Aphasia

Primary Progressive Aphasia (PPA) is a condition caused by various neurodegenerative disorders that mainly affect language abilities. Care for PPA patients is currently limited due to a shortage of specialists and lack of coordinated services. Researchers are evaluating a new treatment approach that combines personalized brain stimulation with language therapy to improve care in early-stage PPA. The study involves 60 patients with mild PPA who will be randomly assigned to receive either active transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex combined with individualized language training, or placebo tDCS combined with the same language training. Treatments consist of 25-minute sessions, five days a week for two weeks. Neuroimaging and biomolecular data will be collected before and after treatment to explore how tDCS may affect the brain. Participants will undergo cognitive and language testing, neurological exams, and brain scans at the start, after treatment, and three months later. Trained neuropsychologists will conduct assessments to measure changes in naming ability, language function, quality of life, dementia severity, behavior, and molecular biomarkers. This study aims to determine the effectiveness of combining tDCS with language therapy for improving symptoms in PPA over time.

Researchers are developing an Adaptive and Individualized Augmentative and Alternative Communication (AAC) system designed to help individuals with severe motor impairments communicate more effectively. This study focuses on creating a personalized communication device that automatically adapts to the user's physical abilities by customizing a comprehensive keyboard interface. The goal is to improve communication access for people who rely on alternative methods due to conditions like spinal cord injury, cerebral palsy, or locked-in syndrome. Participants will use two types of AAC systems during the study: an Experimental AAC system featuring wearable sensors to detect movement and muscle activity for cursor control and selection, integrated with an adaptive keyboard; and a Generic AAC system similar to devices they normally use, such as eye-tracking with a generic keyboard. Each participant will use both systems in sequence to compare communication performance, with the Experimental AAC aiming to enhance information transfer and user experience. During the study, participants will attend approximately 5 testing sessions involving the use of these AAC systems over about one year. Researchers will assess communication effectiveness using tools such as the Tele-healthcare Satisfaction Questionnaire, Information Transfer Rate measurement, and the NASA Task Load Index. Additional evaluations include character movement time, path efficiency, word completion usage, and writing fluency. The study will monitor usability, acceptance, and benefits of the AAC system for people with severe motor challenges.

Researchers are studying aphasia, a language disorder caused by stroke and other brain injuries that affects over two million people in the United States. This research focuses on improving treatments for anomia, a word-finding difficulty that is a major frustration for people with aphasia. The study aims to evaluate new approaches to naming treatment that enhance long-term retention and help patients use their naming skills in daily life. This sub-study is part of a larger project and specifically investigates the benefits of adaptive trial scheduling. Participants will take part in a randomized crossover study comparing three treatment conditions: an adaptive spacing condition, a high-item non-adaptive spacing condition, and a low-item non-adaptive spacing condition. Each participant will receive all three conditions in a random order. Treatment involves computer-based training sessions lasting 30 minutes, four times per week for ten weeks per condition. During sessions, participants practice naming pictured objects using flashcards and rate their own accuracy. Responses and accuracy are recorded, and participants can replay and repeat answers if needed. All sessions, assessments, and probes are conducted via telehealth. Participants will undergo baseline assessments, treatment sessions, and follow-up probes at 1 week, 3 months, and 6 months after treatment. There are typically 3-4 but up to 6 assessment sessions and around 120 one-on-one treatment sessions per participant over approximately one year to 18 months. The primary outcomes measured are changes in correct naming of treated and untreated pictured objects and generalization to everyday contexts. Secondary outcomes include language use in discourse, communication abilities, and motivation. The study is sponsored by the University of Pittsburgh and involves detailed monitoring through telehealth technology.

Researchers are evaluating the effects of a high-intensity exercise program specifically designed for individuals with chronic post-stroke aphasia. This randomized trial aims to determine whether participating in this program leads to improvements in physical health, language, cognitive, motor recovery, psychological, and psychosocial areas compared to a low-intensity exercise program. The study will assess both short- and long-term effects over several months. Participants will be randomly assigned to one of two groups: one group will engage in a 12-week high-intensity interval training full-body workout called Aphasia Physical EXercise (APEX), tailored to accommodate stroke survivors' motor abilities and fitness levels. The other group will participate in a 12-week low-intensity non-aerobic exercise program that reflects standard physical therapy without cardiovascular or strengthening components. Both interventions are delivered in group settings. During the study, participants will undergo evaluations at multiple time points, including baseline, pre-treatment, post-treatment, and a 3-month follow-up. Assessments include language testing with the Western Aphasia Battery and other language and cognitive tests, physical fitness measures like aerobic capacity and gait speed, as well as motor performance and functional tests. Researchers will monitor changes in these areas to understand the impact of the exercise programs on recovery after stroke.

Researchers are studying Frontotemporal Lobar Degeneration (FTLD), including both sporadic and familial forms, along with asymptomatic family members of those with familial FTLD. This research combines two consortia, ARTFL and LEFFTDS, to better understand these conditions and support future clinical trials. The study focuses on characterizing participants over time through detailed assessments. The study includes two groups: a longitudinal arm and a biofluid-focused arm. Participants in the longitudinal arm attend annual clinic visits for comprehensive assessments including clinical, functional, imaging, and biofluid data collection. The biofluid-focused arm involves a single clinic visit with limited clinical data collection alongside biospecimen sampling. Both arms aim to gather important information about FTLD progression. Participants will undergo evaluations such as brain imaging and clinical tests at baseline and yearly for up to five years in the longitudinal arm. Researchers will measure changes in brain volumes, executive function scores, and impairment ratings over time. Plasma neurofilament light chain levels will also be assessed after five years. Safety monitoring and follow-up continue throughout the study, which lasts several years depending on the participant's arm.

