Overcoming Learned Non-Use in Chronic Aphasia

NCT ID: NCT02012374

Last Updated: 2022-12-20

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 24 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2012-02-26
• Study Completion Date: 2015-07-09

Brief Summary

In this study the investigators are examining the effectiveness of intensive speech therapy in chronic moderate-to-severe stroke-induced aphasia under two conditions - responses "constrained" or unconstrained to speech. Both treatments involve massed practice communicating, using intensive language action therapy 3 hours/day, 5 days/week for two weeks, followed by six months of a home practice program. One treatment stresses spoken responses as the preferred expressive modality during intensive therapy. Before and after treatment, and following the home practice program and a period of no practice, the investigators will administer several tests and discourse samples to examine changes associated with the treatments. Participants will also undergo structural and functional MRI testing at these time points. The investigators will also attempt to quantify the degree to which improvements following intensive language therapy and home practice correlate with changes in Quality of Life measures as perceived by both participants with aphasia and their significant others. It is hypothesized that, whereas both treatments will lead to improvements in naming practiced words and communicating, outcomes will be enhanced for the group randomly assigned to the "constraint" condition. Moreover, performance will be enhanced on words practiced during the home practice program, including those that were not practiced during intensive therapy. Improved naming will correlate with modulation of 'signature' language and attentional networks, whose variability will depend on remaining viable brain structures. Initial severity and site/extent of lesion should predict patients' ability to transfer gains in naming to improvements in discourse.

Conditions

Stroke-induced Aphasia

Keywords

aphasia; anomia; speech therapy; rehabilitation; neuroplasticity; fMRI; quality of life

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Intensive Language Action Therapy ("constrained")

Following a phase of baseline pre-treatment testing, speech therapy sessions take place 5 days/week for 3 hours per session during two consecutive weeks. Spoken responses are explicitly modeled and encouraged during therapy. Following the intensive 2-week treatment, participants are trained in using individualized home practice programs on iPads. They practice approximately daily for six months, checking in weekly with an SLP via videoconferencing software and return for probes monthly. Six months post-treatment testing will take place following completion of the home practice phase and again at 12 months post-treatment.

Group Type: EXPERIMENTAL

Intensive Language Action Therapy

Intervention Type: BEHAVIORAL

Unconstrained Intensive Language Action Therapy

Following a phase of baseline pre-treatment testing, speech therapy sessions take place 5 days/week for 3 hours per session during two consecutive weeks. All communicative responses are encouraged during therapy. Following the intensive 2-week treatment, participants are trained in using individualized home practice programs on iPads. They practice approximately daily for six months, checking in weekly with an SLP via videoconferencing software and return for probes monthly. Six months post-treatment testing will take place following completion of the home practice phase and again at 12 months post-treatment.

Group Type: EXPERIMENTAL

Intensive Language Action Therapy

Intervention Type: BEHAVIORAL

Interventions

Intensive Language Action Therapy

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• unilateral left hemisphere stroke at least 6 months earlier
• aphasia with moderate-to-severe word retrieval impairments
• at least 21 years of age
• premorbidly right handed
• native speaker of English

Exclusion Criteria

• history of developmental learning difficulties
• history of prior neurological illnesses
• chronic medical illnesses that restrict participation in intensive therapy
• recent alcohol or drug dependence
• severe uncorrected impairments of vision or hearing
• any contraindication to a 3T MRI procedure (e.g., claustrophobia, metal implants or fragments in body, pregnancy)

• Minimum Eligible Age: 21 Years
• Maximum Eligible Age: 90 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

National Institute on Deafness and Other Communication Disorders (NIDCD)

NIH

Sponsor Role: collaborator

University of Massachusetts, Amherst

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Jacquie Kurland, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

UMass Amherst

Locations

University of Massachusetts Amherst

Amherst, Massachusetts, United States

Countries

United States

Other Identifiers

2011-1065

Identifier Type: -

Identifier Source: org_study_id