The Relationship between Frontotemporal Effective Connectivity during Picture Naming, Behavior, and Preserved Cortical Tissue in Chronic Aphasia.

While several studies of task-based effective connectivity of normal language processing exist, little is known about the functional reorganization of language networks in patients with stroke-induced chronic aphasia. During oral picture naming, activation in neurologically intact individuals is found in "classic" language regions involved with retrieval of lexical concepts [e.g., left middle temporal gyrus (LMTG)], word form encoding [e.g., left posterior superior temporal gyrus, (LpSTG)], and controlled retrieval of semantic and phonological information [e.g., left inferior frontal gyrus (LIFG)] as well as domain-general regions within the multiple demands network [e.g., left middle frontal gyrus (LMFG)]. After stroke, lesions to specific parts of the left hemisphere language network force reorganization of this system. While individuals with aphasia have been found to recruit similar regions for language tasks as healthy controls, the relationship between the dynamic functioning of the language network and individual differences in underlying neural structure and behavioral performance is still unknown. Therefore, in the present study, we used dynamic causal modeling (DCM) to investigate differences between individuals with aphasia and healthy controls in terms of task-induced regional interactions between three regions (i.e., LIFG, LMFG, and LMTG) vital for picture naming. The DCM model space was organized according to exogenous input to these regions and partitioned into separate families. At the model level, random effects family wise Bayesian Model Selection revealed that models with driving input to LIFG best fit the control data whereas models with driving input to LMFG best fit the patient data. At the parameter level, a significant between-group difference in the connection strength from LMTG to LIFG was seen. Within the patient group, several significant relationships between network connectivity parameters, spared cortical tissue, and behavior were observed. Overall, this study provides some preliminary findings regarding how neural networks for language reorganize for individuals with aphasia and how brain connectivity relates to underlying structural integrity and task performance.