Clinical and Imagiological Findings After Intensive Speech Therapy on Post Stroke Aphasia: A Case Report
DOI:
https://doi.org/10.25759/spmfr.458Keywords:
Aphasia, Magnetic Resonance Recovery Function, Stroke/complicationsAbstract
A 45-year-old female patient suffered from a stroke due to a left middle cerebral artery dissecting aneurysm, resulting in persistent expressive aphasia. Due to minor clinical response after 1 year of rehabilitation, a patient-center clinical evaluation and a tailored and intensive program were performed. Significant improvements were reported on cognitive, language and functional scales. Functional magnetic resonance also depicted a global increase in cortical activation, namely on language areas. Despite available evidence displaying that most neurological recovery occurs within the first 6–9 months after stroke, this case exemplifies that additional recovery might occur in later stages, pending on intensive and individualized treatments. Also, we highlight that the number of activations on functional magnetic resonance imaging (fMRI) is, by itself, debatable as a surrogate for neurological recovery. Nevertheless, its’ relationship with clinical improvement is valuable information.
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Small SL, Buccino G, Solodkin A. Brain repair after stroke-a novel neurological model. Nat Rev Neurol. 2013;9:698-707. doi: 10.1038/nrneurol.2013.222.
Brady MC, Kelly H, Godwin J, Enderby P, Campbell P. Speech and language therapy for aphasia following stroke. Cochrane Database Syst Rev. 2016:CD000425.
Iorga M, Higgins J, Caplan D, Zinbarg R, Kiran S, Thompson CK, et al. Predicting language recovery in post-stroke aphasia using behavior and functional MRI. Sci Rep. 2021;11:8419. doi: 10.1038/s41598-021-88022-z.
Wong GK, Mak JS, Wong A, Zheng VZ, Poon WS, Abrigo J, et al. Minimum Clinically Important Difference of Montreal Cognitive Assessment in aneurysmal subarachnoid hemorrhage patients. J Clin Neurosci. 2017;46:41-4. doi: 10.1016/j.jocn.2017.08.039.
Beninato M, Gill-Body KM, Salles S, Stark PC, Black-Schaffer RM, Stein J. Determination of the minimal clinically important difference in the FIM instrument in patients with stroke. Arch Phys Med Rehabil. 2006;87:32-39.
Hamilton RH, Chrysikou EG, Coslett B. Mechanisms of aphasia recovery after stroke and the role of noninvasive brain stimulation. Brain Lang. 2011;118:40-50.
Stockert A, Wawrzyniak M, Klingbeil J, Wrede K, Kümmerer D, Hartwigsen G, et al. Dynamics of language reorganization after left temporo-parietal and frontal stroke. Brain. 2020;143:844-61. doi: 10.1093/brain/awaa023.
Shimizu T, Hosaki A, Hino T, Sato M, Komori T, Hirai S, et al. Motor cortical disinhibition in the unaffected hemisphere after unilateral cortical stroke. Brain. 2002;125:1896-907. doi: 10.1093/brain/awf183.
Gold BT, Kertesz A. Right hemisphere semantic processing of visual words in an aphasic patient: an fMRI study. Brain Lang. 2000;73:456-65.
Rosen HJ, Petersen SE, Linenweber MR, Snyder AZ, White DA, Chapman L, et al. Neural correlates of recovery from aphasia after damage to left inferior frontal cortex. Neurology. 2000 26;55:1883-94. doi: 10.1212/wnl.55.12.1883.
Stefaniak JD, Halai AD, Lambon Ralph MA. The neural and neurocomputational bases of recovery from post-stroke aphasia. Nat Rev Neurol. 2020;16:43-55. doi: 10.1038/s41582-019-0282-1.
Saur D, Lange R, Baumgaertner A, Schraknepper V, Willmes K, Rijntjes M, et al. Dynamics of language reorganization after stroke. Brain. 2006;129:1371-84. doi: 10.1093/brain/awl090.
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