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Background: Group therapy has shown benefit in language recovery in patients with aphasia (PWA). However, many in the field question its role in improving quality of life for PWA, as well as whethe...

Background: Individuals with aphasia show difficulty producing sentences as a result of impaired syntactic production. Studies of structural priming in healthy speakers show that long-term ...

Background: Approximately, 38% of stroke survivors develop a language disorder known as aphasia. Aphasia can affect each language differentially and can lead to different language recovery patterns...

Background: Post-stroke loss and recovery of language functions evolves in time and space. A high functional dynamic can be observed in the first days and weeks after stroke, which has been associated with reorganisation processes in the left-lateralised language network, its right-hemisphere homologues and in the vicinity of the lesion site. With the advances in in vivo neuroimaging techniques, mapping changes in the language network over time (e.g., lesion extent, structural integrity of grey or white matter, task-based activity, functional or structural connectivity) is currently the focus of ongoing investigations.Main Contribution: This review highlights the recent findings on the neurobiology of language recovery from the hyperacute to the subacute phase after stroke. It relates pathophysiological processes of stroke evolution and the spatio-temporal characteristics of recovery patterns within the anatomically distributed language network to the behavioural dynamics of early language recovery.Conclu...

Background: The role of the right hemisphere (RH) in the recovery of language is quite controversial.Aims: The aim of the present survey consisted in taking into account three main models advanced to explain the reconstitution of language systems: (1) the “perilesional hypothesis,” which maintains that language recovery is mainly subsumed by left hemisphere (LH) tissue adjacent to the lesion; (2) the “right hemisphere hypothesis,” which assumes that restitution of language entails an increased participation of the RH; and (3) the “disinhibition hypothesis,” which maintains that recovery is facilitated by disruption of inhibitions exerted by RH regions over LH language areas.Methods & Procedures: The prognostic factors in poststroke aphasia are discussed first, focusing attention on factors that could subsume an increased participation of the RH to the recovery of language. Then results obtained with techniques of noninvasive brain stimulations of the RH are taken critically into account.Outcomes & Results...

In the past few years, noninvasive cerebral stimulations have been used to modulate language task performance in healthy and aphasic patients. In this study, a dual transcranial direct current stimulation (tDCS) on anterior and posterior language areas was applied for 2 weeks to a patient with a possible crossed aphasia following a right hemisphere stroke. Inhibitory cathodal stimulation of the right Brodmann areas (BA) 44/45 and simultaneous anodal stimulation of the left BA 44/45 improved the patient’s performance in picture naming. Conversely, the same bilateral montage on BA 39/40 did not produce any significant improvement; finally, electrode polarity inversion over BA 39/40 yielded a further improvement compared with the first anterior stimulation. Our findings suggest that ipsilesional and contralesional areas could be useful in poststroke functional reorganization and provide new evidences for the therapeutic value of tDCS in aphasia.

Background: The reacquisition of language after stroke may profit from intense training with several hours of language exercises provided on each training day, especially in the chronic stage. Despite the general effectiveness of this, few studies to date have examined which brain regions mediate successful language recovery as a result of intense training. This knowledge is particularly important because the necessity of several hours of language exercises each day draws a considerable amount of (a) attentional and cognitive resources from the patients and (b) financial and personnel resources from the health system. Aims: Not all aphasia patients may be equally suited for intense training approaches. Functional imaging studies of treatment‐induced recovery in chronic aphasia may provide answers to this question and may allow the target‐oriented allocation of aphasia patients to (intense) training in the future. In the following sections we will provide a comprehensive review of functional imaging studie...

This paper explores the process of language recovery in an English-Spanish bilingual six year old child. One of the first languages of the child had become passive, that is she was able to understand what was said to her in Spanish but she was no longer able to speak it. On a subsequent visit to a Spanish-speaking country data were gathered to piece together the process of her recovery of the production abilities in the language. This paper documents the rapid process of recovery that took place and, based on these results, considers the value of maintaining 'passive bilingualism' in children and examines the strategy employed by the family to achieve this. The paper contributes to the study of the language development of the bilingual and documents language change in progress. It also provides a positive alternative approach to maintaining bilingualism in children in contrast to the more 'strict/purist' line advocated in the literature on bilingualism.

We have assessed 26 aphasic patients, matched in pairs as closely as possible for personal data (age, sex, education), neurological damage suffered (nature, site and size of lesions) and characteristics of linguistic impairments (type of aphasic syndrome and severity of aphasia). These patients were therefore distinguishable only by the presence (n=13) or absence (n=13) of structured, systematic language therapy. The assignment to one group or the other was not random; rather, the patients who constitute the non-rehabilitated group could not, for logistic and/or familial reasons, attend language therapy sessions. Our findings confirm the effectiveness of language rehabilitation in aphasic disorders: at the end of 6 months of therapy the number of patients who met our criterion for improvement was significantly higher in the treated group in the expressive language modality. The rehabilitated and non-rehabilitated groups did not differ significantly at 4 months post-onset, while they did differ si...

Having determined the efficacy of aphasia therapy and the importance of early intervention, the next step to take in aphasia treatment research is ‘to accumulate clinical research designed to test hypotheses on the relative effectiveness of various approaches to treatment’ (LaPointe 1984, p. 307). Following LaPointe's advice this study examined two approaches to early aphasia treatment by further analysing data collected by Holland and colleagues (1983).

