Recovery of Injured Arcuate Fasciculus in the Dominant Hemisphere in a Patient with an Intracerebral Hemorrhage

Jang, Sung Ho; Lee, Han Do

doi:10.1097/phm.0000000000000202

Cited by 10 publications

(28 citation statements)

References 19 publications

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“…In addition to functional connectivity, recent research has suggested that intact structural connectivity is beneficial for successful aphasia recovery (Bonilha, Gleichgerrcht, Nesland, Rorden, & Fridriksson, 2016;Bonilha et al, 2017;Griffis, Nenert, Allendorfer, & Szaflarski, 2017;Yourganov, Fridriksson, Rorden, Gleichgerrcht, & Bonilha, 2016). Several studies have demonstrated the importance of the AF for language recovery after stroke, especially for improvement in speech production (Breier, Juranek, & Papanicolaou, 2011;Hosomi, Nagakane, & Yamada, 2009;Jang, 2013;Jang & Lee, 2014). This finding is consistent with the assumed function of this white-matter pathway in mapping acoustic representations of sounds with their motor representation (Saur et al, 2008).…”

Section: Association With Language Outcomessupporting

confidence: 58%

A Review on Treatment-Related Brain Changes in Aphasia

Schevenels

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et al. 2020

Neurobiology of Language

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Numerous studies have investigated brain changes associated with interventions targeting a range of language problems in patients with aphasia. We strive to integrate the results of these studies to examine (1) whether the focus of the intervention (i.e. phonology, semantics, orthography, syntax or rhythmic-melodic) determines in which brain regions changes occur, (2a) whether the most consistent changes occur within the language network or outside, and (2b) whether these are related to individual differences in language outcomes. The results of 32 studies with 204 unique patients were considered. Concerning (1), the location of treatment-related changes does not clearly depend on the type of language processing targeted. However, there is some support that rhythmic-melodic training has more impact on the right hemisphere than linguistic training. Concerning (2), we observed that language recovery is not only associated with changes in traditional language-related structures in the left hemisphere and homolog regions in the right hemisphere. Treatment-related changes also occurred more medially and subcortically (e.g. precuneus and basal ganglia). Although it is difficult to draw strong conclusions, because there is a lack of systematic large-scale studies on this topic, this review highlights the need for an integrated approach to investigate how language interventions impact on the brain. Future studies need to focus on larger samples preserving subject-specific information (such as lesion effects) to cope with the inherent heterogeneity of stroke-induced aphasia. In addition, recovery-related changes in whole-brain connectivity patterns need more investigation to provide a comprehensive neural account of treatment-related brain plasticity and language recovery.

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Section: Association With Language Outcomessupporting

confidence: 58%

A Review on Treatment-Related Brain Changes in Aphasia

Schevenels

Price

Zink

et al. 2020

Neurobiology of Language

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“…[ 14 , 21 – 24 ] These include the contribution of either the peri-lesional brain region in the affected hemisphere or homologous language regions in the unaffected hemisphere, facilitation of the AF in the nondominant hemisphere, and recovery of an injured AF. [ 14 , 21 – 24 ] A right-handed patient completely recovered from a discontinued left AF over 21 months, concurrent with marked clinical recovery from aphasia following intracerebral hemorrhage. [ 14 ] However, no study on recovery of an injured AF in patients with TBI, like this study, has been reported.…”

Section: Discussionmentioning

confidence: 99%

“…[ 14 , 21 – 24 ] A right-handed patient completely recovered from a discontinued left AF over 21 months, concurrent with marked clinical recovery from aphasia following intracerebral hemorrhage. [ 14 ] However, no study on recovery of an injured AF in patients with TBI, like this study, has been reported.…”

Section: Discussionmentioning

confidence: 99%

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Recovery of injured Broca's portion of arcuate fasciculus in the dominant hemisphere in a patient with traumatic brain injury

