Stroke Clinical Trial
Official title:
Brain Connectivity Supporting Language Recovery in Aphasia
The integrity of structural connectivity supporting cortical regions in the left brain hemisphere is hypothesized to enable treatment-induced naming recovery in persons with language difficulties after a stroke (aphasia). The investigators will map whole brain connectivity (i.e., the brain connectome) to investigate the role of cortical connectivity in impairment (Aim 1) and recovery (Aim 2) in patients with aphasia undergoing treatment. This information will be used to construct personalized markers of anomia treatment outcome (Aim 3), which may serve as a guide for speech-language pathologists and neurologists when facing patient management decisions.
Aphasia, an impairment of language processing, is one of the most common consequences of
strokes affecting the dominant brain hemisphere4. Patients with aphasia are usually incapable
of working, and their interactions with family and friends are often severely affected. The
hallmark deficit of aphasia is the inability to name objects or people (anomia)12. The
severity of anomia is closely related to a poor quality of life.
While many patients with aphasia exhibit some language recovery in the first days to weeks
after the stroke, 30-40% persist with long lasting naming impairments4. Fortunately, speech
therapy can be very effective to improve naming for some patients with chronic aphasia5-8.
However, it is well recognized among clinicians that speech therapy can be ineffective for
other patients, making it difficult to predict how and why some patients benefit from naming
treatment, while others show little or no improvement.
Here, the investigators propose to evaluate whether naming impairment and naming recovery are
related to the extent of structural damage to the cortical language network. Importantly, the
investigators will evaluate damage as the combined effect of cortical necrosis and cortical
disconnection. The investigators hypothesize that assessing anomia as being either due to
gray matter necrosis or due to cortical disconnection constitutes a false dichotomy since
most chronic patients exhibit gray and white matter damage. Furthermore, the investigators
propose that disconnection of seemingly spared cortical areas has up till now been
underappreciated in patients with stroke due to limitations in brain connectivity assessment
tools. By examining only areas of cortical necrosis without considering disconnected areas,
one may underestimate the magnitude of language network damage. A better understanding of the
effects from both cortical damage and disconnection on anomia and its recovery could lead to
an improved clinical management of aphasia.
The investigators will employ the innovative concept of the brain connectome, i.e., the
individualized map of neural connections in the brain, to evaluate whether naming recovery is
supported by preserved gray matter and preserved connectivity involving key language areas in
the left hemisphere. The investigators propose that left frontal and left temporal
connectivity mapped based on the individual's connectome is an important explanatory variable
towards naming impairment and recovery.
The investigators believe that this research is significant for the three main reasons.
First, it can have a direct clinical impact by providing a better understanding of which
patients can benefit from therapy. Second, it can unveil the neurobiological mechanisms
supporting language recovery, improving our understanding of brain plasticity related to
language rehabilitation. Finally, if disconnection contributes to language impairment, our
methods can be developed to test specific theories of language organization in the brain. The
significance of these aspects is explained in detail below.
;
Status | Clinical Trial | Phase | |
---|---|---|---|
Recruiting |
NCT04043052 -
Mobile Technologies and Post-stroke Depression
|
N/A | |
Recruiting |
NCT03869138 -
Alternative Therapies for Improving Physical Function in Individuals With Stroke
|
N/A | |
Completed |
NCT04101695 -
Hemodynamic Response of Anodal Transcranial Direct Current Stimulation Over the Cerebellar Hemisphere in Healthy Subjects
|
N/A | |
Completed |
NCT04034069 -
Effects of Priming Intermittent Theta Burst Stimulation on Upper Limb Motor Recovery After Stroke: A Randomized Controlled Trial
|
N/A | |
Terminated |
NCT03052712 -
Validation and Standardization of a Battery Evaluation of the Socio-emotional Functions in Various Neurological Pathologies
|
N/A | |
Completed |
NCT00391378 -
Cerebral Lesions and Outcome After Cardiac Surgery (CLOCS)
|
N/A | |
Recruiting |
NCT06204744 -
Home-based Arm and Hand Exercise Program for Stroke: A Multisite Trial
|
N/A | |
Active, not recruiting |
NCT06043167 -
Clinimetric Application of FOUR Scale as in Treatment and Rehabilitation of Patients With Acute Cerebral Injury
|
||
Active, not recruiting |
NCT04535479 -
Dry Needling for Spasticity in Stroke
|
N/A | |
Completed |
NCT03985761 -
Utilizing Gaming Mechanics to Optimize Telerehabilitation Adherence in Persons With Stroke
|
N/A | |
Recruiting |
NCT00859885 -
International PFO Consortium
|
N/A | |
Recruiting |
NCT06034119 -
Effects of Voluntary Adjustments During Walking in Participants Post-stroke
|
N/A | |
Completed |
NCT03622411 -
Tablet-based Aphasia Therapy in the Chronic Phase
|
N/A | |
Completed |
NCT01662960 -
Visual Feedback Therapy for Treating Individuals With Hemiparesis Following Stroke
|
N/A | |
Recruiting |
NCT05854485 -
Robot-Aided Assessment and Rehabilitation of Upper Extremity Function After Stroke
|
N/A | |
Active, not recruiting |
NCT05520528 -
Impact of Group Participation on Adults With Aphasia
|
N/A | |
Completed |
NCT03366129 -
Blood-Brain Barrier Disruption in People With White Matter Hyperintensities Who Have Had a Stroke
|
||
Completed |
NCT05805748 -
Serious Game Therapy in Neglect Patients
|
N/A | |
Completed |
NCT03281590 -
Stroke and Cerebrovascular Diseases Registry
|
||
Recruiting |
NCT05621980 -
Finger Movement Training After Stroke
|
N/A |