1. Matthew Cloud, BS1,2; Jana Downum, MA, BCB, CBIS1;
Changes in brain activity associated with treatment and recovery of aphasia: a functional near infrared spectroscopy (fNIRS) study
Matthew Cloud, BS1,2; Jana Downum, MA, BCB, CBIS1;
Angela Graybill,M.Ed. CCC/SLP 1; Sid Dickson, PhD, ABPP1; Patrick M. Plenger, PhD, ABPP1
1Pate Rehabilitation, 2The University of Texas Arlington & Southwestern Joint Biomedical Engineering Program
Objectives:
Characterize plasticity with recovery
Characterize the effect of specific aphasia treatments
Determine potential use of fNIRS in rehabilitation. a) b) c) d)
Fig 3) NIRS-SPM t-maps at p=0.05; Speech Assessment Session 1 (a) and Session 10 taken 3 months apart showing only significant voxels; Structured Therapy (c) and Traditional Therapy (d) no significant voxels, showing pattern recognition to stimulus.
Assessment – Session 1
Assessment – Session 10
Structured Therapy
Traditional Therapy
Background: Single case study of 63 year-old, right-handed female who sustained an apparent left parietal bleed subsequent to biopsy. Subject experienced significant right hemiparesis along with impairment in expressive and receptive language.
Fig. 1) Optode array (3x5) identical for Left and Right
Procedure/Results: The subject received daily individual traditional treatment (using pictures and phonemic cueing) and group structured speech therapy (using dialogue and contextual situations) sessions over a period of 9 months in an outpatient setting. Two data sets were analyzed. The first analysis compared two sessions of visual naming to confrontation using a Hitachi ETG-4000 fNIRS system and taken three months apart. The second data set was of fifteen minute speech sessions of traditional vs. structured therapy, again taking fNIRS measures. The resulting fNIRS data were analyzed using HomER and NIRS-SPM. During the naming trials, the only significant region of interest appeared greatly superior to Broca’s area during initial trials, shifting after 3 month’s to Broca’s area. While no voxels were significant (alpha=0.05) and both treatment types resulted in activation of Broca’s area, the structured therapy showed greater overall correlation and activation with Broca’s area vs. traditional therapy. In addition the patient appeared more comfortable, creating fewer movement artifacts during the structured therapy. Although the patient did not produce more correct responses to visual naming from the first to the third month, she did produce more words that tended to be semantic approximations.
Fig. 2) Channel positions
Channel
Session 1
Session 10
4 (Broca)
4.4396 22
4.3872
1.562
Structured
Traditional 3
1.1667
1.3894 9
References:
 Tak, S., Jang, K. E., Jung, J., Jang, J., Jeong, Y., & Ye, J. C. (2008). NIRS-SPM: statistical parametric mapping for near infrared spectroscopy (manual). Proceedings of SPIE.
Ye, J. C., Tak, S., Jang, K. E., Jung, J., & Jang, J. (2009). NIRS-SPM: statistical parametric mapping for near-infrared spectroscopy. Neuroimage, . doi: /j.neuroimage , 44,
Hitachi Medical Systems, Inc.
Conclusions: Significant increases in activation of Broca’s area during repeated speech assessment suggested that improvements in speech and language were mediated by increased activity in Broca’s area. Activation of Broca’s area during structured therapy compared to the corresponding assessment session (visual naming) demonstrated that relevant cerebral activity can be increased with the introduction of a more functionally relevant speech task. More research is required in order to determine deferential patterns associated with degree of recovery and response to treatment.
Table 1) Selected Significant Channels (p=0.05)