| Authors | Barbieri E, Mack J, Chiappetta B, Europa E, Thompson CK |
| Title | Recovery of offline and online sentence processing in aphasia: Language and domain-general network neuroplasticity |
| Reference | Cortex 2019; 120: 394-418 |
| PMID | 31419597 |
| DOI | 10.1016/j.cortex.2019.06.015 |
| Language | US English |
| Inclusion criteria | — |
| Number of individuals with aphasia | 18 (plus 1 excluded: developed a hematoma between baseline and post-testing) |
| Number of control participants | 23 |
| Were any of the participants included in any previous studies? | No |
| Is age reported for patients and controls, and matched? | No (range 22-73 years; controls were younger) |
| Is sex reported for patients and controls, and matched? | Yes (males: 11; females: 7) |
| Is handedness reported for patients and controls, and matched? | No (right: 15; left: 3; not stated for controls) |
| Is time post stroke onset reported and appropriate to the study design? | Yes (range 13-107 months) |
| To what extent is the nature of aphasia characterized? | Comprehensive battery |
| Language evaluation | WAB, Northwestern Assessment of Verbs and Sentences (NAVS), Northwestern Naming Battery (NNB), analysis of spontaneous speech (Cinderella story) using Northwestern Narrative Language Analysis (NNLA) protocol |
| Aphasia severity | AQ range 52.8-91.7 |
| Aphasia type | Not stated, except that "language deficits were consistent with nonfluent aphasia and agrammatism" |
| First stroke only? | Yes |
| Stroke type | Mixed etiologies |
| To what extent is the lesion distribution characterized? | Lesion overlay |
| Lesion extent | Not stated |
| Lesion location | Mostly L MCA but some lesions include PCA or ACA territory |
| Participants notes | One patient had two strokes within one day, but we would consider that essentially a single stroke |
| Modality | fMRI |
| Is the study cross-sectional or longitudinal? | Longitudinal—chronic treatment |
| If longitudinal, at what time point(s) were imaging data acquired? | T1: pre-treatment/chronic; T2: post-treatment, ~12 weeks later |
| If longitudinal, was there any intervention between the time points? | 13 patients were treated and 5 were not; treatment of underlying forms; 90 minutes/session, 2 sessions/week until 80% accuracy met on weekly probe task, then 1 session/week, 12 weeks except for one patient who demonstrated rapid improvement and completed treatment in 6 weeks |
| Is the scanner described? | Yes (Siemens Trio 3 Tesla or Siemens Prisma 3 Tesla) |
| Is the timing of stimulus presentation and image acquisition clearly described and appropriate? | No* (moderate limitation) (stimulus timing described does not match stated duration of data acquisition; timing of language and control trials not matched) |
| Design type | Block |
| Total images acquired | ~482 |
| 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 | 2 runs before treatment and 2 runs after treatment; each pair of runs took place on two separate days (1-7 days apart) |
| Are the conditions clearly described? | Yes |
| Condition | Response type | Repetitions | All groups could do? | All individuals could do? |
|---|---|---|---|---|
| auditory sentence-picture verification | Button press | 32 | Unknown | Unknown |
| listening to reversed speech and viewing scrambled pictures | Button press | 8 | Unknown | Unknown |
| Conditions notes | Based on the behavioral data obtained outside the scanner, it is likely that many patients were at chance on the language task |
| Are the contrasts clearly described? | No (see specific limitation(s) below) |
| Language condition | Auditory sentence-picture verification |
| Control condition | Listening to reversed speech and viewing scrambled pictures |
| Are the conditions matched for visual demands? | Yes |
| Are the conditions matched for auditory demands? | Yes |
| Are the conditions matched for motor demands? | Yes |
| Are the conditions matched for cognitive/executive demands? | No |
| Is accuracy matched between the language and control tasks for all relevant groups? | Unknown, not reported |
| Is reaction time matched between the language and control tasks for all relevant groups? | Unknown, not reported |
| Behavioral data notes | — |
| Are control data reported in this paper or another that is referenced? | Yes |
| Does the contrast selectively activate plausible relevant language regions in the control group? | Somewhat |
| Are activations lateralized in the control data? | Somewhat |
| Control activation notes | L-lateralized inferior frontal and posterior temporal, but also bilateral posterior inferior temporal and lateral occipital activations |
| Contrast notes | Contrast described as "passive > control" but seems to involve active and passive sentences |
