Neuroplastic Changes Associated with Speech Therapy in Traumatic Brain Injury Rehabilitation

Abstract

Background: Traumatic brain injury is a major cause of acquired communication disorders in Pakistan, often resulting in long-term speech and language impairments. Despite growing awareness of the link between speech therapy and neural recovery, local research exploring neuroplastic changes remains limited. Objective: To investigate the neuroplastic changes associated with structured speech therapy among traumatic brain injury patients undergoing rehabilitation at Lahore General Hospital, Lahore, and to evaluate its effectiveness in improving speech performance and functional communication. Methodology: A mixed-methods design was employed with 20 adult participants diagnosed with moderate to severe traumatic brain injury, aged between 18 and 55 years were recruited through purposive sampling, verified through CT or MRI imaging, with a post-injury duration of three to twelve months, and the presence of speech or language impairments as determined by the Western Aphasia Battery. Patients with progressive neurological disorders, notable hearing loss, or psychiatric comorbidities were excluded from the study. Each received individualized speech therapy sessions three times a week for 12 weeks. Pre- and post-intervention assessments included functional MRI and EEG scans to track cortical reorganization, along with standardized speech evaluations measuring articulation, fluency, and intelligibility. The qualitative insights were gathered through semi-structured interviews with patients and caregivers. Differences in pre- and post-intervention speech performance were evaluated using paired t-tests, and correlations between neuroimaging and behavioral outcomes were determined using Pearson’s correlation coefficient. Results: Neuroimaging revealed increased cortical activation in perilesional and contralateral hemispheres post-therapy. Statistically notable improvements were observed in articulation clarity and verbal fluency (p<0.05). Participants also reported enhanced confidence and communication in daily interactions. Conclusion: Findings demonstrate that structured speech therapy promotes measurable neuroplastic changes that correspond with improved speech outcomes in TBI patients. Incorporating such interventions within Pakistan’s rehabilitation programs could meaningfully improve recovery and quality of life for individuals with brain injury.