Parallel recovery in a bilingual aphasic: a neurolinguistic and fMRI study

In bilingual aphasics, the neural correlates of rehabilitation benefits and their generalization across languages are still scarcely understood. The authors present the case of a highly proficient bilingual woman (Flemish, L1/Italian, L2) with chronic aphasia who, in the presence of the same pattern of impairment in both languages, showed parallel recovery in both languages after long-term rehabilitation therapy in L2. The authors postulated that this recovery was due to the engagement of the same neural substrates. To confirm this the authors used an event-related functional magnetic resonance imaging (fMRI) paradigm to explore cortical activation during an overt picture naming task, performed in both Flemish and Italian once before and once after 2 weeks of training in L2. Behaviorally, the patient showed complete recovery of both languages. The fMRI results indicated that the same cerebral regions were recruited for both languages before and after training. Increasing activations were observed perilesionally and in homologous contralesional areas. Our data, in agreement with previous results of fMRI studies in healthy bilinguals, indicate a promising direction for future research on the neural mechanisms associated with recovery in bilingual aphasics.