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01-06-2007 | Original Paper

Functional MRI of Language in Aphasia: A Review of the Literature and the Methodological Challenges

Authors: Bruce Crosson, Keith McGregor, Kaundinya S. Gopinath, Tim W. Conway, Michelle Benjamin, Yu-Ling Chang, Anna Bacon Moore, Anastasia M. Raymer, Richard W. Briggs, Megan G. Sherod, Christina E. Wierenga, Keith D. White

Published in: Neuropsychology Review | Issue 2/2007

Abstract

Animal analogue studies show that damaged adult brains reorganize to accommodate compromised functions. In the human arena, functional magnetic resonance imaging (fMRI) and other functional neuroimaging techniques have been used to study reorganization of language substrates in aphasia. The resulting controversy regarding whether the right or the left hemisphere supports language recovery and treatment progress must be reframed. A more appropriate question is when left-hemisphere mechanisms and when right-hemisphere mechanisms support recovery of language functions. Small lesions generally lead to good recoveries supported by left-hemisphere mechanisms. However, when too much language eloquent cortex is damaged, right-hemisphere structures may provide the better substrate for recovery of language. Some studies suggest that recovery is particularly supported by homologues of damaged left-hemisphere structures. Evidence also suggests that under some circumstances, activity in both the left and right hemispheres can interfere with recovery of function. Further research will be needed to address these issues. However, daunting methodological problems must be managed to maximize the yield of future fMRI research in aphasia, especially in the area of language production. In this review, we cover six challenges for imaging language functions in aphasia with fMRI, with an emphasis on language production: (1) selection of a baseline task, (2) structure of language production trials, (3) mitigation of motion-related artifacts, (4) the use of stimulus onset versus response onset in fMRI analyses, (5) use of trials with correct responses and errors in analyses, and (6) reliability and stability of fMRI images across sessions. However, this list of methodological challenges is not exhaustive. Once methodology is advanced, knowledge from conceptually driven fMRI studies can be used to develop theoretically driven, mechanism-based treatments that will result in more effective therapy and to identify the best patient candidates for specific treatments. While the promise of fMRI in the study of aphasia is great, there is much work to be done before this technique will be a useful clinical tool.

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Title: Functional MRI of Language in Aphasia: A Review of the Literature and the Methodological Challenges
Authors: Bruce Crosson
Keith McGregor
Kaundinya S. Gopinath
Tim W. Conway
Michelle Benjamin
Yu-Ling Chang
Anna Bacon Moore
Anastasia M. Raymer
Richard W. Briggs
Megan G. Sherod
Christina E. Wierenga
Keith D. White
Publication date: 01-06-2007
Publisher: Springer US
Published in: Neuropsychology Review / Issue 2/2007
Print ISSN: 1040-7308
Electronic ISSN: 1573-6660
DOI: https://doi.org/10.1007/s11065-007-9024-z

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Functional MRI of Language in Aphasia: A Review of the Literature and the Methodological Challenges

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