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Structural plasticity linked to speech therapy benefits for stroke patients

Thursday 13th July 2017
Researchers have identified links between the ability of the brains language network to rebuild itself and the benefits of speech therapy. Image credit: Lighthaunter via iStock
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The benefits that can be gained by patients who have experienced language disturbances (aphasia) after a stroke are directly linked to structural plasticity - the ability of the brain's language network to rebuild itself.

That is one of the key findings of a recent study led by the Medical University of South Carolina (MUSC) and published in the Annals of Neurology.

Researchers tested eight aphasia patients who had experienced a single stroke at least one year previously that affected the inferior longitudinal fasciculus (ILF) region of the brain.

Participants underwent a series of tests and MRI scans before and after a three-week course of intensive speech therapy. 

The results showed significant pre- to post-therapy improvements in ILF areas that had sustained the most damage. Participant scores in object-naming tests improved from the baseline, partly as a result of fewer semantic errors.

Furthermore, the study supported the dual-stream language theory, which states that ventral brain networks are linked to semantic skills (finding the correct word to use) and dorsal networks are associated with phonemic skills (pronouncing words).

Summarising the findings, Leonardo Bonilha MD, PhD, an associate professor of neurology at MUSC and senior author of the report, said people experiencing benefits from speech therapy "got better because their brain network got structurally stronger".

He added: "The residual connections got stronger in an area where semantic knowledge is integrated. Phonemics weren't related to these changes."

Lead author Emilie McKinnon, an MD and PhD candidate in MUSC's Department of Neurology, said the ultimate goal from a therapeutic point of view is to be able to look at an MRI scan and identify a patient's residual strength.

"If we see that the ventral area is really weak, but the phonemics network is damaged beyond repair, we could recommend semantically oriented therapies," she explained.

This approach could also prove useful in other cases, such as when motor control is affected by stroke.

Written by James Puckle

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