Clinical trial NCT00064805: Therapy for Reading Problems in Adults After Brain Injury
Official title: Cognitively-based Treatments of Acquired Dyslexias
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Dyslexia, Acquired
Brain Injuries
Cerebrovascular Accident
Keywords: Cognitive therapy
Aphasia therapy
Alexia
Acquired dyslexia
Phonological deficits
Orthographic deficits
Brain disorders
Brain injury
Stroke
Lead sponsor: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Sponsor class: NIH
First posted: 2003-07-15
Enrollment: 58
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Adults who sustain brain damage due to stroke, head injury, or traumatic surgery may develop difficulty reading. This study examines the effectiveness of behavior-based programs to improve reading ability in these individuals.

Detailed description: Acquired disorders of reading (acquired dyslexia) are common in patients with aphasia subsequent to left hemisphere stroke. Even when language functions recover sufficiently to enable the patient to return to work, continuing dyslexia often interferes significantly with job performance. This study will evaluate cognitive therapies for the treatment of acquired dyslexia.

Each therapy is based upon a cognitive neuropsychological model of reading; the therapies target specific types of reading deficit and stem from the question of re-learning versus re-organization of function. The therapies focus on dyslexic disorders stemming from the following underlying deficits: 1) impaired access to the orthographic word form from the visual modality (pure alexia); 2) impaired orthographic/phonologic connections (phonologic/deep dyslexia); and 3) decreased ability to hold phonologic codes in memory (phonologic text alexia).

Participants in this study will undergo a comprehensive and detailed battery of reading and reading-related tests to determine the underlying impairment causing the reading deficit. Based upon the results of these tests, the patient's dyslexic disorder will be characterized and, if appropriate, the patient will be assigned to one of the treatment programs devised specifically for that type of deficit. Treatment programs are evaluated for efficacy by comparing the accuracy and speed of reading pre- and post-treatment.

Eligibility criteria: Inclusion Criteria

* Reading deficit subsequent to stroke, traumatic brain injury, brain surgery, or other brain damage
* Ability to attend 2-3 sessions per week for several months at Georgetown University in Washington, DC

Exclusion Criteria

* History of developmental dyslexia or learning disabilities
* Best corrected vision less than 20/40
* Less than 10 years of formal education
* Significant memory or comprehension problems

Primary outcomes:
measure: Improved accuracy and/or speed of reading individual words aloud.
Secondary outcomes:
measure: Improved accuracy and/or speed of reading text aloud.
Other outcomes:
Locations:
city: Washington
country: United States
facility: Georgetown University Medical Center
state: District of Columbia
Study officials:
affiliation: Georgetown University Medical School
name: Rhonda B. Friedman, Ph.D.
role: PRINCIPAL_INVESTIGATOR
References:
citation: Friedman RB, Lott SN. Rapid word identification in pure alexia is lexical but not semantic. Brain Lang. 2000 May;72(3):219-37. doi: 10.1006/brln.2000.2286.
citation: Nitzberg Lott S, Friedman RB. Can treatment for pure alexia improve letter-by-letter reading speed without sacrificing accuracy? Brain Lang. 1999 May;67(3):188-201. doi: 10.1006/brln.1999.2054.
citation: Friedman RB, Sample DM, Lott SN. The role of level of representation in the use of paired associate learning for rehabilitation of alexia. Neuropsychologia. 2002;40(2):223-34. doi: 10.1016/s0028-3932(01)00098-7.
citation: Marchand Y, Friedman RB. Impaired oral reading in two atypical dyslexics: a comparison with a computational lexical-analogy model. Brain Lang. 2005 Jun;93(3):255-66. doi: 10.1016/j.bandl.2004.10.013. Epub 2004 Dec 15.
citation: Lott SN, Sample DM, Oliver RT, Lacey EH, Friedman RB. A patient with phonologic alexia can learn to read "much" from "mud pies". Neuropsychologia. 2008 Aug;46(10):2515-23. doi: 10.1016/j.neuropsychologia.2008.04.004. Epub 2008 Apr 16.
citation: Lott SN, Carney AS, Glezer LS, Friedman RB. Overt use of a tactile-kinesthetic strategy shifts to covert processing in rehabilitation of letter-by-letter reading. Aphasiology. 2010 Nov;24(11):1424-1442. doi: 10.1080/02687030903580333.
citation: Lacey EH, Lott SN, Snider SF, Sperling A, Friedman RB. Multiple Oral Re-reading treatment for alexia: The parts may be greater than the whole. Neuropsychol Rehabil. 2010 Aug;20(4):601-23. doi: 10.1080/09602011003710993. Epub 2010 Jul 6.
citation: Kurland J, Cortes CR, Wilke M, Sperling AJ, Lott SN, Tagamets MA, Vanmeter J, Friedman RB. Neural Mechanisms Underlying Learning following Semantic Mediation Treatment in a case of Phonologic Alexia. Brain Imaging Behav. 2008 Sep;2(3):147. doi: 10.1007/s11682-008-9027-2.