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Sample records for repetition conduction aphasia

  1. Pre-Lexical Disorders in Repetition Conduction Aphasia

    Science.gov (United States)

    Sidiropoulos, Kyriakos; de Bleser, Ria; Ackermann, Hermann; Preilowski, Bruno

    2008-01-01

    At the level of clinical speech/language evaluation, the repetition type of conduction aphasia is characterized by repetition difficulties concomitant with reduced short-term memory capacities, in the presence of fluent spontaneous speech as well as unimpaired naming and reading abilities. It is still unsettled which dysfunctions of the…

  2. A review of conduction aphasia.

    Science.gov (United States)

    Ardila, Alfredo

    2010-11-01

    In this paper, a historical overview of the interpretation of conduction aphasia is initially presented. It is emphasized that the name conduction aphasia was proposed by Wernicke and was interpreted as a disconnection between the temporal and frontal brain language areas; this interpretation was re-taken by Geschwind, attributing the arcuate fasciculus the main role in speech repetition disturbances and resulting in the so-called Wernicke-Geschwind model of language. With the introduction of contemporary neuroimaging techniques, this interpretation of conduction aphasia as a disconnection syndrome due to an impairment of the arcuate fasciculus has been challenged. It has been disclosed that the arcuate fasciculus does not really connect Wernicke's and Broca's areas, but Wernicke's and motor/premotor frontal areas. Furthermore, conduction aphasia can be found in cases of cortical damage without subcortical extension. It is concluded that conduction aphasia remains a controversial topic not only from the theoretic point of view, but also from the understanding of its neurologic foundations.

  3. Diffusion tensor imaging depicting damage to the arcuate fasciculus in patients with conduction aphasia: a study of the Wernicke-Geschwind model.

    Science.gov (United States)

    Zhang, Yumei; Wang, Chunxue; Zhao, Xingquan; Chen, Hongyan; Han, Zaizhu; Wang, Yongjun

    2010-09-01

    In contrast with disorders of comprehension and spontaneous expression, conduction aphasia is characterized by poor repetition, which is a hallmark of the syndrome. There are many theories on the repetition impairment of conduction aphasia. The disconnection theory suggests that a damaged in the arcuate fasciculus, which connects Broca's and Wernicke's area, is the cause of conduction aphasia. In this study, we examined the disconnection theory. We enrolled ten individuals with conduction aphasia and ten volunteers, and analysed their arcuate fasciculus using diffusion tensor imaging (DTI) and obtained fractional anisotropy (FA) values. Then, the results of the left hemisphere were compared with those of the right hemisphere, and the results of the conduction aphasia cases were compared with those of the volunteers. There were significant differences in the FA values between the left and right hemispheres of volunteers and conduction cases. In volunteers, there was an increase in fiber in the left hemisphere compared with the right hemisphere, whereas there was an increase in fiber in the right hemisphere compared with the left hemisphere in conduction aphasia patients. The results of diffusion tensor tractography suggested that the configuration of the arcuate fasciculus was different between conduction aphasia patients and volunteers, suggesting that there was damage to the arcuate fasciculus of conduction aphasia cases. The damage seen in the arcuate fasciculus of conduction aphasia cases in this study supports the Wernicke-Geschwind disconnection theory. A disconnection between Broca's area and Wernicke's area is likely to be one mechanism of conduction aphasia repetition impairment.

  4. Cerebral glucose metabolism in Wernicke's, Broca's, and conduction aphasia

    International Nuclear Information System (INIS)

    Metter, E.J.; Kempler, D.; Jackson, C.; Hanson, W.R.; Mazziotta, J.C.; Phelps, M.E.

    1989-01-01

    Cerebral glucose metabolism was evaluated in patients with either Wernicke's (N = 7), Broca's (N = 11), or conduction (N = 10) aphasia using 18 F-2-fluoro-2-deoxy-D-glucose with positron emission tomography. The three aphasic syndromes differed in the degree of left-to-right frontal metabolic asymmetry, with Broca's aphasia showing severe asymmetry and Wernicke's aphasia mild-to-moderate metabolic asymmetry, while patients with conduction aphasia were metabolically symmetric. On the other hand, the three syndromes showed the same degree of metabolic decline in the left temporal region. The parietal region appeared to separate conduction aphasia from both Broca's and Wernicke's aphasias. Common aphasic features in the three syndromes appear to be due to common changes in the temporal region, while unique features were associated with frontal and parietal metabolic differences

  5. Conduction Aphasia, Sensory-Motor Integration, and Phonological Short-Term Memory--An Aggregate Analysis of Lesion and fMRI Data

    Science.gov (United States)

    Buchsbaum, Bradley R.; Baldo, Juliana; Okada, Kayoko; Berman, Karen F.; Dronkers, Nina; D'Esposito, Mark; Hickok, Gregory

    2011-01-01

    Conduction aphasia is a language disorder characterized by frequent speech errors, impaired verbatim repetition, a deficit in phonological short-term memory, and naming difficulties in the presence of otherwise fluent and grammatical speech output. While traditional models of conduction aphasia have typically implicated white matter pathways,…

  6. Sources of Phoneme Errors in Repetition: Perseverative, Neologistic, and Lesion Patterns in Jargon Aphasia

    Directory of Open Access Journals (Sweden)

    Emma Pilkington

    2017-05-01

    Full Text Available This study examined patterns of neologistic and perseverative errors during word repetition in fluent Jargon aphasia. The principal hypotheses accounting for Jargon production indicate that poor activation of a target stimulus leads to weakly activated target phoneme segments, which are outcompeted at the phonological encoding level. Voxel-lesion symptom mapping studies of word repetition errors suggest a breakdown in the translation from auditory-phonological analysis to motor activation. Behavioral analyses of repetition data were used to analyse the target relatedness (Phonological Overlap Index: POI of neologistic errors and patterns of perseveration in 25 individuals with Jargon aphasia. Lesion-symptom analyses explored the relationship between neurological damage and jargon repetition in a group of 38 aphasia participants. Behavioral results showed that neologisms produced by 23 jargon individuals contained greater degrees of target lexico-phonological information than predicted by chance and that neologistic and perseverative production were closely associated. A significant relationship between jargon production and lesions to temporoparietal regions was identified. Region of interest regression analyses suggested that damage to the posterior superior temporal gyrus and superior temporal sulcus in combination was best predictive of a Jargon aphasia profile. Taken together, these results suggest that poor phonological encoding, secondary to impairment in sensory-motor integration, alongside impairments in self-monitoring result in jargon repetition. Insights for clinical management and future directions are discussed.

  7. Aphasia

    Science.gov (United States)

    ... cannot find the words he needs. (2) Receptive aphasia (Wernicke's aphasia) involves difficulty understanding spoken or written language. ... cannot find the words he needs. (2) Receptive aphasia (Wernicke's aphasia) involves difficulty understanding spoken or written language. ...

  8. Verifying the hypothesis of disconnection syndrome in patients with conduction aphasia using diffusion tensor imaging

    Institute of Scientific and Technical Information of China (English)

    Yanqin Guo; Jing Xu; Yindong Yang

    2007-01-01

    BACKGROUND: It is thought in disconnection theory that connection of anterior and posterior language function areas, i.e. the lesion of arcuate fasciculus causes conduction aphasia.OBJECTIVE: To verify the theory of disconnection elicited by repetition disorder in patients with conduction aphasia by comparing the characteristics of diffusion tensor imaging between healthy persons and patients with conduction aphasia.DESIGN: Case-control observation.SETTING: Department of Neurology, Hongqi Hospital Affiliated to Mudanjiang Medical College.PARTICIPANTS: Five male patients with cerebral infarction-involved arcuate fasciculus conduction aphasia, averaged (43±2) years, who hospitalized in the Department of Neurology, Hongqi Hospital Affiliated to Mudanjiang Medical College from February 2004 to February 2005 were involved in this experiment. The involved patients were all confirmed as cerebral infarction by skull CT and MRI, and met the diagnosis criteria revised in 1995 4th Cerebrovascular Conference. They were examined by the method of Aphasia Battery of Chinese (ABC) edited by Surong Gao. The results were poorer than auditory comprehension disproportionately, and consistented with the mode of conduction aphasia. Another 5 male healthy persons, averaged (43 ± 1 ) years, who were physicians receiving further training in the Department of Neurology, Beijing Tiantan Hospital were also involved in this experiment. Informed consents of detected items were obtained from all the subjects.METHODS: All the subjects were performed handedness assessment with assessment criteria of handedness formulated by Department of Neurology, First Hospital Affiliated to Beijing Medical University. Arcuate fasciculus of involved patients and health controls were analyzed with diffusion tensor imaging (DTI) and divided into 3 parts (anterior, middle and posterior segments) for determining FA value (mean value was obtained after three times of measurements), and a comparison of FA value was

  9. Cholinergic Potentiation and Audiovisual Repetition-Imitation Therapy Improve Speech Production and Communication Deficits in a Person with Crossed Aphasia by Inducing Structural Plasticity in White Matter Tracts.

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    Berthier, Marcelo L; De-Torres, Irene; Paredes-Pacheco, José; Roé-Vellvé, Núria; Thurnhofer-Hemsi, Karl; Torres-Prioris, María J; Alfaro, Francisco; Moreno-Torres, Ignacio; López-Barroso, Diana; Dávila, Guadalupe

    2017-01-01

    Donepezil (DP), a cognitive-enhancing drug targeting the cholinergic system, combined with massed sentence repetition training augmented and speeded up recovery of speech production deficits in patients with chronic conduction aphasia and extensive left hemisphere infarctions (Berthier et al., 2014). Nevertheless, a still unsettled question is whether such improvements correlate with restorative structural changes in gray matter and white matter pathways mediating speech production. In the present study, we used pharmacological magnetic resonance imaging to study treatment-induced brain changes in gray matter and white matter tracts in a right-handed male with chronic conduction aphasia and a right subcortical lesion (crossed aphasia). A single-patient, open-label multiple-baseline design incorporating two different treatments and two post-treatment evaluations was used. The patient received an initial dose of DP (5 mg/day) which was maintained during 4 weeks and then titrated up to 10 mg/day and administered alone (without aphasia therapy) during 8 weeks (Endpoint 1). Thereafter, the drug was combined with an audiovisual repetition-imitation therapy (Look-Listen-Repeat, LLR) during 3 months (Endpoint 2). Language evaluations, diffusion weighted imaging (DWI), and voxel-based morphometry (VBM) were performed at baseline and at both endpoints in JAM and once in 21 healthy control males. Treatment with DP alone and combined with LLR therapy induced marked improvement in aphasia and communication deficits as well as in selected measures of connected speech production, and phrase repetition. The obtained gains in speech production remained well-above baseline scores even 4 months after ending combined therapy. Longitudinal DWI showed structural plasticity in the right frontal aslant tract and direct segment of the arcuate fasciculus with both interventions. VBM revealed no structural changes in other white matter tracts nor in cortical areas linked by these tracts. In

  10. Aphasia

    Science.gov (United States)

    ... a person with Broca's aphasia may say, "Walk dog," meaning, "I will take the dog for a walk," or "book book two table," ... the brain. Individuals with global aphasia have severe communication difficulties and may be extremely limited in their ...

  11. Study of conduction aphasia by positron emission tomography

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    Shoji, Mikio; Harigawa, Yasuo; Kawarabayashi, Takeshi; Hirai, Shunsaku; Tamada, Junpei.

    1988-04-01

    We reported two cases of conduction aphasia with distinctive language disorder from early stage of stroke, as well as their cerebral blood flow and oxygen consumption investigated with PET. The case was a 72-year-old right handed man whose speech disturbance began acutely. On admission, neurological examination revealed hand pronation sign on the right and speech disturbance. Other neurological findings including cortical functions were normal. Brain CT scan showed low density area in the white matter of the left supramarginal gyrus. The diagnosis was cerebral infarction. The case 2 was a 64-year-old right handed man. He suffered right hemiparesis 2 months before. Neurological examination revealed mild right hemiparesis and speech disturbance. Other cortical functions were noncontributory. Brain CT scan showed old subcortical infarction of the left frontal lobe and new cerebral infarction. with supramarginal gyrus. The low density area of the supramarginal cortex extended into the subcortical white matter. The language performances in these two cases were similar. Two patients were definitely fluent, but the verbal output was contaminated by paraphasias which were predominantly literal. They performed poorly when attempting to repeat despite good comprehension. Thus, the primary characteristics of conduction aphasia were present. PET studies resulted as follows. 1) rCBF reduced 36 % in the supramarginal cortex, 50 % in the white matter. 2) rCMRO/sub 2/ reduced 37 % in the supramarginal cortex, 45 % in the white matter. 3) The CBF and the CMRO/sub 2/ images indicated that cerebral blood flow and oxygen consumption reduced in wider range of area than that shown by brain CT. These results indicated that not only the cortex but also the white matter were damaged in conduction aphasia and several methods including PET should be used to determine the locus of abnormality in conduction aphasia.

  12. A study of conduction aphasia by positron emission tomography

    International Nuclear Information System (INIS)

    Shoji, Mikio; Harigawa, Yasuo; Kawarabayashi, Takeshi; Hirai, Shunsaku; Tamada, Junpei.

    1988-01-01

    We reported two cases of conduction aphasia with distinctive language disorder from early stage of stroke, as well as their cerebral blood flow and oxygen consumption investigated with PET. The case was a 72-year-old right handed man whose speech disturbance began acutely. On admission, neurological examination revealed hand pronation sign on the right and speech disturbance. Other neurological findings including cortical functions were normal. Brain CT scan showed low density area in the white matter of the left supramarginal gyrus. The diagnosis was cerebral infarction. The case 2 was a 64-year-old right handed man. He suffered right hemiparesis 2 months before. Neurological examination revealed mild right hemiparesis and speech disturbance. Other cortical functions were noncontributory. Brain CT scan showed old subcortical infarction of the left frontal lobe and new cerebral infarction. with supramarginal gyrus. The low density area of the supramarginal cortex extended into the subcortical white matter. The language performances in these two cases were similar. Two patients were definitely fluent, but the verbal output was contaminated by paraphasias which were predominantly literal. They performed poorly when attempting to repeat despite good comprehension. Thus, the primary characteristics of conduction aphasia were present. PET studies resulted as follows. 1) rCBF reduced 36 % in the supramarginal cortex, 50 % in the white matter. 2) rCMRO 2 reduced 37 % in the supramarginal cortex, 45 % in the white matter. 3) The CBF and the CMRO 2 images indicated that cerebral blood flow and oxygen consumption reduced in wider range of area than that shown by brain CT. These results indicated that not only the cortex but also the white matter were damaged in conduction aphasia and several methods including PET should be used to determine the locus of abnormality in conduction aphasia. (author)

  13. Modulation of N400 in Chronic Non-Fluent Aphasia Using Low Frequency Repetitive Transcranial Magnetic Stimulation (rTMS)

    Science.gov (United States)

    Barwood, Caroline H. S.; Murdoch, Bruce E.; Whelan, Brooke-Mai; Lloyd, David; Riek, Stephan; O'Sullivan, John D.; Coulthard, Alan; Wong, Andrew

    2011-01-01

    Low frequency Repetitive Transcranial Magnetic Stimulation (rTMS) has previously been applied to language homologues in non-fluent populations of persons with aphasia yielding significant improvements in behavioral language function up to 43 months post stimulation. The present study aimed to investigate the electrophysiological correlates…

  14. Cholinergic Potentiation and Audiovisual Repetition-Imitation Therapy Improve Speech Production and Communication Deficits in a Person with Crossed Aphasia by Inducing Structural Plasticity in White Matter Tracts

    Directory of Open Access Journals (Sweden)

    Marcelo L. Berthier

    2017-06-01

    Full Text Available Donepezil (DP, a cognitive-enhancing drug targeting the cholinergic system, combined with massed sentence repetition training augmented and speeded up recovery of speech production deficits in patients with chronic conduction aphasia and extensive left hemisphere infarctions (Berthier et al., 2014. Nevertheless, a still unsettled question is whether such improvements correlate with restorative structural changes in gray matter and white matter pathways mediating speech production. In the present study, we used pharmacological magnetic resonance imaging to study treatment-induced brain changes in gray matter and white matter tracts in a right-handed male with chronic conduction aphasia and a right subcortical lesion (crossed aphasia. A single-patient, open-label multiple-baseline design incorporating two different treatments and two post-treatment evaluations was used. The patient received an initial dose of DP (5 mg/day which was maintained during 4 weeks and then titrated up to 10 mg/day and administered alone (without aphasia therapy during 8 weeks (Endpoint 1. Thereafter, the drug was combined with an audiovisual repetition-imitation therapy (Look-Listen-Repeat, LLR during 3 months (Endpoint 2. Language evaluations, diffusion weighted imaging (DWI, and voxel-based morphometry (VBM were performed at baseline and at both endpoints in JAM and once in 21 healthy control males. Treatment with DP alone and combined with LLR therapy induced marked improvement in aphasia and communication deficits as well as in selected measures of connected speech production, and phrase repetition. The obtained gains in speech production remained well-above baseline scores even 4 months after ending combined therapy. Longitudinal DWI showed structural plasticity in the right frontal aslant tract and direct segment of the arcuate fasciculus with both interventions. VBM revealed no structural changes in other white matter tracts nor in cortical areas linked by these

  15. Cerebral glucose metabolism in Wernicke's, Broca's, and conduction aphasia

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    Metter, E.J.; Kempler, D.; Jackson, C.; Hanson, W.R.; Mazziotta, J.C.; Phelps, M.E.

    1989-01-01

    Cerebral glucose metabolism was evaluated in patients with either Wernicke's (N = 7), Broca's (N = 11), or conduction (N = 10) aphasia using /sup 18/F-2-fluoro-2-deoxy-D-glucose with positron emission tomography. The three aphasic syndromes differed in the degree of left-to-right frontal metabolic asymmetry, with Broca's aphasia showing severe asymmetry and Wernicke's aphasia mild-to-moderate metabolic asymmetry, while patients with conduction aphasia were metabolically symmetric. On the other hand, the three syndromes showed the same degree of metabolic decline in the left temporal region. The parietal region appeared to separate conduction aphasia from both Broca's and Wernicke's aphasias. Common aphasic features in the three syndromes appear to be due to common changes in the temporal region, while unique features were associated with frontal and parietal metabolic differences.

  16. Dissociated repetition deficits in aphasia can reflect flexible interactions between left dorsal and ventral streams and gender-dimorphic architecture of the right dorsal stream.

    Science.gov (United States)

    Berthier, Marcelo L; Froudist Walsh, Seán; Dávila, Guadalupe; Nabrozidis, Alejandro; Juárez Y Ruiz de Mier, Rocío; Gutiérrez, Antonio; De-Torres, Irene; Ruiz-Cruces, Rafael; Alfaro, Francisco; García-Casares, Natalia

    2013-01-01

    Assessment of brain-damaged subjects presenting with dissociated repetition deficits after selective injury to either the left dorsal or ventral auditory pathways can provide further insight on their respective roles in verbal repetition. We evaluated repetition performance and its neural correlates using multimodal imaging (anatomical MRI, DTI, fMRI, and(18)FDG-PET) in a female patient with transcortical motor aphasia (TCMA) and in a male patient with conduction aphasia (CA) who had small contiguous but non-overlapping left perisylvian infarctions. Repetition in the TCMA patient was fully preserved except for a mild impairment in nonwords and digits, whereas the CA patient had impaired repetition of nonwords, digits and word triplet lists. Sentence repetition was impaired, but he repeated novel sentences significantly better than clichés. The TCMA patient had tissue damage and reduced metabolism in the left sensorimotor cortex and insula. DTI showed damage to the left temporo-frontal and parieto-frontal segments of the arcuate fasciculus (AF) and part of the left ventral stream together with well-developed right dorsal and ventral streams, as has been reported in more than one-third of females. The CA patient had tissue damage and reduced metabolic activity in the left temporoparietal cortex with additional metabolic decrements in the left frontal lobe. DTI showed damage to the left temporo-parietal and temporo-frontal segments of the AF, but the ventral stream was spared. The direct segment of the AF in the right hemisphere was also absent with only vestigial remains of the other dorsal subcomponents present, as is often found in males. fMRI during word and nonword repetition revealed bilateral perisylvian activation in the TCMA patient suggesting recruitment of spared segments of the left dorsal stream and right dorsal stream with propagation of signals to temporal lobe structures suggesting a compensatory reallocation of resources via the ventral streams. The

  17. Conduction Aphasia, Sensory-Motor Integration, and Phonological Short-term Memory – an Aggregate analysis of Lesion and fMRI data

    Science.gov (United States)

    Buchsbaum, Bradley R.; Baldo, Juliana; Okada, Kayoko; Berman, Karen F.; Dronkers, Nina; D’Esposito, Mark; Hickok, Gregory

    2011-01-01

    Conduction aphasia is a language disorder characterized by frequent speech errors, impaired verbatim repetition, a deficit in phonological short-term memory, and naming difficulties in the presence of otherwise fluent and grammatical speech output. While traditional models of conduction aphasia have typically implicated white matter pathways, recent advances in lesions reconstruction methodology applied to groups of patients have implicated left temporoparietal zones. Parallel work using functional magnetic resonance imaging (fMRI) has pinpointed a region in the posterior most portion of the left planum temporale, area Spt, which is critical for phonological working memory. Here we show that the region of maximal lesion overlap in a sample of 14 patients with conduction aphasia perfectly circumscribes area Spt, as defined in an aggregate fMRI analysis of 105 subjects performing a phonological working memory task. We provide a review of the evidence supporting the idea that Spt is an interface site for the integration of sensory and vocal tract-related motor representations of complex sound sequences, such as speech and music and show how the symptoms of conduction aphasia can be explained by damage to this system. PMID:21256582

  18. Conduction aphasia, sensory-motor integration, and phonological short-term memory - an aggregate analysis of lesion and fMRI data.

    Science.gov (United States)

    Buchsbaum, Bradley R; Baldo, Juliana; Okada, Kayoko; Berman, Karen F; Dronkers, Nina; D'Esposito, Mark; Hickok, Gregory

    2011-12-01

    Conduction aphasia is a language disorder characterized by frequent speech errors, impaired verbatim repetition, a deficit in phonological short-term memory, and naming difficulties in the presence of otherwise fluent and grammatical speech output. While traditional models of conduction aphasia have typically implicated white matter pathways, recent advances in lesions reconstruction methodology applied to groups of patients have implicated left temporoparietal zones. Parallel work using functional magnetic resonance imaging (fMRI) has pinpointed a region in the posterior most portion of the left planum temporale, area Spt, which is critical for phonological working memory. Here we show that the region of maximal lesion overlap in a sample of 14 patients with conduction aphasia perfectly circumscribes area Spt, as defined in an aggregate fMRI analysis of 105 subjects performing a phonological working memory task. We provide a review of the evidence supporting the idea that Spt is an interface site for the integration of sensory and vocal tract-related motor representations of complex sound sequences, such as speech and music and show how the symptoms of conduction aphasia can be explained by damage to this system. 2011 Elsevier Inc. All rights reserved.

  19. Aphasia caused by intracerebral hemorrhage

    International Nuclear Information System (INIS)

    Furuya, Kazuhide; Segawa, Hiromu; Shiokawa, Yoshiaki; Hasegawa, Isao; Sano, Keiji

    1992-01-01

    It is generally accepted that cases of aphasia can be divided into several groups according to verbal fluency, auditory comprehension, and repetition abilities. Although many authors have studied aphasia and its location by means of a CT scan, the primary lesion on a CT scan with regard to the subtypes of aphasia still remains controversial. In this report we present our new CT classification for the syndromes of aphasia and the prognosis. Twenty-one patients with intracerebral hematoma (ICH) were followed up for more than 3 months after onset. ICH was classified according to the mode of the horizontal extension of the hematoma on a CT scan. Four lines were decided as follows: Line (a) is between the anterior horn of the lateral ventricle and the midpoint of the third ventricle; Line (b) is the vertical line to the saggital line which originates from the midpoint of the third ventricle; Line (c) is between the trigone of the lateral ventricle and the midpoint of the third ventricle. The CT classification consisted of 4 types: in Type A, ICH was located anterior to line (a); in Type B, ICH was located between line (a) and line (b); in Type C, ICH was located between line (b) and line (c); Type B+C, was a combination of Type B and Type C. Transcortical motor aphasia belonged to the Type A group. Transcortical sensory aphasia belonged to the Type B and Type B+C groups. Wernicke's and anomic aphasia belonged to the Type C group. Conduction and global aphasia belonged to the Type B+C group. Pure Broca's aphasia could not be observed in this series. Several relationships between the syndromes of aphasia and its CT findings were evident. On the other hand, the syndromes of aphasia and the degree of recovery were not correlated, except for global aphasia. (author)

  20. Visuomotor Tracking Abilities of Speakers with Apraxia of Speech or Conduction Aphasia

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    Robin, Donald A.; Jacks, Adam; Hageman, Carlin; Clark, Heather M.; Woodworth, George

    2008-01-01

    This investigation examined the visuomotor tracking abilities of persons with apraxia of speech (AOS) or conduction aphasia (CA). In addition, tracking performance was correlated with perceptual judgments of speech accuracy. Five individuals with AOS and four with CA served as participants, as well as an equal number of healthy controls matched by…

  1. Add-on Effects of Repetitive Transcranial Magnetic Stimulation on Subacute Aphasia Therapy: Enhanced Improvement of Functional Communication and Basic Linguistic Skills. A Randomized Controlled Study.

    Science.gov (United States)

    Rubi-Fessen, Ilona; Hartmann, Alexander; Huber, Walter; Fimm, Bruno; Rommel, Thomas; Thiel, Alexander; Heiss, Wolf-Dieter

    2015-11-01

    To determine to what extent repetitive transcranial magnetic stimulation (rTMS) combined with speech and language therapy improves functional communication and basic linguistic skills of individuals with subacute aphasia. Randomized, blinded, and sham-controlled study. Neurologic rehabilitation hospital. Participants (N=30) with subacute aphasia after stroke. During a 2-week treatment period, half of the participants received 10 sessions of 20-minute inhibitory 1-Hz rTMS over the right inferior frontal gyrus (Brodmann area 45), and the other half received sham stimulation. Directly thereafter, all the participants underwent 45 minutes of speech and language therapy. Aachen Aphasia Test, Amsterdam-Nijmegen Everyday Language Test (ANELT), a naming screening, and subscales of the FIM, all assessed the day before and the day after treatment period. The participants who received real rTMS significantly improved with respect to all 10 measures of basic linguistic skills and functional communication, whereas sham-treated participants significantly improved in only 6 of 10 measures (paired t tests, Pcommunication (ANELT) (repeated-measures analysis of variance, P≤.05). For the first time, this study has demonstrated that basic linguistic skills as well as functional communication are bolstered by combining rTMS and behavioral language therapy in patients with subacute aphasia. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  2. Diffusion tensor imaging and diffusion tensor imaging-fibre tractograph depict the mechanisms of Broca-like and Wernicke-like conduction aphasia.

    Science.gov (United States)

    Song, Xinjie; Dornbos, David; Lai, Zongli; Zhang, Yumei; Li, Tieshan; Chen, Hongyan; Yang, Zhonghua

    2011-06-01

    Conduction aphasia is usually considered a result of damage of the arcuate fasciculus, which is subjacent to the parietal portion of the supra-marginal gyrus and the upper part of the insula. It is important to stress that many features of conduction aphasia relate to a cortical deficit, more than a pure disconnection mechanism. In this study, we explore the mechanism of Broca-like and Wernicke-like conduction aphasia by using diffusion tensor imaging (DTI) and diffusion tensor imaging-fibre tractograph (DT-FT). We enrolled five Broca-like conduction aphasia cases, five Wernicke-like aphasia conduction cases and 10 healthy volunteers residing in Beijing and speaking Mandarin. All are right handed. We analyzed the arcuate fasciculus, Broca's areas and Wernicke's areas by DTI and measured fractional anisotrogy (FA). The results of left and right hemispheres were compared in both conduction aphasia cases and volunteers. Then the results of the conduction aphasia cases were compared with those of volunteers. The fibre construction of Broca's and Wernicke's areas was also compared by DTI-FT. The FA occupied by the identified connective pathways (Broca's area, Wernicke's area and the arcuate fasciculus) in the left hemisphere was larger than that in the right hemisphere in the control group (Paphasia cases, the FA of the left Broca's area was smaller than that of the right mirror side (PWernicke-like conduction aphasia patients, the FA of the left Wernicke's area was smaller than that of right mirror side (Paphasia results from not only arcuate fasciculus destruction, but also from disruption of the associated cortical areas. Along different segments of the arcuate fasciculus, the characteristics of language disorders of conduction aphasia were different. A lesion involving Broca's area and the anterior segments of the arcuate fasciculus would lead to Broca-like conduction aphasia, whereas a lesion involved Wernicke's area and posterior segments of the arcuate fasciculus

  3. Repetitive deep transcranial magnetic stimulation improves verbal fluency and written language in a patient with primary progressive aphasia-logopenic variant (LPPA).