Aphasia is a language disorder caused by stroke and other brain injuries that affects many people and impacts their ability to communicate and participate in daily life. This research focuses on anomia, a common difficulty in finding words, and aims to evaluate new treatment approaches that improve long-term retention of naming skills and their use in everyday situations. The study is part of a larger project and specifically investigates balancing effort and accuracy with adaptive speeded naming deadlines. Participants will receive three different naming treatment conditions in a randomized order: an accuracy-maximized condition where the target word is immediately provided, an effort-maximized condition allowing up to 10 seconds to respond before the target is given, and an effort-accuracy balanced condition where deadlines adapt based on individual performance. Each condition consists of eight treatment sessions over four weeks, with treatment time controlled to eight hours per condition. Treatments involve naming pictures with cues and feedback on accuracy. Participants will be assessed at baseline and followed up one week, three months, and six months after treatment using naming tests, language assessments, and questionnaires on communication effectiveness and motivation. Assessments include confrontation naming of treated and untreated objects, discourse analysis, and communication outcome measures. The study will last about 10 to 18 months per participant, with data collection occurring at the university lab, participants' homes, or private public spaces.

Researchers are studying how hearing our own speech influences the planning and execution of speaking movements. This study includes both typical speakers and patients with Deep Brain Stimulation (DBS) implants. It aims to understand whether the way we hear ourselves affects future speech and which brain areas contribute to adjusting speech movements, especially in DBS patients. The study involves manipulating real-time auditory feedback during speech using devices like digital vocal processors or software, as well as altering visual feedback during upper limb reaching movements with a virtual reality system. For DBS patients, the intervention includes switching their brain stimulator ON and OFF while performing speech tasks. These interventions help explore the role of sensory feedback and brain stimulation in speech and movement control. Participants will read words, sentences, or random syllables while their speech is recorded, and some will wear an electrode cap to record brain activity. DBS patients perform tasks with stimulator ON and OFF. Measurements include speech sounds, arm movement directions, brain electrical responses, and accuracy and timing of speech sequences. Each data session lasts from about half an hour to two hours. The study provides insight into brain and speech motor control with no treatment involved.

Researchers are investigating whether group singing can improve speech-in-noise perception and psychosocial wellbeing in older adults aged 60 and above who have unaddressed mild-to-moderate hearing loss. This international, multisite, randomized controlled trial addresses previous research limitations by using a large sample size and rigorous statistical methods to explore these potential benefits. Participants will be randomly assigned to one of two groups for a 12-week intervention: a group singing program with 1.5 hours of in-person choir instruction each week, or an audiobook club with 1.5 hours of in-person discussion weekly as a control activity. The interventions are designed to assess the effects of group singing compared to an active social activity on hearing-related and psychosocial outcomes. Throughout the study, participants will undergo multiple assessments at baseline, post-intervention, and during weekly sessions. These include tests of speech-in-noise perception, emotional speech perception, quality of life, anxiety, depression, self-esteem, social connectedness, and various aspects of music perception. Psychosocial questionnaires and heart-rate variability will also be collected to evaluate emotional and social changes. The total participation time covers the 12-week training with measurements taken before, during, and after the intervention period.

Researchers are evaluating whether electrical brain stimulation called transcranial direct current stimulation (tDCS) applied to the front parts of the brain can help people who have had a stroke improve their fatigue, language, and attention. The study aims to compare active tDCS with sham stimulation to see if active treatment better reduces post-stroke fatigue and aphasia. It also explores which participant characteristics are linked to greater improvements in these symptoms. Participants will receive 10 sessions of either active or sham tDCS targeting the left dorsolateral prefrontal cortex during behavioral therapy. The behavioral treatments include attention-focused sentence comprehension therapy or sentence picture matching therapy, each lasting 10 sessions. Active tDCS involves applying 2mA current for 20 minutes, while sham tDCS mimics this briefly without lasting stimulation. Four groups combine these device and therapy variations. During the study, participants complete fatigue, language, and cognitive tests before treatment, within one week after completing the sessions, and again at 3 months. Researchers will use tools such as the Fatigue Interference and Severity Scale for Aphasia, Continuous Performance Test, Attention Network Test, and sentence comprehension tasks to assess outcomes. The study includes safety monitoring and audio-recording of sessions over several months of follow-up.

Researchers are investigating the short- and long-term effects of an intensive speech-language pathology program combined with physiotherapy on aphasia and apraxia of speech (AOS) in thirty people with chronic stroke. The study aims to assess changes in speech, language, communication, and brain structure and function using standardized speech-language tests and advanced brain imaging methods like voxel-based morphometry and resting state functional connectivity. The goal is to understand how intensive rehabilitation affects neuroplasticity and daily communication abilities in people with these chronic conditions. Participants receive a Multimodal Intensive Rehabilitation program for Aphasia and Apraxia of Speech (MIRAA), an intensive comprehensive aphasia program that includes at least three hours of speech-language training daily over ten days, alongside physical therapy. The therapy is individualized based on participant goals set with a team of speech-language pathologists, physiotherapists, and neurologists. The program features individual therapy, group sessions, and computer-based activities, and includes education for participants and their families about communication and neuroplasticity. During the study, speech-language pathologists conduct evaluations before treatment, immediately after, and again about 16 weeks later, using various speech and communication tests recorded on video and audio for detailed analysis. Brain changes are monitored through imaging techniques focused on language and cognitive processing areas. Researchers measure improvements in language, speech motor planning, communication participation, and quality of life. The total participation duration includes intensive treatment plus follow-up assessments to track lasting effects.