CClinicalTrials.gg
CompletedNCT00843427Updated May 11, 2018

fMRI of Language Recovery Following Stroke in Adults

An interventional study of CIAT in Aphasia and Stroke, sponsored by University of Alabama at Birmingham. Completed at 1 site in United States. Open to participants aged 19 Years and older. Per ClinicalTrials.gov, last updated 2018-05-11.

Sponsored by University of Alabama at Birmingham · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
24
Allocation
Randomized
Ages
19 Years and older
Sex
All
01

Study summary

The purpose of this study is to test the effectiveness of constraint-induced aphasia therapy.

Read the detailed description

Aphasia (difficulty speaking) is one of the most dreaded consequences of stroke. It is associated with high mortality and severe motor, social, and cognitive disability. During the past decade, therapies administered by stroke teams have made great strides in limiting the damage due to a stroke. Unfortunately, progress in aphasia rehabilitation has not experienced the same rapid advancement. Evidence suggests that the brain may have untapped potential for recovery of aphasia after stroke.

Using functional magnetic resonance imaging (fMRI), researchers now are able to examine the areas of the brain that are responsible for language recovery after stroke. Such data may explain how the brain recovers after stroke, and may lead to new therapies to help individuals who have suffered an aphasia-causing stroke.

In this study, researchers will examine the changes the brain undergoes while recovering from an aphasia-causing stroke and the mechanisms that underlie such recovery, and test the effectiveness of a new and promising method of aphasia rehabilitation called constraint-induced aphasia therapy (CIAT). The scientists will perform fMRI studies of brain activation in people who have suffered an aphasia-causing stroke in order to better understand the underlying mechanisms of recovery from aphasia. Specifically the researchers will compare language activation between adults with stroke and children with perinatal and postnatal stroke (from previous studies); map changes in language activation, characterize the patterns of language reorganization that occur following stroke; and use the fMRI measures to assess recovery using CIAT.

The study will last one year, during this time participants will have language testing to evaluate the degree of aphasia and its recovery; and five fMRI scans scheduled at 2 weeks, 6 weeks, 12 weeks, 26 weeks, and 56 weeks. Participants with remaining moderate aphasia will be offered a chance to participate in an extension treatment study that will last up to 3 months (STUDY).

A better understanding of brain changes during recovery from aphasia may help develop new methods to improve recovery.

02

Conditions studied

  • Aphasia
  • Stroke

Browse trials for

Keywords

  • aphasia
  • stroke
  • functional magnetic resonance imaging
  • fMRI
  • language recovery after stroke
  • constraint-induced aphasia therapy
  • CIAT
03

In context

Stroke

7,286 studies on the registry are indexed under Stroke; 2,007 are open to participants now.

This study's enrollment of 24 is below the median of 50 across 5,369 interventional studies indexed under Stroke.

Browse Stroke studies →

Lead sponsor

University of Alabama at Birmingham is the lead sponsor of 1,396 studies on the registry; 284 are open to participants now.

Of its 156 completed or terminated interventional studies of FDA-regulated products, 124 (79%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
19 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • MCA stroke as indicated by the presence of aphasia and MRI lesion in the LMCA distribution
  • Moderate aphasia (Token Test score between 40th and 90th percentile)
  • Written informed consent by the patient or the next of kin

Exclusion criteria

Exclusion Criteria:

  • Underlying degenerative or metabolic disorder or supervening medical illness
  • Severe depression or other psychiatric disorder
  • Pregnancy
  • Any contraindication to an MRI procedure (i.e., metal implants, claustrophobia)
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
24 participants (actual)

Study arms

  • Experimental
    Aphasia - CIAT

    Patients with aphasia \>1 year after left MCA stroke who will be randomized to receive CIAT

    Behavioral: CIAT

  • No intervention
    Aphasia - observation

    Patients with aphasia \>1 year after left MCA stroke who will be randomized to no intervention (observation)

Interventions

  • BehavioralCIAT

    Patients are to receive constraint-induced aphasia therapy for 2 weeks at 4 hours per day. Detailed description of this intervention is in Szaflarski et al., 2015 Medical Science Monitor.

