Open Access Highly Accessed Case report

Brain regions essential for improved lexical access in an aged aphasic patient: a case report

Marcus Meinzer1*, Tobias Flaisch1, Jonas Obleser12, Ramin Assadollahi1, Daniela Djundja1, Gabriela Barthel1 and Brigitte Rockstroh1

Author Affiliations

1 University of Konstanz, Department of Psychology, Universitätsstr.10, P.O. Box 23, 78457 Konstanz, Germany

2 University College London, Institute of Cognitive Neuroscience, 17 Queen Square, WC1N 3AR, London, Great Britain

For all author emails, please log on.

BMC Neurology 2006, 6:28  doi:10.1186/1471-2377-6-28

Published: 17 August 2006

Abstract

Background

The relationship between functional recovery after brain injury and concomitant neuroplastic changes is emphasized in recent research. In the present study we aimed to delineate brain regions essential for language performance in aphasia using functional magnetic resonance imaging and acquisition in a temporal sparse sampling procedure, which allows monitoring of overt verbal responses during scanning.

Case presentation

An 80-year old patient with chronic aphasia (2 years post-onset) was investigated before and after intensive language training using an overt picture naming task. Differential brain activation in the right inferior frontal gyrus for correct word retrieval and errors was found. Improved language performance following therapy was mirrored by increased fronto-thalamic activation while stability in more general measures of attention/concentration and working memory was assured. Three healthy age-matched control subjects did not show behavioral changes or increased activation when tested repeatedly within the same 2-week time interval.

Conclusion

The results bear significance in that the changes in brain activation reported can unequivocally be attributed to the short-term training program and a language domain-specific plasticity process. Moreover, it further challenges the claim of a limited recovery potential in chronic aphasia, even at very old age. Delineation of brain regions essential for performance on a single case basis might have major implications for treatment using transcranial magnetic stimulation.