Neurobiology of Language Recovery in Aphasia: Natural History and Treatment-Induced Recovery

Study Overview
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Brief Summary
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The purpose of this study is to investigate the effects of treatment for specific language deficits in people with aphasia. In addition to language and cognitive measures, changes in brain function will also be gathered before and after the treatment is administered in order to track any changes resulting from receiving treatment.

Detailed Description
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Naming Impairments (Anomia): The labs of Dr. Swathi Kiran (Boston University) and Dr. David Caplan (Harvard University, Massachusetts General Hospital) will be studying language recovery in adults with anomia (naming impairments) following a stroke. Participants will receive treatment focusing on the semantic features of common objects (e.g., that birds can fly). The study will examine how naming and other language abilities change in response to treatment, as well as how the brain changes, as measured by magnetic resonance imaging (MRI) and other techniques. Spelling/Writing Impairments (Dysgraphia): At Johns Hopkins University, the lab of Dr. Brenda Rapp will investigate the neurobiology of language recovery in individuals with dysgraphia (spelling/writing impairments) resulting from a stroke. In this study, treatment will focus on improving spelling ability. The study will examine how spelling and other language abilities change in response to treatment, as well as how the brain changes, as measured by magnetic resonance imaging (MRI) and other techniques. Deficits in Sentence Comprehension & Production: Dr. Cynthia Thompson's lab at Northwestern University will investigate language recovery in individuals with deficits in sentence production and comprehension. Treatment focuses on production and comprehension of complex sentences. At baseline (week 0) and after the treatment period (at week 12), participants take part in language, eye-tracking, and MRI testing, in order to learn how the processing of language, as well as brain function, changes as a result of treatment.

Official Title
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The Center for the Neurobiology of Language Recovery (CNLR)

Conditions
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Aphasia, Anomia, Dysgraphia, Agrammatism, Stroke

Intervention / Treatment
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* Behavioral: Treatment Focusing on Naming Objects
* Behavioral: Treatment Focusing on Improving Spelling Abilities
* Behavioral: Treatment Focusing on Improving Sentence Processing
* Behavioral: No Treatment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Aphasia following a stroke Stoke was at least 1 year ago Medically stable Right-handed Normal or 'corrected to normal' vision and hearing English as primary language At least a high school education Exclusion Criteria: History of neurological disease, head trauma, psychiatric disorders, alcoholism, or developmental speech, language, or learning disabilities

Ages Eligible for Study
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Minimum Age: 35 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Naming Deficits<br>Language treatment will focus on improving naming deficits in people who have aphasia. An experimental group will receive treatment focusing on naming objects and a control/natural history group will receive no treatment. Both groups will be assessed at baseline (week 0), at week 12, and at week 24. | Behavioral: Treatment Focusing on Naming Objects<br>* Treatment will be administered from week 0 until week 12.<br>* Other names: Language treatment;Behavioral: No Treatment<br>* No treatment will be administered.<br>|
| Experimental: Spelling and/or Writing Deficits<br>Language treatment will focus on improving writing and/or spelling deficits in people who have aphasia. An experimental group will receive treatment focusing on improving spelling abilities and a control/natural history group will receive no treatment. Both groups will be assessed at baseline (week 0), at week 12, and at week 24. | Behavioral: Treatment Focusing on Improving Spelling Abilities<br>* Treatment will be administered from week 0 until week 12.<br>* Other names: Language Treatment;Behavioral: No Treatment<br>* No treatment will be administered.<br>|
| Experimental: Sentence Processing<br>Language treatment will focus on improving sentence comprehension and production deficits in people who have aphasia. An experimental group will receive treatment focusing on improving sentence processing and a control/natural history group will receive no treatment. Both groups will be assessed at baseline (week 0), at week 12, and at week 24. | Behavioral: Treatment Focusing on Improving Sentence Processing<br>* Treatment will be administered from week 0 until week 12.<br>* Other names: Language Treatment;Behavioral: No Treatment<br>* No treatment will be administered.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in language and cognitive abilities as a result of treatment | Standard and non-standard measures of language and cognitive abilities will be gathered at baseline (week 0) to see if language deficits improve after treatment is administered (week 12). | week 0 to week 12 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Composite change in brain function as a result of treatment | Neural correlates of treatment effects will be examined using: Functional Magnetic Resonance Imaging (fMRI) Diffusion Tensor Imaging (DTI) Perfusion Imaging Functional Connectivity Rest state Connectivity | week 0 to week 12 | 
| Maintenance of language and cognitive abilities as a result of treatment | Standard and non-standard measures of language and cognitive abilities administered at week 12 will be compared to those administered at week 24 to see if improvement in language abilities as a result of treatment is maintained. | week 12 to week 24 | 
| Maintenance of composite changes in brain function as a result of treatment | Neural correlates of treatment effects that are maintained for 12 weeks after treatment ends (week 12 to week 24) will be examined using: Functional Magnetic Resonance Imaging (fMRI) Diffusion Tensor Imaging (DTI) Perfusion Imaging Functional Connectivity Rest state Connectivity | week 12 to week 24 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Aphasia, Dysgraphia, Anomia, Agrammatism, Stroke, Language Recovery, Treatment, Biomarkers of Recovery