Aphasia Neuroplasticity Review

Leff et al. (2002)

Reference

AuthorsLeff A, Crinion J, Scott S, Turkheimer F, Howard D, Wise R
TitleA physiological change in the homotopic cortex following left posterior temporal lobe infarction
ReferenceAnn Neurol 2002; 51: 553-558
PMID12112100
DOI10.1002/ana.10181

Participants

LanguageUK English
Inclusion criteria
Number of individuals with aphasia15
Number of control participants8
Were any of the participants included in any previous studies?No
Is age reported for patients and controls, and matched?Yes (range 43-76 years)
Is sex reported for patients and controls, and matched?Yes (males: 11; females: 4)
Is handedness reported for patients and controls, and matched?Yes (right: 11; left: 0)
Is time post stroke onset reported and appropriate to the study design?Yes (range 5-76 months)
To what extent is the nature of aphasia characterized?Not at all
Language evaluationPPT (Dutch), British picture vocabulary scale, Action for Dysphasic Adults lexical decision battery, auditory maximal pairs (an offline phoneme discrimination test)
Aphasia severityNot stated
Aphasia typeNot stated, but all 6 patients with pSTS damage had single word comprehension deficits acutely
First stroke only?Yes
Stroke typeNot stated
To what extent is the lesion distribution characterized?Extent and location
Lesion extentRange 0.5-14% of total brain volume
Lesion location9 L but sparing pSTS, 6 L including pSTS
Participants notes

Imaging

ModalityPET (rCBF)
Is the study cross-sectional or longitudinal?Cross-sectional
If longitudinal, at what time point(s) were imaging data acquired?
If longitudinal, was there any intervention between the time points?
Is the scanner described?Yes (CTI-Siemens ECAT EXACT HR++/966)
Is the timing of stimulus presentation and image acquisition clearly described and appropriate?Yes
Design typePET
Total images acquired16
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?Yes
Is intersubject normalization adequately described and appropriate?Yes
Imaging notes

Conditions

Are the conditions clearly described?Yes
ConditionResponse typeRepetitionsAll groups could do?All individuals could do?
listening to words at 10 wpmNone2N/AN/A
listening to words at 35 wpmNone2N/AN/A
listening to words at 55 wpmNone2N/AN/A
listening to words at 70 wpmNone2N/AN/A
listening to words at 85 wpmNone2N/AN/A
listening to words at 95 wpmNone2N/AN/A
listening to words at 115 wpmNone2N/AN/A
listening to words at 130 wpmNone2N/AN/A
Conditions notes

Contrasts

Are the contrasts clearly described?Yes

Contrast 1: higher word rates vs lower word rates

Language conditionHigher word rates
Control conditionLower word rates
Are the conditions matched for visual demands?Yes
Are the conditions matched for auditory demands?No
Are the conditions matched for motor demands?Yes
Are the conditions matched for cognitive/executive demands?Yes
Is accuracy matched between the language and control tasks for all relevant groups?N/A, no behavioral measure
Is reaction time matched between the language and control tasks for all relevant groups?N/A, no timeable task
Behavioral data notes
Are control data reported in this paper or another that is referenced?Somewhat
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 activation is bilateral in primary auditory cortex and the lateral STG (Fig. 1, labels 1 and 2), but there is a left-lateralized activation in the pSTS (label 3); the scatter plots in Fig. 1 show activity-word rate curves for peak pSTS voxels in individual subjects; slopes were steeper in the left hemisphere (p < 0.05), however, the identification of these voxels is not described in sufficient detail (i.e. what was the search region?)
Contrast notes

Analyses

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

Voxelwise analysis 1

First level contrastHigher word rates vs lower word rates
Analysis classCross-sectional aphasia vs control
Group(s)Aphasia with pSTS damage (n = 6) vs control
Covariate
Is the second level contrast valid in terms of the group(s), time point(s), and measures involved?Yes
Is accuracy matched across the second level contrast?N/A, no behavioral measure
Is reaction time matched across the second level contrast?N/A, no timeable task
Behavioral data notes
Type of analysisVoxelwise
Search volumeWhole brain
Correction for multiple comparisonsNo direct comparison
SoftwareSPM99
Voxelwise p
Cluster extent
Statistical detailsQualitative comparison on p. 555; a FWE-corrected SPM is reported of the relationship in the 6 patients with L pSTS damage (Fig. 2), however it is masked in a way that is not explained (see figure caption), and there is no direct comparison between patients with L pSTS damage and controls
Findings↑ R posterior STS
Findings notes

Voxelwise analysis 2

First level contrastHigher word rates vs lower word rates
Analysis classCross-sectional between two groups with aphasia
Group(s)Aphasia with pSTS (n = 6) damage vs without pSTS damage (n = 9)
Covariate
Is the second level contrast valid in terms of the group(s), time point(s), and measures involved?Yes
Is accuracy matched across the second level contrast?N/A, no behavioral measure
Is reaction time matched across the second level contrast?N/A, no timeable task
Behavioral data notes
Type of analysisVoxelwise
Search volumeWhole brain
Correction for multiple comparisonsNo direct comparison
SoftwareSPM99
Voxelwise p
Cluster extent
Statistical detailsQualitative comparison on p. 555; a FWE-corrected SPM is reported of the relationship in the 6 patients with L pSTS damage (Fig. 2), however it is masked in a way that is not explained (see figure caption), and there is no direct comparison between patients with L pSTS damage and patients with R pSTS damage
Findings↑ R posterior STS
Findings notes

ROI analysis 1

First level contrastHigher word rates vs lower word rates
Analysis classCross-sectional aphasia vs control
Group(s)Aphasia with pSTS damage (n = 6) vs control (n = 8)
Covariate
Is the second level contrast valid in terms of the group(s), time point(s), and measures involved?Yes
Is accuracy matched across the second level contrast?N/A, no behavioral measure
Is reaction time matched across the second level contrast?N/A, no timeable task
Behavioral data notes
Type of analysisRegion of interest (ROI)
ROI typeFunctional
How many ROIs are there?1
What are the ROI(s)?R pSTS
How are the ROI(s) defined?The peak voxel for the contrast in the R pSTS from each subject's individual analysis, but the search region is not stated
Correction for multiple comparisonsOne only
Statistical detailsThe controls and patients without pSTS damage were combined, however it is stated in the caption to Figure 2 that the patients with pSTS damage were significantly different to both
Findings↑ R posterior STS
Findings notes

ROI analysis 2

First level contrastHigher word rates vs lower word rates
Analysis classCross-sectional between two groups with aphasia
Group(s)Aphasia with pSTS damage (n = 6) vs aphasia without pSTS damage (n = 9)
Covariate
Is the second level contrast valid in terms of the group(s), time point(s), and measures involved?Yes
Is accuracy matched across the second level contrast?N/A, no behavioral measure
Is reaction time matched across the second level contrast?N/A, no timeable task
Behavioral data notes
Type of analysisRegion of interest (ROI)
ROI typeFunctional
How many ROIs are there?1
What are the ROI(s)?R pSTS
How are the ROI(s) defined?The peak voxel for the contrast in the R pSTS from each subject's individual analysis, but the search region is not stated
Correction for multiple comparisonsOne only
Statistical detailsThe controls and patients without pSTS damage were combined, however it is stated in the caption to Figure 2 that the patients with pSTS damage were significantly different to both
Findings↑ R posterior STS
Findings notes

Notes

Excluded analyses