# Recovery of language and theory of mind after stroke

> **NIH NIH R01** · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · 2024 · $705,242

## Abstract

Project Summary
Left and right hemisphere (RH) strokes occur at similar frequencies and both are associated with life-altering
communication deficits. However, patients with RH stroke rarely receive speech-language intervention, likely because
they do not present with obvious language deficits like aphasia. Instead, they have difficulties engaging in typical
conversations which require understanding what a speaker means, especially when in opposition to what was actually
said, such as occurs in sarcasm, humor and metaphors. A specific deficit in the ability to understand others’ perspectives
and intended meanings, known as theory of mind (ToM) may be a primary cause of communication deficits and a
critical component of differential recovery after RH stroke. Inappropriately responding during conversation due to
misunderstandings of what a speaker knows and intends creates poor social interactions and negatively impacts
relationships. For those living with RH stroke, communication deficits have profoundly damaging effects on quality of
life. Our central hypothesis is that RH stroke causes discourse-level language deficits due to damage to brain areas
critical to ToM, an essential component of social communication. Our goal is to assess language and ToM abilities from
acute to chronic stages of RH stroke while collecting neuroanatomical and quality of life data. We will measure the
contribution of other social deficits including the processing of emotional prosody and non-verbal cues (e.g., facial
expressions) as well as cognitive deficits including working memory, executive function, and attention. To date,
estimates of language and ToM deficits which occur after RH stroke and the relationship between them are inconsistent
or unexplored. Most studies examine patients in rehabilitation settings who likely have large strokes and more severe
communication disorders, creating a bias in our knowledge about the effects of stroke. The effects of damage to RH
brain regions, their connections, and how they contribute to language recovery are also unknown, limiting decisions
about treatment priorities. Lastly, whether language recovery depends on ToM is unknown as there are no longitudinal
studies of communication recovery from acute RH stroke. We will address these gaps by examining individuals in a large
group of acute stroke subjects, as they progress from acute to chronic stroke to evaluate the relationship between
changes in language, ToM and their dependence on neural recovery. Our innovative approach combines recent
advances in neuropsychological testing and neuroimaging analysis to provide converging causal evidence to validate a
ToM theory of RH stroke communication. Aim 1 tests the hypothesis that language depends on intact ToM at the acute
stage of stroke before functional reorganization. Aim 2 tests the hypothesis that language depends on ToM associated
neural structures and connectivity acutely, before functional reorganization. Aim 3 examines r...

## Key facts

- **NIH application ID:** 11102479
- **Project number:** 7R01DC019828-03
- **Recipient organization:** UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
- **Principal Investigator:** MARGARET LEHMAN BLAKE
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $705,242
- **Award type:** 7
- **Project period:** 2022-06-01 → 2027-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11102479

## Citation

> US National Institutes of Health, RePORTER application 11102479, Recovery of language and theory of mind after stroke (7R01DC019828-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/11102479. Licensed CC0.

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