Academic Journal
Right hemisphere involvement in intensive aphasia therapy outcomes: a multimodal neuroimaging concept study.
| Title: | Right hemisphere involvement in intensive aphasia therapy outcomes: a multimodal neuroimaging concept study. |
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| Authors: | Scholtes N; Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen, Germany.; Division of Neuropediatrics and Integrated Health Care, Department of Pediatrics and Adolescent Medicine, KJF Klinikum Josefinum, Augsburg, Germany., Heim S; Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen, Germany.; Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany.; Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich GmbH, Jülich, Germany.; Institute for Midwifery, Medical Faculty, RWTH Aachen University, Aachen, Germany., Binkofski F; Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen, Germany.; Division for Clinical Cognitive Sciences, Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen, Germany.; Institute of Neuroscience and Medicine (INM-4), Research Centre Jülich GmbH, Jülich, Germany., Werner CJ; Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen, Germany. cornelius.werner@rwth-aachen.de.; Department of Neurology and Geriatrics, Johanniter Hospital, Stendal, Germany. cornelius.werner@rwth-aachen.de. |
| Source: | Journal of neurology [J Neurol] 2026 Jul 24; Vol. 273 (8). Date of Electronic Publication: 2026 Jul 24. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Springer-Verlag Country of Publication: Germany NLM ID: 0423161 Publication Model: Electronic Cited Medium: Internet ISSN: 1432-1459 (Electronic) Linking ISSN: 03405354 NLM ISO Abbreviation: J Neurol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Berlin ; New York, Springer-Verlag |
| MeSH Terms: | Aphasia*/diagnostic imaging , Aphasia*/physiopathology , Aphasia*/therapy , Aphasia*/rehabilitation , Aphasia*/pathology , Language Therapy*/methods , Functional Laterality*/physiology , Brain*/diagnostic imaging , Brain*/physiopathology, Humans ; Female ; Male ; Middle Aged ; Magnetic Resonance Imaging ; Aged ; Treatment Outcome ; Diffusion Tensor Imaging ; Adult ; Language Tests ; Multimodal Imaging ; Image Processing, Computer-Assisted ; Brain Mapping |
| Abstract: | Background: Few studies investigated factors that predict intensive language therapy (ILT) outcome. This study aimed to analyze multimodal neural factors that possibly underly ILT success. Methods: Lesion volume and DTI analyses were performed with 17 aphasic individuals, and complemented by fMRI analysis in 12 patients (due to drop-outs). Structural and functional data were collected at the beginning of a seven week ILT program and correlated with language changes, measured using the Aachen Aphasia Test. Additionally, all analyses were correlated with the patients' initial aphasia severity. Results: Therapy success was associated with functional activity in right inferior and middle temporal gyri, bilateral superior frontal gyrus/ adjacent anterior cingulate cortex, and right occipital lobe (lingual gyrus, fusiform gyrus, lateral occipital cortex). Statistically uncorrected DTI analysis (p(uncorr) < .001) revealed a positive correlation between language improvement and structural integrity in the right temporal lobe and two left-hemisphere white matter clusters (frontal, parietal). Neither global nor language-specific lesion volume was correlated with therapy outcome. However, lesion volume in insula, putamen and white matter tracts was correlated with initial aphasia severity. Conclusions: Our preliminary results suggest a predictive role of right temporal structures and functional activation in areas associated with healthy language processing. They also indicate a contribution of functional activation in brain areas associated with cognitive control and non-linguistic semantic processing. Further, lesion volume in both global and language-specific structures proved relevant for the initial severity of aphasia but not for recovery potential following ILT. Our results should be regarded as hypothesis-generating for future research. (© 2026. The Author(s).) |
| Competing Interests: | Declarations. Conflicts of interest: None declared. Ethical approval: This study was performed in line with the principles of the Declaration of Helsinki. It was approved by the Ethics Committee of the Medical Faculty of RWTH Aachen University (vote number: EK 188/12). Informed consent: Informed written consent was obtained from all participants before enrollment. |
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| Grant Information: | 691239 Medizinische Fakultät, RWTH Aachen University |
| Contributed Indexing: | Keywords: Aphasia; Functional MRI; Intensive language therapy; Lesion volume; Neuroplasticity; Structural MRI |
| Entry Date(s): | Date Created: 20260724 Date Completed: 20260724 Latest Revision: 20260727 |
| Update Code: | 20260727 |
| PubMed Central ID: | PMC13400484 |
| DOI: | 10.1007/s00415-026-13999-4 |
| PMID: | 42498848 |
| Database: | MEDLINE |
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