- Fatigue is one of the most overlooked consequences of stroke and 51爆料网 researchers are working to change that.
- An NIH-funded clinical trial at the 51爆料网 Aphasia Lab pairs language therapy with noninvasive brain stimulation to improve outcomes for stroke survivors.
- Undergraduate and graduate students are contributing to research that directly impacts people living with aphasia in their community.
Ellyn Riley was in high school when her grandmother had a stroke. A writer, she had built a life around language鈥攂ut afterward, struggled with the very thing that had defined her.
鈥淟anguage wasn鈥檛 just a skill for her, it was how she thought and how she expressed who she was,鈥� explains Riley, an associate professor in the . 鈥淚 didn鈥檛 have the vocabulary for it at the time, but what I was watching was aphasia鈥攁nd the frustration it caused her has never left me,鈥� Riley says.
Aphasia, a language disorder that affects about one-third of stroke survivors, impacts word finding, sentence formation and language comprehension.
I want our research to be part of building the evidence base that demands better. More targeted treatment, longer duration of care and real attention to the invisible burdens like fatigue that make recovery so much harder.
Dr. Ellyn Riley, Associate Professor
Riley now leads the one of the only research programs in the country focused not just on aphasia, but the fatigue that impedes recovery.
鈥淔atigue is one of the most debilitating consequences of stroke, yet it鈥檚 very often overlooked in rehabilitation,鈥� Riley explains. 鈥淲e鈥檙e talking about a pervasive lack of energy that affects both physical and cognitive functioning鈥攏ot simply feeling tired at the end of a long day. People come to therapy already depleted, and we鈥檙e asking them to do cognitively demanding work.鈥�
That disconnect has driven a new set of research questions: Where does this fatigue come from, what intensifies it, and what would it mean to treat it directly?
Fighting Fatigue
Associate professor Ellyn Riley leads the 51爆料网 Aphasia Lab, one of the few research programs in the country focused on how fatigue impedes stroke recovery.
For Riley and her team, some of the answers have been counterintuitive. People with milder aphasia sometimes report greater fatigue than those with more severe impairments.
鈥淲e think this may reflect the enormous cognitive effort required when you鈥檙e aware of your deficits and pushing hard to compensate,鈥� Riley says. 鈥淭hat finding alone tells us we might be underestimating what these individuals are dealing with every day.鈥�
To address both language and fatigue, Riley鈥檚 lab is running a National Institutes of Health-funded clinical trial that pairs language therapy with transcranial direct current stimulation (tDCS)鈥攁 noninvasive technique that delivers a mild electrical current to specific regions of the brain.
鈥淭he idea is that tDCS may prime the brain to be more responsive to therapy by modulating neural excitability, essentially making the learning environment more favorable,鈥� Riley explains.
Participants complete sentence comprehension tasks while receiving either active stimulation or a sham condition, allowing researchers to isolate the technology鈥檚 effect.
Transcranial direct current stimulation delivers a mild electrical current to targeted brain regions, helping prime the brain to be more receptive to language therapy.
鈥淲hat makes our trial distinctive is that fatigue is a primary outcome, not an afterthought,鈥� Riley says. 鈥淲e鈥檙e hoping to find that this combined approach not only improves language but also reduces the fatigue burden鈥攁nd we gather enough data to start understanding who responds and why.鈥�
鈥淭his research, like other clinical trials, could form the backbone of a new treatment option in traditional clinical settings,鈥� says Jenny Fortin, one of the lab鈥檚 clinical research speech-language pathologists who works directly with participants.
Ph.D. student Hannah Rembrandt, who runs testing sessions for the trial, is also examining how fatigue shapes narrative ability. Participants watch a video and then retell the story under varying levels of induced fatigue.
鈥淚鈥檓 measuring their language and also using eye tracking and pupillometry as a physiological proxy for fatigue,鈥� explains Rembrandt, 鈥渓ooking at pupil diameter changes, blinks and eye movement.鈥�
The work quantifies what patients and clinicians have long observed: 鈥淧eople have always said, 鈥榃hen I鈥檓 more tired, talking is harder,鈥欌�� Rembrandt explains. 鈥淣ow we can measure that.鈥�
The Human Stakes
Ph.D. student Hannah Rembrandt (far right) and undergraduate researcher Luke Sippel 鈥�26 (center) review research with Riley (left). 鈥淓llyn has been a really excellent mentor鈥攏ot just for me in my Ph.D. program, but also for undergrads and graduate students,鈥� says Rembrandt.
The implications extend well beyond clinical metrics. 鈥淚f we only measure whether someone can name pictures more accurately after treatment, we鈥檙e missing almost everything that matters to that person,鈥� Riley says. 鈥淭hey want to have a conversation with their spouse. They want to go back to work, or call their grandchildren, or feel like themselves again.鈥�
Luke Sippel 鈥�26, a triple major in economics, biology and neuroscience on the pre-med track, has been involved in the Aphasia Lab as an undergraduate researcher for the past two years. 鈥淪eeing the severity, and the varying severity, in what someone has to deal with in daily life鈥擨 can definitely feel the purpose right in front of me,鈥� Sippel says.
The experience has also clarified his career aspirations: 鈥淚t solidifies the fact that I want to do research,鈥� he says.
Fortin has found many participants are motivated not only by their own recovery but by the chance to help future survivors. 鈥淢any participants tell me they want to help others who have had a stroke by taking part in the study鈥攖hey want to contribute to the knowledge base.鈥�
A participant completes a language therapy task during the lab鈥檚 National Institutes of Health-funded clinical trial, which pairs speech therapy with brain stimulation to improve outcomes for people with aphasia.
It鈥檚 a dynamic Riley also sees clearly. 鈥淭he stroke survivors we work with are navigating something most of us can鈥檛 imagine, and they do it with extraordinary resilience and often a real generosity toward research,鈥� she says.
For Riley, the work is still rooted in that early, formative experience鈥攚atching someone she loved struggle to hold onto language as a way of being in the world. What has changed is the clarity of the questions, and the growing sense that answers are within reach.
鈥淚 want our research to be part of building the evidence base that demands better,鈥� Riley says. 鈥淢ore targeted treatment, longer duration of care and real attention to the invisible burdens like fatigue that make recovery so much harder.鈥�
鈥淎phasia sits at this remarkable intersection of neuroscience, cognition and profoundly human experience,鈥� Riley says. 鈥淟anguage is so central to who we are, how we connect, how we think, how we tell our own story, and when it鈥檚 disrupted, the impact ripples through every part of a person鈥檚 life.鈥�
