Protocol Number: 04-N-0100

Title:

Role of the Right Hemisphere in Recovery of Language Function in Chronic Stroke

Number:

04-N-0100

Summary:

This study will examine in healthy individuals and in patients with aphasia (a language disturbance that is usually caused by stroke, brain disease, or injury) which parts of the brain are involved in naming everyday objects. In most people, language and speech originate in the left side of the brain. When this side of the brain is damaged, language function is often impaired. Often, however, function partly recovers, possibly because the right half of the brain takes over some language functions when the left half is injured.

Healthy volunteers and patients with aphasia due to stroke may be eligible for this study. All candidates must be 18 years of age and older. Patients' aphasia must have occurred as the result of a stroke that occurred more than 12 months before entering the study. In addition, their stroke must not have affected the brainstem or cerebellum. Candidates will be screened with a medical history, brief physical examination, and questionnaire about handedness. Participants will undergo the following tests and procedures:

Session 1: Magnetic resonance scanning (MRI)

MRI is a diagnostic and research tool that uses a strong magnetic field and radio waves to obtain images of body organs and tissues, including the brain. The subject lies in a cylindrical machine for up to 60 minutes. Loud thumping noises occur when the radiofrequency circuits are switched; this noise can be muffled by the use of earplugs.

Sessions 2 and 3: Picture naming during transcranial magnetic stimulation (TMS)

For transcranial magnetic stimulation, a wire coil is held on the subject's scalp. A brief electrical current is passed through the coil, creating a magnetic pulse that stimulates the brain. The subject hears a click and feels a pulling sensation on the skin under the coil. There may also be a twitch in the muscles of the arm or leg. During the TMS, subjects are asked to name pictures of common everyday objects that appear on a computer screen. They are asked to name them as fast and as accurately as possible. Their voice is recorded to determine the accuracy of their answers and the time it takes to answer. Subjects may also be asked to tense certain muscles slightly or perform other simple actions during the TMS to position the coil properly.

Sponsoring Institute:

National Institute of Neurological Disorders and Stroke (NINDS)

Recruitment Detail

Type: Active Accrual Of New Subjects

Gender: Male & Female

Referral Letter Required: No

Population Exclusion(s): Children

Eligibility Criteria:

INCLUSION CRITERIA:

We will include patients with thromboembolic non-hemorrhagic hemispheric lesions and with hemorrhagic hemispheric lesions (as documented by CT or MRI) at least 12 months after the stroke.

We will choose subjects with chronic stable aphasia, that initially presented with severe aphasia and have partially recovered.

Assessment of the initial functional state will be taken either from patient report or medical records. All of the aphasic patients are already known to the investigators from the NIDCD.

EXCLUSION CRITERIA - HEALTHY CONTROLS:

Unable to perform the task (naming of everyday objects in less than 10 s).

History of alcohol or drug abuse or psychiatric illness like depression.

Epilepsy.

Are less than 18 years of age.

Pregnant or breast feeding a child.

EXCLUSION CRITERIA - PATIENTS:

Unable to perform the task (naming of everyday objects in less than 10 s).

History of alcohol or drug abuse or psychiatric illness like depression.

Epilepsy.

Are less than 18 years of age.

Pregnant or breast feeding a child.

Patients with cerebellar or brainstem lesions.

Patients or subjects with severe uncontrolled medical problems (e.g. cardiovascular disease, severe rheumatoid arthritis, active joint deformity of arthritic origin, active cancer or renal disease, any kind of end-stage pulmonary or cardiovascular disease).

Patients or subjects with increased intracranial pressure as evaluated by clinical means.

Individuals receiving drugs acting primarily on the central nervous system.

Special Instructions: Currently Not Provided

Keywords:

Aphasia

Rehabilitation

Neuroplasticity

Picture Naming

Transcranial Magnetic

Recruitment Keywords:

Stroke

Aphasia

Healthy Volunteer

HV

Conditions:

Aphasia

Cerebrovascular Accident

Investigational Drug(s):

None

Investigational Device(s):

None

Contacts:

Patient Recruitment and Public Liaison Office
Building 61
10 Cloister Court
Bethesda, Maryland 20892-4754
Toll Free: 1-800-411-1222
TTY: 301-594-9774 (local),1-866-411-1010 (toll free)
Fax: 301-480-9793

Electronic Mail:prpl@mail.cc.nih.gov

Citations:

Abrahams S, et al. Functional magnetic resonance imaging of verbal fluency and confrontation naming using compressed image acquisition to permit overt responses. Hum Brain Mapp. 2003 Sep; 20(1): 29-40. PMID: 12953304

Amassian VE, et al. The polarity of the induced electric field influences magnetic coil inhibition of human visual cortex: implications for the site of excitation. Electroencephalogr Clin Neurophysiol. 1994 Feb; 93(1): 21-6. PMID: 7511518

Basso A, et. al. The role of the right hemisphere in recovery from aphasia. Two case studies. Cortex. 1989 Dec; 25(4): 555-66. PMID: 2612175

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