The neural substrates of improved phonological processing following successful treatment in a case of phonological alexia and agraphia

ABSTRACT

Phonological deficits are common in aphasia after left-hemisphere stroke, and can have significant functional consequences for spoken and written language. While many individuals improve through treatment, the neural substrates supporting improvements are poorly understood. We measured brain activation during pseudoword reading in an individual through two treatment phases. Improvements were associated with greater activation in residual left dorsal language regions and bilateral regions supporting attention and effort. Gains were maintained, while activation returned to pre-treatment levels. This case demonstrates the neural support for improved phonology after damage to critical regions and that improvements may be maintained without markedly increased effort.

KEYWORDS:

• Acquired alexia
• acquired agraphia
• aphasia
• functional MRI
• phonological impairment
• rehabilitation

Acknowledgments

This work was supported by the National Institute on Deafness and Other Communication Disorders (DC007646 to P.M.B., DC010878 to S.M.W, and DC014389 to A.T.D) and the University of Arizona. We thank Scott Squire for assistance with imaging data collection, and the individuals who participated in our study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplemental material

The supplemental data for this article can be accessed here.

Additional information

Funding

This work was supported by the National institute of Deafness and other Communication Disorders [DC007646,DC010878,DC014389].