Aphasia Neuroplasticity Review

Skipper-Kallal et al. (2017b)

Reference

Authors	Skipper-Kallal LM, Lacey EH, Xing S, Turkeltaub PE
Title	Right hemisphere remapping of naming functions depends on lesion size and location in poststroke aphasia
Reference	Neural Plast 2017b; 2017: 8740353
PMID	28168061
DOI	10.1155/2017/8740353

Participants

Language	US English
Inclusion criteria	10% accuracy on scanner task
Number of individuals with aphasia	39 (plus 10 excluded: < 10% accuracy in scanner)
Number of control participants	37
Were any of the participants included in any previous studies?	Yes (29 of the participants overlap with the other Skipper-Kallal et al. (2017) paper)
Is age reported for patients and controls, and matched?	Yes (mean 59.8 ± 10.0 years)
Is sex reported for patients and controls, and matched?	Yes (males: 26; females: 13)
Is handedness reported for patients and controls, and matched?	Yes (right: 33; left: 4; other: 2; missing for 2 participants)
Is time post stroke onset reported and appropriate to the study design?	Yes (mean 52.9 ± 51.4 months, range 6.3-255.7 months)
To what extent is the nature of aphasia characterized?	Comprehensive battery
Language evaluation	WAB, PNT
Aphasia severity	Not stated
Aphasia type	23 anomic, 11 Broca's, 3 conduction, 1 transcortical sensory, 1 Wernicke's
First stroke only?	Not stated
Stroke type	Not stated
To what extent is the lesion distribution characterized?	Lesion overlay
Lesion extent	Not stated
Lesion location	L MCA
Participants notes	—

Imaging

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 (Siemens Trio 3 Tesla)
Is the timing of stimulus presentation and image acquisition clearly described and appropriate?	No* (moderate limitation) (total images acquired not stated; separation of adjacent events (covert and overt naming) will be limited because of the small amount of jitter in their timing (only 1500 ms))
Design type	Event-related
Total images acquired	~450 but not stated
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?	No* (moderate limitation) (not stated but see Skipper-Kallal et al. (2017b))
Is intersubject normalization adequately described and appropriate?	Yes
Imaging notes	at each voxel, individuals with lesions to that voxel were excluded from analysis

Conditions

Are the conditions clearly described?

Yes

Condition	Response type	Repetitions	All groups could do?	All individuals could do?
picture naming (prepare to name)	Word (covert)	32	Yes	Yes
picture naming (produce the name)	Word (overt)	32	Yes	Yes
rest	None	implicit baseline	N/A	N/A

Conditions notes

Covert and overt naming were modeled as two phases of each trial (there was a cue to produce the name after 7500-9000 ms); 14 participants who were more impaired were given easier pictures to name; patients who named less than 10% of items correctly were excluded

Contrasts

Are the contrasts clearly described?

Yes

Contrast 1: picture naming (prepare to name, correct trials) vs rest

Language condition	Picture naming (prepare to name, correct trials)
Control condition	Rest
Are the conditions matched for visual demands?	No
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?	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	—
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?	No
Are activations lateralized in the control data?	No
Control activation notes	Bilateral frontal and occipito-temporal, but not posterior temporal
Contrast notes	—

Contrast 2: picture naming (produce the name, correct trials) vs rest

Language condition	Picture naming (produce the name, correct trials)
Control condition	Rest
Are the conditions matched for visual demands?	No
Are the conditions matched for auditory demands?	No
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	—
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?	No
Are activations lateralized in the control data?	No
Control activation notes	Bilateral frontal and occipito-temporal, but not posterior temporal; speech motor activation not readily apparent
Contrast notes	—

Analyses

Are the analyses clearly described?

