| Authors | Robson H, Zahn R, Keidel JL, Binney RJ, Sage K, Lambon Ralph MA |
| Title | The anterior temporal lobes support residual comprehension in Wernicke's aphasia |
| Reference | Brain 2014; 137: 931-943 |
| PMID | 24519979 |
| DOI | 10.1093/brain/awt373 |
| Language | UK English |
| Inclusion criteria | Wernicke's aphasia (impaired spoken single word comprehension, impaired single word repetition, fluent, sentence-like speech with phonological/neologistic errors) |
| Number of individuals with aphasia | 12 |
| Number of control participants | 12 |
| Were any of the participants included in any previous studies? | No |
| Is age reported for patients and controls, and matched? | Yes (mean 70.1 ± 8.7 years, range 59-87 years) |
| Is sex reported for patients and controls, and matched? | Yes (males: 10; females: 2) |
| Is handedness reported for patients and controls, and matched? | Yes (right: 12; left: 0) |
| Is time post stroke onset reported and appropriate to the study design? | Yes (range 7-84 months) |
| To what extent is the nature of aphasia characterized? | Comprehensive battery |
| Language evaluation | BDAE, PPT, word-to-picture matching test from Cambridge Semantic Battery, single word reading aloud from PALPA |
| Aphasia severity | BDAE comprehension range 6-26 (out of 32); BDAE comprehension scores and percentiles do not seem entirely commensurate |
| Aphasia type | All Wernicke's |
| First stroke only? | Yes |
| Stroke type | Mixed etiologies |
| To what extent is the lesion distribution characterized? | Lesion overlay |
| Lesion extent | Not stated |
| Lesion location | L MCA; all involved STG extending into IPL and temporoparietal junction; 8 extending into MTL; 4 extending into inferior frontal |
| Participants notes | — |
| Modality | fMRI |
| Is the study cross-sectional or longitudinal? | Cross-sectional |
| If longitudinal, at what time point(s) were imaging data acquired? | — |
| If longitudinal, was there any intervention between the time points? | — |
| Is the scanner described? | Yes (Philips Achieva 3 Tesla) |
| Is the timing of stimulus presentation and image acquisition clearly described and appropriate? | No* (moderate limitation) (each condition was acquired in a separate run, which is suboptimal) |
| Design type | Block |
| Total images acquired | 417 |
| Are the imaging acquisition parameters, including coverage, adequately described and appropriate? | Yes (whole brain) |
| Is preprocessing and intrasubject coregistration adequately described and appropriate? | Yes |
| Is first level model fitting adequately described and appropriate? | Yes |
| Is intersubject normalization adequately described and appropriate? | Yes |
| Imaging notes | spin echo fMRI to minimize ATL dropout |
| Are the conditions clearly described? | Yes |
| Condition | Response type | Repetitions | All groups could do? | All individuals could do? |
|---|---|---|---|---|
| semantic decision (written word) | Button press | 16 | Yes | No |
| semantic decision (picture) | Button press | 16 | Yes | No |
| visual decision | Button press | 16 | Yes | No |
| rest | None | 48 | N/A | N/A |
| Conditions notes | — |
| Are the contrasts clearly described? | No (see specific limitation(s) below) |
| Language condition | Semantic decision (written word and picture) |
| Control condition | Visual decision and rest |
| Are the conditions matched for visual demands? | No |
| Are the conditions matched for auditory demands? | Yes |
| Are the conditions matched for motor demands? | No |
| Are the conditions matched for cognitive/executive demands? | No |
| Is accuracy matched between the language and control tasks for all relevant groups? | N/A, tasks not comparable |
| Is reaction time matched between the language and control tasks for all relevant groups? | N/A, tasks not comparable |
| Behavioral data notes | Not comparable because the control condition includes rest |
| Are control data reported in this paper or another that is referenced? | Somewhat |
| Does the contrast selectively activate plausible relevant language regions in the control group? | Somewhat |
| Are activations lateralized in the control data? | No |
| Control activation notes | Control data are provided in Table 6 for contrasts of written word semantic decision vs dual baseline, and picture semantic decision vs dual baseline, but not for the main effect of semantic decision; these data suggest that the contrast activates ventral temporal regions bilaterally |
| Contrast notes | Two contrasts are described: (1) written word judgment versus a dual baseline of visual judgment and rest; (2) picture judgment versus a dual baseline of visual judgment and rest; these two primary contrasts are reported in patients and controls separately, but no between-group contrasts are reported, so these contrasts are excluded from our review; rather, the between-groups analyses in the paper take the form of ANOVAs; the main effect of group in these ANOVAs collapses across the two described contrasts, therefore we have coded the contrast as the average of the two described contrasts; the exact nature of the computation of dual baseline contrasts is not described |
| Are the analyses clearly described? | No* (moderate limitation) (see specific limitation(s) below) |
| First level contrast | Semantic decision (written word and picture) vs visual decision and rest |
| Analysis class | Cross-sectional aphasia vs control |
| Group(s) | Aphasia vs control |
| Covariate | — |
| Is the second level contrast valid in terms of the group(s), time point(s), and measures involved? | Yes |
| Is accuracy matched across the second level contrast? | No, different |
| Is reaction time matched across the second level contrast? | No, different |
| Behavioral data notes | Patients also less accurate on control condition, but control condition includes rest so coded based on language condition only |
| Type of analysis | Voxelwise |
| Search volume | Whole brain |
| Correction for multiple comparisons | Clusterwise correction based on arbitrary cluster extent |
| Software | SPM8 |
| Voxelwise p | .005 |
| Cluster extent | 4 voxels (size not stated) |
| Statistical details | Dual baseline computation not explained |
| Findings | ↑ L IFG pars orbitalis ↑ L mid temporal ↑ L anterior temporal ↑ L cerebellum ↑ L hippocampus/MTL ↑ R mid temporal ↑ R anterior temporal ↑ R posterior inferior temporal gyrus/fusiform gyrus ↑ R cerebellum ↑ R hippocampus/MTL ↓ R posterior cingulate |
| Findings notes | — |
| First level contrast | Semantic decision (written word and picture) vs visual decision and rest |
| Analysis class | Cross-sectional aphasia vs control |
| Group(s) | Aphasia vs control |
| Covariate | — |
| Is the second level contrast valid in terms of the group(s), time point(s), and measures involved? | Yes |
| Is accuracy matched across the second level contrast? | No, different |
| Is reaction time matched across the second level contrast? | No, different |
| Behavioral data notes | Patients also less accurate on control condition, but control condition includes rest so coded based on language condition only |
| Type of analysis | Regions of interest (ROI) |
| ROI type | Functional |
| How many ROIs are there? | 10 |
| What are the ROI(s)? | (1) L anterior fusiform gyrus; (2) L temporal pole; (3) L anterior STS; (4) L IFG; (5) L ventral occipito-temporal; (6-10) homotopic counterparts |
| How are the ROI(s) defined? | Spheres around functional peaks from literature |
| Correction for multiple comparisons | No correction |
| Statistical details | Dual baseline computation not explained |
| Findings | ↑ L anterior temporal ↑ L posterior inferior temporal gyrus/fusiform gyrus ↑ R posterior inferior temporal gyrus/fusiform gyrus |
| Findings notes | — |
| Excluded analyses | (1) main effect of condition (written words vs pictures); (2) interactions of condition by group (all of which were non-significant); (3) additional analyses were run including only participants who performed above chance, and only correct responses from all participants, but these gave essentially similar results |
