Aphasia Neuroplasticity Review

Warren et al. (2009)

Reference

AuthorsWarren JE, Crinion JT, Lambon Ralph MA, Wise RJ
TitleAnterior temporal lobe connectivity correlates with functional outcome after aphasic stroke
ReferenceBrain 2009; 132: 3428-3442
PMID19903736
DOI10.1093/brain/awp270

Participants

LanguageUK English
Inclusion criteriaComprehension deficit per CAT and TROG (1 patient did not meet this criterion); anterolateral superior temporal cortex spared
Number of individuals with aphasia16 (plus 8 excluded: lesions involved L anterolateral superior temporal cortex)
Number of control participants11
Were any of the participants included in any previous studies?Yes (reanalysis of subset of dataset from Crinion et al. (2006))
Is age reported for patients and controls, and matched?No (mean 65.8 ± 2.0 SEM years; controls were younger)
Is sex reported for patients and controls, and matched?Yes (males: 11; females: 5)
Is handedness reported for patients and controls, and matched?Yes (right: 16; left: 0)
Is time post stroke onset reported and appropriate to the study design?No (mean 28.8 ± 9.2 months SEM; minimum time post onset not reported, but some patients in Crinion et al. (2006) were subacute)
To what extent is the nature of aphasia characterized?Not at all
Language evaluationCAT, TROG
Aphasia severityNot stated
Aphasia typeNot stated
First stroke only?Yes
Stroke typeIschemic only
To what extent is the lesion distribution characterized?Lesion overlay
Lesion extentPatients with positive anterior temporal interconnectivity: mean 93.3 ± 24.0 cc; patients with negative anterior temporal interconnectivity: mean 96.1 ± 27.6 cc
Lesion locationL not including anterolateral superior temporal cortex; maximal overlap in posterior superior temporal cortex
Participants notes

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 (10 patients and all controls) or GE Advance (6 patients))
Is the timing of stimulus presentation and image acquisition clearly described and appropriate?Yes
Design typePET
Total images acquired12-16
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 notestwo different scanners used for patients, but not for controls

Conditions

Are the conditions clearly described?Yes
ConditionResponse typeRepetitionsAll groups could do?All individuals could do?
listening to narrative speechNone6-8N/AN/A
listening to reversed speechNone6-8N/AN/A
Conditions notes

Contrasts

Are the contrasts clearly described?Yes

Contrast 1: listening to narrative speech vs listening to reversed speech

Language conditionListening to narrative speech
Control conditionListening to reversed speech
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?N/A, no behavioral measure
Is reaction time matched between the language and control tasks for all relevant groups?N/A, no timeable task
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?Somewhat
Control activation notes11 participants; L-lateralized posterior temporal, bilateral anterior temporal, no frontal
Contrast notes

Analyses

Are the analyses clearly described?Yes

ROI analysis 1

First level contrastListening to narrative speech vs listening to reversed speech
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?N/A, no behavioral measure
Is reaction time matched across the second level contrast?N/A, no timeable task
Behavioral data notes
Type of analysisRegions of interest (ROI)
ROI typeAnatomical
How many ROIs are there?6
What are the ROI(s)?(1) L anterior superior temporal cortex; (2) L basal temporal language area; (3) L IFG pars triangularis; (4-6) homotopic counterparts
How are the ROI(s) defined?ROIs were defined anatomically in regions that were functionally connected with L anterior superior temporal cortex in controls (1-4) or homotopic to these (5-6)
Correction for multiple comparisonsNo correction
Statistical detailsSomewhat circular because ROIs were defined only in regions where controls showed significant connectivity (even though ROIs were anatomical)
FindingsNone
Findings notesL IFG pars triangularis almost reached significance (p = .053) for more activation in patients

ROI analysis 2

First level contrastListening to narrative speech vs listening to reversed speech
Analysis classCross-sectional correlation with language or other measure
Group(s)Aphasia
CovariateAuditory sentence comprehension
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?N/A, no behavioral measure
Is reaction time matched across the second level contrast?N/A, no timeable task
Behavioral data notes
Type of analysisRegions of interest (ROI)
ROI typeAnatomical
How many ROIs are there?6
What are the ROI(s)?(1) L anterior superior temporal cortex; (2) L basal temporal language area; (3) L IFG pars triangularis; (4-6) homotopic counterparts
How are the ROI(s) defined?ROIs were defined anatomically in regions that were functionally connected with L anterior superior temporal cortex in controls (1-4) or homotopic to these (5-6)
Correction for multiple comparisonsNo correction
Statistical details
Findings↑ L anterior temporal
Findings notes

