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Brain Friends
Brain Friends: The Podcast is a global space for stroke, science, and equity. Hosted by Angie Cauthorn — two-time stroke survivor and unapologetic aphasia advocate — this show unpacks the cognitive, behavioral and communication disorders that follow stroke, and the systems that shape recovery.
This podcast began with my friend and co-host, Dr. D. Seles Gadson — a brilliant neuroscientist, speech-language pathologist, and fearless champion for equity in healthcare. Her work focused on health disparities in aphasia care, particularly within the Black community, and she believed deeply in making science accessible for all. I carry her legacy forward in every conversation.
There are no survivor interviews here. Instead, we focus on the research, the roadblocks, and the real work of making neurorehabilitation more equitable, inclusive, and understood — especially for people with aphasia.
Our listeners span over 80 countries and include speech-language pathology professionals, researchers, and people with aphasia who want more than inspiration — they want information that matters.
If you're here to rethink recovery, reimagine access, and stay grounded in the science — you're in the right place.
Welcome to Brain Friends.
Brain Friends
Aphasia, Dementia, and Stroke with Dr Roy Hamilton
A face that slips, a word that won’t come, an arm that won’t lift—tiny moments that point to massive truths about how the brain works, heals, and sometimes declines. I invited Dr. Roy Hamilton, neurologist, neuroplasticity researcher, and one of the clearest teachers in our field, to help us untangle aphasia, dementia, and stroke with practical language and unforgettable analogies.
We start by separating terms people often blend. Dementia isn’t just memory loss; it’s a progressive decline across thinking skills that eventually limits independence. Aphasia is a language disorder: after stroke it strikes suddenly and often improves over time, while in primary progressive aphasia it creeps in gradually and can ultimately meet criteria for dementia. Along the way, we explore why prior stroke raises future risk, how small vessel disease can silently chip away at cognition, and what high blood pressure, cholesterol, diabetes, and smoking do to the brain’s “sprinkler system.”
Then we get tactical. Dr. Hamilton breaks down ischemic versus hemorrhagic stroke, how atrial fibrillation forms clots that travel to the brain, and why time is brain when speech slips or a face droops. Don’t sleep it off—modern teams can give clot‑busting drugs, thread catheters to dissolve or remove clots, and save language if you act fast. We spotlight neuroplasticity as the engine of recovery and show why practice is the original brain‑changing tool. We also share how non‑invasive brain stimulation—magnetic and electrical—aims to boost language networks in subacute stroke and help people with primary progressive aphasia hold on to communication longer.
If you or someone you love is navigating aphasia—whether after a recent stroke or as language slowly changes—this conversation blends clarity, science, and hope. Share it with your circle, watch for FAST warning signs, and ask your care team about therapy intensity, prevention, and research options. If this helped you see the brain more clearly, follow the show, leave a rating or review, and pass it on to someone who needs it.
www.aphasiaadvocates.com for Brain Friends Merch
https://www.cognitiverecoverylab.com/seles
https://aphasia.org/stories/announcing-the-davetrina-seles-gadson-health-equity-grant-program/
Our beloved colleague, Dr. Davetrina Seles Gadson, passed away January 11, 2025. Dr. Gadson was an extraordinary speech-language pathologist and neuroscience researcher who devoted her energy to studying health disparities in aphasia recovery. She was a fierce advocate for improving services for individuals with aphasia, particularly Black Americans. Her research transformed our understanding of these health disparities and shed light on how we can address them. We were privileged to have Dr. Gadson as a cherished member of our lab community for four years, first as a postdoctoral fellow and then as an Instructor of Rehabilitation Medicine. She was still a close collaborator and friend to many of us at the time of her passing. Dr. Gadson was an incredible person—compassionate, inspiring, and full of life. Her dedication to advancing equity in aphasia recovery and her profound impact on our community will never be forgotten. We are committed to honoring her memory by continuing to push our field forward and fight for equitable services for all people with aphasia.
