Ultra-rapid access to words in chronic aphasia: the effects of intensive language action therapy (ILAT)

Lucy J MacGregor, Stephanie Difrancesco, Friedemann Pulvermüller, Yury Shtyrov, Bettina Mohr, Lucy J MacGregor, Stephanie Difrancesco, Friedemann Pulvermüller, Yury Shtyrov, Bettina Mohr

Abstract

Effects of intensive language action therapy (ILAT) on automatic language processing were assessed using Magnetoencephalography (MEG). Auditory magnetic mismatch negativity (MMNm) responses to words and pseudowords were recorded in twelve patients with chronic aphasia before and immediately after two weeks of ILAT. Following therapy, Patients showed significant clinical improvements of auditory comprehension as measured by the Token Test and in word retrieval and naming as measured by the Boston Naming Test. Neuromagnetic responses dissociated between meaningful words and meaningless word-like stimuli ultra-rapidly, approximately 50 ms after acoustic information first allowed for stimulus identification. Over treatment, there was a significant increase in the left-lateralisation of this early word-elicited activation, observed in perilesional fronto-temporal regions. No comparable change was seen for pseudowords. The results may reflect successful, therapy-induced, language restitution in the left hemisphere.

Figures

Fig. 1
Fig. 1
Bar charts showing significant improvements in performance in naming as measured by the Boston Naming Test (top) and in auditory comprehension as measured by the Token Test (bottom)
Fig. 2
Fig. 2
ERFs (n = 12) observed in response to standard stimuli (black line), deviant word stimuli (grey line) and deviant pseudoword stimuli (dotted line) before therapy (top panel) and after therapy (middle panel) for clusters of 12 gradiometer pairs in the left and right hemispheres (highlighted in the lower panel). For each gradiometer pair data were combined to give a single value by taking the square root of the sum of squares of the amplitudes of the two gradiometers. This calculation was performed separately for the averages of the standard and the deviant stimuli. Data are filtered between 0.1 and 70 Hz. Lower panel shows the location of the selected 24 gradiometer pairs over fronto-temporal areas of the left and right hemisphere
Fig. 3
Fig. 3
ERFs (n = 12) showing the MMNm responses (deviant minus standard) for words (black line) against pseudowords (grey line) before therapy (top panel) and after therapy (middle panel) for clusters of 12 gradiometer pairs in the left and right hemispheres (highlighted in the lower panel). For each gradiometer pair data were combined to give a single value by taking the square root of the sum of squares of the amplitudes of the two gradiometers. This calculation was performed separately for the averages of the MMNm responses for the words and the pseudowords. Data are filtered between 0.1 and 70 Hz. Topographical field gradient maps show the distribution of activations over the selected time window of 40–60 ms, for words and pseudowords, separately. Lower panel shows the location of the selected 24 gradiometer pairs over fronto-temporal areas of the left and right hemisphere

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