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    Trebbastoni, Alessandro; Raccah, Ruggero; de Lena, Carlo; Zangen, Abraham; Inghilleri, Maurizio

    2013-07-01

    To date, no therapies are available for the logopenic variant of primary progressive aphasia (LPPA). Even though deep repetitive transcranial magnetic stimulation (rTMS) may improve cognitive functions in some neurodegenerative disorders, no previous studies investigated its effects in patients with LPPA. Our aim was to investigate the effects on cognitive function of high frequency rTMS (hf-rTMS) delivered over the left dorso-lateral prefrontal cortex (DLPFC) through a coil designed for deep rTMS, compared to a SHAM stimulation, in a right-handed patient with LPPA. The patient presented a progressive language impairment (phonological errors in speech and naming, impaired single word retrieval and sentences repetition) and predominant left perisylvian atrophy and hypoperfusion. He received four stimulation cycles (two REAL and two SHAM) each of whom lasted 20 min for 5 consecutive days. Patient's performances in frontal, visuo-spatial and linguistic tasks were evaluated before and after each stimulation session. Test scores after REAL were compared with those obtained at baseline and after SHAM. We found a temporary and highly significant improvement in the linguistic skills (both oral and written tasks) but not in the other cognitive domains tested, after REAL, but not SHAM stimulations. Hf-rTMS delivered over the DLPFC could improve language in LPPA by enhancing long-term potentiation and synaptic plasticity within the stimulated and interconnected areas involved in language network. Our findings might prompt future researches into the feasibility and efficacy of deep hf-rTMS as a therapeutic tool in progressive aphasia syndromes and other neurodegenerative disorders. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Aphasia caused by intracerebral hemorrhage; CT-scan findings and prognosis

    Energy Technology Data Exchange (ETDEWEB)

    Furuya, Kazuhide; Segawa, Hiromu; Shiokawa, Yoshiaki; Hasegawa, Isao; Sano, Keiji (Fuji Brain Institute and Hospital, Shizuoka (Japan))

    1992-10-01

    It is generally accepted that cases of aphasia can be divided into several groups according to verbal fluency, auditory comprehension, and repetition abilities. Although many authors have studied aphasia and its location by means of a CT scan, the primary lesion on a CT scan with regard to the subtypes of aphasia still remains controversial. In this report we present our new CT classification for the syndromes of aphasia and the prognosis. Twenty-one patients with intracerebral hematoma (ICH) were followed up for more than 3 months after onset. ICH was classified according to the mode of the horizontal extension of the hematoma on a CT scan. Four lines were decided as follows: Line (a) is between the anterior horn of the lateral ventricle and the midpoint of the third ventricle; Line (b) is the vertical line to the saggital line which originates from the midpoint of the third ventricle; Line (c) is between the trigone of the lateral ventricle and the midpoint of the third ventricle. The CT classification consisted of 4 types: in Type A, ICH was located anterior to line (a); in Type B, ICH was located between line (a) and line (b); in Type C, ICH was located between line (b) and line (c); Type B+C, was a combination of Type B and Type C. Transcortical motor aphasia belonged to the Type A group. Transcortical sensory aphasia belonged to the Type B and Type B+C groups. Wernicke's and anomic aphasia belonged to the Type C group. Conduction and global aphasia belonged to the Type B+C group. Pure Broca's aphasia could not be observed in this series. Several relationships between the syndromes of aphasia and its CT findings were evident. On the other hand, the syndromes of aphasia and the degree of recovery were not correlated, except for global aphasia. (author).

  5. Aphasia caused by intracerebral hemorrhage; CT-scan findings and prognosis

    Energy Technology Data Exchange (ETDEWEB)

    Furuya, Kazuhide; Segawa, Hiromu; Shiokawa, Yoshiaki; Hasegawa, Isao; Sano, Keiji [Fuji Brain Institute and Hospital, Shizuoka (Japan)

    1992-10-01

    It is generally accepted that cases of aphasia can be divided into several groups according to verbal fluency, auditory comprehension, and repetition abilities. Although many authors have studied aphasia and its location by means of a CT scan, the primary lesion on a CT scan with regard to the subtypes of aphasia still remains controversial. In this report we present our new CT classification for the syndromes of aphasia and the prognosis. Twenty-one patients with intracerebral hematoma (ICH) were followed up for more than 3 months after onset. ICH was classified according to the mode of the horizontal extension of the hematoma on a CT scan. Four lines were decided as follows: Line (a) is between the anterior horn of the lateral ventricle and the midpoint of the third ventricle; Line (b) is the vertical line to the saggital line which originates from the midpoint of the third ventricle; Line (c) is between the trigone of the lateral ventricle and the midpoint of the third ventricle. The CT classification consisted of 4 types: in Type A, ICH was located anterior to line (a); in Type B, ICH was located between line (a) and line (b); in Type C, ICH was located between line (b) and line (c); Type B+C, was a combination of Type B and Type C. Transcortical motor aphasia belonged to the Type A group. Transcortical sensory aphasia belonged to the Type B and Type B+C groups. Wernicke's and anomic aphasia belonged to the Type C group. Conduction and global aphasia belonged to the Type B+C group. Pure Broca's aphasia could not be observed in this series. Several relationships between the syndromes of aphasia and its CT findings were evident. On the other hand, the syndromes of aphasia and the degree of recovery were not correlated, except for global aphasia. (author).

  6. Alexia and agraphia in Wernicke's aphasia.

    OpenAIRE

    Kirshner, H S; Webb, W G

    1982-01-01

    Three patients with otherwise typical Wernicke's aphasia showed consistently greater impairment of reading than auditory comprehension. While this syndrome resembles alexia with agraphia, the paraphasia of speech, repetition, and naming underline the aphasic nature of the disorder. Together with previous reports of isolated word deafness in Wernicke's aphasia, these cases suggest a relative independence of auditory and visual language processing.

  7. Varieties of semantic 'access' deficit in Wernicke's aphasia and semantic aphasia.

    Science.gov (United States)

    Thompson, Hannah E; Robson, Holly; Lambon Ralph, Matthew A; Jefferies, Elizabeth

    2015-12-01

    Comprehension deficits are common in stroke aphasia, including in cases with (i) semantic aphasia, characterized by poor executive control of semantic processing across verbal and non-verbal modalities; and (ii) Wernicke's aphasia, associated with poor auditory-verbal comprehension and repetition, plus fluent speech with jargon. However, the varieties of these comprehension problems, and their underlying causes, are not well understood. Both patient groups exhibit some type of semantic 'access' deficit, as opposed to the 'storage' deficits observed in semantic dementia. Nevertheless, existing descriptions suggest that these patients might have different varieties of 'access' impairment-related to difficulty resolving competition (in semantic aphasia) versus initial activation of concepts from sensory inputs (in Wernicke's aphasia). We used a case series design to compare patients with Wernicke's aphasia and those with semantic aphasia on Warrington's paradigmatic assessment of semantic 'access' deficits. In these verbal and non-verbal matching tasks, a small set of semantically-related items are repeatedly presented over several cycles so that the target on one trial becomes a distractor on another (building up interference and eliciting semantic 'blocking' effects). Patients with Wernicke's aphasia and semantic aphasia were distinguished according to lesion location in the temporal cortex, but in each group, some individuals had additional prefrontal damage. Both of these aspects of lesion variability-one that mapped onto classical 'syndromes' and one that did not-predicted aspects of the semantic 'access' deficit. Both semantic aphasia and Wernicke's aphasia cases showed multimodal semantic impairment, although as expected, the Wernicke's aphasia group showed greater deficits on auditory-verbal than picture judgements. Distribution of damage in the temporal lobe was crucial for predicting the initially 'beneficial' effects of stimulus repetition: cases with

  8. Varieties of semantic ‘access’ deficit in Wernicke’s aphasia and semantic aphasia

    Science.gov (United States)

    Robson, Holly; Lambon Ralph, Matthew A.; Jefferies, Elizabeth

    2015-01-01

    Comprehension deficits are common in stroke aphasia, including in cases with (i) semantic aphasia, characterized by poor executive control of semantic processing across verbal and non-verbal modalities; and (ii) Wernicke’s aphasia, associated with poor auditory–verbal comprehension and repetition, plus fluent speech with jargon. However, the varieties of these comprehension problems, and their underlying causes, are not well understood. Both patient groups exhibit some type of semantic ‘access’ deficit, as opposed to the ‘storage’ deficits observed in semantic dementia. Nevertheless, existing descriptions suggest that these patients might have different varieties of ‘access’ impairment—related to difficulty resolving competition (in semantic aphasia) versus initial activation of concepts from sensory inputs (in Wernicke’s aphasia). We used a case series design to compare patients with Wernicke’s aphasia and those with semantic aphasia on Warrington’s paradigmatic assessment of semantic ‘access’ deficits. In these verbal and non-verbal matching tasks, a small set of semantically-related items are repeatedly presented over several cycles so that the target on one trial becomes a distractor on another (building up interference and eliciting semantic ‘blocking’ effects). Patients with Wernicke’s aphasia and semantic aphasia were distinguished according to lesion location in the temporal cortex, but in each group, some individuals had additional prefrontal damage. Both of these aspects of lesion variability—one that mapped onto classical ‘syndromes’ and one that did not—predicted aspects of the semantic ‘access’ deficit. Both semantic aphasia and Wernicke’s aphasia cases showed multimodal semantic impairment, although as expected, the Wernicke’s aphasia group showed greater deficits on auditory-verbal than picture judgements. Distribution of damage in the temporal lobe was crucial for predicting the initially

  9. Aphasia following left thalamic hemorrhage

    International Nuclear Information System (INIS)

    Makishita, Hideo; Miyasaka, Motomaro; Tanizaki, Yoshio; Yanagisawa, Nobuo; Sugishita, Morihiro.

    1984-01-01

    We reported 7 patients with left thalamic hemorrhage in the chronic stage (from 1.5 months to 4.5 months), and described language disorders examined by Western Aphasia Battery (WAB) and measured cerebral blood flow by single photon emission CT. Examination of language by WAB revealed 4 aphasics out of 7 cases, and 3 patients had no language deficit. The patient with Wernicke's aphasia showed low density area only in the left posterior thalamus in X-ray CT, and revealed severe low blood flow area extending to left temporal lobe in emission CT. In the case with transcortical sensory aphasia, although X-ray CT showed no obvious low density area, emission CT revealed moderate low flow area in watershed area that involved the territory between posterior cerebral and middle cerebral arteries in the left temporooccipital region in addition to low blood flow at the left thalamus. In one of the two patients classified as anomic aphasia, whose score of repetition (8.4) was higher than that of comprehension (7.4), emission CT showed slight low flow area at the temporo-occipital region similarly as the case with transcortical sensory aphasia. In another case with anomic aphasia, scored 9 on both fluensy and comprehension subtests and 10 on repetition, there was wide low density area all over the left thalamus and midline shift to the right in X-ray CT, and emission CT showed severe low blood flow in the same region spreading widely toward the cerebral surface. On the other hand, in all of the 3 patients without aphasia, emission CT showed low flow region restricted to the left thalamus. (J.P.N.)

  10. Severity of post-stroke aphasia according to aphasia type and lesion location in Koreans.

    Science.gov (United States)

    Kang, Eun Kyoung; Sohn, Hae Min; Han, Moon-Ku; Kim, Won; Han, Tai Ryoon; Paik, Nam-Jong

    2010-01-01

    To determine the relations between post-stroke aphasia severity and aphasia type and lesion location, a retrospective review was undertaken using the medical records of 97 Korean patients, treated within 90 days of onset, for aphasia caused by unilateral left hemispheric stroke. Types of aphasia were classified according to the validated Korean version of the Western Aphasia Battery (K-WAB), and severities of aphasia were quantified using WAB Aphasia Quotients (AQ). Lesion locations were classified as cortical or subcortical, and were determined by magnetic resonance imaging. Two-step cluster analysis was performed using AQ values to classify aphasia severity by aphasia type and lesion location. Cluster analysis resulted in four severity clusters: 1) mild; anomic type, 2) moderate; Wernicke's, transcortical motor, transcortical sensory, conduction, and mixed transcortical types, 3) moderately severe; Broca's aphasia, and 4) severe; global aphasia, and also in three lesion location clusters: 1) mild; subcortical 2) moderate; cortical lesions involving Broca's and/or Wernicke's areas, and 3) severe; insular and cortical lesions not in Broca's or Wernicke's areas. These results revealed that within 3 months of stroke, global aphasia was the more severely affected type and cortical lesions were more likely to affect language function than subcortical lesions.

  11. Neuroimaging and neurorehabilitation for aphasia patients

    International Nuclear Information System (INIS)

    Abo, Masahiro

    2012-01-01

    Recently, low-frequency repetitive transcranial magnetic stimulation (rTMS) which can suppress neural activity of selected brain areas, has been introduced for stroke patients with aphasia as a therapeutic tool. To assess the therapeutic effects of an 11-days in-hospital protocol of intensive speech therapy (ST) combined with low-frequency rTMS on language function in patients with poststroke aphasia. Twenty patients with left-hemispheric stroke and aphasia were included in this study During their 11-day hospitalization, each patient received 10 treatment sessions consisting of 40-min of 1 Hz repetitive low-frequency TMS and 60-min of intensive ST (one session/day), excluding Sundays. The scalp area for stimulation was selected based on functional (f) MRI and determination of the type of aphasia. Repetitive low-frequency-TMS was applied to the inferior frontal gyrus (IFG) for patients with motor-dominant aphasia and to the superior temporal gyrus (STG) for patients with sensory-dominant aphasia. Language function was evaluated by the Japanese version of the Western Aphasia Battery (WAB), the Standard Language Test of Aphasia (SLTA) and the supplementary test of SLTA at one week before admission, 1 hr after the last rTMS session and 4 weeks after discharge from the hospital. On pretreatment fMRI, the most activated areas were in the left hemisphere (n=11) and the right hemisphere (n=9). Aphasia types were sensory-dominant (n=9) and motor-dominant (n=11). The repetitive low-frequency TMS was applied to the right STG (n=5), left STG (n=4), right IFG (n=8) and left IFG (n=3). All patients with motor-dominant aphasia showed improvement while those with sensory-dominant aphasia showed improvement in spontaneous speed only. Our fMRI-based repetitive low-frequency TMS strategy for aphasic stroke patients seems to be a novel neurorehabilitative approach facilitating the reorganization of language function with a low risk of adverse effects. (author)

  12. Transcranial Magnetic Stimulation and Aphasia Rehabilitation

    Science.gov (United States)

    Naeser, Margaret A.; Martin, Paula I; Ho, Michael; Treglia, Ethan; Kaplan, Elina; Bhashir, Shahid; Pascual-Leone, Alvaro

    2013-01-01

    Repetitive transcranial magnetic stimulation (rTMS) has been reported to improve naming in chronic stroke patients with nonfluent aphasia since 2005. In Part 1, we review the rationale for applying slow, 1 Hz, rTMS to the undamaged right hemisphere in chronic nonfluent aphasia patients following a left hemisphere stroke; and present a TMS protocol used with these patients that is associated with long-term, improved naming post- TMS. In Part, 2 we present results from a case study with chronic nonfluent aphasia where TMS treatments were followed immediately by speech therapy (constraint-induced language therapy). In Part 3, some possible mechanisms associated with improvement following a series of TMS treatments in stroke patients with aphasia are discussed. PMID:22202188

  13. Clinicoanatomical correlation in stroke related aphasia

    Directory of Open Access Journals (Sweden)

    Vikram Bohra

    2015-01-01

    Full Text Available Context: With advances in neuroimaging, traditional views regarding the clinicoanatomic correlation in stroke patients with aphasia are being challenged and it has been observed that lesions at a given cortical or subcortical site may manifest with different aphasia profiles. Aims: To study as to whether there is a strict clinicoanatomical correlation between the type of aphasia and lesion site in patients with first ever stroke. Settings and Design: Observational study, based in a tertiary care center. Materials and Methods: Stroke patient′s ≥18 years of age were screened and those with first ever stroke and aphasia were subjected to a detailed stroke workup and language assessment using the Hindi version of Western Aphasia Battery (WAB. Statistical analysis was done with χ2 test with Yates correction and Kruskal-Wallis test. The level of significance was set at P < 0.05. Results: Overall aphasia was detected in 27.9% of the 260 screened cases with stroke. Amongst 60 cases with first ever stroke and aphasia, the aphasia type was: Global (33.33%, Broca′s (28.3%, transcortical motor (13.33%, transcortical sensory (10%, Wernicke′s (8.33%, anomic (5%, and conduction (1.67% aphasia. A definite correlation between the lesion site and the type of aphasia as per the traditional classification was observed in 35% cases only. Conclusions: No absolute correlation exists between the lesion site and the type of clinical aphasia syndrome in majority of the patients with cortical and subcortical stroke.

  14. Neuroradiologic correlation with aphasias. Cortico-subcortical map of language.

    Science.gov (United States)

    Jiménez de la Peña, M M; Gómez Vicente, L; García Cobos, R; Martínez de Vega, V

    Aphasia is an acquired language disorder due to a cerebral lesion; it is characterized by errors in production, denomination, or comprehension of language. Although most aphasias are mixed, from a practical point of view they are classified into different types according to their main clinical features: Broca's aphasia, Wernicke's aphasia, conduction aphasia, transcortical aphasia, and alexia with or without agraphia. We present the clinical findings for the main subtypes of aphasia, illustrating them with imaging cases, and we provide an up-to-date review of the language network with images from functional magnetic resonance imaging and tractography. Copyright © 2018 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Age and type of aphasia in patients with stroke.

    Science.gov (United States)

    Eslinger, P J; Damasio, A R

    1981-01-01

    The age and gender of a series of patients with different types of aphasia were analysed. Regardless of gender, patients with Broca and conduction aphasias were significantly younger than those with Wernicke and global aphasias. Considering the established cerebral localisation of each of those aphasia types, it appears that, with age, stroke in the territory of the middle cerebral artery will tend to either shift posteriorly (producing Wernicke aphasia) or occupy most of the middle cerebral artery territory (producing global aphasia). But in the absence of concurrent verification of the locus of lesion in each of the cases in our sample, a possible alternative hypothesis must be entertained: that there might be age-related changes in the neurophysiological mechanism subserving language, such that some types of aphasia would tend to be more prevalent with age, regardless of lesion location. PMID:7264683

  16. Validity, Reliability and Standardization Study of the Language Assessment Test for Aphasia

    Directory of Open Access Journals (Sweden)

    Bülent Toğram

    2012-09-01

    Full Text Available OBJECTIVE: Aphasia assessment is the first step towards a well- founded language therapy. Language tests need to consider cultural as well as typological linguistic aspects of a given language. This study was designed to determine the standardization, validity and reliability of Language Assessment Test for Aphasia, which consists of eight subtests including spontaneous speech and language, auditory comprehension, repetition, naming, reading, grammar, speech acts, and writing. METHODS: The test was administered to 282 healthy participants and 92 aphasic participants in age, education and gender matched groups. The validity study of the test was investigated with analysis of content, structure and criterion-related validity. For reliability of the test, the analysis of internal consistency, stability and equivalence reliability was conducted. The influence of variables on healhty participants’ sub-test scores, test score and language score was examined. According to significant differences, norms and cut-off scores based on language score were determined. RESULTS: The group with aphasia performed highly lower than healthy participants on subtest, test and language scores. The test scores of healthy group were mostly affected by age and educational level but not affected by gender. According to significant differences, age and educational level for both groups were determined. Considering age and educational levels, the reference values for the cut-off scores were presented. CONCLUSION: The test was found to be a highly reliable and valid aphasia test for Turkish- speaking aphasic patients either in Turkey or other Turkish communities around the world

  17. Aphasia vs. Apraxia

    Science.gov (United States)

    ... After Stroke Inspirational Stories Stroke Heroes Among Us Aphasia vs. Apraxia Updated:Oct 24,2016 Excerpted from " ... treated by a speech-language pathologist. Read more Aphasia articles: Talking Tech: How technology helps survivors with ...

  18. Primary Progressive Aphasia

    Science.gov (United States)

    ... which cause different symptoms. Semantic variant primary progressive aphasia Symptoms include these difficulties: Comprehending spoken or written ... word meanings Naming objects Logopenic variant primary progressive aphasia Symptoms include: Having difficulty retrieving words Frequently pausing ...

  19. Cerebral circulation and metabolism with recovery of chronic poststroke aphasia

    International Nuclear Information System (INIS)

    Yamada, Tomoyuki; Kabasawa, Hidehiro; Matsubara, Michitaka; Hibino, Hiroaki; Kamimoto, Kaoru; Fukagawa, Kazutoshi

    2004-01-01

    The recruitment of cerebral circulation and oxygen metabolism in the particular brain areas responsible for poststroke aphasia are necessary for recovery. This study was undertaken to investigate changes in cerebral circulation and oxygen metabolism corresponding to improvement of aphasia. Twenty-nine right-handed chronic aphasic patients with left hemispheric stroke were studied. Aphasia was evaluated as the score of fluency, comprehension, repetition and naming by the Western Aphasia Battery (Japanese version). Concurrent with the evaluation of aphasia, positron emission tomography (PET) scans were performed. After several months of speech therapy, PET scans and evaluation of aphasia were reperformed. Both regional cerebral blood flow and the cerebral metabolic rate for oxygen significantly increased in the left upper superior and middle temporal gyri, and in the left upper inferior frontal gyrus in the fair recovery group for comprehension, repetition and naming. In the fair recovery group for fluency, the cerebral metabolic rate for oxygen significantly increased in the left upper superior and middle temporal gyri, but regional cerebral blood flow increased insignificantly in these areas. In the lower white matter of the right parietal lobe, both the regional cerebral blood flow and the cerebral metabolic rate for oxygen were significantly increased in the fair recovery group for all aphasic features. The recruitment of cerebral circulation and oxygen metabolism in the left temporo-parietal area, in the left inferior frontal area, and in the right deep parietal area are essentially responsible for the recovery of aphasia. (author)

  20. Hermann Oppenheim's observations about music in aphasia.

    Science.gov (United States)

    Graziano, Amy B; Pech, Anja; Hou, Craig; Johnson, Julene K

    2012-01-01

    Hermann Oppenheim was influential in many areas of neurology, but his ideas about music are relatively unknown. In 1888, he published a paper that outlined how the assessment of music skills in patients with aphasia could lead to a better understanding of aphasia and language. Oppenheim conducted the first comprehensive music assessment as part of a neurologic examination and presented the first case series of music in aphasia. His paper was widely cited and had significant influence over the next 30 years. Although largely unrecognized as such, Oppenheim was an important historical figure in the study of music and neurology.

  1. Anatomy of aphasia revisited.

    Science.gov (United States)

    Fridriksson, Julius; den Ouden, Dirk-Bart; Hillis, Argye E; Hickok, Gregory; Rorden, Chris; Basilakos, Alexandra; Yourganov, Grigori; Bonilha, Leonardo

    2018-01-17

    In most cases, aphasia is caused by strokes involving the left hemisphere, with more extensive damage typically being associated with more severe aphasia. The classical model of aphasia commonly adhered to in the Western world is the Wernicke-Lichtheim model. The model has been in existence for over a century, and classification of aphasic symptomatology continues to rely on it. However, far more detailed models of speech and language localization in the brain have been formulated. In this regard, the dual stream model of cortical brain organization proposed by Hickok and Poeppel is particularly influential. Their model describes two processing routes, a dorsal stream and a ventral stream, that roughly support speech production and speech comprehension, respectively, in normal subjects. Despite the strong influence of the dual stream model in current neuropsychological research, there has been relatively limited focus on explaining aphasic symptoms in the context of this model. Given that the dual stream model represents a more nuanced picture of cortical speech and language organization, cortical damage that causes aphasic impairment should map clearly onto the dual processing streams. Here, we present a follow-up study to our previous work that used lesion data to reveal the anatomical boundaries of the dorsal and ventral streams supporting speech and language processing. Specifically, by emphasizing clinical measures, we examine the effect of cortical damage and disconnection involving the dorsal and ventral streams on aphasic impairment. The results reveal that measures of motor speech impairment mostly involve damage to the dorsal stream, whereas measures of impaired speech comprehension are more strongly associated with ventral stream involvement. Equally important, many clinical tests that target behaviours such as naming, speech repetition, or grammatical processing rely on interactions between the two streams. This latter finding explains why patients with

  2. Overprotection in couples with aphasia.

    Science.gov (United States)

    Croteau, C; Le Dorze, G

    1999-09-01

    The study aimed to measure the perception of overprotection in 21 couples living with aphasia, relative to controls. The 'Questionnaire on Resources and Stress' assessed the spouses' perception and the 'Overprotection Scale for Adults' measured the perception of persons with aphasia. Husbands of women with aphasia did not differ from husbands of women without aphasia. Wives of men with aphasia reported more overprotection than wives of men without aphasia, even when functional impairment was controlled. The men with aphasia did not report feeling overprotected. No significant relationship was uncovered between the report of overprotection and feeling overprotected in couples with aphasia. Overprotection is present in some couples coping with aphasia.

  3. Brain Stimulation and the Role of the Right Hemisphere in Aphasia Recovery.

    Science.gov (United States)

    Turkeltaub, Peter E

    2015-11-01

    Aphasia is a common consequence of left hemisphere stroke and causes a disabling loss of language and communication ability. Current treatments for aphasia are inadequate, leaving a majority of aphasia sufferers with ongoing communication difficulties for the rest of their lives. In the past decade, two forms of noninvasive brain stimulation, repetitive transcranial magnetic stimulation and transcranial direct current stimulation, have emerged as promising new treatments for aphasia. The most common brain stimulation protocols attempt to inhibit the intact right hemisphere based on the hypothesis that maladaptive activity in the right hemisphere limits language recovery in the left. There is now sufficient evidence to demonstrate that this approach, at least for repetitive transcranial magnetic stimulation, improves specific language abilities in aphasia. However, the biological mechanisms that produce these behavioral improvements remain poorly understood. Taken in the context of the larger neurobiological literature on aphasia recovery, the role of the right hemisphere in aphasia recovery remains unclear. Additional research is needed to understand biological mechanisms of recovery, in order to optimize brain stimulation treatments for aphasia. This article summarizes the current evidence on noninvasive brain stimulation methods for aphasia and the neuroscientific considerations surrounding treatments using right hemisphere inhibition. Suggestions are provided for further investigation and for clinicians whose patients ask about brain stimulation treatments for aphasia.

  4. Effect of high-frequency repetitive transcranial magnetic stimulation on motor cortical excitability and sensory nerve conduction velocity in subacute-stage incomplete spinal cord injury patients.

    Science.gov (United States)

    Cha, Hyun Gyu; Ji, Sang-Goo; Kim, Myoung-Kwon

    2016-07-01

    [Purpose] The aim of the present study was to determine whether repetitive transcranial magnetic stimulation can improve sensory recovery of the lower extremities in subacute-stage spinal cord injury patients. [Subjects and Methods] This study was conducted on 20 subjects with diagnosed paraplegia due to spinal cord injury. These 20 subjects were allocated to an experimental group of 10 subjects that underwent active repetitive transcranial magnetic stimulation or to a control group of 10 subjects that underwent sham repetitive transcranial magnetic stimulation. The SCI patients in the experimental group underwent active repetitive transcranial magnetic stimulation and conventional rehabilitation therapy, whereas the spinal cord injury patients in the control group underwent sham repetitive transcranial magnetic stimulation and conventional rehabilitation therapy. Participants in both groups received therapy five days per week for six-weeks. Latency, amplitude, and sensory nerve conduction velocity were assessed before and after the six week therapy period. [Results] A significant intergroup difference was observed for posttreatment velocity gains, but no significant intergroup difference was observed for amplitude or latency. [Conclusion] repetitive transcranial magnetic stimulation may be improve sensory recovery of the lower extremities in subacute-stage spinal cord injury patients.

