Search Abstracts | Symposia | Slide Sessions | Poster Sessions
Creative Storytelling Intervention in Aphasia: Discourse Change and Cortical Reorganization Measured with fNIRS
Poster Session D, Thursday, October 1, 4:30 - 6:30 pm, Wangari Maathai
Bijoyaa Mohapatra1, Biraj Bhattarai1; 1Louisiana State University
Traditional aphasia therapies often target discrete linguistic impairments with the assumption that gains will generalize to functional communication. In contrast, participation-based interventions grounded in the Life Participation Approach to Aphasia emphasize meaningful communication and discourse engagement. Creative storytelling interventions such as TimeSlips™ encourage imaginative narrative generation through open-ended visual prompts and collaborative meaning-making. Prior studies have demonstrated improvements in communication confidence, conversational participation, and discourse informativeness following storytelling-based interventions in persons with aphasia (PWA). However, the neural mechanisms underlying these discourse-level changes remain poorly understood. Functional near-infrared spectroscopy (fNIRS), a noninvasive neuroimaging technique sensitive to cortical hemodynamic changes during naturalistic language tasks, offers a promising method for examining therapy-induced neuroplasticity in aphasia. This exploratory case study investigated behavioral discourse outcomes and cortical reorganization following a creative storytelling intervention in aphasia. A single-subject pre-post intervention design was employed. A 66-year-old female with chronic mild Broca’s aphasia secondary to left hemisphere stroke, with no additional neurological diagnoses or prefrontal lesions participated in a six-week TimeSlips™ storytelling intervention consisting of ten individual 90-minute sessions delivered three times weekly by an ASHA-certified speech-language pathologist trained in the TimeSlips™ approach. Sessions utilized visual prompts from the TimeSlips™ database and guided open-ended questioning (e.g., “What do you see/hear/smell in this picture?”) to facilitate spontaneous narrative generation, semantic elaboration, and conversational interaction. Behavioral outcomes included discourse analyses across multiple discourse genres, including story retell, picture description, and procedural discourse tasks. Measures included total number of words, words per minute (WPM), percentage of Correct Information Units (%CIUs), and maze production. Neuroimaging data were collected pre- and post-intervention using an 18-channel Brite MKIII fNIRS system positioned over bilateral perisylvian language regions, including Broca’s area, dorsolateral prefrontal cortex (dlPFC), and supramarginal gyrus. Hemodynamic responses were analyzed during discourse tasks, and resting-state functional connectivity analyses were conducted using Homer3 and FC-NIRS processing pipelines. Behaviorally, findings demonstrated genre-dependent changes following intervention. In the Cinderella story retell, total word output increased from 601 to 654 words, accompanied by slight increases in WPM. During the Bear and Fly retell, discourse informativeness improved substantially, with %CIUs increasing from 59.8% to 69.8%. Procedural discourse also demonstrated increased informativeness, with %CIUs improving from 87.3% to 90.45%. Neuroimaging analyses revealed a general post-treatment trend of increased oxygenated hemoglobin and decreased deoxygenated hemoglobin across optode groups. Pre-treatment activation patterns were predominantly right-lateralized, particularly within the right supramarginal gyrus. Following intervention, greater activation was observed in the right supramarginal gyrus and homologous Broca’s region, along with additional recruitment of the left dlPFC during discourse production. Resting-state analyses further demonstrated a shift from fragmented and diffuse connectivity toward more coherent intra- and interhemispheric network organization. These findings suggest that creative storytelling interventions may support both discourse-level language improvement and therapy-related cortical reorganization in chronic aphasia. Increased bilateral recruitment and strengthened functional connectivity may reflect compensatory and executive-supportive neural mechanisms underlying narrative discourse production. This study contributes preliminary neurophysiological evidence supporting ecologically valid, participation-focused interventions in aphasia rehabilitation and highlights the utility of fNIRS for examining neural changes during naturalistic communication tasks.
Topic Areas: Disorders: Acquired, Meaning: Discourse and Pragmatics