Laughter may be the best medicine for the 100,000 Americans diagnosed with aphasia each year, according to Harvey Wolf, clinical health psychologist at Northwest Community Health Care in Arlington Heights. Wolf was one of several speakers at the Midwest Regional Aphasia Conference held in Northbrook recently and sponsored by the Aphasia and Neurolinguistics Research Laboratory at Northwestern University. The conference was for those with aphasia and their caregivers.

Aphasia is a disorder that affects the ability to understand and produce language, usually resulting from stroke or head injury. The part of the brain that processes language is damaged, said Cynthia K. Thompson, professor of communication sciences and disorders and neurology at Northwestern University. “Nobody knows about aphasia unless you study it or you have it. It’s a very silent disorder because people with language impairment can’t advocate for themselves.”

Whether people with aphasia can hold a job depends on job demands and the person’s age, said Thompson. “Some people are retired. However, many are young and wish to return to gainful employment after their stroke.”

When words bring frustration, laughter can promote health, said Wolf. Laughter provides a light, whole body workout by increasing oxygen, improving alertness and memory, decreasing pain, working muscles and decreasing stress.

When we laugh, we are coping, said Wolf. Laughter, tears, anger and frustration are all part of coping. The person who calls me to talk is coping. Not coping is ignoring or hiding to avoid the situation.”

Patients who allow themselves the full range of mood states – happiness, sadness, anger -- have better outcomes and live longer, Wolf said. Crying or laughing de-stresses the body. “When we laugh we release endorphins. Crying is healthy too. You are taking an emotional leak.”

While sadness is a mood state that comes and goes, depression is an illness. During depression, the brain’s level of serotonin decreases. “Serotonin is happy juice in the nervous system,” Wolf said. “Through talking and positive activity you can increase positive brain chemicals and it’s easier to laugh.”

People with aphasia should view anxiety as their friend, he continued. “It’s the only way your nervous system has of getting your attention. It shakes you up. If you ignore it, your body will turn up the anxiety until you pay attention. Then you’ll have a panic attack. A panic attack equals an emotional earthquake.”

Aphasia has many approaches to treatment, and recovery varies based on the deficit, said Thompson. “We’ve found that in recovery the person’s environment affects how the brain recovers. We think that, because persons with aphasia had an intact language system prior to their stroke and many can understand language that they cannot produce, they still have linguistic knowledge in their heads. The problem is accessing that knowledge for communicating.”

Thompson’s approach is to stimulate language recovery by providing a context-based environment. “Our brains are organized in terms of categories, based on the way words sound or are related in meaning. This means that words with similar sounds or meaning are stored and accessed together in the brain.”

Knowing this, Thompson and colleagues help patients by reorganizing the brain or rewiring the neural networks that will allow access to those categories. “We present patients with items, for example, fruits and vegetables and ask them to name them. We start with more complex items, such as ‘artichoke.’ We show them a picture and train them to say ‘artichoke.’ By training the more complex items first, patients improve in naming the more common ones without any practice. Training from simple to complex is not as effective.”

The conventional wisdom is that the earlier a patient is treated after stroke, the better the outcome. “Many third-party payors cover very few treatment sessions, but in our lab we see recovery in patients up to 10 years post-stroke,” said Thompson. “It is well known that spontaneous recovery occurs within the first few months following stroke and treatment during this period is often beneficial.” However, this is when most payors stop paying. The brain continues to recover throughout life, but continued recovery depends partly on how much language is used and in what contexts, she said.

Thompson has a 5-year, $3 million grant from the National Institutes of Health to study early- versus late-onset treatment. Some people have very mild strokes and can regain a good deal of language ability. Most people don’t recover language completely but continue to improve.

Thompson’s lab recruits research participants from hospitals and support groups. “Because we’re doing research, we don’t charge for treatment. As America ages, many of us will have strokes and aphasia and we need continued research in order to understand how treatment and recovery interact and what treatments are most effective for improving language.”

For information, call the Aphasia and Neurolinguistics Research Laboratory  at 847-467-7592.

By Terri Yablonsky Stat

Special to the Tribune