  5. Aphasia following anterior cerebral artery occlusion

    International Nuclear Information System (INIS)

    Shimosaka, Shinichi; Waga, Shiro; Kojima, Tadashi; Shimizu, Takeo; Morikawa, Atsunori

    1982-01-01

    We have report two cases of aphasia that had infarcts in the distribution of the left or right anterior cerebral artery, as confirmed by computed tomography. Case 1 is a right-handed, 65-year-old man in whom computerized tomographic scanning revealed an infarction of the territory of the left anterior cerebral artery after the clipping of the anterior communicating artery aneurysm. The standard language test of aphasia (SLTA) revealed non-fluent aphasia with dysarthria, good comprehension, almost normal repetition with good articulation, and a defectiveness in writing. This syndrome was considered an instance of transcortical motor aphasia. Although three years had passed from the onset, his aphasia did not show any improvement. Case 2 is a 37-year-old man who is right-handed but who can use his left hand as well. He was admitted because of subarachnoid hemorrhage from an anterior communicating aneurysm. Because of postoperative spasm, an infarction in the distribution of the right anterior cerebral artery developed. He was totally unable to express himself vocally, but he could use written language quite well to express his ideas and had a good comprehension of spoken language. This clinical picture was considered that of an aphemia. After several weeks, his vocalization returned, but the initial output was still hypophonic. (J.P.N.)

  6. The rate and extent of improvement with therapy from the different types of aphasia in the first year after stroke.

    Science.gov (United States)

    Bakheit, A M O; Shaw, S; Carrington, S; Griffiths, S

    2007-10-01

    To examine the rate and extent of improvement from the different types of aphasia in the first year after stroke. A prospective longitudinal study. A specialist stroke unit. Seventy-five aphasic patients with first-ever stroke. The type of aphasia was classified according to the criteria of the Western Aphasia Battery. The Western Aphasia Battery aphasia quotient was used to measure the initial severity and the rate and extent of improvement from aphasia. Assessments were made at baseline and 4, 8, 12 and 24 weeks later. The median percentage increase in the Western Aphasia Battery aphasia quotient was statistically higher in patients with Broca's aphasia than in the other groups at all weeks. Patients with Wernicke's aphasia had a significantly greater median percentage increase in their aphasia quotient than those with conduction and anomic aphasia at weeks 12 and 24, but less than patients with global aphasia at week 24. Patients with Broca's aphasia appear to have the best prognosis for improvement of language function in the first year of stroke. The extent of improvement in patients with global aphasia is better than that of patients with Wernicke's aphasia.

  7. Computer-Based Script Training for Aphasia: Emerging Themes from Post-Treatment Interviews

    Science.gov (United States)

    Cherney, Leora R.; Halper, Anita S.; Kaye, Rosalind C.

    2011-01-01

    This study presents results of post-treatment interviews following computer-based script training for persons with chronic aphasia. Each of the 23 participants received 9 weeks of AphasiaScripts training. Post-treatment interviews were conducted with the person with aphasia and/or a significant other person. The 23 interviews yielded 584 coded…

  8. Iterative design and field trial of an aphasia-friendly email tool

    NARCIS (Netherlands)

    Al Mahmud, A.; Martens, J.B.O.S.

    2015-01-01

    In this article, we describe the iterative design and field trial of Amail, an email client specifically designed for people with aphasia who have problems expressing themselves verbally. We conducted a 3-month study with eight persons with aphasia to better understand how people with aphasia could

  9. Meynert on Wernicke's aphasia.

    Science.gov (United States)

    Eling, Paul

    2006-08-01

    This paper examines Meynert's contribution to aphasia, in particular the suggestion that Meynert already had described the syndrome of sensory aphasia. I examine Meynert's own writings on this subject, Wernicke's statements on this issue and biographies of Meynert and Wernicke. I argue that Meynert did not describe sensory aphasia, nor is there convincing evidence that he stimulated Wernicke in this direction. Meynert was primarily interested in the global neuroanatomical organization of the brain and in particular the special role of the frontal lobes.

  10. Recurrent epileptic Wernicke aphasia.

    Science.gov (United States)

    Sahaya, Kinshuk; Dhand, Upinder K; Goyal, Munish K; Soni, Chetan R; Sahota, Pradeep K

    2010-04-15

    We report a patient with recurrent epileptic Wernicke aphasia who prior to this presentation, had been misdiagnosed as transient ischemic attacks for several years. This case report emphasizes the consideration of epileptic nature of aphasia when a clear alternate etiology is unavailable, even when EEG fails to show a clear ictal pattern. We also present a brief discussion of previously reported ictal aphasias. Copyright 2010 Elsevier B.V. All rights reserved.

  11. Intensive comprehensive aphasia programs: an international survey of practice.

    Science.gov (United States)

    Rose, Miranda L; Cherney, Leora R; Worrall, Linda E

    2013-01-01

    In response to the need to simultaneously address multiple domains of the International Classification of Functioning, Disability and Health (ICF) in aphasia therapy and to incorporate intensive treatment doses consistent with principles of neuroplasticity, a potentially potent treatment option termed intensive comprehensive aphasia programs (ICAPs) has been developed. To conduct an international survey of ICAPs to determine the extent of their use and to explore current ICAP practices. A 32-item online survey was distributed internationally through Survey Monkey between May and August 2012. The survey addressed ICAP staffing, philosophy, values, funding, admission criteria, activities, family involvement, outcome measures, and factors considered important to success. Twelve ICAPs responded: 8 from the United States, 2 from Canada, and 1 each from Australia and the United Kingdom. The majority of ICAPs are affiliated with university programs and are funded through participant self-pay. ICAPs emphasize individualized treatment goals and evidence-based practices, with a focus on applying the principles of neuroplasticity related to repetition and intensity of treatment. On average, 6 people with aphasia attend each ICAP, for 4 days per week for 4 weeks, receiving about 100 hours of individual, group, and computer-based treatment. Speech-language pathologists, students, and volunteers staff the majority of ICAPs. ICAPs are increasing in number but remain a rare service delivery option. They address the needs of individuals who want access to intensive treatment and are interested in making significant changes to their communication skills and psychosocial well-being in a short period of time. Their efficacy and cost-effectiveness require future investigation.

  12. Shared neural substrates of apraxia and aphasia.

    Science.gov (United States)

    Goldenberg, Georg; Randerath, Jennifer

    2015-08-01

    Apraxia is regularly associated with aphasia, but there is controversy whether their co-occurrence is the expression of a common basic deficit or results from anatomical proximity of their neural substrates. However, neither aphasia nor apraxia is an indivisible entity. Both diagnoses embrace diverse manifestations that may occur more or less independently from each other. Thus, the question whether apraxia is always accompanied by aphasia may lead to conflicting answers depending on which of their manifestations are considered. We used voxel based lesion symptom mapping (VLSM) for exploring communalities between lesion sites associated with aphasia and with apraxia. Linguistic impairment was assessed by the Aachen Aphasia Test (AAT) subtests naming, comprehension, repetition, written language, and Token Test. Apraxia was examined for imitation of meaningless hand and finger postures and for pantomime of tool use. There were two areas of overlap between aphasia and apraxia. Lesions in the anterior temporal lobe interfered with pantomime of tool use and with all linguistic tests. In the left inferior parietal lobe there was a large area where lesions were associated with defective imitation of hand postures and with poor scores on written language and the Token Test. Within this large area there were also two spots in supramarginal and angular gyrus where lesions were also associated with defective pantomime. We speculate that the coincidence of language impairment and defective pantomime after anterior temporal lesions is due to impaired access to semantic memory. The combination of defective imitation of hand postures with poor scores on Token Test and written language is not easily compatible with a crucial role of parietal regions for the conversion of concepts of intended actions into motor commands. It accords better with a role of left inferior parietal lobe regions for the categorical perception of spatial relationships. Copyright © 2015 Elsevier Ltd. All

  13. Word and nonword repetition in patients with Schizophrenia

    Directory of Open Access Journals (Sweden)

    Alireza Farnam

    2015-08-01

    Full Text Available Introduction: The assessment of the verbal repetition is important in the study of acquired language disorders and neuropsychology. It is helpful in differential diagnosis of aphasia subtypes, auditory breakdowns, and working memory (WM performance. Though different linguistic disorders have been identified in patients with schizophrenia, very little is known about their verbal repetition ability. Methods: The present study was conducted in the inpatient ward of Razi Psychiatric Hospital, Tabriz University of Medical Sciences, Iran, during the year 2013. Participants were: 30 patients diagnosed with schizophrenia during the maintenance phase of treatment and 30 healthy people as control group. They were asked to repeat 15 words and 15 nonwords immediately. The stimuli were 1, 2, and 3 syllabic in Turkish language. Any incorrect repetition scored 1 and correct repetitions scored 0. Lexicalization errors were compared between groups too. Results: Both groups repeated words better than nonwords. Patients showed lower ability to repeat nonwords than controls, especially in 3 syllabics. There was no significant difference in the repetition of words between groups though it was better in controls. Patients with schizophrenia made more errors in both words and nonwords and lexicalization errors were twice more. Conclusion: Lower ability to repeat nonwords (than words in patients with schizophrenia may show the involvement of phonological loop of WM. More lexicalization errors may take place because of dis-inhibition.

  14. Meynert on Wernicke's aphasia

    NARCIS (Netherlands)

    Eling, P.A.T.M.

    2006-01-01

    This paper examines Meynert’s contribution to aphasia, in particular the suggestion that Meynert already had described the syndrome of sensory aphasia. I examine Meynert’s own writings on this subject, Wernicke’s statements on this issue and biographies of Meynert and Wernicke. I argue that Meynert

  15. The spectrum of aphasia subtypes and etiology in subacute stroke.

    Science.gov (United States)

    Hoffmann, Michael; Chen, Ren

    2013-11-01

    Aphasia is one of the most common stroke syndrome presentations, yet little is known about the spectrum of different subtypes or their stroke mechanisms. Yet, subtypes and etiology are known to influence the prognosis and recovery. Our aim is to analyze aphasia subtypes and etiology in a large subacute stroke population. Consecutive patients from a dedicated cognitive stroke registry were accrued. A validated cognitive screening examination was administered during the first month of stroke presentation, which enabled a diagnosis of 14 different aphasic subtypes. The evolution from one subtype to another in the acute and subacute period, at times, resulted in more than 1 subtype being diagnosed. Etiology of stroke was determined by the modified Trial of Org 10172 in Acute Stroke Treatment criteria that included intracerebral hemorrhage. Exclusions included dementia, chronic medical illness, substance abuse, and severe depression. Of 2389 stroke patients, after exclusions (n=593), aphasias numbered 625 (625 of 1796; 34.8%), and the subtype frequencies included Broca aphasia (n=170; 27.2%), anomic aphasia (n=165; 26.4%), global aphasia (n=119; 19.04%), and subcortical aphasia (n=57; 9.12%). Less frequent subtypes (total n=40; 6.7%) included transcortical aphasia (n=11), Wernicke aphasia (n=10), conduction aphasia (n=7), aphemia (n=3), semantic aphasia (n=3), crossed aphasia (n=3), pure word deafness (n=2), and foreign accent syndrome (n=1). Aphasia subtypes and etiologies had some significant associations (chi-square: 855.8, P valueaphasia had a significant association with small-vessel disease (SVD) (odds ratio [OR]=2.0254, 95% confidence interval [CI]: 1.3820-2.9681), and global aphasia patients mostly had cardioembolic (CE) causes (OR=2.3589, 95% CI: 1.5506-3.5885) and less likely SVD (OR=.2583, 95% CI: .1444-.4654). Other notable inferences were included. Wernicke aphasia was caused by either CE (6 of 12; 50%) or hemorrhage (4 of 12; 33.3%) in a combined 83% of

  16. Localization of lesions in aphasia

    International Nuclear Information System (INIS)

    Hojo, Kei; Watanabe, Shunzo; Tasaki, Hiroichi; Sato, Tokijiro; Metoki, Hirobumi.

    1984-01-01

    Using a microcomputer, the locus and extent of the lesions, as demonstrated by computed tomography for 127 cases with various types of aphasia were superimposed onto standardized marices. The relationship between the foci of the lesions and the types of aphasia was investigated. Broca aphasics (n=39) : Since the accumulated site of the lesions highly involved the deep structures of the lower part of the precentral gyrus as well as the insula and lenticular nucleus, only 60% of the Broca aphasics had lesions on these areas. This finding has proved to have little localizing value. Wernicke aphasics (n=23) : The size of the lesion was significantly smaller than Broca's aphasia. At least 70% of the patients had the superior temporal lesions involving Wernicke's area and subcortical lesions of the superior and middle temporal gyri. Amnestic aphasics (n=18) : The size of the lesion was smaller than any other types. While there was some concentration of the lesions (maximum 40%) in the area of the subcortical region of the anterior temporal gyrus adjacent to Wernicke's area and the lenticular nucleus, the lesions were distributed throughout the left hemisphere. Amnestic aphasia was thought to be the least localizable. Conduction aphasics (n=11) : The lesions were relatively small in size. Many patients had posterior speech area lesions involving at least partially Wernicke's area. In particular, more than 80% of the conduction aphasics had lesions of the supramarginal gyrus and it's adjacent deep structures. Global aphasics (n=36) : In general, the size of the lesion was very large and 70% of the global aphasics had extensive lesions involving both Broca's and Wernicke's areas. However, there were observations showing that the lesions can be small and confined. (J.P.N.)

  17. What is Aphasia? | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... issue contents Features: Aphasia Follow us What is Aphasia? What Is Aphasia? Aphasia makes it hard to read, write, say ... tumor or disease that affects brain tissue. Preventing aphasia One way to prevent aphasia is to lower ...

  18. Fluent Aphasia From Herpes Simplex Encephalitis

    Directory of Open Access Journals (Sweden)

    Fariba Yadegari

    2006-09-01

    Full Text Available The present case report introduces a patient with fluent aphasia, anterograde amnesia and anosmia due to herpes simplex encephalitis after her first delivery. The left medial temporal lobe was one of the main areas involved. On aphasia testing she showed severe anomia on both confrontation and free recall, agraphia, alexia, repetition disorder and some auditory comprehension impairments. Therapy was focused on the following issues: phonological output lexicon , using graphemes as a source of reestablishing phonological representation; describing pictures to reinforce free recall and self-cuing word retrieval strategies; sequencing the events for language memory reinforcement, etc. Results showed improvement in confrontational naming, free recall, correct responses without priming, writing on dictation, spontaneous writing and reading comprehension.

  19. Global aphasia without hemiparesis: language profiles and lesion distribution

    Science.gov (United States)

    Hanlon, R.; Lux, W.; Dromerick, A.

    1999-01-01

    OBJECTIVES—Global aphasia without hemiparesis (GAWH) is an uncommon stroke syndrome involving receptive and expressive language impairment, without the hemiparesis typically manifested by patients with global aphasia after large left perisylvian lesions. A few cases of GAWH have been reported with conflicting conclusions regarding pathogenesis, lesion localisation, and recovery. The current study was conducted to attempt to clarify these issues.
METHODS—Ten cases of GAWH were prospectively studied with language profiles and lesion analysis; five patients had multiple lesions, four patients had a single lesion, and one had a subarachnoid haemorrhage. Eight patients met criteria for cardioembolic ischaemic stroke.
RESULTS—Cluster analysis based on acute language profiles disclosed three subtypes of patients with GAWH; these clusters persisted on follow up language assessment. Each cluster evolved into a different aphasia subtype: persistent GAWH, Wernicke's aphasia, or transcortical motor aphasia (TCM). Composite lesion analysis showed that persistent GAWH was related to lesioning of the left superior temporal gyrus. Patients with acute GAWH who evolved into TCM type aphasia had common lesioning of the left inferior frontal gyrus and adjacent subcortical white matter. Patients with acute GAWH who evolved into Wernicke's type aphasia were characterised by lesioning of the left precentral and postcentral gyri. Recovery of language was poor in all but one patient.
CONCLUSIONS—Although patients with acute GAWH are similar on neurological examination, they are heterogeneous with respect to early aphasia profile, language recovery, and lesion profile.

 PMID:10084536

  20. Early Recovery of Aphasia through Thrombolysis: The Significance of Spontaneous Speech.

    Science.gov (United States)

    Furlanis, Giovanni; Ridolfi, Mariana; Polverino, Paola; Menichelli, Alina; Caruso, Paola; Naccarato, Marcello; Sartori, Arianna; Torelli, Lucio; Pesavento, Valentina; Manganotti, Paolo

    2018-07-01

    Aphasia is one of the most devastating stroke-related consequences for social interaction and daily activities. Aphasia recovery in acute stroke depends on the degree of reperfusion after thrombolysis or thrombectomy. As aphasia assessment tests are often time-consuming for patients with acute stroke, physicians have been developing rapid and simple tests. The aim of our study is to evaluate the improvement of language functions in the earliest stage in patients treated with thrombolysis and in nontreated patients using our rapid screening test. Our study is a single-center prospective observational study conducted at the Stroke Unit of the University Medical Hospital of Trieste (January-December 2016). Patients treated with thrombolysis and nontreated patients underwent 3 aphasia assessments through our rapid screening test (at baseline, 24 hours, and 72 hours). The screening test assesses spontaneous speech, oral comprehension of words, reading aloud and comprehension of written words, oral comprehension of sentences, naming, repetition of words and a sentence, and writing words. The study included 40 patients: 18 patients treated with thrombolysis and 22 nontreated patients. Both groups improved over time. Among all language parameters, spontaneous speech was statistically significant between 24 and 72 hours (P value = .012), and between baseline and 72 hours (P value = .017). Our study demonstrates that patients treated with thrombolysis experience greater improvement in language than the nontreated patients. The difference between the 2 groups is increasingly evident over time. Moreover, spontaneous speech is the parameter marked by the greatest improvement. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  1. Types of Aphasia

    Science.gov (United States)

    ... continue to limit distractions such as background noise (music, other talking, TV). As you become more comfortable ... Aphasia," Stroke Connection Magazine, March/April 2006 (Last science update March 2013) Constraint-induced therapies (CIT) have ...

  2. Improving production of treated and untreated verbs in aphasia: A meta-analysis

    Directory of Open Access Journals (Sweden)

    Vânia de Aguiar

    2016-09-01

    Full Text Available BACKGROUND. Demographic and clinical predictors of aphasia recovery have been identified in the literature. However, little attention has been devoted to identifying and distinguishing predictors of improvement for different outcomes, e.g., production of treated vs. untreated materials. These outcomes may rely on different mechanisms, and therefore be predicted by different variables. Furthermore, treatment features are not typically accounted for when studying predictors of aphasia recovery. This is partly due to the small numbers of cases reported in studies, but also to limitations of data analysis techniques usually employed. METHOD. We reviewed the literature on predictors of aphasia recovery, and conducted a meta-analysis of single-case studies designed to assess the efficacy of treatments for verb production. The contribution of demographic, clinical, and treatment-related variables was assessed by means of Random Forests (a machine-learning technique used in classification and regression. Two outcomes were investigated: production of treated (for 142 patients and untreated verbs (for 166 patients. RESULTS. Improved production of treated verbs was predicted by a three-way interaction of pre-treatment scores on tests for verb comprehension and word repetition, and the frequency of treatment sessions. Improvement in production of untreated verbs was predicted by an interaction including the use of morphological cues, presence of grammatical impairment, pre-treatment scores on a test for noun comprehension and frequency of treatment sessions. CONCLUSION. Improvement in the production of treated verbs occurs frequently. It may depend on restoring access to and/or knowledge of lexeme representations, and requires relative sparing of semantic knowledge (as measured by verb comprehension and phonological output abilities (including working memory, as measured by word repetition. Improvement in the production of untreated verbs has not been

  3. Effects of Repetitive Transcranial Magnetic Stimulation in the Rehabilitation of Communication and Deglutition Disorders: Systematic Review of Randomized Controlled Trials.

    Science.gov (United States)

    Gadenz, Camila Dalbosco; Moreira, Tais de Campos; Capobianco, Dirce Maria; Cassol, Mauriceia

    2015-01-01

    To systematically review randomized controlled trials that evaluate the effects of repetitive transcranial magnetic stimulation (rTMS) on rehabilitation aspects related to communication and swallowing functions. A search was conducted on PubMed, Clinical Trials, Cochrane Library, and ASHA electronic databases. Studies were judged according to the eligibility criteria and analyzed by 2 independent and blinded researchers. We analyzed 9 studies: 4 about aphasia, 3 about dysphagia, 1 about dysarthria in Parkinson's disease and 1 about linguistic deficits in Alzheimer's disease. All aphasia studies used low-frequency rTMS to stimulate Broca's homologous area. High-frequency rTMS was applied over the pharyngoesophageal cortex from the left and/or right hemisphere in the dysphagia studies and over the left dorsolateral prefrontal cortex in the Parkinson's and Alzheimer's studies. Two aphasia and all dysphagia studies showed a significant improvement of the disorder, compared to the sham group. The other 2 studies related to aphasia found a benefit restricted to subgroups with a severe case or injury on the anterior portion of the language cortical area, respectively, whereas the Alzheimer's study demonstrated positive effects specific to auditory comprehension. There were no changes for vocal function in the Parkinson's study. The benefits of the technique and its applicability in neurogenic disorders related to communication and deglutition are still uncertain. Therefore, other randomized controlled trials are needed to clarify the optimal stimulation protocol for each disorder studied and its real effects. © 2015 S. Karger AG, Basel.

  4. PREDICTING APHASIA TYPE FROM BRAIN DAMAGE MEASURED WITH STRUCTURAL MRI

    Science.gov (United States)

    Yourganov, Grigori; Smith, Kimberly G.; Fridriksson, Julius; Rorden, Chris

    2015-01-01

    Chronic aphasia is a common consequence of a left-hemisphere stroke. Since the early insights by Broca and Wernicke, studying the relationship between the loci of cortical damage and patterns of language impairment has been one of the concerns of aphasiology. We utilized multivariate classification in a cross-validation framework to predict the type of chronic aphasia from the spatial pattern of brain damage. Our sample consisted of 98 patients with five types of aphasia (Broca’s, Wernicke’s, global, conduction, and anomic), classified based on scores on the Western Aphasia Battery. Binary lesion maps were obtained from structural MRI scans (obtained at least 6 months poststroke, and within 2 days of behavioural assessment); after spatial normalization, the lesions were parcellated into a disjoint set of brain areas. The proportion of damage to the brain areas was used to classify patients’ aphasia type. To create this parcellation, we relied on five brain atlases; our classifier (support vector machine) could differentiate between different kinds of aphasia using any of the five parcellations. In our sample, the best classification accuracy was obtained when using a novel parcellation that combined two previously published brain atlases, with the first atlas providing the segmentation of grey matter, and the second atlas used to segment the white matter. For each aphasia type, we computed the relative importance of different brain areas for distinguishing it from other aphasia types; our findings were consistent with previously published reports of lesion locations implicated in different types of aphasia. Overall, our results revealed that automated multivariate classification could distinguish between aphasia types based on damage to atlas-defined brain areas. PMID:26465238

  5. Predicting aphasia type from brain damage measured with structural MRI.

    Science.gov (United States)

    Yourganov, Grigori; Smith, Kimberly G; Fridriksson, Julius; Rorden, Chris

    2015-12-01

    Chronic aphasia is a common consequence of a left-hemisphere stroke. Since the early insights by Broca and Wernicke, studying the relationship between the loci of cortical damage and patterns of language impairment has been one of the concerns of aphasiology. We utilized multivariate classification in a cross-validation framework to predict the type of chronic aphasia from the spatial pattern of brain damage. Our sample consisted of 98 patients with five types of aphasia (Broca's, Wernicke's, global, conduction, and anomic), classified based on scores on the Western Aphasia Battery (WAB). Binary lesion maps were obtained from structural MRI scans (obtained at least 6 months poststroke, and within 2 days of behavioural assessment); after spatial normalization, the lesions were parcellated into a disjoint set of brain areas. The proportion of damage to the brain areas was used to classify patients' aphasia type. To create this parcellation, we relied on five brain atlases; our classifier (support vector machine - SVM) could differentiate between different kinds of aphasia using any of the five parcellations. In our sample, the best classification accuracy was obtained when using a novel parcellation that combined two previously published brain atlases, with the first atlas providing the segmentation of grey matter, and the second atlas used to segment the white matter. For each aphasia type, we computed the relative importance of different brain areas for distinguishing it from other aphasia types; our findings were consistent with previously published reports of lesion locations implicated in different types of aphasia. Overall, our results revealed that automated multivariate classification could distinguish between aphasia types based on damage to atlas-defined brain areas. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Analyses of AphasiaBank Data

    Directory of Open Access Journals (Sweden)

    Brian Macwhinney

    2015-04-01

    7.\tSocial Factors. Four studies have examined the impact of social factors such as dialect, gender, educational level, and occupation on performance in the protocol. 8.\tTreatment and Recovery. Several studies are now examining patterns of recovery based on successive administrations of the protocol, as well as repeated work with the scripting treatment. Work is in progress to extend AphasiaBank to include data on scripted repetition, participation in group therapy discussions, famous people descriptions, interactions with web-based therapy, and dense longitudinal tracking.

  7. Aphasia Classification Using Neural Networks

    DEFF Research Database (Denmark)

    Axer, H.; Jantzen, Jan; Berks, G.

    2000-01-01

    A web-based software model (http://fuzzy.iau.dtu.dk/aphasia.nsf) was developed as an example for classification of aphasia using neural networks. Two multilayer perceptrons were used to classify the type of aphasia (Broca, Wernicke, anomic, global) according to the results in some subtests...

  8. LASER BIOLOGY AND MEDICINE: Effect of repetitive laser pulses on the electrical conductivity of intervertebral disc tissue

    Science.gov (United States)

    Omel'chenko, A. I.; Sobol', E. N.

    2009-03-01

    The thermomechanical effect of 1.56-μm fibre laser pulses on intervertebral disc cartilage has been studied using ac conductivity measurements with coaxial electrodes integrated with an optical fibre for laser radiation delivery to the tissue. The observed time dependences of tissue conductivity can be interpreted in terms of hydraulic effects and thermomechanical changes in tissue structure. The laserinduced changes in the electrical parameters of the tissue are shown to correlate with the structural changes, which were visualised using shadowgraph imaging. Local ac conductivity measurements in the bulk of tissue can be used to develop a diagnostic/monitoring system for laser regeneration of intervertebral discs.

  9. Starting an aphasia center?

    Science.gov (United States)

    Elman, Roberta J

    2011-08-01

    Starting an aphasia center can be an enormous challenge. This article provides initial issues to review and consider when deciding whether starting a new organization is right for you. Determining the need for the program in your community, the best size and possible affiliation for the organization, and available resources, as well as developing a business plan, marketing the program, and building awareness in the community, are some of the factors that are discussed. Specific examples related to starting the Aphasia Center of California are provided. © Thieme Medical Publishers.

  10. Former Auctioneer Finds Voice After Aphasia

    Science.gov (United States)

    ... Aphasia Follow us Former Auctioneer Finds Voice After Aphasia Speech impairment changed his life One unremarkable September ... 10 Tips for Communicating with Someone who has Aphasia Talk to them in a quiet, calm, relaxed ...

  11. Using computers to enable self-management of aphasia therapy exercises for word finding: the patient and carer perspective.

    Science.gov (United States)

    Palmer, Rebecca; Enderby, Pam; Paterson, Gail

    2013-01-01

    Speech and language therapy (SLT) for aphasia can be difficult to access in the later stages of stroke recovery, despite evidence of continued improvement with sufficient therapeutic intensity. Computerized aphasia therapy has been reported to be useful for independent language practice, providing new opportunities for continued rehabilitation. The success of this option depends on its acceptability to patients and carers. To investigate factors that affect the acceptability of independent home computerized aphasia therapy practice. An acceptability study of computerized therapy was carried out alongside a pilot randomized controlled trial of computer aphasia therapy versus usual care for people more than 6 months post-stroke. Following language assessment and computer exercise prescription by a speech and language therapist, participants practised three times a week for 5 months at home with monthly volunteer support. Semi-structured interviews were conducted with 14 participants who received the intervention and ten carers (n = 24). Questions from a topic guide were presented and answered using picture, gesture and written support. Interviews were audio recorded, transcribed verbatim and analysed thematically. Three research SLTs identified and cross-checked themes and subthemes emerging from the data. The key themes that emerged were benefits and disadvantages of computerized aphasia therapy, need for help and support, and comparisons with face-to-face therapy. The independence, flexibility and repetition afforded by the computer was viewed as beneficial and the personalized exercises motivated participants to practise. Participants and carers perceived improvements in word-finding and confidence-talking. Computer practice could cause fatigue and interference with other commitments. Support from carers or volunteers for motivation and technical assistance was seen as important. Although some participants preferred face-to-face therapy, using a computer for

  12. Perseveration and other repetitive verbal behaviors: functional dissociations.

    Science.gov (United States)

    Christman, Sarah S; Boutsen, Frank R; Buckingham, Hugh W

    2004-11-01

    This article will review types of perseveration from a neurolinguistic perspective. During the course of the article, continuous, stuck-in-set, and recurrent perseveration will be placed in contradistinction to several other types of repetitive behaviors commonly associated with neurogenic communication disorders. These include echolalia in mixed transcortical aphasia; conduite d'approche and conduite d'ecart in fluent aphasias; lexical and nonlexical automatisms in nonfluent aphasias; palilalia in neuromotor disorders, such as Parkinson's disease (PD); and sound, syllable, word, and phrase repetitions in neurogenic stuttering. When differentiating these phenomena from perseveration, it is helpful to consider the salient factors that condition observed behaviors in individual patients, such as overall speech fluency, inventory of available utterances, nature of eliciting tasks, and propositionality of responses. Information such as communication disorder diagnosis, underlying etiology, and known sites of lesion from each patient's total clinical profile may also assist with differentiation.

