Aphasia Research Finder: Aphasia research studies

Conversation Group Treatment for Aphasia: Does it Work?

Principle Investigator: NA

Institution: Boston University Charles River Campus

Country: United States

City: Boston, Massachusetts; Maywood, New Jersey; Philadelphia, Pennsylvania

Brief Description:

The proposed research will test the efficacy of group conversation treatment for people with aphasia and explore whether the effects of treatment differ as a result of the following factors:

Group size: Do large groups of 6-8 people with aphasia or dyads of 2 people with aphasia demonstrate different levels of improvement with this treatment? Group composition: Do effects of conversation group treatment differ if the groups include members with similar or different types of aphasia? Aphasia severity: Do effects of conversation group treatment differ if the individuals within the group have mild-moderate or moderate-severe profiles of aphasia?

Treatment sessions will occur in groups of 6-8 people with aphasia or with 2 people with aphasia. During treatment sessions, discourse will be facilitated on a focused set of every day topics, such as current events or travel. Linguistic and multi modal cueing hierarchies will be tailored to individual client goals and used to maximize communication success.

The prediction is that conversation treatment is an effective method for improving communication in people with aphasia, but that specific benefits may differ based on variables such as group size, group composition, and aphasia severity. The results will help inform best practices for aphasia treatment and refine a hypothesized model about the mechanisms underlying conversation treatment.

Inclusion Criteria:

Criteria for All Treatment Cycles

Clinical diagnosis of aphasia

At least 6 months post-onset of stroke in the language-dominant hemisphere.

Native English speakers

Demonstrate sufficient auditory comprehension skills to participate in a supported conversation, based on results of standardized aphasia tests

Exclusion

No history of neurological disease (other than stroke)

No history of developmental speech, language, or learning disabilities

No current serious medical illness (e.g., cancer)

Participants will be asked to abstain from concurrent speech language treatment.

Separate criteria for Treatment Cycles 1, 2, and 3 based on aphasia severity:

Cycle 1 Severity-based Inclusion Criteria (Planned 2022):

– All aphasia profiles and severity levels.

Cycle 2 Severity-based Inclusion Criteria (Planned 2023):

– Participants with severe aphasia

Cycle 3 Severity-based Inclusion Criteria (Planned 2024):

– Participants with mild-moderate aphasia.

Exlcusion Criteria:

Contact Information:

Elizabeth Hoover, PhD
Phone:	353-8967
Email:	ehoover@bu.edu
Gayle DeDe, PhD
Phone:	204-2453
Email:	gayle.dede@temple.edu

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Assessing an Animal-Assisted Treatment Program for Adults With Aphasia: The Persons With Aphasia Training Dogs Program

Principle Investigator: Sharon Antonucci, PhD

Institution: Albert Einstein Healthcare Network

Country: United States

City: Elkins Park, Pennsylvania

Brief Description:

The lives of more than 2 million Americans are affected by aphasia, an acquired language impairment most commonly resulting from stroke that affects the ability to remember and express words. The well-being of these individuals is affected not just by the loss of words that is aphasia, but also the loss of friendships and opportunities for community engagement in which the loss of words can result. This study evaluates an animal-assisted treatment, The Persons with Aphasia Training Dogs (PATD) Program, designed to target the psychosocial consequences of aphasia by training participants in positive reinforcement dog training techniques that harness new skill learning and the advantages of interaction with family- or shelter-dwelling dogs to increase confidence and social engagement to support participants in living well with aphasia.

Inclusion Criteria:

Clinical diagnosis of aphasia acquired as the result of cerebro-vascular accident (CVA)

English as a native or primary language

Evidence of linguistic and cognitive capacity to understand the research requirements

Willingness and stamina to participate in the protocol

Lives within 1 hour driving distance to MRRI (50 Township Line Rd, Elkins Park, PA 19027 and (as appropriate) PSPCA HQ (350 E. Erie Ave., Philadelphia, PA 19134

Exlcusion Criteria:

• Diagnosis of neurological injury or disease other than CVA

Contact Information:

Sharon M. Antonucci, Ph.D.
Phone:	215-663-6145
Email:	sharon.antonucci@jefferson.edu
Steph Wolfert
Phone:	215-663-6145
Email:	sharon.antonucci@jefferson.edu

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Changes in Neuroplasticity Following Intensive Rehabilitation of Aphasia and/or Apraxia of Speech

Principle Investigator: Ellika Schalling

Institution: Karolinska Institutet

Country: Sweden

City: Uppsala

Brief Description:

The present study aims to investigate the short- and long-term effects of two weeks of intensive speech-language pathology intervention with additional physiotherapy, on aphasia and apraxia of speech (AOS) and their neural correlates in thirty persons with chronic stroke. Changes are studied following intensive treatment of aphasia and AOS with standardised speech-language testing and testing of communication and with voxel-based morphometry (VBM) analysis and resting state functional connectivity (rsFC).

Inclusion Criteria:

Aphasia 7 months post stroke diagnosed by SLP

Apraxia of Speech 7 months post stroke diagnosed by SLP

Exlcusion Criteria:

Dementia

Severe loss of sight

Severe loss of hearing

Metal implants (preventing fMRI)

Claustrophobia (preventing fMRI)

Contact Information:

Marika J Schütz, Ph.D student
Phone:	0046737570430
Email:	marika.schutz@uu.se

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Telerehabilitation for Aphasia (TERRA)

Principle Investigator: Julius Fridriksson

Institution: University of South Carolina

Country: United States

City: Columbia, South Carolina

Brief Description:

Speech-language therapy is generally found to be helpful in the rehabilitation of aphasia. However, not all patients with aphasia have access to adequate treatment to maximize their recovery. The goal of this project is to compare the efficacy of telerehabilitation or Aphasia Remote Therapy (ART) to the more traditional In-Clinic Therapy (I-CT).

Inclusion Criteria:

Participants must have sustained a left hemisphere ischemic or hemorrhagic stroke at least 12 months prior to enrollment.

Participants must primarily speak English for at least the past 20 years.

Participants must be capable of giving informed consent or indicating another to provide informed consent.

Participants must be between 21-80 years of age.

Participants must be magnetic resonance imaging (MRI) compatible (e.g., no metal implants, not claustrophobic) on a 3-Tesla (3T) scanner.

Exlcusion Criteria:

Participants must not have previous neurological disease affecting the brain (e.g. history of traumatic brain injury).

Participants must not have severely limited speech production (severe unintelligibility) and/or auditory comprehension that interferes with adequate participation in the therapy provided (i.e., WAB-R Spontaneous Speech rating scale score of 0-1 or WAB-R Comprehension score of 0-1).

Participants must not have a history of stroke to the right hemisphere of the brain.

Participants must not have a bilateral, cerebellar or brainstem stroke.

Participants must not have anything that makes them be 3T MRI incompatible

Insufficient intelligible speech to provide accurate responses with discourse/naming.

Contact Information:

Kelli Powell, B.S.
Phone:	803-777-2693
Email:	ssayers@mailbox.sc.edu
Sara Sayers, M.S.
Phone:	803-777-5051
Email:	KELLIAP@mailbox.sc.edu

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Translation and Clinical Implementation of a Test of Language and Short-term Memory in Aphasia

Principle Investigator: Nadine Martin

Institution: Temple University

Country: United States

City: Philadelphia, Pennsylvania; Seattle, Washington

Brief Description:

This project aims to develop a clinically feasible version of a laboratory-developed assessment battery for language and verbal short-term memory difficulties in aphasia.

Inclusion Criteria:

. single or multiple left hemisphere lesions

at least one year post-stroke.

high-school educated

negative histories for mental illness and alcohol/substance abuse.

passed an audiometric pure-tone, air conduction screening at 25 dB HL at 1K, 2K and 4K Hz for at least one ear.

Exlcusion Criteria:

English as a second language Right hemisphere stroke Less than 6 months post-onset of stroke.

Contact Information:

Nadine Martin, Ph.D.
Phone:	215 294 1870
Email:	nmartin@temple.edu
Wendy Greenspan, MA
Phone:	215-204-1790
Email:	wendy.greenspan@temple.edu

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Effects of High-intensity Exercise Training on Physical Fitness, Cognition, Language in Post-stroke Aphasia

Principle Investigator: Maria Ivanova

Institution: University of California, Berkeley

Country: United States

City: Berkeley, California; Hayward, California; San Francisco, California; San Francisco, California

Brief Description:

The goal of this clinical trial is to establish the feasibility and fidelity of a high-intensity exercise program for individuals with post-stroke aphasia. The main questions it aims to answer are:

Is it feasible for stroke survivors with aphasia to participate in a long in-person physical exercise program? Does participation in a physical exercise program lead to physical fitness, cognitive, language and/or psychological changes?

Participants can take part in two different physical exercise interventions:

Low intensity intervention (control intervention); High-intensity physical exercise intervention (target intervention).

Inclusion Criteria:

aphasia following left hemisphere ischemic or hemorrhagic stroke;

at least 6 months from the last stroke;

proficient in English before the stroke;

at least 8 years of education;

between the ages of 18 and 80;

independent with ambulation without a device (single-point cane accepted);

medically stable with no contraindications to participate in regular physical exercise as determined by the patient’s own primary care provider or other treating provider.

Exlcusion Criteria:

prior history of dementia, neurologic illness (other than stroke), or substance abuse;

significant visual or hearing disabilities (e.g., neglect, uncorrected visual or hearing loss) that interfere with testing;

per self-report uncontrolled cardiorespiratory and/or metabolic disorders incompatible with exercise.

Contact Information:

Maria Ivanova, PhD
Phone:	4156389880
Email:	ivanova@berkeley.edu

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pBFS-guided cTBS at Different Doses for Aphasia After Stroke

Principle Investigator: NA

Institution: Changping Laboratory

Country: China

City: Nanyang, Henan; Zhengzhou, Henan

Brief Description:

The objective of this trial is to evaluate the effectiveness and safeness of different doses of continuous Theta Burst Stimulation (cTBS) over the right Superior Frontal Gyrus (SFG), guided by personalized Brain Function Sector (pBFS) technology, on language function recovery in patients with post-stroke aphasia.

