Browsing by Author "Roberts, Sophie"
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Item Better long-term speech outcomes in stroke survivors who received early clinical speech and language therapy: What’s driving recovery?(2021) Roberts, Sophie; Bruce, Rachel M.; Lim, Louise; Woodgate, Hayley; Ledingham, Kate; Anderson, Storm; Lorca-Puls, Diego L.; Gajardo-Vidal, Andrea; Leff, Alexander P.; Hope, Thomas M.H.; Green, David W.; Crinion, Jennifer T.; Price, Cathy J.Establishing whether speech and language therapy after stroke has beneficial effects on speaking ability is challenging because of the need to control for multiple non-therapy factors known to influence recovery. We investigated how speaking ability at three time points post-stroke differed in patients who received varying amounts of clinical therapy in the first month post-stroke. In contrast to prior studies, we factored out variance from: initial severity of speaking impairment, amount of later therapy, and left and right hemisphere lesion size and site. We found that speaking ability at one month post-stroke was significantly better in patients who received early therapy (n = 79), versus those who did not (n = 64), and the number of hours of early therapy was positively related to recovery at one year post-stroke. We offer two non-mutually exclusive interpretations of these data: (1) patients may benefit from the early provision of self-management strategies; (2) therapy is more likely to be provided to patients who have a better chance of recovery (e.g., poor physical and/or mental health may impact suitability for therapy and chance of recovery). Both interpretations have implications for future studies aiming to predict individual patients’ speech outcomes after stroke, and their response to therapy.Item Right cerebral motor areas that support accurate speech production following damage to cerebellar speech areas(2021) Geva, Sharon; Schneider, Letitia; Roberts, Sophie; Khan, Shamima; Gajardo-Vidal, Andrea; Lorca, Diego; PLORAS team; Hope, Thomas; Green, David; Price, CathySpecific regions of the cerebellum are activated when neurologically intact adults speak, and cerebellar damage can impair speech production early after stroke, but how the brain supports accurate speech production years after cerebellar damage remains unknown. We investigated this in patients with cerebellar lesions affecting regions that are normally recruited during speech production. Functional MRI activation in these patients, measured during various single word production tasks, was compared to that of neurologically intact controls, and patient controls with lesions that spared the cerebellar speech production regions. Our analyses revealed that, during a range of speech production tasks, patients with damage to cerebellar speech production regions had greater activation in the right dorsal premotor cortex (r-PMd) and right supplementary motor area (r-SMA) compared to neurologically intact controls. The loci of increased activation in cerebral motor speech areas motivate future studies to delineate the functional contributions of different parts of the speech production network, and test whether non-invasive stimulation to r-PMd and r-SMA facilitates speech recovery after cerebellar stroke.