| Authors | Skipper-Kallal LM, Lacey EH, Xing S, Turkeltaub PE |
| Title | Functional activation independently contributes to naming ability and relates to lesion site in post-stroke aphasia |
| Reference | Hum Brain Mapp 2017a; 38: 2051-2066 |
| PMID | 28083891 |
| DOI | 10.1002/hbm.23504 |
| Language | US English |
| Inclusion criteria | Able to name 20% of pictures correctly in the scanner |
| Number of individuals with aphasia | 32 (plus 14 excluded: < 20% accuracy in scanner) |
| Number of control participants | 25 |
| Were any of the participants included in any previous studies? | Yes (29 of the participants overlap with the other Skipper-Kallal et al. (2017) paper) |
| Is age reported for patients and controls, and matched? | Yes (mean 58.8 ± 8.6 years, range 45.7-78.2 years) |
| Is sex reported for patients and controls, and matched? | Yes (males: 19; females: 12; stated to be not matched, but difference not significant) |
| Is handedness reported for patients and controls, and matched? | Yes (right: 26; left: 3; other: 2) |
| Is time post stroke onset reported and appropriate to the study design? | Yes (mean 40.9 ± 36.1 months, 4.9-151.0 months) |
| To what extent is the nature of aphasia characterized? | Comprehensive battery |
| Language evaluation | WAB, PNT |
| Aphasia severity | AQ mean 77.7 ± 21.0, range 22.8-99.2 |
| Aphasia type | 21 anomic, 7 Broca's, 3 conduction, 1 transcortical sensory |
| First stroke only? | Not stated |
| Stroke type | Not stated |
| To what extent is the lesion distribution characterized? | Lesion overlay |
| Lesion extent | Mean 27.5 ± 22.9 cc |
| Lesion location | L MCA |
| Participants notes | — |
| Modality | fMRI |
| 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 (Siemens Trio 3 Tesla) |
| Is the timing of stimulus presentation and image acquisition clearly described and appropriate? | No* (moderate limitation) (total images acquired not stated; separation of adjacent events (covert and overt naming) will be limited because of the small amount of jitter in their timing (only 1500 ms)) |
| Design type | Event-related |
| Total images acquired | ~450 but not stated |
| 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? | No* (moderate limitation) (entire phases where picture was displayed modeled as covert and overt naming; difficult to separate phases due to timing) |
| Is intersubject normalization adequately described and appropriate? | Yes |
| Imaging notes | — |
| Are the conditions clearly described? | Yes |
| Condition | Response type | Repetitions | All groups could do? | All individuals could do? |
|---|---|---|---|---|
| picture naming (silently name) | Word (covert) | 32 | Yes | Yes |
| picture naming (produce the name) | Word (overt) | 32 | Yes | Yes |
| rest | None | implicit baseline | N/A | N/A |
| Conditions notes | Covert and overt naming were modeled as two phases of each trial (there was a cue to produce the name after 7500-9000 ms); 5 participants who were more impaired were given easier pictures to name; patients who named less than 20% of items correctly were excluded |
| Are the contrasts clearly described? | No (see specific limitation(s) below) |
| Language condition | Picture naming (silently name, correct trials) |
| Control condition | Rest |
| Are the conditions matched for visual demands? | No |
| Are the conditions matched for auditory demands? | Yes |
| Are the conditions matched for motor demands? | Yes |
| 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? | Yes |
| Does the contrast selectively activate plausible relevant language regions in the control group? | No |
| Are activations lateralized in the control data? | No |
| Control activation notes | Bilateral frontal and occipito-temporal, but not posterior temporal |
| Contrast notes | — |
| Language condition | Picture naming (produce the name, correct trials) |
| Control condition | Rest |
| Are the conditions matched for visual demands? | No |
| 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? | Yes |
| Does the contrast selectively activate plausible relevant language regions in the control group? | No |
| Are activations lateralized in the control data? | No |
| Control activation notes | Bilateral frontal and occipito-temporal, but not posterior temporal; speech motor activation not readily apparent |
| Contrast notes | — |
| Language condition | Picture naming (both phases, correct trials) |
| Control condition | Picture naming (both phases, incorrect trials) |
| Are the conditions matched for visual demands? | Yes |
| Are the conditions matched for auditory demands? | Unknown |
| Are the conditions matched for motor demands? | Unknown |
| Are the conditions matched for cognitive/executive demands? | Yes |
| Is accuracy matched between the language and control tasks for all relevant groups? | No, by design |
| Is reaction time matched between the language and control tasks for all relevant groups? | Unknown, not reported |
| Behavioral data notes | — |
| Are control data reported in this paper or another that is referenced? | N/A |
| Does the contrast selectively activate plausible relevant language regions in the control group? | N/A |
| Are activations lateralized in the control data? | N/A |
