Aphasia Neuroplasticity Review

Szaflarski et al. (2014)

Reference

AuthorsSzaflarski JP, Allendorfer JB, Byars AW, Vannest J, Dietz A, Hernando KA, Holland SK
TitleAge at stroke determines post-stroke language lateralization
ReferenceRestor Neurol Neurosci 2014; 32: 733-742
PMID25159870
DOI10.3233/rnn-140402

Participants

LanguageUS English
Inclusion criteria
Number of individuals with aphasia32
Number of control participants32
Were any of the participants included in any previous studies?Yes (some participants included in Allendorfer et al. (2012))
Is age reported for patients and controls, and matched?Yes (mean 51.8 ± 15.1 years)
Is sex reported for patients and controls, and matched?Yes (males: 18; females: 14)
Is handedness reported for patients and controls, and matched?No
Is time post stroke onset reported and appropriate to the study design?Yes (mean 3.2 ± 3.1 years, > 6 months)
To what extent is the nature of aphasia characterized?Not at all
Language evaluationNot stated
Aphasia severity"complete or almost complete" recovery in a "substantial proportion" of the patients
Aphasia typeNot stated
First stroke only?Not stated
Stroke typeNot stated
To what extent is the lesion distribution characterized?Lesion overlay
Lesion extent60.1 ± 57.5 cc
Lesion locationL MCA
Participants notesOne participant was < 18 years old at time of stroke; there was also a perinatal stroke group, not relevant for this review; 3 participants were excluded but it is not stated whether they were adult or perinatal patients.

Imaging

ModalityfMRI
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 (Philips Achieva 3 Tesla, except for 1 patient and 1 control on a Bruker 3 Tesla)
Is the timing of stimulus presentation and image acquisition clearly described and appropriate?Yes
Design typeBlock
Total images acquired165
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?
verb generationMultiple words (covert)5YesUnknown
finger tappingOther6YesYes
Conditions notes

Contrasts

Are the contrasts clearly described?Yes

Contrast 1: verb generation vs finger tapping

Language conditionVerb generation
Control conditionFinger tapping
Are the conditions matched for visual demands?Yes
Are the conditions matched for auditory demands?Yes
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?Yes
Are activations lateralized in the control data?Somewhat
Control activation notesControl data in Szaflarski et al. (2008); frontal activation L-lateralized, temporal less so
Contrast notes

Analyses

Are the analyses clearly described?Yes

Voxelwise analysis 1

First level contrastVerb generation vs finger tapping
Analysis classCross-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?Unknown, not reported
Is reaction time matched across the second level contrast?Unknown, not reported
Behavioral data notes
Type of analysisVoxelwise
Search volumeWhole brain
Correction for multiple comparisonsNo direct comparison
SoftwareCCHIPS
Voxelwise p
Cluster extent
Statistical detailsQualitative comparison on pp. 5-6 (page numbers refer to PMC author manuscript)
Findings↓ L inferior parietal lobule
↓ L superior parietal
↓ L posterior STG/STS/MTG
↓ L occipital
↓ R occipital
Findings notes

ROI analysis 1

First level contrastVerb generation vs finger tapping
Analysis classCross-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?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 typeLaterality indi(ces)
How many ROIs are there?3
What are the ROI(s)?(1) frontal LI; (2) temporal LI; (3) language network LI
How are the ROI(s) defined?
Correction for multiple comparisonsNo correction
Statistical details
Findings↓ LI (language network)
↓ LI (frontal)
Findings notesTemporal LI was also marginally significantly reduced (p = .08)

Notes

Excluded analysesAll analyses involving perinatal stroke group; distribution of language lateralization categories (derived from LI) also differed between patients and controls