ROI analysis 3

First level contrastListening to narrative speech vs listening to reversed speech
Analysis classCross-sectional correlation with language or other measure
Group(s)Aphasia
CovariateWritten sentence comprehension
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?N/A, no behavioral measure
Is reaction time matched across the second level contrast?N/A, no timeable task
Behavioral data notes
Type of analysisRegions of interest (ROI)
ROI typeAnatomical
How many ROIs are there?6
What are the ROI(s)?(1) L anterior superior temporal cortex; (2) L basal temporal language area; (3) L IFG pars triangularis; (4-6) homotopic counterparts
How are the ROI(s) defined?ROIs were defined anatomically in regions that were functionally connected with L anterior superior temporal cortex in controls (1-4) or homotopic to these (5-6)
Correction for multiple comparisonsNo correction
Statistical details
FindingsNone
Findings notes

ROI analysis 4

First level contrastListening to narrative speech vs listening to reversed speech
Analysis classCross-sectional correlation with language or other measure
Group(s)Aphasia
CovariateAuditory single word comprehension
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?N/A, no behavioral measure
Is reaction time matched across the second level contrast?N/A, no timeable task
Behavioral data notes
Type of analysisRegions of interest (ROI)
ROI typeAnatomical
How many ROIs are there?6
What are the ROI(s)?(1) L anterior superior temporal cortex; (2) L basal temporal language area; (3) L IFG pars triangularis; (4-6) homotopic counterparts
How are the ROI(s) defined?ROIs were defined anatomically in regions that were functionally connected with L anterior superior temporal cortex in controls (1-4) or homotopic to these (5-6)
Correction for multiple comparisonsNo correction
Statistical details
FindingsNone
Findings notesL anterior temporal p = .08

ROI analysis 5

First level contrastListening to narrative speech vs listening to reversed speech
Analysis classCross-sectional correlation with language or other measure
Group(s)Aphasia
CovariateAuditory syntactic comprehension
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?N/A, no behavioral measure
Is reaction time matched across the second level contrast?N/A, no timeable task
Behavioral data notes
Type of analysisRegions of interest (ROI)
ROI typeAnatomical
How many ROIs are there?6
What are the ROI(s)?(1) L anterior superior temporal cortex; (2) L basal temporal language area; (3) L IFG pars triangularis; (4-6) homotopic counterparts
How are the ROI(s) defined?ROIs were defined anatomically in regions that were functionally connected with L anterior superior temporal cortex in controls (1-4) or homotopic to these (5-6)
Correction for multiple comparisonsNo correction
Statistical details
FindingsNone
Findings notesL anterior temporal p = .09

ROI analysis 6

First level contrastListening to narrative speech vs listening to reversed speech
Analysis classCross-sectional correlation with language or other measure
Group(s)Aphasia
CovariateConnectivity between L and R ATL
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?N/A, no behavioral measure
Is reaction time matched across the second level contrast?N/A, no timeable task
Behavioral data notes
Type of analysisRegions of interest (ROI)
ROI typeAnatomical
How many ROIs are there?2
What are the ROI(s)?(1) L anterior superior temporal cortex; (2) R anterior superior temporal cortex
How are the ROI(s) defined?ROIs were defined anatomically in regions that were functionally connected with L anterior superior temporal cortex in controls (1-4) or homotopic to these (5-6)
Correction for multiple comparisonsNo correction
Statistical details
FindingsNone
Findings notes

ROI analysis 7

First level contrastListening to narrative speech vs listening to reversed speech
Analysis classCross-sectional correlation with language or other measure
Group(s)Aphasia
CovariateTime post onset
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?N/A, no behavioral measure
Is reaction time matched across the second level contrast?N/A, no timeable task
Behavioral data notes
Type of analysisRegion of interest (ROI)
ROI typeAnatomical
How many ROIs are there?1
What are the ROI(s)?L anterior superior temporal cortex
How are the ROI(s) defined?ROIs were defined anatomically in regions that were functionally connected with L anterior superior temporal cortex in controls (1-4) or homotopic to these (5-6)
Correction for multiple comparisonsOne only
Statistical details
FindingsNone
Findings notes

