New S.C. speech study gives stroke patient hope
At 70, Mike Boomer is learning how to speak all over again.
For about eight years now, Boomer has had trouble finding the words he wants to use, difficulty spitting them out and matching the sounds in his head to the movement of his tongue and his lips.
The medical term for such language problems is aphasia. It’s a common symptom of severe brain injuries, including stroke, and one that researchers at the Medical University of South Carolina and the University of South Carolina are trying to crack.
A research trial recently launched in Charleston and Columbia is now studying stroke patients. When Boomer learned about a chance to improve the way he talks, he didn’t hesitate to sign up.
Boomer’s stroke hit the left side of his brain like a Mack truck on Aug. 26, 2004. After three weeks in the hospital, doctors said he could no longer live alone, so he moved from Northern Virginia to live with a friend in Charleston.
Several years of speech therapy following the stroke helped, but his improvement plateaued and health insurance stopped paying for therapy. Boomer, a retired life insurance salesman, says a few phrases very clearly: “Yes,” “No,” “I know,” “Thank you.”
He points an index finger to prompt his friend, Jessica Flowers, to speak for him. Flowers, who lives with Boomer on Folly Beach, has an uncanny ability to voice exactly what he is trying to say.
Strokes kill as many as 130,000 people in the U.S. each year, according to the Centers of Disease Control and Prevention. And those who survive aren’t left unscathed. Depending on the region of the brain damaged by the stroke, symptoms can include paralysis, aphasia and even personality changes.
Dr. David Bachman, a neurologist at the Medical University of South Carolina, said South Carolina ranks among the worst for strokes.
“South Carolina is in the buckle of the stroke belt,” Bachman said.
In the case of stroke patients like Boomer, who lose their ability to speak clearly, speech therapy is useful to an extent, Bachman said, but progress tends to peter out.
“There are many patients who are left with significant deficits,” Bachman said. “There’s a very novel treatment that’s been looked at in the last five to 10 years. It’s transcranial direct current stimulation. This is pretty much exactly what it sounds like. Electrodes are pasted to the scalp that give a very low direct current — 1 to 2 milliamps. It’s the kind of current you’d get out of a AAA battery.”
Researchers think that the electric current combined with therapy may enhance a patient’s potential to regain speech abilities, Bachman said.
So for 15 days last month, Boomer reported to MUSC for this new treatment. A speech pathologist attached electrodes to his scalp and he watched images flash one-by-one on a laptop screen.
He punched “Yes” and “No” buttons depending on whether the picture on the screen matched the word he heard through a set of headphones.
Bachman, one of the lead investigators of the research study funded by the National Institute on Aging, said the trial is blind, meaning some of the patients won’t actually receive any electric current, because their electrodes are inactive.
“Half the patients will get the electrical stimulation and half the patients won’t,” Bachman said.
Boomer won’t know which group he was part of for another five years, when the study is complete, but he told MUSC speech pathologist Jo Ann Fisher during a one-month follow-up visit Thursday that he thinks his speech has improved. Flowers watched as the pathologist interviewed Boomer.
“Has it continued to get better?” Fisher asked.
“Yes,” Boomer said, pausing, searching for more words.
“Take a deep breath,” said Flowers, sitting behind Boomer in the treatment room.
“No, I don’t know,” he said, frustrated.
“Yes. Yes, you can do this,” Flowers encouraged him. “I’ve noticed it.”
“And the words just come out?” Fisher asked.
“Well, yeah,” Boomer said.
“It just comes out more naturally,” Flowers said. “Last night we were talking ... but then he said, ‘She’s along for the ride.’ And I was like ‘Wow!’”
Five words in a row may be an incidental example of progress, but MUSC and USC researchers will use more scientific benchmarks to study Boomer’s improvement.
MRIs taken before the study will be compared with ones taken after, and Boomer will return for additional sessions this year with Fisher, who will grade his ability to identify images on a computer screen.
On Thursday, Boomer identified — and, in some cases, struggled to identify — hundreds of images. Some words, like whale, candle, scissors, came out flawlessly. Other words, like dishwasher and asparagus, were too difficult. Many were just slightly off. Pear came out “prayer.” Squirrel came out as “whirl.”
The study has given them hope again, Flowers said. Participation in the trial prohibits Boomer from enrolling in speech therapy for another six months, but he intends to recommit to it later this year.
“It was a godsend,” Flowers said.
Reach Lauren Sausser at 937-5598.