Yes

Voxelwise analysis 1

First level contrast	Picture naming (prepare to name, correct trials) vs 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?	Yes, correct trials only
Is reaction time matched across the second level contrast?	Unknown, not reported
Behavioral data notes	Covert phase but accuracy derived from overt phase
Type of analysis	Voxelwise
Search volume	Whole brain
Correction for multiple comparisons	Clusterwise correction with with GRFT and lenient voxelwise p
Software	FSL 5.0.6
Voxelwise p	.01
Cluster extent	Based on GRFT
Statistical details	—
Findings	↑ L cerebellum ↑ L thalamus ↑ L basal ganglia ↑ R IFG pars opercularis ↑ R insula ↑ R cerebellum ↑ R basal ganglia ↓ L dorsolateral prefrontal cortex ↓ L orbitofrontal ↓ L intraparietal sulcus ↓ L anterior cingulate ↓ R dorsolateral prefrontal cortex
Findings notes	Based on Table 2

Voxelwise analysis 2

First level contrast	Picture naming (produce the name, correct trials) vs 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?	Yes, correct trials only
Is reaction time matched across the second level contrast?	Unknown, not reported
Behavioral data notes	—
Type of analysis	Voxelwise
Search volume	Whole brain
Correction for multiple comparisons	Clusterwise correction with with GRFT and lenient voxelwise p
Software	FSL 5.0.6
Voxelwise p	.01
Cluster extent	Based on GRFT
Statistical details	—
Findings	↑ L somato-motor ↑ L intraparietal sulcus ↑ L anterior cingulate ↑ R insula ↑ R dorsal precentral ↑ R somato-motor ↑ R supramarginal gyrus ↑ R posterior MTG ↑ R Heschl's gyrus ↓ L ventral precentral/inferior frontal junction ↓ L somato-motor ↓ L posterior STG/STS/MTG ↓ L mid temporal ↓ L anterior temporal ↓ L cerebellum ↓ L thalamus ↓ L hippocampus/MTL
Findings notes	Based on Table 3

Voxelwise analysis 3

First level contrast	Picture naming (prepare to name, correct trials) vs rest
Analysis class	Cross-sectional correlation with language or other measure
Group(s)	Aphasia
Covariate	Lesion volume
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?	Yes, correct trials only
Is reaction time matched across the second level contrast?	Unknown, not reported
Behavioral data notes	Covert phase but accuracy derived from overt phase
Type of analysis	Voxelwise
Search volume	Whole brain
Correction for multiple comparisons	Clusterwise correction with with GRFT and lenient voxelwise p
Software	FSL 5.0.6
Voxelwise p	.01
Cluster extent	Based on GRFT
Statistical details	—
Findings	↑ L ventral precentral/inferior frontal junction ↑ L intraparietal sulcus ↑ L superior parietal ↑ L occipital ↑ L basal ganglia ↑ R IFG ↑ R insula ↑ R ventral precentral/inferior frontal junction ↑ R SMA/medial prefrontal ↑ R somato-motor ↑ R intraparietal sulcus ↑ R occipital ↑ R cerebellum ↑ R brainstem ↑ R basal ganglia
Findings notes	Based on Table 4, except for R frontal activations which are missing from the table, and were added based on the figure

Voxelwise analysis 4

First level contrast	Picture naming (produce the name, correct trials) vs rest
Analysis class	Cross-sectional correlation with language or other measure
Group(s)	Aphasia
Covariate	Lesion volume
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?	Yes, correct trials only
Is reaction time matched across the second level contrast?	Unknown, not reported
Behavioral data notes	—
Type of analysis	Voxelwise
Search volume	Whole brain
Correction for multiple comparisons	Clusterwise correction with with GRFT and lenient voxelwise p
Software	FSL 5.0.6
Voxelwise p	.01
Cluster extent	Based on GRFT
Statistical details	—
Findings	↑ L somato-motor ↑ L precuneus ↑ L occipital ↑ L cerebellum ↑ R IFG pars triangularis ↑ R insula ↑ R ventral precentral/inferior frontal junction ↑ R SMA/medial prefrontal ↑ R posterior STG/STS/MTG ↑ R mid temporal ↑ R occipital ↑ R cerebellum ↑ R basal ganglia ↑ R hippocampus/MTL
Findings notes	Based on Table 4, except for bilateral occipital activations which are missing from the table, and were added based on the figure