| Are the analyses clearly described? | No* (moderate limitation) (see specific limitation(s) below) |
| First level contrast | Auditory sentence-picture verification vs listening to reversed speech and viewing scrambled pictures |
| Analysis class | Longitudinal change in aphasia |
| Group(s) | Aphasia treated (n = 13) T2 vs T1 |
| 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? | Unknown, not reported |
| Is reaction time matched across the second level contrast? | Unknown, not reported |
| Behavioral data notes | Out-of-scanner performance on passive sentences improved |
| Type of analysis | Voxelwise |
| Search volume | |
| Correction for multiple comparisons | Clusterwise correction based on 3dClustSim |
| Software | SPM8 |
| Voxelwise p | .001 |
| Cluster extent | 37 voxels (size not stated) |
| Statistical details | — |
| Findings | ↑ L precuneus ↑ R ventral precentral/inferior frontal junction ↑ R somato-motor ↑ R supramarginal gyrus ↑ R intraparietal sulcus ↑ R superior parietal ↑ R precuneus |
| Findings notes | Based on Table 7 and Figure 8 |
| First level contrast | Auditory sentence-picture verification vs listening to reversed speech and viewing scrambled pictures |
| Analysis class | Longitudinal change in aphasia |
| Group(s) | Aphasia natural history (n = 5) T2 vs T1 |
| 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? | Unknown, not reported |
| Is reaction time matched across the second level contrast? | Unknown, not reported |
| Behavioral data notes | — |
| Type of analysis | Voxelwise |
| Search volume | |
| Correction for multiple comparisons | Clusterwise correction based on 3dClustSim |
| Software | SPM8 |
| Voxelwise p | .001 |
| Cluster extent | 37 voxels (size not stated) |
| Statistical details | — |
| Findings | None |
| Findings notes | — |
| First level contrast | Auditory sentence-picture verification vs listening to reversed speech and viewing scrambled pictures |
| Analysis class | Longitudinal between two groups with aphasia |
| Group(s) | (Aphasia treated (n=13) T2 vs T1) vs (aphasia natural history (n=5) T2 vs T1) |
| 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? | Unknown, not reported |
| Is reaction time matched across the second level contrast? | Unknown, not reported |
| Behavioral data notes | — |
| Type of analysis | Regions of interest (ROI) |
| ROI type | Anatomical |
| How many ROIs are there? | 4 |
| What are the ROI(s)? | (1) L hemisphere sentence processing network (IFGpt, pMTG, pSTG, AG); (2) R hemisphere homotopic regions; (3) L dorsal attention network (MFG, PrCG, SPL, sLOC); (4) R dorsal attention network (same regions) |
| How are the ROI(s) defined? | Sentence processing network based on Walenski et al. (2019); dorsal attention network based on Corbetta et al. (2008) and Vincent et al. (2008); ROIs were defined based on Harvard-Oxford atlas which would align imperfectly with these functional networks; dependent variable was number of active voxels (p < .001, uncorrected) divided by number of intact voxels |
| Correction for multiple comparisons | No correction |
| Statistical details | Derivation of dependent measures from ROIs difficulty to follow, but it seems that ROIs with less than 5 voxels upregulated were excluded and deactivations were not considered, meaning that estimates of change may be biased |
| Findings | ↑ L dorsolateral prefrontal cortex ↑ L ventral precentral/inferior frontal junction ↑ L dorsal precentral ↑ L angular gyrus ↑ L intraparietal sulcus ↑ L superior parietal ↑ R dorsolateral prefrontal cortex ↑ R ventral precentral/inferior frontal junction ↑ R dorsal precentral ↑ R angular gyrus ↑ R intraparietal sulcus ↑ R superior parietal |
| Findings notes | Bilateral dorsal attention network; findings were for networks as a whole; regions coded correspond to atlas ROIs |
| First level contrast | Auditory sentence-picture verification vs listening to reversed speech and viewing scrambled pictures |
| Analysis class | Longitudinal correlation with language or other measure |
| Group(s) | Aphasia T2 vs T1 |
| Covariate | ∆ offline comprehension composite |
| 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? | Unknown, not reported |
| Is reaction time matched across the second level contrast? | Unknown, not reported |
| Behavioral data notes | — |
| Type of analysis | Regions of interest (ROI) |
| ROI type | Anatomical |
| How many ROIs are there? | 4 |
| What are the ROI(s)? | (1) L hemisphere sentence processing network (IFGpt, pMTG, pSTG, AG); (2) R hemisphere homotopic regions; (3) L dorsal attention network (MFG, PrCG, SPL, sLOC); (4) R dorsal attention network (same regions) |
