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A functional dissociation of the left frontal regions that contribute to single word production tasks
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In: Neuroimage (2021)
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Lesions that do or do not impair digit span: a study of 816 stroke survivors
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In: Brain Commun (2021)
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Damage to Broca’s area does not contribute to long-term speech production outcome after stroke
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In: Brain (2021)
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Clinical Effectiveness of the Queen Square Intensive Comprehensive Aphasia Service for Patients With Poststroke Aphasia
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In: Stroke (2021)
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How does iReadMore therapy change the reading network of patients with central alexia?
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Abstract:
Central alexia (CA) is an acquired reading disorder co-occurring with a generalised language deficit (aphasia). The roles of perilesional and ipsilesional tissue in recovery from post-stroke aphasia are unclear. We investigated the impact of reading training (using iReadMore, a therapy app) on the connections within and between the right and left hemisphere of the reading network of patients with CA. In patients with pure alexia, iReadMore increased feedback from left inferior frontal region (IFG) to the left occipital (OCC) region. We aimed to identify if iReadMore therapy was effective through a similar mechanism in CA patients.Participants with chronic post-stroke CA (n=23) completed 35 hours of iReadMore training over four weeks. Reading accuracy for trained and untrained words was assessed before and after therapy. The neural response to reading trained and untrained words in the left and right OCC, ventral occipitotemporal (vOT) and IFG was examined using event-related magnetoencephalography.The training-related modulation in effective connectivity between regions was modelled at the group level with Dynamic Causal Modelling.iReadMore training improved participants' reading accuracy by an average of 8.4% (range: -2.77 to 31.66) while accuracy for untrained words was stable. Training increased regional sensitivity in bilateral frontal and occipital regions, and strengthened feedforward connections within the left hemisphere. Our data suggests that iReadMore training in these patients modulates lower-order visual representations, as opposed to higher-order, more abstract ones, in order to improve word reading accuracy.SIGNIFICANCE STATEMENTThis is the first study to conduct a network-level analyses of therapy effects in participants with post-stroke central alexia. When patients trained with iReadMore (a multimodal, behavioural, mass practice, computer-based therapy), reading accuracy improved by an average 8.4% on trained items. A network analysis of the magnetoencephalography data associated with this improvement revealed an increase in regional sensitivity in bilateral frontal and occipital regions and strengthening of feedforward connections within the left hemisphere. This indicates that in CA patients iReadMore engages lower-order, intact resources within the left hemisphere (posterior to their lesion locations) to improve word reading. This provides a foundation for future research to investigate reading network modulation in different CA subtypes, or for sentence level therapy.
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URL: https://ueaeprints.uea.ac.uk/id/eprint/71246/
https://ueaeprints.uea.ac.uk/id/eprint/71246/1/Accepted_Manuscript.pdf
https://doi.org/10.1523/JNEUROSCI.1426-18.2019
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How Does iReadMore Therapy Change the Reading Network of Patients with Central Alexia?
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Randomized trial of iReadMore word reading training and brain stimulation in central alexia
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Auditory training changes temporal lobe connectivity in Wernicke's aphasia: a randomised trial
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Normal Adult Aging and the Contextual Influences Affecting Speech and Meaningful Sound Perception
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The Role of Brodmann Area 47 in Acute Stroke Patients with Language Impairment
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Patterns of Breakdown in Spelling in Primary Progressive Aphasia
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Vowel-specific mismatch responses in the anterior superior temporal gyrus: An fMRI study
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Temporal lobe regions engaged during normal speech comprehension
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