Neuroplasticity and aphasia treatments: new approaches for an old problem

J Neurol Neurosurg Psychiatry. 2019 Oct;90(10):1147-1155. doi: 10.1136/jnnp-2018-319649. Epub 2019 May 4.

Abstract

Given the profound impact of language impairment after stroke (aphasia), neuroplasticity research is garnering considerable attention as means for eventually improving aphasia treatments and how they are delivered. Functional and structural neuroimaging studies indicate that aphasia treatments can recruit both residual and new neural mechanisms to improve language function and that neuroimaging modalities may hold promise in predicting treatment outcome. In relatively small clinical trials, both non-invasive brain stimulation and behavioural manipulations targeting activation or suppression of specific cortices can improve aphasia treatment outcomes. Recent language interventions that employ principles consistent with inducing neuroplasticity also are showing improved performance for both trained and novel items and contexts. While knowledge is rapidly accumulating, larger trials emphasising how to select optimal paradigms for individualised aphasia treatment are needed. Finally, a model of how to incorporate the growing knowledge into clinical practice could help to focus future research.

Keywords: aphasia; brain mapping; functional imaging; rehabilitation; stroke.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Aphasia / diagnostic imaging
  • Aphasia / etiology
  • Aphasia / physiopathology
  • Aphasia / rehabilitation*
  • Brain / diagnostic imaging
  • Brain / physiopathology
  • Functional Neuroimaging
  • Humans
  • Language Therapy*
  • Neuronal Plasticity*
  • Stroke / complications
  • Stroke / physiopathology*
  • Stroke Rehabilitation
  • Transcranial Direct Current Stimulation*
  • Transcranial Magnetic Stimulation*