New treatment may improve speech after stroke

A new treatment has been shown to significantly improve the speech and word production of stroke patients with aphasia.

The treatment – developed by a speech therapist and cognitive neuroscientists at The University of Manchester who were part-funded by the MRC – uses special software which gradually encourages patients to produce words increasingly quickly.

The researchers hope that the treatment will eventually improve the ability of stroke patients with aphasia across the NHS to access intensive treatment, and improve their symptoms and speech recovery after stroke. 

The study, published in the journal Brain, tested the new treatment on 20 stroke patients and found it was around twice as effective in terms of words deployed by the patients in their speech. 

The treatment, which is administered over several training sessions, uses photos shown on a laptop, initially giving patients three seconds to react.  Gradually, the time is reduced, aiming to achieve a response of one second – which is normal for people over 65.

Professor Matthew Lambon Ralph, senior author on the study from The University of Manchester, said: “This is a novel approach: we had not really considered before, that speed of naming seems to play an important part in speech therapy. It’s cheap, quick to administer and more effective than current treatments. However, now that we have proof of principle, we hope to move on to a larger scale multi-centre trial. But our ultimate aim is for this treatment to be available for the NHS within fiveyears.” 

The researchers tested three measures, each compared to standard speech therapy treatment – and then retested the patients after a month.

The accuracy of the patients’ word retrieval was 25% better with the treatment and 10% better with the standard treatment.

Deployment – the use of words appropriately in speech – rose from 17% to 59% after treatment, compared to 14% to 33% with standard treatment. Patients with no treatment at all improved from 15% to 24% – so the impact of standard treatment was limited.

For speed of response, patients improved from three seconds to 1.6 seconds with the new treatment and three seconds to two seconds with standard treatment. However, the effect of the standard treatment was lost after a month, whereas the effect of the new treatment remained.

Dr Paul Conroy, lead author on the study from the Neuroscience and Aphasia Research Unit at The University of Manchester, said: “We know from Stroke Association data that there are more than 100,000 strokes in the UK each year, that is around one stroke every five minutes. So there are over 1.2 million stroke survivors in the UK and about one third of stroke survivors will have aphasia as a long term disability.”

“And though symptoms can vary, the consequences of aphasia at its worst can be devastating; not being able to use words, understand, read or write words can be very tough even at the less affected end of the spectrum. So we’re excited this new approach seems to yield significant benefits.”

The research was funded by the MRC, the Rosetrees Trust and the European Research Council.

This article is adapted from materials supplied by the University of Manchester



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