Aphasia Neuroplasticity Review

Blank et al. (2003)

Reference

AuthorsBlank SC, Bird H, Turkheimer F, Wise RJ
TitleSpeech production after stroke: the role of the right pars opercularis
ReferenceAnn Neurol 2003; 54: 310-320
PMID12953263
DOI10.1002/ana.10656

Participants

LanguageUK English
Inclusion criteriaInitial non-fluent aphasia due to anterior perisylvian lesion; subsequently recovered the ability to speak in sentences; patients were divided into those with and without damage to the IFG pars opercularis (POp+: n = 7; POp-: n = 7)
Number of individuals with aphasia14
Number of control participants12
Were any of the participants included in any previous studies?No
Is age reported for patients and controls, and matched?Yes (POp+: median 50 years, range 36-72 years; POp-: median 61 years, range 39-70 years)
Is sex reported for patients and controls, and matched?Yes (males: 8; females: 6)
Is handedness reported for patients and controls, and matched?Yes (right: 14; left: 0)
Is time post stroke onset reported and appropriate to the study design?Yes (POp+: median 39 months, range 19-134 months; POp-: median 17 months, range 6-240 months)
To what extent is the nature of aphasia characterized?Type only
Language evaluationCAT, QPA
Aphasia severityNot stated
Aphasia typePOp+: 4 non-fluent but not agrammatic, 2 agrammatic, 1 recovered; POp-: 4 non-fluent but not agrammatic, 3 recovered
First stroke only?No
Stroke typeNot stated
To what extent is the lesion distribution characterized?Individual lesions
Lesion extentNot stated
Lesion locationL frontal, occasionally extending into temporal
Participants notes8 of 12 controls included in Blank et al. (2002)

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 acquired15 (patients); 12 (controls)
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?
propositional speech productionSentence (overt)aphasia: 5; control: 4YesYes
countingMultiple words (overt)aphasia: 5; control: 4YesYes
restNoneaphasia: 5; control: 4N/AN/A
Conditions notesAlertness maintained in rest by asking participants to listen to environmental sounds that were presented before and after data acquisition; speech was recorded and rate was measured, also QPA was done of a separate speech sample outside the scanner

Contrasts

Are the contrasts clearly described?Yes

Contrast 1: propositional speech production vs rest

Language conditionPropositional speech production
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?Yes
Does the contrast selectively activate plausible relevant language regions in the control group?Somewhat
Are activations lateralized in the control data?Somewhat
Control activation notesMuch bilateral activation due to overt speech but pars opercularis and supratemporal plane L-lateralized
Contrast notes

Contrast 2: propositional speech production vs counting

Language conditionPropositional speech production
Control conditionCounting
Are the conditions matched for visual demands?Yes
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?Somewhat
Are activations lateralized in the control data?Somewhat
Control activation notesExtrasylvian; somewhat L-lateralized
Contrast notes

Analyses

Are the analyses clearly described?Yes

Voxelwise analysis 1

First level contrastPropositional speech production vs rest
Analysis classCross-sectional aphasia vs control
Group(s)Aphasia with IFG POp damage (n = 7) 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?No, different
Is reaction time matched across the second level contrast?N/A, no timeable task
Behavioral data notesWord rates not reported, but offline speech sample differed
Type of analysisVoxelwise
Search volumeVoxels spared in all patients
Correction for multiple comparisonsSmall volume correction
SoftwareSPM99
Voxelwise pFWE p < .05 with SVC in R pars opercularis
Cluster extent
Statistical details
Findings↑ R IFG pars opercularis
Findings notesNo voxels survived FWE correction without SVC

Voxelwise analysis 2

First level contrastPropositional speech production vs rest
Analysis classCross-sectional aphasia vs control
Group(s)Aphasia without IFG POp damage (n = 7) 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?No, different
Is reaction time matched across the second level contrast?N/A, no timeable task
Behavioral data notesWord rates not reported, but offline speech sample differed
Type of analysisVoxelwise
Search volumeVoxels spared in all patients
Correction for multiple comparisonsSmall volume correction
SoftwareSPM99
Voxelwise pFWE p < .05 with SVC in R pars opercularis
Cluster extent
Statistical details
Findings↑ R IFG pars opercularis
Findings notes

