Perilesional Perfusion in Chronic Stroke-Induced Aphasia and Its Response to Behavioral Treatment Interventions

Matthew Walenski, Yufen Chen, Kaitlyn A. Litcofsky, David Caplan, Swathi Kiran, Brenda Rapp, Todd B. Parrish, Cynthia K. Thompson*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Stroke-induced alterations in cerebral blood flow (perfusion) may contribute to functional language impairments in chronic aphasia, particularly in perilesional tissue. Abnormal perfusion in this region may also serve as a biomarker for predicting functional improvements with behavioral treatment interventions. Using pseudo-continuous arterial spin labeling in magnetic resonance imaging (MRI), we examined perfusion in chronic aphasia, in perilesional rings in the left hemisphere and their right hemisphere homologues. In the left hemisphere we found a gradient pattern of decreasing perfusion closer to the lesion. The opposite pattern was found in the right hemisphere, with significantly increased perfusion close to the lesion homologue. Perfusion was also increased in the right hemisphere lesion homologue region relative to the surrounding tissue. We next examined changes in perfusion in two groups: one group who underwent MRI scanning before and after three months of a behavioral treatment intervention that led to significant language gains, and a second group who was scanned twice at a three-month interval without a treatment intervention. For both groups, there was no difference in perfusion over time in either the left or the right hemisphere. Moreover, within the treatment group pre-treatment perfusion scores did not predict treatment response; neither did pre-treatment perfusion predict post-treatment language performance. These results indicate that perfusion is chronically abnormal in both hemispheres, but chronically abnormal perfusion did not change in response to our behavioral treatment interventions, and did not predict responsiveness to language treatment.

Original languageEnglish (US)
Pages (from-to)345-363
Number of pages19
JournalNeurobiology of Language
Volume3
Issue number2
DOIs
StatePublished - May 11 2022

Funding

We tested 71 participants with aphasia subsequent to a single LH ischemic stroke (Table 1A). Participants with different aphasias were recruited from three research sites, Northwestern University (agrammatism; n = 17), Boston University (anomia; n = 30), and Johns Hopkins University (dysgraphia; n = 24), as part of a large-scale Clinical Research Center funded by the NIDCD (National Institute on Deafness and Other Communication Disorders). The study was approved by the Institutional Review Boards of all three universities, and all participants This work was supported by the NIH-NIDCD, Clinical Research Center Grant, P50DC012283 (PI: Cynthia K. Thompson), and was completed while the first author (Matthew Walenski) was at Northwestern University. The authors wish to thank Xue Wang, Elena Barbieri, Sladjana Lukic, and Brianne Dougherty for assistance with data collection and analysis, and to thank Neda Mohammadi for assistance with literature review.

Keywords

  • Aphasia
  • MRI
  • Perfusion
  • Stroke
  • Treatment

ASJC Scopus subject areas

  • Linguistics and Language
  • Neurology

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