Aphasia Neuroplasticity Review

Nardo et al. (2017)

Reference

AuthorsNardo D, Holland R, Leff AP, Price CJ, Crinion JT
TitleLess is more: neural mechanisms underlying anomia treatment in chronic aphasic patients
ReferenceBrain 2017; 140: 3039-3054
PMID29053773
DOI10.1093/brain/awx234

Participants

LanguageUK English
Inclusion criteriaAnomia; good single word comprehension; relatively spared word and nonword repetition; no AoS; spared or partially spared L IFG
Number of individuals with aphasia18
Number of control participants0
Were any of the participants included in any previous studies?No
Is age reported for patients and controls, and matched?Yes (mean 50 ± 12 years, range 21-67 years)
Is sex reported for patients and controls, and matched?Yes (males: 12; females: 6)
Is handedness reported for patients and controls, and matched?Yes (right: 18; left: 0)
Is time post stroke onset reported and appropriate to the study design?Yes (mean 61 ± 58 months, range 5-264 months)
To what extent is the nature of aphasia characterized?Not at all
Language evaluationBNT, one CAT subtest, two PALPA subtests
Aphasia severityNot stated
Aphasia typeNot stated
First stroke only?Yes
Stroke typeNot stated
To what extent is the lesion distribution characterized?Lesion overlay
Lesion extentNot stated
Lesion locationL MCA
Participants notes

Imaging

ModalityfMRI
Is the study cross-sectional or longitudinal?Longitudinal—chronic treatment
If longitudinal, at what time point(s) were imaging data acquired?T1: pre-treatment/chronic; T2: post-treatment, ~6 weeks later
If longitudinal, was there any intervention between the time points?Anomia treatment (computer-based practice), 2+ hours/day, 6 weeks
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 acquired696
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?
picture naming (untrained items, word cue)Word (overt)54YesUnknown
picture naming (untrained items, initial phonemes cue)Word (overt)54YesUnknown
picture naming (untrained items, final phonemes cue)Word (overt)54YesUnknown
picture naming (untrained items, no cue)Word (overt)54YesUnknown
picture naming (trained items, word cue)Word (overt)53YesUnknown
picture naming (trained items, initial phonemes cue)Word (overt)53YesUnknown
picture naming (trained items, final phonemes cue)Word (overt)53YesUnknown
picture naming (trained items, no cue)Word (overt)53YesUnknown
restNoneimplicit baselineN/AN/A
Conditions notesSpectrally rotated noise vocoded auditory stimulus in no-cue conditions; one patient had a BNT of 1/60 so it is unclear whether that patient could do the task

Contrasts

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

Contrast 1: picture naming (all conditions, correct trials) vs rest

Language conditionPicture naming (all conditions, correct trials)
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?No
Does the contrast selectively activate plausible relevant language regions in the control group?Unknown
Are activations lateralized in the control data?Unknown
Control activation notes
Contrast notesIt is difficult to determine exactly what contrasts were employed

Contrast 2: picture naming (untrained items, no cue, correct trials) vs picture naming (trained items, no cue, correct trials)

Language conditionPicture naming (untrained items, no cue, correct trials)
Control conditionPicture naming (trained items, no cue, correct trials)
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?Yes
Is accuracy matched between the language and control tasks for all relevant groups?Yes, correct trials only
Is reaction time matched between the language and control tasks for all relevant groups?No, different
Behavioral data notesUntrained items significantly slower at T2
Are control data reported in this paper or another that is referenced?No
Does the contrast selectively activate plausible relevant language regions in the control group?Unknown
Are activations lateralized in the control data?Unknown
Control activation notes
Contrast notesIt is difficult to determine exactly what contrasts were employed

Analyses

Are the analyses clearly described?No* (moderate limitation) (see specific limitation(s) below)

Voxelwise analysis 1

First level contrastPicture naming (all conditions, correct trials) 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?Yes, correct trials only
Is reaction time matched across the second level contrast?No, different
Behavioral data notesRT faster at T2
Type of analysisVoxelwise
Search volumeWhole brain
Correction for multiple comparisonsVoxelwise FWE correction
SoftwareSPM12
Voxelwise pFWE p < .05
Cluster extent
Statistical details
FindingsNone
Findings notes

ROI analysis 1

First level contrastPicture naming (untrained items, no cue, correct trials) vs picture naming (trained items, no cue, correct trials)
Analysis classCross-sectional correlation with language or other measure
Group(s)Aphasia T2
Covariate"a change in un-cued naming RT" (exact measure unclear)
Is the second level contrast valid in terms of the group(s), time point(s), and measures involved?Somewhat (unclear whether behavioral measure is longitudinal)
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 analysisRegions of interest (ROI)
ROI typeFunctional
How many ROIs are there?4
What are the ROI(s)?(1) R anterior insula; (2) R IFG; (3) dorsal anterior cingulate; (4) L premotor cortex
How are the ROI(s) defined?Peaks (only with SVC) for the main effect of untrained (4 conditions) vs trained (4 conditions) in T2 aphasia
Correction for multiple comparisonsNo correction
Statistical detailsUnclear what the behavioral measure was exactly
Findings↑ R IFG pars opercularis
↑ R insula
Findings notes

Notes

Excluded analysesMost analyses were between conditions in people with aphasia, so did not meet criteria for this review