Hey Brain Friends. Before I dive in, a quick heads up. Today you will hear the original Brain Friends intro. Well, actually, you'll hear that for a while. But I just wanted to give folks a heads up that you will be hearing the original Brain Friends intro. I I still need, I need it. So I'm doing that for me, and because she is still very much the heartbeat of this channel. While I've been away, some amazing things have happened. Brain Friends now has listeners in over 90 countries. Y'all kept the show going, y'all kept sharing, y'all kept showing up, and y'all kept spreading the word. And I ask you to continue to do that. It truly does mean the world to me. I am your host, Danji Clawthorn. Welcome to Brain Friends.
SPEAKER_01:Welcome to Brain Friends, where two neuronerds talk all things aphasia, language recovery, culture, and community. I am Dr. Dacrina Celeste Gatson, a clinical speech language pathologist and neuroscientist.
SPEAKER_02:And I am Angie Cawthorn, stroke survivor and aphasia advocate.
SPEAKER_01:Welcome to our show. Welcome to Brain Friends. We want to thank all of our listeners for downloading the podcast. We appreciate everyone listening. So please tell a friend to tell a friend that we are here. And we are.
SPEAKER_02:Introduce yourself to the people. Tell the people about what you're doing, how you've been, and what's been going on with you.
SPEAKER_04:All right. Well, it is such a pleasure. Thank you so much for having me on Brain Friends. My name is Roy Hamilton. Dr. Roy Hamilton. I am a uh a professor at the University of Pennsylvania. I'm a professor in neurology, but uh also in psychiatry and in physical medicine and rehabilitation. And so um I see patients who have problems with memory and also problems with language and other abilities. I try to help them uh have the best outcomes they can with respect to their mental abilities. I also run a lab and a center that does non-invasive brain stimulation, so electrical and magnetic stimulation of the brain. We try to we put magnets and electrodes on people's heads and we try to make them think better. And so the my main area of research in brain stimulation is in aphasia. I try to stimulate the language system in people who have had strokes or didn't or what's called progressive aphasia and see if we can improve their language ability. So that's that's uh that's what I do.
SPEAKER_02:Today we're gonna be clearing up some big confusion. Aphasia and dementia. They're they are related for some people, separate for others. Those two different disorders, but they are related in some ways. We're gonna discuss how they relate and where they differ. But the quick overview. Dementia is a progressive change, it it goes across your thinking and eventually limits your daily life. Aphasia, on the other hand, is a language disorder that can come on suddenly after a stroke or some type of acute event, or it can progress slowly over time. When it progresses slowly over time, that's when it's connected to PPA, which is primary progressive aphasia. But we'll get into all of that. I am excited about all I have to share with you today. I'm even more excited for you guys to learn from Dr. Roy. He is brilliant, he won't brag about himself, so I will. He is one of the clearest teachers in our field. A bable. He is able to turn medical fog into everyday clarity, uh, a great teacher and a great friend to the room. Let's get it, Dr. Roy.
SPEAKER_04:But so I I would say that the relationship between dementia and aphasia is a somewhat complicated one, but worth talking about in in some detail to understand. Okay, so so I think the most important first part of this is to understand what dementia is, right? And once we come up with a reasonable definition of what dementia is, then that allows us to understand how sometimes dementia and aphasia are very separate. Sometimes they are running together, sometimes uh aphasia, having had aphasia is uh puts you at, depending on what the cause of your aphasia is, puts you at some degree of risk of in the future developing dementia, right? So let's start by talking about what dementia is. And and one of the things that I really want to clarify uh is that dementia isn't just memory loss. So they are not synonymous. So what I want you to think of dementia as is dementia is uh the set of progressive neurologic conditions that cause a person to have decline in their cognitive abilities, writ large, right? So not just your memory, but your cognitive abilities, to the point that they prevent you from independently engaging in your normal activities of daily living. Okay, so when when you have and and they are progressive. So, in other words, you started out without these problems, and then over the course of time you develop these problems, they typically go through some stage where they're pretty mild, you can kind of work around them, but over time they get to the point where you can no longer work around them, somebody needs to help you, and at that point, irrespective of what you which specific disease label we're gonna put on the cause of it, whether it's Alzheimer's disease or frontotemporal dementia or vascular dementia, at that point it is a dementia. You have a dementia level of impairment. Okay.
