Aphasia Neuroplasticity Review

Geranmayeh et al. (2017)

Reference

AuthorsGeranmayeh F, Chau TW, Wise RJS, Leech R, Hampshire A
TitleDomain-general subregions of the medial prefrontal cortex contribute to recovery of language after stroke
ReferenceBrain 2017; 140: 1947-1958
PMID29177494
DOI10.1093/brain/awx134

Participants

LanguageUK English
Inclusion criteria
Number of individuals with aphasia27
Number of control participants0
Were any of the participants included in any previous studies?Yes (patients are a subset of those in Geranmayeh et al. (2016))
Is age reported for patients and controls, and matched?Yes (mean 59.1 ± 10.8 years, range 39-77 years)
Is sex reported for patients and controls, and matched?Yes (males: 18; females: 9)
Is handedness reported for patients and controls, and matched?Yes (right: 26; left: 1)
Is time post stroke onset reported and appropriate to the study design?Yes (T1: 15 ± 7.6 days (range 5-35 days); T2: 108 ± 26 days (range 87-200 days))
To what extent is the nature of aphasia characterized?Not at all
Language evaluationCAT, QPA
Aphasia severityNot stated
Aphasia typeNot stated
First stroke only?No
Stroke typeNot stated
To what extent is the lesion distribution characterized?Lesion overlay
Lesion extentMean 41.4 ± 44.4 cc, range 3.8-173.9 cc
Lesion locationL; modest R involvement in 3 cases
Participants notes24 control participants are described, but no imaging data from the controls are analyzed in this paper

Imaging

ModalityfMRI
Is the study cross-sectional or longitudinal?Longitudinal—recovery
If longitudinal, at what time point(s) were imaging data acquired?T1: 15 ± 7.6 days (range 5-35 days); T2: 108 ± 26 days (range 87-200 days)
If longitudinal, was there any intervention between the time points?Variable modest amounts of SLT (range 0-18 hours) reported in Supplementary Table 1
Is the scanner described?Yes (Siemens Trio 3 Tesla)
Is the timing of stimulus presentation and image acquisition clearly described and appropriate?Yes
Design typeEvent-related
Total images acquired213
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 notessparse sampling; mini-blocks of 2-4 trials

Conditions

Are the conditions clearly described?Yes
ConditionResponse typeRepetitionsAll groups could do?All individuals could do?
propositional speech productionSentence (overt)60YesYes
countingMultiple words (overt)48YesUnknown
target decisionButton press48YesNo
restNone45N/AN/A
Conditions notesAll participants could do the target decision task except for one who was at chance

Contrasts

Are the contrasts clearly described?No (see specific limitation(s) below)

Contrast 1: propositional speech production vs rest

Language conditionPropositional speech production
Control conditionRest
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 notesControl data in Geranmayeh et al. (2014); speech not language; relevant activations are bilateral
Contrast notesNot entirely clear that the whole brain analysis is indeed propositional speech production vs rest; a contrast of target decision vs mean of propositional speech and counting is also used to define the preSMA/dACC ROI

Analyses

Are the analyses clearly described?Yes

Voxelwise analysis 1

First level contrastPropositional speech production vs rest
Analysis classCross-sectional correlation with language or other measure
Group(s)Aphasia mean of T1, T2
CovariateSimultaneous Δ (T2 vs T1) number of appropriate information-carrying words
Is the second level contrast valid in terms of the group(s), time point(s), and measures involved?Somewhat (potentially confounded by T1 and T2 language function; language function at T1 was predictive of change in language function)
Is accuracy matched across the second level contrast?Appear mismatched
Is reaction time matched across the second level contrast?Unknown, not reported
Behavioral data notesT1 AICW correlated with change in AICW, but not stated whether T2 AICW correlated with change in AICW
Type of analysisVoxelwise
Search volumeVoxels spared in all patients
Correction for multiple comparisonsClusterwise correction based on arbitrary cluster extent
SoftwareFSL
Voxelwise p.05
Cluster extent1.6 cc
Statistical details
Findings↑ L SMA/medial prefrontal
↑ L anterior cingulate
↑ R SMA/medial prefrontal
↑ R somato-motor
↑ R posterior STS
↑ R anterior cingulate
Findings notesFindings based on figures and coordinates; the pre-SMA/dACC peak noted to survive FWE correction at p < .001

