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Poster D48, Friday, August 17, 4:45 – 6:30 pm, Room 2000AB

Sensorimotor Strategies for the Improvement of Naming Abilities in Aphasia: Neural and Behavioral Correlates of POEM – Personalized Observation, Execution, and Mental Imagery Therapy in two participants with verb anomia

Edith Durand1,2, Pierre Berroir1,3, Ana Inés Ansaldo1,2,3;1Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal CRIUGM, Canada, 2Ecole d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Canada, 3Université de Montréal et Ecole polytechnique, Institut de génie biomédical, Canada

Anomia is the most frequent and pervasive symptom for people with aphasia (PWA) and can affect all grammatical categories. Research has long focused on noun retrieval, while therapies targeting verb anomia remain scarce. This is somewhat surprising, considering the central role of verbs in sentence and speech production. Single word retrieval therapy for verbs is effective across different approaches, namely therapies based on sensorimotor strategies. However, this kind of therapy has been rarely explored. This study reports on the efficacy of Personalized Observation, Execution, and Mental Imagery (POEM) therapy, a new approach designed to integrate sensorimotor and language-based strategies to treat verb anomia, a frequent aphasia sign. Two participants with chronic aphasia and verb anomia were followed up in a pre-/post-therapy fMRI study. Tests of language and cognitive functions were completed. A personalized set of stimuli was built based on the naming performance on baseline and controlled for linguistic variables. POEM was administered in a massed stimulation schedule: three one hour-sessions per week over five weeks. Both participants benefited from POEM, with improvements observed with both trained and untrained items. Concurrently with the behavioral improvement, changes in the neural substrates sustaining verb naming were observed for both participants, with distinctive activation patterns, reflecting a reduction in the number of recruited areas supporting recovered naming, and the recruitment of brain areas, part of language and mirror neuron systems. In sum, the evidence suggests that structured anomia treatment integrating sensorimotor strategies can improve word retrieval of treated and untreated verbs. In particular, POEM’ is the first to show generalization of therapy effects to untreated verbs in two cases, which suggests that POEM favors the implementation of sensorimotor-based word-retrieval strategy that can be generalized to untrained items. This sensorimotor strategy resulting from POEM is also witnessed by the post-intervention activation pattern observed in the two participants, who showed for P1 significant activation of premotor cortex being part of the sensorimotor circuit, and for P2 significant activation of cerebellum and middle temporal gyri, known to participate namely in semantic processing and verb generation. The activation patterns are consistent with the sensorimotor nature of POEM and therefore is likely to have been therapy-induced. Finally, the fact that a reduction in the number of brain areas supporting correct naming was observed following therapy suggests that POEM leads to more efficient use of brain resources. To conclude, behavioral and functional neuroimaging data provide preliminary evidence on the effects of POEM to treat verb anomia, and highlight the added value of combined language and sensorimotor strategies in contributing to consolidate a word-retrieval strategy that can be better generalized to untrained words. Future studies with a larger sample of participants are required to further explore this avenue.

Topic Area: Language Therapy