Inclusion Criteria:

The patient’s age ranges from 35 to 75 years old (including 35 and 75 years old);

Meet the diagnostic criteria for ischemic stroke (according to the guidelines developed by the American Heart Association/American Stroke Association in 2019 and the guidelines developed by the Neurology Branch of the Chinese Medical Association in 2018) or meet the diagnostic criteria for hemorrhagic stroke (according to the guidelines developed by the American Heart Association/American Stroke Association in 2022 and the guidelines developed by the Neurology Branch of the Chinese Medical Association in 2019) ，with lesions located in the left hemisphere, and a duration of illness ranging from 15 days to 6 months.

Diagnosed as aphasia patient according to the Chinese version of Western Aphasia Battery (WAB), with a WAB-aphasia quotient of less than 93.8 points;

First onset of stroke;

Normal language function before the onset of stroke, and the patient’s native language is Chinese with at least 6 years of education;

Understand the trial and signed the informed consent form.

Exlcusion Criteria:

Combined dysarthria (NIHSS item 10 score ≥2 points);

Aphasia caused by bilateral hemisphere stroke, brain tumor, traumatic brain injury, Parkinson’s disease, motor neuron disease, or other diseases；

Patients with implanted electronic devices such as cardiac pacemakers, cochlear implants, or other metal foreign bodies, or those with MRI contraindications such as claustrophobia or TMS treatment contraindications;

History of epilepsy;

Patient with concomitant severe systemic diseases affecting the heart, lungs, liver, kidneys, etc., and uncontrolled by conventional medication, as detected and confirmed through laboratory testing and examination;

Patients with consciousness disorders (NIHSS 1(a) score ≥1);

Patients with malignant hypertension;

Patients with severe organic diseases, such as malignant tumors, with an expected survival time of less than 1 year;

Patients with severe hearing, visual, cognitive impairment or inability to cooperate with the trial;

Patients with severe depression, anxiety, or diagnosed with other mental illnesses that prevent them from completing the trial;

Patients who have received other neuromodulation treatments such as TMS, transcranial electric stimulation, etc. in the 3 months prior to enrollment;

Patients with a history of alcoholism, drug abuse, or other substance abuse;

Patients with other abnormal findings that the researchers judge are not suitable for participation in this trial;

Patients who are unable to complete follow-up due to geographical or other reasons;

Women of childbearing age who are currently pregnant, breastfeeding, or planning or may become pregnant during the trial;

Patients who are currently participating in other clinical trials.

Contact Information:

Ruiqi Pan
Phone:	010-80726688
Email:	ruiqipanedu@163.com

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Incorporating Strategy Training Into Naming Treatment in Aphasia

Principle Investigator: Sofia Vallila Rohter

Institution: MGH Institute of Health Professions

Country: United States

City: Boston, Massachusetts

Brief Description:

This study incorporates metacognitive strategy training into semantic feature analysis treatment. Semantic feature analysis treatment has a strong evidence base and capacity to improve word retrieval by encouraging circumlocution. Circumlocution facilitates self-cued naming and assists listener comprehension when naming fails. However, semantic feature analysis treatment does not include direct techniques to teach patients with aphasia to generalize the use of semantic feature analysis treatment’s circumlocution procedure. Therefore, this study proposes that combining semantic feature analysis treatment and metacognitive strategy training will stimulate the semantic system and increase patients with aphasias’ use of circumlocution across divergent contexts.

This study aims to measure the treatment’s effect on naming accuracy for trained and untrained items. The study also aim to measure the treatment’s effect on people with aphasias’ knowledge of the strategy components and changes in verbalizations during retrieval attempts. The central hypothesis is that strategy training will increase patients with aphasias’ explicit knowledge about circumlocution and enable them to use it to (1) self-facilitate naming, and (2) produce more informative connected speech.

Inclusion Criteria:

Experienced a single left-hemisphere stroke,

Have aphasia due to stroke,

Be in the chronic stages of their aphasia, at least 6 months post onset of stroke.

Be between the ages of 18 and 89 years of age, and

Be a proficient English speaker,

Have no history of neurodegenerative disease, motor speech disorder, significant mental illness, psychiatric disorder, drug/alcohol abuse, or neurological condition that could influence their cognitive, language, and memory systems.

Exlcusion Criteria:

Experienced multiple strokes;

Be in the acute stage of their aphasia, <6 months post onset of stroke;

Have a diagnosis of neurodegenerative disease, significant mental illness, psychiatric disorder, drug/alcohol abuse, or neurological condition that could influence cognitive, language, and memory systems

Contact Information:

Marjorie Nicholas, PhD
Phone:	617-724-3824
Email:	svallilarohter@mghihp.edu
Sofia Vallila Rohter, PhD
Phone:	617-726-0685
Email:	mlnicholas@mghihp.edu

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Speech Entrainment for Aphasia Recovery

Principle Investigator: Leonardo Bonilha

Institution: Medical University of South Carolina

Country: United States

City: Charleston, South Carolina; Columbia, South Carolina; Salt Lake City, Utah

Brief Description:

After a stroke, many people experience a language impairment called aphasia. One of the most debilitating types of aphasia is non-fluent aphasia. Non-fluent aphasia is defined by significantly reduced speech production, with the speaker producing only a few words or even less. Speech entrainment therapy (SET) is a treatment that has been shown to increase fluency in people with non-fluent aphasia. The study looks to define the best dose of SET that leads to sustained improvements in spontaneous speech production.