| Control activation notes | Control data N/A because controls do not typically make errors |
| Contrast notes | It is unclear whether there were no-response trials and whether they were modeled as incorrect |
| Are the analyses clearly described? | Yes |
| First level contrast | Picture naming (silently name, correct trials) vs rest |
| Analysis class | Cross-sectional aphasia vs control |
| Group(s) | Aphasia 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? | Yes, correct trials only |
| Is reaction time matched across the second level contrast? | Unknown, not reported |
| Behavioral data notes | Covert phase but accuracy derived from overt phase |
| Type of analysis | Voxelwise |
| Search volume | Whole brain gray matter |
| Correction for multiple comparisons | Clusterwise correction with with GRFT and lenient voxelwise p |
| Software | FSL 5.0.6 |
| Voxelwise p | ~.01 (z > 2.3) |
| Cluster extent | Based on GRFT |
| Statistical details | Threshold of z > 3.1 mentioned in results, but presume 2.3 based on methods and figure |
| Findings | ↑ R precuneus ↓ L occipital |
| Findings notes | — |
| First level contrast | Picture naming (produce the name, correct trials) vs rest |
| Analysis class | Cross-sectional aphasia vs control |
| Group(s) | Aphasia 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? | Yes, correct trials only |
| Is reaction time matched across the second level contrast? | Unknown, not reported |
| Behavioral data notes | — |
| Type of analysis | Voxelwise |
| Search volume | Whole brain gray matter |
| Correction for multiple comparisons | Clusterwise correction with with GRFT and lenient voxelwise p |
| Software | FSL 5.0.6 |
| Voxelwise p | ~.01 (z > 2.3) |
| Cluster extent | Based on GRFT |
| Statistical details | Threshold of z > 3.1 mentioned in results, but presume 2.3 based on methods and figure |
| Findings | ↑ L SMA/medial prefrontal ↑ L orbitofrontal ↑ L precuneus ↑ R insula ↑ R ventral precentral/inferior frontal junction ↑ R SMA/medial prefrontal ↑ R orbitofrontal ↑ R somato-motor ↑ R supramarginal gyrus ↑ R posterior STS ↓ L IFG ↓ L insula ↓ L ventral precentral/inferior frontal junction ↓ L intraparietal sulcus ↓ L anterior temporal ↓ L hippocampus/MTL ↓ R intraparietal sulcus |
| Findings notes | Labels based largely on text with some adjustments based on figures; overall pattern of decreased L activity and increased R activity is quite convincing |
| First level contrast | Picture naming (silently name, correct trials) vs rest |
| Analysis class | Cross-sectional correlation with language or other measure |
| Group(s) | Aphasia |
| Covariate | PNT |
| 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? | Yes, correct trials only |
| Is reaction time matched across the second level contrast? | Unknown, not reported |
| Behavioral data notes | Covert phase but accuracy derived from overt phase |
| Type of analysis | Voxelwise |
| Search volume | Whole brain gray matter |
| Correction for multiple comparisons | Clusterwise correction with with GRFT and lenient voxelwise p |
| Software | FSL 5.0.6 |
| Voxelwise p | ~.01 (z > 2.3) |
| Cluster extent | Based on GRFT |
| Statistical details | — |
| Findings | ↑ L anterior temporal ↓ L SMA/medial prefrontal ↓ L supramarginal gyrus ↓ R SMA/medial prefrontal ↓ R somato-motor |
| Findings notes | L anterior temporal correlation remained significant after accounting for lesion load and other factors |
| First level contrast | Picture naming (produce the name, correct trials) vs rest |
| Analysis class | Cross-sectional correlation with language or other measure |
| Group(s) | Aphasia |
| Covariate | PNT |
| 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? | Yes, correct trials only |
| Is reaction time matched across the second level contrast? | Unknown, not reported |
| Behavioral data notes | — |
| Type of analysis | Voxelwise |
| Search volume | Whole brain gray matter |
| Correction for multiple comparisons | Clusterwise correction with with GRFT and lenient voxelwise p |
| Software | FSL 5.0.6 |
| Voxelwise p | ~.01 (z > 2.3) |
| Cluster extent | Based on GRFT |
| Statistical details | — |
| Findings | ↑ L posterior STG ↑ R somato-motor ↑ R posterior STS ↑ R occipital ↓ L IFG pars orbitalis ↓ L dorsolateral prefrontal cortex ↓ L angular gyrus |
| Findings notes | L IFG pars orbitalis, R pSTS, and R somato-motor correlations remained remained significant after accounting for lesion load and other factors; note that the pars orbitalis region is described as frontal pole in the paper but the coordinates and image support pars orbitalis |
| First level contrast | Picture naming (both phases, correct trials) vs picture naming (both phases, incorrect trials) |
| Analysis class | Cross-sectional performance-defined conditions |
| Group(s) | Aphasia with naming < 80% (n = 24) |
| 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? | No, by design |
| Is reaction time matched across the second level contrast? | Unknown, not reported |
| Behavioral data notes | — |
| Type of analysis | Voxelwise |
| Search volume | Whole brain gray matter |
| Correction for multiple comparisons | Clusterwise correction with with GRFT and lenient voxelwise p |
