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Resting state fmri and assessment of language recovery in poststroke sensory aphasia


V.M. Shklovsky Dr. Sc. (Psychol.), Professor, Academician of the Russian Academy of Education, Scientific Supervisor, Center for Strategic Research of the RAS;Centre of Speech Pathology and neurorehabilitation (Moscow)
L.A. Mayorova Ph.D. (Med.), Research Scientist, Laboratory of Applied Physiology of Human Higher Nervous Activity, Institute of Higher Nervous Activity and Neurophysiology of RAS (Moscow); Centre of Speech Pathology and Neurorehabilitation (Moscow)
V.V. Alferova – Dr. Sc. (Med.), Neurologist, Center for Speech Pathology and Neurorehabilitation of the Moscow Department of Health; Clinical Base of the Federal Medical Research Center for Psychiatry and Addictology named after V.P. Serbsky Ministry of Health of Russia (Moscow) Russian Medical Research University. N.I. Pirogov Ministry of Health of Russia (Moscow)
A.G. Petrushevsky Radiologist, Centre of Speech Pathology and Neurorehabilitation (Moscow)
E.G. Ivanova Ph.D. (Psychol.), Neuropsychologist, Center for Speech Pathology and Neurorehabilitation of the Moscow Department of Health, Clinical base of the Federal Medical Research Center for Psychiatry and Addictology named after V.P. Serbsky Ministry of Health of Russia (Moscow); Russian Medical Research University. N.I. Pirogov Ministry of Health of Russia (Moscow)
S.V. Kuptsova neuropsychologist, Junior Research Scientist, Centre of speech pathology and neurorehabilitation (Moscow); Institute of higher nervous activity and neurophysiology of RAS (Moscow)

Rehabilitation of patients after a stroke is an important social and economic problem. In this regard, the development of objective methods for assessing the effectiveness of the neurorehabilitation process is an actual scientific and practical task.
Among the researchers, it is believed that condition of the so-called resting state networks before and after the patient's training can serve as an additional criterion for evaluating the neuronal rearrangements corresponding to the restoration of the impaired function.
In this pilot study, we attempted to evaluate the possibility of longitudinal monitoring of functional changes in brain regions in pa-tients after a stroke, and also to make a preliminary representation of cerebral correlates of post-stroke neuroplasticity at terms of up to 1 year.
The work was conducted on the basis of the Center for Pathology of Speech and Neurorehabilitation (CSP&NR). A longitudinal examination of 5 patients in the early stages of a stroke with sensory aphasia in the diagnosis. Patients were hospitalized 2 times and underwent fMRI examination with registration of resting networks at admission and at discharge (4 total examinations).
A detailed neuropsychological examination was performed on a 10-point scale for assessing neuropsychological symptoms before and after a course of restorative therapy (4 in total). The total follow-up time was 8.5 months.
The fMRI method was used in this study as the main instrumental technique that allows mapping resting state networks that characterize the activity of the brain that is not involved in the performance of any special task.
As areas of interest were identified: the areas of the anterior and posterior upper temporal gyrus, marginal and angular gyrations from both sides.
In general, stepwise involvement of left-handed speech zones in the process of restoration of functional connectivity according with clinical improvement was observed. Analysis of changes in functional connectivity for the entire observation period shown the increase of largescale functional connectivity of areas of interest with the nodes of other rest networks. Perhaps the strengthening of interaction with other rest networks reflects the process of integrating the "speech" network (as it is being restored) to higher levels of neural network interactions.
The possibility of observing functional brain reconstructions in patients with sensory aphasia was introduced and preliminary data on functional patterns of post-stroke neuroplasticity were obtained depending on the duration of the stroke.

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June 24, 2020
May 29, 2020

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