ROI analysis 1

First level contrastPropositional speech production vs rest
Analysis classLongitudinal change in aphasia
Group(s)Aphasia 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?No, different
Is reaction time matched across the second level contrast?Unknown, not reported
Behavioral data notesNumber of AICW increased
Type of analysisRegion of interest (ROI)
ROI typeFunctional
How many ROIs are there?1
What are the ROI(s)?L pre-SMA
How are the ROI(s) defined?Peak voxel of the contrast of target decision vs mean of propositional speech and counting in people with aphasia
Correction for multiple comparisonsOne only
Statistical detailsNo main effect of session in session by language recovery ANOVA
FindingsNone
Findings notes

ROI analysis 2

First level contrastPropositional speech production vs rest
Analysis classLongitudinal correlation with language or other measure
Group(s)Aphasia T2 vs T1
CovariateΔ number of appropriate information-carrying words
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 analysisRegion of interest (ROI)
ROI typeFunctional
How many ROIs are there?1
What are the ROI(s)?L pre-SMA
How are the ROI(s) defined?Peak voxel of the contrast of target decision vs mean of propositional speech and counting in people with aphasia
Correction for multiple comparisonsOne only
Statistical detailsNo interaction of session by language recovery in ANOVA
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 mean of T1, T2
CovariateSimultaneous Δ (T2 vs T1) number of appropriate information-carrying words
Is the second level contrast valid in terms of the group(s), time point(s), and measures involved?Somewhat (potentially confounded by T1 and T2 language function; language function at T1 was predictive of change in language function)
Is accuracy matched across the second level contrast?Appear mismatched
Is reaction time matched across the second level contrast?Unknown, not reported
Behavioral data notesT1 AICW correlated with change in AICW, but not stated whether T2 AICW correlated with change in AICW
Type of analysisRegion of interest (ROI)
ROI typeFunctional
How many ROIs are there?1
What are the ROI(s)?L pre-SMA
How are the ROI(s) defined?Peak voxel of the contrast of target decision vs mean of propositional speech and counting in people with aphasia
Correction for multiple comparisonsOne only
Statistical details
Findings↑ L SMA/medial prefrontal
Findings notesPatients with more pre-SMA activity improved more

ROI analysis 4

First level contrastPropositional speech production vs rest
Analysis classCross-sectional correlation with language or other measure
Group(s)Aphasia mean of T1, T2
CovariateSimultaneous Δ (T2 vs T1) number of appropriate information-carrying words
Is the second level contrast valid in terms of the group(s), time point(s), and measures involved?Somewhat (potentially confounded by T1 and T2 language function; language function at T1 was predictive of change in language function)
Is accuracy matched across the second level contrast?Appear mismatched
Is reaction time matched across the second level contrast?Unknown, not reported
Behavioral data notesT1 AICW correlated with change in AICW, but not stated whether T2 AICW correlated with change in AICW
Type of analysisRegion of interest (ROI)
ROI typeFunctional
How many ROIs are there?1
What are the ROI(s)?L pre-SMA
How are the ROI(s) defined?Peak voxel of the contrast of target decision vs mean of propositional speech and counting in people with aphasia
Correction for multiple comparisonsOne only
Statistical detailsLesion size covariate
Findings↑ L SMA/medial prefrontal
Findings notesPatients with more pre-SMA activity improved more

