title: Use of fMRI in the study of chronic aphasia recovery after therapy: a case study.
abstract: OBJECTIVE
  The role of intensity of aphasia therapy was investigated using functional magnetic resonance imaging (fMRI) to document changes in neural activation patterns associated with massed versus distributed therapy in an individual with chronic conduction aphasia.
  
  
  METHODS
  Language therapy targeted word-finding deficits and phonological processing. fMRI scans were acquired at baseline, after massed therapy, and after distributed therapy.
  
  
  RESULTS
  Treatment was effective, as demonstrated by increases in performance on standardized measures, narrative analysis, and task performance in the fMRI scanner. Task improvement across fMRI testing sessions corresponded with increases in fMRI blood oxygenation level dependent (BOLD) signal. Greatest behavioral gains and BOLD signal increases occurred after massed therapy, with slight gains accompanying distributed therapy. Increases in fMRI BOLD signal occurred after therapy in left basal ganglia and right hemisphere frontotemporal cortex.
  
  
  CONCLUSIONS
  Intensity of aphasia therapy impacts the recovery process and warrants additional research. Basal ganglia and right hemisphere structures may be important neural substrates for aphasia recovery.
authors.affiliation: Department of Neurology, University of Florida, Gainesville, Florida, USA.
authors.forename: Stacy M
authors.initials: SM
authors.lastname: Harnish
authors.forename: Jean
authors.initials: J
authors.lastname: Neils-Strunjas
authors.forename: Martine
authors.initials: M
authors.lastname: Lamy
authors.forename: James C
authors.initials: JC
authors.lastname: Eliassen
mesh_terms: D001037:Aphasia / Q000503:physiopathology / Q000534:rehabilitation* / Q000628:therapy*; D001479:Basal Ganglia / Q000502:physiology; D002540:Cerebral Cortex / Q000502:physiology; D002908:Chronic Disease; D004292:Dominance, Cerebral / Q000502:physiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D020127:Recovery of Function / Q000502:physiology*; D013070:Speech Therapy