Voxelwise analysis 5

First level contrast	Picture naming (prepare to name, correct trials) vs rest
Analysis class	Cross-sectional between two groups with aphasia
Group(s)	Aphasia with IPS damage (n not stated) vs without IPS damage (n not stated)
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?	Yes, correct trials only
Is reaction time matched across the second level contrast?	Unknown, not reported
Behavioral data notes	Covert phase but accuracy derived from overt phase
Type of analysis	Voxelwise
Search volume	Whole brain
Correction for multiple comparisons	Clusterwise correction with with GRFT and lenient voxelwise p
Software	FSL 5.0.6
Voxelwise p	.01
Cluster extent	Based on GRFT
Statistical details	Lesion volume covariate
Findings	None
Findings notes	—

Voxelwise analysis 6

First level contrast	Picture naming (prepare to name, correct trials) vs rest
Analysis class	Cross-sectional between two groups with aphasia
Group(s)	Aphasia with insula damage (n = 18) vs without insula damage (n = 21)
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?	Yes, correct trials only
Is reaction time matched across the second level contrast?	Unknown, not reported
Behavioral data notes	Covert phase but accuracy derived from overt phase
Type of analysis	Voxelwise
Search volume	Whole brain
Correction for multiple comparisons	Clusterwise correction with with GRFT and lenient voxelwise p
Software	FSL 5.0.6
Voxelwise p	.01
Cluster extent	Based on GRFT
Statistical details	Lesion volume covariate
Findings	↓ R IFG pars triangularis ↓ R dorsolateral prefrontal cortex
Findings notes	—

Voxelwise analysis 7

First level contrast	Picture naming (prepare to name, correct trials) vs rest
Analysis class	Cross-sectional between two groups with aphasia
Group(s)	Aphasia with IFG POp damage (n = 16) vs without IFG POp damage (n = 23)
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?	Yes, correct trials only
Is reaction time matched across the second level contrast?	Unknown, not reported
Behavioral data notes	Covert phase but accuracy derived from overt phase
Type of analysis	Voxelwise
Search volume	Whole brain
Correction for multiple comparisons	Clusterwise correction with with GRFT and lenient voxelwise p
Software	FSL 5.0.6
Voxelwise p	.01
Cluster extent	Based on GRFT
Statistical details	Lesion volume covariate
Findings	↓ R IFG pars triangularis ↓ R dorsolateral prefrontal cortex
Findings notes	—

Voxelwise analysis 8

First level contrast	Picture naming (produce the name, correct trials) vs rest
Analysis class	Cross-sectional between two groups with aphasia
Group(s)	Aphasia with motor cortex damage (n = 24) vs without motor cortex damage (n = 15)
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?	Yes, correct trials only
Is reaction time matched across the second level contrast?	Unknown, not reported
Behavioral data notes	—
Type of analysis	Voxelwise
Search volume	Whole brain
Correction for multiple comparisons	Clusterwise correction with with GRFT and lenient voxelwise p
Software	FSL 5.0.6
Voxelwise p	.01
Cluster extent	Based on GRFT
Statistical details	Lesion volume covariate
Findings	None
Findings notes	—

Voxelwise analysis 9

First level contrast	Picture naming (produce the name, correct trials) vs rest
Analysis class	Cross-sectional between two groups with aphasia
Group(s)	Aphasia with STS damage (n not stated) vs without STS damage (n not stated)
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?	Yes, correct trials only
Is reaction time matched across the second level contrast?	Unknown, not reported
Behavioral data notes	—
Type of analysis	Voxelwise
Search volume	Whole brain
Correction for multiple comparisons	Clusterwise correction with with GRFT and lenient voxelwise p
Software	FSL 5.0.6
Voxelwise p	.01
Cluster extent	Based on GRFT
Statistical details	Lesion volume covariate
Findings	None
Findings notes	—

ROI analysis 1

First level contrast	Picture naming (prepare to name, correct trials) vs rest
Analysis class	Cross-sectional correlation with language or other measure
Group(s)	Aphasia with IFG POp damage (n = 16)
Covariate	PNT
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?	Yes, correct trials only
Is reaction time matched across the second level contrast?	Unknown, not reported
Behavioral data notes	Covert phase but accuracy derived from overt phase
Type of analysis	Region of interest (ROI)
ROI type	Functional
How many ROIs are there?	1
What are the ROI(s)?	R DLPFC
How are the ROI(s) defined?	Peak location for decreased activation for patients with left insula and left POp lesions compared to patients without said damage
Correction for multiple comparisons	One only
Statistical details	Lesion volume covariate
Findings	None
Findings notes	—

