Stroke is a leading cause of disability in the United States, frequently leading to speech impairment that creates barriers to participation in professional, social, and family settings. While recovery can be promoted with speech treatment targeted to the specific locus of impairment, improvement remains modest and typically requires a large amount of therapy which contributes to rising health care costs. Thus, there is a need for time- and cost-efficient interventions to expedite and enhance recovery. Recent studies from related domains of stroke rehabilitation (limb motor control and language) indicate that non-invasive neurostimulation such as transcranial direct current stimulation (tDCS) may enhance treatment outcomes, but the potential for improving outcomes specifically for speech impairment has not yet been explored. The career development and research plans of the proposed project will allow the candidate to establish a T2 translational research program as an independent investigator to systematically explore the potential for tDCS to enhance treatment outcomes in individuals with stroke-induced speech impairment. The career development plan will help expand the candidate's research program to include basic and clinical investigations of tDCS-induced plasticity and its potential to facilitate speech motor learning in unimpaired and impaired speakers. The research plan provides an empirical foundation for this research program by investigating the interaction of tDCS and practice-induced speech motor learning. The long-term goal of this research is to develop effective intervention approaches for individuals with acquired speech impairment by combining theoretically-guided intervention with treatment-enhancing neuromodulation techniques. The main objective of this proposal is to establish a best-practice approach for using tDCS to support speech motor learning. The central hypothesis of this proposal is that non-invasive neuromodulation can enhance speech motor learning, including treatment outcomes for targeted interventions for acquired speech impairment. The rationale for the proposed research is that understanding the interaction between neuromodulation and speech motor learning may help determine the most effective approach to enhancing stroke treatment outcomes while extending our basic science knowledge of the relationship between speech and non-speech motor learning. The proposed research is significant because it will enable the development of intervention procedures that maximize recovery from acquired speech impairment, combining targeted therapy with tDCS to unmask the residual capacity for cortical plasticity in chronic stroke survivors. The proposed research is relevant to that part of NIH's mission that pertains to developing fundamental knowledge that will potentially help to reduce the burdens of human disability.

Public Health Relevance

Stroke is a leading cause of disability in the United States, frequently leading to acquired speech deficits that pose a significant barrier to effective communication, and limit participation in professional, social, and family environments. Current treatments can promote some limited recovery, but residual disability remains a problem. This research will meet a public health need by investigating whether treatment outcomes can be enhanced with transcranial direct current stimulation (tDCS), an approach that has been successful in facilitating rehabilitation from stroke-induced deficits affecting language processin and other motor functions.

National Institute of Health (NIH)
National Institute on Deafness and Other Communication Disorders (NIDCD)
Research Scientist Development Award - Research & Training (K01)
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Communication Disorders Review Committee (CDRC)
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Rivera-Rentas, Alberto L
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New York University
Other Health Professions
Schools of Education
New York
United States
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Rimikis, Stacey; Buchwald, Adam (2018) The impact of morphophonological patterns on verb production: evidence from acquired morphological impairment. Clin Linguist Phon :1-27
Buchwald, Adam; Gagnon, Bernadine; Miozzo, Michele (2017) Identification and Remediation of Phonological and Motor Errors in Acquired Sound Production Impairment. J Speech Lang Hear Res 60:1726-1738
Buchwald, Adam (2017) Complexity in articulatory and segmental levels of production. Cogn Neuropsychol 34:488-492
Lowe, Mara Steinberg; Buchwald, Adam (2017) The Impact of Feedback Frequency on Performance in a Novel Speech Motor Learning Task. J Speech Lang Hear Res 60:1712-1725