Deans' stroke musings: Functional Magnetic Resonance Imaging Before and After Aphasia Therapy

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, January 14, 2014

Functional Magnetic Resonance Imaging Before and After Aphasia Therapy

Amazing, someone doing actual objective determination of changes in the brain as a result of therapy. Give that team a prize, everyone else can sit in the corner.
But then using fMRI to analyze anything at all is problematic.
The Multiple Comparisons Problem
False Discovery Rate (FDR)
What a dead salmon reminds us about fMRI analysis The igNobel was won for this one.

The fMRI on aphasia here;
http://stroke.ahajournals.org/content/35/2/554.full.pdf

Kyung K. Peck, PhD; Anna B. Moore, PhD; Bruce A. Crosson, PhD; Megan Gaiefsky, MSc;

Kaundinya S. Gopinath, MSc; Keith White, PhD; Richard W. Briggs, PhD

Background and Purpose

—Comparing the temporal characteristics of hemodynamic responses in activated cortical regions of aphasic patients before and after therapy would provide insight into the relationship between improved task

performance and changes in blood oxygenation level– dependent (BOLD) functional MRI (fMRI) signal. This study investigated differences in the time to peak (TTP) of hemodynamic responses in activated regions of interest (ROIs), before and after therapy, and related them to changes in task performance.

Methods

—Three aphasic patients and 3 controls overtly generated a single exemplar in response to a category. For the patients, TTP of hemodynamic responses in selected ROIs was compared before and after language therapy. The timing differences between auditory cues and verbal responses were compared with TTP differences between auditory and

motor cortices.

Results

—The selected ROIs were significantly activated in both aphasic patients and controls during overt word generation. In the aphasic patients, both the timing difference from auditory cues to verbal responses and the TTP difference between auditory and motor cortices decreased after rehabilitation, becoming similar to the values found in controls.

Conclusions

—Findings indicate that (1) rehabilitation increased the speed of word-finding processes; (2) TTP analysis was sensitive to this functional change and can be used to represent improvement in behavior; and (3) it is important to monitor the behavioral performance that might correlate with the temporal pattern of the hemodynamic response.

(Stroke. 2004;35:554-559.)