Cerebral reorganization patterns predicting language recovery in individuals with post-stroke anomia: Evidence from functional near-infrared spectroscopy

This study integrates functional near-infrared spectroscopy (fNIRS) with network-based statistics (NBS) to investigate the brain functional reorganization patterns in patients with post-stroke anomia (PSA) and their relationship with language recovery. The study included 28 patients with mild to moderate PSA and a matched healthy control group (HC). A parallel controlled trial design was employed to compare neural and behavioral changes before and after language intervention between the normal treatment (NT) and deferred treatment (DT) groups. The results revealed that: (1) in PSA patients, activation of the left hemisphere Broca's area and supramarginal gyrus (SMG) was significantly reduced during an overt naming task, while compensatory activation in the right hemisphere inferior frontal gyrus (IFG) was enhanced; (2) following treatment, the NT group exhibited a significant increase in hemodynamic responses and functional connectivity in the left hemisphere premotor and supplementary motor area (pSMA), Broca's area, and SMG, accompanied by a reduction in right hemisphere activation, whereas the DT group relied primarily on inefficient reorganization within the right hemisphere and visual cortex; (3) graph theory analysis demonstrated a significant positive correlation between node centrality in the left hemisphere Broca's area and SMG, as well as improvements in naming accuracy and language scores. The study confirms that efficient reorganization of the left hemisphere language network is a core mechanism underlying PSA recovery, with targeted language therapy promoting functional compensation through network integration, while spontaneous recovery depends on atypical pathways. This study provides dynamic evidence for the neuroplastic mechanisms of post-stroke language impairment and supports neuroimaging-based evidence for early clinical intervention.