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Journal of Neurology

12-04-2024 | Aphasia | Review

The role of language-related functional brain regions and white matter tracts in network plasticity of post-stroke aphasia

Authors: Yue Han, Yuanyuan Jing, Yanmin Shi, Hongbin Mo, Yafei Wan, Hongwei Zhou, Fang Deng

Published in: Journal of Neurology

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Abstract

The neural mechanisms underlying language recovery after a stroke remain controversial. This review aimed to summarize the plasticity and reorganization mechanisms of the language network through neuroimaging studies. Initially, we discussed the involvement of right language homologues, perilesional tissue, and domain-general networks. Subsequently, we summarized the white matter functional mapping and remodeling mechanisms associated with language subskills. Finally, we explored how non-invasive brain stimulation (NIBS) promoted language recovery by inducing neural network plasticity. It was observed that the recruitment of right hemisphere language area homologues played a pivotal role in the early stages of frontal post-stroke aphasia (PSA), particularly in patients with larger lesions. Perilesional plasticity correlated with improved speech performance and prognosis. The domain-general networks could respond to increased “effort” in a task-dependent manner from the top-down when the downstream language network was impaired. Fluency, repetition, comprehension, naming, and reading skills exhibited overlapping and unique dual-pathway functional mapping models. In the acute phase, the structural remodeling of white matter tracts became challenging, with recovery predominantly dependent on cortical activation. Similar to the pattern of cortical activation, during the subacute and chronic phases, improvements in language functions depended, respectively, on the remodeling of right white matter tracts and the restoration of left-lateralized language structural network patterns. Moreover, the midline superior frontal gyrus/dorsal anterior cingulate cortex emerged as a promising target for NIBS. These findings offered theoretical insights for the early personalized treatment of aphasia after stroke.
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Metadata
Title
The role of language-related functional brain regions and white matter tracts in network plasticity of post-stroke aphasia
Authors
Yue Han
Yuanyuan Jing
Yanmin Shi
Hongbin Mo
Yafei Wan
Hongwei Zhou
Fang Deng
Publication date
12-04-2024
Publisher
Springer Berlin Heidelberg
Keywords
Aphasia
Stroke
Published in
Journal of Neurology
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-024-12358-5