Jang

Kim

et al. 2017

Medicine

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Rationale:Recovery of injured AF in patients with traumatic brain injury (TBI) has not been reported. In this study, we report on a patient with TBI who recovered from an injury to Broca's portion of AF in the dominant hemisphere, diagnosed by diffusion tensor tractography (DTT).Patient concerns:A 28-year-old right-handed male patient suffered head trauma resulting from sliding while riding a motorcycle.Diagnoses:He was diagnosed with a traumatic contusional hemorrhage in the left frontal lobe, subarachnoid hemorrhage, and subdural hemorrhage in the left fronto-temporal lobe.Interventions:He underwent craniectomy on the left fronto-temporal area, and hematoma removal for the subdural hemorrhage in the neurosurgery department of a university hospital. Two weeks after the injury, he was transferred to the rehabilitation department of another university hospital. He showed severe aphasia and brain MRI showed leukomalactic lesion in the left frontal lobe.Outcomes:The result WAB for the patient showed severe aphasia, with an aphasia quotient of 45.3 percentile. However, his aphasia improved rapidly by 9 months with an aphasia quotient at the 100.0 percentile. 2-week DTT detected discontinuity in the subcortical white matter at the branch to Broca's area of left AF. By contrast, on 9-month DTT, the discontinued portion of left AF was elongated to the left Broca's area.Lessons:Recovery of injured Broca's portion of AF in the dominant hemisphere along with excellent improvement of aphasia was demonstrated in a patient with TBI. This study has important implications in brain rehabilitation because the mechanism of recovery from aphasia following TBI has not been elucidated.

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“…With regards to long-term recovery, Hillis et al (2018) reported that improvement in overall naming from acute to chronic post-stroke stages was linked to less damage in posterior LSTG (LpSTG) and to the left arcuate fasciculus (LAF). The integrity of LAF also has been implicated in acute to chronic longitudinal recovery from aphasia in general ( Hosomi et al, 2009 ; Jang and Lee, 2014 ; Kim and Jang, 2013 ) and in response to a variety of therapies in individuals with chronic aphasia ( Breier et al, 2011 ; Holland et al, 2016 ; Schlaug et al, 2009 ; van Hees et al, 2014 ). Other studies in chronic aphasia have highlighted the importance of ventral white matter tracts, such as the left inferior longitudinal fasciculus (LILF) ( Bonilha et al, 2016 ; McKinnon et al, 2017 ; Meier et al, 2019 ) in response to naming therapy.…”

Section: Introductionmentioning

confidence: 99%

Naming errors and dysfunctional tissue metrics predict language recovery after acute left hemisphere stroke

et al. 2020

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Language recovery following acute left hemisphere (LH) stroke is notoriously difficult to predict. Global language measures (e.g., overall aphasia severity) and gross lesion metrics (e.g., size) provide incomplete recovery predictions. In this study, we test the hypothesis that the types of naming errors patients produce, combined with dysfunctional brain tissue metrics, can provide additional insight into recovery following acute LH stroke. One hundred forty-eight individuals who were hospitalized with a new LH stroke completed clinical neuroimaging and assessments of naming and global language skills. A subset of participants again completed language testing at subacute, early (5–7 months post-stroke), and late (≥11 months post-stroke) chronic phases. At each time point, we coded naming errors into four types ( semantic , phonological , mixed and unrelated ) and determined error type totals and proportions. Dysfunctional tissue measures included the percentage of damage to language network regions and hypoperfusion in vascular territories. A higher proportion of semantic errors was associated with better acute naming, but higher proportions of other error types was related to poorer accuracy. Naming and global language skills significantly improved over time , but naming error profiles did not change. Fewer acute unrelated errors and less damage to left angular gyrus resulted in optimal naming and language recovery by the final testing time point, yet patients with more acute errors and damage to left middle temporal gyrus demonstrated the greatest increases in language over time. These results illustrate that naming error profiles, particularly unrelated errors, add power to predictions of language recovery after stroke.

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Recovery of Injured Arcuate Fasciculus in the Dominant Hemisphere in a Patient with an Intracerebral Hemorrhage

Cited by 10 publications

References 19 publications

A Review on Treatment-Related Brain Changes in Aphasia

A Review on Treatment-Related Brain Changes in Aphasia

Recovery of injured Broca's portion of arcuate fasciculus in the dominant hemisphere in a patient with traumatic brain injury

Naming errors and dysfunctional tissue metrics predict language recovery after acute left hemisphere stroke

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