Participants who are eligible will undergo baseline language testing, an MRI, and will be randomized into one of 4 treatment groups: SET for 3 weeks, SET for 4.5 weeks, SET for 6 weeks, and no treatment (control group).

Inclusion Criteria:

Aphasia as a result of a left hemisphere ischemic or hemorrhagic stroke (WAB-R Aphasia Quotient <93.8).

Presence of left hemisphere stroke in clinical imaging (CT/MRI) and NIHSS

Participants must have spoken English as their primary language.

21-81 years old

Pre-stroke modified Rankin Scale (mRS)= 2 or less

Post-stroke mRS= 4 or less.

At least 6 months post-stroke.

Non-fluent aphasia (WAB-R Comprehension score >4 and WAB-R Fluency score <6).

Technological compatibility (to be determined by clinical judgment of SLP)

Exlcusion Criteria:

History of chronic neurological or psychiatric diseases (excluding migraines, depression, or post-stroke epilepsy). Self-reported history of learning disability.

Severe dysarthria (determined via SLP clinical judgment from spontaneous speech tasks on the ASRS 3.0).

Global aphasia.

History of right-hemisphere strokes or brain stem/cerebellar strokes with persistent deficits (as evidenced by MRI/CT and NIHSS).

Uncorrectable hearing as determined by the SLP’s clinical judgment.

Uncorrectable vision.

Contraindications to MRI or inability to complete the MRI scanning session.

Women who are pregnant.

Contact Information:

Kelly Krajeck, MHA
Phone:	792-3678
Email:	cute@musc.edu
Stephanie Cute, CCC-SLP
Phone:	792-0189
Email:	krajeck@musc.edu

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pBFS-guided cTBS Over the Inferior Frontal Gyrus for Aphasia After Ischemic Stroke

Principle Investigator: NA

Institution: Changping Laboratory

Country: China

City: Fuzhou, Fujian

Brief Description:

The objective of this trial is to evaluate the effectiveness and safeness of continuous Theta Burst Stimulation (cTBS) over the right Inferior Frontal Gyrus (IFG), guided by personalized Brain Functional Sector (pBFS) technology, on language function recovery in patients with post-ischemic stroke aphasia.

Inclusion Criteria:

Patients between the ages of 35 and 75 years (including 35 and 75 years).

Meet the diagnostic criteria of acute ischemic stroke (using the 2019 American Heart Association/American Stroke Association Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke and the 2018 Chinese Society of Neurology Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke in China). All lesions should be in the left hemisphere, and the course of disease should be more than or equal to 15 days and less than or equal to 3 months .

Meet the diagnostic criteria for aphasia according to the Chinese version of the Western Aphasia Battery (WAB), with a WAB-aphasia quotient less than 93.8.

First onset stroke.

Normal functioning language abilities before the stroke, with Mandarin as their native language and an educational level higher than primary school (more than 6 years’ education).

Understand the trial and be able to provide informed consent.

Exlcusion Criteria:

Combined severe dysarthria (NIHSS item 10 score ≥ 2 points);

Aphasia caused by bilateral hemispheric stroke, brain tumors, traumatic brain injury, Parkinson’s disease, motor neuron disease, or other diseases;

History of epilepsy;

Patients with severe systemic diseases such as heart, lung, liver, kidney diseases, etc., which cannot be controlled by routine medications as confirmed by laboratory tests and examinations;

Impaired consciousness (NIHSS item 1(a) score ≥ 1 point);

Malignant hypertension;

Malignant tumor;

Patients with a life expectancy of less than 1 year due to reasons other than stroke;

Severe hearing, visual, or cognitive impairments that prevent the patient from completing the trial;

Patients with severe depression, anxiety, or other mental illnesses that prevent them from completing the trial;

Patients who have received other neuroregulatory treatments such as TMS or transcranial electrical stimulation within 3 months before enrollment;

History of alcohol abuse, drug abuse, or other substance abuse;

Patients with other abnormal test results that make them unsuitable for participating in this trial as determined by the researchers;

Women of childbearing age who are pregnant or planning to become pregnant;

Patients participating in other clinical trials.

Contact Information:

Jianting Huang, MD,PhD
Phone:	010-80726688
Email:	jianting.huang@pku.edu.cn
Ruiqi Pan
Phone:	010-80726688
Email:	ruiqipanedu@163.com

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Establishment of Virtual Reality System for Stroke Patients With Aphasia

Principle Investigator: NA

Institution: Taipei Veterans General Hospital, Taiwan

Country: Taiwan

City: Taipei city

Brief Description:

Aphasia can significantly influence a person’s social relationship and quality of life. To achieve positive language outcomes, an intensive and high-repetition speech therapy is essential. However, due to the limited number of speech therapists, the intensity and frequency of training are often insufficient. Therefore, it is critical to develop other rehabilitation approaches to enhance the benefits of aphasia intervention. Virtual reality (VR) is an immersive and interactive computer simulation technology that can promote the ecological validity of speech therapy. In this study, we develop an innovative VR software for speech training to explore the effects of VR on various aspects of language outcomes.

