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  Dynamics of language reorganization after left temporo-parietal and frontal stroke

Stockert, A., Wawrzyniak, M., Klingbeil, J., Wrede, K., Kümmerer, D., Hartwigsen, G., et al. (2020). Dynamics of language reorganization after left temporo-parietal and frontal stroke. Brain, 143(3), 844-861. doi:10.1093/brain/awaa023.

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Item Permalink: http://hdl.handle.net/21.11116/0000-0006-3E2D-4 Version Permalink: http://hdl.handle.net/21.11116/0000-0006-3E2E-3
Genre: Journal Article

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 Creators:
Stockert, Anika1, Author              
Wawrzyniak, Max1, Author              
Klingbeil, Julian1, Author
Wrede, Katrin1, Author
Kümmerer, Dorothee2, Author
Hartwigsen, Gesa3, Author              
Kaller, Christoph P.2, Author
Weiller, Cornelius2, Author
Saur, Dorothee1, Author
Affiliations:
1Language & Aphasia Laboratory, Clinic for Cognitive Neurology, University of Leipzig, Germany, ou_persistent22              
2Department of Neurology, University Medical Center, Freiburg, Germany, ou_persistent22              
3Lise Meitner Research Group Cognition and Plasticity, MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_3025665              

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Free keywords: Language; Aphasia recovery; fMRI; Domain-general networks; Language networks
 Abstract: The loss and recovery of language functions are still incompletely understood. This longitudinal functional MRI study investigated the neural mechanisms underlying language recovery in patients with post-stroke aphasia putting particular emphasis on the impact of lesion site. To identify patterns of language-related activation, an auditory functional MRI sentence comprehension paradigm was administered to patients with circumscribed lesions of either left frontal (n = 17) or temporo-parietal (n = 17) cortex. Patients were examined repeatedly during the acute (≤1 week, t1), subacute (1-2 weeks, t2) and chronic phase (>6 months, t3) post-stroke; healthy age-matched control subjects (n = 17) were tested once. The separation into two patient groups with circumscribed lesions allowed for a direct comparison of the contributions of distinct lesion-dependent network components to language reorganization between both groups. We hypothesized that activation of left hemisphere spared and perilesional cortex as well as lesion-homologue cortex in the right hemisphere varies between patient groups and across time. In addition, we expected that domain-general networks serving cognitive control independently contribute to language recovery. First, we found a global network disturbance in the acute phase that is characterized by reduced functional MRI language activation including areas distant to the lesion (i.e. diaschisis) and subsequent subacute network reactivation (i.e. resolution of diaschisis). These phenomena were driven by temporo-parietal lesions. Second, we identified a lesion-independent sequential activation pattern with increased activity of perilesional cortex and bilateral domain-general networks in the subacute phase followed by reorganization of left temporal language areas in the chronic phase. Third, we observed involvement of lesion-homologue cortex only in patients with frontal but not temporo-parietal lesions. Fourth, irrespective of lesion location, language reorganization predominantly occurred in pre-existing networks showing comparable activation in healthy controls. Finally, we detected different relationships of performance and activation in language and domain-general networks demonstrating the functional relevance for language recovery. Our findings highlight that the dynamics of language reorganization clearly depend on lesion location and hence open new perspectives for neurobiologically motivated strategies of language rehabilitation, such as individually-tailored targeted application of neuro-stimulation.

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Language(s): eng - English
 Dates: 2019-11-252018-09-182019-12-162020-02-182020-03
 Publication Status: Published in print
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Type: -
 Identifiers: DOI: 10.1093/brain/awaa023
PMID: 32068789
 Degree: -

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Title: Brain
  Other : Brain
Source Genre: Journal
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Publ. Info: London : Macmillan
Pages: - Volume / Issue: 143 (3) Sequence Number: - Start / End Page: 844 - 861 Identifier: ISSN: 0006-8950
CoNE: https://pure.mpg.de/cone/journals/resource/954925385135