SPEAKER_03:Okay.
SPEAKER_04:So how is that how is that different than aphasia? Well, aphasia is uh an acquired loss of your language and communication abilities specifically. And so, and and for lots of people, for for example, the people who have aphasia due to stroke, uh that that isn't exactly a progressive event, right? It wasn't like over the course of weeks and months and years, it was you were doing your thing, and then bam, now you're not doing your thing, right? And now you're not. Right. And often for people, the course after a stroke also, in addition to being sudden, it also doesn't follow the progression that I was talking about, right? So for most people of post-stroke aphasia, they would think back and think, yes, this was worse right after the stroke, right? And then over time, it's sort of been getting better. It's gonna vary a lot between person to person, how much better it's gonna get, but it's been getting better as opposed to getting worse, right?
SPEAKER_02:Which is what um, like uh Bruce Willis has a progressive correct.
SPEAKER_04:So now let's talk about the fact that there are a fraction of people who have aphasia where their aphasia is progressive, right? They started out healthy, uh, or at least they didn't know it any problems with their communication, and then gradually over time, their communication abilities got progressively weaker, right? Right, those people have a progressive aphasia, and that progressive, and remember, remember how we're gonna define dementia. Dementia is a cause of cognitive change, it's progressive over time, and it gets to a point where you can't engage in your normal activities anymore, you can't work around it, so other people have to help you. So it is reasonable to think that for patients with primary progressive aphasia, they that if it gets to a point where that progressive problem in their communication and their ability to understand other people often, if it gets to a point where they can't do for themselves, they can't work around it, right, it falls into that same bucket, that bigger bucket. So it's a complicated relationship, right? Sometimes aphasia is a hallmark of is associated with dementia, sometimes it is not, right? Right. It has different causes. The other thing I'll say is that that when you look under the microscope at the cells of people who have primary progressive aphasia, what you find is the same kinds of proteins, the same kinds of cellular abnormalities that you see in people who uh under other circumstances with different cognitive problems end up with a diagnosis of Alzheimer's disease or in some cases frontotemporal dementia. Right? And so it's not just that these people have a progressive course, it's it's uh it's that the pathology, the thing that's going on in the brain is very similar in terms of what's happening compared to other patients who have these syndromes that that we commonly associate with dementia, right? So so it's a it's a different flavor, and sort of a different there's there's a spectrum there and a relationship. Now, I I do want to say persons who have post-stroke dementia are not necessarily totally off the hook.
SPEAKER_03:Okay.
SPEAKER_04:And the reason why why you're you're not totally off the hook is that one of the biggest risks for or biggest predictors for having another stroke or for having uh other kinds of vascular disease and vascular impairment in the brain is a history of having had a stroke.
SPEAKER_02:Wait, what? Say that again.
SPEAKER_04:All right, all right, all right, all right. So think about it this way, okay? Um, vascular disease, if it gets bad enough, uh, can certainly progress to affect all sorts of different aspects of your vascular. Oh, thank you, thank you, thank you, thank you. Yes, um your brain is full of, just like your body, is full of blood vessels. Okay, uh arteries and veins. Okay. So arteries and veins are carrying all the nutrients, the energy, the oxygen to your brain. Okay. Um when you have a stroke, what is what has happened is something has happened to stop that flow of energy, oxygen, and nutrients to part of your brain. All right, and the bigger the bigger the area of the brain that's not getting those those things to it, right, the bigger your stroke, the worse your deficit. Okay. Now, there are a variety of reasons why a person could have a stroke, but but um you know they include things like well, if you had uh blood clots that went to your brain, uh, if you have uh uh a collection of what people call atherosclerosis, basically imagine the pipes getting progressively clogged with gunk, and so they clog off, and then once they clog off, then nothing's getting through them, right? That's another cause for a stroke. Okay. So one thing, if you think about it, should be the case, right? That if if you've had a stroke, something's going on, right? Something caused it, right? So so you can treat the stroke, you can get a person through the hospital and make sure they're alive and uh uh and so on and so forth, right? And and they'll have the problems they have after their stroke. But one thing you figure is well, you had some problems with those blood vessels, and here's where I'm going to introduce that term vascular again. Vascular is just the term we use for the the you know related to the blood vessels in your brain, right? So if I use that term again, you now you know. Uh, by virtue of the fact that we just watched you had watched you have a major event, we know there's something going on there, so that means that you are the kind of person whose brain is at risk of having more events. Your brain is susceptible, right? Because you proved it to us. It's already happened, it's happened, right? Right? That's what I mean when I say that one of the biggest predictors of vascular disease is having had a stroke.
unknown:Wow.
