Project sheet
Project Title:
Rotterdam Aphasia Therapy Study (RATS) – 3; “The efficacy of cognitive-linguistic
therapy in the acute stage of aphasia: a randomized controlled trial”.
Period:
January 2011 – January 2015
January 2011 – January 2012: start-up phase
January 2012 – January 2014: inclusion phase
Participating Departments:
Erasmus MC Department of Neurology
Erasmus MC Department of Radiology
Rijndam Rehabilitation Centre Department of Rehabilitation Medicine
Erasmus MC Department of Rehabilitation
Participants:
L.M.L de Lau, Department of Neurology, Erasmus MC
F. Nouwens, Department of Neurology, Erasmus MC
D.W.J. Dippel, Department of Neurology, Erasmus MC
M. Smits, Department of Radiology, Erasmus MC
C. Mendez-Orellana, Department of Neurology & Department of Radiology, Erasmus MC
A. van der Lugt, Department of Radiology, Erasmus MC
P.J. Koudstaal, Department of Neurology, Erasmus MC
E.G. Visch-Brink, Department of Neurology, Erasmus MC
M. de Jong-Hagelstein, Department of Neurology, Erasmus MC
W.M.E. van de Sandt-Koenderman, Rijndam Rehabilitation Centre & Department of Rehabilitation, Erasmus MC
Funding agency:
-
Fellowship of Hersenstichting Nederland, granted to L.M.L. de Lau.
-
Stichting Zabawas
-
Stichting Coolsingel
-
Vriendenfonds Erasmus MC
Project description:
This study is the third phase in the Rotterdam Aphasia Therapy Studies (RATS). This study aims to test the hypothesis that
patients with aphasia due to stroke benefit more from early intensive cognitive-linguistic therapy (CLT) than from regular less
intensive language therapy initiated a few weeks after stroke. Patients with aphasia due to stroke will be randomized to either
the intervention group (intensive CLT initiated within two weeks after stroke) or the control group (deferred regular language
therapy started 4 weeks after inclusion). All participants will be tested with a set of linguistic tests at 4 weeks, 3 months, and 6
months after inclusion. Eligible participants will be requested to undergo additional fMRI scans (FIAT study; Functional Imaging
in Aphasia Treatment). Using functional magnetic resonance imaging, the neurophysiologic correlate of the effect of CLT on
verbal communication will be evaluated. The effect of CLT on fMRI measures is also evaluated in a group of chronic aphasic
patients (1-3 years post stoke).
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Research questions:
-
Do patients with aphasia due to stroke benefit more from early intensive CLT than later initiated regular language therapy?
-
Will the supposed effect of early intensive CLT last for at least six months?
-
Do chronic patients benefit from intensive CLT (FIAT)?
-
Which neurophysiologic processes occur early after stroke as a result of intensive CLT
compared to no language therapy (FIAT)?
-
Which neurophysiologic processes occur in chronic aphasia as a result of intensive CLT
compared to no language therapy (FIAT)?
Inclusion criteria:
1.
Aphasia after stroke, determined by a neurologist or rehabilitation physician and speech and language therapist;
2.
Within two weeks after stroke;
3.
Testable with ScreeLing;
4.
Aphasia ascertained with short Token Test and/or a score < 5 on Goodglass Aphasia Severity Rating Scale;
5.
Age between 18 and 85 years;
6.
Language near native Dutch;
7.
Life expectancy of more than six months.
Additional inclusion criteria for the fMRI scanning in chronic patients:
1.
1-3 years post stroke
Exclusion criteria:
1.
Pre-existing aphasia;
2.
Subarachnoid/subdural haemorrhage/hematoma;
3.
Severe threats to success and/or feasibility of language therapy;
a.
Severe dysarthria;
b.
Premorbid dementia;
c.
Illiteracy;
d.
Severe developmental dyslexia;
e.
Severe visual perceptual disorders;
f.
Recent psychiatric history.
Additional exclusion criteria for fMRI scanning:
1.
Age > 80 years;
2.
Left handedness or ambidexterity;
3.
Bilingualism;
4.
Prior stroke (acute patients only);
5.
Contradictions for MRI scanning;
6.
Severe motor disability (inability to make independent transfers);
7.
Cortical lesions in the right hemisphere as assessed by MRI.
Name and date
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