Aphasia Neuroplasticity Review

Kessler et al. (2000)

Reference

AuthorsKessler J, Thiel A, Karbe H, Heiss WD
TitlePiracetam improves activated blood flow and facilitates rehabilitation of poststroke aphasic patients
ReferenceStroke 2000; 31: 2112-2116
PMID10978039
DOI10.1161/01.str.31.9.2112

Participants

LanguageGerman
Inclusion criteriaMild to moderate aphasia on TT; at least 50 out of 150 on AAT repetition
Number of individuals with aphasia24
Number of control participants0
Were any of the participants included in any previous studies?No
Is age reported for patients and controls, and matched?Yes (piracetam group: mean 57.4 ± 13.5 years; placebo group: mean 56.3 ± 10.0 years)
Is sex reported for patients and controls, and matched?Yes (males: 13; females: 11)
Is handedness reported for patients and controls, and matched?Yes (right: 24; left: 0)
Is time post stroke onset reported and appropriate to the study design?Yes (T1: ~2 weeks; T2: ~8 weeks)
To what extent is the nature of aphasia characterized?Severity only
Language evaluationAAT
Aphasia severityT1: piracetam group: TT 17.16 ± 14.31 errors; placebo group: TT 17.91 ± 15.47 errors; T2: piracetam group: TT 9.66 ± 12.62 errors; placebo group: TT 12.50 ± 16.88 errors
Aphasia typeNot stated
First stroke only?Yes
Stroke typeIschemic only
To what extent is the lesion distribution characterized?Location only
Lesion extentNot stated
Lesion location10 L frontal, 6 L subcortical, 8 L temporal
Participants notes

Imaging

ModalityPET (rCBF)
Is the study cross-sectional or longitudinal?Longitudinal—mixed
If longitudinal, at what time point(s) were imaging data acquired?T1: pre-treatment, ~2 weeks post onset; T2: post-treatment, ~8 weeks post onset
If longitudinal, was there any intervention between the time points?SLT, 1 hour/day, 5 days/week, 6 weeks; 12 patients received piracetam and 12 received placebo; note that the two groups are not directly compared in any imaging or behavioral analyses
Is the scanner described?Yes (CTI-Siemens ECAT EXACT HR)
Is the timing of stimulus presentation and image acquisition clearly described and appropriate?Yes
Design typePET
Total images acquired8
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?N/A—no intersubject normalization
Imaging notes

Conditions

Are the conditions clearly described?Yes
ConditionResponse typeRepetitionsAll groups could do?All individuals could do?
word repetitionWord (overt)4YesYes
restNone4N/AN/A
Conditions notesInclusion criterion was applied to ensure that the task could be performed

Contrasts

Are the contrasts clearly described?Yes

Contrast 1: word repetition vs rest

Language conditionWord repetition
Control conditionRest
Are the conditions matched for visual demands?Yes
Are the conditions matched for auditory demands?No
Are the conditions matched for motor demands?No
Are the conditions matched for cognitive/executive demands?No
Is accuracy matched between the language and control tasks for all relevant groups?N/A, tasks not comparable
Is reaction time matched between the language and control tasks for all relevant groups?N/A, tasks not comparable
Behavioral data notes
Are control data reported in this paper or another that is referenced?No
Does the contrast selectively activate plausible relevant language regions in the control group?Unknown
Are activations lateralized in the control data?Unknown
Control activation notesNo control data are reported or cited, however the same task was used in several previous studies by this group
Contrast notes

Analyses

Are the analyses clearly described?Yes

ROI analysis 1

First level contrastWord repetition vs rest
Analysis classLongitudinal change in aphasia
Group(s)Aphasia treated with pirecetam (n = 12) T2 vs T1
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?Unknown, not reported
Is reaction time matched across the second level contrast?Unknown, not reported
Behavioral data notes
Type of analysisRegions of interest (ROI)
ROI typeAnatomical
How many ROIs are there?14
What are the ROI(s)?(1) L BA 44; (2) L BA 45; (3) L ventral PrCG; (4) L HG; (5) L BA 41 and 42; (6) L BA 22; (7) L SMA; (8-14) homotopic counterparts
How are the ROI(s) defined?Individual anatomical images
Correction for multiple comparisonsNo correction
Statistical details
Findings↑ L IFG pars triangularis
↑ L posterior STG
↑ L Heschl's gyrus
Findings notes

ROI analysis 2

First level contrastWord repetition vs rest
Analysis classLongitudinal change in aphasia
Group(s)Aphasia treated with placebo (n = 12) T2 vs T1
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?Unknown, not reported
Is reaction time matched across the second level contrast?Unknown, not reported
Behavioral data notes
Type of analysisRegions of interest (ROI)
ROI typeAnatomical
How many ROIs are there?14
What are the ROI(s)?(1) L BA 44; (2) L BA 45; (3) L ventral PrCG; (4) L HG; (5) L BA 41 and 42; (6) L BA 22; (7) L SMA; (8-14) homotopic counterparts
How are the ROI(s) defined?Individual anatomical images
Correction for multiple comparisonsNo correction
Statistical details
Findings↑ L ventral precentral/inferior frontal junction
Findings notes

Notes

Excluded analyses