Intrahemispheric Perfusion in Chronic Stroke-Induced Aphasia

Cynthia K Thompson, Matthew Walenski, YuFen Chen, David Caplan, Swathi Kiran, Brenda Rapp, Kristin Grunewald, Mia Nunez, Richard Zinbarg, Todd B Parrish, Cynthia K Thompson, Matthew Walenski, YuFen Chen, David Caplan, Swathi Kiran, Brenda Rapp, Kristin Grunewald, Mia Nunez, Richard Zinbarg, Todd B Parrish

Abstract

Stroke-induced alterations in cerebral blood flow (perfusion) may contribute to functional language impairments and recovery in chronic aphasia. Using MRI, we examined perfusion in the right and left hemispheres of 35 aphasic and 16 healthy control participants. Across 76 regions (38 per hemisphere), no significant between-subjects differences were found in the left, whereas blood flow in the right was increased in the aphasic compared to the control participants. Region-of-interest (ROI) analyses showed a varied pattern of hypo- and hyperperfused regions across hemispheres in the aphasic participants; however, there were no significant correlations between perfusion values and language abilities in these regions. These patterns may reflect autoregulatory changes in blood flow following stroke and/or increases in general cognitive effort, rather than maladaptive language processing. We also examined blood flow in perilesional tissue, finding the greatest hypoperfusion close to the lesion (within 0-6 mm), with greater hypoperfusion in this region compared to more distal regions. In addition, hypoperfusion in this region was significantly correlated with language impairment. These findings underscore the need to consider cerebral perfusion as a factor contributing to language deficits in chronic aphasia as well as recovery of language function.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Lesion overlap map for 35 participants with aphasia, by axial slices (a) and with a three-dimensional view (b), using the neurological convention (left hemisphere is on the left). The color bar indicates the degree of overlap from minimal overlap (violet; N = 2 participants overlapping) to maximum overlap (red; N = 25 participants overlapping). The overlap map was spatially smoothed (3 mm).
Figure 2
Figure 2
Mean right-occipital-normalized perfusion values for participants with aphasia and healthy controls, averaged across the 38 ROIs for the left and right hemispheres. Error bars are standard error. ∗ indicates a significant left versus right difference (p < .05).
Figure 3
Figure 3
ROIs with greater perfusion (hyperperfusion; red-yellow color scale) and lesser perfusion (hypoperfusion; blue-green color scale) in patients relative to control participants, in three-dimensional and axial slice views (left hemisphere is on the left). Only regions that differ significantly across groups (patients versus controls; p < .05) are indicated.
Figure 4
Figure 4
Mean right-occipital-normalized perfusion values for participants with aphasia for the left perilesional tissue and the corresponding right homologous regions in the 0–6 mm, 6–12 mm, and remaining (12+ mm) ROIs. Error bars are standard error. ∗ indicates a significant difference (p < .05). Significance is not indicated for left versus right differences (all ROIs are significant between hemispheres).

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