2023-09-08 04:00:05
In France, between 130,000 and 150,000 people suffer a stroke each year. “However, among them, 50,000 to 70,000 develop aphasia – a language disorder – which is more or less disabling”observes Charlotte Jacquemot, director of the cognitive studies department at the Ecole Normale Supérieure (ENS) and researcher in the interventional neuropsychology laboratory, jointly between the Mondor Institute of Biomedical Research, in Créteil, and the ENS. “These language difficulties weigh heavily on daily life: they limit social interactions and professional prospects. They also hinder the rehabilitation of other post-stroke cognitive disorders”she specifies.
These aphasias can lead to depression, especially since rehabilitation is not always effective and the number of speech therapists is notoriously insufficient. The situation could improve with a new test developed by Charlotte Jacquemot’s team, the Core Assessment of Language Processing, Calap. This makes possible rapid identification, in less than fifteen minutes, of the damaged language component(s). This makes it possible to target rehabilitation on these components.
Currently, after a stroke, a scale, the National Institutes of Health Stroke Scale (NIHSS), determines in emergency departments whether it is necessary to perform, within four hours, thrombolysis, the injection of a medication aimed at thin the blood clot in the brain. “As language is little explored by the NIHSS, we added a very short and summary test to detect if there is aphasia requiring thrombolysis and rehabilitation”explains Cécilia Jubin, speech therapist in the neurology department of Henri-Mondor hospital (AP-HP), in Créteil.
If aphasia is detected, the patient is referred for a more detailed assessment during rehabilitation. But this assessment, carried out by speech therapists using standardized tools, lasts almost three hours. It tires the patient, who rarely reaches the end, and the results are disastrous. Result: rehabilitation, poorly targeted, is far from always effective. “When it doesn’t work, the patient becomes discouraged and ends up stopping”notes Marie Villain, speech therapist and neuroscientist, currently in a postdoctoral position at the Brain Institute in Paris.
“Saving valuable time”
When Charlotte Jacquemot looked into this problem in the early 2000s, she noted with astonishment that we did not understand why rehabilitation works or not: “None used the language processing models that I am familiar with as a psycholinguist. » She then examines data from recent studies on the subject (124 patients in total) through a model that divides language into five levels: phonology (sounds), morphology (word structure), lexicon (words), syntax and semantics. Everyone can be harmed independently of others. She discovers that rehabilitation only works if it is applied to the “broken” components of language. His study appeared in 2012. No tool knew how to detect these broken components.
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