Insights into early language recovery: from basic principles to practical applications

Abstract

Background: Post-stroke loss and recovery of language functions evolves in time and space. A high functional dynamic can be observed in the first days and weeks after stroke, which has been associated with reorganisation processes in the left-lateralised language network, its right-hemisphere homologues and in the vicinity of the lesion site. With the advances in in vivo neuroimaging techniques, mapping changes in the language network over time (e.g., lesion extent, structural integrity of grey or white matter, task-based activity, functional or structural connectivity) is currently the focus of ongoing investigations.

Main Contribution: This review highlights the recent findings on the neurobiology of language recovery from the hyperacute to the subacute phase after stroke. It relates pathophysiological processes of stroke evolution and the spatio-temporal characteristics of recovery patterns within the anatomically distributed language network to the behavioural dynamics of early language recovery.

Conclusions: Understanding distinct, yet characteristic, recovery patterns within the language network promoting an improvement of language functions has lately provided new targets for non-invasive brain stimulation to enhance language rehabilitation mainly in the chronic phase after stroke. We argue that a more profound understanding of the natural history of behaviour–physiology relationships during aphasia evolution could open up new opportunities for an early system-level, neurobiologically motivated therapeutic use of neuromodulation techniques during language rehabilitation.

Keywords:

• aphasia
• acute phase
• language recovery
• stroke
• neuroimaging
• brain stimulation

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Dorothee Saur is supported by a Scholar Award (Understanding Human Cognition) of the James S. McDonnell Foundation.