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Stroke: improving speech recovery

Project details

Researcher
Haya Akkad
Institute
UCL Institute of Cognitive Neuroscience
Research area
Stroke
Funding type
PhD studentship
Awarded in
March 2019
Completion
Ongoing

Overview

Haya Akkad was awarded a Brain Research UK PhD studentship in 2019 to enable her to pursue research aimed at improving recovery in patients left with speech and language impairments after stroke.  

Having graduated from UCL with an MSc in Clinical Neuroscience in 2015, Haya subsequently worked as a postgraduate researcher in the Nuffield Centre of Clinical Neuroscience, Oxford, and the Department of Clinical and Movement Neuroscience at UCL Institute of Neurology.

Her academic and research experience inspired Haya to pursue a PhD in this area of research, with the ultimate aim of developing new therapies for the treatment of neurological disorders. 

About aphasia

Being able to communicate via speech is something that most of us take for granted. Speaking is a fundamental skill that we use every day and losing this skill can be devastating.

Aphasia - speech and language impairment – is the second most common major impairment after stroke, affecting an estimated 350,000 people in the UK. It is a severely disabling disorder, everyday communication becomes a source of profound frustration for those affected, often leading to social withdrawal and a higher risk of depression.

Despite the prevalence of aphasia, few patients receive sufficient speech and language therapy through the NHS. On average, patients receive 8 to 12 hours in total, yet the recommended dose to bring about significant change is 100 hours. As a result, many patients simply do not recover good function.

There is a pressing need to develop economically feasible ways to boost the effects of therapy and restore people's ability to communicate effectively.

Read more: About stroke

Modulating speech recovery after stroke

Non-invasive electrical brain stimulation is becoming widely used as a tool to promote recovery of the brain after injury.

For her PhD project, Haya is building on work carried out during her time working as a postgraduate researcher with Professor Charlotte Stagg in Oxford and Professor Sven Bestmann at UCL, during which she developed a new protocol for the use of a type of brain stimulation called tACS. This is a non-invasive, safe and painless method of brain stimulation that interacts with brainwaves at a particular type of frequency. Haya achieved striking results, showing how tACS can boost learning when paired with behavioural training.  

Working with patients from the new intensive aphasia clinical service at the National Hospital for Neurology and Neurosurgery (NHNN) in London, Haya will now pair the brain stimulation protocol with language training, with the aim of boosting speech recovery in patients suffering from chronic aphasia following stroke.

To optimise the effectiveness of the brain stimulation, she will use a new tool to personalise the dose to each patient’s own brain scans – to ensure that the current is being targeted appropriately.

She will assess whether the tACS protocol can improve immediate speech performance and whether it can enhance the long-term benefits of speech training. She also wants to find out whether it’s possible to predict which patients will do well in response to speech therapy.

Haya will be jointly supervised by Professor Jenny Crinion and Professor Sven Bestmann, who between them have a wealth of experience in neuro-rehabilitation, speech and language therapy, brain stimulation and neuro-imaging.

Professor Crinion heads the aphasia clinical service at NHNN, and her team includes a number of speech and language therapists, who will support Haya in administering the behavioural tests and training.

This is a very impressive candidate, who will have access to amazing collaborators and together I think they could do something exciting.

- External reviewer

Impact

It is hoped that this type of brain stimulation will provide a low-cost, portable neuro-rehabilitation tool that can be used alongside training to reliably boost patients’ recovery after stroke. Boosting speech recovery would have a great impact on patient well-being, increasing independence, ability to return to work and overall quality of life.

This is a proof-of-concept study, linked with an NHS clinical service. If successful, it could lead to a wider scale clinical trial on the use of brain stimulation as an adjunct to neuro-rehabilitation to boost recovery in chronic stroke patients.

Given the enormous impact of aphasia on patients’ lives as well as society as a whole, and the current lack of available therapeutic approaches that are both effective and efficient, the proposed research is a particularly important contribution to translate pioneering neuro-scientific research into the clinic.

- External reviewer

Equally important, through this PhD studentship, we are nurturing the development of a promising young researcher who we hope will go on to develop a long and illustrious career in this important field.

Related projects

Acquired brain and spinal cord injury (including stroke) is one of our current research priorities, reflecting the large unmet need in this area. Our aim is to fund research to advance understanding of how to promote repair of the brain and spinal cord following injury.

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