Language recovery: brain networks and aphasia rehabilitation in the chronic stage post stroke

Anomia (word finding difficulties) is the hallmark of chronic aphasia.  Speech production is dependent both on regional changes within the left inferior frontal cortex (LIFC) and modulation between and within anatomically distinct but functionally connected brain regions. Interregional changes are particularly important in speech recovery after stroke, when neural plasticity changes underpinning behavioural improvements are observed in both ipsilesional and contralesional frontal cortices. However, the neural mechanisms underpinning plasticity within language and cognitive control regions required for re-learning and recovery of speech function, are not well understood, especially in the chronic phase post stroke.  It is also not known which the best treatment approach for chronic aphasia rehabilitation. To address these questions, I will outline three recent clinical neuroimaging studies ongoing in our lab and clinical neuro- rehabilitation practice within the UK National Health Service (NHS).