Brain Correlates of Multimodal Rehabilitation in Chronic Post-stroke Aphasia
Status:
Completed
Trial end date:
2020-10-20
Target enrollment:
Participant gender:
Summary
Post-stroke aphasia (PSA), the partial or total loss of the ability to produce and/or
understand language associated with stroke, is a highly prevalent and disabling disorder that
negatively impacts the personal, social and working life of patients and families. Modern
theory-based language therapies (LT) with proved efficacy in chronic PSA are brief (weeks),
intensive, and oriented to specific domains (e.g., anomia). However, in order to maximize
therapeutic benefits, it becomes essential to implement complementary strategies that boost
gains in language, communication and behaviour and also to identify predictors of treatment
response (demographics, anatomical) that enable to customize interventions adjusting them to
each profile (linguistic deficits, brain structure and connectivity). Our group has
repeatedly shown that LT combined with cognitive enhancing drugs (CED) (e.g., Donepezil and
Memantine) are safe and promote better outcomes that when these interventions are
administered separately. Moreover, non-invasive brain stimulation techniques (NIBS), such as
transcranial direct current stimulation (tDCS), are also emerging as a promising treatment
option for chronic PSA. However, is still unknown whether or not treatments that combine
several biological strategies aid to improve outcomes further. Brain changes induced by these
interventions and the premorbid characteristic of a "good responder" are also unknown. The
aims of this clinical trial are: (1) Study the efficacy of combined treatments in a sample of
patients with chronic PSA (n = 40); (2) Document with multimodal neuroimaging the functional
and connectivity changes (neuroplasticity) promoted by these interventions; and (3) Identify
linguistic, cognitive and behavioural variables that may predict outcomes for each
intervention.