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      Relating resting-state hemodynamic changes to the variable language profiles in post-stroke aphasia

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          Abstract

          Linking both structural lesions and the functional integrity of remaining brain tissue to patients' behavioural profile may be critical in discovering the limits of behavioural recovery post stroke. In the present study, we explored the relationship between temporal hemodynamic changes and language performance in chronic post-stroke aphasia. We collected detailed language and neuropsychological data for 66 patients with chronic (>1 year) post-stroke aphasia. We used principal component analysis to extract their core language-neuropsychological features. From resting-state fMRI scans in 35 patients, we calculated the lag in the time-course of the intact brain voxels in each patient. Finally, variation across the language-cognitive factors was related to both the patients' structural damage and the time-course changes in each patient's intact tissue. Phonological abilities were correlated with the structural integrity of the left superior temporal, angular gyrus, supramarginal gyrus and arcuate fasciculus regions and hemodynamic advance in the left intra-parietal sulcus. Speech fluency related to integrity of premotor regions, plus hemodynamic advance in the left middle/superior temporal gyrus, left middle occipital gyrus, and right angular gyrus. Semantic performance reflected a combination of medial ventral temporal lobe status and hemodynamic delay in the left posterior middle temporal gyrus. Finally, executive abilities correlated with hemodynamic delay in the left middle/inferior frontal gyrus, right rolandic operculum, bilateral supplementary motor areas/middle cingulum areas, and bilateral thalamus/caudate. Following stroke, patients' patterns of chronic language abilities reflects a combination of structural and functional integrity across a distributed network of brain regions. The correlation between hemodynamic changes and behaviours may have clinical importance.

          Highlights

          • Examination of the functional integrity of remaining brain tissue in post stroke aphasia.

          • Mapping lag in the time-course of the intact brain voxels from resting-state fMRI scans.

          • Functional integrity was related to patients' language-cognitive abilities.

          • Patients' language abilities reflect a combination of structural and functional integrity.

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          Most cited references39

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          Conflict monitoring and cognitive control.

          A neglected question regarding cognitive control is how control processes might detect situations calling for their involvement. The authors propose here that the demand for control may be evaluated in part by monitoring for conflicts in information processing. This hypothesis is supported by data concerning the anterior cingulate cortex, a brain area involved in cognitive control, which also appears to respond to the occurrence of conflict. The present article reports two computational modeling studies, serving to articulate the conflict monitoring hypothesis and examine its implications. The first study tests the sufficiency of the hypothesis to account for brain activation data, applying a measure of conflict to existing models of tasks shown to engage the anterior cingulate. The second study implements a feedback loop connecting conflict monitoring to cognitive control, using this to simulate a number of important behavioral phenomena.
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            The role of the medial frontal cortex in cognitive control.

            Adaptive goal-directed behavior involves monitoring of ongoing actions and performance outcomes, and subsequent adjustments of behavior and learning. We evaluate new findings in cognitive neuroscience concerning cortical interactions that subserve the recruitment and implementation of such cognitive control. A review of primate and human studies, along with a meta-analysis of the human functional neuroimaging literature, suggest that the detection of unfavorable outcomes, response errors, response conflict, and decision uncertainty elicits largely overlapping clusters of activation foci in an extensive part of the posterior medial frontal cortex (pMFC). A direct link is delineated between activity in this area and subsequent adjustments in performance. Emerging evidence points to functional interactions between the pMFC and the lateral prefrontal cortex (LPFC), so that monitoring-related pMFC activity serves as a signal that engages regulatory processes in the LPFC to implement performance adjustments.
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              Common regions of the human frontal lobe recruited by diverse cognitive demands.

              Though many neuroscientific methods have been brought to bear in the search for functional specializations within prefrontal cortex, little consensus has emerged. To assess the contribution of functional neuroimaging, this article reviews patterns of frontal-lobe activation associated with a broad range of different cognitive demands, including aspects of perception, response selection, executive control, working memory, episodic memory and problem solving. The results show a striking regularity: for many demands, there is a similar recruitment of mid-dorsolateral, mid-ventrolateral and dorsal anterior cingulate cortex. Much of the remainder of frontal cortex, including most of the medial and orbital surfaces, is largely insensitive to these demands. Undoubtedly, these results provide strong evidence for regional specialization of function within prefrontal cortex. This specialization, however, takes an unexpected form: a specific frontal-lobe network that is consistently recruited for solution of diverse cognitive problems.
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                Author and article information

                Contributors
                Journal
                Neuroimage Clin
                Neuroimage Clin
                NeuroImage : Clinical
                Elsevier
                2213-1582
                21 August 2018
                2018
                21 August 2018
                : 20
                : 611-619
                Affiliations
                [a ]Neuroscience and Aphasia Research Unit, School of Biological Sciences, University of Manchester, UK;
                [b ]Department of Psychology, University of Cambridge, UK
                [c ]MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
                Author notes
                Article
                S2213-1582(18)30263-8
                10.1016/j.nicl.2018.08.022
                6120600
                30186765
                d4a6d9a4-d15e-409f-adc1-76991b00051b
                © 2018 The Authors

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 29 November 2017
                : 14 August 2018
                : 16 August 2018
                Categories
                Regular Article

                stroke aphasia,lesion,resting-state fmri,hemodynamic changes

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