BACKGROUND Predicting aphasia recovery is difficult due to a high variability in treatment response. Detailed measures of treatment response are compounded by a dearth of information that examine brain connections that contribute to clinical improvement. In this study we measure alterations to cortical connectivity pathways during a therapy paradigm to detect whether key brain connections that contribute to language recovery can be detected prior to therapy. METHODS We conducted a case-control trial with twenty-three adults including eight adults with chronic, post-stroke aphasia. Aphasia patients underwent 12 naming therapy sessions over 4 weeks, consisting of semantic and phonological treatment approaches. High-density electroencephalography (128 channel EEG) was measured prior to therapy and immediately following treatment in patients with aphasia. Analysis via a dynamic causal modelling (DCM) was used to assess which cortical connections significantly correlated with therapy response. RESULTS Altered cortical responses in aphasia patients measured bilaterally in a dual stream DCM connectivity model were predictive of treatment-induced improvement in naming. Pre-treatment DCM coupling (i.e., strength of cortical connections) significant correlated with naming improvement for items treated with semantic therapy, as indicated by increased connection strengths between left inferior parietal lobule (LIPL) and inferior frontal gyrus (LIFG, r = .63, pFDR = .016). In particular, the mediating role of contralateral regions significantly influences overall treatment improvement in the latter stages of stroke recovery. CONCLUSIONS Our findings identify a potential means to stratify larger cohorts of patients in neurorehabilitation settings into distinct treatments that are tailored to their individual language deficit.

中文翻译：

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双流连通性的改变可预测中风后对失语症治疗的反应。

背景技术由于治疗反应的高度可变性，难以预测失语症的恢复。缺乏详细信息可检查治疗反应的详细方法，这些信息检查了有助于临床改善的脑部连接。在这项研究中，我们测量了治疗范例期间皮质连接通路的变化，以检测在治疗之前是否可以检测到有助于语言恢复的关键大脑连接。方法我们对23名成年人（其中包括8名患有慢性中风后失语症的成年人）进行了病例对照试验。失语症患者在4周内接受了12次命名治疗，包括语义和语音治疗方法。对于失语症患者，在治疗前和治疗后立即测量高密度脑电图（128通道脑电图）。通过动态因果模型（DCM）进行分析，以评估哪些皮质连接与治疗反应显着相关。结果在双流DCM连接模型中，双侧失语症患者的皮质反应改变，可预测治疗引起的命名改善。预处理DCM耦合（即，皮质连接的强度）与用语义疗法治疗的物品的命名改善显着相关，如左下顶叶（LIPL）和额下回之间的连接强度增加（LIFG，r = 0.63） ，pFDR = .016）。特别是，对侧区域的中介作用在中风恢复的后期显着影响整体治疗的改善。结论我们的发现确定了一种潜在的手段，可以将较大规模的神经康复患者队列分为针对其个别语言缺陷的独特治疗方法。