| Software | FSL 5.0.6 |
| Voxelwise p | ~.01 (z > 2.3) |
| Cluster extent | Based on GRFT |
| Statistical details | — |
| Findings | None |
| Findings notes | — |
| First level contrast | Picture naming (produce the name, correct trials) vs rest |
| Analysis class | Cross-sectional correlation with language or other measure |
| Group(s) | Aphasia |
| Covariate | PNT |
| 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? | Yes, correct trials only |
| Is reaction time matched across the second level contrast? | Unknown, not reported |
| Behavioral data notes | — |
| Type of analysis | Regions of interest (ROI) |
| ROI type | Functional |
| How many ROIs are there? | 11 |
| What are the ROI(s)? | (1) right IPS; (2) left IPS; (3) left PTr; (4) left dPOp; (5) right superior motor cortex; (6) right ventral motor cortex; (7) right supramarginal sulcus; (8) left medial SMA; (9) right marginal sulcus; (10) left dorsal motor cortex; (11) right STS |
| How are the ROI(s) defined? | Regions that were activated for control > aphasia (ROIs 1-4) or aphasia > control (ROIs 5-11) |
| Correction for multiple comparisons | Familywise error (FWE) |
| Statistical details | — |
| Findings | ↑ R ventral precentral/inferior frontal junction ↑ R posterior STS ↓ L IFG pars opercularis |
| Findings notes | The L IFG pars opercularis and the R posterior STS also contributed to predicting PNT scores even when lesion load on critical areas for picture naming, and several other variables, were included in multiple regression models |
| First level contrast | Picture naming (silently name, correct trials) vs rest |
| Analysis class | Cross-sectional aphasia vs control |
| Group(s) | Aphasia 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? | Yes, correct trials only |
| Is reaction time matched across the second level contrast? | Unknown, not reported |
| Behavioral data notes | — |
| Type of analysis | Region of interest (ROI) |
| ROI type | Functional |
| How many ROIs are there? | 1 |
| What are the ROI(s)? | L anterior temporal |
| How are the ROI(s) defined? | Activity for covert naming correlated with naming ability in patients, after controlling for lesion and demographic factors |
| Correction for multiple comparisons | One only |
| Statistical details | — |
| Findings | None |
| Findings notes | — |
| First level contrast | Picture naming (produce the name, correct trials) vs rest |
| Analysis class | Cross-sectional aphasia vs control |
| Group(s) | Aphasia 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? | Yes, correct trials only |
| Is reaction time matched across the second level contrast? | Unknown, not reported |
| Behavioral data notes | — |
| Type of analysis | Regions of interest (ROI) |
| ROI type | Functional |
| How many ROIs are there? | 3 |
| What are the ROI(s)? | (1) L frontal pole; (2) R postcentral gyrus; (3) R STS |
| How are the ROI(s) defined? | Activity for overt naming correlated with naming ability in patients, after controlling for lesion and demographic factors |
| Correction for multiple comparisons | No correction |
| Statistical details | — |
| Findings | ↑ R somato-motor ↑ R posterior STS |
| Findings notes | — |
| First level contrast | Picture naming (produce the name, correct trials) vs rest |
| Analysis class | Cross-sectional correlation with language or other measure |
| Group(s) | Aphasia |
| Covariate | Lesion patterns identified with SVR-LSM |
| 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? | Yes, correct trials only |
| Is reaction time matched across the second level contrast? | Unknown, not reported |
| Behavioral data notes | — |
| Type of analysis | Complex |
| Statistical details | SVR-LSM was used to identify regions of damage associated with activation of R pSTS ROI (defined based on SPM analysis 2). The results were thresholded at voxelwise p < .01 (CDT), cluster extent > 500 voxels. |
| Findings | Other |
| Findings notes | Damage to the L IFG pars opercularis was associated with more activity in the R pSTS. Damage to the L pSTS was associated with less activity in the R pSTS. |
| First level contrast | Picture naming (produce the name, correct trials) vs rest |
| Analysis class | Cross-sectional correlation with language or other measure |
| Group(s) | Aphasia without IFG POp damage (n = 26) |
| Covariate | Lesion patterns identified with SVR-LSM |
| 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? | Yes, correct trials only |
| Is reaction time matched across the second level contrast? | Unknown, not reported |
| Behavioral data notes | — |
| Type of analysis | Complex |
| Statistical details | SVR-LSM was used to identify regions of damage associated with activation of L IFG pars opercularis ROI (defined based on SPM analysis 2). The results were thresholded at voxelwise p < .01 (CDT), cluster extent > 500 voxels. |
| Findings | Other |
| Findings notes | Damage to the L pSTG, L pSTS, and white matter underlying the L precuneus was associated with more activity in the L IFG pars opercularis. There were no regions associated with less activity. |
| Excluded analyses | Negative correlation between functional activation in the L IFG pars opercularis and R pSTS |
