When words fail, Linda Shuster knows better than most not to look for them on the tip of a tongue.

Shuster, a faculty member in the Department of Speech Pathology and Audiology in West Virginia Universitys College of Human Resources and Education and a certified speech-language pathologistis using advanced imaging equipment to examine speech at its sourcethe brain.

While studying the impulses that translate thought into word, Shuster hopes to help patients who have suffered a stroke or other neurological disorders to recover quicker and more completely. Around 19 percent of all stroke survivors suffer from some sort of language deficiency whether expression, comprehension or both.

Some may have fully functioning facial muscles but suffer from aphasia, a debilitating stroke symptom that affects the brains language center usually on the left side. Each persons speech and language problem is unique, ranging from trouble finding words to being unable to talk at all. Some people have problems understanding what others are saying or have trouble with reading, writing or math. In other cases, a person with aphasia may have trouble talking but can understand what others say.

Shuster also sees individuals suffering from apraxia of speech, or AOS , a problem that frequently occurs with aphasia. People with AOS have difficulty initiating and executing the voluntary movement patterns necessary to produce speech when there is no paralysis or weakness of speech muscles. AOS may cause problems producing the desired speech sound or using the correct rhythm and rate of speaking.

Shuster said many stroke patients dont show obvious traces of the traumatic, life-changing health issue that occurred. But internally, she knows there can be a struggle going on.

Ive seen individuals who have almost made a complete recovery but cant seem to come up with a simple word, and its a recurring problem,Shuster said.Its very frustrating when youre trying to tell your spouse you need something and cant come up with a word or words, especially since theyre just simple, common words that everybody knows.

Along with affecting communication, a continued failure to convey simple words often leads to depression, Shuster said.

Using functional magnetic resonance imaging (fMRI) available at the WVU Department of Radiologys Center for Advanced Imaging , Shuster is recording images of brain activity that creates speech. The fMRI produces an image of the brain with color-highlighted areas appearing where activity occurs. The color scale indicates the intensity of the brain activity. The images will be compared to activity in a stroke survivors brain.

Speech usually originates from the left side of the brain, but brain damage to the left side following a stroke often reroutes those impulses to other areas. In finding out which of these new areas produces the best speech in individuals, Shuster hopes to tailor treatment plans and monitor the patients progress via fMRI. Similar studies have been done on limb recovery, post-stroke.

When an area in the brain is lighting up after a stroke, is it good for speech recovery or is it bad? Thats what we want to find out,Shuster said.Activity originating from a new area may be helpful or it may impede recovery. We want to see what is helping and try to tailor our speech treatments to engage the areas that are helpful for recovery. Using these data, we may also be able to predict who is more likely to recover and how quickly.

She is also studying the mouth movements necessary for speech by comparing the patterns of fMRI brain activation during the production of short and long words, which require different movement planning.

Ultimately, Shuster hopes these scans will reveal patterns that will give speech therapists a better guideline for the treatment of stroke patients

If it can improve the quality of life or have any positive effect on these patients, it will be a big step,she said.Even small gains are huge.