Theory-Driven Treatment of Language and Cognitive Processes in Aphasia

The aim of this research is to translate a theory of the cognitive relationship between verbal short--term memory (STM) and word processing impairments in aphasia to treatment approaches for language impairment in aphasia. It has been proposed that the co-occurrence of these impairments is due to a disruption of cognitive processes that support both abilities: maintenance of activated semantic and phonological representations of words, hereafter the 'activation--maintenance hypothesis'.

This hypothesis will be tested in the context of a treatment approach that aims to improve word processing and verbal STM abilities. The grant supporting this work has ended. therefore, participants are entered into the study by invitation only.

Study Overview

• Status: Enrolling by invitation
• Conditions: Aphasia
• Intervention / Treatment: Behavioral: Word repetition after a time delay.

Detailed Description

Based on research of word processing and verbal STM impairments in aphasia, it has been proposed that the co-occurrence of these impairments is due to a disruption of cognitive processes that support both abilities: maintenance of activated semantic and phonological representations of words, hereafter the 'activation--maintenance hypothesis'.

This hypothesis will be tested in the context of a treatment approach that aims to improve word processing and verbal STM abilities. Recently, the importance of treatment research has been emphasized as a critical testing ground for theories of language processing. Although it has been demonstrated that associations between impairments of word processing and reduced verbal STM capacity support the 'activation-maintenance hypothesis', direct treatments to improve the ability to maintain activation of word representations will serve as a stronger test of this hypothesis. First, empirical support will be established for the hypothesis that impairment to short-term maintenance of activated semantic and phonological representations of words impairs language and verbal STM abilities in aphasia and that direct treatment of this deficit will improve both abilities (Specific Aim 1). Second, the effects of this treatment will be compared under two administration conditions, high and low intensity (Specific aim 2). Finally, the neural regions associated with semantic STM and phonological STM will be investigated using voxel--based lesion--symptom mapping (Bates et al., 2003) (Specific Aim 3).

This research represents a unique attempt to apply more recent processing theories of aphasia to treatment of the disorder.The outcomes will have important implications for aphasia rehabilitation research.

• Study Type: Interventional
• Enrollment (Estimated): 130
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Pennsylvania
    • Philadelphia, Pennsylvania, United States, 19121
      • Temple University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 21 years to 80 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Experimental participants:

Inclusion Criteria:

• Aphasia
• Single left hemisphere lesions
• Right handed
• At least six months post-stroke
• Aged 21 to 80
• High-school educated with English as their primary language
• Passed an audiometric pure tone, air conduction screening at 25 dB HL at 1K, 2K and 4K Hz for at least one ear (with or without correction)
• Demonstrate adequate vision with or without correction.
• Will not exclude individuals with a mild apraxia of speech or mild dysarthria of speech.

Exclusion Criteria:

• History of mental illness
• Alcohol/substance abuse
• Pregnant
• Unable to personally give informed consent

Control participants:

Inclusion Criteria:

• Aged 21 to 80
• High school educated or above
• Pass an audiometric pure tone, air conduction screening at 25 dB HL at 1K, 2K and 4K Hz for at least one ear.

Exclusion Criteria:

• History of neurological disease or language disability
• Histories for mental illness
• Alcohol/substance abuse.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Word repetition after a tiem delay; People with Aphasia and Short-Term Memory impairment will receive a behavioral treatment: Word repetition after a time delay. This is the intervention: repetition of words after a 5 or 10 second delay.	Behavioral: Word repetition after a time delay.; This is a behavioral intervention, Word repetition after a time delay. Individuals listen to words and repeat them after 5 or 10 seconds.; Other Names: Repetition after delay

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from Baseline Verbal Short-Term Memory (STM) Span at 6 weeks	It is expected that this treatment will increase verbal STM span (primary)	Baseline and 6 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in proportion of words retrieved in picture naming	More words will be retrieved accurately in picture naming.	Post treatment, after 6 weeks of treatment
Discourse measures, changes in rates of context information units	Proportion of content information units will increase as a consequence of htis therapy.	Post treatment, after 6 weeks of treatment

Collaborators and Investigators

• Sponsor: Temple University
• Collaborators: University of Pennsylvania; National Institute on Deafness and Other Communication Disorders (NIDCD)
• Investigators: Principal Investigator: Nadine Martin, Ph.D., Temple University

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2014
• Primary Completion (Estimated): November 30, 2025
• Study Completion (Estimated): November 30, 2025

Study Registration Dates

• First Submitted: January 15, 2016
• First Submitted That Met QC Criteria: January 26, 2016
• First Posted (Estimated): January 27, 2016

Study Record Updates

• Last Update Posted (Actual): April 11, 2024
• Last Update Submitted That Met QC Criteria: April 9, 2024
• Last Verified: April 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Nervous System Diseases; Neurologic Manifestations; Neurobehavioral Manifestations; Language Disorders; Communication Disorders; Speech Disorders; Aphasia
• Other Study ID Numbers: 21987; 5R01DC013196 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO