Aphasia Neuroplasticity Review

Blank et al. (2003)

Reference

Authors	Blank SC, Bird H, Turkheimer F, Wise RJ
Title	Speech production after stroke: the role of the right pars opercularis
Reference	Ann Neurol 2003; 54: 310-320
PMID	12953263
DOI	10.1002/ana.10656

Participants

Language	UK English
Inclusion criteria	Initial non-fluent aphasia due to anterior perisylvian lesion; subsequently recovered the ability to speak in sentences; patients were divided into those with and without damage to the IFG pars opercularis (POp+: n = 7; POp-: n = 7)
Number of individuals with aphasia	14
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 (POp+: median 50 years, range 36-72 years; POp-: median 61 years, range 39-70 years)
Is sex reported for patients and controls, and matched?	Yes (males: 8; females: 6)
Is handedness reported for patients and controls, and matched?	Yes (right: 14; left: 0)
Is time post stroke onset reported and appropriate to the study design?	Yes (POp+: median 39 months, range 19-134 months; POp-: median 17 months, range 6-240 months)
To what extent is the nature of aphasia characterized?	Type only
Language evaluation	CAT, QPA
Aphasia severity	Not stated
Aphasia type	POp+: 4 non-fluent but not agrammatic, 2 agrammatic, 1 recovered; POp-: 4 non-fluent but not agrammatic, 3 recovered
First stroke only?	No
Stroke type	Not stated
To what extent is the lesion distribution characterized?	Individual lesions
Lesion extent	Not stated
Lesion location	L frontal, occasionally extending into temporal
Participants notes	8 of 12 controls included in Blank et al. (2002)

Imaging

Modality	PET (rCBF)
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 (CTI-Siemens ECAT EXACT HR++ (966))
Is the timing of stimulus presentation and image acquisition clearly described and appropriate?	Yes
Design type	PET
Total images acquired	15 (patients); 12 (controls)
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	—

Conditions

Are the conditions clearly described?

Yes

Condition	Response type	Repetitions	All groups could do?	All individuals could do?
propositional speech production	Sentence (overt)	aphasia: 5; control: 4	Yes	Yes
counting	Multiple words (overt)	aphasia: 5; control: 4	Yes	Yes
rest	None	aphasia: 5; control: 4	N/A	N/A

Conditions notes

Alertness maintained in rest by asking participants to listen to environmental sounds that were presented before and after data acquisition; speech was recorded and rate was measured, also QPA was done of a separate speech sample outside the scanner

Contrasts

Are the contrasts clearly described?

Yes

Contrast 1: propositional speech production vs rest

Language condition	Propositional speech production
Control condition	Rest
Are the conditions matched for visual demands?	Yes
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?	Somewhat
Are activations lateralized in the control data?	Somewhat
Control activation notes	Much bilateral activation due to overt speech but pars opercularis and supratemporal plane L-lateralized
Contrast notes	—

Contrast 2: propositional speech production vs counting

Language condition	Propositional speech production
Control condition	Counting
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?	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?	Somewhat
Are activations lateralized in the control data?	Somewhat
Control activation notes	Extrasylvian; somewhat L-lateralized
Contrast notes	—

Analyses

Are the analyses clearly described?

Yes

Voxelwise analysis 1

First level contrast	Propositional speech production vs rest
Analysis class	Cross-sectional aphasia vs control
Group(s)	Aphasia with IFG POp damage (n = 7) 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?	N/A, no timeable task
Behavioral data notes	Word rates not reported, but offline speech sample differed
Type of analysis	Voxelwise
Search volume	Voxels spared in all patients
Correction for multiple comparisons	Small volume correction
Software	SPM99
Voxelwise p	FWE p < .05 with SVC in R pars opercularis
Cluster extent	—
Statistical details	—
Findings	↑ R IFG pars opercularis
Findings notes	No voxels survived FWE correction without SVC

Voxelwise analysis 2

First level contrast	Propositional speech production vs rest
Analysis class	Cross-sectional aphasia vs control
Group(s)	Aphasia without IFG POp damage (n = 7) 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?	N/A, no timeable task
Behavioral data notes	Word rates not reported, but offline speech sample differed
Type of analysis	Voxelwise
Search volume	Voxels spared in all patients
Correction for multiple comparisons	Small volume correction
Software	SPM99
Voxelwise p	FWE p < .05 with SVC in R pars opercularis
Cluster extent	—
Statistical details	—
Findings	↑ R IFG pars opercularis
Findings notes	—