  13. Crossroads in aphasia rehabilitation

    NARCIS (Netherlands)

    W.M.E. van de Sandt-Koenderman (Mieke)

    2007-01-01

    textabstractThis thesis focusses on two types of aphasia rehabilitation, cognitive linguistic treatment (CLT) and AAC (Augmentative and Alternative Communication) training. In a study of the effect of nonlinguistic variables on the outcome of CLT, it was shown, that neuropsychological data

  14. Severity of Post-stroke Aphasia According to Aphasia Type and Lesion Location in Koreans

    OpenAIRE

    Kang, Eun Kyoung; Sohn, Hae Min; Han, Moon-Ku; Kim, Won; Han, Tai Ryoon; Paik, Nam-Jong

    2009-01-01

    To determine the relations between post-stroke aphasia severity and aphasia type and lesion location, a retrospective review was undertaken using the medical records of 97 Korean patients, treated within 90 days of onset, for aphasia caused by unilateral left hemispheric stroke. Types of aphasia were classified according to the validated Korean version of the Western Aphasia Battery (K-WAB), and severities of aphasia were quantified using WAB Aphasia Quotients (AQ). Lesion locations were clas...

  15. Extending knowledge of the public awareness of aphasia in the Balkans: Serbia and Montenegro.

    Science.gov (United States)

    Vuković, Mile; Matić, Dušanka; Kovač, Ana; Vuković, Irena; Code, Chris

    2017-11-01

    Public awareness of aphasia has been surveyed in a number of countries revealing that it is universally low. We report results of surveys in the Balkan countries Serbia and Montenegro and compare results with data from Croatia and Slovenia. Convenience surveys of the general public were conducted in public places like shopping centers/malls and parks in Serbia (N = 400) and Montenegro (N = 500) using an adapted version of the public awareness of aphasia survey questionnaire. Respondents were asked whether they have heard of aphasia and tested with questions about aphasia. Information on gender, age, occupation and education was recorded. Twelve percent (Serbia) and 11% (Montenegro) had heard of aphasia, but just 4% (Serbia) and 3.2% (Montenegro) had a basic knowledge of aphasia. Age, gender and occupation interacted variably with awareness. Between 16% (Slovenia) and 60% (Croatia) said they had heard of aphasia (10.5% overall mean for the four countries) and basic knowledge of aphasia across the four countries ranged between 3.2 and 7%. Levels of awareness of aphasia in the Balkans are low and variably associated with age, gender, socio-economic and educational levels. Respondents with some knowledge of aphasia gained it through personal or professional interaction with aphasia or the media. The data provide a basis for awareness raising in Balkan countries to reduce stigmatization, improve community access and understanding. Implications for rehabilitation Awareness of aphasia is low universally, even among healthcare workers. Low public awareness of a condition, like aphasia, results in under-funded research and service provision. In order to raise public awareness of aphasia we need to know how many members of the general public know about it. Improvements in public awareness could positively affect funding, the quality of services, and the public understanding and acceptance of individuals with aphasia in the community. Improving awareness of aphasia in

  16. Current concepts in adult aphasia.

    Science.gov (United States)

    McNeil, M R

    1984-01-01

    This paper provides a review of recent research from the areas of speech and language pathology, cognitive psychology, psycholinguistics, neurology, and rehabilitation medicine which is used to refine and extend current definitions of aphasia. Evidence is presented from these diverse disciplines, which supports a multimodality, performance-based, verbal and non-verbal, cortical and subcortical, and cognitively multidimensional view of aphasia. A summary of current practice in the assessment and treatment of adult aphasia is summarized.

  17. TMS suppression of right pars triangularis, but not pars opercularis, improves naming in aphasia

    Science.gov (United States)

    Naeser, Margaret A.; Martin, Paula I.; Theoret, Hugo; Kobayashi, Masahito; Fregni, Felipe; Nicholas, Marjorie; Tormos, Jose M.; Steven, Megan S.; Baker, Errol H.; Pascual-Leone, Alvaro

    2011-01-01

    This study sought to discover if an optimum 1 cm2 area in the non-damaged right hemisphere (RH) was present, which could temporarily improve naming in chronic, nonfluent aphasia patients when suppressed with repetitive transcranial magnetic stimulation (rTMS). Ten minutes of slow, 1 Hz rTMS was applied to suppress different RH ROIs in eight aphasia cases. Picture naming and response time (RT) were examined before, and immediately after rTMS. In aphasia patients, suppression of right pars triangularis (PTr) led to significant increase in pictures named, and significant decrease in RT. Suppression of right pars opercularis (POp), however, led to significant increase in RT, but no change in number of pictures named. Eight normals named all pictures correctly; similar to aphasia patients, RT significantly decreased following rTMS to suppress right PTr, versus right POp. Differential effects following suppression of right PTr versus right POp suggest different functional roles for these regions. PMID:21864891

  18. A Comparison of Coverbal Gesture Use in Oral Discourse Among Speakers With Fluent and Nonfluent Aphasia

    Science.gov (United States)

    Law, Sam-Po; Chak, Gigi Wan-Chi

    2017-01-01

    Purpose Coverbal gesture use, which is affected by the presence and degree of aphasia, can be culturally specific. The purpose of this study was to compare gesture use among Cantonese-speaking individuals: 23 neurologically healthy speakers, 23 speakers with fluent aphasia, and 21 speakers with nonfluent aphasia. Method Multimedia data of discourse samples from these speakers were extracted from the Cantonese AphasiaBank. Gestures were independently annotated on their forms and functions to determine how gesturing rate and distribution of gestures differed across speaker groups. A multiple regression was conducted to determine the most predictive variable(s) for gesture-to-word ratio. Results Although speakers with nonfluent aphasia gestured most frequently, the rate of gesture use in counterparts with fluent aphasia did not differ significantly from controls. Different patterns of gesture functions in the 3 speaker groups revealed that gesture plays a minor role in lexical retrieval whereas its role in enhancing communication dominates among the speakers with aphasia. The percentages of complete sentences and dysfluency strongly predicted the gesturing rate in aphasia. Conclusions The current results supported the sketch model of language–gesture association. The relationship between gesture production and linguistic abilities and clinical implications for gesture-based language intervention for speakers with aphasia are also discussed. PMID:28609510

  19. Error Variability and the Differentiation between Apraxia of Speech and Aphasia with Phonemic Paraphasia

    Science.gov (United States)

    Haley, Katarina L.; Jacks, Adam; Cunningham, Kevin T.

    2013-01-01

    Purpose: This study was conducted to evaluate the clinical utility of error variability for differentiating between apraxia of speech (AOS) and aphasia with phonemic paraphasia. Method: Participants were 32 individuals with aphasia after left cerebral injury. Diagnostic groups were formed on the basis of operationalized measures of recognized…

  20. Localization of lesions in aphasia. Clinical-CT scan correlations, (1)

    Energy Technology Data Exchange (ETDEWEB)

    Hojo, Kei; Watanabe, Shunzo; Tasaki, Hiroichi; Sato, Tokijiro; Metoki, Hirobumi

    1984-10-01

    Using a microcomputer, the locus and extent of lesions in 127 patients with various types of aphasia was demonstrated by computerized tomography. The relationship between the foci of the lesions and the types of aphasia was investigated. Broca, Wernicke, amnestic, conduction and global aphasics were included in the study.

  1. [Aphasia and artistic creation].

    Science.gov (United States)

    Kornyey, E

    1977-01-01

    An artist active drawing and waterpainting, most prominent in sculpture, suffered an apopleptic insult at 66 years of age. Right hemiparesis and severe motor aphasia remained but this with rare unexpected and sometimes rather complicated productions in spoken, and also in written language in spite of modest progress in writing exercise. His behaviour witnessed of the memory of remote and complicated stored material. Some months after the insult he resumed his artistic activity using his left hand and continued it principally in the same manner as before his illness. His drawing and water-painting displayed some uncertainty of lines and sometimes coarseness of the stain spots. His pieces of sculpture regained the quality of his earlier works, as proven already by the first statue he made after the insult. While it is generally accepted that the motor aphasia does not essentially affect the artistic production, even of high quality, in painting, this is the first instance which proves that the same holds true for sculpture. In this case the mechanisms inciting the finest innervation on the side of the cortical center of the left hand, can work with promptness. In motor aphasia the mechanisms indispensable for the correct realisation of the function are affected without a final extinction of the function itself. Motor asphasia is an instrumental disorder not necessarily accompanied by disturbances of the intelligence.

  2. Research with Transcranial Magnetic Stimulation in the Treatment of Aphasia

    Science.gov (United States)

    Martin, Paula I; Naeser, Margaret A.; Ho, Michael; Treglia, Ethan; Kaplan, Elina; Baker, Errol H.; Pascual-Leone, Alvaro

    2010-01-01

    Repetitive transcranial magnetic stimulation (rTMS) has been used to improve language behavior, including naming, in stroke patients with chronic, nonfluent aphasia. Part 1 of this paper reviews functional imaging studies related to language recovery in aphasia. Part 2 reviews the rationale for using rTMS to treat nonfluent aphasia (based on functional imaging); and presents our current rTMS protocol. We present language results from our rTMS studies, and imaging results from overt naming fMRI scans obtained pre- and post- a series of rTMS treatments. Part 3 presents results from a pilot study where rTMS treatments were followed immediately by constraint-induced language therapy. Part 4 reviews our diffusion tensor imaging study that examined possible connectivity of arcuate fasciculus to different parts of Broca’s area (pars triangularis, PTr; pars opercularis, POp); and to ventral premotor cortex (vPMC). The potential role of mirror neurons in R POp and vPMC in aphasia recovery is discussed. PMID:19818232

  3. Word deafness in Wernicke's aphasia.

    OpenAIRE

    Kirshner, H S; Webb, W G; Duncan, G W

    1981-01-01

    Three patients with otherwise typical Wernicke's aphasia showed consistent superiority of visual over auditory comprehension. The precedents for and anatomical basis of a selective auditory deficit in Wernicke's aphasia are discussed, including the relationship to pure word deafness. One implication of spared visual language function may be the use of gesture in language therapy for such patients.

  4. Aphasia, an acquired language disorder

    African Journals Online (AJOL)

    2009-10-11

    Oct 11, 2009 ... In this article we will review the types of aphasia, an approach to its diagnosis, aphasia subtypes, rehabilitation and prognosis. ... language processing in both the written and spoken forms.6 ... The angular gyrus (Brodman area 39) is located at the .... of his or her quality of life, emotional state, sense of well-.

  5. Symptoms of aphasia and lesions in the brain

    International Nuclear Information System (INIS)

    Totsuka, Genkichi; Fujibayashi, Mariko; Funai, Hiroaki; Fukusako, Yoko; Sasanuma, Sumiko.

    1981-01-01

    Sixty-nine cases with a variety of types of aphasia were studied to determine the relationship between the locus and extent of the lesion, as demonstrated by cranial tomography, and the speech and language function of the patients, as evaluated by the Comprehensive Examination of Aphasia (CEA, the latest revised version of the Schuell-Sasanuma Diagnosis Test of Aphasia). The figure of the lateral view of the brain illustrating the lesion site was made from the horizontal tomogram for each patient. The figures thus obtained for all the patients in each subtest of ECA were processed by the following two methods: (1) a superimposed illustration showing only the patients whose test scores were smaller than the average and (2) an illustration showing the distribution of the average test scores on the lateral view of the brain. The results were summarized as follows: 1. Of 14 speech and language tests, the performance in the 6 areas listed below was exclusively related to the frontal lobe: description of pictured situation phonemic paraphasia fluency imitating examiner; palatal movements rapid repetition of monosyllables rapid repetition of three-syllables (e.g., pa-ta-ka) 2. Concerning the speech areas in the frontal lobe, they were distributed throughout instead of being limited to Broca's area. 3. It became clear that the performance in all the areas except those mentioned above had a close connection with the parietal, temporal, and occipital lobes, while, at the same time, partly involving the frontal lobe. (author)

  6. Improved language in a chronic nonfluent aphasia patient after treatment with CPAP and TMS.

    Science.gov (United States)

    Naeser, Margaret A; Martin, Paula I; Lundgren, Kristine; Klein, Reva; Kaplan, Jerome; Treglia, Ethan; Ho, Michael; Nicholas, Marjorie; Alonso, Miguel; Pascual-Leone, Alvaro

    2010-03-01

    To present pretreatment and post-treatment language data for a nonfluent aphasia patient who received 2 treatment modalities: (1) continuous positive airway pressure (CPAP) for his sleep apnea, starting 1-year poststroke; and (2) repetitive transcranial magnetic brain stimulation (TMS), starting 2 years poststroke. Language data were acquired beyond the spontaneous recovery period of 3 to 6 months poststroke onset. CPAP restores adequate oxygen flow throughout all stages of sleep, and may improve cognition. A series of slow, 1 Hz repetitive TMS treatments to suppress a posterior portion of right pars triangularis has been shown to improve phrase length and naming in chronic nonfluent aphasia. The Boston Diagnostic Aphasia Examination and Boston Naming Test were administered pre-CPAP, and after 2 to 5 months of CPAP. These same tests were administered pre-TMS, and at 3 and 6 months post-TMS, and again 2.4 years later. Post-CPAP testing showed increased Phrase Length, Auditory Comprehension, and naming Animals and Tools/Implements (Boston Diagnostic Aphasia Examination). Testing at 3 and 6 months post-TMS showed significant increase in Phrase Length, Auditory Comprehension, and Boston Naming Test compared with pre-TMS. These gains were retained at 2.4 years post-TMS. CPAP use continued throughout. Physiologic treatment interventions may promote language recovery in chronic aphasia.

  7. Crossed aphasia with jargonagraphia due to right putaminal hemorrhage

    International Nuclear Information System (INIS)

    Washimi, Yukihiko; Makishita, Hideo; Miyasaka, Motomaro; Fujita, Tsutomu; Yanagisawa, Nobuo.

    1987-01-01

    The patient was a 47 year-old right handed male. He had been dextral since infancy with no familial background of sinistrality. On June 10, 1982 he suddenly developed hemiplegia, hemisensory disturbance on the left side and aphasia. On the same day he fell into a coma. CT scan revealed right putaminal hemorrhage. The patient was operated on to evacuate the hematoma. On October 25 he was admitted to our hospital, when left spastic hemiplegia, sensory deficit and left Babinski sign were noted. Neuropsychological examination showed fluent spontaneous speech but no dysprosodia. The result of Standard language test of aphasia were fairly good except for naming low frequency words. Repetition and auditory comprehension were normal. Dyslexia was not observed. Dyscaliculia was also observed. Idiomotor apraxia, ideational apraxia and dressing apraxia were not observed. This case is characterized by 1) fluent aphasia without agrammatism, and 2) jargonagraphia. Fluent aphasia in a right-hander is said to be caused by a left postrolandic lesion. Lesions judged by computed tomography were located from the right putamen to the corona radiata. Single photon emission CT (SPECT) was performed with the 133 Xe inhalation method. SPECT revealed a low blood flow area in the basal ganglia, a branch of the right anterior cerebral and of the middle cerebral artery. Furthermore the low blood flow area extended to the post-central gyrus of the right cerebrum. No obvious low blood flow area was seen in the left hemisphere. The most difficult problem for clinical diagnosis of crossed aphasia is whether the lesion is localized solely in the right hemisphere or not. SPECT is very helpful for detecting lesions not revealed by CT. (J.P.N.)

  8. Interaction-focussed therapy for aphasia: Effects on communication and quality of life.

    Science.gov (United States)

    Barnes, Scott; Nickels, Lyndsey

    2017-07-06

    This study examined the effects of an interaction-focussed therapy for aphasia, which involved both people with aphasia and their familiar conversation partners. It was hypothesised the interaction-focussed therapy would lead to positive changes in targeted conversation behaviours, and improved quality of life for participants with aphasia. Three people with chronic aphasia and three of their familiar conversation partners completed an 8-week interaction-focussed therapy programme. A series of single case multiple-baseline ABA experiments were conducted. Outcome measures focussed on changes in targeted behaviours between pre- and post-therapy conversation samples, and changes in quality of life. All participant dyads improved their conversations. Familiar conversation partners demonstrated significant changes in targeted behaviours, while only one participant with aphasia achieved significant improvements. There was little evidence of a positive impact on quality of life for participants with aphasia. Interaction-focussed therapy enhances everyday communication for people with aphasia and their conversation partners. However, the complex nature of learning in this intervention means that further, likely interdisciplinary work is required to better understand what mediates skill acquisition and therapeutic change and its psychosocial impact. This information is particularly important for optimising interaction-focussed therapy for people with aphasia.

  9. Slowly progressive fluent aphasia

    International Nuclear Information System (INIS)

    Sakurai, Yasuhisa; Momose, Toshimitsu; Watanabe, Toshiaki; Ishikawa, Takashi; Iwata, Makoto; Bando, Mitsuaki.

    1991-01-01

    Three patients with slowly progressive fluent aphasia are reported. One of the patients presented with memory disturbance. They were characterized clinically by having selective deficits in vocabulary, which resulted in impairment of confrontation naming, and auditory comprehension. MRI showed an atrophy not only in the left temporal lobe (including the superior, middle and inferior temporal gyri), hippocampus, parahippocampual gyrus, and fusiform gyrus, but also in the left parietal lobe. I-123 IMP SPECT and F-18 FDG PET were used to determine regional cerebral blood flow and regional cerebral metabolic rate, respectively. In addition to the decreased tracer uptake in the left temporal and/or parietal lobe, a decreased uptake was seen in the bilateral basal ganglia, the inner side of the temporal lobe (including the bilateral hippocampus), the right anterior temporal lobe, and the left thalamus. These findings may deny the previous thought that lesions are localized in slowly progressive fluent aphasia. Furthermore, noticeable difficulty in naming, i.e., patients unable to recognize the right answer, are considered attributable to widespread lesions from the whole left temporal lobe, including the hippocampus, to the right temporal lobe. (N.K.)

  10. Classification and clinicoradiologic features of primary progressive aphasia (PPA) and apraxia of speech.

    Science.gov (United States)

    Botha, Hugo; Duffy, Joseph R; Whitwell, Jennifer L; Strand, Edythe A; Machulda, Mary M; Schwarz, Christopher G; Reid, Robert I; Spychalla, Anthony J; Senjem, Matthew L; Jones, David T; Lowe, Val; Jack, Clifford R; Josephs, Keith A

    2015-08-01

    The consensus criteria for the diagnosis and classification of primary progressive aphasia (PPA) have served as an important tool in studying this group of disorders. However, a large proportion of patients remain unclassifiable whilst others simultaneously meet criteria for multiple subtypes. We prospectively evaluated a large cohort of patients with degenerative aphasia and/or apraxia of speech using multidisciplinary clinical assessments and multimodal imaging. Blinded diagnoses were made using operational definitions with important differences compared to the consensus criteria. Of the 130 included patients, 40 were diagnosed with progressive apraxia of speech (PAOS), 12 with progressive agrammatic aphasia, 9 with semantic dementia, 52 with logopenic progressive aphasia, and 4 with progressive fluent aphasia, while 13 were unclassified. The PAOS and progressive fluent aphasia groups were least impaired. Performance on repetition and sentence comprehension was especially poor in the logopenic group. The semantic and progressive fluent aphasia groups had prominent anomia, but only semantic subjects had loss of word meaning and object knowledge. Distinct patterns of grey matter loss and white matter changes were found in all groups compared to controls. PAOS subjects had bilateral frontal grey matter loss, including the premotor and supplementary motor areas, and bilateral frontal white matter involvement. The agrammatic group had more widespread, predominantly left sided grey matter loss and white matter abnormalities. Semantic subjects had bitemporal grey matter loss and white matter changes, including the uncinate and inferior occipitofrontal fasciculi, whereas progressive fluent subjects only had left sided temporal involvement. Logopenic subjects had diffuse and bilateral grey matter loss and diffusion tensor abnormalities, maximal in the posterior temporal region. A diagnosis of logopenic aphasia was strongly associated with being amyloid positive (46

  11. Living successfully with aphasia: a qualitative meta-analysis of the perspectives of individuals with aphasia, family members, and speech-language pathologists.

    Science.gov (United States)

    Brown, Kyla; Worrall, Linda E; Davidson, Bronwyn; Howe, Tami

    2012-04-01

    The concept of living successfully with aphasia has recently emerged as an alternative to more traditional "deficit" models in aphasiology, encouraging a focus on positive rather than negative outcomes. This research aimed to integrate findings from studies exploring the perspectives of three participant groups (individuals with aphasia, speech-language pathologists, and family members) about living successfully with aphasia. Qualitative meta-analysis of three studies conducted by the authors was used to integrate perspectives across the participant groups. Steps in the qualitative meta-analysis were based on those described in the process of "meta-ethnography" by Noblit and Hare (1988) . Analysis was an inductive process, in which data from each study were re-analysed and translated into each other in order to identify higher-level overarching themes that accounted for similarities and discrepancies across the original studies. A total of seven overarching themes related to living successfully with aphasia were identified. These were: participation, meaningful relationships, support, communication, positivity, independence and autonomy, and living successfully with aphasia as a journey over time. Findings indicate the need for a holistic, client-centred approach that considers communication in the broader context of an individual's daily life. The overarching themes may act as guides for areas of importance to be addressed in clinical practice, as well as in future research. By working in partnership with individuals with aphasia and their families, speech-language pathologists are challenged to continue to improve services and assist clients on their journey of living successfully with aphasia.

  12. Tips for Socializing with Aphasia

    Science.gov (United States)

    ... continue to limit distractions such as background noise (music, other talking, TV). As you become more comfortable ... Aphasia," Stroke Connection Magazine, March/April 2006 (Last science update March 2013) Constraint-induced therapies (CIT) have ...

  13. Communicating with someone with aphasia

    Science.gov (United States)

    ... cases, aphasia will not get better. Improving Daily Communication There are many ways to help people with ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...

  14. Repetitive Stress Injuries

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Repetitive Stress Injuries KidsHealth / For Teens / Repetitive Stress Injuries What's ... t had any problems since. What Are Repetitive Stress Injuries? Repetitive stress injuries (RSIs) are injuries that ...

  15. An Introduction to Research on Aphasia

    Institute of Scientific and Technical Information of China (English)

    陈逸

    2014-01-01

    Language is a complex cognitive psychological activity exclusive to human beings. Based on scientific researches on aphasia, this paper reviews origin and classification of aphasiology, displays different aphasia symptoms, and briefly introduces brain function al ocation theory.

  16. Restoring one's language edifice: A case study of long-term effects of intensive aphasia therapy employing cognitive modifiability strategies.

    Science.gov (United States)

    Anaki, David; Goldenberg, Rosalind; Devisheim, Haim; Rosenfelder, Diana; Falik, Lou; Harif, Idit

    2016-06-23

    NG is an architect who suffered a left occipital-parietal hemorrhage cerebral vascular accident (CVA) in 2000, resulting in aphasia of Wernicke and conduction types. He was characterized with fluent paraphasic speech, decreased repetition, and impaired object naming. Comprehension was relatively preserved but reading and writing were severely compromised, as well as his auditory working memory. Despite a grim prognosis he underwent intensive aphasia therapy, lasting from 2001 to 2010, at the Center for Cognitive Rehabilitation of the Brain Injured at the Feuerstein Institute. The tailored-made interventions, applied in NG's therapy, were based upon the implementation of the principles of the Structural Mediated Learning Experience (MLE) and the Feuerstein Instrumental Enrichment (FIE) Program, to optimize his rehabilitation. As a result NG improved in most of his impaired linguistic capacities, attested by the results of neuropsychological and linguistic assessments performed throughout the years. More importantly, he was able to manage again his daily functions at a high level, and to resume his occupational role as an architect, a role which he holds to this day.

  17. Structural prediction in aphasia

    Directory of Open Access Journals (Sweden)

    Tessa Warren

    2015-05-01

    Full Text Available There is considerable evidence that young healthy comprehenders predict the structure of upcoming material, and that their processing is facilitated when they encounter material matching those predictions (e.g., Staub & Clifton, 2006; Yoshida, Dickey & Sturt, 2013. However, less is known about structural prediction in aphasia. There is evidence that lexical prediction may be spared in aphasia (Dickey et al., 2014; Love & Webb, 1977; cf. Mack et al, 2013. However, predictive mechanisms supporting facilitated lexical access may not necessarily support structural facilitation. Given that many people with aphasia (PWA exhibit syntactic deficits (e.g. Goodglass, 1993, PWA with such impairments may not engage in structural prediction. However, recent evidence suggests that some PWA may indeed predict upcoming structure (Hanne, Burchert, De Bleser, & Vashishth, 2015. Hanne et al. tracked the eyes of PWA (n=8 with sentence-comprehension deficits while they listened to reversible subject-verb-object (SVO and object-verb-subject (OVS sentences in German, in a sentence-picture matching task. Hanne et al. manipulated case and number marking to disambiguate the sentences’ structure. Gazes to an OVS or SVO picture during the unfolding of a sentence were assumed to indicate prediction of the structure congruent with that picture. According to this measure, the PWA’s structural prediction was impaired compared to controls, but they did successfully predict upcoming structure when morphosyntactic cues were strong and unambiguous. Hanne et al.’s visual-world evidence is suggestive, but their forced-choice sentence-picture matching task places tight constraints on possible structural predictions. Clearer evidence of structural prediction would come from paradigms where the content of upcoming material is not as constrained. The current study used self-paced reading study to examine structural prediction among PWA in less constrained contexts. PWA (n=17 who

  18. Testing of super conducting low-beta 704 Mhz cavities at 50 Hz pulse repetition rate in view of SPL- first results

    CERN Document Server

    Höfle, W; Lollierou, J; Valuch, D; Chel, S; Devanz, G; Desmons, M; Piquet, O; Paparella, R; Pierini, P

    2010-01-01

    In the framework of the preparatory phase for the luminosity upgrade of the LHC (SLHC-PP ) it is foreseen to characterize two superconducting RF cavities and demonstrate compliance of the required SPL field stability in amplitude and phase using a prototype LLRF system. We report on the preparation for testing of two superconducting low-beta cavities at 50 Hz pulse repetition rate including the setting-up of the low level RF control system to evaluate the performance of the piezo-tuning system and cavity field stability in amplitude and phase. Results from tests with 50 Hz pulse repetition rate are presented. Simulations of the RF system will be used to predict the necessary specifications for power and bandwidth to control the cavity field and derive specifications for the RF system and its control. Exemplary results of the simulation are presented.

  19. ALTERNATIVE FORMS OF COMMUNICATION AMONG PERSONS WITH APHASIA

    Directory of Open Access Journals (Sweden)

    Elena TASHKOVA

    2012-03-01

    group included 30 members of the patients' families and the third group included 27 persons of the medical personnel employed in the physical therapy in Shtip. The research included patients that recovered from a brain stroke between 2009 and 2010, having at least four months being passed after the brain stroke and were in a phase of stabilization of the disease. The respondents, the members of their families and the medical personnel were questioned regarding the AAK, after which an evaluation of the effects of using the different forms of AAK was made. The descriptive statistics show the structure and the inferential statistic c²test analyzes the difference in the data between the categories, where this difference is considered as significant at level of p<0.05. The results of the research are given by a specific order. An important part of the results is dedicated to the analysis of the data conducted after examining the medical personnel regarding the possibility for communication and understanding the persons with Brokin's and Vernike's aphasia. At the end of this chapter are given the results conducted after examining the patients' caregivers. Special importance has the comparison of the results conducted from the persons with Brokin's and Vernike's aphasia, regarding their separate values for using the alternative forms and methods of communication. In the Discussion the results of the research are analyzed and they are compared against the results conducted by other authors. Then they are brought in connection with postulation of the possibility and the meaning that using alternative methods of communication in the rehabilitation of the patients suffering from aphasia has, as well as their integration in the family and the wider social setting. In accordance to the goals, the established hypothesis and the results from the research, certain conclusions are extracted of which we highlight the following:1. There is a difference between the persons with Brokin

  20. Creutzfeldt-Jakob Disease with Mixed Transcortical Aphasia: Insights into Echolalia

    Directory of Open Access Journals (Sweden)

    S. E. McPherson

    1994-01-01

    Full Text Available Aphasia is a common manifestation of Creutzfeldt-Jakob disease (CJD, and investigation of the linguistic disorders of CJD patients may provide insights into the neurobiological mechanisms of language and aphasia. We report an autopsy-confirmed case of CJD in which the presenting symptom was change in language abilities. The patient ultimately evidenced mixed transcortical aphasia (MTA with echolalia. Disruption of frontal-subcortical circuits with environmental dependency accounts for the symptoms in MTA, including intact repetition and echolalia. Observation in this patient and a review of the literature suggest that frontal-subcortical circuit dysfunction may contribute to the syndrome of echolalia. This hypothesis offers an alternative explanation to “isolation” of the speech area as the cause of MTA.

