The goal of this project is to examine the impact of aphasia on the physiologic stress response (hypercortisolemia) following stroke. The stress response will be monitored through measuring changes in salivary cortisol over time as recovery from aphasia occurs. Despite observations of stress related behaviors in individuals with aphasia, the physiologic stress response in this population has not previously been studied. Elevated cortisol levels (hypercortisolemia) are found following stroke and have been associated with additional cognitive impairments and illness in other populations. Greater understanding of the stress response, as reflected in increased cortisol levels may contribute to theoretical and intervention models of aphasia. The following theoretically and clinically relevant questions will be addressed: 1. Do individuals with aphasia experience a greater physiologic stress response than individuals post-stroke with no aphasia? 2. After controlling for other known stroke outcome predictors, is there an association between linguistic improvements in aphasia recovery and stress responses as assessed by cortisol levels? Two groups of stroke patients will be studied: left-hemisphere stroke with aphasia and right-hemisphere stroke with no aphasia. Participants, starting one to three months post onset will be followed for three months. Salivary cortisol levels, communication skills, in addition to other factors known to impact stress responses and post-stroke recovery, such as blood pressure, body temperature, degree of hemiparesis, and psychosocial parameters will be measured once biweekly over the course of the three months, in order to measure change overtime. It is proposed that individuals with aphasia experience a stress reaction to their loss of language that contributes to hypercortisolemia. Because hypercortisolemia following a stroke has been linked in stroke prognosis, a clear understanding of this additional response to an aphasic deficit is critical in developing more effective treatment that can speed recovery. It is hypothesized that language and communication demands encountered in natural contexts will induce a physiological stress response in individuals with aphasia, and that this response is greater than that found with stroke and no evidence of aphasia (right hemisphere CVA).
| Laures-Gore, Jacqueline S; Defife, Lauren C (2013) Perceived stress and depression in left and right hemisphere post-stroke patients. Neuropsychol Rehabil 23:783-97 |
| Laures-Gore, Jacqueline S (2012) Aphasia severity and salivary cortisol over time. J Clin Exp Neuropsychol 34:489-96 |
| Laures-Gore, Jacqueline; Marshall, Rebecca Shisler; Verner, Erin (2011) Performance of Individuals with Left-Hemisphere Stroke and Aphasia and Individuals with Right Brain Damage on Forward and Backward Digit Span Tasks. Aphasiology 25:43-56 |
| Laures-Gore, Jacqueline S; DuBay, Michaela F; Duff, Melissa C et al. (2010) Identifying behavioral measures of stress in individuals with aphasia. J Speech Lang Hear Res 53:1394-400 |
