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Functional MRI of Language in Aphasia: A Review of the Literature and the Methodological Challenges

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Abstract

Animal analogue studies show that damaged adult brains reorganize to accommodate compromised functions. In the human arena, functional magnetic resonance imaging (fMRI) and other functional neuroimaging techniques have been used to study reorganization of language substrates in aphasia. The resulting controversy regarding whether the right or the left hemisphere supports language recovery and treatment progress must be reframed. A more appropriate question is when left-hemisphere mechanisms and when right-hemisphere mechanisms support recovery of language functions. Small lesions generally lead to good recoveries supported by left-hemisphere mechanisms. However, when too much language eloquent cortex is damaged, right-hemisphere structures may provide the better substrate for recovery of language. Some studies suggest that recovery is particularly supported by homologues of damaged left-hemisphere structures. Evidence also suggests that under some circumstances, activity in both the left and right hemispheres can interfere with recovery of function. Further research will be needed to address these issues. However, daunting methodological problems must be managed to maximize the yield of future fMRI research in aphasia, especially in the area of language production. In this review, we cover six challenges for imaging language functions in aphasia with fMRI, with an emphasis on language production: (1) selection of a baseline task, (2) structure of language production trials, (3) mitigation of motion-related artifacts, (4) the use of stimulus onset versus response onset in fMRI analyses, (5) use of trials with correct responses and errors in analyses, and (6) reliability and stability of fMRI images across sessions. However, this list of methodological challenges is not exhaustive. Once methodology is advanced, knowledge from conceptually driven fMRI studies can be used to develop theoretically driven, mechanism-based treatments that will result in more effective therapy and to identify the best patient candidates for specific treatments. While the promise of fMRI in the study of aphasia is great, there is much work to be done before this technique will be a useful clinical tool.

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Acknowledgments

This research was supported by Research Career Scientist Award # B3470S and by Center of Excellence grant # F2182C and from the Department of Veterans Affairs Rehabilitation Research and Development Service, and by grants # P50 DC03888 and # R01 DC007387 from the National Institute on Deafness and Other Communication Disorders.

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Authors and Affiliations

  1. Department of Veterans Affairs Rehabilitation Research and Development Brain Rehabilitation Research Center at the Malcom Randall VA Medical Center, Gainesville, Florida, USA

    Bruce Crosson, Tim W. Conway, Megan G. Sherod, Christina E. Wierenga & Keith D. White

  2. University of Florida Department of Clinical and Health Psychology, Gainesville, Florida, USA

    Bruce Crosson, Tim W. Conway, Michelle Benjamin, Yu-Ling Chang, Megan G. Sherod & Christina E. Wierenga

  3. University of Florida, Department of Psychology, Gainesville, Florida, USA

    Keith McGregor & Keith D. White

  4. McKnight Brain Institute of the University of Florida, Gainesville, Florida, USA

    Bruce Crosson, Keith McGregor, Tim W. Conway & Keith D. White

  5. University of Texas Southwestern Medical School Department of Radiology, Dallas, Texas, USA

    Kaundinya S. Gopinath & Richard W. Briggs

  6. Aging Veterans with Vision Loss Center, Atlanta VA Medical Center, Atlanta, Georgia, USA

    Anna Bacon Moore

  7. Emory University, Department of Physical Medicine and Rehabilitation, Atlanta, Georgia, USA

    Anna Bacon Moore

  8. Old Dominion University Department of Early Childhood, Speech-Language Pathology, and Special Education, Norfolk, Virginia, USA

    Anastasia M. Raymer

  9. University of California, San Diego Department of Psychiatry, San Diego, California, USA

    Christina E. Wierenga

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  1. Bruce Crosson
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  2. Keith McGregor
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  3. Kaundinya S. Gopinath
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  5. Michelle Benjamin
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  11. Christina E. Wierenga
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  12. Keith D. White
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Correspondence to Bruce Crosson.

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Crosson, B., McGregor, K., Gopinath, K.S. et al. Functional MRI of Language in Aphasia: A Review of the Literature and the Methodological Challenges. Neuropsychol Rev 17, 157–177 (2007). https://doi.org/10.1007/s11065-007-9024-z

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  • DOI: https://doi.org/10.1007/s11065-007-9024-z

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