Aphasia Neuroplasticity Review

Weiller et al. (1995)

Reference

AuthorsWeiller C, Isensee C, Rijntjes M, Huber W, Müller S, Bier D, Dutschka K, Woods RP, Noth J, Diener HC
TitleRecovery from Wernicke's aphasia: a positron emission tomographic study
ReferenceAnn Neurol 1995; 37: 723-732
PMID7778845
DOI10.1002/ana.410370605

Participants

LanguageGerman
Inclusion criteriaLesion including L pSTG; moderate-to-severe Wernicke's aphasia in the subacute period; now recovered and not aphasic per formal testing; able to perform verb generation task
Number of individuals with aphasia6
Number of control participants6
Were any of the participants included in any previous studies?No
Is age reported for patients and controls, and matched?No (mean 58 years, range 50-66 years; controls were younger: mean 35 years; range 27-50 years)
Is sex reported for patients and controls, and matched?Yes (males: 6; females: 0)
Is handedness reported for patients and controls, and matched?Yes (right: 6; left: 0)
Is time post stroke onset reported and appropriate to the study design?Yes (range 5-117 months)
To what extent is the nature of aphasia characterized?Comprehensive battery
Language evaluationAAT
Aphasia severityRecovered; not aphasic per formal testing
Aphasia typeRecovered, but all had moderate-severe Wernicke's aphasia in the subacute period
First stroke only?Yes
Stroke typeIschemic only
To what extent is the lesion distribution characterized?Individual lesions
Lesion extentNot stated
Lesion locationPosterior L MCA infarct, lesion to the L posterior STG usually extending to MTG and AG
Participants notes6 patients were selected from a database of 600 carefully documented cases

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 ECAT 953/15)
Is the timing of stimulus presentation and image acquisition clearly described and appropriate?Yes
Design typePET
Total images acquired6
Are the imaging acquisition parameters, including coverage, adequately described and appropriate?Yes (axial; field of view = 5.4 cm; perisylvian only)
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)2YesYes
pseudoword repetitionMultiple words (covert)2YesYes
restNone2N/AN/A
Conditions notesAuditory presentation; pre-scan behavioral data reported

Contrasts

Are the contrasts clearly described?Yes

Contrast 1: verb generation vs rest

Language conditionVerb generation
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?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?Somewhat
Does the contrast selectively activate plausible relevant language regions in the control group?Yes
Are activations lateralized in the control data?Yes
Control activation notesL posterior temporal, IFG and ventral precentral gyrus, much smaller activations in the R hemisphere
Contrast notes

Contrast 2: pseudoword repetition vs rest

Language conditionPseudoword 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?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?Somewhat
Does the contrast selectively activate plausible relevant language regions in the control group?Somewhat
Are activations lateralized in the control data?Somewhat
Control activation notesL posterior temporal only; similar but less extensive activation in the R hemisphere
Contrast notes

Analyses

Are the analyses clearly described?Yes

Voxelwise analysis 1

First level contrastVerb generation vs rest
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?Appear mismatched
Is reaction time matched across the second level contrast?Unknown, not reported
Behavioral data notesIn practice trials, patients produced 1.5 words on average per prompt, not all of which were verbs, while controls 2.3 words on average per prompt, almost all of which were verbs
Type of analysisVoxelwise
Search volumePerisylvian
Correction for multiple comparisonsNo direct comparison
SoftwareSPM
Voxelwise p
Cluster extent
Statistical detailsQualitative comparison on p. 729 (the word "significant" is used)
Findings↑ R IFG
↑ R posterior STG/STS/MTG
↓ L posterior STG/STS/MTG
Findings notesBased more on Figure 2 than the text

Voxelwise analysis 2

First level contrastPseudoword repetition vs rest
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?Appear similar
Is reaction time matched across the second level contrast?Unknown, not reported
Behavioral data notesAll participants are reported to have had no difficulties in performing the repetition task
Type of analysisVoxelwise
Search volumePerisylvian
Correction for multiple comparisonsNo direct comparison
SoftwareSPM
Voxelwise p
Cluster extent
Statistical detailsQualitative comparison on p. 729 (the word "significant" is used)
Findings↑ L ventral precentral/inferior frontal junction
↑ R IFG
↑ R posterior STG/STS/MTG
↓ L posterior STG/STS/MTG
Findings notesBased more on Figure 2 than the text

Notes

Excluded analyses