Summary: Overall section Stroke is the leading cause of adult disability in the United States, making it a major public health concern (1). Approximately a quarter of all chronic stroke survivors present with aphasia, a language disorder caused by damage to the speech and language areas of the brain (3, 4). In a recently published report, Simmons-Mackie (1) estimates that over two million people in North America are currently living with aphasia. Stroke is typically thought to affect older persons; however, the incidence of stroke in younger individuals has been steadily increasing (2). In fact, at least half of all stroke patients in the state of South Carolina are under the age of 60 (2). Aphasia can vary in severity from very profound impairment that renders patients mute and without the ability to understand others’ speech, to milder forms where patients have great difficulty retrieving specific words. In the chronic stage of stroke, aphasia has been identified as the strongest predictor of poor quality of life. Aphasia not only influences the ability to communicate with family and friends, but also drastically decreases education and employment opportunities. Although some degree of spontaneous recovery from aphasia is typical in the first weeks and months following stroke, many patients are left with devastating communication problems and never fully recover. To address the need for studies improving long-term outcomes in aphasia, the Center for the Study of Aphasia Recovery (C-STAR), funded for just under four years at the time of this application, has made great progress towards understanding the mechanisms that promote spontaneous and therapy-induced recovery in aphasia. The overarching goal of the research proposed in this renewal application is to maintain our focus on aphasia therapy. Specifically, during the next funding phase, the focus of C-STAR is to improve access to aphasia therapy, enhance the effect of behavioral aphasia therapy to promote an improved aphasia therapy outcome, and understand overall health and neurolinguistic factors that influence aphasia recovery. To accomplish our research goals, this project will continue to rely on collaboration among five main investigators: Drs. Julius Fridriksson, Argye Hillis, Leonardo Bonilha, Chris Rorden, and Greg Hickok. Projects led by Fridriksson (chronic patients) and Hillis (acute patients) will continue to focus on factors that may promote improved outcome of aphasia therapy. Both projects have proven successful in yielding a vast, unique dataset including measures of brain status and response to aphasia therapy. Relying on this dataset, Bonilha and Rorden’s project will focus on the relationship between brain health and recovery from aphasia, whereas Hickok will utilize the same data to better understand aphasic impairment in relation to aphasia therapy success as well as new neurolinguistic models of speech and language processing.