The respective contributions of the left and right cerebral hemispheres in the recovery from aphasia are a matter of debate. This paper is devoted to a review of several different sources of related clinical and experimental evidence: bilateral lesion cases, laterality studies in aphasics, neurophysiological and neuroimaging investigations. The data collected with these different approaches provide converging evidence for the contribution of both hemispheres to the process of language recovery. Time post-onset, as well as a number of lesion-related and individual differences, modulate the relative contribution of each hemisphere in the individual case.

This study evaluates the correlation of initial aphasia examination and several neuroradiologic variables with language recovery 1 year after the onset of global aphasia in 13 patients. Initial performance on language tests—particularly, auditory-verbal comprehension—is strongly correlated with outcome, while the neuroradiologic measures are not. While cerebral tissue characteristics may influence linguistic capabilities either acutely or chronically in the global aphasic patient, the initial language assessment appears to be more reliably associated with improvement than are CT indices of lesion characteristics.

The preliminary findings of a prospective study aimed at investigating changes in the language abilities of a group of children treated for posterior fossa tumours are reported. The results indicated that there is considerable variation in the effects of tumour treatment on language abilities in the period up to 28 months post-treatment, with the presence of residual language deficits being a possible, but not inevitable, outcome. Severe semantic-lexical deficits detected immediately post-treatment improved dramatically in the first six months after treatment.

The speech and language abilities of four subjects with CT scan documented dominant hemisphere striato-capsular haemorrhages were assessed at three, six and twelve months post-onset in order to document patterns of speech and language recovery. At three months post-onset, all the subjects studied presented with some aphasic features although the pattern of language disorder exhibited by the group was heterogeneous. At twelve months post-onset, all four had some degree of long-lasting deficit detected by the assessments used in the current study. The striato-capsular aphasics assessed here had variable lesion sites and aphasia types and did not display a homogeneous pattern of recovery, nor did they recover to the same extent. It is suggested that similar prognostic variables (e.g. size of the lesion, severity of the language disorder at onset) are operational in the recovery of aphasia whether the lesion site is cortical or subcortical. The possible mechanisms underlying the observed aphasias are...

The purpose of this study was a systematic examination of language recovery in a sample of left-handed aphasic patients (n = 19) with unilateral cerebrovascular lesions. Language behaviour was assessed using a wide range of measures from the Boston Diagnostic Aphasic Examination (BDAE) (Goodglass and Kaplan 1972), involving spontaneous speech output, auditory comprehension, repetition, naming, reading and writing. Overall, performance on the individual BDAE subtests was remarkably stable across testing sessions. When recovery did occur among these left-handers, it was most pronounced in the first 6 months, for comprehension functions, and for material processed at the single-word level. This pattern of recovery is similar to that which has been reported for right-handed aphasic patients.

Recovery of language function following brain injury has been attributed to various phenomena including spontaneous recovery of function, reduction of physiological symptoms (for example, reduced oedema), and to the transfer of function to surrounding cerebral structures. These explanations have been based on the concept of the left hemisphere as the sole processor of language. The present article reviews the research findings which provide evidence to support a hypothesis of right hemispheric compensation as one of the major mechanisms for language recovery/compensation in many aphasic patients.

Two chronic fluent aphasic patients were assessed on a range of standard, functional and linguistic measures at a testing interval of five years. Though no change was noted in the performance of either patient on the standard test, a shift was seen in both patients in functional communication and on certain syntactic and pragmatic dimensions. These shifts were interpreted within a framework of compensatory strategies. Certain processes common to both patients and related to increased communicative effectiveness are described and discussed. The chronic patient is viewed as an individual with potential for dynamic functional language change in certain aspects of communication not directly linked to the structural components of the message. Implications for therapy are discussed.

This paper reviews a number of studies with aphasic stroke patients after the acute stage. It is suggested that the main pathophysiological mechanism of recovery is a cortical functional reorganization involving both hemispheres and that the participation of the various cortical areas in the recovery process is not uniformly efficient. In some categories of aphasia there is a partial shift of language towards the right hemisphere. It is noted that information concerning the prognosis can be obtained from the analysis of the initial clinical picture (type and severity of aphasia), from CTScan data (size of the lesion when the infarct is cortico-subcortical) and from rCBF studies during functional tests. In general, the presence of widespread and important activation patterns in the left hemisphere characterizes the patients with a good prognosis and, moreover, in each clinical category of aphasia, the activation of some particular regions proves necessary for a good recovery.

A linguistic-manual paradigm involving the concurrent performance of a linguistic and index-finger tapping task was administered to five right-handed aphasic subjects exhibiting good speech and language recovery following a cerebrovascular accident in the post-rolandic region of the left hemisphere. The specific intent of this study was to establish the language lateralization of a group of aphasic subjects, according to the linguistic–manual paradigm, in order to investigate the role of the right hemisphere in aphasic language recovery. In addition, an attempt was made to relate the site and extent of cortical and/or subcortical damage, as derived from C.T. scans, to the language lateralization revealed by the paradigm. Collectively, the aphasic subjects displayed a relatively greater manual performance decrement for the left hand, than for the right under the concurrent expressive and receptive language conditions, implicating right hemisphere participation in the language functioning of the aphasic sub...

The involvement of sensory-motor factors in language recovery following left-hemisphere brain damage was investigated. GB, a right-handed male, three years post-onset of conduction jargonaphasia, was given a psychomotor treatment aimed at improving his speech-related sensory-motor function. Repeated language assessments showed marked improvements in a wide range of lexical language processes, but not in repetition or naming. Of special significance was the substantial reduction in jargon production and improved sublexical phonological targeting. It is suggested that the sensory-motor factors affecting GB's jargon-aphasia include feedback mechanisms and the modulation of low-level activity of the CNS.