  1. Creutzfeldt-Jakob disease with mixed transcortical aphasia: insights into echolalia.

    Science.gov (United States)

    McPherson, S E; Kuratani, J D; Cummings, J L; Shih, J; Mischel, P S; Vinters, H V

    1994-01-01

    Aphasia is a common manifestation of Creutzfeldt-Jakob disease (CJD), and investigation of the linguistic disorders of CJD patients may provide insights into the neurobiological mechanisms of language and aphasia. We report an autopsy-confirmed case of CJD in which the presenting symptom was change in language abilities. The patient ultimately evidenced mixed transcortical aphasia (MTA) with echolalia. Disruption of frontal-subcortical circuits with environmental dependency accounts for the symptoms in MTA, including intact repetition and echolalia. Observation in this patient and a review of the literature suggest that frontal-subcortical circuit dysfunction may contribute to the syndrome of echolalia. This hypothesis offers an alternative explanation to "isolation" of the speech area as the cause of MTA.

  2. Stimulating Conversation: Enhancement of Elicited Propositional Speech in a Patient with Chronic Non-Fluent Aphasia following Transcranial Magnetic Stimulation

    Science.gov (United States)

    Hamilton, Roy H.; Sanders, Linda; Benson, Jennifer; Faseyitan, Olufunsho; Norise, Catherine; Naeser, Margaret; Martin, Paula; Coslett, H. Branch

    2010-01-01

    Although evidence suggests that patients with left hemisphere strokes and non-fluent aphasia who receive 1Hz repetitive transcranial magnetic stimulation (rTMS) over the intact right inferior frontal gyrus experience persistent benefits in naming, it remains unclear whether the effects of rTMS in these patients generalize to other language…

  3. Communication activity in stroke patients with aphasia.

    Science.gov (United States)

    Mazaux, Jean-Michel; Lagadec, Tiphaine; de Sèze, Mathieu Panchoa; Zongo, Drissa; Asselineau, Julien; Douce, Emmanuelle; Trias, Joel; Delair, Marie-France; Darrigrand, Bénédicte

    2013-04-01

    To study communication disability in stroke patients with aphasia. Prospective, multicentric cohort study of patients with aphasia, consecutively included after a first stroke, and examined 1 year later at home. Assessment included a stroke severity scale, the Barthel Index, the boston diagnostic aphasia examination, a communication questionnaire, and the aphasia depression rating scale. A total of 164 patients were included. Among the 100 survivors assessed at follow-up, 24% had severe aphasia, 12% moderate aphasia and 64% mild aphasia according to the Boston diagnostic aphasia examination severity score. Patients mainly reported difficulties in conversation with strangers and/or on abstract topics, using a phone, reading and writing administrative documents, dealing with money and outdoor communication activities. Communication was strongly related to aphasia severity. Age, gender, education level, residence status and type of stroke had no influence on communication activity. On multivariate analysis, severity of stroke and severity of aphasia on inclusion were found to account for 58% of variance and were independent predictors of the communication questionnaire score at follow-up. Documenting the most impaired communication skills may help to set priority goals for speech and language therapy in aphasia.

  4. Imaging in primary progressive aphasia

    International Nuclear Information System (INIS)

    Abe, K.; Ukita, H.; Yanagihara, T.

    1997-01-01

    Primary progressive aphasia (PPA) presents with aphasia, with or without other minor cognitive dysfunction. We report five patients with PPA to show the correlation between their clinical signs and imaging findings. The patients can be divided into those with nonfluent (group 1) and those with fluent (group 2) aphasia. The characteristic speech impairment was bradylalia in group 1 and word amnesia in group 2. Impairment of comprehension was common but mild in both groups. On MRI, patients in group 1 showed predominantly left frontal and perisylvian atrophy with reduced uptake in the same region on single photon emission computed tomography (SPECT) using technetium-99m hexamethyl propyleneamine oxime ( 99m Tc HMPAO). Patients in group 2 showed left temporal atrophy involving the superior, middle and inferior temporal gyri, hippocampus and parahippocampal gyrus on MRI and reduced uptake in the same region on SPECT. These findings correlated well with the functional anatomy of speech impairment. (orig.). With 4 figs., 1 tab

  5. Imaging in primary progressive aphasia

    Energy Technology Data Exchange (ETDEWEB)

    Abe, K. [Department of Neurology, Osaka University Medical School, 2-2 Yamadaoka, Suita, Osaka 565 (Japan); Ukita, H. [Rehabilitation Service, Osaka University Hospital, Osaka (Japan); Yanagihara, T. [Department of Neurology, Osaka University Medical School, 2-2 Yamadaoka, Suita, Osaka 565 (Japan)

    1997-08-01

    Primary progressive aphasia (PPA) presents with aphasia, with or without other minor cognitive dysfunction. We report five patients with PPA to show the correlation between their clinical signs and imaging findings. The patients can be divided into those with nonfluent (group 1) and those with fluent (group 2) aphasia. The characteristic speech impairment was bradylalia in group 1 and word amnesia in group 2. Impairment of comprehension was common but mild in both groups. On MRI, patients in group 1 showed predominantly left frontal and perisylvian atrophy with reduced uptake in the same region on single photon emission computed tomography (SPECT) using technetium-99m hexamethyl propyleneamine oxime ({sup 99m}Tc HMPAO). Patients in group 2 showed left temporal atrophy involving the superior, middle and inferior temporal gyri, hippocampus and parahippocampal gyrus on MRI and reduced uptake in the same region on SPECT. These findings correlated well with the functional anatomy of speech impairment. (orig.). With 4 figs., 1 tab.

  6. Cognitive performance and aphasia recovery.

    Science.gov (United States)

    Fonseca, José; Raposo, Ana; Martins, Isabel Pavão

    2018-03-01

    Objectives This study assessed cognitive performance of subjects with aphasia during the acute stage of stroke and evaluated how such performance relates to recovery at 3 months. Materials & methods Patients with aphasia following a left hemisphere stroke were evaluated during the first (baseline) and the fourth-month post onset. Assessment comprised non-verbal tests of attention/processing speed (Symbol Search, Cancelation Task), executive functioning (Matrix Reasoning, Tower of Hanoi, Clock Drawing, Motor Initiative), semantic (Camel and Cactus Test), episodic and immediate memory (Memory for Faces Test, 5 Objects Memory Test, and Spatial Span. Recovery was measured by the Token Test score at 3 months. The impact of baseline performance on recovery was evaluated by logistic regression adjusting for age, education, severity of aphasia and the Alberta Stroke Program Early CT (ASPECT) score. Results Thirty-nine subjects (with a mean of 66.5 ± 10.6 years of age, 17 men) were included. Average baseline cognitive performance was within normal range in all tests except in memory tests (semantic, episodic and immediate memory) for which scores were ≤-1.5sd. Subjects with poor aphasia recovery (N = 27) were older and had fewer years of formal education but had identical ASPECT score compared to those with favorable recovery. Considering each test individually, the score obtained on the Matrix Reasoning test was the only one to predict aphasia recovery (Exp(B)=24.085 p = 0.038). Conclusions The Matrix Reasoning Test may contribute to predict aphasia recovery. Cognitive performance is a measure of network disruption but may also indicate the availability of recovery strategies.

  7. Neuropharmacology In Individual With Aphasia: A Review

    Directory of Open Access Journals (Sweden)

    Mohammad Rezaei

    2017-02-01

    Full Text Available Introduction: The neuropharmacology of aphasia is an area of cognitive neuroscience. In this article we review what is known about these domain, especially with regard to treating aphasia with drugs. Neurotransmitters can improve language function in certain patients with aphasia. We discuss which neurotransmitters work for which language functions in which patients. Method: PubMed and Science databases were searched to identify studies investigated effects of drugs on language function in aphasia in peer-reviewed journals between 2000 and 2015.   Results: Studies show that Catecholamines seem especially promising for nonfluent aphasias. Dopamine agonists, in particular bromocriptine, improve verbal fluency in transcortical motor aphasia. Norepinephrine affects prefrontal functions and seems to relieve symptoms of depression and improve overall recovery of function, including language, following stroke. Amphetamines potentiate norepinephrine to promote general recovery, and have been shown to improve language performance in some patients with nonfluent aphasia. Conclusion: studies have been looking at the possibility of manipulating brain chemistry for functional gain in patients with aphasia, but, to date, no overwhelming evidence has emerged to support routine use of drugs as either a complementary or alternative treatment for aphasia. Studies have been largely anecdotal with small numbers of patients and varying types of aphasia. Improvements due to spontaneous recovery have been difficult to separate from treatment benefits.

  8. Development and standardization of Indian aphasia battery

    Directory of Open Access Journals (Sweden)

    Harsimarpreet Kaur

    2017-01-01

    Full Text Available Background: Aphasia is a language disorder which may disrupt an individual's functioning. To plan a mode of therapeutic/rehabilitative work, it is important to assess problems from a neuropsychological perspective focused on remediation of the impaired processes or compensation through the intact processes or both. Aim: Due to the paucity of tests available for the assessment of aphasia in the Indian population with specific colloquial expression, the aim of the present study was to develop an aphasia test for Hindi-speaking population and to provide evidence with its reliability and validity. Methods: The conception of the test took place in two phases: Phase 1 was the development of Indian Aphasia Battery (IAB and Phase 2 was its standardization. IAB was administered along the Hindi adaptation of the Western Aphasia Battery (WAB-H on participants with aphasia, probable aphasia, and healthy volunteers. Outcomes and Results: Based on the results of this study, IAB has a high concurrent validity and test–retest reliability in comparison to WAB-H. The subtests are sensitive enough to contribute to global aphasia quotient as a functional measure of aphasia in Indian brain-damaged patients. Conclusion: IAB is a quick and easy to administer measure for assessment of aphasia in Hindi-speaking population with high reliability and validity.

  9. Aphasia and literacy—the insider's perspective

    Science.gov (United States)

    Kjellén, Emma; Laakso, Katja

    2016-01-01

    Abstract Background Few studies have investigated how people with aphasia (PWA) experience literacy skills. Taking the insider's perspective is a way to increase understanding of the individual experiences of literacy among PWA, which may have clinical implications. Aims To describe how literacy, i.e., reading and writing, is experienced in everyday life by PWA and to gain insight into the part played by literacy skills in their lives. Methods & Procedures A qualitative descriptive research approach was taken. In‐depth interviews were conducted with 12 PWA (six women and six men) who had all lived with aphasia for at least 6 months post‐stroke. The interviews were analysed using qualitative content analysis. Outcomes & Results One overarching theme emerged from the data: literacy as an ongoing recovery process. Based on this overarching theme, two subthemes were identified: changes in conditions for literacy (experiences of reading and writing initially post‐onset compared with experiences at the time of the interview); and facing expectations about literacy (participants’ own and other people's expectations of them in terms of literacy). Conclusions & Implications The findings are important at a general level in that they indicate that PWA are able to articulate their individual experiences and thoughts about literacy, i.e., reading and writing. Specifically, PWA in this study experience literacy as playing an essential part in their lives and the findings imply that personal experiences are important in the design of reading and writing interventions in speech and language therapy. PMID:28039933

  10. An Aphasia Mentoring Program: Perspectives of Speech-Language Pathology Students and of Mentors with Aphasia

    Science.gov (United States)

    Purves, Barbara A.; Petersen, Jill; Puurveen, Gloria

    2013-01-01

    Purpose: In contrast to clinician-as-expert models, social models of clinical practice typically acknowledge people with aphasia as equal partners in intervention. Given this, there may be a place within speech-language pathology education for programs situating people with aphasia as experts. This paper describes an aphasia mentoring program that…

  11. Aphasia Centers and the Life Participation Approach to Aphasia: A Paradigm Shift

    Science.gov (United States)

    Elman, Roberta J.

    2016-01-01

    The Aphasia Center is a service delivery model that provides an interactive community for persons with aphasia. This model has been increasing in popularity over the last 20 years. Aphasia Centers are consistent with a social model of health care and disability. They offer the potential for linguistic, communicative, and psychosocial benefits. The…

  12. Frontal dynamic aphasia in progressive supranuclear palsy: Distinguishing between generation and fluent sequencing of novel thoughts.

    Science.gov (United States)

    Robinson, Gail A; Spooner, Donna; Harrison, William J

    2015-10-01

    Frontal dynamic aphasia is characterised by a profound reduction in spontaneous speech despite well-preserved naming, repetition and comprehension. Since Luria (1966, 1970) designated this term, two main forms of dynamic aphasia have been identified: one, a language-specific selection deficit at the level of word/sentence generation, associated with left inferior frontal lesions; and two, a domain-general impairment in generating multiple responses or connected speech, associated with more extensive bilateral frontal and/or frontostriatal damage. Both forms of dynamic aphasia have been interpreted as arising due to disturbances in early prelinguistic conceptual preparation mechanisms that are critical for language production. We investigate language-specific and domain-general accounts of dynamic aphasia and address two issues: one, whether deficits in multiple conceptual preparation mechanisms can co-occur; and two, the contribution of broader cognitive processes such as energization, the ability to initiate and sustain response generation over time, to language generation failure. Thus, we report patient WAL who presented with frontal dynamic aphasia in the context of progressive supranuclear palsy (PSP). WAL was given a series of experimental tests that showed that his dynamic aphasia was not underpinned by a language-specific deficit in selection or in microplanning. By contrast, WAL presented with a domain-general deficit in fluent sequencing of novel thoughts. The latter replicated the pattern documented in a previous PSP patient (Robinson, et al., 2006); however, unique to WAL, generating novel thoughts was impaired but there was no evidence of a sequencing deficit because perseveration was absent. Thus, WAL is the first unequivocal case to show a distinction between novel thought generation and subsequent fluent sequencing. Moreover, WAL's generation deficit encompassed verbal and non-verbal responses, showing a similar (but more profoundly reduced) pattern

  13. Regional cerebral blood flow in aphasia

    DEFF Research Database (Denmark)

    Soh, K; Larsen, B; Skinhøj, E

    1978-01-01

    . In motor (nonfluent) aphasia, the rCBF method showed areas of cortical dysfunction that always included the lower part of the rolandic area while Broca's area was not consistently affected. In sensory (fluent) aphasia, the superior-posterior temporal cortex was involved in all cases. In global aphasia......, the abnormalities included both regions consistently involved in the other types of aphasia. The 133Xe injection method for mapping abnormalities relevant for localizing the cortical speech areas was superior to the classical neuroradiological methods in that several cases failed to show any relevant lesion...

  14. Recurrent Wernicke's aphasia: migraine and not stroke!

    Science.gov (United States)

    Mishra, Nishant Kumar; Rossetti, Andrea O; Ménétrey, André; Carota, Antonio

    2009-05-01

    We report the clinical findings of a 40-year-old woman with recurrent migraine presenting with Wernicke's aphasia in accordance with the results of a standardized battery for language assessment (Boston Aphasia Diagnostic Examination). The patient had no evidence of parenchymal or vascular lesions on MRI and showed delta and theta slowing over the left posterior temporal leads on the EEG. Although the acute onset of a fluent aphasia suggested stroke as a likely etiology, the recurrence of aphasia as the initial symptom of migraine was related to cortical spreading depression and not to stroke.

  15. Aphasia centers in North America: a survey.

    Science.gov (United States)

    Simmons-Mackie, Nina; Holland, Audrey L

    2011-08-01

    There is a growing trend toward dedicated programs designed to improve the lives of people with aphasia and their families. We are referring to these programs collectively as "aphasia centers." These programs purportedly differ from more traditional medically based aphasia rehabilitation. However, there is no directory of aphasia centers and no definition of what constitutes such a program. Therefore, an online survey was designed to identify and describe aphasia centers in the United States and Canada. A 37-question survey was posted online via SurveyMonkey. An introductory letter was distributed by electronic mail to a listserv and mailing lists of programs associated with aphasia. Potential respondents who considered themselves an aphasia center were asked to complete the survey. A total of 33 survey responses were analyzed, and descriptive data were compiled resulting in a description of the following aspects of aphasia centers: demographic information, mission, admission and discharge policies, assessment practices, program logistics, staffing patterns, marketing, funding, and services offered. In addition, a qualitative analysis of written text responses revealed the following key themes that appear to characterize the responding programs: services that differ from traditional aphasia rehabilitation; a sense of community; a holistic focus on quality of life, psychosocial well-being, participation, and social support; the centrality of group interaction; and variety/intensity of services. © Thieme Medical Publishers.

  16. Repetition and the Concept of Repetition

    Directory of Open Access Journals (Sweden)

    Arne Grøn

    2013-11-01

    Full Text Available This paper offers a description of the meaning of the category of repetition. Firstly, it is pointed out that Constantin uses repetition as a concept that means the creation of epochs; the passing from Greece to Modernity is accomplished distinguishing between recollection, a concept that looks back to the past, and repetition, a concept that looks forward to future. Secondly, it is showed that the category of repetition, as a religious category, relates with what Climacus calls “ethic despair” and with what Vigilius calls “second ethics”; it is through repetition that it can be understood that sin finds its place in ethics and these shows the tension between it and dogmatics. And thirdly, it is showed that the descovery of the new category of repetition is a rediscovery of what Kierkegaard calls category of spirit; repetition has for its object the individuality, and coming to be oneself is what Kierkegaard undertands as liberty. At the end of the paper it is questioned if the category of repetition is inconsistent with the book Repetition.

  17. Poststroke aphasia : epidemiology, pathophysiology and treatment.

    Science.gov (United States)

    Berthier, Marcelo L

    2005-01-01

    Aphasia, the loss or impairment of language caused by brain damage, is one of the most devastating cognitive impairments of stroke. Aphasia is present in 21-38% of acute stroke patients and is associated with high short- and long-term morbidity, mortality and expenditure. Recovery from aphasia is possible even in severe cases. While speech-language therapy remains the mainstay treatment of aphasia, the effectiveness of conventional therapies has not been conclusively proved. This has motivated attempts to integrate knowledge from several domains in an effort to plan more rational therapies and to introduce other therapeutic strategies, including the use of intensive language therapy and pharmacological agents. Several placebo-controlled trials suggest that piracetam is effective in recovery from aphasia when started soon after the stroke, but its efficacy vanishes in patients with chronic aphasia. Drugs acting on catecholamine systems (bromocriptine, dexamfetamine) have shown varying degrees of efficacy in case series, open-label studies and placebo-controlled trials. Bromocriptine is useful in acute and chronic aphasias, but its beneficial action appears restricted to nonfluent aphasias with reduced initiation of spontaneous verbal messages. Dexamfetamine improves language function in subacute aphasia and the beneficial effect is maintained in the long term, but its use is restricted to highly selected samples. Pharmacological agents operating on the cholinergic system (e.g. donepezil) have shown promise. Data from single-case studies, case series and an open-label study suggest that donepezil may have beneficial effects on chronic poststroke aphasia. Preliminary evidence suggests that donepezil is well tolerated and its efficacy is maintained in the long term. Randomised controlled trials of donepezil and other cholinergic agents in poststroke aphasia are warranted.

  18. Semantic Dementia and Persisting Wernicke's Aphasia: Linguistic and Anatomical Profiles

    Science.gov (United States)

    Ogar, J. M.; Baldo, J. V.; Wilson, S. M.; Brambati, S. M.; Miller, B. L.; Dronkers, N. F.; Gorno-Tempini, M. L.

    2011-01-01

    Few studies have directly compared the clinical and anatomical characteristics of patients with progressive aphasia to those of patients with aphasia caused by stroke. In the current study we examined fluent forms of aphasia in these two groups, specifically semantic dementia (SD) and persisting Wernicke's aphasia (WA) due to stroke. We compared…

  19. Combined Aphasia and Apraxia of Speech Treatment (CAAST): effects of a novel therapy.

    Science.gov (United States)

    Wambaugh, Julie L; Wright, Sandra; Nessler, Christina; Mauszycki, Shannon C

    2014-12-01

    This investigation was designed to examine the effects of a newly developed treatment for aphasia and acquired apraxia of speech (AOS). Combined Aphasia and Apraxia of Speech Treatment (CAAST) targets language and speech production simultaneously, with treatment techniques derived from Response Elaboration Training (Kearns, 1985) and Sound Production Treatment (Wambaugh, Kalinyak-Fliszar, West, & Doyle, 1998). The purpose of this study was to determine whether CAAST was associated with positive changes in verbal language and speech production with speakers with aphasia and AOS. Four participants with chronic aphasia and AOS received CAAST applied sequentially to sets of pictures in the context of multiple baseline designs. CAAST entailed elaboration of participant-initiated utterances, with sound production training applied as needed to the elaborated productions. The dependent variables were (a) production of correct information units (CIUs; Nicholas & Brookshire, 1993) in response to experimental picture stimuli, (b) percentage of consonants correct in sentence repetition, and (c) speech intelligibility. CAAST was associated with increased CIU production in trained and untrained picture sets for all participants. Gains in sound production accuracy and speech intelligibility varied across participants; a modification of CAAST to provide additional speech production treatment may be desirable.

  20. Induction of neuroplasticity and recovery in post-stroke aphasia by non-invasive brain stimulation

    Directory of Open Access Journals (Sweden)

    Priyanka eShah

    2013-12-01

    Full Text Available Stroke victims tend to prioritize speaking, writing and walking as the three most important rehabilitation goals. Of note is that two of these goals involve communication. This underscores the significance of developing successful approaches to aphasia treatment for the several hundred thousand new aphasia patients each year and over 1 million stroke survivors with chronic aphasia in the U.S. alone. After several years of growth as a research tool, noninvasive brain stimulation (NBS is gradually entering the arena of clinical aphasiology. In this review, we first examine the current state of knowledge of post-stroke language recovery including the contributions from the dominant and non-dominant hemispheres. Next, we briefly discuss the methods and the physiologic basis of the use of inhibitory and excitatory repetitive transcranial magnetic stimulation (rTMS and transcranial direct current stimulation (tDCS as research tools in patients who experience post-stroke aphasia. Finally, we provide a critical review of the most influential evidence behind the potential use of these two brain stimulation methods as clinical rehabilitative tools.

  1. Aphasia with left occipitotemporal hypometabolism: a novel presentation of posterior cortical atrophy?

    Science.gov (United States)

    Wicklund, Meredith R; Duffy, Joseph R; Strand, Edythe A; Whitwell, Jennifer L; Machulda, Mary M; Josephs, Keith A

    2013-09-01

    Alzheimer's disease is a common neurodegenerative disease often characterized by initial episodic memory loss. Atypical focal cortical presentations have been described, including the logopenic variant of primary progressive aphasia (lvPPA) which presents with language impairment, and posterior cortical atrophy (PCA) which presents with prominent visuospatial deficits. Both lvPPA and PCA are characterized by specific patterns of hypometabolism: left temporoparietal in lvPPA and bilateral parietoccipital in PCA. However, not every patient fits neatly into these categories. We retrospectively identified two patients with progressive aphasia and visuospatial deficits from a speech and language based disorders study. The patients were further characterized by MRI, fluorodeoxyglucose F18 and Pittsburgh Compound B (PiB) positron emission tomography. Two women, aged 62 and 69, presented with a history of a few years of progressive aphasia characterized by fluent output with normal grammar and syntax, anomia without loss of word meaning, and relatively spared repetition. They demonstrated striking deficits in visuospatial function for which they were lacking insight. Prominent hypometabolism was noted in the left occipitotemporal region and diffuse retention of PiB was noted. Posterior cortical atrophy may present focally with left occipitotemporal metabolism characterized clinically with a progressive fluent aphasia and prominent ventral visuospatial deficits with loss of insight. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Induction of neuroplasticity and recovery in post-stroke aphasia by non-invasive brain stimulation.

    Science.gov (United States)

    Shah, Priyanka P; Szaflarski, Jerzy P; Allendorfer, Jane; Hamilton, Roy H

    2013-12-24

    Stroke victims tend to prioritize speaking, writing, and walking as the three most important rehabilitation goals. Of note is that two of these goals involve communication. This underscores the significance of developing successful approaches to aphasia treatment for the several hundred thousand new aphasia patients each year and over 1 million stroke survivors with chronic aphasia in the U.S. alone. After several years of growth as a research tool, non-invasive brain stimulation (NBS) is gradually entering the arena of clinical aphasiology. In this review, we first examine the current state of knowledge of post-stroke language recovery including the contributions from the dominant and non-dominant hemispheres. Next, we briefly discuss the methods and the physiologic basis of the use of inhibitory and excitatory repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) as research tools in patients who experience post-stroke aphasia. Finally, we provide a critical review of the most influential evidence behind the potential use of these two brain stimulation methods as clinical rehabilitative tools.

  3. Aphasia Handbook for Adults and Children.

    Science.gov (United States)

    Agranowitz, Aleen; McKeown, Milfred Riddle

    The occurance of aphasia in adults and children is discussed along with therapeutic measures. An orientation of what aphasia is and the problems it presents for adults is followed by a statement of present methods of retraining. Consideration is given to an evaluation of defects, attitudes and techniques in retraining, group therapy, and…

  4. Crossed Wernicke's Aphasia: A Case Report

    Science.gov (United States)

    Sheehy, Laurie M.; Haines, Mary E.

    2004-01-01

    Crossed aphasia is a phenomenon in which an individual sustains a lesion in the right hemisphere (typically non-language dominant), but who exhibits an aphasic syndrome. The authors present a case study of an individual with crossed aphasia (CA) in an attempt to provide anecdotal information for four questions posed by Pita, Karavelis, and…

  5. Primary progressive aphasia and apraxia of speech.

    Science.gov (United States)

    Jung, Youngsin; Duffy, Joseph R; Josephs, Keith A

    2013-09-01

    Primary progressive aphasia is a neurodegenerative syndrome characterized by progressive language dysfunction. The majority of primary progressive aphasia cases can be classified into three subtypes: nonfluent/agrammatic, semantic, and logopenic variants. Each variant presents with unique clinical features, and is associated with distinctive underlying pathology and neuroimaging findings. Unlike primary progressive aphasia, apraxia of speech is a disorder that involves inaccurate production of sounds secondary to impaired planning or programming of speech movements. Primary progressive apraxia of speech is a neurodegenerative form of apraxia of speech, and it should be distinguished from primary progressive aphasia given its discrete clinicopathological presentation. Recently, there have been substantial advances in our understanding of these speech and language disorders. The clinical, neuroimaging, and histopathological features of primary progressive aphasia and apraxia of speech are reviewed in this article. The distinctions among these disorders for accurate diagnosis are increasingly important from a prognostic and therapeutic standpoint. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  6. Language as a Stressor in Aphasia

    Science.gov (United States)

    Cahana-Amitay, Dalia; Albert, Martin L.; Pyun, Sung-Bom; Westwood, Andrew; Jenkins, Theodore; Wolford, Sarah; Finley, Mallory

    2012-01-01

    Background Persons with aphasia often report feeling anxious when using language while communicating. While many patients, caregivers, clinicians and researchers would agree that language may be a stressor for persons with aphasia, systematic empirical studies of stress and/or anxiety in aphasia remain scarce. Aim The aim of this paper is to review the existing literature discussing language as a stressor in aphasia, identify key issues, highlight important gaps, and propose a program for future study. In doing so, we hope to underscore the importance of understanding aspects of the emotional aftermath of aphasia, which plays a critical role in the process of recovery and rehabilitation. Main Contribution Post stroke emotional dysregulation in persons with chronic aphasia clearly has adverse effects for language performance and prospects of recovery. However, the specific role anxiety might play in aphasia has yet to be determined. As a starting point, we propose to view language in aphasia as a stressor, linked to an emotional state we term “linguistic anxiety.” Specifically, a person with linguistic anxiety is one in whom the deliberate, effortful production of language involves anticipation of an error, with the imminence of linguistic failure serving as the threat. Since anticipation is psychologically linked to anxiety and also plays an important role in the allostatic system, we suggest that examining physiologic stress responses in persons with aphasia when they are asked to perform a linguistic task would be a productive tool for assessing the potential relation of stress to “linguistic anxiety.” Conclusion Exploring the putative relationship between anxiety and language in aphasia, through the study of physiologic stress responses, could establish a platform for investigating language changes in the brain in other clinical populations, such as in individuals with Alzheimer’s disease or persons with post traumatic stress disorder, or even with

  7. Effect of aphasia on acute stroke outcomes

    Science.gov (United States)

    Boehme, Amelia K.; Martin-Schild, Sheryl; Marshall, Randolph S.