Inclusion Criteria:

Diagnosis of stroke with aphasia, including fluent and non-fluent types

Age between 20~80-year-old

Able to understand virtual reality training

Able to cooperate with instructions and follow the rules

Able to use the virtual reality controller and device

Able to sign the subject’s informed consent

Exlcusion Criteria:

Diagnosis of brain pathology other than stoke, such as brain tumor, Parkinson’s disease, dementia

Unable to cooperate with the instructions

Unable to learn how to use the virtual reality controller and device

Any medical diseases or unstable vital signs that may cause safety concern

Severe hearing or vision impairments

Have ever received any form of speech therapy or virtual reality training

Contact Information:

Po-Yi Tsai, MD
Phone:	886-2-2871-2121
Email:	pytsai@vghtpe.gov.tw

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Efficacy of Low-frequency rTMS in Aphasia

Principle Investigator: Talat Bulut

Institution: Medipol University

Country: Turkey

City: Istanbul

Brief Description:

In a randomized controlled trial, efficacy of low-frequency, inhibitory rTMS will be examined in rehabilitation of acquired aphasia. Two cortical sites will be targeted: Right-hemispheric homologues of Broca’s and Wernicke’s areas.

In addition to cognitive screening prior to onset of rTMS, language assessments will be conducted before, during and after the intervention. An eyetracking-while-listening experiment will also be conducted before and after the intervention to investigate morphosyntactic processing.

Inclusion Criteria:

Right-handedness,

Normal or corrected-to-normal vision and hearing,

Aphasia following cerebrovascular accident,

Cerebrovascular accident at least 6 months prior to enrolment in the study,

Satisfying current TMS safety guidelines (Rossi et al. 2009, 2021), which are:

No previous history of epilepsy,

No implant (e.g., cochlear implant) or stimulator (e.g., deep brain stimulation) in the head which may interact with the magnetic field,

No use of central nervous system active drugs that lower seizure threshold (as listed in the aforementioned guidelines)

Exlcusion Criteria:

Left-handedness, ambidexterity,

Impaired and uncorrected vision or hearing,

No aphasia symptoms following cerebrovascular accident,

Time since cerebrovascular accident less than 6 months,

Violating current TMS safety guidelines (Rossi et al. 2009, 2021). In other words:

Having a previous history of epilepsy,

Having an implant (e.g., cochlear implant) or stimulator (e.g., deep brain stimulation) in the head which may interact with the magnetic field,

Taking central nervous system active drugs that lower seizure threshold (as listed in the aforementioned guidelines)

Contact Information:

MEDKOM
Phone:	+905313327754
Email:	tbulut@medipol.edu.tr
Talat Bulut, Ph.D.
Phone:	+90 444 85 44
Email:	tbulut@medipol.edu.tr

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Effect of Communication Partner Training Program for the Management of Persons With Aphasia

Principle Investigator: NA

Institution: Riphah International University

Country: Pakistan

City: Lahore, Punjab

Brief Description:

Communication Partner Training (CPT) is an evidence-based intervention that teaches communication partners (e.g., family members, friends, healthcare workers) how to best support conversation and interaction for a person with aphasia. It does not matter how mild or severe a person’s aphasia is, they can be a good candidate for CPT as long as their communication partner is motivated and willing to adapt their communication style. The objective of this study is to see the effects of communication partner training for the management of persons with aphasia. A randomized controlled trial will be conducted. In total, 6 dyads will be randomly assigned to the intervention (CPT program) or usual care (control) group. Statistical Package for Social Sciences (SPSS) V 25. will be used for Data analysis. Results will be extracted. Conclusion will be made after comparing the pre and post treatment results on person with aphasia.

Inclusion Criteria:

The participant’s aphasia must be caused by stroke and to have occurred at least 12 months before the study takes place.

The participant’s aphasia could be of all degrees of severity (clinically assessed as mild, moderate, or severe on GCS).

The participants with aphasia are required to be 18 years or older, living at home or planned to live at home after rehabilitation, and have no other speech or language impairments (such as severe dysarthria)

Others have to communicate with the person with aphasia on a regular basis (at least once a week).

Exlcusion Criteria:

The participants will be excluded if the persons with aphasia:

Are diagnosed with dementia or any other known significant cognitive impairment.

Have significant hearing or vision problems.

Have known alcohol or drug abuse.

