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Impact of Art Therapy on Brain Connectivity in Recent Post-Stroke Aphasia

Not Applicable
Recruiting
Conditions
Ischemic or Hemorrhagic Stroke
Interventions
Other: Art therapy and standard orthophonic rehabilitation
Registration Number
NCT03820843
Lead Sponsor
Assistance Publique - Hôpitaux de Paris
Brief Summary

A stroke located in the left parieto-temporal junction is associated, in aphasic right-handed patients, with a poor prognosis for language recovery. The role of the right hemisphere in recovering post-stroke aphasia is still controversial. Our hypothesis, based on recent work in imaging, is that early activation of the right hemisphere linked to the practice of the visual arts could facilitate language recovery in extended posterior left strokes that completely disrupt language areas.

Detailed Description

The investigators will evaluate, at inclusion and at 6 weeks, the reorganization of functional and structural brain connectivity maps before and after rehabilitation of aphasia with art therapy and standard orthophonic rehabilitation versus a control group that received only standard orthophonic rehabilitation.

The investigators will include all consecutive patients with recent ischemic or hemorrhagic stroke with unilateral lesion(s) of the parieto-temporal left junction present on the Diffusion MRI (DWI) performed in acute phase at 24-48h.

All patients will undergo 2 MRI with tensor diffusion sequences (structural connectivity) and fMRI (functional magnetic resonance imaging) resting state sequences (functional connectivity) at inclusion and 6 weeks after rehabilitation with or without art therapy.

The investigators aimed to demonstrate that early activation of the right hemisphere related to the practice of the visual arts could facilitate the recovery of language in later strokes completely disrupting the language areas of the left hemisphere.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Patients with recent ischemic or haemorrhagic stroke with unilateral lesion (s) of the parieto-temporal left junction present on the Diffusion MRI (DWI) performed in acute phase at 24-48h
  • Post stroke delay of 15 days to 2 months
  • Existence of moderate to severe phasic disorders on Aphasia Rapid Test score (ART, score> 6, scale of 26 items)
  • Patient able to read and understand French
  • Rightful
  • Normal and corrected vision and hearing
  • Absence of pre-existing degenerative neurological disorder
  • Patient having signed his consent
  • Age ≥ 18 years
Exclusion Criteria
  • Patients with contraindications to MRI or claustrophobic
  • Patients under legal protection
  • Patients with behavioral disorders or disabling neurovisual disorders making participation in art therapy impossible
  • Mute patients, illiterate patients
  • Patients leaving the neurological SSR department prematurely
  • Patients not affiliated to a social security scheme
  • Pregnant or lactating women.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Art therapyArt therapy and standard orthophonic rehabilitationArt therapy and standard orthophonic rehabilitation
Primary Outcome Measures
NameTimeMethod
change from baseline measurement of white substance bundles volumes for structural connectivity at 6 weeksfrom inclusion at 6 weeks
change from baseline measurement of synchrony amplitude of slow fluctuations for functional Connectivity at 6 weeksfrom inclusion at 6 weeks
Secondary Outcome Measures
NameTimeMethod
change from baseline Quality of life self-assessment at 6 weeksfrom inclusion at 6 weeks

Visual Analogic scale of patient quality of life is a 0% to 100% scale, with 100 indicating the best health status

change from baseline Aphasia at 6 weeksfrom inclusion at 6 weeks

The ART (Aphasia Rapid Test) score ranges from 0 to 26, with higher values indicating more severe impairment

change from baseline Anxiety and depression at 6 weeksfrom inclusion and at 6 weeks

The HADS (Hospital Anxiety and Depression Scale) scores ranges from 0 to 21 for both anxiety and depression scores, with higher values indicating more severe impairment

Satisfaction self-assessment at 6 weeksat 6 weeks only

visual analogic scale of patient satisfaction is a 0 to 10 scale, with higher values indicating better satisfaction

Trial Locations

Locations (1)

Groupe Hospitalier Pitié-Salpêtrière, Soins de Suite et Réadaptation

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Paris, France

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