Neuroscience-based aphasia therapy of word finding

Successful MRC National Productivity Investment Fund (NPIF) 2017 Studentships application
M. Lambon Ralph, S. Bruehl (nee Abel), in collaboration with G. Parker, University of Manchester

Neuroscience-based therapy of word-finding difficulties in post-stroke aphasia
This PhD forms part of a new and exciting interdisciplinary research programme to bring cognitive-clinical neuroscience together with speech therapy in order to understand the brain mechanisms that support successful therapy for aphasia (acquired language impairments), and with translational neuroscience to develop powerful MRI based diagnostic imaging applications and imaging services to improve clinical diagnostics and patient treatment.
We will use fMRI techniques for the first time to determine neural networks underlying therapy for aphasic word-finding difficulties. These forms of acquired speech deficits are especially disabling because everyday conversation requires the timely retrieval of various word types. This language function can be improved through speech therapy training (Abel, Weiller, Huber, Willmes, & Specht, 2015; Breitenstein et al., 2017). However, it remains unresolved which neural basis underpins successful/failed therapy, which brain areas that specifically underpin phonology, semantics, speech fluency and executive function (Halai, Woollams, & Lambon Ralph, 2017) contribute to compensation, and which critical language pathways (Parker et al., 2005; Bajada et al., 2016) affect therapy outcomes. Moreover, the present project translates the stratified medicine approach to speech therapy, which opens up new opportunities for intervention in the highly heterogeneous group of people with aphasia, and will enhance understanding of learning in the healthy elderly*. The project applies and develops digital technologies for diagnosis (brain imaging, computer-based tests), data analyses (statistical analyses), and clinical translation (computer-based treatments; online therapy tools, manuals or webpages for delivery of interventions).
Our key research questions include (i) which compensatory brain mechanisms are triggered by aphasia therapy, (ii) which behavioural and neural patient characteristics affect therapy outcomes, and (ii) which aspects of therapy methods are crucial for optimal therapy outcomes. We will use neuroimaging (MRI, fMRI, DTI) and behavioural methods to study brain reorganisation for language as a direct result of intensive lexical training in persons with word-finding deficits in aphasia (n=40).
The project fills the critical need for neuro-rehabilitation in the context of an ageing population. Our innovative approach offers better matching of people and treatments, better improvement after stroke, cost savings due to smarter and quicker treatments, and ultimately better quality of life for people who experience aphasia after stroke. Neurorehabilitation of stroke-related language disorders as featured in the project offers a regenerative medicine approach with high translational impact.

Gore, K.R., Woollams, A.M., Bruehl, S., Halai, A.D., Lambon Ralph, M.A. (2022; 2021 Online). Direct neural evidence for the contrastive roles of the complementary learning systems in adult acquisition of native vocabulary. Cerebral Cortex , 32, 3392-3405. (Request HERE)

* The training later used in healthy participants (first study of the PhD project) was partly based on a previous study on verbal learning (see Project on verbal learning):
  • Pohl, A., Meyer, C.M., Deckers, A., Eckmann, T., Barthel, J., Huber, W., Habel, U., Willmes, K. & Abel, S. (2017). Training-related changes of brain activation during speech production in healthy speakers – a longitudinal fMRI study. Aphasiology, 31 (5), 495-518.
Bruehl was 2nd supervisor of the PhD project of Katherine Gore 10/2017-04/2019, after successful co-application to Medical Research Council. The PhD project including the project summary was publicly announced via Find A PhD.