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| ID | Type | Description | Link |
|---|---|---|---|
| N° IDRCB: 2018-A02462-53 | Other Identifier | ANSM |
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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Art therapy | Experimental | Art therapy and standard orthophonic rehabilitation |
|
| Control group | No Intervention | Only standard orthophonic rehabilitation |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Art therapy and standard orthophonic rehabilitation | Other | In addition to standard orthophonic rehabilitation, the patient will receive 12 sessions of art therapy |
|
| Measure | Description | Time Frame |
|---|---|---|
| change from baseline measurement of white substance bundles volumes for structural connectivity at 6 weeks | from inclusion at 6 weeks | |
| change from baseline measurement of synchrony amplitude of slow fluctuations for functional Connectivity at 6 weeks | from inclusion at 6 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| 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 | from inclusion at 6 weeks |
| change from baseline Aphasia at 6 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Sophie Dupont | Assistance Publique - Hôpitaux de Paris | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Groupe Hospitalier Pitié-Salpêtrière, Soins de Suite et Réadaptation | Paris | 75013 | France |
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| ID | Term |
|---|---|
| D007511 | Ischemia |
| D000083302 | Hemorrhagic Stroke |
| D001037 | Aphasia |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D020521 | Stroke |
| D002561 | Cerebrovascular Disorders |
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| ID | Term |
|---|---|
| D001155 | Art Therapy |
| ID | Term |
|---|---|
| D026421 | Sensory Art Therapies |
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
| D012046 | Rehabilitation |
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The investigators will evaluate 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.
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Single-blind: only the art therapist knows the randomization arm. The investigators involved in the outcomes assessement, will remain blinded with regard to the randomized treatment assignments
The ART (Aphasia Rapid Test) score ranges from 0 to 26, with higher values indicating more severe impairment
| 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 | 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 | 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 | at 6 weeks only |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D013064 | Speech Disorders |
| D007806 | Language Disorders |
| D003147 | Communication Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D000359 |
| Aftercare |
| D003266 | Continuity of Patient Care |
| D005791 | Patient Care |
| D011613 | Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |