Document Detail

Role of the right and left hemispheres in recovery of function during treatment of intention in aphasia.
MedLine Citation:
PMID:  15814000     Owner:  NLM     Status:  MEDLINE    
Two patients with residual nonfluent aphasia after ischemic stroke received an intention treatment that was designed to shift intention and language production mechanisms from the frontal lobe of the damaged left hemisphere to the right frontal lobe. Consistent with experimental hypotheses, the first patient showed improvement on the intention treatment but not on a similar attention treatment. In addition, in keeping with experimental hypotheses, the patient showed a shift of activity to right presupplementary motor area and the right lateral frontal lobe from pre- to post-intention treatment functional magnetic resonance imaging (fMRI) of language production. In contrast, the second patient showed improvement on both the intention and attention treatments. During pre-treatment fMRI, she already showed lateralization of intention and language production mechanisms to the right hemisphere that continued into post-intention treatment imaging. From pre- to post-treatment fMRI of language production, both patients demonstrated increased activity in the posterior perisylvian cortex, although this activity was lateralized to left-hemisphere language areas in the second but not the first patient. The fact that the first patient's lesion encompassed almost all of the dominant basal ganglia and thalamus whereas the second patient's lesion spared these structures suggests that the dominant basal ganglia could play a role in spontaneous reorganization of language production functions to the right hemisphere. Implications regarding the theoretical framework for the intention treatment are discussed.
Bruce Crosson; Anna Bacon Moore; Kaundinya Gopinath; Keith D White; Christina E Wierenga; Megan E Gaiefsky; Katherine S Fabrizio; Kyung K Peck; David Soltysik; Christina Milsted; Richard W Briggs; Tim W Conway; Leslie J Gonzalez Rothi
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of cognitive neuroscience     Volume:  17     ISSN:  0898-929X     ISO Abbreviation:  J Cogn Neurosci     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-04-07     Completed Date:  2005-05-27     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8910747     Medline TA:  J Cogn Neurosci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  392-406     Citation Subset:  IM    
Malcom Randall Veterans Affairs Medical Center, Gainesville, FL, USA.
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MeSH Terms
Aphasia / physiopathology,  therapy*
Attention / physiology
Brain Mapping
Frontal Lobe / blood supply,  pathology,  physiopathology*
Functional Laterality / physiology*
Image Processing, Computer-Assisted / methods
Intensive Care / methods*
Language Tests
Magnetic Resonance Imaging / methods
Middle Aged
Oxygen / blood
Recovery of Function / physiology*
Time Factors
Treatment Outcome
Grant Support
Reg. No./Substance:

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