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NEUROLOGY 1996;47:1504-1511
© 1996 American Academy of Neurology

Recovery from nonfluent aphasia after melodic intonation therapy

A PET study

P. Belin, Van Eeckhout, Ph., M. Zilbovicius, MD, PhD, Ph. Remy, MD, C. Francois, S. Guillaume, F. Chain, MD, G. Rancurel, MD and Y. Samson, MD

From Service Hospitalier Frederic Joliot (P. Belin and Drs. Zilbovicius, Remy, and Samson), DRM-CEA, Orsay; Centre du Langage (Ph. Van Eeckhout, C. Francois, S. Guillaume, and Dr. Chain), CHU Pitie-Salpetriere, Paris; Inserm U316 (Dr. Zilbovicius), CHU Bretonneau, Tours; and Service des Urgences Cerebro-Vasculaires (Drs. Rancurel and Samson), CHU Pitie-Salpetriere, Paris, France.
Supported in part by grant no. CRE-921010 from INSERM.
Received March 8, 1996. Accepted in final form April 23, 1996.
Address correspondence and reprint requests to Pascal Belin, Service Hospitalier Frederic Joliot, CEA 4, Place du General Leclerc, 91401 Orsay Cedex, France.

We examined mechanisms of recovery from aphasia in seven nonfluent aphasic patients, who were successfully treated with melodic intonation therapy (MIT) after a lengthy absence of spontaneous recovery.We measured changes in relative cerebral blood flow (CBF) with positron emission tomography (PET) during hearing and repetition of simple words, and during repetition of MIT-loaded words. Without MIT, language tasks abnormally activated right hemisphere regions, homotopic to those activated in the normal subject, and deactivated left hemisphere language zones. In contrast, repeating words with MIT reactivated Broca's area and the left prefrontal cortex, while deactivating the counterpart of Wernicke's area in the right hemisphere. The recovery process induced by MIT in these patients probably coincides with this reactivation of left prefrontal structures. In contrast, the right hemisphere regions abnormally activated during simple language tasks seem to be associated with the initial persistence of the aphasia. This study supports the idea that abnormal activation patterns in the lesioned brain are not necessarily related to the recovery process.

NEUROLOGY 1996;47: 1504-1511




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