Contact Information:

Fazaila Ehsan, PhD*
Phone:	0320-4587164
Email:	Fazaila.ehsan@riphah.edu.pk
Nazia Mumtaz, PhD
Phone:	0333-5196500
Email:	Nazia.mumtaz@riphah.edu.pk

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Effects of Neuronavigated Theta Burst Stimulation in Therapy of Post-stroke Aphasia

Principle Investigator: Katarzyna Polanowska

Institution: Institute of Psychiatry and Neurology, Warsaw

Country: Poland

City: Warsaw, Masovian Voivodeship

Brief Description:

Aphasia is an impairment in the ability to express and/or understand language, commonly observed after stroke to the language dominant (left) hemisphere. Despite natural tendency to spontaneous functional recovery in the first months post stroke and language improvement due to application of behavioral speech and language therapy (SLT), many aphasic patients do not achieve satisfactory level of verbal communication. The aim of the planned study is to explore the potential of the noninvasive repetitive Transcranial Magnetic Stimulation (rTMS) as a therapeutic tool for aphasia in addition to traditional behavioral therapy. In case of aphasia, studies on therapeutic effectiveness of rTMS aim to increase the activity of the language-dominant left cerebral hemisphere, which may be achieved in an indirect manner by inhibiting the activity of the opposite (right) hemisphere or in a direct manner by increasing the excitability of preserved language areas in the left hemisphere. In our study, we plan to administer the newest form of rTMS called Theta Burst Stimulation (TBS), which is safer than the conventional rTMS, even when used in the perilesional area. Computer-based neuronavigation system will be implemented to precisely localize stimulation targets, control administration of stimuli during rTMS sessions, and evaluate differences between participants regarding deviations from established stimulation points. 45 patients (all right-handed, polish native speakers, aged 18-75 years, diagnosed with non-fluent aphasia) will be enrolled in a randomized, double-blind, sham-controlled trial. Subjects will be randomly assigned to one of the three groups: 1) a group with excitatory intermittent TBS of the left hemisphere (iTBS group), 2) a group with inhibitory continuous TBS of the right hemisphere (cTBS group), 3) a group with sham TBS (sTBS group as a control group). Specific forms of stimulation will be carried out for three consecutive weeks (Monday to Friday; a total of 15 stimulation sessions). Immediately after each session of the stimulation, patients will undergo individual SLT. Assessment of language functioning will be carried out three times: before and after the therapy period, and 3 months after its completion. Results of the study will broaden knowledge about hemispherical mechanisms of language and speech recovery after stroke and provide insight into possibilities of their modulation for the purpose of post-stroke rehabilitation.

Inclusion Criteria:

First-ever left middle cerebral artery ischemic stroke (brain damage localization confirmed by magnetic resonance imaging, MRI)

3 or more months from the onset of stroke

Non-fluent aphasia (confirmed in the BDAE test) with functional communication difficulties ranging from mild to significant (grades from 2 to 4 in ASRS), marked difficulties in naming, and relatively preserved everyday speech comprehension

Native Polish speaker

Right-handedness prior to stroke

Signing of the informed consent for the participation in the study.

Exlcusion Criteria:

Psychiatric and/or neurological comorbidity (e. g. dementia, depressive disorder, alcohol dependence)

Diagnose of epilepsy or epileptic changes in EEG, also frequent losses of consciousness of unclear etiology which might suggest epileptic seizures

History of any neurosurgical procedure around the head area

1.5 T MRI examination contraindications (metal elements in the body, e. g. implantable cardioverter-defibrillator, deep brain stimulation devices; claustrophobia)

Regular intake of medication that could affect cortical excitability (e. g. antiepileptic or antipsychotic drugs, antidepressants, benzodiazepines) or medication influencing neuroplastic processes (e. g. dopamine)

Significant cognitive impairment limiting patient’s cooperation during assessment and behavioral aphasia therapy

Visual deficits significantly hindering the perception of therapeutic tasks presented visually on a computer’s screen

New neurological episode (e. g. another brain stroke) or somatic illness (e. g. COVID-19) during the cycle of the therapy, requiring its interruption.

Contact Information:

Katarzyna E Polanowska, PhD
Phone:	+48224582870
Email:	kpolanowska@ipin.edu.pl
Szczepan Iwański, PhD
Phone:	+48224582870
Email:	iwanski@ipin.edu.pl

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Efficacy of Language Games as Therapy for Post Stroke Aphasia

Principle Investigator: NA

Institution: University of Birmingham

Country: United Kingdom

City: Birmingham, West Midlands

Brief Description:

Aphasia is a language impairment experienced by about one third of stroke patients. This often devastating condition is treated by speech and language therapists (SLTs). There is evidence that language games delivered at the right intensity are an efficacious means of improving communication for people with post stroke aphasia. However, it is unclear which mechanism of language facilitation used in a game works best. This study will provide evidence for the “active ingredient” of a game, together with measures of efficacy, feasibility and enjoyment compared to standard aphasia therapy.

Inclusion Criteria:

Adults who have suffered a stroke a minimum of 2 months prior to commencement of the intervention. They will present with expressive aphasia, with relatively preserved language comprehension. They will have been fully fluent in English before the stroke.

Exlcusion Criteria:

Severe perceptual or cognitive deficits. History of other neurological, psychiatric or neurodegenerative disease impairing language or communicative ability. Severe visual agnosia. Severe limb apraxia. Severe dysarthria. Drug or alcohol abuse.

