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Aphasia is a condition that can occur suddenly after a stroke or brain injury and impacts a person’s ability to speak, to understand language and to read and write. For many, aphasia can take a toll on confidence in communicating and overall quality of life.
Researchers at the Center for Aphasia Research & Treatment at Shirley Ryan AbilityLab hope to find new ways to personalize treatment and improve outcomes for people with aphasia — using a non-invasive neuroimaging technique to discover how the brain responds during therapy.
Background on Functional Near-infrared Spectroscopy (fNIRS)
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Neuroimaging has long been a valuable tool for assessing brain function, but many current systems require patients to lie completely still in a noisy, enclosed space which can be challenging for many patients. Furthermore, some neuroimaging procedures may not be safe for people with metallic implants such as pacemakers or aneurysm clips.
There’s a pressing need to study brain activity in a real-world clinical setting where patients are more comfortable and safe. Functional near-infrared spectroscopy (fNIRS) is a portable, more affordable neuroimaging technique that allows patients to sit upright and move freely — as one would in an actual therapy session.
Patients wear a cap fitted with specialized light sources that shine near-infrared light through the scalp and skull into the brain. When a part of the brain is active, it needs more oxygen, so oxygen-rich blood flows to that area. The cap is also fitted with detectors which can track where this oxygenated blood is going because oxygen-rich blood absorbs light in a specific way. By tracking light absorption, fNIRS can map brain areas that are active during specific tasks.
Studying the Benefits of fNIRS in Individuals With Aphasia
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Few studies have been conducted using fNIRS to observe brain activity in people with aphasia during language tasks — until now. In a recent study, “Brain Activation During Oral Reading for Language in Aphasia Using fNIRS,” the Shirley Ryan AbilityLab research team leveraged the benefits of fNIRS to explore brain activity in stroke survivors with aphasia.
Participants engaged in Oral Reading for Language in Aphasia (ORLA), an intervention developed by Shirley Ryan AbilityLab scientists in which an individual repeatedly listens to and reads sentences with the support of a speech and language therapist. Four tasks that are part of ORLA were measured using fNIRS: research participants listened to a sentence read by a computer-based avatar; read the sentence in unison with the avatar; read the sentence aloud by themselves; and read the sentence silently.
Key Findings
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Overall, brain activation increased significantly for study participants in the left hemisphere — the hemisphere most important for language. Notably, brain activity was specific to the ORLA task of interest. This illustrates that ORLA tasks effectively engage multiple key language-processing regions in the brain, highlighting the importance of their inclusion as an intervention to help patients with aphasia improve communication skills.
The study was presented in November 2025 at the ASHA Convention, hosted by the American Speech-Language-Hearing Association (ASHA) in Washington, D.C. The researchers also presented another fNIRS study at the 2026 Clinical Aphasiology Conference in Pittsburgh. This second study is designed to assess the test-retest reliability of fNIRS technology (e.g., to measure the consistency of results on a test or other assessment instrument over time). In the future, scientists hope to expand the use of fNIRS across other areas of rehabilitation research at Shirley Ryan AbilityLab.