SPEAKER_04:Okay, so now if vascular disease, and there are different ways to have it, some of those ways are sudden, right? Like a like a big stroke, some of those ways are more subtle. Okay, so imagine the pipes, you know, uh it's like a plumbing system. Uh, but but the thing is the pipes, it goes from big pipes to smaller pipes to even smaller pipes to get all the little areas of brain. Okay, when you get down to the smallest pipes, sometimes those can close off or have damage to them and not do their job very well. And it's it's happening a little bit at a time. It's it's so it's so little that you don't notice. Okay, from day to day, you don't notice, but it kind of collects, right? So it is possible that over time a person who has vascular disease is the person who's likely to develop problems with the blood vessels of their brain, that they too can get a kind of progressive problem with their cognition. Well, we call vascular cognitive impairment or vascular dementia. In a couple of ways, sometimes it happens because you've had a stroke, and so, and so you know, you're you're you're humming along, and then you get one one set of problems, and then you're humming along, and you get another stroke, new set of problems. Well, eventually, if you have enough of those problems, you're gonna get to a point where you're not gonna be able to function in and your brain is misfiring.
SPEAKER_02:Things are just misfiring.
SPEAKER_04:Or yeah, or it could happen very gradually. Like those two things can both happen with vascular disease, and they're not mutually exclusive either, they can both happen, right? So uh I will say that while the typical course for a person who's had post-stroke aphasia is you're humming along, bam, you get worse, and then you get better, you are at risk down the line for having either more strokes that give you more problems, right? Or for having this sort of progressive vascular impairment because the the the little the smallest pipes are closing off and you don't notice it, right? And that's why the that's why when you see a stroke doctor, after you've had your stroke, they're paying very special attention to the major things that could cause you to have either another stroke or more of this, you know, this what I'm gonna call we we we call it small vessel disease. Oh either so think of this big vessel disease, stroke, small vessel disease, this like little closing of the pipe, vascular, just little little decline, the small little decline. Small little ones, yeah. It's sort of like uh, you know, you're you you know that uh that that metaphor about the boiling frog? No, you know, you know how you can boil a frog, like because it just changes the change the temperature a little bit. Oh, so he doesn't even move the water, and the frog doesn't know that it's boiling, right? That vascular disease can sneak up on you, like little the little disease, right? The little vessels closing off, so people don't realize that there's a change. Anyway, anyway, so that's why your neurologist spends so much time thinking about controlling things like your blood pressure, um, your cholesterol, your blood sugar, basically all the things that um can make it likely that in the future you will suffer from more vascular disease, right? So as soon as you've demonstrated to the world that you have the capacity to have vascular disease, they're on you. You know, right? They're on you like a hawk, right? Trying to make sure that you don't have your next one.
SPEAKER_02:When speech changes, face droops, or one side goes weak, don't sleep it off. Treat it like a brain attack. Time opens doors, clock busting meds, they can pull it out, spritz it, do all kinds of stuff, but it's about you realizing your symptoms, locking in and getting to the hospital as soon as you can. Do not take a nap. This is just a question. Which ones will cause uh hemorrhagic or an ischemic? Is there are they seen in different types of blood vessels?
SPEAKER_04:Uh so it's so hemorrhagic strokes. So, first of all, let's break it down by percentages, all right? So, if we're gonna talk about aphasia due to stroke, actually, if we're just gonna talk about stroke in general, uh roughly 85% of the time, we're talking about ischemic strokes. Okay, so we're talking about we're talking about uh I'm I'm gonna use the plumbing analogy, and now I'm gonna uh I'm gonna call I'm gonna use an irrigation, like lawn irrigation analogy, right? So like imagine you're you got a sprinkler system for a big lawn. Like I got a park outside here, it's got it like a you know sprinkler sprinkler system.
