Intensive Language Action Therapy II: Mechanisms in the Neurorehabilitation of Language

• Applicant: Professor Dr. Friedemann Pulvermüller, since 6/2019
• Subject Area: General and Comparative Linguistics, Experimental Linguistics, Typology, Non-European Languages ; Personality Psychology, Clinical and Medical Psychology, Methodology
• Term: from 2014 to 2024
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 253775312

Constraint-induced aphasia therapy or intensive language action therapy (CIAT/ILAT) is an established method for improving language performance in chronic post-stroke aphasia patients. Although several randomised controlled trials (RCTs) have shown that CIAT/ILAT is efficient in improving language and communication in only two weeks, even at old age and several years after disease onset, the reasons and mechanisms underlying its efficacy are still not fully understood. This project examines the role of the three main features of CIAT/ILAT: the amount and intensity of the training, the action-embedding and behavioural relevance of language use, and the level of guidance constraining the patient’s actions in therapy. In the first part of this project, we performed two randomised controlled therapeutic trials, which provided evidence that the factors action-embedding and duration, but not level of intensity, exerted specific effects on therapy success. These results have important implications for clinical practice and lead to additional novel questions equally relevant for future clinical practice. These new questions now call for additional experimental work.Therefore, we apply here for a second funding period to conduct additional RCTs, which, respectively, address the following issues: (1) Can the beneficial effect of action-embedding, which our project work has demonstrated for non-fluent aphasia, be shown for all aphasia syndromes more generally? (2) Given that moderately- and highly-intensive speech-language therapy is equally effective, as our previous project work has shown, which intensity threshold guarantees optimal use of time resources combined with best therapy efficacy? (3) Will specific constraints emphazing verbal language make aphasia therapy more efficient than unconstrained, free use of various communication channels? As a further highlight of the second project part, which builds upon results from the first part, the role of language therapy on post-stroke depression, and quality-of-life of partaking patients will be in focus. In the context of planned RCTs, brain imaging (EEG and fMRI) data will be used to examine possible effects of cortical reorganisation correlating with CIAT/ILAT-induced language improvement. Importantly, long-term follow-up testing will examine whether improvements in language, severity of depressive symptoms and quality of life observed directly after therapy can be maintained up to 1-2 years post treatment. We expect important new insights relevant for improving the way aphasia therapy is delivered in clinical practice and clues for understanding the neuronal mechanisms underlying the neurorehabilitation of neurological language deficits.

• DFG Programme: Research Grants
• Ehemalige Antragstellerin: Professorin Dr. Bettina Mohr-Pulvermüller, until 6/2019