Voxelwise analysis 3

First level contrastPropositional speech production vs rest
Analysis classCross-sectional between two groups with aphasia
Group(s)Aphasia with IFG POp damage (n = 7) vs without IFG POp damage (n = 7)
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, different
Is reaction time matched across the second level contrast?N/A, no timeable task
Behavioral data notesWord rates not reported, but offline speech sample differed
Type of analysisVoxelwise
Search volumeVoxels spared in all patients
Correction for multiple comparisonsSmall volume correction
SoftwareSPM99
Voxelwise pFWE p < .05 with SVC in R pars opercularis
Cluster extent
Statistical details
FindingsNone
Findings notesPatients with L IFG POp damage showed numerically more signal in the R IFG POp

Voxelwise analysis 4

First level contrastPropositional speech production vs counting
Analysis classCross-sectional aphasia vs control
Group(s)Aphasia with IFG POp damage (n = 7) 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?No, different
Is reaction time matched across the second level contrast?N/A, no timeable task
Behavioral data notesWord rates not reported, but offline speech sample differed
Type of analysisVoxelwise
Search volumeVoxels spared in all patients
Correction for multiple comparisonsSmall volume correction
SoftwareSPM99
Voxelwise pFWE p < .05 with SVC in R pars opercularis
Cluster extent
Statistical details
FindingsNone
Findings notes

Voxelwise analysis 5

First level contrastPropositional speech production vs counting
Analysis classCross-sectional aphasia vs control
Group(s)Aphasia without IFG POp damage (n = 7) 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?No, different
Is reaction time matched across the second level contrast?N/A, no timeable task
Behavioral data notesWord rates not reported, but offline speech sample differed
Type of analysisVoxelwise
Search volumeVoxels spared in all patients
Correction for multiple comparisonsSmall volume correction
SoftwareSPM99
Voxelwise pFWE p < .05 with SVC in R pars opercularis
Cluster extent
Statistical details
FindingsNone
Findings notes

Voxelwise analysis 6

First level contrastPropositional speech production vs counting
Analysis classCross-sectional between two groups with aphasia
Group(s)Aphasia with IFG POp damage (n = 7) vs without IFG POp damage (n = 7)
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, different
Is reaction time matched across the second level contrast?N/A, no timeable task
Behavioral data notesWord rates not reported, but offline speech sample differed
Type of analysisVoxelwise
Search volumeVoxels spared in all patients
Correction for multiple comparisonsSmall volume correction
SoftwareSPM99
Voxelwise pFWE p < .05 with SVC in R pars opercularis
Cluster extent
Statistical details
FindingsNone
Findings notes

ROI analysis 1

First level contrastPropositional speech production vs rest
Analysis classCross-sectional correlation with language or other measure
Group(s)Aphasia with IFG POp damage (n = 7)
CovariateSpeech rate during scan
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?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 IFG pars opercularis
How are the ROI(s) defined?Defined by flipping L IFG pars opercularis activation in controls
Correction for multiple comparisonsOne only
Statistical details
FindingsNone
Findings notes

ROI analysis 2

First level contrastPropositional speech production vs rest
Analysis classCross-sectional correlation with language or other measure
Group(s)Aphasia without IFG POp damage (n = 7)
CovariateSpeech rate during scan
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?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 IFG pars opercularis
How are the ROI(s) defined?Defined by flipping L IFG pars opercularis activation in controls
Correction for multiple comparisonsOne only
Statistical details
FindingsNone
Findings notes

ROI analysis 3

First level contrastPropositional speech production vs rest
Analysis classCross-sectional correlation with language or other measure
Group(s)Aphasia with IFG POp damage (n = 7)
CovariateFour different QPA measures
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?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 IFG pars opercularis
How are the ROI(s) defined?Defined by flipping L IFG pars opercularis activation in controls
Correction for multiple comparisonsOne only
Statistical details
FindingsNone
Findings notes

Notes

Excluded analysesROI analyses may have been carried out for both contrasts, but this is not stated