    Also known as: CILT

06

What researchers measure

Primary outcomes

  1. Primary outcome measure is aphasia improvement.

    The Token Test was used only for primary screening and study qualification. All participants received NAT which included: (1) the Boston Naming Test (BNT) (Kaplan, Goodglass et al. 1983), (2) the Controlled Oral Word Association Test (Lezak 1995), (3) the Semantic Fluency Test (SFT) (Kozora and Cullum 1995, Lezak 1995), (4) the Complex Ideation subtest from the Boston Diagnostic Aphasia Examination (BDAE) (Goodglass and Kaplan 1972), (5) the Peabody Picture Vocabulary Test III (PPVT III) (Dunn and Dunn 1997), and (6) the Mini-Communicative Activities Log (Mini-CAL) which is a subjective measure of communicative abilities (Pulvermuller, Neininger et al. 2001, Szaflarski, Ball et al. 2008).

    Time frame: 1 week and 3 months after intervention

07

Study locations

1 site
  • University of Alabama at Birmingham
    Birmingham, Alabama 35294, United States
08

References and documents

Publications

  • Binder JR, Rao SM, Hammeke TA, Frost JA, Bandettini PA, Jesmanowicz A, Hyde JS. Lateralized human brain language systems demonstrated by task subtraction functional magnetic resonance imaging. Arch Neurol. 1995 Jun;52(6):593-601. doi: 10.1001/archneur.1995.00540300067015. PubMed 7763208 ↗
  • Booth JR, MacWhinney B, Thulborn KR, Sacco K, Voyvodic JT, Feldman HM. Developmental and lesion effects in brain activation during sentence comprehension and mental rotation. Dev Neuropsychol. 2000;18(2):139-69. doi: 10.1207/S15326942DN1802_1. PubMed 11280962 ↗
  • Borod JC, Carper M, Naeser M, Goodglass H. Left-handed and right-handed aphasics with left hemisphere lesions compared on nonverbal performance measures. Cortex. 1985 Mar;21(1):81-90. doi: 10.1016/s0010-9452(85)80017-4. PubMed 3987313 ↗
  • Breier JI, Hasan KM, Zhang W, Men D, Papanicolaou AC. Language dysfunction after stroke and damage to white matter tracts evaluated using diffusion tensor imaging. AJNR Am J Neuroradiol. 2008 Mar;29(3):483-7. doi: 10.3174/ajnr.A0846. Epub 2007 Nov 26. PubMed 18039757 ↗
  • Cao Y, Vikingstad EM, George KP, Johnson AF, Welch KM. Cortical language activation in stroke patients recovering from aphasia with functional MRI. Stroke. 1999 Nov;30(11):2331-40. doi: 10.1161/01.str.30.11.2331. PubMed 10548667 ↗
  • Carlomagno S, Pandolfi M, Labruna L, Colombo A, Razzano C. Recovery from moderate aphasia in the first year poststroke: effect of type of therapy. Arch Phys Med Rehabil. 2001 Aug;82(8):1073-80. doi: 10.1053/apmr.2001.25155. PubMed 11494187 ↗
  • Geschwind N, Galaburda AM. Cerebral lateralization. Biological mechanisms, associations, and pathology: I. A hypothesis and a program for research. Arch Neurol. 1985 May;42(5):428-59. doi: 10.1001/archneur.1985.04060050026008. No abstract available. PubMed 3994562 ↗
  • Hillis AE, Kleinman JT, Newhart M, Heidler-Gary J, Gottesman R, Barker PB, Aldrich E, Llinas R, Wityk R, Chaudhry P. Restoring cerebral blood flow reveals neural regions critical for naming. J Neurosci. 2006 Aug 2;26(31):8069-73. doi: 10.1523/JNEUROSCI.2088-06.2006. PubMed 16885220 ↗
  • Jacola LM, Schapiro MB, Schmithorst VJ, Byars AW, Strawsburg RH, Szaflarski JP, Plante E, Holland SK. Functional magnetic resonance imaging reveals atypical language organization in children following perinatal left middle cerebral artery stroke. Neuropediatrics. 2006 Feb;37(1):46-52. doi: 10.1055/s-2006-923934. PubMed 16541368 ↗
  • Lee RG, van Donkelaar P. Mechanisms underlying functional recovery following stroke. Can J Neurol Sci. 1995 Nov;22(4):257-63. doi: 10.1017/s0317167100039445. PubMed 8599767 ↗
