Search

Background: Aphasia is a debilitating language impairment, affecting millions of people worldwide. About 40% of stroke survivors develop chronic aphasia, resulting in life-long disability. Objective: This review examines extrinsic and intrinsic neuromodulation techniques, aimed at enhancing the effects of speech and language therapies in stroke survivors with aphasia. Methods: We discuss the available evidence supporting the use of transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation, and functional MRI (fMRI) real-time neurofeedback in aphasia rehabilitation. Results: This review systematically evaluates studies focusing on efficacy and implementation of specialized methods for post-treatment outcome optimization and transfer to functional skills. It considers stimulation target determination and various targeting approaches. The translation of neuromodulation interventions to clinical practice is explored, emphasizing generalization and functional communication. The review also covers real-time fMRI neurofeedback, discussing current evidence for efficacy and essential implementation parameters. Finally, we address future directions for neuromodulation research in aphasia. Conclusions: This comprehensive review aims to serve as a resource for a broad audience of researchers and clinicians interested in incorporating neuromodulation for advancing aphasia care. [ABSTRACT FROM AUTHOR]

The modified Story Memory Technique (mSMT) is a memory rehabilitation program that combines training in visualization and context formation to improve learning and memory. Previous studies have shown improvement in learning and memory in individuals with multiple sclerosis (MS) after undergoing the mSMT, including changes in brain activity related to working memory and word encoding. The current study examined changes in brain activity in 16 individuals diagnosed with MS (n treatment = 6; n placebo control = 10) when they were presented with to-be-remembered information within a meaningful context (i.e. a paragraph) from before to after mSMT treatment. We expected treatment-related changes in brain activation in the language network (LAN), default mode network (DMN), and executive control network (ECN). Consistent with this prediction, fMRI results revealed reduced brain activation in the LAN, DMN and ECN after completing the mSMT treatment in the context of paragraph learning. While no significant behavioral changes were observed, a marginally significant improvement with a large effect size was noted between baseline and follow-up performance on the Rivermead Behavioral Memory Test in persons who completed treatment. Results are discussed in terms of the impact of imagery training on patterns of cerebral activation when learning words presented within a context. • Brain activation changes in MS during an fMRI task pre- and post-mSMT were examined. • Language, default mode, and executive control networks showed reduced activation. • mSMT is effective cognitive rehabilitation technique that leads to neuroplasticity. [ABSTRACT FROM AUTHOR]

Reading is an essential part of contemporary society, yet much is still unknown about the physiological underpinnings of its information processing components. Two influential cognitive models of reading, the connectionist and dual-route cascaded models, offer very different accounts, yet evidence for one or the other remains equivocal. These models differ in several ways, including the role of semantics (word meaning) in mapping spelling to sound. We used a new effective connectivity algorithm, IMaGES, to provide a network-level perspective on these network-level models. Left hemisphere regions of interest were defined based on main effects in functional magnetic resonance imaging and included two regions linked with semantic processing-ngular gyrus (AG) and inferior temporal sulcus (ITS)-and two regions linked with phonological processing-posterior superior temporal gyrus (pSTG) and posterior middle temporal gyrus (pMTG). Participants read aloud words of high or low spelling-sound consistency, word frequency, and imageability. Only the connectionist model predicted increased contributions from semantic areas with those computing phonology for low-consistency words. Effective connectivity analyses revealed that areas supporting semantic processing (e.g., the ITS) interacted with phonological areas (e.g., the pSTG), with the pattern changing as a function of word properties. Connectivity from semantic to phonological areas emerged for high- compared to low-imageability words, and a similar pattern emerged for low-consistency words, though only under certain conditions. Analyses of individual differences also showed that variation in the strength of modulation of ITS by AG was associated with reading aloud performance. Overall, these results suggest that connections with semantic processing areas are not only associated with reading aloud, but that these connections are also associated with optimal reading performance. [ABSTRACT FROM AUTHOR]

Functional disability due to spatial neglect hinders recovery in up to 30% of stroke survivors. Prism adaptation treatment (PAT) may alleviate the disabling consequences of spatial neglect, but we do not yet know why some individuals show much better outcomes following PAT than others. The goal of this scoping review and meta-analysis was to investigate the neural mechanisms underlying prism adaptation (PA). We conducted both quantitative and qualitative analyses across fMRI studies investigating brain activity before, during, and after PA, in healthy individuals and patients with right or left brain damage (RBD or LBD) due to stroke. In healthy adults, PA was linked with activity in posterior parietal and cerebellar clusters, reduced bilateral parieto-frontal connectivity, and increased fronto-limbic and sensorimotor network connectivity. In contrast, RBD individuals with spatial neglect relied on different circuits, including an activity cluster in the intact left occipital cortex. This finding is consistent with a shift in hemispheric dominance in spatial processing to the left hemisphere. However, more studies are needed to clarify the contribution of lesion location and load on the circuits involved in PA after unilateral brain damage. Future studies are also needed to clarify the relationship of decreasing resting state functional connectivity (rsFC) to visuomotor function. [ABSTRACT FROM AUTHOR]