ROI analysis 2

First level contrast	Picture naming (prepare to name, correct trials) vs rest
Analysis class	Cross-sectional correlation with language or other measure
Group(s)	Aphasia without IFG POp damage (n = 23)
Covariate	PNT
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?	Yes, correct trials only
Is reaction time matched across the second level contrast?	Unknown, not reported
Behavioral data notes	Covert phase but accuracy derived from overt phase
Type of analysis	Region of interest (ROI)
ROI type	Functional
How many ROIs are there?	1
What are the ROI(s)?	R DLPFC
How are the ROI(s) defined?	Peak location for decreased activation for patients with left insula and left POp lesions compared to patients without said damage
Correction for multiple comparisons	One only
Statistical details	Lesion volume covariate
Findings	None
Findings notes	—

ROI analysis 3

First level contrast	Picture naming (prepare to name, correct trials) vs rest
Analysis class	Cross-sectional correlation with language or other measure
Group(s)	Aphasia with insula damage (n = 18)
Covariate	PNT
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?	Yes, correct trials only
Is reaction time matched across the second level contrast?	Unknown, not reported
Behavioral data notes	Covert phase but accuracy derived from overt phase
Type of analysis	Region of interest (ROI)
ROI type	Functional
How many ROIs are there?	1
What are the ROI(s)?	R DLPFC
How are the ROI(s) defined?	Peak location for decreased activation for patients with left insula and left POp lesions compared to patients without said damage
Correction for multiple comparisons	One only
Statistical details	Lesion volume covariate
Findings	None
Findings notes	—

ROI analysis 4

First level contrast	Picture naming (prepare to name, correct trials) vs rest
Analysis class	Cross-sectional correlation with language or other measure
Group(s)	Aphasia without insula damage (n = 21)
Covariate	PNT
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?	Yes, correct trials only
Is reaction time matched across the second level contrast?	Unknown, not reported
Behavioral data notes	Covert phase but accuracy derived from overt phase
Type of analysis	Region of interest (ROI)
ROI type	Functional
How many ROIs are there?	1
What are the ROI(s)?	R DLPFC
How are the ROI(s) defined?	Peak location for decreased activation for patients with left insula and left POp lesions compared to patients without said damage
Correction for multiple comparisons	One only
Statistical details	Lesion volume covariate
Findings	None
Findings notes	—

ROI analysis 5

First level contrast	Picture naming (prepare to name, correct trials) vs rest
Analysis class	Cross-sectional between two groups with aphasia
Group(s)	Aphasia with IPS damage (n not stated) vs without IPS damage (n not stated)
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?	Yes, correct trials only
Is reaction time matched across the second level contrast?	Unknown, not reported
Behavioral data notes	Covert phase but accuracy derived from overt phase
Type of analysis	Regions of interest (ROI)
ROI type	Functional
How many ROIs are there?	5
What are the ROI(s)?	(1) L IPS; (2) L insula; (3) L IFG pars opercularis; (4) R IPS; (5) R insula
How are the ROI(s) defined?	5 mm spheres around control peaks
Correction for multiple comparisons	No correction
Statistical details	Lesion volume covariate
Findings	None
Findings notes	—

ROI analysis 6

First level contrast	Picture naming (prepare to name, correct trials) vs rest
Analysis class	Cross-sectional between two groups with aphasia
Group(s)	Aphasia with insula damage (n = 18) vs without insula damage (n = 21)
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?	Yes, correct trials only
Is reaction time matched across the second level contrast?	Unknown, not reported
Behavioral data notes	Covert phase but accuracy derived from overt phase
Type of analysis	Regions of interest (ROI)
ROI type	Functional
How many ROIs are there?	5
What are the ROI(s)?	(1) L IPS; (2) L insula; (3) L IFG pars opercularis; (4) R IPS; (5) R insula
How are the ROI(s) defined?	5 mm spheres around control peaks
Correction for multiple comparisons	No correction
Statistical details	Lesion volume covariate
Findings	None
Findings notes	—

