When stroke robs the brain of language

To sign up or for more information about the, email Rebecca Shisler Marshall at rshisler@uga.edu, the Aphasia and Aging Lab at UGA at aphasia.uga@gmail.com or call 706-583-0737

They’d been at Browns Mill Golf Course barely 10 minutes when Booker Izell teed off, hitting the ball somewhere near a lake.

As he and longtime friend George Alford searched for the ball Alford realized something had gone terribly wrong. Izell, his face twisted, was gagging and unable to speak.

Are you all right, Alford asked him but nothing.

For much of his life, Izell, a 74-year-old East Point resident, had made a living as a vice president of community affairs and workforce diversity for the Atlanta Journal-Constitution, a job that involved constant networking and speaking engagements at community events. Now he was literally at a loss for words, unable to connect his thoughts to language.

Alford managed to get him back on the golf cart and the two of them headed back up the hill to the clubhouse parking lot, where Alford dialed 911.

Within minutes, the fire department responded and helped Izell onto a stretcher and then into an emergency vehicle.

“They looked at me and said it appeared he had had a stroke,” Alford recalled the other day. “We’re going to take him to Grady.”

Condition affects thousands

Every year, according to the Centers for Disease Control and Prevention, more than 795,000 people in the United States have a stroke, the most common cause of aphasia, the condition that impairs the ability to use and understand words.

In most people, including Izell, it occurs when a stroke damages the left side of the brain, which is where language is processed. Some people with aphasia talk easily but can’t understand what people are saying. Others, like Izell, have trouble talking but can easily understand speech.

Researchers at the University of Georgia recently launched a study examining “mindfulness meditation” in hopes of using it with or in addition to traditional speech-language therapy. Mindfulness meditation is not intended to change who we already are, but to help us be present in the moment.

While traditional therapy typically targets a specific language skill that may be deficient, mindfulness meditation has been shown to improve attention, said Rebecca Shisler Marshall, an associate professor of communication sciences and special education at the University of Georgia and lead researcher of the study.

“Research has shown that adults with aphasia may have problems in paying attention. Our hope is to boost their attention and potentially help them regain their ability to communicate,” she said.

Izell was among the first stroke victims to enroll in the study, which launched in October.

Soon after his stroke in 2008, Izell could neither walk nor talk even though doctors successfully relieved the pressure on his brain.

“He was in very bad shape,” his wife Birdie said recently. “When the doctors talked to him, his only response was to hold up three fingers. Each day, he started to get better but never spoke.”

For two weeks, Izell lingered in Grady’s Intensive Care unit unable to speak. Fluid on his knees prevented him from even standing. Doctors referred him to a nursing home

“It was horrible,” he said, still struggling to find the words. “It was like ‘One Flew over the Cuckoo’s Nest. I had to get out of there.”

Izell soon began physical therapy to regain the use of the left side of his body. On Christmas Eve, he was transferred to Emory’s Center for Rehabilitation Medicine.

“The people at the nursing home had taken him as far as they could,” Birdie said. “He needed more intensive therapy.”

Father’s focus improved

But by then, Izell had made significant progress. He could say his name, his wife Birdie’s and daughter Gwen’s. He could say yes and no. He was even physically stronger but still couldn’t walk independently.

For the next two months he had daily sessions of physical, occupational, and speech therapy.

By February 2009, he’d reached his insurance limit and switched to outpatient therapy.

But it wasn’t until last year that he got the chance to participate in UGA’s aphasia study made possible by a $15,000 grant from the Academy of Neurologic Communication Disorders and Sciences Collaborative.

Marshall, along with Jacqueline Laures-Gore, a Georgia State University professor and speech language pathologist, launched the study in September and will continue it through August at Georgia State and UGA.

Anyone who had a stroke more than six months ago, has aphasia and is not receiving any other speech language therapy is qualified to participate. Participants cannot, however, have any other neurological disorders such as dementia.

Participation in the two-week study includes mindfulness meditation training. Researchers also collect cortisol levels from saliva to determine the role of stress in the post-stroke brain and language recovery and how performance is affected. Cortisol, a hormone released into the bloodstream as a result of stress, suppresses immune system activity, among other functions.

Gwen Izell, a speech-language pathologist by training, said that even though the study was short-lived she saw some improvement in her father.

“It made him focus more,” she said.

But she said, “I’m realistic. He may never be 100 percent but his communicative intent is there. He can relay a message.”