Project 1

Stroke is the leading cause of adult disability in the United States, and aphasia, or the loss of language due to brain injury, occurs in approximately one-third of individuals following a stroke to the left hemisphere of the brain. Aphasia can also persist into the chronic phase (i.e., greater than six months post stroke). It is understood that aphasia therapy in the chronic phase can improve aphasia recovery; however, very little is known about how different patients respond to different types of treatments. Therefore, an important purpose of this study is to understand how different factors influence an individual’s response to aphasia treatment. Secondly, to make therapy more affordable and accessible, particularly to patients in suburban and rural areas, it is important to explore whether telerehabilitation yields the same results as in-person therapy, and what are the factors that determine who responds better to one or the other type of therapy.

Questions this project will address include:

• Does pre-therapy language, such as picture naming ability or the ability to differentiate between sounds in complex words, predict therapy response?
• Does cognition, such as memory for the relationship between related items or the ability to say a long string of digits backward, predict therapy response?
• What measures of general brain health, as well as characteristics of the stroke and the resulting brain damage, predict treatment response?
• Is telerehabilitation equally effective as in-person therapy, and/or which patient characteristics predict better response to one or the other?

In order to address these questions, participants that take part in this project will receive an MRI of their brain, and participate in a series of assessments of their speech, language, attention, and memory. These will be conducted before therapy begins.

Participants will be enrolled in two, three-week treatment sessions lead by certified speech-language pathologists (SLPs), either remotely (via a computer and an internet connection with the therapist) or in person in our lab. As was done pre-therapy, assessments of their behavior will be assessed after the two treatment sessions.

Researchers will then analyze pre-therapy brain scans alongside pre-therapy behavioral assessments to find out what predicts an individual’s response to therapy. We use this information to help us understand factors that influence recovery, and importantly, to develop ways to improve aphasia treatment.