c-MycERTAM transgene silencing in a genetically modified human neural stem cell line implanted into MCAo rodent brain |
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Authors: | Lara Stevanato Randolph L Corteling Paul Stroemer Andrew Hope Julie Heward Erik A Miljan John D Sinden |
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Institution: | 1. Department of Neurology, University of Münster, Münster, Germany 2. Department of Clinical Neurology, Oxford University, Oxford, UK 3. Department of Clinical & Health Psychology, University of Florida, Gainesville, USA 4. Department of Clinical Radiology, University of Münster, Münster, Germany 5. Department of Health Sciences, Hochschule Fresenius, University of Applied Sciences, Hamburg, Germany 6. Neurocenter, Sch?n Klinik, Hamburg, Germany
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Abstract: | Background To date, functional imaging studies of treatment-induced recovery from chronic aphasia only assessed short-term treatment effects after intensive language training. In the present study, we show with functional magnetic resonance imaging (fMRI), that different brain regions may be involved in immediate versus long-term success of intensive language training in chronic post-stroke aphasia patients. Results Eight patients were trained daily for three hours over a period of two weeks in naming of concrete objects. Prior to, immediately after, and eight months after training, patients overtly named trained and untrained objects during event-related fMRI. On average the patients improved from zero (at baseline) to 64.4% correct naming responses immediately after training, and treatment success remained highly stable at follow-up. Regression analyses showed that the degree of short-term treatment success was predicted by increased activity (compared to the pretraining scan) bilaterally in the hippocampal formation, the right precuneus and cingulate gyrus, and bilaterally in the fusiform gyri. A different picture emerged for long-term training success, which was best predicted by activity increases in the right-sided Wernicke's homologue and to a lesser degree in perilesional temporal areas. Conclusion The results show for the first time that treatment-induced language recovery in the chronic stage after stroke is a dynamic process. Initially, brain regions involved in memory encoding, attention, and multimodal integration mediated treatment success. In contrast, long-term treatment success was predicted mainly by activity increases in the so-called 'classical' language regions. The results suggest that besides perilesional and homologue language-associated regions, functional integrity of domain-unspecific memory structures may be a prerequisite for successful (intensive) language interventions. |
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