    2016-01-01

    Objective: To determine the independent effects of aphasia on outcomes during acute stroke admission, controlling for total NIH Stroke Scale (NIHSS) scores and loss of consciousness. Methods: Data from the Tulane Stroke Registry were used from July 2008 to December 2014 for patient demographics, NIHSS scores, length of stay (LOS), complications (sepsis, deep vein thrombosis), and discharge modified Rankin Scale (mRS) score. Aphasia was defined as a score >1 on question 9 on the NIHSS on admission and hemiparesis as >1 on questions 5 or 6. Results: Among 1,847 patients, 866 (46%) had aphasia on admission. Adjusting for NIHSS score and inpatient complications, those with aphasia had a 1.22 day longer LOS than those without aphasia, whereas those with hemiparesis (n = 1,225) did not have any increased LOS compared to those without hemiparesis. Those with aphasia had greater odds of having a complication (odds ratio [OR] 1.44, confidence interval [CI] 1.07–1.93, p = 0.0174) than those without aphasia, which was equivalent to those having hemiparesis (OR 1.47, CI 1.09–1.99, p = 0.0137). Controlling for NIHSS scores, aphasia patients had higher odds of discharge mRS 3–6 (OR 1.42 vs 1.15). Conclusion: Aphasia is independently associated with increased LOS and complications during the acute stroke admission, adding $2.16 billion annually to US acute stroke care. The presence of aphasia was more likely to produce a poor functional outcome than hemiparesis. These data suggest that further research is necessary to determine whether establishing adaptive communication skills can mitigate its consequences in the acute stroke setting. PMID:27765864

  8. [The phonological variant of primary progressive aphasia, a single case study].

    Science.gov (United States)

    Diesfeldt, H F A

    2011-04-01

    Primary progressive aphasia (PPA) is a neurodegenerative syndrome characterized by an insidious onset and gradual progression of deficits that can involve any aspect of language, including word finding, object naming, fluency, syntax, phonology and word comprehension. The initial symptoms occur in the absence of major deficits in other cognitive domains, including episodic memory, visuospatial abilities and visuoconstruction. According to recent diagnostic guidelines, PPA is typically divided into three variants: nonfluent variant PPA (also termed progressive nonfluent aphasia), semantic variant PPA (also termed semantic dementia) and logopenic/phonological variant PPA (also termed logopenic progressive aphasia). The paper describes a 79-yr old man, who presented with normal motor speech and production rate, impaired single word retrieval and phonemic errors in spontaneous speech and confrontational naming. Confrontation naming was strongly affected by lexical frequency. He was impaired on repetition of sentences and phrases. Reading was intact for regularly spelled words but not for irregular words (surface dyslexia). Comprehension was spared at the single word level, but impaired for complex sentences. He performed within the normal range on the Dutch equivalent of the Pyramids and Palm Trees (PPT) Pictures Test, indicating that semantic processing was preserved. There was, however, a slight deficiency on the PPT Words Test, which appeals to semantic knowledge of verbal associations. His core deficit was interpreted as an inability to retrieve stored lexical-phonological information for spoken word production in spontaneous speech, confrontation naming, repetition and reading aloud.

  9. Using language for social interaction: Communication mechanisms promote recovery from chronic non-fluent aphasia.

    Science.gov (United States)

    Stahl, Benjamin; Mohr, Bettina; Dreyer, Felix R; Lucchese, Guglielmo; Pulvermüller, Friedemann

    2016-12-01

    Clinical research highlights the importance of massed practice in the rehabilitation of chronic post-stroke aphasia. However, while necessary, massed practice may not be sufficient for ensuring progress in speech-language therapy. Motivated by recent advances in neuroscience, it has been claimed that using language as a tool for communication and social interaction leads to synergistic effects in left perisylvian eloquent areas. Here, we conducted a crossover randomized controlled trial to determine the influence of communicative language function on the outcome of intensive aphasia therapy. Eighteen individuals with left-hemisphere lesions and chronic non-fluent aphasia each received two types of training in counterbalanced order: (i) Intensive Language-Action Therapy (ILAT, an extended form of Constraint-Induced Aphasia Therapy) embedding verbal utterances in the context of communication and social interaction, and (ii) Naming Therapy focusing on speech production per se. Both types of training were delivered with the same high intensity (3.5 h per session) and duration (six consecutive working days), with therapy materials and number of utterances matched between treatment groups. A standardized aphasia test battery revealed significantly improved language performance with ILAT, independent of when this method was administered. In contrast, Naming Therapy tended to benefit language performance only when given at the onset of the treatment, but not when applied after previous intensive training. The current results challenge the notion that massed practice alone promotes recovery from chronic post-stroke aphasia. Instead, our results demonstrate that using language for communication and social interaction increases the efficacy of intensive aphasia therapy. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Communication Partner Training in Aphasia: An Updated Systematic Review.

    Science.gov (United States)

    Simmons-Mackie, Nina; Raymer, Anastasia; Cherney, Leora R

    2016-12-01

    To update a previous systematic review describing the effect of communication partner training on individuals with aphasia and their communication partners, with clinical questions addressing effects of partner training on language, communication activity/participation, psychosocial adjustment, and quality of life. Twelve electronic databases were searched using 23 search terms. References from relevant articles were hand searched. Three reviewers independently reviewed abstracts, excluding those that failed to meet inclusion criteria. Thirty-two full text articles were reviewed by 2 independent reviewers. Articles not meeting inclusion criteria were eliminated, resulting in a corpus of 25 articles for full review. For the 25 articles, 1 reviewer extracted descriptive data regarding participants, intervention, outcome measures, and results. A second reviewer verified the accuracy of the extracted data. The 3-member review team classified studies using the American Academy of Neurology levels of evidence. Two independent reviewers evaluated each article using design-specific tools to assess research quality. All 25 of the current review articles reported positive changes from partner training. Therefore, to date, 56 studies across 2 systematic reviews have reported positive outcomes from communication partner training in aphasia. The results of the current review are consistent with the previous review and necessitate no change to the earlier recommendations, suggesting that communication partner training should be conducted to improve partner skill in facilitating the communication of people with chronic aphasia. Additional high-quality research is needed to strengthen the original 2010 recommendations and expand recommendations to individuals with acute aphasia. High-quality clinical trials are also needed to demonstrate implementation of communication partner training in complex environments (eg, health care). Copyright © 2016 American Congress of

  11. Spontaneous speech: Quantifying daily communication in Spanish-speaking individuals with aphasia.

    Directory of Open Access Journals (Sweden)

    Silvia Martínez-Ferreiro

    2015-04-01

    ratio of words per sentence related to group: NBDs > Fluent > Non-fluent (MLU = 10.4, 6.5, and 6 respectively. This is also the case for the MLU without repetitions (NBDs = 10.1, Fluent = 6, Non-fluent = 5, the percentage of finite sentences (NBDs = 85.5%, Fluent = 72.3%, Non-fluent = 63.2%, and the percentage of grammatical sentences (NBDs = 97.7%, Fluent = 73.3%, Non-Fluent = 43.8%. Significant differences were found in the comparison of the MLU across groups (Kruskal Wallis: χ2 (2, N = 25 = 17.2, p = .000. Further analyses revealed differences between both aphasia groups and NBDs (Mann-Whitney U Tests; Fluent vs. NBDs: U = 1; Z = -2.547, p = .005; Non-Fluent vs. NBDs: U = 0; Z = -3.701, p = .000, but not between individuals in the fluent and the non-fluent group (Mann Whitney U Test: U = 5; Z = -1.254; p = .267. Main differences between individuals with aphasia and controls have been represented in figure 1. No differences were found in the production of verbs when both lexical and auxiliary verbs were analyzed together (NBDs = 53.7, 18.4%; Fluent = 60.3, 21.8%; Non-fluent = 48.4, 18.8% (Kruskal Wallis – N. of verbs: χ2 (2, N = 25 = 3.2, p = .201; Type/token ratio: χ2 (2, N = 25 = 3.5, p = .168. However, the analysis of lexical verbs alone revealed differences in the type/token ratio across groups (χ2 (2, N = 25 = 6.258, p = .044. Contrary to what we would expect, the mean seems to favor individuals in both aphasia groups (Mean Type/Token ratio lexical verbs: 0.64 aphasia groups vs. 0.6 controls. Asymmetries across groups were also traceable when lexical verbs were classified according to their argument structure. Although transitive verbs are relatively more frequent than unergatives and unacussatives, the latter being the less used forms in all groups, significant differences were found between individuals in both aphasia groups and NBDs as for the use of unaccusative verbs (Mann-Whitney U-Test: U=34, Z=-2,299, p=.023. Additionally, while all individuals with

  12. Lesion localization in aphasia without hemiparesis

    International Nuclear Information System (INIS)

    Komatsu, Midori; Senoh, Yoko; Okamoto, Koichi; Morimatsu, Mitsunori; Hirai, Shunsaku

    1983-01-01

    The distribution of the lesions responsible for aphasia unassociated with right-sided hemiparesis was evaluated by cranial computed tomography (CT) among stroke patients. In the Broca aphasia group were observed atypical aphasic symptoms, and the lesions were far more localized than in ordinary Broca one. In the Wernicke aphasia group showed relatively large lesions in the left superior temporal gyrus, sometimes extending to supramarginal and angular gyri, which caused such additional symptoms as apraxia without motor paresis in some cases. In the Transcortical motor aphasia group showed the occlusion of the left internal carotid artery, though without obvious abnormality at CT. In another patient a circumscribed low density lesion was disclosed in the area anterior and superior to so-called Broca's area. In the Transcortical sensory aphasia group, the lesion involved the borderzone supplied by the left middle and posterior cerebral arteries. In the Amnestic aphasia group showed a lesion in the left parietal lobe, while in another no remarkable change was demonstrated. In the Global aphasia group, one had multiple isolated lesions in both anterior and posterior speech areas. Another showed a large lesion involving the whole territory of the left middle cerebral artery. In the remaining one a high density area was observed in the left superior temporal, supramarginal and angular gyri, not extending to the frontal lobe beyond with sylvian fissure. Therefore, in interpreting CTs of such aphasic patients we must take account of not only the extent of the lesion but also the severity of destruction. (J.P.N.)

  13. Aphasia As a Predictor of Stroke Outcome.

    Science.gov (United States)

    Lazar, Ronald M; Boehme, Amelia K

    2017-09-19

    Aphasia is a common feature of stroke, affecting 21-38% of acute stroke patients and an estimated 1 million stroke survivors. Although stroke, as a syndrome, is the leading cause of disability in the USA, less is known about the independent impact of aphasia on stroke outcomes. During the acute stroke period, aphasia has been found to increase length of stay, inpatient complications, overall neurological disability, mortality, and to alter discharge disposition. Outcomes during the sub-acute and chronic stroke periods show that aphasia is associated with lower Functional Independence Measures (FIM) scores, longer stays in rehabilitation settings, poorer function in activities of daily living, and mortality. Factors that complicate the analysis of aphasia on post-stroke outcomes, however, include widely different systems of care across international settings that result in varying admission patterns to acute stroke units, allowable length of stays based on reimbursement, and criteria for rehabilitation placement. Aphasia arising from stroke is associated with worse outcomes both in the acute and chronic periods. Future research will have to incorporate disparate patterns in analytic models, and to take into account specific aphasia profiles and evolving methods of post-stroke speech-language therapy.

  14. Lesion localization in aphasia without hemiparesis

    Energy Technology Data Exchange (ETDEWEB)

    Komatsu, Midori; Senoh, Yoko; Okamoto, Koichi; Morimatsu, Mitsunori; Hirai, Shunsaku (Gunma Univ., Maebashi (Japan). School of Medicine)

    1983-06-01

    The distribution of the lesions responsible for aphasia unassociated with right-sided hemiparesis was evaluated by cranial computed tomography (CT) among stroke patients. In the Broca aphasia group were observed atypical aphasic symptoms, and the lesions were far more localized than in ordinary Broca one. In the Wernicke aphasia group showed relatively large lesions in the left superior temporal gyrus, sometimes extending to supramarginal and angular gyri, which caused such additional symptoms as apraxia without motor paresis in some cases. In the Transcortical motor aphasia group showed the occlusion of the left internal carotid artery, though without obvious abnormality at CT. In another patient a circumscribed low density lesion was disclosed in the area anterior and superior to so-called Broca's area. In the Transcortical sensory aphasia group, the lesion involved the borderzone supplied by the left middle and posterior cerebral arteries. In the Amnestic aphasia group showed a lesion in the left parietal lobe, while in another no remarkable change was demonstrated. In the Global aphasia group, one had multiple isolated lesions in both anterior and posterior speech areas. Another showed a large lesion involving the whole territory of the left middle cerebral artery. In the remaining one a high density area was observed in the left superior temporal, supramarginal and angular gyri, not extending to the frontal lobe beyond with sylvian fissure. Therefore, in interpreting CTs of such aphasic patients we must take account of not only the extent of the lesion but also the severity of destruction.

  15. Aphasia: its effect on marital relationships.

    Science.gov (United States)

    Williams, S E; Freer, C A

    1986-04-01

    The primary purpose of this study was to determine if a relationship exists between marital satisfaction and knowledge of aphasia of the spouse of a stroke patient. Other factors such as the severity of the aphasia, length of time poststroke, and length of marriage were also examined. The subjects, 16 spouses of aphasic patients, were grouped according to severity of the aphasia (mild, moderate, severe). Spouses completed a Knowledge of Aphasia questionnaire and pre/poststroke forms of a Marital Satisfaction Scale (MSS). The questionnaire measured spouse understanding of aphasia, while the MSS examined changes in spouse attitudes toward their marriages after the patients became aphasic. Neither spouses' knowledge of aphasia nor its severity was related to their marital satisfaction. However, there was a significant negative change between the pre/poststroke MSS scores. Spouses of mildly impaired patients were less knowledgeable about aphasia than were those of severely impaired patients. Results are discussed in terms of the counseling needs of families of aphasic patients.

  16. Constraint-Induced Aphasia Therapy for Treatment of Chronic Post-Stroke Aphasia: A Randomized, Blinded, Controlled Pilot Trial.

    Science.gov (United States)

    Szaflarski, Jerzy P; Ball, Angel L; Vannest, Jennifer; Dietz, Aimee R; Allendorfer, Jane B; Martin, Amber N; Hart, Kimberly; Lindsell, Christopher J

    2015-09-24

    To provide a preliminary estimate of efficacy of constraint-induced aphasia therapy (CIAT) when compared to no-intervention in patients with chronic (>1 year) post-stroke aphasia in order to plan an appropriately powered randomized controlled trial (RCT). We conducted a pilot single-blinded RCT. 24 patients were randomized: 14 to CIAT and 10 to no-intervention. CIAT groups received up to 4 hours/day of intervention for 10 consecutive business days (40 hours or therapy). Outcomes were assessed within 1 week of intervention and at 1 and 12 weeks after intervention and included several linguistic measures and a measure of overall subjective communication abilities (mini-Communicative Abilities Log (mini-CAL)). Clinicians treating patients (CIAT group) did not communicate with other team members to maintain blinding and the testing team members were blinded to treatment group assignment. Overall, the results of this pilot RCT support the results of previous observational studies that CIAT may lead to improvements in linguistic abilities. At 12 weeks, the treatment group reported better subjective communication abilities (mini-CAL) than the no-intervention group (p=0.019). Other measures trended towards better performance in the CIAT group. In this pilot RCT intensive language therapy led to an improvement in subjective language abilities. The effects demonstrated allow the design of a definitive trial of CIAT in patients with a variety of post-stroke aphasia types. In addition, our experiences have identified important considerations for designing subsequent trial(s) of CIAT or other interventions for post-stroke aphasia.

  17. Where are aphasia theory and management "headed"?

    Science.gov (United States)

    Tippett, Donna C; Hillis, Argye E

    2017-01-01

    The sequelae of post-stroke aphasia are considerable, necessitating an understanding of the functional neuroanatomy of language, cognitive processes underlying various language tasks, and the mechanisms of recovery after stroke. This knowledge is vital in providing optimal care of individuals with aphasia and counseling to their families and caregivers. The standard of care in the rehabilitation of aphasia dictates that treatment be evidence-based and person-centered. Promising techniques, such as cortical stimulation as an adjunct to behavioral therapy, are just beginning to be explored. These topics are discussed in this review.

  18. Communication confidence in persons with aphasia.

    Science.gov (United States)

    Babbitt, Edna M; Cherney, Leora R

    2010-01-01

    Communication confidence is a construct that has not been explored in the aphasia literature. Recently, national and international organizations have endorsed broader assessment methods that address quality of life and include participation, activity, and impairment domains as well as psychosocial areas. Individuals with aphasia encounter difficulties in all these areas on a daily basis in living with a communication disorder. Improvements are often reflected in narratives that are not typically included in standard assessments. This article illustrates how a new instrument measuring communication confidence might fit into a broad assessment framework and discusses the interaction of communication confidence, autonomy, and self-determination for individuals living with aphasia.

  19. Assessments in outcome evaluation in aphasia therapy

    DEFF Research Database (Denmark)

    Isaksen, Jytte; Brouwer, Catherine E.

    2015-01-01

    Abstract Outcomes of aphasia therapy in Denmark are documented in evaluation sessions in which both the person with aphasia and the speech-language therapist take part. The participants negotiate agreements on the results of therapy. By means of conversation analysis, we study how such agreements...... on therapy outcome are reached interactionally. The sequential analysis of 34 video recordings focuses on a recurrent method for reaching agreements in these outcome evaluation sessions. In and through a special sequence of conversational assessment it is claimed that the person with aphasia has certain...

  20. Barriers and facilitators to mobile phone use for people with aphasia.

    Science.gov (United States)

    Greig, Carole-Ann; Harper, Renée; Hirst, Tanya; Howe, Tami; Davidson, Bronwyn

    2008-01-01

    Mobile phone use increases social participation. People with the communication disorder of aphasia are disadvantaged in the use of information and communication technology such as mobile phones and are reported to be more socially isolated than their peers. The World Health Organization's International Classification of Functioning, Disability and Health provides a framework to address the impact of environmental factors on individual participation. The aim of this preliminary study was to identify the barriers and facilitators to mobile phone use for people with aphasia. A qualitative descriptive study involving two phases was conducted: (1) semi-structured interviews with 6 individuals with aphasia who owned or expressed a desire to own a mobile phone; (2) structured observations of key scenarios identified in the interviews of 3 participants who were sampled from the interview study. Results identified 18 barriers and 9 facilitators to mobile phone use. Key barriers and facilitators were identified in the areas of design and features, written support and training, and communicative partners. Mobile phone use can be problematic for people with aphasia. Intervention needs to address the barriers and utilise the facilitators to mobile phone use for this population. Further research is required to inform policy and intervention programs to ensure that people with aphasia have access to this technology.

  1. Motor aphasia after cervical myelography with Metrizamide

    International Nuclear Information System (INIS)

    Boeker, D.K.; Sartor, K.; Winkler, D.; Allgemeines Krankenhaus Altona, Hamburg

    1980-01-01

    Two cases of transient motor aphasia after cervical myelography with Metrizamide are described. A possible mechanism is thought to be prolonged contact of contrast with a brain already damaged by a pre-existing vascular abnormality. (orig.) [de

  2. Use of Spatial Communication in Aphasia

    Science.gov (United States)

    Johnson, Sarah; Cocks, Naomi; Dipper, Lucy

    2013-01-01

    Background: Spatial communication consists of both verbal spatial language and gesture. There has been minimal research investigating the use of spatial communication, and even less focussing on people with aphasia.

  3. An Aphasia Database on the Internet

    DEFF Research Database (Denmark)

    Axer, Hubertus; Jantzen, Jan; Graf von Keyserlingk, Diedrich

    2000-01-01

    A web-based software model was developed as an example for data mining in aphasiology. It is used for educating medical and engineering students. It is based upon a database of 254 aphasic patients which contains the diagnosis of the aphasia type, profiles of an aphasia test battery (Aachen Aphasia...... Test), and some further clinical information. In addition, the cerebral lesion profiles of 147 of these cases were standardized by transferring the coordinates of the lesions to a 3D reference brain based upon the ACPC coordinate system. Two artificial neural networks were used to perform...... a classfication of the aphasia type. First, a coarse classification was achieved by using an assessment of spontaneous speech of the patient which produced correct results in 87% of the test cases. Data analysis tools were used to select four features of the 30 available test features to yield a more accurate...

  4. Development of Verbal Expressive Skills Management Programme (VESMP for Patients with Brocas Aphasia

    Directory of Open Access Journals (Sweden)

    Humaira Shamim

    2017-06-01

    Full Text Available Introduction: Disorders of communication, including aphasia (mainly post stroke caused by the left hemisphere brain damage, is a major community health issue. The prevalence of aphasia after stroke is 25% in Pakistan in which Broca’s aphasia is predominant in stroke patients who have anterior lesion in the frontal lobe of the left hemispheres. The verbal expressive skills management programme (VESMP is the software which developed augmented management for patients to enhance verbal expressive skills for patients with severe Broca’s aphasia from different geographic areas. Moreover, the software increases the independencies which are not observed in other traditional techniques. This study is the pathway for maintaining and improving the functional life of patients. Objectives: The main objective was to develop the verbal expressive skills management programme (VESMP to enhance verbal expressive skills of patients with severe Broca’s aphasia. Methodology: Initially a pilot study with eight cases is carried out. The nonprobability purposive sampling technique was used to recruit the patients with severe aphasia who received therapy through VESMP programme on their smart phones. It contains seven domains: spontaneous speech, comprehension, naming, reading, writing, imitation, and automated speech. The programme was developed in Urdu language and its content was selected from grade three Urdu Punjab text books. The program was then updated with the help of guidance and feedback received from five experts of the relevant field. The patients scoring is recorded for each domain on basis of correct responses. The study was conducted in YUSRA general hospital and Pakistan Railway Hospital, Rawalpindi. The study includes patients that are 40+ years old, and have three months of post stroke with diagnosis of chronic Broca’s Aphasias, patients with severe cognitive impairment were excluded from the study. The pre-and post score was recorded for each

  5. Lesion correlates of patholinguistic profiles in chronic aphasia: comparisons of syndrome-, modality- and symptom-level assessment.

    Science.gov (United States)

    Henseler, Ilona; Regenbrecht, Frank; Obrig, Hellmuth

    2014-03-01

    One way to investigate the neuronal underpinnings of language competence is to correlate patholinguistic profiles of aphasic patients to corresponding lesion sites. Constituting the beginnings of aphasiology and neurolinguistics over a century ago, this approach has been revived and refined in the past decade by statistical approaches mapping continuous variables (providing metrics that are not simply categorical) on voxel-wise lesion information (voxel-based lesion-symptom mapping). Here we investigate whether and how voxel-based lesion-symptom mapping allows us to delineate specific lesion patterns for differentially fine-grained clinical classifications. The latter encompass 'classical' syndrome-based approaches (e.g. Broca's aphasia), more symptom-oriented descriptions (e.g. agrammatism) and further refinement to linguistic sub-functions (e.g. lexico-semantic deficits for inanimate versus animate items). From a large database of patients treated for aphasia of different aetiologies (n = 1167) a carefully selected group of 102 first ever ischaemic stroke patients with chronic aphasia (∅ 12 months) were included in a VLSM analysis. Specifically, we investigated how performance in the Aachen Aphasia Test-the standard clinical test battery for chronic aphasia in German-relates to distinct brain lesions. The Aachen Aphasia Test evaluates aphasia on different levels: a non-parametric discriminant procedure yields probabilities for the allocation to one of the four 'standard' syndromes (Broca, Wernicke, global and amnestic aphasia), whereas standardized subtests target linguistic modalities (e.g. repetition), or even more specific symptoms (e.g. phoneme repetition). Because some subtests of the Aachen Aphasia Test (e.g. for the linguistic level of lexico-semantics) rely on rather coarse and heterogeneous test items we complemented the analysis with a number of more detailed clinically used tests in selected mostly mildly affected subgroups of patients. Our results

  6. Aphasia rehabilitation during adolescence: a case report.

    Science.gov (United States)

    Laures-Gore, Jacqueline; McCusker, Tiffany; Hartley, Leila L

    2017-06-01

    Descriptions of speech-language interventions addressing the unique aspects of aphasia in adolescence appear to be nonexistent. The current paper presents the case of a male adolescent who experienced a stroke with resultant aphasia and the speech and language therapy he received. Furthermore, we discuss the issues that are unique to an adolescent with aphasia and how they were addressed with this particular patient. Traditional language and apraxia therapy was provided to this patient with inclusion of technology and academic topics. The patient demonstrated improvements in his speech and language abilities, most notably his reading comprehension and speech production. Age-related issues, including academic needs, group treatment, socialization, adherence/compliance, independence and family involvement, emerged during intervention. Although aphasia therapy for adolescents may be similar in many aspects to selected interventions for adults, it is necessary for the clinician to be mindful of age-related issues throughout the course of therapy. Goals and interventions should be selected based on factors salient to an adolescent as well as the potential long-term impact of therapy. Implications for Research Aphasia and its treatment in adolescence need to be further explored. Academics and technology are important aspects of aphasia treatment in adolescence. Issues specific to adolescence such as socialization, adherence/compliance, and independence are important to address in speech-language therapy.

  7. Fluent Aphasia in Telugu: A Case Comparison Study of Semantic Dementia and Stroke Aphasia

    Science.gov (United States)

    Alladi, Suvarna; Mridula, Rukmini; Mekala, Shailaja; Rupela, Vani; Kaul, Subhash

    2010-01-01

    This study presents two cases with fluent aphasia in Telugu with semantic dementia and post-stroke fluent aphasia. Comparable scores were obtained on the conventional neuropsychological and language tests that were administered on the two cases. Both cases demonstrated fluent, grammatical and well-articulated speech with little content, impaired…

  8. Roles of repetitive sequences

    Energy Technology Data Exchange (ETDEWEB)

    Bell, G.I.

    1991-12-31

    The DNA of higher eukaryotes contains many repetitive sequences. The study of repetitive sequences is important, not only because many have important biological function, but also because they provide information on genome organization, evolution and dynamics. In this paper, I will first discuss some generic effects that repetitive sequences will have upon genome dynamics and evolution. In particular, it will be shown that repetitive sequences foster recombination among, and turnover of, the elements of a genome. I will then consider some examples of repetitive sequences, notably minisatellite sequences and telomere sequences as examples of tandem repeats, without and with respectively known function, and Alu sequences as an example of interspersed repeats. Some other examples will also be considered in less detail.

  9. REPETITIVE STRENGTH AMONG STUDENTS OF AGE 14

    Directory of Open Access Journals (Sweden)

    Besim Halilaj

    2014-06-01

    Full Text Available The study involved 82 male students of the primary school “Qamil Ilazi” in Kaçanik-Kosovo.Four movement tests, which test the repetitive strength, were conducted: 1. Pull-up, 2. Sit-Up, 3. Back extension, 4. Push-up.The main goal of this study was to verify the actual motor status, respectively the component of the repetitive strength among students of age 14 of masculine gender. In addition to verifying the actual motor status, another objective was to verify the relationship between the variables employed.Basic statistical parameters show a distribution which is not significantly different from the normal distribution, yielded highly correlative values among the repetitive strength tests. Space factorization resulted in extracting two latent squares defined as repetitive strength of arms factor, and repetitive strength of body factor.

