Intensive therapy induces contralateral white matter changes in chronic stroke patients with Broca's aphasia

Brain Lang. 2014 Sep;136:1-7. doi: 10.1016/j.bandl.2014.03.011. Epub 2014 Jul 18.


Using a pre-post design, eleven chronic stroke patients with large left hemisphere lesions and nonfluent aphasia underwent diffusion tensor imaging and language testing before and after receiving 15 weeks of an intensive intonation-based speech therapy. This treated patient group was compared to an untreated patient group (n=9) scanned twice over a similar time period. Our results showed that the treated group, but not the untreated group, had reductions in fractional anisotropy in the white matter underlying the right inferior frontal gyrus (IFG, pars opercularis and pars triangularis), the right posterior superior temporal gyrus, and the right posterior cingulum. Furthermore, we found that greater improvements in speech production were associated with greater reductions in FA in the right IFG (pars opercularis). Thus, our findings showed that an intensive rehabilitation program for patients with nonfluent aphasia led to structural changes in the right hemisphere, which correlated with improvements in speech production.

Keywords: Contralateral hemisphere; Diffusion-tensor imaging; Melodic intonation therapy; Plasticity; Stroke; Training.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Anisotropy
  • Aphasia, Broca / etiology
  • Aphasia, Broca / pathology*
  • Aphasia, Broca / physiopathology
  • Aphasia, Broca / rehabilitation*
  • Chronic Disease
  • Diffusion Tensor Imaging
  • Female
  • Frontal Lobe / pathology
  • Humans
  • Language Tests
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Speech Therapy*
  • Stroke / complications*
  • Stroke / pathology
  • Stroke Rehabilitation
  • Temporal Lobe / pathology
  • White Matter / pathology*