{"doi":"10.1101/2020.01.10.20017004","title":"The language network reemerges during recovery from severe traumatic brain injury","abstract":"Abstract Regaining the ability to express and understand language is a key milestone for patients recovering from severe traumatic brain injury (TBI). However, the neurobiological correlates of language recovery after TBI have not been identified. We explored whether recovery of language in patients with acute severe TBI is associated with functional MRI (fMRI) changes within and outside the canonical language network (i.e. bilateral superior temporal gyri [STG] and inferior frontal gyri [IFG]). We consecutively enrolled 16 adult patients with acute severe TBI and performed fMRI assessment using a spoken language stimulus in the intensive care unit. Eight patients, all of whom recovered language function, returned for follow-up fMRI at median [interquartile range] 220.5 [189-473.5] days post-injury. Sixteen age- and sex-matched healthy subjects also completed the fMRI paradigm. Language function was behaviorally assessed immediately before fMRI using the Coma Recovery Scale-Revised and components of the Confusion Assessment Protocol. At follow-up, patients also completed the California Verbal Learning Test-II. We compared acute and follow-up fMRI responses by calculating mean Z-scores of suprathreshold voxels in bilateral STG and IFG regions-of-interest (ROI). We also performed a whole-brain analysis. Significant longitudinal increases to language stimuli were found in the left STG but not the right STG, left IFG, or right IFG. Whole-brain analysis revealed longitudinal changes in the right supramarginal and middle temporal gyri, regions known to be involved in language processing. Both acute and follow-up fMRI responses in patients were indistinguishable from those of healthy subjects at a stringent statistical threshold of Z ≥ 3.1. At lower statistical thresholds (e.g. Z ≥ 2.1) patients assessed acutely demonstrated decreased fMRI responses in right STG and IFG compared to healthy subjects. Collectively, these results provide initial evidence that responses in bihemispheric language-processing regions of cerebral cortex reemerge with recovery of language function in patients with severe TBI.","journal":"medRxiv","year":2020,"id":129098,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9599,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":307820,"name":"Zachary Threlkeld","orcid":"0000-0002-8931-5468","position":1,"is_corresponding":false},{"id":278375,"name":"Yelena G. Bodien","orcid":"0000-0003-4858-2903","position":2,"is_corresponding":false},{"id":109379,"name":"Brian L. Edlow","orcid":"0000-0001-7235-8456","position":3,"is_corresponding":false},{"id":580316,"name":"Brian Coffey","orcid":"0009-0002-2194-8434","position":0,"is_corresponding":true}],"reference_count":35,"raw_metadata":null,"created_at":"2026-07-18T23:15:45.920615Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}