Rehab and treatment for aphasia
Aphasia occurs when there are changes in either the left- or right-side speech centers in the brain: the left controls conversational speech and the right controls creative speech, such as singing. During neurorehabilitation, we focus on practicing activities that stimulate the unaffected side of the brain to take over some of the lost speech faculties.
For PPA, which gets worse over time, we focus on adaptive communication strategies to achieve a new normal. Though speech may not return fully, a speech-language therapist can teach you to use manual and digital tools to express yourself. Patients with neurodegenerative aphasia also learn techniques to reduce the risk of complications, such as choking on or aspirating food when the brain becomes uncoordinated.
Depending on the type of aphasia, treatment may include a combination of proven methods to reduce risks and restore some or all communication abilities.
Speech-language therapy (SLT): Our neuro-trained speech therapists initiate adaptive strategies as well as strengthening exercises for the unaffected speech center of the brain. For example, you might practice a series of vocalizations over and over, and we’ll increase the challenge with each session. With our leading-edge equipment and specialized training, we can adapt the treatment plan to best suit each patient’s specific communication deficits.
Melodic intonation therapy: It’s not uncommon to hear patients singing in our aphasia clinic – singing activates the right side of the brain, allowing us to retrain that speech center to take over more left-brained communication. Patients can sing along with their favorite tunes from home or chant to our metronome as they work to regain speech.
Medications: While there are no medications that specifically target speech centers of the brain, certain drugs for progressive dementia can increase the level of acetylcholine, a neurotransmitter that helps conduct brain signals associated with communication.
Mental health support: Aphasia dramatically changes a patient’s role at home, work, and in the community, and because of that some struggle with anger, frustration, isolation, and depression. Our specialists are trained to screen patients for anxiety and depression throughout the course of care.
For example, we ask patients to return to the hospital within 30 days after a stroke that causes aphasia to identify emotional concerns. Our rehabilitation psychologists can help patients and caregivers access individual and group mental health support here and in their local community.
Stepping up stroke rehab
“Stroke recovery is a combination of hard work, faith, and hope, all of which we provide and believe in as part of an integrated team,” says Nneka Ifejika, M.D., M.P.H., Chief of Stroke Rehabilitation at UT Southwestern. Meet Dr. Ifejika and some of the stroke recovery team as they highlight the care and rehabilitative therapy patients can expect at UT Southwestern.
The future of neurorehabilitation
As Mr. Willis’s case shows, even the most “Unbreakable” people can lose the ability to communicate. UT Southwestern is launching a study to determine whether quicker implementation of rehab might reduce devastation from aphasia and perhaps recover more of a patient’s speech and comprehension.
After a stroke, the current protocol is to start rehab the following day. In our study, we are examining whether specific blood biomarkers that indicate brain inflammation and nerve damage can pinpoint which patients might benefit earlier rehab, within 24 hours after a stroke. We can assess whether positive change occurred by measuring these biomarkers incrementally during treatment. Our goal is to enroll hundreds of patients in this study, giving us data to potentially help more patients, more quickly.
Future studies will explore the role of brain stimulation and neuromodulation to treat patients with neurological symptoms, such as aphasia occurring after stroke. We hope that combining stimulation with rehabilitation can maximize patients’ neurological function and quality of life.
Vocal expression and communication make up a huge part of our personalities. Losing that ability makes life more challenging for patients and their families. If you or a loved one are concerned about a waning ability to speak, read, or process language, connect with a specialist. With a precise diagnosis and personalized treatment, we can help recover part or all of your communication deficits.