  • Meinzer M, Djundja D, Barthel G, Elbert T, Rockstroh B. Long-term stability of improved language functions in chronic aphasia after constraint-induced aphasia therapy. Stroke. 2005 Jul;36(7):1462-6. doi: 10.1161/01.STR.0000169941.29831.2a. Epub 2005 Jun 9. PubMed 15947279 ↗
  • Meinzer M, Elbert T, Wienbruch C, Djundja D, Barthel G, Rockstroh B. Intensive language training enhances brain plasticity in chronic aphasia. BMC Biol. 2004 Aug 25;2:20. doi: 10.1186/1741-7007-2-20. PubMed 15331014 ↗
  • Muller RA, Rothermel RD, Behen ME, Muzik O, Chakraborty PK, Chugani HT. Language organization in patients with early and late left-hemisphere lesion: a PET study. Neuropsychologia. 1999 May;37(5):545-57. doi: 10.1016/s0028-3932(98)00109-2. PubMed 10340314 ↗
  • Muller RA, Rothermel RD, Behen ME, Muzik O, Mangner TJ, Chugani HT. Differential patterns of language and motor reorganization following early left hemisphere lesion: a PET study. Arch Neurol. 1998 Aug;55(8):1113-9. doi: 10.1001/archneur.55.8.1113. PubMed 9708962 ↗
  • Naeser MA, Borod JC. Aphasia in left-handers: lesion site, lesion side, and hemispheric asymmetries on CT. Neurology. 1986 Apr;36(4):471-88. doi: 10.1212/wnl.36.4.471. PubMed 3960321 ↗
  • Poeck K, Huber W, Willmes K. Outcome of intensive language treatment in aphasia. J Speech Hear Disord. 1989 Aug;54(3):471-9. doi: 10.1044/jshd.5403.471. PubMed 2755107 ↗
  • Pulvermuller F, Neininger B, Elbert T, Mohr B, Rockstroh B, Koebbel P, Taub E. Constraint-induced therapy of chronic aphasia after stroke. Stroke. 2001 Jul;32(7):1621-6. doi: 10.1161/01.str.32.7.1621. PubMed 11441210 ↗
  • Sarno MT, Levita E. Recovery in treated aphasia in the first year post-stroke. Stroke. 1979 Nov-Dec;10(6):663-70. doi: 10.1161/01.str.10.6.663. PubMed 524406 ↗
  • Saur D, Lange R, Baumgaertner A, Schraknepper V, Willmes K, Rijntjes M, Weiller C. Dynamics of language reorganization after stroke. Brain. 2006 Jun;129(Pt 6):1371-84. doi: 10.1093/brain/awl090. Epub 2006 Apr 25. PubMed 16638796 ↗
  • Szaflarski JP, Ball A, Grether S, Al-Fwaress F, Griffith NM, Neils-Strunjas J, Newmeyer A, Reichhardt R. Constraint-induced aphasia therapy stimulates language recovery in patients with chronic aphasia after ischemic stroke. Med Sci Monit. 2008 May;14(5):CR243-250. PubMed 18443547 ↗
  • Szaflarski JP, Binder JR, Possing ET, McKiernan KA, Ward BD, Hammeke TA. Language lateralization in left-handed and ambidextrous people: fMRI data. Neurology. 2002 Jul 23;59(2):238-44. doi: 10.1212/wnl.59.2.238. PubMed 12136064 ↗
  • Taub E, Uswatte G, Morris DM. Improved motor recovery after stroke and massive cortical reorganization following Constraint-Induced Movement therapy. Phys Med Rehabil Clin N Am. 2003 Feb;14(1 Suppl):S77-91, ix. doi: 10.1016/s1047-9651(02)00052-9. PubMed 12625639 ↗
  • Tillema JM, Byars AW, Jacola LM, Schapiro MB, Schmithorst VJ, Szaflarski JP, Holland SK. Cortical reorganization of language functioning following perinatal left MCA stroke. Brain Lang. 2008 May;105(2):99-111. doi: 10.1016/j.bandl.2007.07.127. Epub 2007 Oct 1. PubMed 17905426 ↗
09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 11, 2018, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT00843427
Lead sponsor
University of Alabama at Birmingham
Collaborators
National Institute of Neurological Disorders and Stroke (NINDS)
Responsible party
Jerzy P Szaflarski (Professor, University of Alabama at Birmingham) — Principal investigator
First posted
Feb 13, 2009
Start date
Sep 2008
Primary completion
Aug 2015
Completion
Aug 2015
Last update
May 11, 2018

Study contacts

Jerzy P. Szaflarski, MD, PhD
principal investigator · University of Alabama at Birmingham, Department of Neurology

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in May 2018. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion