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Morpho-Phonologically Based Treatment for Hebrew Speaking Individuals with Aphasia: An fMRI Study

Poster B60 in Poster Session B and Reception, Thursday, October 6, 6:30 - 8:30 pm EDT, Millennium Hall

Tammar Truzman¹²³, Michal Biran¹, Eugene Soikher⁴, Nachum Soroker⁵, Tamar Levy⁵, Swathi Kiran⁶, Tali Bitan¹⁷; ¹University of Haifa, ²The Institute of Information Processing and Decision Making (IIPDM), Haifa, Israel, ³The Integrated Brain and Behavior Research Center (IBBRC), Haifa, Israel, ⁴Imaging department, Samson Assuta Ashdod University Hospital, ⁵Neurological rehabilitation department, Loewenstein Hospital, Ra’anana Israel, ⁶6 Health & Rehabilitation Sciences, Boston University, ⁷University of Toronto

*Introduction* Anomia is a common characteristic in all types of aphasia. Despite the extensive knowledge that has been accumulated on aphasia therapy, there are no naming treatments developed for Hebrew. Hebrew is a Semitic language with rich morphology, in which most words are composed of intertwined roots and patterns. Words sharing the same root are often semantically related (Dotan & Friedmann, 2015). Studies have shown the prominent role of the root morpheme in access to Hebrew words. The aim of our study is to examine the effects of a new root-based treatment on naming abilities in Hebrew speaking individuals with aphasia and its brain correlates using fMRI. *Methods* We designed a morpho-phonologically-based treatment in Hebrew, composed of three steps: 1) Increasing morpho-phonological awareness to the semantic-morpho-phonological relations between words sharing a root. 2) Identification of morpho-phonological relations among words sharing a root, and; 3) Picture naming in a sentence completion task, containing a verb with a shared root (Kraizer & Novogrodsky, 2012). *Participants*: Twelve adults (7 females; mean age 61.75 years, range 29-82) with chronic post-stroke aphasia and significant anomia following a single left hemisphere (LH) stroke. All were native Hebrew-speakers, right-handed, with no other neurological history. *Procedure*: Three pre-treatment naming assessments were administrated of morphologically complex words (root+pattern). Based on each participants' naming performance, 30 treated words and 30 untreated words were chosen with matched levels of naming accuracy. Each participant received twenty bi-weekly treatment sessions, followed by three post-treatment naming assessments, and a follow-up assessment 10 weeks post-treatment. Treatment was delivered frontally to four participants, and online to the other eight participants, due to the Covid-19 pandemic, but was otherwise identical. Four participants were also scanned using fMRI before and after the treatment, while performing a picture naming task of treated and untreated words. *Results* Treated Words: all participants but one (11/12) demonstrated significant improvement from pre to post treatment. This improvement was preserved in the 10-week follow-up assessment for all eleven participants. Interestingly, three patients also showed a significant improvement from post-test to the follow-up session. Untreated Words: Six participant significantly improved in naming untreated words following the treatment, a change that was significantly maintained for two of them in the follow-up session. fMRI: Preliminary analysis shows increased activation in language areas from pre- to post treatment both in treated and untreated words. Interestingly, the changes in activation were mainly due to increased activation in left hemisphere posterior language regions (superior temporal gyrus, middle temporal gyrus, angular gyrus) as compared to anterior regions (inferior frontal gyrus, middle frontal gyrus, supplementary motor area). *Conclusions* Following the morpho-phonological naming treatment all patients improved in naming the treated words and some participants demonstrated generalization to untreated words. These improvements were accompanied by increased brain activation post treatment, mainly due to increased activation in left posterior language regions. These initial results point to the potential effectiveness of the treatment for Hebrew speaking individuals with aphasia, accompanied by brain plasticity within regions that are involved in lexico-semantic processing.

Topic Areas: Language Therapy, Morphology