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Predicting Language Outcome and Recovery After Stroke (PLORAS)

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Selected Publications

2019

Loughnan, R., Lorca-Puls, D. L., Gajardo-Vidal, A., Espejo-Videla, V., Gillebert, C. R., Mantini, D., Price, C.J., Hope, T. M. H. 2019. Generalizing post-stroke prognoses from research data to clinical data. Neuroimage: Clinical, 24, 102005.

2018

Hope, T.M.H., Friston, K.J., Price, C.J., Leff, A., Rotstein, P.  & Bowman, H. 2018. Recovery after stroke: not so proportional after all? Brain, 142 (1), 15-22.

Gajardo-Vidal, A., Lorca-Puls, D.L., Hope, T.M.H., Parker Jones, O., Seghier, M.L., Oberhuber, M., Prejawa, S., Crinion, J., Leff, A.P., Green, D.W. & Price, C.J. 2018. How right hemisphere damage after stroke can impair speech comprehension. Brain, 141 (12), 3389-3404. 

Hope, T.M.H., Leff, A.P. & Price, C.J. 2018. Predicting language outcomes after stroke: Is structural disconnection a useful predictor? Neuroimage: Clinical, 19, 22-29.

Seghier, M.L. & Price, C.J. 2018. Interpreting and utilizing inter-subject variability in brain function. Trends in Cognitive Sciences, 22, 517-530.

Lorca-Puls, D., Gajardo-Vidal, A., White, J., Seghier, M., Leff, A., Green, D., Crinion, J., Ludersdorfer, P., Hope, T., Bowman, H. & Price, C.J. 2018. The impact of sample size on the reproducibility of voxel-based lesion-deficit mappings. Neuropsychologia, 115, 101-111.

Gajardo-Vidal, A., Lorca-Puls, D.L., Crinion, J.T., White, J., Seghier, M.L., Leff, A.P., Hope, T.M.H., Ludersdorfer, P., Green, D.W., Bowman, H. & Price, CJ.  2018. How distributed processing produces false negatives in voxel-based lesion-deficit analyses. Neuropsychologia, 115, 124-133.

Aguilar, O.M., Kerry, S.J., Ong, Y-H, Callaghan, M.F., Crinion, J., Woodhead, Z.V.J., Price, C.J., Leff, A.P. & Hope, T.M.H. 2018. Lesion site dependent responses to therapy after aphasic stroke. Journal of Neurology, Neurosurgery, and Psychiatry, 89 (12), 1352-1354.

Price, C.J. 2018. The evolution of cognitive models: From neuropsychology to Neuroimaging and back. Cortex, 107, 37-49.

2017

Nardo, D., Holland, R., Leff, A.P., Price, C.J. & Crinion, J.T. 2017. Less is more: Neural mechanisms underlying anomia treatment in chronic aphasia patients.  Brain, 140, 3039-3054.

Achilles, E.I.S., Weiss, P.H., Fink, G.R., Binder, E., Price, C.J. & Hope, T.M.H. 2017. Using multi-level Bayesian lesion-symptom mapping to probe the body-part-specificity of gesture imitation skills.  Neuroimage, 161, 94-103.

Woodhead, Z.V.J., Crinion, J., Penny, W., Teki, S., Price, C.J. & Leff, A.P. 2017. Auditory training changes temporal lobe connectivity in 'Wernicke’s aphasia': a randomized trial. Journal of Neurology, Neurosurgery, and Psychiatry, 88, 586-594.

Hope, T.M.H., Leff, A.P., Prejawa, S., Bruce, R., Haigh, Z., Lim, L., Ramsden, S., Oberhuber, M., Ludersdorfer, P., Crinion, J., Seghier, M.L. & Price C.J. 2017. Right hemisphere structural adaptation and changing language skills years after left hemisphere stroke. Brain, 140 (6), 1718-1728.

Lorca-Puls, D.L., Gajardo-Vidal, A., Seghier, M.L., Leff, A.P., Sethi, V., Prejawa, S., Hope, T.M.H., Devlin, J.T. and Price, C.J. 2017. Using transcranial magnetic stimulation of the undamaged brain to identify lesion sites that predict language outcome after stroke. Brain, 140 (6), 1729-1742.

Price, C.J., Hope, T.M., Seghier, M.L. 2017. Ten problems and solutions when predicting individual outcome from lesion site after stroke. Neuroimage, 145 (B), 200-208.

2016

Hope, T.M., Seghier, M.L., Prejawa, S., Leff, A.P., Price, C.J. 2016. Distinguishing the effect of lesion load from tract disconnection in the arcuate and uncinate fasciculi. Neuroimage, 125, 1169-1173.

Seghier, M.L., Patel, E., Prejawa, S., Ramsden, S., Selmer, A., Lim, L., Browne, R., Rae, J., Haigh, Z., Ezekiel, D., Hope, T.M., Leff, A.P., Price, C.J. 2016. The PLORAS Database: A data repository for Predicting Language Outcome and Recovery After Stroke. Neuroimage, 124 (B), 1208-1212.

