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  • Title: Different patterns of language activation in post-stroke aphasia are detected by overt and covert versions of the verb generation fMRI task.
    Author: Allendorfer JB, Kissela BM, Holland SK, Szaflarski JP.
    Journal: Med Sci Monit; 2012 Mar; 18(3):CR135-7. PubMed ID: 22367124.
    Abstract:
    BACKGROUND: Post-stroke language functions depend on the relative contributions of the dominant and non-dominant hemispheres. Thus, we aimed to identify the neural correlates of overt and covert verb generation in adult post-stroke aphasia. MATERIAL AND METHODS: Sixteen aphasic LMCA stroke patients (SPs) and 32 healthy controls (HCs) underwent language testing followed by fMRI while performing an overt event-related verb generation task (ER-VGT) isolating activations related to noun-verb semantic processing or to articulation and auditory processing, and a covert block design verb generation task (BD-VGT). RESULTS: BD-VGT activation patterns were consistent with previous studies, while ER-VGT showed different patterns in SPs relative to HCs including less left-hemispheric involvement during semantic processing and predominantly right-sided activation related to articulation and auditory processing. ER-VGT intra-scanner performance was positively associated with activation during semantic associations in the left middle temporal gyrus for HCs (p=0.031) and left middle frontal gyrus for SPs (p=0.042). Increased activation in superior frontal/cingulate gyri was associated with better intra-scanner performance (p=0.020). Lesion size negatively impacted verbal fluency tested with Controlled Oral Word Association Test (p=0.0092) and the Semantic Fluency Test (p=0.033) and trended towards a negative association with verb generation performance on the event-related verb generation task (p=0.081). CONCLUSION: Greater retention of pre-stroke language skills is associated with greater involvement of the left hemisphere with different cortical recruitment patterns observed in SPs versus HCs. Post-stroke verbal fluency may depend more upon the structural and functional integrity of the dominant left hemisphere language network rather than the shift to contralateral homologues.
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