Explaining Language Outcome and Recovery After Stroke (ELORAS)

Two people who have the same stroke can end up with very different language abilities—and this project aims to find out why. Currently, doctors cannot reliably predict which stroke patients with aphasia will recover their speech, or how quickly. The standard assumption has been that the same language task, such as describing a picture, relies on the same brain regions in everyone. This project challenges that assumption. The researcher hypothesises that different people can use different sets of brain pathways to perform the same language task, and that this variation depends on an individual’s prior experience and inherent brain structure. To test this, the team will use functional neuroimaging to map the brain pathways healthy volunteers and stroke patients use during a range of language tasks. They will then cluster participants into groups based on which neural systems they recruit, and compare those groups on demographic, behavioural, and structural brain measures. If successful, the work will produce a new patient stratification system that could make prognoses for aphasia recovery far more accurate. That would allow clinicians to design individualised therapies tailored to the specific neural pathways a patient has available—rather than applying a one-size-fits-all approach. The research is fundamental science: it seeks a deeper theoretical understanding of how the brain sustains language, which could ultimately reshape how post-stroke rehabilitation is designed and evaluated.