures, while in the subacute phase (mean: 12.1 dps) a large increase of activation in the bilateral language network with peak activation in the right Broca-homologue (BHo) was observed. A direct comparison of both examinations revealed the strongest increase of activation in the right BHo and supplementary motor area (SMA). These upregulated areas also showed the strongest correlation between improved language function and increased activation (r(BHo) = 0.88, r(SMA) = 0.92). In the chronic phase (mean: 321 dps), a normalization of activation with a re-shift of peak activation to left-hemispheric language areas was observed, associated with further language improvement. The data suggest that brain reorganization during language recovery proceeds in three phases: a strongly reduced activation of remaining left language areas in the acute phase is followed by an upregulation with recruitment of homologue language zones, which correlates with language improvement. Thereafter, a normalization of activation is observed, possibly reflecting consolidation in the language system.
pubmed:commentsCorrections
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:status
MEDLINE
pubmed:month
Jun
pubmed:issn
1460-2156
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
129
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1371-84
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:16638796-Acute Disease, pubmed-meshheading:16638796-Adolescent, pubmed-meshheading:16638796-Adult, pubmed-meshheading:16638796-Aged, pubmed-meshheading:16638796-Aphasia, pubmed-meshheading:16638796-Brain, pubmed-meshheading:16638796-Brain Mapping, pubmed-meshheading:16638796-Case-Control Studies, pubmed-meshheading:16638796-Chronic Disease, pubmed-meshheading:16638796-Female, pubmed-meshheading:16638796-Follow-Up Studies, pubmed-meshheading:16638796-Functional Laterality, pubmed-meshheading:16638796-Humans, pubmed-meshheading:16638796-Image Processing, Computer-Assisted, pubmed-meshheading:16638796-Infarction, Middle Cerebral Artery, pubmed-meshheading:16638796-Language, pubmed-meshheading:16638796-Language Tests, pubmed-meshheading:16638796-Magnetic Resonance Imaging, pubmed-meshheading:16638796-Male, pubmed-meshheading:16638796-Middle Aged, pubmed-meshheading:16638796-Neuronal Plasticity, pubmed-meshheading:16638796-Recovery of Function
pubmed:year
2006
pubmed:articleTitle
Dynamics of language reorganization after stroke.
pubmed:affiliation
Department of Neurology, University Freiburg, Breisacher Strasse 64, 79106 Freiburg, Germany. dorothee.saur@uniklinik-freiburg.de
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't