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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
 
Final Report Year 2025

Final Report Abstract

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 aimed to examine the role of the two main features of CIAT/ILAT: the amount and intensity of the training and the action-embedding and behavioural relevance of language use and their impact on therapy efficacy. In the first part of this project, we performed two randomised controlled clinical trials, which provided evidence that the factors action-embedding and therapy duration, but not the level of therapy intensity, exerted specific effects on therapy success. These results had important implications for clinical practice and led to additional novel questions equally relevant for future clinical practice, including the following: Can the beneficial effect of actionembedding, which our project work had first demonstrated for non-fluent aphasia, be shown for across variable aphasia syndromes? Would CIAT/ILAT affect the degree of post-stroke depression in persons with aphasia, which may in part be due to the lack of communicative ability and related loss of social contact, and therefore improve their mood and quality of life? How long might the beneficial effects of CIAT/ILAT on language and communication last, and which changes in the brain might they be related to? This second set of questions was addressed in the second funding period. Results confirmed the added value of CIAT/ILAT over conventional therapy (CONV) for a population of post-stroke aphasia patients of different aphasia syndromes and additional beneficial effects on depressiveness and mood. Furthermore, we could show long-lasting stability of the gained language improvements across 1-2 years and report a range of findings about cortical neuroplasticity emerging during short-term ILAT/CIAT therapy within 2 or 4 weeks.

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