Use of fMRI in the study of chronic aphasia recovery after therapy: a case study.

PURPOSE: The role of intensity of aphasia therapy was investigated using functional magnetic resonance imaging (fMRI) to document changes in neural activation patterns associated with massed versus distributed therapy in an individual with chronic conduction aphasia.

METHOD: Language therapy targeted word-finding deficits and phonological processing. fMRI scans were acquired at baseline, after massed therapy, and after distributed therapy.

RESULTS

Treatment was effective, as demonstrated by increases in performance on standardized measures, narrative analysis, and task performance in the fMRI scanner. Task improvement across fMRI testing sessions corresponded with increases in fMRI blood oxygenation level dependent (BOLD) signal. Greatest behavioral gains and BOLD signal increases occurred after massed therapy, with slight gains accompanying distributed therapy. Increases in fMRI BOLD signal occurred after therapy in left basal ganglia and right hemisphere frontotemporal cortex.

CONCLUSIONS

Intensity of aphasia therapy impacts the recovery process and warrants additional research. Basal ganglia and right hemisphere structures may be important neural substrates for aphasia recovery.