Redefining Recovery From Aphasia

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This book focuses on two fundamental aspects of brain-language relations: one concerns the neural organization of language in the healthy brain; the other challenges current approaches to treatment of aphasia and offers a new theory for recovery from aphasia. The essence of the book lies in the phrase neural multifunctionality: the constant and dynamic incorporation of non-linguistic functions into language models of the intact brain.

The book makes the claim that language is a construction, created as we use it, and cannot be understood as being supported by neurally based linguistic networks only. Rather, language emerges from the constant and dynamic interaction among neural networks subserving cognitive, affective, and praxic functions with neural networks subserving lexical retrieval (naming), sentence processing (comprehension), and discourse (communication, conversation).

In persons with stroke-induced aphasia, neural networks for executive system function, attention, memory, motor system function, visual system function, and emotion interact with neural networks for language to produce the aphasia profile and to influence recovery from aphasia. Consequently, neural multifunctionality in aphasia explains individual differences in the lesion-deficit model and continued recovery over time, redefining the concept of recovery from aphasia and offering new opportunities for treatment.

Review: Redefining Recovery from Aphasia is a unique book, tying information from speech/language pathology, neurology, neurolinguistics, and cognitive neuroscience in general into a unified approach to recovery from aphasia. The disparate strands of information which these authors bring together not only illuminate the process of recovery from stroke or brain injury causing aphasia, but also provide insight into new approaches to aphasia rehabilitation.

The key concept is multifunctionality, how the language cortex can recover, with help from structures in the brain more specialized in functions such as attention, short-term and long-term memory, executive function, emotion, praxis, and visual processing. The book should be of interest to all who deal with patients with aphasia, including physiatrists, neurologists, speech/language pathologists, neuropsychologists, and linguists. * Howard Kirshner, MD, Professor and Vice Chair, Neurology, Vanderbilt University Medical Center * Aphasia, an impairment of propositional language caused by brain dysfunction, is one of the most common and disabling disorders afflicting humans.

This important book, written by two world renowned aphasiologists, makes a paradigmatic shift. These authors address aphasic disorders and recovery by examining nonlinguistic neurobehavioral factors, such as emotions, praxis, and executive functions. These nonlinguistic functions are mediated by functional networks that are independent, but strongly interconnected with the primary language areas and thus play an import role in supporting recovery and adaptation.

This important book is critical reading for those clinicians, educators and investigators who deal with people who are suffering with aphasia. * Kenneth M Heilman, MD, The James E. Rooks Jr. Distinguished Professor of Neurology, University of Florida College of Medicine, Gainesville *