300 Section - Mapping Acute Post-Stroke Aphasia: multidimensional language deficits reveal dissociable neural signatures of compensation and inhibition via resting-state fMRI

This study aimed to dissociate the neural signatures of compensation and inhibition in acute post-stroke aphasia by integrating multidimensional language assessment with resting-state fMRI.

Design:

48 acute PSA patients and 45 controls underwent rs-fMRI and the Chinese Aphasia Language Battery. Imaging indices included ALFF, fALFF, ReHo, and network connectivity. Brain–behavior associations were assessed.

Results:

Two language dimensions emerged: lexical–semantic and phonological–auditory. Left perisylvian hypoactivity and cerebellar/RPCC hyperactivity were observed. Left STG activity correlated with semantics; right MTG activity inversely correlated with phonology, supporting interhemispheric inhibition.

Conclusion:

Acute PSA involves compensatory left STG activity and maladaptive right-hemisphere inhibition. Interhemispheric disconnection indicates network failure, offering biomarkers for stratified neurorehabilitation.