Maximizing and predicting sentence processing treatment outcomes in aphasia

The present proposal builds on previous work showing that Treatment of Underlying Forms (TUF, [1-2]), a treatment protocol focused explicitly on improving sentence processing abilites in agrammatic aphasia, results in strong acquisition and generalization effects, changes in on-line sentence processing as identified by visual world eyetracking studies [3-6], and adaptive neuroplasticity as measured by shifts in BOLD signal derived from functional neuroimaging [7-8]. The overarching goal of the proposed studies is to refine TUF to maximize its efficacy and boost treatment outcomes to ultimately increase its clinical use, as well to compare its relative efficacy to another well-researched treatment for verb and sentence processing deficits in aphasia, the Verb Network Strengthening Treatment (VNEST [9]). We propose a set of studies that test the effects of early treatment components of TUF to identify those that are most critical for successful outcomes (Aim 1, Study 1), compare the relative effects of TUF and VNEST on offline, online and neural processing (Aim 2, Study 2) and examine the effects of noninvasive neurostimulation (i.e., transcranial direct current stimulation) as an adjuct to TUF (Aim 3, Study 3). In addition, we will use multimodal neuroimaging and behavioral data to examine the factors underlying successful treatment outcomes and develop algorithms for predicting responsiveness to treatment based on individual behavioral and neural characteristics (Aim 4, Study 4).