Neurobiological and psychosocial predictors of recovery
Aphasia recovery can vary in speed, nature, and the extent of improvement. There are no known clinical characteristics that reliably predict outcomes for individuals. Developing the ability to predict recovery is one of the highest priorities in aphasia research.
We will address limitations in previous attempts to predict aphasia recovery to advance the field by undertaking:
- Neuroimaging and analysis of large data sets for predictive modelling of recovery. This approach will work toward developing a measurable biological indicator (biomarker) for aphasia.
- Innovative predictive-modelling methods to expand the national stroke registry. Establishing accurate predictors of aphasia recovery will help identify factors that:
- optimise recovery
- improve services
- assist discharge planning with patients
- inform policy regarding aphasia care.
Neurological predictors of aphasia recovery and treatment response
Researchers have demonstrated that measures of white matter integrity and functional connectivity are associated with treatment-induced aphasia recovery.
Demographics, behavioural and structural imaging data for individualised recovery have been demonstrated as the PLORAS (Predict Language Outcome and Recovery After Stroke). However, the influence of reperfusion and behavioural treatment on these PLORAS predictions has not been explored.
- Test the accuracy of probabilistic recovery curves derived from PLORAS for patients receiving aphasia therapy.
- To determine the influence of structural damage, and structural and functional connectivity, on language outcome using a patient classification method.
Prospective study of neurobiological and psychosocial predictors
A combination of advanced neuroimaging and comprehensive psychosocial measures at several points will be used to examine how these factors interact and contribute to aphasia recovery and quality of life. It will provide unique insights into the neurobiological basis of major psychosocial factors such as depression in post-stroke aphasia.
To validate predictors of aphasia outcome as identified in CRE project 1, Neurobiological predictors of recovery and to examine the influence of psychosocial factors on recovery.
Establishing a national minimum dataset on aphasia outcomes
Large stroke registry datasets provide a powerful method for characterising outcomes and costs of aphasia, determining factors that influence recovery and improve the quality of services. The existing Australian Stroke Clinical Registry (AuSCR) provided evidence of associations between the quality of acute stroke care and long-term health-related quality of life and survival, but outcomes for patients with aphasia cannot be examined.
To develop a national minimum dataset for aphasia to be embedded within AuSCR.