Elizabeth Usher Memorial Lecture: Lost in Translation? Challenges and future prospects for a neurobiological approach to aphasia rehabilitation

Abstract

While there has been considerable progress in conducting trials of aphasia therapy, there is no consistent evidence for long-term benefits of aphasia treatment, suggesting the need to reconsider current approaches. There are also no accurate methods for determining the amount, type and timing of aphasia therapy that should be provided for an individual. At the same time, there has been increasing interest in applying various principles of neuroplasticity to aphasia treatment and using measures of brain structure and function to predict recovery. This article will consider the potential of neuroplasticity principles and neurobiological predictors to improve our current approach to aphasia rehabilitation and optimise outcomes. Reviewing these principles highlights some of the challenges of translating animal model-based principles and emphases the need to also consider relevant theories of human learning. While considerable progress has been made in considering neurobiological principles and using measures of brain structure and function to predict recovery, there is significant work required to achieve the full potential of this neurobiological approach to aphasia management.

Keywords:

• Aphasia
• neurorehabilitation
• functional neuroimaging
• neuroplasticity
• rehabilitation
• stroke

Acknowledgments

The author would like to acknowledge the significant and longstanding contribution of all former and current lab members, collaborators, and clinical colleagues. I would particularly like to recognise the substantial work reported here led by former PhD students Shiree Heath, Sophia Van Hees, Jade Dignam, and Tracy Roxbury and I would especially like to thank the people with aphasia and their family who have participated in this research and made it possible.

Declaration of interest

The author reports no declarations of interest.

Additional information

Funding

This work was supported by UQ Vice Chancellor’s Fellowship, Australian Research Council Future Fellowship (FT100100976); National Healthy & Medical Research Council (APP1104194, APP1153236, APP519736).