Brain-based Understanding of Individual Language Differences After Stroke

Study Overview
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Brief Summary
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Strokes often cause a loss of communication ability, referred to as aphasia, as well as cognitive difficulties. Each stroke survivor has a unique pattern of strengths and weaknesses in communication and cognition, and a unique course of recovery. The BUILD study aims to understand the brain basis of these individual differences in stroke outcome. Participants with stroke as well as controls matched in age, educational background, race, and sex are examined using a combination of standardized and in-house tests of language and cognition to provide a detailed profile of strengths and weaknesses. Each participant will have between three and six sessions, including an MRI to measure details of the structure, function, and connections in the brain. The data are analyzed to test how patterns in the stroke lesion explain the patterns of communication and cognitive difficulties, and how patterns in the uninjured parts of the brain explain resilience and recovery from the stroke. Ultimately, we hope that BUILD will guide us toward new targets for brain stimulation treatments or other biologically based treatments that improve language and cognitive abilities after stroke.

Official Title
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Understanding the Brain Basis of Language and Cognitive Functions Through the Study of Individuals With Brain Injury and Healthy Controls

Conditions
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Aphasia, Stroke, Alexia

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Stroke Survivors: Age >=18 Stroke in left hemisphere of brain with or without aphasia, or stroke elsewhere causing aphasia Learned English at 8 years or younger Controls: Age >=18 No history of brain injury resulting from stroke, trauma, infection (i.e. encephalitis), or tumor Learned English at 8 years or younger Exclusion Criteria: History of other brain conditions that could impact interpretation of results (such as multiple sclerosis, premorbid dementia) Severe psychiatric condition that would interfere with participation in the study History of a learning disability that could impact interpretation of results Additional Exclusion Criteria for MRIs: Pacemaker or magnetic metal in the body that is not MRI compatible Pregnancy Claustrophobia

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Stroke Survivors<br>Participants have had a left-hemisphere stroke with or without aphasia, or a stroke elsewhere in the brain causing aphasia. They are given a series of standardized and in-house tests of language and cognition to provide a detailed profile of strengths and weaknesses, plus an MRI. | |
| Controls<br>Participants are matched to aphasia cohort in age, educational background, race, and gender but have no history of brain injury. They are also given a series of standardized and in-house tests of language and cognition to provide a detailed profile of strengths and weaknesses, plus an MRI. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| MP-RAGE (Magnetization Prepared Rapid Acquisition Gradient Echo) | Part of MRI sequence that measures deep grey matter structure. | Collected within 1 month of behavioral testing | 
| DTI (Diffusion Tensor Imaging) | Part of MRI sequence that measures the rate of water diffusion between cells to understand and create a map of internal structures. | Collected within 1 month of behavioral testing | 
| Behavioral testing | Battery of standard clinical and in-house behavioral tests to measure speech, language, and cognition. Final score is derived from principle components analysis. | Collected within 1 month of MRI | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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aphasia, stroke, brain injury, speech, language, reading, alexia, apraxia