Contact Information:

Andrew Olson, PhD
Phone:	+44 121 414 3328
Email:	olsonac@bham.ac.uk

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Sentence Production Training in Aphasia

Principle Investigator: Ji Yeon Lee

Institution: Purdue University

Country: United States

City: West Lafayette, Indiana

Brief Description:

This study focuses on developing a novel treatment for sentence production and comprehension in aphasia, using implicit priming. First set of experiments will aim examine which priming conditions are most effective in creating maximal learning effects. Then, in a later experiment, the investigators will develop and test the efficacy of a novel treatment study based on findings from the first set of the experiments.

Inclusion Criteria:

Individuals with post-stroke aphasia

At least 6 months post-onset of eft hemisphere stroke

Native speaker of English

Normal or corrected to normal hearing and vision

High-school educated

Difficulty communicating in sentences, with some ability to use words independently

Exlcusion Criteria:

Severe apraxia of speech

Other neurological conditions affecting communication (e.g., dementia)

Uncontrolled psychiatric/psychological conditions affecting thinking and communication

Active alcohol/substance abuse

Contact Information:

Jiyeon Lee
Phone:	7654943810
Email:	lee1704@purdue.edu
Jiyeon Lee, PhD
Phone:	7654943810
Email:	lee1704@purdue.edu

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Virtual Reality Training for Aphasia Rehabilitation

Principle Investigator: Claudia Repetto

Institution: Catholic University of the Sacred Heart

Country: Italy

City: Brescia

Brief Description:

Aphasia is an acquired deficit following acute damage to the central nervous system that involves the difficulty or impossibility of understanding and formulating language. A typical disorder of non-fluent forms of aphasia is anomia. Anomia refers to the difficulty in finding words, in particular when trying to name objects and actions. According to the Embodied Cognition approach (EC), language is tightly connected to the motor system. In this view, language rehabilitation programs should stimulate language through the activation of the motor system. In this approach, since anomic deficits are often due to a weak link between the meaning of the word and its lemma, the Hebbs’ principles of coincident and correlated learning can be exploited, i.e., by intensifying the synchronous activation of lexicon and semantics and connecting them with the motor counterpart. In this study, the investigators present an innovative training, based on the EC framework, in which they will make use of new technologies for anomia rehabilitation in post-stroke patients. Specifically, the researchers will use immersive 360° videos representing everyday actions displayed from the first-person point of view, experienced through a head-mounted display. The training will be administered 3 times a week for 4 weeks. The control group will watch standard videos representing the same actions recorded from the third-person perspective. Naming abilities will be tested before and after the training together with other cognitive and psychological measures. The investigators expect that the group who will undergo the 360° video-based training will show greater improvement of performance compared to the control group.

Inclusion Criteria:

naming disorder in the post-acute phase (index event occurring at least 6 months earlier)

to have already received rehabilitation treatment in the acute phase

noun naming below cut-off

verbs naming below cut- off

Exlcusion Criteria:

concomitant or pre-existing (with respect to the index event) neurological and psychiatric deficits

epilepsy

balance disorders

neglect

Contact Information:

Alice Cancer, PhD
Phone:	+39 3488122121
Email:	claudia.repetto@unicatt.it
Claudia Repetto, Prof
Phone:	+39 3488122121
Email:	alice.cancer@unicatt.it

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Neural Bases of Vocal Sensorimotor Impairment in Aphasia

Principle Investigator: Dr. Roozbeh Behroozmand

Institution: The University of Texas at Dallas

Country: United States

City: Columbia, South Carolina

Brief Description:

Aphasia is the most common type of post-stroke communication disorder characterized by deficits in speech comprehension, production and control. While recovery can be promoted with speech therapy, improvement remains modest and typically requires a large number of sessions contributing to rising health care costs. Traditional aphasia therapy focus on enhancing speech motor output; however, recent evidence suggests that the auditory feedback also plays a critical role in fluent speech. Therefore, a key step toward refining treatment strategies is to develop objective biomarkers that can probe the integrity of sensorimotor mechanisms of speech auditory feedback and identify their impaired function in patients with post-stroke aphasia. This study aims to examine the behavioral, neurophysiological (EEG), and neuroimaging (fMRI) biomarkers of speech impairment following stroke with focus on understanding the role of auditory feedback for speech production and control. We plan to test individuals with post-stroke aphasia and a matched neuroptypical control group during different speech production tasks under the altered auditory feedback paradigm. In addition, we aim to examine the effect of audio-visual feedback training on enhancing communication ability during speech. These biomarkers will be combined with existing lesion-symptom-mapping data in the aphasic group in order to identify the patterns of brain damage and diminished structural connectivity within the auditory-motor areas of the left hemisphere that predict impaired sensorimotor processing of speech in aphasia. The long-term goal of this research is to develop a model for identifying the source of sensorimotor deficit and improve diagnosis and targeted treatment of speech disorders in aphasia.

Inclusion Criteria:

A total of 50 individuals with aphasia due to chronic left hemisphere stroke (> 6 months post-stroke) and 50 age- and gender-matched healthy control subjects will be recruited in this study. The general inclusion criteria for all subjects include: age range 21-75 years, right-handed, and native speaker of English. The aphasic subjects have previously undergone neuro-psychological speech/language testing and have been diagnosed with one type of aphasia (e.g., Broca’s, Wernicke’s, conduction or anomic). Subjects in the control group will meet the inclusion criteria with having normal voice, speech, language, and hearing function and no history of neurological and psychiatric disorder. We expect that a significant proportion of aphasic patients will show symptoms associated with Apraxia of Speech (AOS) or dysarthria; however, these patients will not be excluded unless their deficits will preclude them from performing the experimental tasks.