SPEAKER_03:Okay.
SPEAKER_04:Um so over at the park over there, right? The sprinkler's gone. And so 85% of the time when you have a stroke, the problem that there's there's a clog in one of the pipes, right? And so then so then the water's not getting to that area of the of the grass, grass starts to die, get yellow, die because it's not getting water, right? So that's that's the problem. 15% of the time it's because the the pipe bursts, all right. And when the pipe bursts, well, obviously you're not getting water pressure on the other side of the pipe, right? So that's a lot of water so there's a lot of water like spilling out damaging the damaging thing, right?
SPEAKER_02:Yeah, right, right. All up on the heater.
SPEAKER_04:Okay, so the the most likely place, just to get back to your question, the most likely place for you to have one of those pipe burstings, which again it's about 15% of the time, is uh when the there's a difference in the pipes. Okay, what I mean by that is remember, uh, you got big blood vessels going up into your head, right? Like just some major highways, and uh it turns out that off some of those major highways, there there are some pretty small, they're not the smallest, but they're pretty small blood vessels coming off the big ones. Okay. Yeah, yeah. And so so uh okay, all right. So let's go the road analogy this time. All right, now let's do roads. Okay. All right. So you imagine that uh if the trap if you're on a big highway, right, super highway, and it splits into like a couple of smaller highways, but still saying they're highways, and and then like you know, those go different places. The flow of traffic, it's it's it's it's not such a problem, or at least it doesn't seem like dangerous, like it would be problematic. But now imagine that coming off, I don't know, uh, off I-95, there's like a city street. Okay, there's like a city street, a little cul-de-sac, the kids playing soccer out there, right? Like, right, imagine no off ramp, no off ramp. Yeah, no off ramp, just like right on the city street. Imagine how hard it would be to make that turn, right? Imagine how like many accidents there there would be. Like, there's a reason civil engineers do not do this, okay? So now there are gonna be a few places in the brain where that's kind of the case. You got these big blood vessels, and then they like right off them, right off them, little blood vessels, and they they tend to go to a couple of uh places deep in the brain. Um, you know, for those taking notes and uh for their neuroscience classes, the basal ganglia is one of them, uh, and the cerebellum is uh is another one, like a few places in the brain where you got these little vessels coming off the big ones, okay? And that's where, especially, especially if you have high blood pressure, okay? So it's not just that you know the traffic's gotta come off all of a sudden at a weird angle, but it's you know, there's a lot of pressure in the system, right? Uh like a lot of traffic, right, right, with the high blood pressure. That's where you have an accident, right? That's where that's where the pipe's gonna burst because that's the that's the weak link in the system. Okay. So it tends not to be in the like in the periphery, like the the tiniest blood vessels, like like the very tiniest ones, they're they're all the way out in the you know, in the boonies, like you know, like and and so it tends to be where the major highways have their those sudden off ramps. Um the pipes, that's one thing.
SPEAKER_02:Now, listen, pressure, pressure bus pipes. Jc said it first, okay?
SPEAKER_04:That's right, that's right.
SPEAKER_02:That's right.
SPEAKER_04:And the other way, the other way, just to just to throw it out there, is um for the for the clogging, right? For this, we're gonna call it the scheming. For the clogging is uh if you have a clot, and the most common place to form a clot that you throw up into your head to clog off the pipes is your heart. So say that again. Say that again. Yeah, yeah, yeah. No, this is important. So um, so uh the uh an important way that you might have one of those ischemic strokes, so other 85%, okay, is that you might throw the a blood clot might get stuck in your brain, right? But remember, it's it's all from the the plumbing, right? It's gotta it's where so where is this clot coming from in the plumbing? It's coming from the source, it's coming from your heart often, right? Okay, and and the reason the most common reason for that, by the way, just so you know, is uh is something called atrial fibrillation. I don't know if you've heard of that, but basically AFib.
SPEAKER_02:I've heard of AFib, but tell me all give me a full-on definition of AFib.
