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Rehab Insights is a weekly blog written by Burke Rehabilitation professionals to offer practical information for patients, families and the community. Its goal is to educate the reader on relevant topics in rehabilitation, general health and wellness.

The Future of Treating Aphasia

June 5, 2018

About 2 million people in the U.S. have aphasia, according to the National Aphasia Association—but despite its prevalence, people often know very little, if anything at all, about this language disorder.

“Aphasia is the loss of language due to stroke, brain injury or neurological illness,” says Susan Wortman-Jutt, MS, CCC-SLP, Speech-Language Pathologist, Advanced Clinician, Outpatient Speech Department at Burke. “Approximately 40 percent of all stroke survivors have aphasia, yet many people have never heard of it.” In fact, the National Aphasia Association found that a whopping 84.5 percent of weren’t familiar with the condition.

But it’s an important condition to understand: “Aphasia can impact all aspects of communication, including verbal expression, comprehension, reading and writing. Levels of severity can vary from mild to severe,” says Wortman-Jutt. While there are different types of aphasia, they are generally put into two different categories—“fluent” and “non-fluent.”

“Non-fluent aphasia, sometimes called ‘expressive’ aphasia, causes difficulty in finding the right words. Speech sounds halting and the persistent searching for words can be very frustrating,” she says. With fluent aphasia, on the other hand, there is comprehension difficulty, making it hard for the patient to understand others people’s words. They may sometimes say things that don’t sound like real words, without being aware of it, says Wortman-Jutt.

Traditionally, aphasia treatment is customized to fit a patient’s needs. “If a patient has fluent aphasia, for example, it's very likely that a speech-language pathologist (SLP) will work on comprehension first. The SLP may have the patient practice following simple directions, or listen to a paragraph for certain words or information,” says Wortman-Jutt. “If a patient has non-fluent aphasia, the SLP may have the patient practice naming objects or attempt to find words that fit a given category. The patient may be asked to describe pictures, or learn new strategies like ‘talking around’ a hard-to-find word.”

There are new methods on the horizon, both through the use of speech therapy—for example, combining speech therapy with medication—and through the use of advanced technology. Practitioners such as Wortman-Jutt are collaborating on research, including working with the Burke Neurological Institute, right on Burke’s campus, to help propel these advances forward.

One area being explored is the use of non-invasive brain stimulation. Recently, Wortman-Jutt worked with Dr. Dylan Edwards of the Burke Neurological Institute on the NORTHSTAR study with McGill University and the Max Planck Institute, “which compared two forms of non-invasive brain stimulation, combined with speech therapy, to promote aphasia recovery,” says Wortman-Jutt. The results of this multi-site study are soon to be published.

The team has worked on other studies as well. “Following that study, we collaborated with an intensive comprehensive aphasia program in Austin, Texas, and the University of Texas, Austin, also using non-invasive brain stimulation coupled with speech therapy, and found that patients who had brain stimulation did better in follow-up testing than those who did not,” she says.

What other types of research does the future hold? “One of our hopes is to investigate multimodal forms of speech therapy that combine language tasks with other activities,” says Wortman-Jutt. “Another possibility would be to engage other scientists in investigating methods for promoting healing near the stroke lesion, while also providing speech therapy to reinforce language improvement. There are many opportunities to explore.”

Overall, the hope is that through research, practitioners will be better able to help their patients.    

“Language; the ability to communicate, whether verbally, in writing or with gesture, is one of the most important, and most complex, of human functions. Aphasia is a language disorder that is also complex and requires continued investigation to improve chances of recovery,” says Wortman-Jutt. “Traditional speech therapies are effective, but a complete return to one's usual form of ‘normal’ communication is often not possible. For that to become a reality, researchers must better understand aphasia and explore new therapies.”

To learn more about Burke’s aphasia program, click here.

--Marisa Iallonardo

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Burke's Rehab Insights blog is intended to provide general information about rehabilitation and other health care topics. It should not take the place of medical care. Burke staff cannot comment on individual medical cases or give medical advice.

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