Research on Aphasia and Spoken Word Comprehension

In a recent development, researchers have suggested that individuals with chronic aphasia can improve their spoken word comprehension many years after stroke. The interesting findings of the study have been put forth in Neurology.

Auditory spoken language comprehension impairments are common in individuals with aphasia, and for many, these remain chronic. Those with severe spoken language comprehension impairments have worse outcomes and higher drop-out rates from rehabilitation programmes. Developing effective evidence-based therapies for such impairments is a priority.

The efficacy of spoken language comprehension therapies for persons with aphasia remains equivocal. With such background, researchers aimed to investigate the efficacy of a self-led therapy app, 'Listen-In', and examined the relation between brain structure and therapy response.

Study Design

A cross-over randomised repeated measures trial with five testing time points (12-week intervals), conducted at the university or participants' homes, captured baseline (T1), therapy (T2-T4) and maintenance (T5) effects. Participants with chronic poststroke aphasia and spoken language comprehension impairments completed consecutive Listen-In and standard care blocks (both 12 weeks with order randomised). Repeated measures analyses of variance compared change in spoken language comprehension on two co-primary outcomes over therapy versus standard care. Three structural MRI scans (T2-T4) for each participant (subgroup, n=25) were analysed using cross-sectional and longitudinal voxel-based morphometry.

Data Analysis

Data analysis revealed some interesting facts:

• Thirty-five participants completed, on average, 85 hours (IQR=70-100) of Listen-In (therapy first, n=18).
• The first study-specific co-primary outcome (Auditory Comprehension Test (ACT)) showed large and significant improvements for trained spoken words over therapy versus standard care (11%, Cohen's d=1.12).
• Gains were largely maintained at 12 and 24 weeks.
• There were no therapy effects on the second standardised co-primary outcome (Comprehensive Aphasia Test: Spoken Words and Sentences).
• Change on ACT trained words was associated with volume of pretherapy right hemisphere white matter and post-therapy grey matter tissue density changes in bilateral temporal lobes.

"Results contribute to hemispheric debates implicating the right hemisphere in therapy-driven language recovery. Listen-In will soon be available on GooglePlay," the team concluded.

For full article follow the link: Efficacy of Spoken Word Comprehension Therapy in Patients With Chronic Aphasia: A Cross-Over Randomised Controlled Trial With Structural Imaging

J. Neurol. Neurosurg. Psychiatr. 2021 Mar 12;[EPub Ahead of Print], V Fleming, S Brownsett, A Krason, MA Maegli, H Coley-Fisher, YH Ong, D Nardo, R Leach, D Howard, H Robson, E Warburton, J Ashburner, CJ Price, JT Crinion, AP Leff

Primary source: Neurology