One of the most prevalent symptoms observed in acquired disorders of language is word-finding difficulty or anomia. Though many promising therapies for language disorders have been developed, there are still fundamental questions that remain unanswered. Memory research established long ago that the most recently acquired memories are also the most fragile. Why then, does aphasia therapy usually end as soon as a pre-determined performance criterion has been reached? Might it make better sense to continue therapy, allowing these hard-earned memories the time they need to consolidate? It is still unclear what factors affect a patient's ability to maintain the benefits of these therapies for the long-term. Without knowing this, it is difficult to determine how many sessions of therapy are needed to achieve the maximum benefit. This project seeks to add to a growing literature on these topics. We will examine whether or not the continuation of therapy after a pre-set criterion has been reached could improve the long-term maintenance of the therapy. The study also seeks to understand the underlying changes in the brain associated with these different levels of training using functional magnetic resonance imaging (fMRI). By using multiple scanning sessions in a within-subjects design as well as by comparison to a control group, we will be able to draw conclusions about the effects of a commonly-used therapy and about the effects of continuing this therapy beyond where it would normally stop in clinical practice. If continuation of therapy proves to make performance gains longer-lasting, our fMRI data will be able to show us the activation patterns associated with a more permanent change in behavior. Almost 1 million adults live with aphasia in America today. Because anomia is its most prevalent symptom, it is essential to public health that we discover better ways of remediating it. We have much to learn about the anatomical changes associated with different types or levels of intensity of therapy in order to use neuroimaging technology to our greatest advantage.
