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This PowerPoint 2007 template produces a 100cmx140cm presentation poster. You can use it to create your research poster and save valuable time placing titles, subtitles, text, and graphics.   We provide a series of online tutorials that will guide you through the poster design process and answer your poster production questions. To view our template tutorials, go online to PosterPresentations.com and click on HELP DESK.   When you are ready to print your poster, go online to PosterPresentations.com Need assistance? Call us at 1.510.649.3001  

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Subjects: •  n=10 patients with moderate, chronic agrammatic aphasia pooled from Thompson et al., 2010 (n=5) and an ongoing study at the Center for the Neurobiology of Language Recovery (CNLR) (n=5).

•  All patients were trained to produce and comprehend non-canonical sentences (object relative in 2010, passive in CNLR) using Treatment of Underlying Forms (Thompson, 2008).

Data Analysis:

•  % ROI Lesioned: After T1 pre-processing in SPM8, MRIcron was used to manually draw lesions and calculate percent tissue lesioned in each ROI (Fig. 3).

•  Perfusion: ’Virtual brain transplant’ technique (Fig. 4) (Solodkin et al., 2010) performed on T1 scans prior to normalization and segmentation in VBM. Custom software used to model CBF using fMRI arterial spin labeling (ASL) images before coregistering to transplanted image. Regional CBF was normalized to mean CBF across the right hemisphere.

•  Cognitive effects of stroke may include agrammatic aphasia, a syntactic processing impairment. Non-canonical word order (2, 3) is more difficult to process than canonical word order (1):

(1) The girl kissed the boy. ACTIVE (2) Pete saw the boy who the girl kissed. OBJECT RELATIVE (3) The boy was kissed by the girl. PASSIVE

•  Patients can improve with treatment, even in the chronic stage of aphasia (Thompson et al., 2010), but the underlying neurobiology of recovery is unclear.

•  Neurobiological effects of stroke include necrosis (lesion) and hypoperfusion, especially in ipsilesional and perilesional tissue (Fig. 1). •  Lesion volume has limited clinical utility for predicting recovery (Caplan et al., 2007). Lesion-deficit relations vary greatly between individuals (Price & Friston, 2002), and recovery during acute stroke can be predicted without lesion volume (El Hachioui et al., 2012). There are likely other important factors (Caplan et al., 2007). •  More-normal hemodynamics is correlated with impairment severity and recovery (Fridriksson et al., 2010; Hillis et al., 2000, 2001; Payabvash et al., 2010; Silvestrini et al., 1998). However, most research in this area has been done on acute stroke, when changes in cerebral physiology occur that may confound these correlations.

Background!

?

The Present Study!

Methods!

Conclusions & Discussion!

Contact: fitzmorris@u.northwestern.edu !

Fig. 4: ‘Brain transplant’ technique

A:  ASL  fMRI:  Ipsilesional  hypoperfusion  (Thompson  et  al.,  2010).  B:  3D  image  reconstruc/on  of  rCBF  in  an  adult  with  chronic  aphasia  (leS)  and  a  healthy  adult  (right).  

Fig. 3: ROIs

Results!•  Left hemisphere was hypoperfused relative to the right hemisphere. •  Significant factors of Improvement:

•  % Compensatory ROI lesioned (r = -.7, p < .05) •  Perilesional perfusion (B = -3, p < .001) •  Study (B = -.2, p < .01) •  Pre-treatment comprehension (B = -.9, p < .001)

•  Total lesion volume was not a predictor of improvement, thus providing further support for lesion-deficit variability (Caplan et al., 2007; Hillis et al., 2000).

•  Greater recovery of sentence comprehension predicted by higher pre-treatment comprehension and lower perfusion in perilesional tissue.

•  Could perilesional tissue hinder, rather than support recovery in chronic stroke?

•  Future studies are needed to investigate links, if any, between pre-treatment perfusion and changes in neural activity associated with language recovery.