Voxelwise analysis 3

First level contrast	Propositional speech production vs rest
Analysis class	Cross-sectional between two groups with aphasia
Group(s)	Aphasia with IFG POp damage (n = 7) vs without IFG POp damage (n = 7)
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?	N/A, no timeable task
Behavioral data notes	Word rates not reported, but offline speech sample differed
Type of analysis	Voxelwise
Search volume	Voxels spared in all patients
Correction for multiple comparisons	Small volume correction
Software	SPM99
Voxelwise p	FWE p < .05 with SVC in R pars opercularis
Cluster extent	—
Statistical details	—
Findings	None
Findings notes	Patients with L IFG POp damage showed numerically more signal in the R IFG POp

Voxelwise analysis 4

First level contrast	Propositional speech production vs counting
Analysis class	Cross-sectional aphasia vs control
Group(s)	Aphasia with IFG POp damage (n = 7) 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?	N/A, no timeable task
Behavioral data notes	Word rates not reported, but offline speech sample differed
Type of analysis	Voxelwise
Search volume	Voxels spared in all patients
Correction for multiple comparisons	Small volume correction
Software	SPM99
Voxelwise p	FWE p < .05 with SVC in R pars opercularis
Cluster extent	—
Statistical details	—
Findings	None
Findings notes	—

Voxelwise analysis 5

First level contrast	Propositional speech production vs counting
Analysis class	Cross-sectional aphasia vs control
Group(s)	Aphasia without IFG POp damage (n = 7) 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?	N/A, no timeable task
Behavioral data notes	Word rates not reported, but offline speech sample differed
Type of analysis	Voxelwise
Search volume	Voxels spared in all patients
Correction for multiple comparisons	Small volume correction
Software	SPM99
Voxelwise p	FWE p < .05 with SVC in R pars opercularis
Cluster extent	—
Statistical details	—
Findings	None
Findings notes	—

Voxelwise analysis 6

First level contrast	Propositional speech production vs counting
Analysis class	Cross-sectional between two groups with aphasia
Group(s)	Aphasia with IFG POp damage (n = 7) vs without IFG POp damage (n = 7)
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?	N/A, no timeable task
Behavioral data notes	Word rates not reported, but offline speech sample differed
Type of analysis	Voxelwise
Search volume	Voxels spared in all patients
Correction for multiple comparisons	Small volume correction
Software	SPM99
Voxelwise p	FWE p < .05 with SVC in R pars opercularis
Cluster extent	—
Statistical details	—
Findings	None
Findings notes	—

ROI analysis 1

First level contrast	Propositional speech production vs rest
Analysis class	Cross-sectional correlation with language or other measure
Group(s)	Aphasia with IFG POp damage (n = 7)
Covariate	Speech rate during scan
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?	N/A, no timeable task
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 IFG pars opercularis
How are the ROI(s) defined?	Defined by flipping L IFG pars opercularis activation in controls
Correction for multiple comparisons	One only
Statistical details	—
Findings	None
Findings notes	—

ROI analysis 2

First level contrast	Propositional speech production vs rest
Analysis class	Cross-sectional correlation with language or other measure
Group(s)	Aphasia without IFG POp damage (n = 7)
Covariate	Speech rate during scan
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?	N/A, no timeable task
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 IFG pars opercularis
How are the ROI(s) defined?	Defined by flipping L IFG pars opercularis activation in controls
Correction for multiple comparisons	One only
Statistical details	—
Findings	None
Findings notes	—

ROI analysis 3

First level contrast	Propositional speech production vs rest
Analysis class	Cross-sectional correlation with language or other measure
Group(s)	Aphasia with IFG POp damage (n = 7)
Covariate	Four different QPA measures
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?	N/A, no timeable task
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 IFG pars opercularis
How are the ROI(s) defined?	Defined by flipping L IFG pars opercularis activation in controls
Correction for multiple comparisons	One only
Statistical details	—
Findings	None
Findings notes	—

Notes

Excluded analyses

ROI analyses may have been carried out for both contrasts, but this is not stated