Article

OBJECTIVE: Tocharacterize the relationship between neurophysiologic changes in the brain and
behavioral response to constraint-induced language therapy (CILT) by using
magnetoencephalography (MEG). DESIGN: Case series.
SETTING: Medical school.
PARTICIPANTS: Patients (N=23) with chronic aphasia after first-time unilateral
stroke in the left hemisphere. INTERVENTIONS: Constraint-induced language therapy
administered for 3 hours 4 times per week for 3 weeks. Language testing and
functional imaging during a language comprehension task using MEG before,
immediately after, and 3 months after CILT with a subgroup of patients undergoing
additional MEG scanning and language testing 3 weeks before CILT.
MAIN OUTCOME MEASURES:
The percent of correct information units and the number of late dipoles
normalized to total activation. RESULTS: Three patterns of behavioral and
neurophysiologic response to CILT were identified. Patients with significant
improvement in language immediately after CILT who lost these gains at follow-up
had greater right hemisphere activation than other patients at all MEG scanning
sessions. Patients with significant improvement in language immediately after
CILT who maintained these gains at follow-up exhibited an increase in left
temporal activation after CILT, whereas patients who did not exhibit significant
improvement in language after CILT exhibited comparably greater activation in left parietal areas.
CONCLUSIONS: Results suggest that although the right
hemisphere may support recovery of language function in response to therapy, this
recovery may not be stable, and some participation of perilesional areas of the
left hemisphere may be necessary for a stable behavioral response.

Langue : ANGLAIS