• Hillis AE, Barker PB, Beauchamp NJ, Gordon B, & Wityk RJ, (2000). MR perfusion imaging reveals regions of hypoperfusion associated with aphasia and neglect. Neurology, 55, 782-788. • Hillis AE, Barker PB, Beauchamp NJ, Winters BD, Mirski M, & Wityk RJ, (2001). Restoring blood pressure reperfused Wernicke’s area and improved language. Neurology, 56, 670-672. •  El Hachioui, H., Lingsma, H. F., van de Sandt-Koenderman, M. W. M. E., Dippel, D. W. J., Koudstaal, P. J., & Visch-Brink, E. G. (2013). Long-term prognosis of aphasia after stroke. Journal of

Neurology, Neurosurgery, and Psychiatry, 84(3), 310–315. http://doi.org/10.1136/jnnp-2012-302596 •  Fridriksson J, Kjartansson O, Morgan PS, Hjaltason H, Magnusdottir S, Bonilha L, & Rorden C, (2010). Impaired speech repetition and left parietal lobe damage. Journal of Neuroscience,

30(33): 11057-11061. •  Fridriksson J, Richardson JD, Fillmore P, & Cai B, (2012). Left hemisphere plasticity and aphasia recovery. NeuroImage, 60, 854-863. •  Pavbayash S, Kamalian S, Fung S, Wang Y, Passanese J, Kamalian S, Souza LCS, Kemmling A, Harris GJ, Halpern EF, Gonzalez RG, Furie KL, Lev MH (2010). Predicting language improvement in

acute stroke patients presenting with aphasia: A multivariate logistic model using location-weighted atlas-based analysis of admission CT perfusion scans. American Journal of Neuroradiology, 31, 1661-1668.

•  Price, C. J., & Friston, K. J. (2002). Degeneracy and cognitive anatomy. Trends in Cognitive Sciences, 6(10), 416–421. •  Solodkin, A., Hasson, U., Siugzdaite, R., Schiel, M., Chen, E. E., Rolf, K., & Small, S. L. (2010). Virtual Brain Transplantation (VBT): A method for accurate image registration and parcellation in

large cortical stroke. Archives Italiennes de Biologie, 148(3), 219–241. http://doi.org/10.4449/aib.v148i3.1221 • Thompson CK, den Ouden DB, Bonakdarpour B, Garibaldi K, Parrish TB (2010). Neural plasticity and treatment-induced recovery of sentence processing in agrammatism. Neuropsychologia

48: 3211-3227. • Thompson (2008). Treatment of syntactic and morphological deficits in agrammatic aphasia: Treatment of Underlying Forms. In R. Chapey (Ed.), Language intervention strategies in aphasia and

related neurogenic communication disorders. Baltimore: Williams & Wilkins.

• Aims: Examine longitudinal relations between pre-treatment perfusion and lesion volume in regions of the brain involved in sentence processing, and treatment-related improvement in non-canonical sentence comprehension. •  Research Questions:

1.  Can regional perfusion predict subsequent language recovery in chronic agrammatic aphasia?

2.  Is the relation between perfusion or lesion volume and improvement in sentence processing specific to language regions?

Selected References!

Fig.  1              A   B  

Statistics: •  Spearman correlations between Improvement in comprehension of trained sentence type, and regional perfusion or lesion volume

•  Stepwise linear regression between improvement and factors: perilesional perfusion, ‘study’, total lesion volume, pre-treatment comprehension.

Research supported by the National Institutes of Health, P50DC012283 and R01-DC007213, and The Graduate School at

Northwestern University

1Aphasia and Neurolinguistics Research Laboratory, Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL 2Center for Translational Imaging, Department of Radiology, Northwestern University, Chicago, IL 3Cognitive Neurology and Alzheimer’s Disease Center and Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL.

Perfusion and Recovery of Syntactic Comprehension in Chronic Agrammatic Aphasia

Ellen Fitzmorris1, Yufen Chen2, Todd Parrish2, Cynthia K. Thompson1,3