Wednesday, December 5, 2012

Current Research Hopefully Allows Aphasia Patients Better Treatment

At this moment in time, aphasia is affecting about or even more than one million people in the United States. We think it may never happen to us (especially because many people have never heard of it before), but in reality, the onset of aphasia can happen suddenly and without warning. Put yourself in the shoes of an aphasia patient—what would it feel like if you lost your ability to speak and process language?

Victims are Thrust into a World of Limited Communication

The reason people may not realize or expect they are falling victim to aphasia is because this disorder is usually a result of other medical conditions. Problems such as head injuries, brain tumors, or strokes can lead to aphasia indirectly. In general, these problems and any other circumstance that kills brain cells in the language processing areas of the brain are the reasons why aphasia occurs. For example, a stroke in the context of the brain means that there is a blockage or rupture of a blood vessel in the brain. If such a rupture occurs near the language processing centers, there is a lack of blood supply coming to these areas of the brain, ultimately causing the death of the brain cells responsible for one’s language function. Depending on the extent to which this happens, the severity of aphasia can vary, but what definitely occurs in every case is the fact that a person’s ability to communicate is unfortunately hindered. After speaking with Dr. Jared M. Novick, a researcher for the Center of Advanced Study of Language (CASL) at the University of Maryland, we can see that a loss of language is a complex problem that of course involves anatomical issues, but also cognitive issues as well.

Handicapping Effect of Aphasia Makes Treatment Important

                Living with aphasia makes it hard to go through day to day life especially because our basic functions are inhibited. Reading, writing, expressing yourself—activities we take for granted—become very difficult for a person affected. The very things that we do to essentially survive become limited in ways that can be inconvenient and uncomfortable. Depending on the type, aphasia can manifest itself in four main ways:

-         - Knowing what you want to say, but having trouble saying or writing it

-         - Hearing or reading words, but not being able to make sense of them

-          - Having trouble using the right terms for objects, places or events

-          - Not being able to speak, read, write, or understand speech overall

Now imagine yourself having any one of the four possibilities…It would be hard, right?
To cope with the effects of aphasia, patients are recommended to do numerous things that include carrying a card around with them that says they have aphasia and says what it is, having an identification card with phone numbers of significant others, and carrying around a pencil and pad around at all times. Not only this, but friends and family have to be conscious of the way they communicate to the victim of aphasia. For example, conversations should be kept one-on-one initially, and sentences have to be slow and short. We’ve all maybe experienced the frustration that comes with miscommunication so imagine having this obstacle on a daily basis. Because of this many patients feel isolated emotionally and feel embarrassed in public—it’s not that victims are not intelligent, they just cannot communicate like they normally would. To prevent this scarring experience, efficient treatment is necessary.

Current Treatments Work, But May Take Long Time
In some mild cases, aphasia can recover their language abilities without undergoing any treatment. While this is the exception, most people have to undergo speech and language therapy to reinvent their language skills and improve on their communication experiences. This process is usually slow and even with therapy, pre-aphasia communication capacity is rarely regained. Therapy with a speech-language pathologist has to start soon after the brain injury or else it will not be as effective. When speech therapy starts, the process starts with the most basic of exercises—simple tasks such as naming objects build up to more complex exercises such as determining the purpose of an object. Activities during therapy also address how to communicate with gestures and drawings to compensate for the language impairment. Novick points out though that while individual one-on-one therapy is useful, the intention is to get the person back and functioning in the real world so working in a group setting and participating in outings that entail communicating in a real-life situation is helpful.

What seems to be an effective way as well is to have a familiar friend or family member be a communication partner which entails having the partner act less like a therapist and more as a natural conversation buddy.

Current Research Looks at Medicinal Drugs to Speed Up Recovery
                As you can see, traditional treatment methods seem long, frustrating, and limited. What researchers are now saying and what Novick says in the following, is that what seems to be effective are medicinal treatments alone, or in supplement with speech therapy.

 Certain drugs studied aim to speed up recovery by increasing blood flow to the brain and more efficiently replacing chemicals in the brain. The intended consequence is that by doing this, brain cells will heal faster and the re-learning process will be able to occur faster because there is better processing on the anatomic level. According to a study done by researchers at UT Southwestern’s stroke program, patients that were exposed to low-dose amphetamine half an hour before their speech-language therapy showed not only immediate sped up recovery, but a longer lasting effect too. The reasoning is that exposure to the drug increases the responsive of brain cells right before therapy, thus allowing learning to happen faster. Especially because patients are decreasingly going to rehabilitation, having these drugs ready and accessible would be more convenient for the patient. Novick cautions, however, that before such treatments are widely adopted, the clinical application should be clear.

Being Aware May Help the Patient's Experience
I think overall that to improve the experience of one afflicted with aphasia, there needs to be more awareness. Social situations would be more comfortable if there was a wider support system for these patients and a lot of the emotional tension that comes with aphasia could be alleviated if people just knew. To put into perspective the lack of education people have on this topic, here is an audio clip from a non-expert…hopefully anything you learned here will be shared for people to know!