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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
15
In addition to standard orthophonic rehabilitation, the patient will receive 12 sessions of art therapy
Groupe Hospitalier Pitié-Salpêtrière, Soins de Suite et Réadaptation
Paris, France
change from baseline measurement of white substance bundles volumes for structural connectivity at 6 weeks
Time frame: from inclusion at 6 weeks
change from baseline measurement of synchrony amplitude of slow fluctuations for functional Connectivity at 6 weeks
Time frame: from inclusion at 6 weeks
change from baseline Aphasia at 6 weeks
The BDAE (Boston Diagnostic Aphasia Examination) score ranges from 0 to 5, with higher values indicating more severe impairment
Time frame: from inclusion at 6 weeks
change from baseline Aphasia at 6 weeks
The ART (Aphasia Rapid Test) score ranges from 0 to 26, with higher values indicating more severe impairment
Time frame: from inclusion at 6 weeks
change from baseline Anxiety and depression 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
Time frame: from inclusion and at 6 weeks
change from baseline Quality of life self-assessment at 6 weeks
Visual Analogic scale of patient quality of life is a 0% to 100% scale, with 100 indicating the best health status
Time frame: from inclusion at 6 weeks
Satisfaction self-assessment at 6 weeks
visual analogic scale of patient satisfaction is a 0 to 10 scale, with higher values indicating better satisfaction
Time frame: at 6 weeks only
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