Upton, Emily Rachel Charlotte;
(2023)
Understanding the behavioural and neurological response to digital therapy in chronic post-stroke aphasia.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
This thesis investigates the efficacy of a novel, self-led, tablet-based, word retrieval therapy for persons with chronic post-stroke aphasia (PWA). In Chapter 1 of this thesis, I analysed data from a Phase II clinical trial of the word retrieval therapy (iTalkBetter), which compared six weeks of therapy with six weeks of standard care. The results showed: (i) PWA made large and significant gains in the retrieval of trained words; (ii) improvements were found for both trained concrete and trained abstract items; (iii) PWA generalised their single word learning to a less constrained task (Spoken Picture Description); (iiii) a combination of baseline factors explained a large amount of the variability in therapy response. In Chapter 2, I used longitudinal voxel-based morphometry (VBM) to explore therapy-induced structural brain changes in a subset of participants (n=17). I found that taking part in the iTalkBetter therapy programme was associated with increased volume in the grey and white matter of the left and right hemispheres, in the language and cognitive networks. In Chapter 3, I investigated therapy-driven changes in task-related functional activity in the same subgroup of participants. This analysis showed that changes in activation at post-therapy were correlated with dose of treatment (how much therapy participants completed). These activity changes were found bilaterally in areas supporting auditory analysis and speech production. In the general discussion section, I discuss the main behavioural, structural and functional findings, limitations, and possible avenues for future research.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Understanding the behavioural and neurological response to digital therapy in chronic post-stroke aphasia |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2023. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10166828 |
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