Research & Development

University of Edinburgh fMRI/React2 Aphasia PhD Research Project

Anna Jones is a qualified Speech and Language Therapist carrying out a PhD at the University of Edinburgh. The PhD study is investigating the benefits of the react2 software program in people who have aphasia, and more specifically auditory comprehension impairment, following a stroke. Anna is using the ‘auditory comprehension’ and ‘semantics’ modules of the react2 program in this study, to look at the efficacy of this computer-assisted therapy tool.

Patients are recruited from across Lothian for the study. They undergo communication, memory and mood assessments, as well as functional MRI (fMRI), before commencing (depending on group allocation) 3 months of independent therapy using the react2 software. Participants then undergo another set of communication, memory and mood assessments and another fMRI scan following the therapy. Further speech and language assessments are carried out 6 months post- therapy to look at the long-term benefits.

Background

Aphasia is a clinical trait characterised by language impairments. After a stroke, approximately 20% of people with aphasia suffer from chronic difficulties. People with aphasia show impairments in one or more area of communication ranging from spoken output to understanding of spoken or written word. This study focuses on those patients who have difficulty with understanding spoken language: auditory comprehension impairment.

Intensive speech and language therapy has been shown to improve chronic stages of aphasia, even when only given for short period of time. However, it is also known that the 3 months following the acute phase correspond to the period of time where patients spontaneously recover.

Spontaneous language recovery has been associated with a reactivation of the peri-lesioned left perisylvian cortex after an early upregulation by the right hemisphere. In order to promote the recovery, it therefore seems desirable to provide therapy during this whole period of time. Providing therapy during this whole time can nowadays be achieved using computer-assisted home therapy programme such as react2. Using an easy PC-tablet, similar to a laptop, with touch-screen technology, allows almost anyone to access therapy. This project will, for the 1st time, investigate the effect of long-term (3 months), independent, training on patient recovery.

Aim

Investigate the benefits of computer assisted home speech and language therapy in left perisylvian ischemic or haemorrhagic stroke (Wernicke aphasia).

Means

Behavioural speech and language performances

Functional magnetic resonance imaging

Objectives

  • Establish the behavioural and neural correlates of specific home speech therapy (patients with specific auditory therapy vs. patients with non specific therapy)
  • Differentiate learning effects from cortical plasticity (control participants vs. stroke participants)
  • Establish long term benefits of computer-assisted home speech and language therapy.

Acknowledgments

The work is being supervised by Dr Cyril Pernet as part of the Language and Categorization Laboratory at the Brain Research Imaging Centre, a member of the SINAPSE collaboration at the Division of Clinical Neurosciences, University of Edinburgh. SINAPSE is funded by the Scottish Funding Council (SFC) and the Chief Scientist Office of the Scottish Executive (CSO).

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