Poster E65, Saturday, August 18, 3:00 – 4:45 pm, Room 2000AB
Aphasia rehabilitation: what we learn from neurolinguistics
Sylvie Moritz-Gasser1,2,3;1University Department of Speech-Language Therapy, University of Montpellier (France), 2Neurosurgery Department, Hospital Gui de Chauliac, Montpellier, 3Institute of Neuroscience of Montpellier (INM), INSERM U1051
At the end of the 19th century, pioneering studies introduced a localizationist and static view of brain functioning according to which some circumscribed cortical areas would process determined functions. This view prevailed during a long time, but the advent of new means of brain study profoundly questioned these propositions, highlighting a connectionist and dynamic brain organization in functional networks. Connectomics attempts to describe these networks constituted of cortical structures interconnected by white matter fascicles. We present here, after a brief history of the evolution of knowledge in this field, a connectomic model of functional brain organization of language based on intraoperative brain mapping performed during awake surgery and brain imaging studies. Leaving definitively the static view of localizationism, we suggest that this dynamic networks-based view of language functioning in the brain brings a valuable insight into speech-language therapy with aphasic persons. Advances in neurolinguistics indeed compel speech-language therapists to reconsider their intervention with aphasic people: if speech-language therapy has been shown to be effective, the efficiency of one therapeutic strategy over another remains a matter of debate, and conventional therapies have so far not really proven their worth. Because clinical presentations are infinitely various, the time has come to consider how to build a specific rehabilitation programme for each aphasic person. We specifically bring clinical and theoretical-based hypotheses about the mechanisms underlying anomia, a central feature in aphasia, explaining its links with other aphasic symptoms and then why restoring lexical access is absolutely essential in the context of aphasia rehabilitation. We then propose a neurolinguistics-based methodology to design individualized rehabilitation programmes, targeting linguistic-related cognitive impairments underlying this symptom from which ensues the whole aphasic clinical presentation. This methodology is in line with the theoretical impairment-based cognitive approach, and indicates that speech-language therapy for aphasic people should absolutely be based upon a comprehensive knowledge not only of psycholinguistic models of language processing and current models of cognitive functioning but also of functional neuroanatomy, in order to get an in-depth understanding of the clinical presentation. We finally present the results of a pilot study based on this methodology, and conclude that speech-language therapy strategies for aphasic persons should be designed from a scientifically sound methodology, based on current neurocognitive and neurobiological models of language processing. By developing and using this methodology, professionals would be led to build their own specific rehabilitation programme for each patient.
Topic Area: History of the Neurobiology of Language