| How are the ROI(s) defined? | Sentence processing network based on Walenski et al. (2019); dorsal attention network based on Corbetta et al. (2008) and Vincent et al. (2008); ROIs were defined based on Harvard-Oxford atlas which would align imperfectly with these functional networks; dependent variable was number of active voxels (p < .001, uncorrected) divided by number of intact voxels |
| Correction for multiple comparisons | No correction |
| Statistical details | Derivation of dependent measures from ROIs difficulty to follow, but it seems that ROIs with less than 5 voxels upregulated were excluded and deactivations were not considered, meaning that estimates of change may be biased |
| Findings | ↑ R IFG pars triangularis ↑ R dorsolateral prefrontal cortex ↑ R ventral precentral/inferior frontal junction ↑ R dorsal precentral ↑ R angular gyrus ↑ R intraparietal sulcus ↑ R superior parietal ↑ R posterior STG/STS/MTG |
| Findings notes | R homotopic sentence processing network and R dorsal attention network; findings were for networks as a whole; regions coded correspond to atlas ROIs |
| First level contrast | Auditory sentence-picture verification vs listening to reversed speech and viewing scrambled pictures |
| Analysis class | Longitudinal correlation with language or other measure |
| Group(s) | Aphasia participants with eye tracking data (n = 16) T2 vs T1 |
| Covariate | ∆ decrease in eye tracking online thematic prediction score |
| 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? | Unknown, not reported |
| Is reaction time matched across the second level contrast? | Unknown, not reported |
| Behavioral data notes | — |
| Type of analysis | Regions of interest (ROI) |
| ROI type | Anatomical |
| How many ROIs are there? | 4 |
| What are the ROI(s)? | (1) L hemisphere sentence processing network (IFGpt, pMTG, pSTG, AG); (2) R hemisphere homotopic regions; (3) L dorsal attention network (MFG, PrCG, SPL, sLOC); (4) R dorsal attention network (same regions) |
| How are the ROI(s) defined? | Sentence processing network based on Walenski et al. (2019); dorsal attention network based on Corbetta et al. (2008) and Vincent et al. (2008); ROIs were defined based on Harvard-Oxford atlas which would align imperfectly with these functional networks; dependent variable was number of active voxels (p < .001, uncorrected) divided by number of intact voxels |
| Correction for multiple comparisons | No correction |
| Statistical details | Derivation of dependent measures from ROIs difficulty to follow, but it seems that ROIs with less than 5 voxels upregulated were excluded and deactivations were not considered, meaning that estimates of change may be biased |
| Findings | ↑ R IFG pars triangularis ↑ R angular gyrus ↑ R posterior STG/STS/MTG |
| Findings notes | R homotopic sentence processing network; findings were for networks as a whole; regions coded correspond to atlas ROIs |
| First level contrast | Auditory sentence-picture verification vs listening to reversed speech and viewing scrambled pictures |
| Analysis class | Longitudinal correlation with language or other measure |
| Group(s) | Aphasia participants with eye tracking data (n = 16) T2 vs T1 |
| Covariate | ∆ eye tracking online thematic integragration score |
| 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? | Unknown, not reported |
| Is reaction time matched across the second level contrast? | Unknown, not reported |
| Behavioral data notes | — |
| Type of analysis | Regions of interest (ROI) |
| ROI type | Anatomical |
| How many ROIs are there? | 4 |
| What are the ROI(s)? | (1) L hemisphere sentence processing network (IFGpt, pMTG, pSTG, AG); (2) R hemisphere homotopic regions; (3) L dorsal attention network (MFG, PrCG, SPL, sLOC); (4) R dorsal attention network (same regions) |
| How are the ROI(s) defined? | Sentence processing network based on Walenski et al. (2019); dorsal attention network based on Corbetta et al. (2008) and Vincent et al. (2008); ROIs were defined based on Harvard-Oxford atlas which would align imperfectly with these functional networks; dependent variable was number of active voxels (p < .001, uncorrected) divided by number of intact voxels |
| Correction for multiple comparisons | No correction |
| Statistical details | Derivation of dependent measures from ROIs difficulty to follow, but it seems that ROIs with less than 5 voxels upregulated were excluded and deactivations were not considered, meaning that estimates of change may be biased |
| Findings | ↑ R dorsolateral prefrontal cortex ↑ R ventral precentral/inferior frontal junction ↑ R dorsal precentral ↑ R angular gyrus ↑ R intraparietal sulcus ↑ R superior parietal |
| Findings notes | R dorsal attention network; findings were for networks as a whole; regions coded correspond to atlas ROIs |
| Excluded analyses | Analysis of relationship between lesion volume with ROIs and functional changes in ROIs, because L and R hemisphere networks seem to be combined |
