Neural Networks and Language Recovery in Aphasia From Stroke: fMRI Studies

NCT00467103 | Completed

• 1 other identifier: MHBB-006-06S
• Study Type: observational
• Target: 62
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this research is to utilize functional magnetic resonance imaging (fMRI) to investigate brain reorganization for language behavior in stroke patients with aphasia. A primary focus of the study is on recovery of nonfluent propositional speech and naming in chronic aphasia patients. The fMRI technique is used to examine activation in the left hemisphere (LH) and right hemisphere (RH), during recovery of specific language behaviors in chronic nonfluent aphasia patients.

Conditions

Aphasia; Nonfluent Aphasia; Stroke

Keywords

Adult Aphasia; Diffusion Tensor Imaging; functional Magnetic Resonance Imaging; Language Recovery; Left Middle Cerebral Artery Stroke; Nonfluent Aphasia

Outcome Measures

Primary Outcomes (1)

• Cerebral Activation in the Left and Right Brain Hemispheres

  Cerebral Activation in the Left and Right Brain Hemispheres

  Out to 6 months, from baseline entry

Study Arms (1)

Chronic Stroke patients with Nonfluent Aphasia

patients with left hemisphere (LH) stroke who have chronic nonfluent aphasia

Eligibility Criteria

• Age: 45 Years - 80 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Chronic stroke patients with nonfluent aphasia

You may qualify if:

• Aphasia patients with a single, unilateral, left hemisphere stroke.
• Patients must be native speakers of English
• Patients must be at least 6 months poststroke and produce mild-severe nonfluent speech. Minimum Language requirements: 2-4 word phrase length on elicited propositional speech
• Auditory Comprehension a the 25th percentile or higher on the BDAE subtests for Word Comprehension and Commands, sufficient to cooperate during testing
• The ability to name a minimum of 3 items on the Boston Naming Test at entry into study.
• Patients must understand the nature of the study and give informed consent.
• Normal right-handed controls with no history of neurological disease or substance abuse; age, education and gender-matched to the Aphasia cases.

You may not qualify if:

• Patients with more than one stroke in the left hemisphere or patients with bilateral strokes.
• Each participant must be able to have an MRI scan.
• MRI is contraindicated for pregnant women.
• Patients will be excluded if they have the following:
• Intracranial metallic bodies from prior neurosurgical procedure, implanted pacemaker, medication pump, vagal stimulator, deep brain stimulator, TENS unit or ventriculoperitoneal shunt
• Past history of seizures within one year or unexplained loss of consciousness Family history of epilepsy
• Acute, unstable medical conditions
• History of substance abuse (within last 6 months)
• Abnormal neurological exam, other than as signs of the condition being studied
• Abnormal MRI, or history of known structural brain abnormality other than as signs of the condition studied in the present protocol.
• Administration of investigational drug within 5 halflives of the drug prior to testing.

Sponsors & Collaborators

• VA Office of Research and Development: lead
• Boston University: collaborator

Study Sites (1)

VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA

Boston, Massachusetts, 02130, United States

Location

Related Publications (7)

• Naeser MA, Martin PI, Baker EH, Hodge SM, Sczerzenie SE, Nicholas M, Palumbo CL, Goodglass H, Wingfield A, Samaraweera R, Harris G, Baird A, Renshaw P, Yurgelun-Todd D. Overt propositional speech in chronic nonfluent aphasia studied with the dynamic susceptibility contrast fMRI method. Neuroimage. 2004 May;22(1):29-41. doi: 10.1016/j.neuroimage.2003.11.016.

  PMID: 15109995 RESULT

• Martin PI, Naeser MA, Theoret H, Tormos JM, Nicholas M, Kurland J, Fregni F, Seekins H, Doron K, Pascual-Leone A. Transcranial magnetic stimulation as a complementary treatment for aphasia. Semin Speech Lang. 2004 May;25(2):181-91. doi: 10.1055/s-2004-825654.

  PMID: 15118944 RESULT

• Martin PI, Naeser MA, Ho M, Doron KW, Kurland J, Kaplan J, Wang Y, Nicholas M, Baker EH, Alonso M, Fregni F, Pascual-Leone A. Overt naming fMRI pre- and post-TMS: Two nonfluent aphasia patients, with and without improved naming post-TMS. Brain Lang. 2009 Oct;111(1):20-35. doi: 10.1016/j.bandl.2009.07.007. Epub 2009 Aug 19.

  PMID: 19695692 RESULT

• Martin PI, Naeser MA, Ho M, Treglia E, Kaplan E, Baker EH, Pascual-Leone A. Research with transcranial magnetic stimulation in the treatment of aphasia. Curr Neurol Neurosci Rep. 2009 Nov;9(6):451-8. doi: 10.1007/s11910-009-0067-9.

  PMID: 19818232 RESULT

• Naeser MA, Martin PI, Lundgren K, Klein R, Kaplan J, Treglia E, Ho M, Nicholas M, Alonso M, Pascual-Leone A. Improved language in a chronic nonfluent aphasia patient after treatment with CPAP and TMS. Cogn Behav Neurol. 2010 Mar;23(1):29-38. doi: 10.1097/WNN.0b013e3181bf2d20.

  PMID: 20299861 RESULT

• Kaplan E, Naeser MA, Martin PI, Ho M, Wang Y, Baker E, Pascual-Leone A. Horizontal portion of arcuate fasciculus fibers track to pars opercularis, not pars triangularis, in right and left hemispheres: a DTI study. Neuroimage. 2010 Aug 15;52(2):436-44. doi: 10.1016/j.neuroimage.2010.04.247. Epub 2010 May 8.

  PMID: 20438853 RESULT

• Naeser MA, Martin PI, Treglia E, Ho M, Kaplan E, Bashir S, Hamilton R, Coslett HB, Pascual-Leone A. Research with rTMS in the treatment of aphasia. Restor Neurol Neurosci. 2010;28(4):511-29. doi: 10.3233/RNN-2010-0559.

  PMID: 20714075 RESULT

Related Links

• VA Boston Healthcare System Research Service Website
• The Harold Goodglass Aphasia Research Center is a service of the National Institute on Deafness and Other Communication Disorders
• Website for The Aphasia Research Lab of Margaret Naeser, Ph.D., VA Boston Healthcare System and Boston University School of Medicine

MeSH Terms

Conditions

Aphasia; Aphasia, Broca; Stroke

Condition Hierarchy (Ancestors)

Speech Disorders; Language Disorders; Communication Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases

Study Officials

• Margaret Naeser, PhD

  VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: FED
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 25, 2007
• First Posted: April 27, 2007
• Study Start: October 1, 1999
• Primary Completion: December 1, 2016
• Study Completion: December 31, 2021
• Last Updated: March 24, 2022

Record last verified: 2022-03

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)