Overview
Dementia affects millions of Americans and their families, yet for many communities, particularly those that are multilingual, the tools to detect, track, and treat language-led dementias are lacking The MADR Lab seeks to change that. Our work builds the scientific foundation for earlier detection, better-informed clinical decisions, and treatments that work across the full range of patients clinicians actually see. Through federally funded longitudinal research, international collaboration, clinical trials, and the development of digital assessment tools, we are working to ensure that advances in Alzheimer's disease and dementia science reach everyone they can help.
1. Treatments that work: speech-language intervention in progressive communication disorders caused by dementia
For decades, progressive language disorders were considered largely untreatable. The MADR Lab is part of a generation of researchers proving that assumption wrong. Our clinical trials test targeted behavioral interventions, speech-language therapies that help patients regain words, rebuild fluency, and stay connected to the people they love. We investigate which treatments work, for whom, how durably, and in what delivery format, including telehealth, and with family care partners as active participants in the recovery process. Below we list the specific research projects associated with this clinical-research topic.
Intervention to promote communication quality of life for persons with language-led dementia and their partners: a randomized pilot trial NIH / NIA R61AG089318 Principal Investigators: Stephanie Grasso & Maya L. Henry Communication is how we maintain relationships, make decisions, and preserve our sense of self. When dementia begins eroding language, the impact extends far beyond the patient—it reshapes every family dynamic. This NIH-funded randomized pilot trial tests a comprehensive, multi-pronged intervention targeting both the patient and their care partner simultaneously: restitutive techniques to rebuild lost language, compensatory strategies to work around what cannot be recovered, and direct training for care partners to support communication at home. We are currently enrolling English and Spanish-speaking participants for this study. |
Investigating the benefits of remotely-supervised neuromodulation in primary progressive aphasia NIH / NIA RF1AG085565 Co-Investigator: Stephanie Grasso · PI: Dr. Maya L. Henry Can mild, targeted electrical stimulation of the brain amplify the benefits of speech-language therapy? This large-scale NIH trial tests remotely supervised transcranial direct current stimulation (tDCS) paired with behavioral intervention in individuals with logopenic variant PPA, delivered at home. If effective, this approach would dramatically expand access to cutting-edge treatment, bringing neurologically-informed care to patients wherever they live. Participants are followed longitudinally to assess both the immediate and long-term durability of treatment gains. |
Dual-language intervention and cross-linguistic transfer in PPA and stroke aphasia When a bilingual person loses language to stroke or neurodegeneration, the clinical picture is more complex—and so is the path to maintaining communication skills. This study develops and evaluates treatment approaches for bilingual speakers with PPA or stroke-related aphasia, testing whether training in one language can generalize to the other, and which treatment models best support both languages simultaneously. We are currently enrolling English, Spanish or Catlan-speaking participants for this study.
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2. Understanding communication-led dementia across populations: the international PPA project
Primary progressive aphasia (PPA) is a devastating form of dementia that leads to a gradual erosion of speech and/or language—often years before other cognitive abilities decline. Yet the science of PPA has been built almost entirely on English-speaking patients. Texas is home to one of the largest Spanish-speaking populations in the country, and many of those individuals, and their families, face this disease without research that reflects their experience. In collaboration with leading neurology centers at Sant Pau Biomedical Research Center, Hospital Clínic de Barcelona, Hospital San Carlos (Madrid), and the Instituto Nacional de Neurología y Neurocirugía (Mexico City), we are building the world's most comprehensive scientific understanding of how PPA unfolds across languages, and how best to treat it.
Bilingual factors associated with cognitive reserve and linguistic resilience in primary progressive aphasia NIH / NIA R01AG080470 Principal Investigators: Stephanie Grasso, Miguel Ángel Santos Santos and Núria Montagut Colomer One of the most compelling questions in dementia science is why some people present with lesser changes in behavior or biological markers of dementia. This NIH-funded study examines how speaking more than one language throughout a lifetime may shape the brain's resilience to Alzheimer's disease. We have built the largest prospective longitudinal cohort of bilingual individuals with PPA in the world, in collaboration with Hospital de la Santa Creu i Sant Pau and Hospital Clínic de Barcelona. Participants undergo comprehensive speech-language evaluation, structural and functional neuroimaging, and cerebrospinal fluid and plasma biomarker assessment, allowing us to directly connect life experience with biological disease processes.
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Establishing acceptability, feasibility, and benefits of speech-language intervention in individuals with language-led dementia in Mexico and the United States Alzheimer's Association Research Grant Principal Investigator: Stephanie Grasso Many patients with dementia never receive speech-language therapy—not because it doesn't work, but because the evidence base has not included them. This study addresses that gap directly, testing the clinical benefits and real-world feasibility of speech-language intervention for individuals with PPA in both the U.S. and Mexico. In partnership with the Instituto Nacional de Neurología y Neurocirugía (INNN) in Mexico City, this is among the first clinical trials of its kind conducted in Latin America, establishing an evidence base with implications for patients across the hemisphere and informing clinical guidelines globally. |
3. Next-generation tools and resources: digital assessment and care partner support
Earlier detection is essential to individuals receiving an accurate diagnosis and accessing appropriate services. The MADR Lab is developing the next generation of digital tools that make it possible to identify dementia earlier, monitor its progression more sensitively, and support the families who carry the weight of care.
DILO: a web-based platform for automated speech analysis and digital assessment of aphasia and dementia Digital tool The way a person speaks, their word choices, fluency, sentence structure, and pause, carries a remarkable amount of information about what is happening in the brain. DILO is a web-based platform that captures and automatically analyzes connected speech samples in Spanish, Catalan, and English to help clinicians and researchers identify signs of aphasia and dementia early and track how language changes over time. By applying computational methods to speech, DILO makes it possible to detect subtle changes that may be missed in a standard clinical visit and to conduct scalable digital assessments without requiring an in-person appointment. |
RESPALDO|CARE-PA: a caregiver education and support program for families navigating language-led dementia AFTD Well-Being Pilot Grant Principal Investigators: Stephanie Grasso and Maya L. Henry Behind every person living with dementia is a family member, a spouse, an adult child, a sibling, of friend, engaging in the daily, often invisible work of care. RESPALDO|CARE-PA is a structured education and support program built specifically for care partners of individuals with progressive communication disorders. Developed in direct partnership with caregivers themselves, the program delivers group education, practical communication strategies, and emotional support through both in-person sessions and a web-based platform that families can access on their own time. |
Additional projects coming soon. Contact us to learn more about opportunities to collaborate or participate in our research.