Exlcusion Criteria:

Subjects with moderate to severe hearing, memory, and/or cognitive impairments will be excluded for both groups. In addition, subjects with history of peripheral laryngeal disorders (e.g., paresis or vocal fold paralysis) will be excluded. Subjects will undergo safety screening and will be excluded if there are any factors counter-indicative for EEG and/or MRI scanning.

Contact Information:

Roozbeh Behroozmand, PhD
Phone:	8037775055
Email:	r-behroozmand@sc.edu

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Word Retrieval in the Wild in People With Post-Stroke Aphasia

Principle Investigator: NA

Institution: Northeastern University

Country: United States

City: Boston, Massachusetts

Brief Description:

People with post-stroke aphasia (PWA) suffer from anomia, a condition where they know what they want to say but cannot retrieve the words. For PWA, word retrieval changes moment-to-moment, leading to diminished motivation to participate in conversations and disengagement from social interactions. In the real world, anomia variability and severity are compounded by contextual factors of communication exchanges (noise, dual-tasking). Ecological momentary assessment (EMA) involves in-situ measurement of a behavior over time during everyday life. EMA has promise for capturing real-world anomia, yet EMA methods have not been tested in PWA. Therefore, the aims of this pilot study are to (1) determine the relative feasibility of two types of smartwatch-delivered EMA (traditional-EMA and micro-EMA) in PWA and (2) determine the extent to which patient-specific factors relate to feasibility. Twenty PWA will be recruited and randomly assigned to either traditional-EMA or micro-EMA conditions. To target in-situ anomia, PWA will complete 36 picture-naming trials/day for three weeks, delivered either as a single trial 36 times per day (micro-EMA) or in four sets of nine trials/set per day (traditional-EMA). Due to the “at-a-glance” single trial delivery of micro-EMA, the investigators hypothesize that PWA in the micro-EMA condition will demonstrate better protocol adherence than PWA in the traditional-EMA condition. Older age, more severe cognitive-linguistic deficits, and greater discomfort with technology will be related to poorer compliance, lower completion, greater perceived burden, and lower intelligibility of naming audio recordings. This bench-to-bedside research will begin a translational path to implement EMA/micro-EMA into routine assessment of aphasia.

Inclusion Criteria:

Current/pre-stroke English proficiency,

Normal/corrected-to-normal vision and hearing,

Medical stability,

History of left hemisphere stroke at least six months prior to enrollment, and

Presence of aphasia

Exlcusion Criteria:

History of neurological disease affecting the brain other than stroke

Contact Information:

Erin L Meier, PhD
Phone:	617-373-7438
Email:	e.meier@northeastern.edu
Stephen Intille, PhD
Phone:	617-373-3711
Email:	s.intille@northeastern.edu

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Semantic Feature Analysis Treatment for Aphasia

Principle Investigator: NA

Institution: VA Pittsburgh Healthcare System

Country: United States

City: Pittsburgh, Pennsylvania

Brief Description:

This randomized controlled comparative effectiveness study examines manipulation of a key component of an established and efficacious treatment for naming impairments in aphasia, along with cognitive and brain correlates of treatment success. Study participants will be randomly assigned to one of two treatment conditions comparing two different versions of Semantic Feature Analysis treatment. Their performance on standardized and study-specific measures will be used to determine which version of the treatment provides superior outcomes, and measures of automatic language processing and functional brain imaging will also be used to identify the underlying neurocognitive mechanisms associated with positive treatment response.

Inclusion Criteria:

6 months post-onset of aphasia due to unilateral left-hemisphere (LH) stroke

Independent in activities of daily living (ADLs) necessary to live in community-based housing or available caregiver to assist with ADLs

Medically stable and able to tolerate intensive treatment schedule (e.g. no uncontrolled seizures, difficulty breathing, frequent migraines)

English as a first language

No participation in any other speech-language treatment during this study, including follow-up period

Sufficient auditory comprehension abilities demonstrated during screening

Sufficient naming impairment exhibited during screening

Exlcusion Criteria:

Right Hemisphere stroke

Neurological disease other than stroke

Significant psychiatric disorder

Severe motor speech disorder

Active substance dependence

Contact Information:

Alyssa Autenreith, M.A.
Phone:	412-360-6472
Email:	mary.sullivan@va.gov
Mary Sullivan, B.S.
Phone:	412-360-6495
Email:	alyssa.autenreith@va.gov

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pBFS-guided Dual-target cTBS for Aphasia After Stroke

Principle Investigator: NA

Institution: Changping Laboratory

Country: China

City: Jinan, Shandong; Qingdao, Shandong

Brief Description:

The objective of this trial is to evaluate the effectiveness and safeness of personalized brain functional sectors (pBFS) technology-guided continuous theta burst stimulation (cTBS) on the inferior frontal gyrus (IFG) combined with the superior temporal gyrus (STG) for language function recovery in post-stroke aphasic patients.