Abstract-Patients with chronic aphasia were assigned randomly to a group to receive either conventional aphasia therapy or constraint-induced (CI) aphasia therapy, a new therapeutic technique requiring intense practice over a relatively short period of consecutive days. CI aphasia therapy is realized in a communicative therapeutic environment constraining patients to practice systematically speech acts with which they have difficulty. Patients in both groups received the same amount of treatment (30 to 35 hours) as 10 days of massed-practice language exercises for the CI aphasia therapy group (3 hours per day minimum; 10 patients) or over a longer period of Ϸ4 weeks for the conventional therapy group (7 patients). CI aphasia therapy led to significant and pronounced improvements on several standard clinical tests, on self-ratings, and on blinded-observer ratings of the patients' communicative effectiveness in everyday life. Patients who received the control intervention failed to achieve comparable improvements. Data suggest that the language skills of patients with chronic aphasia can be improved in a short period by use of an appropriate massed-practice technique that focuses on the patients' communicative needs. (Stroke. 2001;32:1621-1626.)

Sensorimotor areas activate to action- and object-related words, but their role in abstract meaning processing is still debated. Abstract emotion words denoting body internal states are a critical test case because they lack referential links to objects. If actions expressing emotion are crucial for learning correspondences between word forms and emotions, emotion word–evoked activity should emerge in motor brain systems controlling the face and arms, which typically express emotions. To test this hypothesis, we recruited 18 native speakers and used event-related functional magnetic resonance imaging to compare brain activation evoked by abstract emotion words to that by face- and arm-related action words. In addition to limbic regions, emotion words indeed sparked precentral cortex, including body-part–specific areas activated somatotopically by face words or arm words. Control items, including hash mark strings and animal words, failed to activate precentral areas. We conclude that, similar to their role in action word processing, activation of frontocentral motor systems in the dorsal stream reflects the semantic binding of sign and meaning of abstract words denoting emotions and possibly other body internal states.

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The current results challenge the notion that massed practice alone promotes recovery from chronic post-stroke aphasia. Instead, our results demonstrate that using language for communication and social interaction increases the efficacy of intensive aphasia therapy.