ROI analysis 5

First level contrastPropositional speech production vs rest
Analysis classCross-sectional correlation with language or other measure
Group(s)Aphasia mean of T1, T2
CovariateSimultaneous Δ (T2 vs T1) number of appropriate information-carrying words
Is the second level contrast valid in terms of the group(s), time point(s), and measures involved?Yes (this analysis is appropriate because T1 behavior is included in model)
Is accuracy matched across the second level contrast?Appear mismatched
Is reaction time matched across the second level contrast?Unknown, not reported
Behavioral data notesT1 AICW correlated with change in AICW, but not stated whether T2 AICW correlated with change in AICW
Type of analysisRegion of interest (ROI)
ROI typeFunctional
How many ROIs are there?1
What are the ROI(s)?L pre-SMA
How are the ROI(s) defined?Peak voxel of the contrast of target decision vs mean of propositional speech and counting in people with aphasia
Correction for multiple comparisonsOne only
Statistical detailsLesion size, T1 performance, and age covariates
Findings↑ L SMA/medial prefrontal
Findings notesPatients with more pre-SMA activity improved more

ROI analysis 6

First level contrastPropositional speech production vs rest
Analysis classCross-sectional correlation with language or other measure
Group(s)Aphasia mean of T1, T2
CovariateSubsequent outcome (T2) number of appropriate information-carrying words
Is the second level contrast valid in terms of the group(s), time point(s), and measures involved?No (mathematically equivalent to the previous analysis, because of the inclusion of T1 performance as a covariate)
Is accuracy matched across the second level contrast?Appear mismatched
Is reaction time matched across the second level contrast?Unknown, not reported
Behavioral data notesT1 AICW correlated with change in AICW, but not stated whether T2 AICW correlated with change in AICW
Type of analysisRegion of interest (ROI)
ROI typeFunctional
How many ROIs are there?1
What are the ROI(s)?L pre-SMA
How are the ROI(s) defined?Peak voxel of the contrast of target decision vs mean of propositional speech and counting in people with aphasia
Correction for multiple comparisonsOne only
Statistical detailsLesion size, T1 performance, and age covariates
Findings↑ L SMA/medial prefrontal
Findings notes

ROI analysis 7

First level contrastPropositional speech production vs rest
Analysis classCross-sectional correlation with language or other measure
Group(s)Aphasia T1
CovariateSubsequent Δ (T2 vs T1) number of appropriate information-carrying words
Is the second level contrast valid in terms of the group(s), time point(s), and measures involved?Somewhat (potentially confounded by T1 language function; language function at T1 was predictive of change in language function)
Is accuracy matched across the second level contrast?No, different
Is reaction time matched across the second level contrast?Unknown, not reported
Behavioral data notesT1 AICW correlated with change in AICW
Type of analysisRegion of interest (ROI)
ROI typeFunctional
How many ROIs are there?1
What are the ROI(s)?L pre-SMA
How are the ROI(s) defined?Peak voxel of the contrast of target decision vs mean of propositional speech and counting in people with aphasia
Correction for multiple comparisonsOne only
Statistical details
Findings↑ L SMA/medial prefrontal
Findings notes

ROI analysis 8

First level contrastPropositional speech production vs rest
Analysis classCross-sectional correlation with language or other measure
Group(s)Aphasia T2
CovariatePrevious Δ (T2 vs T1) number of appropriate information-carrying words
Is the second level contrast valid in terms of the group(s), time point(s), and measures involved?No (the logic behind correlating activation changes and language outcome is unclear)
Is accuracy matched across the second level contrast?Appear mismatched
Is reaction time matched across the second level contrast?Unknown, not reported
Behavioral data notesT1 AICW correlated with change in AICW, but not stated whether T2 AICW correlated with change in AICW
Type of analysisRegion of interest (ROI)
ROI typeFunctional
How many ROIs are there?1
What are the ROI(s)?L pre-SMA
How are the ROI(s) defined?Peak voxel of the contrast of target decision vs mean of propositional speech and counting in people with aphasia
Correction for multiple comparisonsOne only
Statistical details
Findings↑ L SMA/medial prefrontal
Findings notes

Notes

Excluded analysesIt is mentioned that activity for other tasks did not correlate with language recovery, but no details are provided