Changes in dynamic resting state network connectivity following aphasia therapy

Resting state magnetic resonance imaging (rsfMRI) permits observation of intrinsic neural networks produced by task-independent correlations in low frequency brain activity. Various resting state networks have been described, with each thought to reflect common engagement in some shared function. There has been limited investigation of the plasticity in these network relationships after stroke or induced by therapy. Twelve individuals with language disorders after stroke (aphasia) were imaged at multiple time points before (baseline) and after an imitation-based aphasia therapy. Language assessment using a narrative production task was performed at the same time points. Group independent component analysis (ICA) was performed on the rsfMRI data to identify resting state networks. A sliding window approach was then applied to assess the dynamic nature of the correlations among these networks. Network correlations during each 30-second window were used to cluster the data into ten states for each window at each time point for each subject. Correlation was performed between changes in time spent in each state and therapeutic gains on the narrative task. The amount of time spent in a single one of the (ten overall) dynamic states was positively associated with behavioral improvement on the narrative task at the 6-week post-therapy maintenance interval, when compared with either baseline or assessment immediately following therapy. This particular state was characterized by minimal correlation among the task-independent resting state networks. Increased functional independence and segregation of resting state networks underlies improvement on a narrative production task following imitation-based aphasia treatment. This has important clinical implications for the targeting of noninvasive brain stimulation in post-stroke remediation.