  10. Data-driven classification of patients with primary progressive aphasia.

    Science.gov (United States)

    Hoffman, Paul; Sajjadi, Seyed Ahmad; Patterson, Karalyn; Nestor, Peter J

    2017-11-01

    Current diagnostic criteria classify primary progressive aphasia into three variants-semantic (sv), nonfluent (nfv) and logopenic (lv) PPA-though the adequacy of this scheme is debated. This study took a data-driven approach, applying k-means clustering to data from 43 PPA patients. The algorithm grouped patients based on similarities in language, semantic and non-linguistic cognitive scores. The optimum solution consisted of three groups. One group, almost exclusively those diagnosed as svPPA, displayed a selective semantic impairment. A second cluster, with impairments to speech production, repetition and syntactic processing, contained a majority of patients with nfvPPA but also some lvPPA patients. The final group exhibited more severe deficits to speech, repetition and syntax as well as semantic and other cognitive deficits. These results suggest that, amongst cases of non-semantic PPA, differentiation mainly reflects overall degree of language/cognitive impairment. The observed patterns were scarcely affected by inclusion/exclusion of non-linguistic cognitive scores. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  11. Social Participation through the Eyes of People with Aphasia

    Science.gov (United States)

    Dalemans, Ruth J. P.; de Witte, Luc; Wade, Derick; van den Heuvel, Wim

    2010-01-01

    Background: Little is known about the way people with aphasia perceive their social participation and its influencing factors. Aims: To explore how people with aphasia perceive participation in society and to investigate influencing factors. Methods & Procedures: In this qualitative study thirteen persons with aphasia and twelve central…

  12. Phonological Therapy in Jargon Aphasia: Effects on Naming and Neologisms

    Science.gov (United States)

    Bose, Arpita

    2013-01-01

    Background: Jargon aphasia is one of the most intractable forms of aphasia with limited recommendation on amelioration of associated naming difficulties and neologisms. The few naming therapy studies that exist in jargon aphasia have utilized either semantic or phonological approaches, but the results have been equivocal. Moreover, the effect of…

  13. Repetition and Translation Shifts

    Directory of Open Access Journals (Sweden)

    Simon Zupan

    2006-06-01

    Full Text Available Repetition manifests itself in different ways and at different levels of the text. The first basic type of repetition involves complete recurrences; in which a particular textual feature repeats in its entirety. The second type involves partial recurrences; in which the second repetition of the same textual feature includes certain modifications to the first occurrence. In the article; repetitive patterns in Edgar Allan Poe’s short story “The Fall of the House of Usher” and its Slovene translation; “Konec Usherjeve hiše”; are compared. The author examines different kinds of repetitive patterns. Repetitions are compared at both the micro- and macrostructural levels. As detailed analyses have shown; considerable microstructural translation shifts occur in certain types of repetitive patterns. Since these are not only occasional; sporadic phenomena; but are of a relatively high frequency; they reduce the translated text’s potential for achieving some of the gothic effects. The macrostructural textual property particularly affected by these shifts is the narrator’s experience as described by the narrative; which suffers a reduction in intensity.

  14. Speech-language therapists' process of including significant others in aphasia rehabilitation.

    Science.gov (United States)

    Hallé, Marie-Christine; Le Dorze, Guylaine; Mingant, Anne

    2014-11-01

    Although aphasia rehabilitation should include significant others, it is currently unknown how this recommendation is adopted in speech-language therapy practice. Speech-language therapists' (SLTs) experience of including significant others in aphasia rehabilitation is also understudied, yet a better understanding of clinical reality would be necessary to facilitate implementation of best evidence pertaining to family interventions. To explore the process through which SLTs work with significant others of people with aphasia in rehabilitation settings. Individual semi-structured interviews were conducted with eight SLTs who had been working with persons with aphasia in rehabilitation centres for at least 1 year. Grounded theory principles were applied in analysing interview transcripts. A theoretical model was developed representing SLTs' process of working with significant others of persons with aphasia in rehabilitation. Including significant others was perceived as challenging, yet a bonus to their fundamental patient-centred approach. Basic interventions with significant others when they were available included information sharing. If necessary, significant others were referred to social workers or psychologists or the participants collaborated with those professionals. Participants rarely and only under specific conditions provided significant others with language exercises or trained them to communicate better with the aphasic person. As a result, even if participants felt satisfied with their efforts to offer family and friends interventions, they also had unachieved ideals, such as having more frequent contacts with significant others. If SLTs perceived work with significant others as a feasible necessity, rather than as a challenging bonus, they could be more inclined to include family and friends within therapy with the aim to improve their communication with the person with aphasia. SLTs could also be more satisfied with their practice. In order to

  15. Cross-situational word learning in aphasia.

    Science.gov (United States)

    Peñaloza, Claudia; Mirman, Daniel; Cardona, Pedro; Juncadella, Montserrat; Martin, Nadine; Laine, Matti; Rodríguez-Fornells, Antoni

    2017-08-01

    Human learners can resolve referential ambiguity and discover the relationships between words and meanings through a cross-situational learning (CSL) strategy. Some people with aphasia (PWA) can learn word-referent pairings under referential uncertainty supported by online feedback. However, it remains unknown whether PWA can learn new words cross-situationally and if such learning ability is supported by statistical learning (SL) mechanisms. The present study examined whether PWA can learn novel word-referent mappings in a CSL task without feedback. We also studied whether CSL is related to SL in PWA and neurologically healthy individuals. We further examined whether aphasia severity, phonological processing and verbal short-term memory (STM) predict CSL in aphasia, and also whether individual differences in verbal STM modulate CSL in healthy older adults. Sixteen people with chronic aphasia underwent a CSL task that involved exposure to a series of individually ambiguous learning trials and a SL task that taps speech segmentation. Their learning ability was compared to 18 older controls and 39 young adults recruited for task validation. CSL in the aphasia group was below the older controls and young adults and took place at a slower rate. Importantly, we found a strong association between SL and CSL performance in all three groups. CSL was modulated by aphasia severity in the aphasia group, and by verbal STM capacity in the older controls. Our findings indicate that some PWA can preserve the ability to learn new word-referent associations cross-situationally. We suggest that both PWA and neurologically intact individuals may rely on SL mechanisms to achieve CSL and that verbal STM also influences CSL. These findings contribute to the ongoing debate on the cognitive mechanisms underlying this learning ability. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Agrammatism and Other Aphasia-related Disorders in Moroccan Arabic Speaking Aphasics

    Directory of Open Access Journals (Sweden)

    Bouchra Qorchi

    2016-11-01

    Full Text Available This paper includes the participation of six Moroccan Arabic-speaking aphasics (four with Broca’s aphasia, one with Wernicke’s aphasia and one with global aphasia. In our work, we turn to a particular under-resourced Arabic Dialect, Moroccan Darija or Moroccan Arabic (MA, which is an agglutinative language; that is, a fairly large number of affixes may be added to the root. Negation, tense, aspect, person, number and gender are all expressed by affixes attached to the verb. The speech corpora were taken from samples collected from patients who have attended speech and language therapy sessions. The patients were presented with picture description, repetition and grammaticality judgement tasks in order to examine the extent of impairment on the phonological, lexical, semantic and morpho-syntactic levels. Although agrammatic production is usually described as impaired in all aspects of grammar and in all types of inflection, it was found out that the use of verbal and nominal bound morphemes was spared in the output of the subjects understudy. All the three groups in this study used appropriate verbal and nominal morphology, which does not support the traditional view of agrammatism as being amorphological.

  17. Aphasia following left thalamic hemorrhage. A study by Western Aphasia Battery and single photon emission CT

    Energy Technology Data Exchange (ETDEWEB)

    Makishita, Hideo; Miyasaka, Motomaro; Tanizaki, Yoshio; Yanagisawa, Nobuo; Sugishita, Morihiro

    1984-07-01

    A report is given of 7 patients with left thalamic hemorrhage in the chronic stage (from 1.5 months to 4.5 months) in which language disorders were examined by Western Aphasia Battery (WAB) and cerebral blood flow was measured by single photon emission CT. Examination of language by WAB revealed 4 aphasics out of 7 cases, and 3 patients had no language deficit. The patient with Wernicke's aphasia showed low density area only in the left posterior thalamus in X-ray CT, and revealed severe low blood flow area extending to left temporal lobe in emission CT. In the case with transcortical sensory aphasia, although X-ray CT showed no obvious low density area, emission CT revealed moderate low flow area in the left temporooccipital region and low blood flow at the left thalamus. In one of the two patients classified as anomic aphasia, emission CT showed slight low flow area at the temporo-occipital region similar to the case with transcortical sensory aphasia. In another case with anomic aphasia there was a wide low density area all over the left thalamus and midline shift to the right in X-ray CT, and emission CT showed severe low blood flow in the same region spreading widely toward the cerebral surface. In all of the 3 patients without aphasia, emission CT showed low flow region restricted to the left thalamus.

  18. An aphasia mentoring program: perspectives of speech-language pathology students and of mentors with aphasia.

    Science.gov (United States)

    Purves, Barbara A; Petersen, Jill; Puurveen, Gloria

    2013-05-01

    In contrast to clinician-as-expert models, social models of clinical practice typically acknowledge people with aphasia as equal partners in intervention. Given this, there may be a place within speech-language pathology education for programs situating people with aphasia as experts. This paper describes an aphasia mentoring program that was implemented as part of a speech-language pathology graduate program. Qualitative research methods with thematic analysis of interviews, focus groups, questionnaires, and participant observation were used to develop a description of the mentoring program, including the experiences and perspectives of the participants-both mentors (people with chronic aphasia) and students. Five themes, including getting better, aphasia advocacy, group as versus for therapy, we're a team, and focus on mentoring, emerged from the mentors' data. Five themes, including shifting the power dynamic, getting to know the person, seeing members as mentors, making classroom learning real, and connecting with a community, emerged from the students' data. There were significant overlaps and intersections between the 2 data sets. Findings revealed how an aphasia mentoring program that positions people with aphasia as experts can make a significant contribution to student education while supporting mentors' own goals, with implications for improved quality of life.

  19. Repetitive Questioning Exasperates Caregivers

    Directory of Open Access Journals (Sweden)

    R. C. Hamdy MD

    2018-01-01

    Full Text Available Repetitive questioning is due to an impaired episodic memory and is a frequent, often presenting, problem in patients with Alzheimer’s disease (amnestic type. It is due to the patients’ difficulties learning new information, retaining it, and recalling it, and is often aggravated by a poor attention span and easy distractibility. A number of factors may trigger and maintain repetitive questioning. Caregivers should try to identify and address these triggers. In the case discussion presented, it is due to the patient’s concerns about her and her family’s safety triggered by watching a particularly violent movie aired on TV. What went wrong in the patient/caregiver interaction and how it could have been avoided or averted are explored. Also reviewed are the impact of repetitive questioning, the challenges it raises for caregivers, and some effective intervention strategies that may be useful to diffuse the angst that caregivers experience with repetitive questioning.

  20. 'I do the best I can': an in-depth exploration of the aphasia management pathway in the acute hospital setting.

    Science.gov (United States)

    Foster, Abby M; Worrall, Linda E; Rose, Miranda L; O'Halloran, Robyn

    2016-09-01

    While research has begun to explore the management of aphasia across the continuum of care, to date there is little in-depth, context specific knowledge relating to the speech pathology aphasia management pathway. This research aimed to provide an in-depth understanding of the current aphasia management pathway in the acute hospital setting, from the perspective of speech pathologists. Underpinned by a social constructivist paradigm, the researchers implemented an interpretive phenomenological method when conducting in-depth interviews with 14 Australian speech pathologists working in the acute hospital setting. Interview transcripts and interviewer field notes were subjected to a qualitative content analysis. Analysis identified a single guiding construct and five main categories to describe the management of aphasia in the acute hospital setting. The guiding construct, First contact with the profession, informed the entire management pathway. Five additional main categories were identified: Referral processes; Screening and assessment; Therapeutic intervention; Educational and affective counselling; and Advocacy. Findings suggest significant diversity in the pathways of care for people with aphasia and their families in the acute hospital setting. Additional support mechanisms are required in order to support speech pathologists to minimise the evidence-practice gap. Implications for Rehabilitation Significant diversity exists in the current aphasia management pathway for people with acute post-stroke aphasia and their families in the acute hospital setting. Mechanisms that support speech pathologists to minimise the evidence-practice gap, and consequently reduce their sense of professional dissonance, are required.

  1. Stroke rehabilitation using noninvasive cortical stimulation: aphasia.

    Science.gov (United States)

    Mylius, Veit; Zouari, Hela G; Ayache, Samar S; Farhat, Wassim H; Lefaucheur, Jean-Pascal

    2012-08-01

    Poststroke aphasia results from the lesion of cortical areas involved in the motor production of speech (Broca's aphasia) or in the semantic aspects of language comprehension (Wernicke's aphasia). Such lesions produce an important reorganization of speech/language-specific brain networks due to an imbalance between cortical facilitation and inhibition. In fact, functional recovery is associated with changes in the excitability of the damaged neural structures and their connections. Two main mechanisms are involved in poststroke aphasia recovery: the recruitment of perilesional regions of the left hemisphere in case of small lesion and the acquisition of language processing ability in homotopic areas of the nondominant right hemisphere when left hemispheric language abilities are permanently lost. There is some evidence that noninvasive cortical stimulation, especially when combined with language therapy or other therapeutic approaches, can promote aphasia recovery. Cortical stimulation was mainly used to either increase perilesional excitability or reduce contralesional activity based on the concept of reciprocal inhibition and maladaptive plasticity. However, recent studies also showed some positive effects of the reinforcement of neural activities in the contralateral right hemisphere, based on the potential compensatory role of the nondominant hemisphere in stroke recovery.

  2. Melodic Intonation Therapy in chronic aphasia: evidence from a pilot randomized controlled trial

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    Ineke Van Der Meulen

    2016-11-01

    Full Text Available AbstractMelodic Intonation Therapy (MIT is a language production therapy for severely non-fluent aphasic patients using melodic intoning and rhythm to restore language. Although many studies have reported its beneficial effects on language production, randomized controlled trials (RCT examining the efficacy of MIT are rare. In an earlier publication, we presented the results of an RCT on MIT in subacute aphasia and found that MIT was effective on trained and untrained items. Further, we observed a clear trend in improved functional language use after MIT. Subacute aphasic patients receiving MIT improved considerably on language tasks measuring connected speech and daily life verbal communication. Here, we present the results of a pilot RCT on MIT in chronic aphasia and compare these to the results observed in subacute aphasia. We used a multicenter waiting-list randomized controlled trial design. Patients with chronic (>1 year post-stroke aphasia were randomly allocated to the experimental group (6 weeks MIT or to the control group (6 weeks no intervention followed by 6 weeks MIT. Assessments were done at baseline (T1, after 6 weeks (T2, and 6 weeks later (T3. Efficacy was evaluated at T2 using univariable linear regression analyses. Outcome measures were chosen to examine several levels of therapy success: improvement on trained items, generalization to untrained items, and generalization to verbal communication. Of 17 included patients, 10 were allocated to the experimental condition and 7 to the control condition. MIT significantly improved repetition of trained items (β=13.32, p=.02. This effect did not remain stable at follow-up assessment. In contrast to earlier studies, we found only a limited and temporary effect of MIT, without generalization to untrained material or to functional communication. The results further suggest that the effect of MIT in chronic aphasia is more restricted than its effect in earlier stages post stroke. This

  3. Compounds in different aphasia categories: a study on picture naming.

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    Semenza, Carlo; De Pellegrin, Serena; Battel, Irene; Garzon, Martina; Meneghello, Francesca; Chiarelli, Valentina

    2011-12-01

    This study investigated the production of compounds in Italian-speaking patients affected by different aphasia categories (i.e., Broca's, Wernicke's, and anomic aphasia) in a confrontation naming task. Questions of theoretical interest concerning the processing of compounds within the framework of the "lemma theory" as well as the role of morphological productivity in compound processing are addressed. Results indicate that all persons with aphasia retain knowledge of the morphological status of words, even when they fail to retrieve the corresponding phonological form (the "compound effect"). A difference was found among aphasia categories in the type of errors produced (omission vs. substitution) and in the position (first or second) of these errors within the compound words. In Broca's aphasia, the first component is omitted more frequently than the second one, but only in verb-noun compounds. Anomic and Wernicke's aphasia, unlike in Broca's aphasia, seem to retain sensitivity to morphological productivity.

  4. Hemispheric language dominance measured by repetitive navigated transcranial magnetic stimulation and postoperative course of language function in brain tumor patients.

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    Ille, Sebastian; Kulchytska, Nataliia; Sollmann, Nico; Wittig, Regina; Beurskens, Eva; Butenschoen, Vicki M; Ringel, Florian; Vajkoczy, Peter; Meyer, Bernhard; Picht, Thomas; Krieg, Sandro M

    2016-10-01

    The resection of left-sided perisylvian brain lesions harbors the risk of postoperative aphasia. Because it is known that language function can shift between hemispheres in brain tumor patients, the preoperative knowledge of the patient's language dominance could be helpful. We therefore investigated the hemispheric language dominance by repetitive navigated transcranial magnetic stimulation (rTMS) and surgery-related deficits of language function. We pooled the bicentric language mapping data of 80 patients undergoing the resection of left-sided perisylvian brain lesions in our two university neurosurgical departments. We calculated error rates (ERs; ER = errors per stimulations) for both hemispheres and defined the hemispheric dominance ratio (HDR) as the quotient of the left- and right-sided ER (HDR >1= left dominant; HDR right dominant). The course of the patient's language function was evaluated and correlated with the preoperative HDR. Only three of 80 patients (4%) presented with permanent surgery-related aphasia and 24 patients (30%) with transient surgery-related aphasia. The mean HDR (± standard deviation) of patients with new aphasia after five days was significantly higher (1.68±1.07) than the HDR of patients with no new language deficit (1.37±1.08) (p=0.0482). With a predefined cut-off value of 0.5 for HDR, we achieved a sensitivity for predicting new aphasia of 100%. A higher preoperative HDR significantly correlates with an increased risk for transient aphasia. Moreover, the intensive preoperative workup in this study led to a considerably low rate of permanent aphasia. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Implications of Subcortical structures in Aphasia.

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    Saleh Alamri

    2015-04-01

    Taken together, the results indicate that aphasia is a common outcome after a lesion to subcortical structures. Findings show that 110 out of 394 aphasic patients with lesion in the basal ganglia exhibited comprehension deficits, while 31 participants out of 288 with thalamic aphasia. Likewise, 129 aphasics of affected basal ganglia out of 394 had impaired naming, whereas 12 participants had impaired naming out of 288 individuals with thalamic aphasia. See figure 1. Figure 1: The percentage of language impairment in two sets of aphasic patients (the thalamus and the basal ganglia. Despite contradictory results and even cases of double dissociation (for an example of absence of language deficits in the event of thalamic lesions see Cappa et al., 1986, our literature review confirms the major role of subcortical structures in language processing.

  6. Computer tomographic localization and lesion size in aphasia

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    Hojo, Kei

    1985-01-01

    Using a microcomputer, the locus and extent of the lesions demonstrated on CT were superimposed on standardized matrices in 127 cases with various types of aphasia, to investigate the relationship between location of the lesions and types of aphasia. Main results were as follows. 1. Broca aphasics: The lesions involved rather large areas in the deep structures of the lower part of the precentral gyrus, the insula and the lenticular nucleus. Therefore, the finding was regarded as being of little localizing value. 2. Wernicke aphasics: At least 70 % of the patients had superior temporal lesions involving Wernicke's area and the subcortical lesions of the superior and middle temporal gyri. The site of the lesion corresponded roughly with that in the previous clinico-pathological reports but was indicated in a little deeper area. 3. Amnestic aphasics: The size of the lesion was smaller than any other type but the lesions were distributed throughout the left hemisphere. Amnestic asphasia was thought to be the least localizable. 4. Conduction aphasics: Most patients had lesions in the posterior speech area involving part of Wernicke's area. In particular, in more than 80 % of the conduction aphasics the lesions were revealed in the supramarginal gyrus and it's adjacent deep structures. 5. Global aphasics: In general, the size of the lesion was very large and 70 % of the global aphasics had extensive lesions involving both Broca's and Wernicke's areas. However, there were some patients showing small and confined lesions. (author)

  7. Study on Language Rehabilitation for Aphasia.

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    Yu, Zeng-Zhi; Jiang, Shu-Jun; Jia, Zi-Shan; Xiao, Hong-Yu; Zhou, Mei-Qi

    2017-06-20

    The aim is to update our clinical recommendations for evidence-based language rehabilitation of people with aphasia, based on a systematic review of the literature from 1999 to 2015. Articles referred to in this systematic review of the Medline and PubMed published in English language literatures were from 1998 to 2015. The terms used in the literature searches were aphasia and evidenced-based. The task force initially identified citations for 51 published articles. Of the 51 articles, 44 studies were selected after further detailed review. Six articles, which were not written in English, and one study related to laryngectomy rehabilitation interventions, were excluded from the study. This study referred to all the important and English literature in full. Aphasia is the linguistic disability, which usually results from injuries to the dominant hemisphere of the brain. The rehabilitation of aphasia is until in the process of being debated and researched. Evidence-based medicine (EBM), EBM based on the clinical evidence, promotes the practice of combining the clinicians' first-hand experience and the existing objective and scientific evidence encouraging making decisions based on both empirical evidence and the scientific evidence. Currently, EBM is being gradually implemented in the clinical practice as the aim of the development of modern medicine. At present, the research for the aphasia rehabilitation mainly focuses on the cognitive language rehabilitation and the intensive treatment and the precise treatment, etc. There is now sufficient information to support evidence-based protocols and implement empirically-supported treatments for linguistic disability after traumatic brain injury and stroke, which can be used to develop linguistic rehabilitation guidelines for patients with aphasia.

  8. Vocabulary acquisition in aphasia: Modality can matter.

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    Tuomiranta, Leena; Grönroos, Ann-Mari; Martin, Nadine; Laine, Matti

    2014-11-01

    The present case study investigated modality-specific aspects of novel word acquisition in aphasia. It was prompted by recent aphasia case studies indicating great interindividual variability in the ability to learn and maintain novel words in aphasia. Moreover, two previous case studies revealed a striking effect of input modality by showing effective word learning and re-learning via visual input only (Kohen, Sola, Tuomiranta, Laine, & Martin, 2012; Tuomiranta et al., 2014). The present participant TS with chronic nonfluent aphasia and post-semantic anomia was administered novel word-referent learning tasks. In the first experiment, the learning phase included simultaneous phonological and orthographic input, while the follow-up was probed separately for spoken and written responses. In the second experiment, we studied the effect of four different input and output modality combinations on her ability to learn to name the novel items. In the first experiment, TS's spoken naming performance during the learning phase was just within the range of healthy controls. Maintenance declined and remained outside that range during the whole 6-month follow-up. However, TS maintained the learned words better in written than in spoken naming throughout the follow-up, and in written naming, her maintenance stayed within the control's range up to 8 weeks post-training. The second experiment indicated that the best learning outcome was achieved with orthographic input. Orthographic input combined with orthographic output resulted in fast and accurate learning of the novel words. Interestingly, TS's test profile was opposite to her learning profile, as she repeated better than she read aloud in the linguistic background assessment. The results from the present case highlight the importance of multiple learning channels for word acquisition in individuals with aphasia. Probing the functionality of different input and output channels for learning may also prove valuable in tailoring

  9. Mindfulness meditation in aphasia: A case report.

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    Laures-Gore, Jacqueline; Marshall, Rebecca Shisler

    2016-04-06

    Despite the potential behavioral and neurological benefits of Mindfulness Meditation (MM), its use in treating stroke related communication disabilities appears to be underexplored. Specifically, aphasia, a language disorder resulting from stroke, may be amenable to the benefits of MM because of the observed attention problems often underlying the language symptoms. The current paper presents a case report of an adult with aphasia who was trained in MM. An adult with aphasia completed a five-day mindfulness training, and was assessed on measures of language, attention, and physiological measures of cortisol and heart rate variability. She completed four assessments: two baseline measures, immediately post training, and one week post training (maintenance). Overall, changes were observed in both psychophysiological measures (heart rate and heart rate variability) and behavioral measures (word productivity, phrase length, word generation, decreased impulsivity, and increased attention). Given the psychophysiological and behavioral changes observed in this individual, further exploration of the influence of MM in the treatment of post-stroke aphasia is warranted.

  10. Accent Identification by Adults with Aphasia

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    Newton, Caroline; Burns, Rebecca; Bruce, Carolyn

    2013-01-01

    The UK is a diverse society where individuals regularly interact with speakers with different accents. Whilst there is a growing body of research on the impact of speaker accent on comprehension in people with aphasia, there is none which explores their ability to identify accents. This study investigated the ability of this group to identify the…

  11. Language therapy effects in long term aphasia.

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    Broida, H

    1977-06-01

    This report describes the results of language therapy initiated 1 to 6 years after the onset of aphasia in 14 patients. During the course of treatment, each of the 14 patients improved strongly in their communicative abilities (PICA), according to clinical observation and reports from family, hospital ward personnel, or both.

  12. Further Evidence of Auditory Extinction in Aphasia

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    Marshall, Rebecca Shisler; Basilakos, Alexandra; Love-Myers, Kim

    2013-01-01

    Purpose: Preliminary research ( Shisler, 2005) suggests that auditory extinction in individuals with aphasia (IWA) may be connected to binding and attention. In this study, the authors expanded on previous findings on auditory extinction to determine the source of extinction deficits in IWA. Method: Seventeen IWA (M[subscript age] = 53.19 years)…

  13. Counseling and Aphasia Treatment: Missed Opportunities

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    Simmons-Mackie, Nina; Damico, Jack S.

    2011-01-01

    During clinical interactions between speech-language pathologists and adults with aphasia, a variety of emotional issues arise. The literature suggests that while counseling is within the scope of practice, SLPs tend to avoid emotional issues in therapy (A. Holland, 2007a). The precise mechanisms employed for circumventing emotional issues in…

  14. Understanding email communication of persons with aphasia

    NARCIS (Netherlands)

    Al Mahmud, A.; Martens, J.B.O.S.

    2011-01-01

    An email program has been developed by the Aphasia Union Netherlands (AVN) to enhance communication between aphasics mutually and with their therapists. In this paper we report intermediate evaluation results of the AVN email program. We evaluated the email program in two ways: a. by analyzing the

  15. Global aphasia without hemiparesis: A case series

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    Aparna R Pai

    2011-01-01

    Full Text Available Background: Global aphasia without hemiparesis (GAWH is a rare stroke syndrome characterized by the unusual dissociation of motor and language functions. Issues regarding its etio-pathogenesis, lesion sites, and recovery patterns are extensively being debated in contemporary neuroscience literature. Materials and Methods: Four patients admitted in our hospital between 2005 and 2009 with GAWH caused by ischemic stroke were studied retrospectively with emphasis on number and site of lesions, etiology, and recovery patterns. Results: The clinical findings from our subjects showed that GAWH could result from either single/multiple lesions including subcortical lesions. The recovery was rapid, although not complete. One case evolved into Wernicke′s aphasia as seen in earlier studies. Two subjects revealed evolution to transcortical sensory aphasia and one to Broca′s aphasia which is distinct from previous proposals. Two cases showed lack of clinico-anatomic correlation during recovery. Conclusions: GAWH could result from both embolic and large vessel strokes and single or multiple lesions. The recovery pattern may be variable and may show lack of clinico-anatomical correlation indicating anomalous cerebral functional reorganization, questioning the conventional teaching of language representation in the brain.

  16. Writing Treatment for Aphasia: A Texting Approach

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    Beeson, Pelagie M.; Higginson, Kristina; Rising, Kindle

    2013-01-01

    Purpose: Treatment studies have documented the therapeutic and functional value of lexical writing treatment for individuals with severe aphasia. The purpose of this study was to determine whether such retraining could be accomplished using the typing feature of a cellular telephone, with the ultimate goal of using text messaging for…

  17. Measuring Working Memory Deficits in Aphasia

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    Mayer, Jamie F.; Murray, Laura L.

    2012-01-01

    Purpose: Many adults with aphasia demonstrate concomitant deficits in working memory (WM), but such deficits are difficult to quantify because of a lack of validated measures as well as the complex interdependence between language and WM. We examined the feasibility, reliability, and internal consistency of an "n"-back task for…

  18. Genetics Home Reference: epilepsy-aphasia spectrum

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    ... Szepetowski P, Scheffer IE, Mefford HC. GRIN2A mutations cause epilepsy-aphasia spectrum disorders. Nat Genet. 2013 Sep;45( ... Neubauer BA, Biskup S, von Spiczak S. Mutations in GRIN2A cause idiopathic focal epilepsy with rolandic spikes. Nat Genet. 2013 Sep;45( ...

  19. Novel porcine repetitive elements

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    Nonneman Dan J

    2006-12-01

    Full Text Available Abstract Background Repetitive elements comprise ~45% of mammalian genomes and are increasingly known to impact genomic function by contributing to the genomic architecture, by direct regulation of gene expression and by affecting genomic size, diversity and evolution. The ubiquity and increasingly understood importance of repetitive elements contribute to the need to identify and annotate them. We set out to identify previously uncharacterized repetitive DNA in the porcine genome. Once found, we characterized the prevalence of these repeats in other mammals. Results We discovered 27 repetitive elements in 220 BACs covering 1% of the porcine genome (Comparative Vertebrate Sequencing Initiative; CVSI. These repeats varied in length from 55 to 1059 nucleotides. To estimate copy numbers, we went to an independent source of data, the BAC-end sequences (Wellcome Trust Sanger Institute, covering approximately 15% of the porcine genome. Copy numbers in BAC-ends were less than one hundred for 6 repeat elements, between 100 and 1000 for 16 and between 1,000 and 10,000 for 5. Several of the repeat elements were found in the bovine genome and we have identified two with orthologous sites, indicating that these elements were present in their common ancestor. None of the repeat elements were found in primate, rodent or dog genomes. We were unable to identify any of the replication machinery common to active transposable elements in these newly identified repeats. Conclusion The presence of both orthologous and non-orthologous sites indicates that some sites existed prior to speciation and some were generated later. The identification of low to moderate copy number repetitive DNA that is specific to artiodactyls will be critical in the assembly of livestock genomes and studies of comparative genomics.

