Parallel recovery in a bilingual aphasic: A neurolinguistic and fMRI study.

Abstract

In bilingual aphasics, the neural correlates of rehabilitation benefits and their generalization across languages are still scarcely understood. The authors present the case of a highly proficient bilingual woman (Flemish, L1/Italian, L2) with chronic aphasia who, in the presence of the same pattern of impairment in both languages, showed parallel recovery in both languages after long-term rehabilitation therapy in L2. The authors postulated that this recovery was due to the engagement of the same neural substrates. To confirm this the authors used an event-related functional magnetic resonance imaging (fMRI) paradigm to explore cortical activation during an overt picture naming task, performed in both Flemish and Italian once before and once after 2 weeks of training in L2. Behaviorally, the patient showed complete recovery of both languages. The fMRI results indicated that the same cerebral regions were recruited for both languages before and after training. Increasing activations were observed perilesionally and in homologous contralesional areas. Our data, in agreement with previous results of fMRI studies in healthy bilinguals, indicate a promising direction for future research on the neural mechanisms associated with recovery in bilingual aphasics.

Language specificity of lexical-phonological therapy in bilingual aphasia: A clinical and electrophysiological study

“…In contrast to our results for an absence of CLG to untreated L1, Marangolo et al (2009) used a 6-month phonological therapy in L2 in a bilingual (Flemish/Italian) aphasic patient and found that CLG resulted in a parallel recovery of both languages after the therapy. This positive result possibly followed from the fact that the authors used a long duration therapy (6 months), whereas the intervention was much shorter in our study (4 weeks).…”

“…In contrast, although Hinckley (2003) and Marangolo et al (Marangolo, Rizzi, Peran, Piras, & Sabatini, 2009) showed some level of CLG with mixed semantic-phonological therapy or using phonological therapy in L2, CLG was not found after phonological therapy in Meinzer et al (Meinzer, Obleser, Flaisch, Eulitz, & Rockstroh, 2007), or transfer was limited to phonologically similar words (cognates) (Kohnert, 2004;Pillon & de Partz, 2005). CLG is also influenced by the lexico-semantic organisation in bilingual speakers, which depends on the level of convergence between language representations (Abutalebi & Green, 2007) and lexical processing (Parker Jones et al, 2012).…”

Effect of treatment for bilingual individuals with aphasia: A systematic review of the evidence

“…Outcome measures included the Aechen Aphasia Test (AAT; Huber, Poeck, & Williams, 1984), BAT, ILAT; Boston Naming Test (BNT; Kaplan, Goodglass, & Weintraub, 1983), Snodgrass Naming Battery (SNB; Snodgrass & Vanderwart, 1980) and informal assessment measures. Eight of these studies reported data from acute aphasic participants, seven of which focused on word retrieval, and found statistically significant changes in word retrieval scores (McNemar's change test, p < 0.05) (Abutalebi et al, 2009;Edmonds & Kiran, 2006;Gil & Goral, 2004;Khamis et al, 1996;Laganaro et al, 2003;Maragnolo et al, 2009 study 1 and 2). One case study of an acutely aphasic participant focused on discourse strategies and reported qualitative data and so statistical comparisons could not be made (Penn & Beecham, 1992).…”

“…As for expressive language outcomes, there are data from 11 studies examining L2 to L1 and four studies reporting L1 to L2 (Tables 4a and 4b; Abutalebi et al, 2009;Edmonds & Kiran, 2006;Faroqi & Chengappa, 1996;Gil & Goral, 2004;Goral et al, 2009;Khamis et al, 1996;Maragnolo et al, 2009;Meinzer et al, 2007;Penn & Beecham, 1992;and Ansaldo et al, 2009;Gil & Goral, 2004;Edmonds & Kiran, 2006;Junqué et al, 1989 respectively). Five out of 11 studies found CLT to the untrained L1, of which three described acute participants and two described chronic participants (Faroqi & Chengappa, 1996;Khamis et al, 1996;Maragnolo et al, 2009;Miertsch et al, 2009).…”

“…Other reasons for exclusion were as follows: a) was not a study or systematic review (23%, 37/161), b) not age or population under review (6%, 10/161), c) did not provide original data or separate data from mixed populations or treatments (6%, 10/161), d) was not published in a peer-reviewed journal (7%, 12/161), e) did not target a question (6%, 10/161) or f) could not obtain full-text (1%, 1/161); leaving a total of 13 citations. One citation (Maragnolo, Rizzi, Peran, Piras, & Sabatini, 2009) provided data from two distinct studies resulting in 14 studies for review. The list of excluded articles with reasons for exclusion is provided as Supplementary material (see S.2).…”