Science of Aphasia 5 Cross Linguistic Aspects of Aphasia ...

Deficit-specific speech therapy: er-fMRI evidence from phonologicallycued
training in an anomic patient
Jubin ABUTALEBI * °, Paolo VITALI * ^, Marco TETTAMANTI *, Daniela PERANI
*, & Stefano F. CAPPA *
* Centre for Cognitive Neuroscience, University Vita-Salute San Raffaele and HSR,
Milan, Italy
° Interdisciplinary Center for Cognitive Studies, University of Potsdam, Germany
^ Institut Universitaire de Gériatrie de Montréal, Université de Montréal, Québec, Canada
Clinical neuroscientists have long known that some recovery of function is
possible after injury to the brain but the nature and exact mechanisms of language
recovery after brain damage are still controversial although a strong relationship between
neuroplasticity and recovery is postulated (Blomert, 1998). Indeed, when stroke patients
regain some of their language abilities, their behavioral improvements may result from
either of two mechanisms (Cappa, 2000). Recovery may be achieved by adopting novel
cognitive strategies for function performing (i.e., recruitment of uninjured cerebral areas
which are usually not necessary for the lost function in the intact brain). On the other
hand, recovery may be achieved because of the involvement of homotopic (i.e.
homologous) areas of the controlateral hemisphere that may have compensatory function.
However, how speech therapy may directly influence this cerebral re-organization is a
further matter of debate.
The repeatability of fMRI over time allows one to investigate how patterns of cerebral
activity may change during the course of recovery and to observe consequently the
influence of treatment on brain functioning.
In the present study we investigated the effects of anomia-specific speech therapy
on cerebral re-organization in an anomic patient, G.R.. Using event-related functional
Magnetic Resonance Imaging (er-fMRI), we scanned patient G.R. twice, before and after
specific speech therapy for anomia (phonological cued naming training). The rationale
for concentrating on phonologically cued naming training was inferred by the fact that
G.R. was able to name when cued with the beginning syllable.
A set of pictures that G.R. could not spontaneously name was selected for intensive
speech therapy. After acquisition of the first er-fMRI session, training was intensively
administered on a daily basis by a speech-pathologist, until a 50% correct naming
performance (at least) on the training picture set was achieved. During the pre- and posttraining
er-fMRI acquisition G.R. had to overtly name visually presented pictures of the
trained set and of an un-trained control set. Furthemore, fMRI data were also collected
during a third condition in which G.R. was phonologically cued during naming.