SPEAKER_04:Okay, all right. So your heart normally has its own, it's got a an electrical system in it. Okay, and that electrical system is it's it's pretty independent, actually. Like it's got a kind of rhythm to it, and it's gonna um, it's got uh you know different parts that tell it when to fire when. It's got what are called atria, sort of think of it as like top of the heart, bottom of the heart, and they're they're they're moving in coordination, and the the top of the heart sends a signal down to the bottom of the heart that says, like, okay, I did my job. I sort of move my blood down into your space. Now you do your job and you squeeze and you push it out to the body, okay?
SPEAKER_02:Right.
SPEAKER_04:And so what can happen is sometimes that that communication will actually not uh will get screwed up. And the most common way for that to happen that we're talking about is that the the top of the heart stops like yeah, basically uh sort of doing its job staying rhythmic. It loses its, it it basically loses its groove and it just starts, you know, like sometimes it beats and sometimes it doesn't. It's like I don't, you know, like it would stay right. It should have been bobbing and weaving instead of weaving and bobbing. Yeah, exactly, exactly. Right. And so uh when that happens, what happens is the the the blood, blood. Here's a f here's another factor you have to know. Blood has got to flow. Okay, okay, like blood is this blood is this crazy amazing stuff, if you think about it. I don't know if you've given it much thought.
SPEAKER_02:I really haven't, but I'm here for it.
SPEAKER_04:All right, all right. So so blood, it's it's carrying all your oxygen, right? It's carrying all your nutrients, it's got it's it's got it, it's carrying in the most important parts of your immune system with it. It's just doing all this stuff, right? And um, and moreover, if you ever get injured, if you get cut, what happens? Like the blood flows there, and then within minutes, it's like, okay, time to you know shield up, like uh circle the weapons, right? And like it seals you off, right? That's an amazing property. It really is. It really is, but the thing is, you don't want that to happen inside your body. Well, you want it to happen, like if you get a cut, you want the blood to flow, and then you want to like just close up, right? Right, you want to scab because you want you need a little there to keep you from getting from other stuff getting in there, right? Perfect, great, wonderful, thank you, blood. But if but you don't want that to happen inside your inside the pipe, and the thing is the thing that that mainly tells blood, all right, guys, time to clot up is when it stops moving. Like when it stops moving, it's like, oh, I time to clot. And so, so if you lose this rhythm, right, like what could happen is the blood could stay still for too long in certain parts of the heart. And when it stays still for too long, it's like, well, guess what we do when we stay still for too long? Time to clot. And so now you got this chunk of material in the pipe floating around in the pipe system, right? And so if if a big chunk of that gets up, you know, through these super highways, some like really big blood vessels coming up, right?
SPEAKER_02:They're flowing, and they're flowing up there, so they're making they're making moves, yeah.
SPEAKER_04:And and uh your your body directs a lot of blood to your brain, okay. Your brain is uh just uh the hunger, like a really hungry organ. It's like I need I need it, I need it all the time. Uh energy, uh oxygen, like do not stop my flow. And so the clock gets up in there and like that's it, right? And so if it's stuck in there, then then you could have a stroke, right? So, like again, going with the the garden hose or the irrigation analogy, like something gets stuck in the pipe, pipe can't flow, the you know, your sprinkler doesn't turn on in that section of the grass, and it dies.
SPEAKER_02:And it dies.
SPEAKER_04:That is so that's that's important, and um one of the reasons why that's important, and important to know that clots of blood sitting in your brain are an important cause of stroke. Okay, one of the important reasons to know that is, and this is this this is my um we're not talking about aphasia, but I'm gonna do a stroke PSA right now. Okay, so so so that that is not uh that that is not something that we just sit around and say, like, well, I guess there's a clot there. Well, let's see what happens, right? That if if we are fast enough, if you get yourself, if you are able to. get to medical care fast enough, right?
SPEAKER_02:That that patch of grass isn't dead yet. Right. Right.
SPEAKER_04:Right.
SPEAKER_02:What how much time is that though?
SPEAKER_04:What is you know it depends, but you know, it's it's but the the window keeps getting longer and longer as we invent really. Yeah, as we invent new things. So you know uh so so it used to be you had to you had to be there you know in uh three hours. Now it's long much longer than that.
