Over a period of five years, three severely impaired chronic non-fluent aphasia patients with concomitant apraxia of speech (AOS) received annual treatment periods of specific rhythmic-melodic voice training SIPARI. This therapy concept focusses on improving planning, programming, and sequencing of speech movements emphasizing specifically the training of cognitive capabilities such as executive functions. Behavioral and neural data were assessed at the start of the therapy and continuously after each treatment period. As previously reported, a first major finding was that after the first treatment period, significant improvements in language and speech motor performance were measured going hand in hand with significant additional peri-lesional activation in all patients particularly in the posterior part of the left superior temporal gyrus. This activation pattern was continuously confirmed by each subsequent scan. However, assessments after the third treatment period yielded additional significant activations in dorsolateral prefrontal cortex regions, namely in the left middle and superior frontal gyri, and anterior cingulate gyrus resulting in a further statistically significant increase in speech profile level, an overall and clinically relevant measure of the severity of aphasia. On the basis of our results, we assume that even in long-term rehabilitation of severely impaired non-fluent aphasia patients the applied treatment may support coactivation with dorsolateral prefrontal regions, suggested to be particularly involved in cognitive processing. This left-lateralized dorsolateral prefrontal-parietal network is supposed to be engaged in domain-general aspects of active phonological memory.

To the best of our knowledge, no comparable studies are available as yet. Therefore, we hope that our study may serve to attract more attention for the late stages of long-term rehabilitation, not at least as a challenge for therapists and researchers alike.

在五年的时间里，三名患有严重语言障碍的慢性非流畅性失语症患者同时伴有语言失语症（AOS），接受了特殊的节奏旋律语音训练SIPARI的年度治疗。这种治疗概念专注于改善言语运动的计划，编程和顺序，特别强调对认知能力（例如执行功能）的训练。行为和神经数据在治疗开始时进行评估，并在每个治疗期后连续评估。如先前报道，第一个主要发现是在第一个治疗期后，在所有患者中，特别是在左上颞叶后部，同时测量了语言和言语运动能力的显着改善，并伴有明显的附加病灶周围激活。回旋。每次后续扫描均连续确认该激活模式。然而，第三次治疗后的评估在背外侧前额叶皮层区域（即左中和额额上回以及前扣带回）中产生了额外的显着激活，从而导致语音特征水平进一步统计学上显着增加，这是一项总体和临床相关的措施失语的严重程度。根据我们的结果，我们假设即使在严重受损的非流利性失语症患者的长期康复中，所应用的治疗也可能支持与背外侧前额叶区域的共激活，建议特别参与认知过程。

据我们所知，尚无可比的研究。因此，我们希望我们的研究可以在长期康复的后期吸引更多的注意力，而不是至少对治疗师和研究人员构成挑战。