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Neuroimage. 2019 Apr 15;190:14-31. doi: 10.1016/j.neuroimage.2017.11.056. Epub 2017 Nov 23.

Neuroimaging of stroke recovery from aphasia - Insights into plasticity of the human language network.

Author information

1
Research Group Modulation of Language Networks, Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany. Electronic address: hartwigsen@cbs.mpg.de.
2
Language & Aphasia Laboratory, Department of Neurology, University of Leipzig, Germany. Electronic address: dorothee.saur@medizin.uni-leipzig.de.

Abstract

The role of left and right hemisphere brain regions in language recovery after stroke-induced aphasia remains controversial. Here, we summarize how neuroimaging studies increase the current understanding of functional interactions, reorganization and plasticity in the language network. We first discuss the temporal dynamics across the time course of language recovery, with a main focus on longitudinal studies from the acute to the chronic phase after stroke. These studies show that the functional contribution of perilesional and spared left hemisphere as well as contralesional right hemisphere regions to language recovery changes over time. The second section introduces critical variables and recent advances on early prediction of subsequent outcome. In the third section, we outline how multi-method approaches that combine neuroimaging techniques with non-invasive brain stimulation elucidate mechanisms of plasticity and reorganization in the language network. These approaches provide novel insights into general mechanisms of plasticity in the language network and might ultimately support recovery processes during speech and language therapy. Finally, the neurobiological correlates of therapy-induced plasticity are discussed. We argue that future studies should integrate individualized approaches that might vary the combination of language therapy with specific non-invasive brain stimulation protocols across the time course of recovery. The way forward will include the combination of such approaches with large data sets obtained from multicentre studies.

KEYWORDS:

Broca; Functional magnetic resonance imaging (fMRI); Non-invasive brain stimulation; Plasticity; Reorganization; Speech

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