Published Online
on August 5, 2004

A more recent version of this article appeared on September 1, 2004

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Submitted on February 2, 2004
Revised on May 16, 2004
Accepted on June 22, 2004

Functional MRI Follow-Up Study of Language Processes in Healthy Subjects and During Recovery in a Case of Aphasia

Bruno Fernandez MD^*; Dominique Cardebat PhD; Jean-François Demonet MD, PhD; Pierre Alain Joseph MD; Jean-Michel Mazaux MD; Michel Barat MD; and Michèle Allard MD, PhD

From the Service de Médecine Physique et Réadaptation (B.F., P.A.J., J.-M.M., M.B.) and ERT-Centre National de la Recherche Scientifique Imagerie Moléculaire et Fonctionnelle (M.A.), Université de Bordeaux 2, Bordeaux Cedex, France; and the Institut National de la Santé et de la Recherche Médicale U455 et Service de Neurologie (D.C., J.-F.D.), CHU Purpan, Toulouse, France.

^* To whom correspondence should be addressed. E-mail: b.fernandez{at}tiscali.fr.

Background and Purpose--The goal of this study was to develop a functional MRI (fMRI) paradigm robust and reproducible enough in healthy subjects to be adapted for a follow-up study aiming at evaluating the anatomical substratum of recovery in poststroke aphasia.

Methods--Ten right-handed subjects were studied longitudinally using fMRI (7 of them being scanned twice) and compared with a patient with conduction aphasia during the first year of stroke recovery.

Results--Controls exhibited reproducible activation patterns between subjects and between sessions during language tasks. In contrast, the patient exhibited dynamic changes in brain activation pattern, particularly in the phonological task, during the 2 fMRI sessions. At 1 month after stroke, language homotopic right areas were recruited, whereas large perilesional left involvement occurred later (12 months).

Conclusions--We first demonstrate intersubject robustness and intrasubject reproducibility of our paradigm in 10 healthy subjects and thus its validity in a patient follow-up study over a stroke recovery time course. Indeed, results suggest a spatiotemporal poststroke brain reorganization involving both hemispheres during the recovery course, with an early implication of a new contralateral functional neural network and a later implication of an ipsilateral one.

Key words: language • magnetic resonance imaging • recovery of function • stroke

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