SPEAKER_02:Is it I didn't know that I was expecting I knew the answer three hours.
SPEAKER_04:Yeah you they can do a couple of things they can give you clot busting medication through your veins right so a medication that goes up in there and it's like okay guys false alarm let's break the part now okay they can put it through the arteries they can actually snake it up in there they can they can put a device like a wire now this this sounds like it's a little scary don't but but you know these are paid professionals we're talking about right they'll actually go up through with a wire in through the blood vessels up to where the clot is and sort of like literally spritz it with the stuff that like you know breaks up the clot other other cases they can they can take a like a little basically a little uh they can screw into it and pull it out pull it out okay and so if you just if you uh start noticing a change in your speech or your face droops or your arms weak or your legs weak right and you're like I'm I'm gonna just sleep it off I I know I'm I'm a little tired I'm just I'm gonna take a nap now right like you you are you are robbing yourself of that that very opportunity it is so crazy how many people have said well I didn't feel good this happened that happened my face was off my was literally off and I went and laid down I'm like your face was off what do you mean you went to go lay down yeah like and that's it's like three of the fast how do you not you know face what is it face arms speech speech and time right yeah and that's the time that's the time piece right funny thing is people don't you know they don't I don't know maybe they do maybe there's someone who sits around and says like oh I've got crushing chest pain I'm gonna just wait it out see what happens right everyone no okay I'm I'm I shouldn't say everyone like there's that person out there who'll just like try and sit it out but a lot of people would say like oh I'm having a heart attack um right let's let's let's this is a problem let's this is a problem okay uh but you'd be amazed at the number of people who are like I don't realize that I am having and uh let I'm gonna say this is the equivalent of a heart attack for the brain right same basic mechanism you're having a brain attack yes and people don't know they're right they that that when you're having a brain attack you got to get to the hospital because you're you're robbing yourself of the opportunity to have it reversed.
SPEAKER_02:And here's but here's the thing I will say this I had no mic for myself I didn't know I'd had a stroke even had a stroke I knew something was wrong I knew I couldn't talk and my hand I couldn't use my hand but I was in very very lucid very lucid and I was making sure I was lucid like my we were like we gotta go to the hospital I told you the guy didn't even want to take me that night he told me I was having a panic attack so sometimes that happens if I would have taken his advice yeah yeah you're right I'm probably tripping yeah all right so here's the thing your brain changes practice is the original neuroplasticity tool like Dr.
SPEAKER_04:Roy says before they had all these things the only thing they had was practice talking about practice man good that's good I think I so I think you said a couple of really important things here all right so uh first thing just to go back I mean you were reflecting on people who have who have been mistreated right because because it wasn't commonly understood because uh a lot of people don't understand what this condition is and think about this way all right so the global burden of stroke is about one in six people all right of stroke over the course of the lifespan it's a very common condition around the world depending on what papers you read the incidence of aphasia depending on I mean let's let's be conservative 20 to 40 percent of people walking out uh uh of the stroke unit right so let's split that down the middle let's let's just call it a third I mean that's an enormous burden right that's an enormous number of people who've had this condition so it's it's much more than uh conditions for which we have names for which people are very familiar with the condition Parkinson's Parkinson's disease uh ALS Luke Gehrig's disease right I mean uh everyone knows those names and yet for a condition that's far more common uh we don't have a lot of awareness right and so I think an important thing that you're doing that I try to do in my life is just to raise awareness of of what this condition is right and then the second thing I love about what you were talking about right you you were talking about those steps you're talking about taking those steps right and and making progress because because it's it's really important and that to to understand that there is a uh a potential for progress right and that that potential for progress is dependent on how much you put into it right right but it turns out that I I'm a I'm a neuroplasticity neuroscientist right where I do this brain stimulation the whole goal of the brain stimulation is to try and make the brain more plastic to to help people have more change in their brain circuits in order to help them uh acquire their language abilities back right after after their stroke or or uh to hang on to their language abilities longer for people with primary progressive aphasia for that for those degenerative aphasias but uh so that's what we do but practice practice is the original neuroplasticity intervention yep you know before people made machines they stick on your head and flip on right practice is how how you and I and everyone on an everyday basis changes their brain right so if you want to change your brain with respect to language you you need practice and I think you're you know you're you're a living testimony to that right if you or a loved one are living with primary progressive aphasia or recovering after a recent stroke there may be a study for you.