ROI analysis 7

First level contrast	Picture naming (prepare to name, correct trials) vs rest
Analysis class	Cross-sectional between two groups with aphasia
Group(s)	Aphasia with IFG POp damage (n = 16) vs without IFG POp damage (n = 23)
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?	Yes, correct trials only
Is reaction time matched across the second level contrast?	Unknown, not reported
Behavioral data notes	Covert phase but accuracy derived from overt phase
Type of analysis	Regions of interest (ROI)
ROI type	Functional
How many ROIs are there?	5
What are the ROI(s)?	(1) L IPS; (2) L insula; (3) L IFG pars opercularis; (4) R IPS; (5) R insula
How are the ROI(s) defined?	5 mm spheres around control peaks
Correction for multiple comparisons	No correction
Statistical details	Lesion volume covariate
Findings	None
Findings notes	—

ROI analysis 8

First level contrast	Picture naming (produce the name, correct trials) vs rest
Analysis class	Cross-sectional between two groups with aphasia
Group(s)	Aphasia with motor cortex damage (n = 24) vs without motor cortex damage (n = 15)
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?	Yes, correct trials only
Is reaction time matched across the second level contrast?	Unknown, not reported
Behavioral data notes	—
Type of analysis	Regions of interest (ROI)
ROI type	Functional
How many ROIs are there?	4
What are the ROI(s)?	(1) L motor; (2) L pSTS; (3) R motor; (4) R pSTS
How are the ROI(s) defined?	5 mm spheres around control peaks
Correction for multiple comparisons	No correction
Statistical details	Lesion volume covariate
Findings	↑ R somato-motor
Findings notes	—

ROI analysis 9

First level contrast	Picture naming (produce the name, correct trials) vs rest
Analysis class	Cross-sectional between two groups with aphasia
Group(s)	Aphasia with STS damage (n not stated) vs without STS damage (n not stated)
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?	Yes, correct trials only
Is reaction time matched across the second level contrast?	Unknown, not reported
Behavioral data notes	—
Type of analysis	Regions of interest (ROI)
ROI type	Functional
How many ROIs are there?	4
What are the ROI(s)?	(1) L motor; (2) L pSTS; (3) R motor; (4) R pSTS
How are the ROI(s) defined?	5 mm spheres around control peaks
Correction for multiple comparisons	No correction
Statistical details	Lesion volume covariate
Findings	↓ R somato-motor
Findings notes	—

ROI analysis 10

First level contrast	Picture naming (produce the name, correct trials) vs rest
Analysis class	Cross-sectional correlation with language or other measure
Group(s)	Aphasia without motor cortex damage (n = 15)
Covariate	PNT
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?	Yes, correct trials only
Is reaction time matched across the second level contrast?	Unknown, not reported
Behavioral data notes	—
Type of analysis	Region of interest (ROI)
ROI type	Functional
How many ROIs are there?	1
What are the ROI(s)?	R motor
How are the ROI(s) defined?	5 mm sphere around control peak
Correction for multiple comparisons	One only
Statistical details	Lesion volume covariate
Findings	None
Findings notes	—

ROI analysis 11

First level contrast	Picture naming (produce the name, correct trials) vs rest
Analysis class	Cross-sectional correlation with language or other measure
Group(s)	Aphasia with motor cortex damage (n = 24)
Covariate	PNT
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?	Yes, correct trials only
Is reaction time matched across the second level contrast?	Unknown, not reported
Behavioral data notes	—
Type of analysis	Region of interest (ROI)
ROI type	Functional
How many ROIs are there?	1
What are the ROI(s)?	R motor
How are the ROI(s) defined?	5 mm sphere around control peak
Correction for multiple comparisons	One only
Statistical details	Lesion volume covariate
Findings	↑ R somato-motor
Findings notes	—

Notes

Excluded analyses

—