ROI analysis 8

First level contrastListening to narrative speech vs listening to reversed speech
Analysis classCross-sectional correlation with language or other measure
Group(s)Aphasia
CovariateLesion volume
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?N/A, no behavioral measure
Is reaction time matched across the second level contrast?N/A, no timeable task
Behavioral data notes
Type of analysisRegion of interest (ROI)
ROI typeAnatomical
How many ROIs are there?1
What are the ROI(s)?L anterior superior temporal cortex
How are the ROI(s) defined?ROIs were defined anatomically in regions that were functionally connected with L anterior superior temporal cortex in controls (1-4) or homotopic to these (5-6)
Correction for multiple comparisonsOne only
Statistical details
FindingsNone
Findings notes

ROI analysis 9

First level contrastListening to narrative speech vs listening to reversed speech
Analysis classCross-sectional aphasia vs control
Group(s)Aphasia with positive anterior temporal interconnectivity (n = 8) 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?N/A, no behavioral measure
Is reaction time matched across the second level contrast?N/A, no timeable task
Behavioral data notes
Type of analysisRegions of interest (ROI)
ROI typeAnatomical
How many ROIs are there?6
What are the ROI(s)?(1) L anterior superior temporal cortex; (2) L basal temporal language area; (3) L IFG pars triangularis; (4-6) homotopic counterparts
How are the ROI(s) defined?ROIs were defined anatomically in regions that were functionally connected with L anterior superior temporal cortex in controls (1-4) or homotopic to these (5-6)
Correction for multiple comparisonsNo correction
Statistical detailsSomewhat circular because ROIs were defined only in regions where controls showed significant connectivity (even though ROIs were anatomical); excluded 3 patients with L IFG damage
Findings↑ L IFG pars triangularis
Findings notes

ROI analysis 10

First level contrastListening to narrative speech vs listening to reversed speech
Analysis classCross-sectional aphasia vs control
Group(s)Aphasia with negative anterior temporal interconnectivity (n = 8) 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?N/A, no behavioral measure
Is reaction time matched across the second level contrast?N/A, no timeable task
Behavioral data notes
Type of analysisRegions of interest (ROI)
ROI typeAnatomical
How many ROIs are there?6
What are the ROI(s)?(1) L anterior superior temporal cortex; (2) L basal temporal language area; (3) L IFG pars triangularis; (4-6) homotopic counterparts
How are the ROI(s) defined?ROIs were defined anatomically in regions that were functionally connected with L anterior superior temporal cortex in controls (1-4) or homotopic to these (5-6)
Correction for multiple comparisonsNo correction
Statistical detailsSomewhat circular because ROIs were defined only in regions where controls showed significant connectivity (even though ROIs were anatomical); excluded 1 patient with L IFG damage
FindingsNone
Findings notes

ROI analysis 11

First level contrastListening to narrative speech vs listening to reversed speech
Analysis classCross-sectional between two groups with aphasia
Group(s)Aphasia with positive anterior temporal interconnectivity (n = 8) vs with negative anterior temporal interconnectivity (n = 8)
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?N/A, no behavioral measure
Is reaction time matched across the second level contrast?N/A, no timeable task
Behavioral data notes
Type of analysisRegions of interest (ROI)
ROI typeAnatomical
How many ROIs are there?6
What are the ROI(s)?(1) L anterior superior temporal cortex; (2) L basal temporal language area; (3) L IFG pars triangularis; (4-6) homotopic counterparts
How are the ROI(s) defined?ROIs were defined anatomically in regions that were functionally connected with L anterior superior temporal cortex in controls (1-4) or homotopic to these (5-6)
Correction for multiple comparisonsNo correction
Statistical detailsExcluded 4 patients with L IFG damage
Findings↑ L IFG pars triangularis
Findings notes

Complex analysis 1

First level contrastListening to narrative speech vs listening to reversed speech
Analysis classCross-sectional correlation with language or other measure
Group(s)Aphasia
CovariateLesion status of each voxel
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?N/A, no behavioral measure
Is reaction time matched across the second level contrast?N/A, no timeable task
Behavioral data notes
Type of analysisComplex
Statistical detailsVLSM with FDR correction was used to identify any regions in which damage was predictive of L anterior temporal activation.
FindingsNone
Findings notes

Notes

Excluded analyses(1) all connectivity analyses because they were based on either both conditions (whole brain analysis) or only the narrative condition (ROI analyses), except where connectivity was investigated in relation to task-based activation differences; (2) correlation with age (covariate not language-related)