Brain regions essential for improved lexical access in an aged aphasic patient: a case report.
BACKGROUND
The relationship between functional recovery after brain injury and concomitant neuroplastic changes is emphasized in recent research. In the present study we aimed to delineate brain regions essential for language performance in aphasia using functional magnetic resonance imaging and acquisition in a temporal sparse sampling procedure, which allows monitoring of overt verbal responses during scanning.


METHODS
An 80-year old patient with chronic aphasia (2 years post-onset) was investigated before and after intensive language training using an overt picture naming task. Differential brain activation in the right inferior frontal gyrus for correct word retrieval and errors was found. Improved language performance following therapy was mirrored by increased fronto-thalamic activation while stability in more general measures of attention/concentration and working memory was assured. Three healthy age-matched control subjects did not show behavioral changes or increased activation when tested repeatedly within the same 2-week time interval.


CONCLUSIONS
The results bear significance in that the changes in brain activation reported can unequivocally be attributed to the short-term training program and a language domain-specific plasticity process. Moreover, it further challenges the claim of a limited recovery potential in chronic aphasia, even at very old age. Delineation of brain regions essential for performance on a single case basis might have major implications for treatment using transcranial magnetic stimulation.
Meinzer
Marcus
M
University of Konstanz, Department of Psychology, Universitätsstr.10, P.O. Box 23, 78457 Konstanz, Germany. marcus.meinzer@uni-konstanz.de
Flaisch
Tobias
T
Obleser
Jonas
J
Assadollahi
Ramin
R
Djundja
Daniela
D
Barthel
Gabriela
G
Rockstroh
Brigitte
B
D000368:Aged; D000369:Aged, 80 and over; D001041:Aphasia, Wernicke / Q000209:etiology / Q000473:pathology* / Q000534:rehabilitation*; D001921:Brain / Q000098:blood supply / Q000503:physiopathology*; D001931:Brain Mapping; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007802:Language; D007808:Language Therapy / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods; D010100:Oxygen / Q000097:blood; D020521:Stroke / Q000150:complications; D014705:Verbal Behavior / Q000502:physiology
D010100:Oxygen