2015

Hope, T.M., Parker Jones, O., Grogan, A., Crinion, J., Rae, J., Ruffle, L., Leff, A.P., Seghier, M.L., Price, C.J., Green, D.W. 2015. Comparing language outcomes in monolingual and bilingual stroke patients. Brain, 1-14.

2014

Seghier, M.L., Ramsden, S., Lim, L., Leff, A. P. and Price, C. 2014. Gradual Lesion Expansion and Brain Shrinkage Years After Stroke. Stroke, 45, 877-879.

2013

Hope, T., Seghier M., Leff, A. and Price, C. 2013. Predicting outcome and recovery after stroke with lesions extracted from MRI images. NeuroImage: Clinical, 2(1), 424-433.

Overview

  • This paper presents a method that combines the influence of stroke, time post stroke and demographic information in a large group of stroke patients to predict the likely course of recovery over time in new patients.

2010

Ambridge, L., Leff, A., Crinion, J., and Price, C. October 2010. Predicting language outcome and recovery after stroke. Royal College of Speech & Language Therapists Bulletin, 12-15. PDF iconFull Article (pdf). 

Overview

  • This article was written for the Royal College of Speech & Language Therapists Bulletin.  
  • It gives an overview of the reasons for the project, the methods used, and some findings.

Price, C., Seghier, M., and Leff, A. 2010. Predicting language outcome and recovery after stroke: the PLORAS system. Nature Reviews Neurology, 6, 202-210.

Overview

  • This paper presents a new approach for predicting language outcome and recovery after stroke.
  • It compares the practicality of two different possibilities.
  • The initial perspective was to understand the neural circuits that support language (the wiring in the brain) but this is a complicated endeavour.
  • The new method is more pragmatic and makes predictions on the basis of the recovery of previous patients with the same type of stroke.
  • This method requires a database that records the speech and language skills of a large group of patients who have a range of stroke sites. 
  • It also requires a very precise and accurate way of measuring the location and extent of the lesion in three dimensional high definition space.

Price, C., Crinion, J., Leff, A., Richardson, F., Schofield, T., Prejawa, S., Ramsden, S., Gazarian, K., Lawrence, M., Ambridge, L., Andric, M., Small, S. and Seghier, M. 2010. Lesion sites that predict the ability to gesture how an object is used. Archives Italiennes de Biologie, 148(3), 243-258. PDF iconFull Text (pdf).

Overview

  • This study combined three methodologies to identify the brain regions where damage impairs the ability to gesture how an object is moved while preserving the ability to recognise the object and move the hands.
  • The results demonstrate that the mapping between lesion site and symptoms is not one-to-one, because different lesion sites can cause the same symptom and different symptoms can result from the same lesion site, depending on the degree of damage to other areas.  For example, the effect of losing the use of your index finger depends on whether or not the other fingers can still be used.
  • The take home message is that predicting outcome from lesion sites requires a consideration of the combination of regions that are damaged.

2008

Seghier, M., Ramlackhansingh, A., Crinion, J., Leff, A. and Price, C. 2008. Lesion identification using unified segmentation-normalisation models and fuzzy clustering. Neuroimage, 41, 1253.

Overview

  • This paper introduces a new procedure for identifying stroke sites from MRI scan images of the brain. 
  • This procedure is able to detect stroke sites with different sizes, locations, and textures. 
  • The approach can help to explain how different stroke sites affect behaviour of a stroke survivor (such as language skills) 
  • The method should help to find the total volume of the stroke site or to find the exact boundaries of the stroke.  This could be useful for surgical purposes or diagnosing problems.

2002

Price, C. and Friston, K. 2002. Degeneracy and cognitive anatomy. Trends in Cognitive Sciences, 6(10), 416-421.  Abstract.  Contact Us for the full text.

Overview

  • This paper was fundamental in shaping our approach to understanding the relationship between lesion site and cognitive deficit.
  • The core idea is that the brain has different ways of doing the same thing. This is similar to knowing that it is possible to write using either the left or the right hand. If we lose the left hand, we become more reliant on the right hand, and if we lose the right hand, we can use our left hand (with practice).
  • These alternative ways of doing the same thing are available in the healthy brain (or body) but there are a limited number of options.  For example, if you lose the use of both your right and left hand then you may need to learn to write with a pen in your mouth or your toes.  There are not an infinite number of viable options and the alternative possibilities may be laborious. 
  • Recovery therefore depends on the availability of efficient options. 
  • In terms of methodology, the paper proposes a way to understand and delineate the sets of brain regions that can support a particular function.  
  • However, as described in more recent papers (see above), we now think that it is more effective to predict outcome and recovery using a pragmatic database approach as opposed to understanding all the underlying theory. 
  • Likewise, although it is important that you know that your car won't start if the engine's battery is dead, a driver does not need to  know how the battery or the engine work.

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