title: Hidden word learning capacity through orthography in aphasia.
abstract: The ability to learn to use new words is thought to depend on the integrity of the left dorsal temporo-frontal speech processing pathway. We tested this assumption in a chronic aphasic individual (AA) with an extensive left temporal lesion using a new-word learning paradigm. She exhibited severe phonological problems and Magnetic Resonance Imaging (MRI) suggested a complete disconnection of this left-sided white-matter pathway comprising the arcuate fasciculus (AF). Diffusion imaging tractography confirmed the disconnection of the direct segment and the posterior indirect segment of her left AF, essential components of the left dorsal speech processing pathway. Despite her left-hemispheric damage and moderate aphasia, AA learned to name and maintain the novel words in her active vocabulary on par with healthy controls up to 6 months after learning. This exceeds previous demonstrations of word learning ability in aphasia. Interestingly, AA's preserved word learning ability was modality-specific as it was observed exclusively for written words. Functional magnetic resonance imaging (fMRI) revealed that in contrast to normals, AA showed a significantly right-lateralized activation pattern in the temporal and parietal regions when engaged in reading. Moreover, learning of visually presented novel word-picture pairs also activated the right temporal lobe in AA. Both AA and the controls showed increased activation during learning of novel versus familiar word-picture pairs in the hippocampus, an area critical for associative learning. AA's structural and functional imaging results suggest that in a literate person, a right-hemispheric network can provide an effective alternative route for learning of novel active vocabulary. Importantly, AA's previously undetected word learning ability translated directly into therapy, as she could use written input also to successfully re-learn and maintain familiar words that she had lost due to her left hemisphere lesion.
authors.affiliation: Department of Psychology and Logopedics, Abo Akademi University, Turku, Finland.
authors.forename: Leena M
authors.initials: LM
authors.lastname: Tuomiranta
authors.affiliation: Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Estela
authors.initials: E
authors.lastname: Càmara
authors.affiliation: Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College, London, UK.
authors.forename: Seán
authors.initials: S
authors.lastname: Froudist Walsh
authors.affiliation: Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Basic Psychology, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Ripollés
authors.affiliation: Medical Imaging Centre of Southwest Finland, Turku, Finland.
authors.forename: Jani P
authors.initials: JP
authors.lastname: Saunavaara
authors.affiliation: Medical Imaging Centre of Southwest Finland, Turku, Finland.
authors.forename: Riitta
authors.initials: R
authors.lastname: Parkkola
authors.affiliation: Department of Communication Sciences and Disorders, Eleanor M. Saffran Center for Cognitive Neuroscience, Temple University, Philadelphia, PA, USA.
authors.forename: Nadine
authors.initials: N
authors.lastname: Martin
authors.affiliation: Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Basic Psychology, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Rodríguez-Fornells
authors.affiliation: Department of Psychology and Logopedics, Abo Akademi University, Turku, Finland. Electronic address: matti.laine@abo.fi.
authors.forename: Matti
authors.initials: M
authors.lastname: Laine
mesh_terms: D000465:Algorithms; D001037:Aphasia / Q000209:etiology / Q000523:psychology* / Q000534:rehabilitation*; D016000:Cluster Analysis; D056324:Diffusion Tensor Imaging; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009434:Neural Pathways / Q000033:anatomy & histology / Q000502:physiology; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000523:psychology; D011597:Psychomotor Performance / Q000502:physiology; D011932:Reading; D013345:Subarachnoid Hemorrhage / Q000150:complications; D014706:Verbal Learning / Q000502:physiology*; D014825:Vocabulary
keywords: Anomia; Aphasia; Aphasia treatment; Learning; Vocabulary