Functional recovery in subcortical crossed and standard aphasia

• Functional recovery of anomia was studied on a longitudinal basis by means of er-fMRI before and after speech therapy.
• We studied a case of subcortical crossed and a case of subcortical non-crossed aphasia.
• Recovery in subcortical aphasia occurs primarily through homologous areas regardless of hemispheric dominance for language.
• The contralateral IFG represents the functional grounding for successful recovery from anomia in subcortical aphasia.

There are very few longitudinal studies investigating functional recovery in aphasics affected by subcortical lesions. In addition, no longitudinal follow-up studies exist of patients with subcortical crossed aphasia.Our aim was to investigate functional recovery in two anomic patients with subcortical aphasia, one crossed aphasia and one standard, uncrossed aphasia due to a similar subcortical lesion. An er-fMRI follow-up paradigm was employed during a picture-naming task. Both patients were scanned prior to speech therapy (T0), after 3 months of anomia-specific rehabilitation (T1) and following 6 months of conventional language rehabilitation (T2). Irrespectively of lesion lateralization, fMRI data disclosed a grounding role for homologue naming-specific areas (respectively, LIFG and RIFG) in determining the progressive pattern of behavioural naming recovery throughout different disease phases. Thus, functional recovery, parallelled by improvement in behavioural naming performance, seems to be strictly related to recruitment of homologue areas in the hemisphere opposite to the aphasiogenic lesion.