SPEAKER_02:Dr.
SPEAKER_04:Hamilton's team is exploring new ways the brain stimulation might help or protect or improve your language so when you would help somebody that has aphasia if somebody is listening and they have aphasia and they're like what that's a thing can you tell me a little bit about well first of all are you looking for participants and are you looking for uh like patients if they're in the Philadelphia area uh we are looking for people who have what's called primary progressive aphasia I alluded to it already think of this as people who didn't have a stroke but instead have noticed that over time their language ability has progressively gotten worse that and specifically their language ability we are looking for those people for a study involving electrical stimulation of the brain we think we can stimulate the language circuits in those individuals to help them keep their language ability for as long as possible on the other side of the fence we are very much looking for people who have had a stroke anaphasia and in particular we are right now really focused on persons who have recently had a stroke we we think that if we can get in and affect people who have recently had a stroke and stimulate their brains in this case it's with magnetic stimulation that we can affect the trajectory what their future looks like with respect to their recovery and so it's very hard to find these individuals because of you know a lot's changed in your life after you've just had a stroke and like are you you know is it easy to come in for a research study every day for a couple weeks on end to get stimulated probably not right but but we think we have the possibility of making a real difference in their recovery so you know I I understand most people who've had stroke and aphasia who are listening to a podcast have probably had it for a minute but uh if anyone knows anyone who is has just had a stroke and has aphasia uh we would love to help them on their road to recovery.
SPEAKER_02:Wow that's awesome that's awesome so you have a way that you if you can catch them almost like the stroke buster thing with you having a stroke if we you can get to them early enough you might be able to help them restore some of the things that they lost help them build those roads a little bit faster.
SPEAKER_04:That's right that's right so you know the brain undergoes a a lot of changes on its own okay after you've had an injury and you you you know that's true because if it wasn't changing after you had your stroke you would you would always be as bad as when you just had your stroke right day one you would nope no right right so you know it's gotta be get things that got to be changing up up inside right and so we think that maybe the best time to to make more change is when the brain is especially prone to change in the first place. It's already it's ready for the prompt yeah that's right um and so that's why we wanna I wanted to highlight that study that we're specifically looking for people. By the way we're also looking for people uh although we haven't had as much trouble finding people for this one uh we're also looking for people who have had stroke in the in the past right so six months or more so we call that chronic uh but their symptoms are relatively mild we're looking for people who um and and the reason for that is that there's this whole window of people persons living with stroke where the they've improved up to a certain point but there's still not there's still a gap there that they're trying to cross right and and so one of the questions we're trying to ask is well can we can we help close that distance for them right right right that's a third study but really I I especially of all the three I want to emphasize that uh that sub what we call subacute that's that period right after the stroke right subacute stroke if anyone knows anyone we would love to have them oh wow that is phenomenal and uh shout out to and neurology dr voy and his whole staff they are phenomenal and uh their brain friends brain friends see this is he gets it let me get it every time dr voy drops it he doesn't just give you facts he gives you frame he breaks it down in ways that makes you sit up lean in and actually get it and for me that's the mark of a true brain friend brain friends so again thank you to Dr.
SPEAKER_01:Roy Hamilton for joining me on this episode and to my girl Celeste for being that whisper in my ear to continue to show up here on the mic brain friends has always been about more than a podcast it's about advocacy understanding and inclusion it's about taking what feels impossible to explain and making it livable relatable and clear so if today gave you something to hold on to share it tell a friend drop it in your group chat because awareness spreads when we do and I promise you this we'll keep showing up every episode until aphasia is no longer invisible my name is Angie Cawthon Peace we hope you enjoyed this episode of Brain Friends please leave us a five star review on Apple Podcasts or your favorite streaming platform also make sure you subscribe to our YouTube channel Brain Friends the podcast