  20. Imbalance between abstract and concrete repetitive thinking modes in schizophrenia.

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    Maurage, Pierre; Philippot, Pierre; Grynberg, Delphine; Leleux, Dominique; Delatte, Benoît; Mangelinckx, Camille; Belge, Jan-Baptist; Constant, Eric

    2017-10-01

    Repetitive thoughts can be divided in two modes: abstract/analytic (decontextualized and dysfunctional) and concrete/experiential (problem-focused and adaptive). They constitute a transdiagnostic process involved in many psychopathological states but have received little attention in schizophrenia, as earlier studies only indexed increased ruminations (related to dysfunctional repetitive thoughts) without jointly exploring both modes. This study explored the two repetitive thinking modes, beyond ruminations, to determine their imbalance in schizophrenia. Thirty stabilized patients with schizophrenia and 30 matched controls completed the Repetitive Response Scale and the Mini Cambridge-Exeter Repetitive Thought Scale, both measuring repetitive thinking modes. Complementary measures related to schizophrenic symptomatology, depression and anxiety were also conducted. Compared to controls, patients with schizophrenia presented an imbalance between repetitive thinking modes, with increased abstract/analytic and reduced concrete/experiential thoughts, even after controlling for comorbidities. Schizophrenia is associated with stronger dysfunctional repetitive thoughts (i.e. abstract thinking) and impaired ability to efficiently use repetitive thinking for current problem-solving (i.e. concrete thinking). This imbalance confirms the double-faced nature of repetitive thinking modes, whose influence on schizophrenia's symptomatology should be further investigated. The present results also claim for evaluating these processes in clinical settings and for rehabilitating the balance between opposite repetitive thinking modes. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Comprehensibility and neural substrate of communicative gestures in severe aphasia.

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    Hogrefe, Katharina; Ziegler, Wolfram; Weidinger, Nicole; Goldenberg, Georg

    2017-08-01

    Communicative gestures can compensate incomprehensibility of oral speech in severe aphasia, but the brain damage that causes aphasia may also have an impact on the production of gestures. We compared the comprehensibility of gestural communication of persons with severe aphasia and non-aphasic persons and used voxel based lesion symptom mapping (VLSM) to determine lesion sites that are responsible for poor gestural expression in aphasia. On group level, persons with aphasia conveyed more information via gestures than controls indicating a compensatory use of gestures in persons with severe aphasia. However, individual analysis showed a broad range of gestural comprehensibility. VLSM suggested that poor gestural expression was associated with lesions in anterior temporal and inferior frontal regions. We hypothesize that likely functional correlates of these localizations are selection of and flexible changes between communication channels as well as between different types of gestures and between features of actions and objects that are expressed by gestures. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Teaching nursing assistant students about aphasia and communication.

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    Welsh, Jessica Dionne; Szabo, Gretchen Beideman

    2011-08-01

    Research indicates that communication between patients with communication disorders and their health care providers may be compromised, which leads to adverse outcomes and reduced participation in patients' own health care. Emerging studies demonstrate that effective communication education programs may decrease communication difficulties. This feasibility study of an education program that includes people with aphasia as educators aims to improve nursing assistant students' knowledge of aphasia and awareness of supported communication strategies while also examining the experiences of participants with aphasia. This preliminary study suggests that explicit aphasia and communication training delivered in this format has positive learning outcomes for nursing assistant students and potential psychosocial benefits to participants with aphasia. The format can be modified for a variety of health care audiences and lends itself to implementation by community aphasia groups and centers. © Thieme Medical Publishers.

  3. A Multidimensional Review of Bilingual Aphasia as a Language Disorder

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    Mohsen Akbari

    2014-04-01

    Full Text Available Aphasia as a multifaceted language disorder associated with the complicated links between language and brain has been and is of interest and significance to the stream of research in different disciplines including neurolinguistics, psycholinguistics, cognitive studies and language acquisition. Along with explorations into the manifestations of aphasia in monolingual speakers, bilingual aphasia has similarly become the most current form of this language disorder due to the rising number of bilingual speakers in recent decades all over the world and the probability of facing bilinguals suffering from this language deficit. To paint a picture of this multidimensional linguistic impairment and to get out of the labyrinth of aphasia and in particular bilingual aphasia, the present review study aims to provide a summary of aphasia-related studies in different contexts worldwide and run through the variables affecting the manifestations and language recovery patterns in bilingual aphasic speakers.

  4. Conducted noise analysis and protection of 45 kJ/s, ±50 kV capacitor charging power supply when interfaced with repetitive Marx based pulse power system

    Science.gov (United States)

    Naresh, P.; Patel, Ankur; Sharma, Archana

    2015-09-01

    Pulse power systems with highly dynamic loads like klystron, backward wave oscillator (BWO), and magnetron generate highly dynamic noise. This noise leads to frequent failure of controlled switches in the inverter stage of charging power supply. Designing a reliable and compatible power supply for pulse power applications is always a tricky job when charging rate is in multiples of 10 kJ/s. A ±50 kV and 45 kJ/s capacitor charging power supply based on 4th order LCLC resonant topology has been developed for a 10 Hz repetitive Marx based system. Conditions for load independent constant current and zero current switching (ZCS) are derived mathematically. Noise generated at load end due to dynamic load is tackled effectively and reduction in magnitude noise voltage is achieved by providing shielding between primary and secondary of high voltage high frequency transformer and with LCLC low pass filter. Shielding scales down the ratio between coupling capacitance (Cc) and the collector-emitter capacitance of insulated gate bi-polar transistor switch, which in turn reduces the common mode noise voltage magnitude. The proposed 4th order LCLC resonant network acts as a low pass filter for differential mode noise in the reverse direction (from load to source). Power supply has been tested repeatedly with 5 Hz repetition rate with repetitive Marx based system connected with BWO load working fine without failure of single switch in the inverter stage.

  5. Repetitive Questioning II

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    R. C. Hamdy MD

    2018-02-01

    Full Text Available Repetitive questioning is a major problem for caregivers, particularly taxing if they are unable to recognize and understand the reasons why their loved one keeps asking the same question over and over again. Caregivers may be tempted to believe that the patient does not even try to remember the answer given or is just getting obnoxious. This is incorrect. Repetitive questioning is due to the underlying disease: The patient’s short term memory is impaired and he is unable to register, encode, retain and retrieve the answer. If he is concerned about a particular topic, he will keep asking the same question over and over again. To the patient each time she asks the question, it is as if she asked it for the first time. Just answering repetitive questioning by providing repeatedly the same answer is not sufficient. Caregivers should try to identify the underlying cause for this repetitive questioning. In an earlier case study, the patient was concerned about her and her family’s safety and kept asking whether the doors are locked. In this present case study, the patient does not know how to handle the awkward situation he finds himself in. He just does not know what to do. He is not able to adjust to the new unexpected situation. So he repeatedly wants to reassure himself that he is not intruding by asking the same question over and over again. We discuss how the patient’s son-in-law could have avoided this situation and averted the catastrophic ending.

  6. Aphasia therapy in the age of globalization: cross-linguistic therapy effects in bilingual aphasia.

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    Ansaldo, Ana Inés; Saidi, Ladan Ghazi

    2014-01-01

    Globalization imposes challenges to the field of behavioural neurology, among which is an increase in the prevalence of bilingual aphasia. Thus, aphasiologists have increasingly focused on bilingual aphasia therapy and, more recently, on the identification of the most efficient procedures for triggering language recovery in bilinguals with aphasia. Therapy in both languages is often not available, and, thus, researchers have focused on the transfer of therapy effects from the treated language to the untreated one. This paper discusses the literature on bilingual aphasia therapy, with a focus on cross-linguistic therapy effects from the language in which therapy is provided to the untreated language. Fifteen articles including two systematic reviews, providing details on pre- and posttherapy in the adult bilingual population with poststroke aphasia and anomia are discussed with regard to variables that can influence the presence or absence of cross-linguistic transfer of therapy effects. . The potential for CLT of therapy effects from the treated to the untreated language depends on the word type, the degree of structural overlap between languages, the type of therapy approach, the pre- and postmorbid language proficiency profiles, and the status of the cognitive control circuit.

  7. De novo status epilepticus with isolated aphasia.

    Science.gov (United States)

    Flügel, Dominique; Kim, Olaf Chan-Hi; Felbecker, Ansgar; Tettenborn, Barbara

    2015-08-01

    Sudden onset of aphasia is usually due to stroke. Rapid diagnostic workup is necessary if reperfusion therapy is considered. Ictal aphasia is a rare condition but has to be excluded. Perfusion imaging may differentiate acute ischemia from other causes. In dubious cases, EEG is required but is time-consuming and laborious. We report a case where we considered de novo status epilepticus as a cause of aphasia without any lesion even at follow-up. A 62-year-old right-handed woman presented to the emergency department after nurses found her aphasic. She had undergone operative treatment of varicosis 3 days earlier. Apart from hypertension and obesity, no cardiovascular risk factors and no intake of medication other than paracetamol were reported. Neurological examination revealed global aphasia and right pronation in the upper extremity position test. Computed tomography with angiography and perfusion showed no abnormalities. Electroencephalogram performed after the CT scan showed left-sided slowing with high-voltage rhythmic 2/s delta waves but no clear ictal pattern. Intravenous lorazepam did improve EEG slightly, while aphasia did not change. Lumbar puncture was performed which likely excluded encephalitis. Magnetic resonance imaging showed cortical pathological diffusion imaging (restriction) and cortical hyperperfusion in the left parietal region. Intravenous anticonvulsant therapy under continuous EEG resolved neurological symptoms. The patient was kept on anticonvulsant therapy. Magnetic resonance imaging after 6 months showed no abnormalities along with no clinical abnormalities. Magnetic resonance imaging findings were only subtle, and EEG was without clear ictal pattern, so the diagnosis of aphasic status remains with some uncertainty. However, status epilepticus can mimic stroke symptoms and has to be considered in patients with aphasia even when no previous stroke or structural lesions are detectable and EEG shows no epileptic discharges. Epileptic origin is

  8. Rehabilitation Of Stroke Aphasia: Topics Of Research

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    Fariba Yadegari

    2017-02-01

    Full Text Available Background: Stroke may result in aphasia, an acquired language disorder which affects receptive and expressive language. The symptoms are observed in the auditory-verbal processing, oral expression, written expression and written language processing. As spoken language is the strongest tool of human communication, loss of it may cause great destructive consequences in the social and personal life of the affected individual. People with aphasia (PWA and their carers seek rehabilitation in an effort to remove or reduce the effects. Speech-language pathologists (SLPs are professional in offering such service. This paper aims at addressing new approaches and current research questions about the factors affecting the therapy. Main points: The issues which aphasia therapy research and reviews have addressed are the ones that are asked frequently in clinical settings and research areas. These include the intensity of treatment, the best post-onset time to start, quality of individualized treatment, efficacy of newly-introduced interventions, and the interventions based on the International Classification of Functioning, Disability and Health (ICF model with emphasis on activity/participation. Findings: The results of studies have revealed that compact therapy in a short period of time might result in better recovery of aphasia. Studies also indicated that starting treatments very early with intensive programs leads to the best therapy results. Chronic stage is good for some intervention strategies as well; however, the effectiveness of these interventions requires further investigations. Moreover, better treatment results could be attained by tailoring the program to match with individual needs. Manipulation of word frequency, personal relevance, and considering reaction time are among important factors in tailor-made therapies. Besides, the conceptual model of ICF which incorporates impairment (body structure and function, activity and participation

  9. Integration of speech and gesture in aphasia.

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    Cocks, Naomi; Byrne, Suzanne; Pritchard, Madeleine; Morgan, Gary; Dipper, Lucy

    2018-02-07

    Information from speech and gesture is often integrated to comprehend a message. This integration process requires the appropriate allocation of cognitive resources to both the gesture and speech modalities. People with aphasia are likely to find integration of gesture and speech difficult. This is due to a reduction in cognitive resources, a difficulty with resource allocation or a combination of the two. Despite it being likely that people who have aphasia will have difficulty with integration, empirical evidence describing this difficulty is limited. Such a difficulty was found in a single case study by Cocks et al. in 2009, and is replicated here with a greater number of participants. To determine whether individuals with aphasia have difficulties understanding messages in which they have to integrate speech and gesture. Thirty-one participants with aphasia (PWA) and 30 control participants watched videos of an actor communicating a message in three different conditions: verbal only, gesture only, and verbal and gesture message combined. The message related to an action in which the name of the action (e.g., 'eat') was provided verbally and the manner of the action (e.g., hands in a position as though eating a burger) was provided gesturally. Participants then selected a picture that 'best matched' the message conveyed from a choice of four pictures which represented a gesture match only (G match), a verbal match only (V match), an integrated verbal-gesture match (Target) and an unrelated foil (UR). To determine the gain that participants obtained from integrating gesture and speech, a measure of multimodal gain (MMG) was calculated. The PWA were less able to integrate gesture and speech than the control participants and had significantly lower MMG scores. When the PWA had difficulty integrating, they more frequently selected the verbal match. The findings suggest that people with aphasia can have difficulty integrating speech and gesture in order to obtain

  10. Reducing the psychosocial impact of aphasia on mood and quality of life in people with aphasia and the impact of caregiving in family members through the Aphasia Action Success Knowledge (Aphasia ASK) program: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Worrall, Linda; Ryan, Brooke; Hudson, Kyla; Kneebone, Ian; Simmons-Mackie, Nina; Khan, Asaduzzaman; Hoffmann, Tammy; Power, Emma; Togher, Leanne; Rose, Miranda

    2016-03-22

    People with aphasia and their family members are at high risk of experiencing post stroke depression. The impact of early interventions on mood and quality of life for people with aphasia is unknown. This study will determine whether an early intervention for both the person with aphasia after stroke and their family members leads to better mood and quality of life outcomes for people with aphasia, and less caregiver burden and better mental health for their family members. This is a multicenter, cluster-randomized controlled trial. Clusters, which are represented by Health Service Districts, will be randomized to the experimental intervention (Aphasia Action Success Knowledge Program) or an attention control (Secondary Stroke Prevention Information Program). People with aphasia and their family members will be blinded to the study design and treatment allocation (that is, will not know there are two arms to the study). Both arms of the study will receive usual care in addition to either the experimental or the attention control intervention. A total of 344 people with aphasia and their family members will be recruited. Considering a cluster size of 20, the required sample size can be achieved from 18 clusters. However, 20 clusters will be recruited to account for the potential of cluster attrition during the study. Primary outcome measures will be mood and quality of life of people with aphasia at 12 months post stroke. Secondary measures will be family member outcomes assessing the impact of caregiving and mental health, and self-reported stroke risk-related behaviors of people with aphasia. This is the first known program tailored for people with aphasia and their family members that aims to prevent depression in people with aphasia by providing intervention early after the stroke. This trial is registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) as ACTRN12614000979651 . Date registered: 11 September 2014.

  11. AphasiaBank as BigData.

    Science.gov (United States)

    MacWhinney, Brian; Fromm, Davida

    2016-02-01

    AphasiaBank has used a standardized protocol to collect narrative, procedural, personal, and descriptive discourse from 290 persons with aphasia, as well as 190 control participants. These data have been transcribed in the Codes for the Human Analysis of Transcripts (CHAT) format for analysis by the Computerized Language Analysis (CLAN) programs. Here, we review results from 45 studies based on these data that investigate aphasic productions in terms of these eight areas: discourse, grammar, lexicon, gesture, fluency, syndrome classification, social factors, and treatment effects. For each area, we also indicate how use of the CLAN programs has facilitated the analysis. We conclude with an examination of ways in which the size of the database could be increased through on-site recordings and data from teletherapy. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  12. AphasiaBank: a resource for clinicians.

    Science.gov (United States)

    Forbes, Margaret M; Fromm, Davida; Macwhinney, Brian

    2012-08-01

    AphasiaBank is a shared, multimedia database containing videos and transcriptions of ~180 aphasic individuals and 140 nonaphasic controls performing a uniform set of discourse tasks. The language in the videos is transcribed in Codes for the Human Analysis of Transcripts (CHAT) format and coded for analysis with Computerized Language ANalysis (CLAN) programs, which can perform a wide variety of language analyses. The database and the CLAN programs are freely available to aphasia researchers and clinicians for educational, clinical, and scholarly uses. This article describes the database, suggests some ways in which clinicians and clinician researchers might find these materials useful, and introduces a new language analysis program, EVAL, designed to streamline the transcription and coding processes, while still producing an extensive and useful language profile. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  13. Influence of Cognitive Ability on Therapy Outcomes for Anomia in Adults with Chronic Poststroke Aphasia

    Science.gov (United States)

    Dignam, Jade; Copland, David; O'Brien, Kate; Burfein, Penni; Khan, Asaduzzaman; Rodriguez, Amy D.

    2017-01-01

    Purpose: The relationship between cognitive abilities and aphasia rehabilitation outcomes is complex and remains poorly understood. This study investigated the influence of language and cognitive abilities on anomia therapy outcomes in adults with aphasia. Method: Thirty-four adults with chronic aphasia participated in Aphasia Language Impairment…

  14. Progress in the last decade in our understanding of primary progressive aphasia

    Directory of Open Access Journals (Sweden)

    Ratnavalli Ellajosyula

    2010-10-01

    Full Text Available Primary progressive aphasia (PPA is a focal neurodegeneration of the brain affecting the language network. Patients can have isolated language impairment for years without impairment in other areas. PPA is classified as primary progressive nonfluent aphasia (PNFA, semantic dementia (SD, and logopenic aphasia, which have distinct patterns of atrophy on neuroimaging. PNFA and SD are included under frontotemporal lobar degenerations. PNFA patients have effortful speech with agrammatism, which is frequently associated with apraxia of speech and demonstrate atrophy in the left Broca′s area and surrounding region on neuroimaging. Patients with SD have dysnomia with loss of word and object (or face meaning with asymmetric anterior temporal lobe atrophy. Logopenic aphasics have word finding difficulties with frequent pauses in conversation, intact grammar, and word comprehension but impaired repetition for sentences. The atrophy is predominantly in the left posterior temporal and inferior parietal regions. Recent studies have described several progranulin mutations on chromosome 17 in PNFA. The three clinical syndromes have a less robust relationship to the underlying pathology, which is heterogeneous and includes tauopathy, ubiquitinopathy, Pick′s disease, corticobasal degeneration, progressive supranuclear palsy, and Alzheimer′s disease. Recent studies, however, seem to indicate that a better characterization of the clinical phenotype (apraxic, agrammatic, semantic, logopenic, jargon increases the predictive value of the underlying pathology. Substantial advances have been made in our understanding of PPAs but developing new biomarkers is essential in making accurate causative diagnoses in individual patients. This is critically important in the development and evaluation of disease-modifying drugs.

  15. Repetition or Reconfiguration

    DEFF Research Database (Denmark)

    Andersen, Kristina Vaarst

    , the cognitive quality of knowledge held by individual professionals is the key microfoundation for project level performance. This paper empirically tests effects of project participants with and without knowledge diversity for project level performance for projects aiming for varying degrees of repetition...... and reconfiguration. The results indicate that project performance benefits form contributions from individuals holding diverse knowledge only when projects aim for high differentiation levels. This positive association is not just moderated, it may even be reversed in the case of professionals participating in low...

  16. MIMICRY, DIFFERENCE AND REPETITION

    Directory of Open Access Journals (Sweden)

    Marcelo Mendes de Souza

    2008-07-01

    Full Text Available This article addresses Homi K. Bhabha’s concept of mimicry in a broader context, other than that of cultural studies and post-colonial studies, bringing together other concepts, such as that of Gilles Deleuze in Difference and repetition, among other texts, and other names, such as Silviano Santiago, Jorge Luís Borges, Franz Kafka and Giorgio Agamben. As a partial conclusion, the article intends to oppose Bhabha’s freudian-marxist view to Five propositions on Psychoanalysis (1973, Gilles Deleuze’s text about Psychoanalysis published right after his book The Anti-Oedipus.

  17. Low-frequency rTMS with language therapy over a 3-month period for sensory-dominant aphasia: case series of two post-stroke Japanese patients.

    Science.gov (United States)

    Kakuda, Wataru; Abo, Masahiro; Uruma, Go; Kaito, Nobuyoshi; Watanabe, Motoi

    2010-01-01

    To examine the safety and feasibility of therapeutic application of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with language therapy for post-stroke patients with sensory-dominant aphasia. Two post-stroke Japanese patients with sensory-dominant aphasia were studied. In both patients, 10 sessions of 20-minute low-frequency rTMS with 1 Hz to the Wernicke's area were provided throughout 6-day hospitalization, followed by weekly outpatient rTMS treatment for 3 months. The language therapy was also provided through the period of in- and out-patient treatment. Language function was evaluated using the Token test and the Standard Language Test of Aphasia (SLTA) at the start and end of the in-patient treatment and the end of the outpatient treatment. The therapeutic protocol was well tolerated throughout the in- and out-patient treatments, without any adverse effects. The scores of the Token test and certain sub-categories of SLTA increased in both patients after the in-patient rTMS treatment. Persistent improvement of the score was noted over the 3-month post-discharge period. The proposed protocol of long-term application of low-frequency rTMS to the Wernicke's area and language therapy is considered a safe and feasible therapeutic approach for post-stroke patients with sensory-dominant aphasia.

  18. Effect of low-frequency rTMS on aphasia in stroke patients: a meta-analysis of randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Cai-Li Ren

    Full Text Available Small clinical trials have reported that low-frequency repetitive transcranial magnetic stimulation (rTMS might improve language recovery in patients with aphasia after stroke. However, no systematic reviews or meta-analyses studies have investigated the effect of rTMS on aphasia. The objective of this study was to perform a meta-analysis of studies that explored the effects of low-frequency rTMS on aphasia in stroke patients.We searched PubMed, CENTRAL, Embase, CINAHL, ScienceDirect, and Journals@Ovid for randomized controlled trials published between January 1965 and October 2013 using the keywords "aphasia OR language disorders OR anomia OR linguistic disorders AND repetitive transcranial magnetic stimulation OR rTMS". We used fixed- and random-effects models to estimate the standardized mean difference (SMD and a 95% CI for the language outcomes.Seven eligible studies involving 160 stroke patients were identified in this meta-analysis. A significant effect size of 1.26 was found for the language outcome severity of impairment (95% CI = 0.80 to 1.71 without heterogeneity (I2 = 0%, P = 0.44. Further analyses demonstrated prominent effects for the naming subtest (SMD = 0.52, 95% CI = 0.18 to 0.87, repetition (SMD = 0.54, 95% CI = 0.16 to 0.92, writing (SMD = 0.70, 95% CI = 0.19 to 1.22, and comprehension (the Token test: SMD = 0.58, 95% CI = 0.07 to 1.09 without heterogeneity (I2 = 0%. The SMD of AAT and BDAE comprehension subtests was 0.32 (95% CI = -0.08 to 0.72 with moderate heterogeneity (I2 = 32%,P = 0.22. The effect size did not change significantly even when any one trial was eliminated. None of the patients from the 7 included articles reported adverse effects from rTMS.Low-frequency rTMS with a 90% resting motor threshold that targets the triangular part of the right inferior frontal gyrus (IFG has a positive effect on language recovery in patients with aphasia following

  19. Stroke-related Wernicke's Aphasia Mistaken for Psychosis: A Case ...

    African Journals Online (AJOL)

    Patients with isolated Wernicke' aphasia present a variety of challenges to healthcare providers, The presentation of speech and language problems, especially with the features seen in Wernicke's aphasia, can be misinterpreted as psychiatric disorders. The authors present the case of a man who sustained a right-sided ...

  20. Oral and Written Picture Description in Individuals with Aphasia

    Science.gov (United States)

    Vandenborre, Dorien; Visch-Brink, Evy; van Dun, Kim; Verhoeven, Jo; Mariën, Peter

    2018-01-01

    Background: Aphasia is characterized by difficulties in connected speech/writing. Aims: To explore the differences between the oral and written description of a picture in individuals with chronic aphasia (IWA) and healthy controls. Descriptions were controlled for productivity, efficiency, grammatical organization, substitution behaviour and…

  1. Aphasia and Topic Initiation in Conversation: A Case Study

    Science.gov (United States)

    Barnes, Scott E.; Candlin, Christopher N.; Ferguson, Alison

    2013-01-01

    Background: Aphasiologists often research, assess and treat linguistic impairment and its consequences for daily life separately. Studies that link the language used by people with aphasia to routine communicative activities may expand the linguistic forms treated as relevant for successful communication by people with aphasia. Previous research…

  2. International Patterns of the Public Awareness of Aphasia

    Science.gov (United States)

    Code, Chris; Papathanasiou, Ilias; Rubio-Bruno, Silvia; Cabana, María de la Paz; Villanueva, Maria Marta; Haaland-Johansen, Line; Prizl-Jakovac, Tatjana; Leko, Ana; Zemva, Nada; Patterson, Ruth; Berry, Richard; Rochon, Elizabeth; Leonard, Carol; Robert, Amelie

    2016-01-01

    Background: It has been suggested that public awareness of aphasia is vital for extending services, research support, social inclusion and targeted raising of awareness. Earlier studies show that knowledge of aphasia varies across a range of variables, but is very low compared with other conditions. Aims: To report a series of surveys of public…

  3. Combined Dextroamphetamine and Transcranial Direct Current Stimulation in Poststroke Aphasia.

    Science.gov (United States)

    Keser, Zafer; Dehgan, Michelle Weber; Shadravan, Shaparak; Yozbatiran, Nuray; Maher, Lynn M; Francisco, Gerard E

    2017-10-01

    There is a growing need for various effective adjunctive treatment options for speech recovery after stroke. A pharmacological agent combined with noninvasive brain stimulation has not been previously reported for poststroke aphasia recovery. In this "proof of concept" study, we aimed to test the safety of a combined intervention consisting of dextroamphetamine, transcranial direct current stimulation, and speech and language therapy in subjects with nonfluent aphasia. Ten subjects with chronic nonfluent aphasia underwent two experiments where they received dextroamphetamine or placebo along with transcranial direct current stimulation and speech and language therapy on two separate days. The Western Aphasia Battery-Revised was used to monitor changes in speech performance. No serious adverse events were observed. There was no significant increase in blood pressure with amphetamine or deterioration in speech and language performance. Western Aphasia Battery-Revised aphasia quotient and language quotient showed a statistically significant increase in the active experiment. Comparison of proportional changes of aphasia quotient and language quotient in active experiment with those in placebo experiment showed significant difference. We showed that the triple combination therapy is safe and implementable and seems to induce positive changes in speech and language performance in the patients with chronic nonfluent aphasia due to stroke.

  4. Designing a playful communication support tool for persons with aphasia

    NARCIS (Netherlands)

    Al Mahmud, A.; Ayoola, I.B.I.; Martens, J.B.O.S.; Campos, P.; Graham, N.; George, J.; Nunes, N.; Palanque, P.; Winckler, M.

    2011-01-01

    Many studies have investigated ways to leverage communication with people with aphasia. Here, a new concept is developed for people with non-severe aphasia in a way that accesses the emotional and unaware layer of a conversation and then communicates certain information to the partner hence;

  5. Automated Proposition Density Analysis for Discourse in Aphasia

    Science.gov (United States)

    Fromm, Davida; Greenhouse, Joel; Hou, Kaiyue; Russell, G. Austin; Cai, Xizhen; Forbes, Margaret; Holland, Audrey; MacWhinney, Brian

    2016-01-01

    Purpose: This study evaluates how proposition density can differentiate between persons with aphasia (PWA) and individuals in a control group, as well as among subtypes of aphasia, on the basis of procedural discourse and personal narratives collected from large samples of participants. Method: Participants were 195 PWA and 168 individuals in a…

  6. Mild Aphasia: Is This the Place for an Argument?

    Science.gov (United States)

    Armstrong, Elizabeth; Fox, Sarah; Wilkinson, Ray

    2013-01-01

    Purpose: Individuals with mild aphasia often report significant disruption to their communication despite seemingly minor impairment. This study explored this phenomenon through examining conversations of a person with mild aphasia engaging in argumentation--a skill she felt had significantly deteriorated after her stroke. Method: A person with…

  7. Who Benefits from an Intensive Comprehensive Aphasia Program?

    Science.gov (United States)

    Babbitt, Edna M.; Worrall, Linda; Cherney, Leora R.

    2016-01-01

    Purpose: This article summarizes current outcomes from intensive comprehensive aphasia programs (ICAPs) and examines data from one ICAP to identify those who respond and do not respond to treatment. Methods: Participants were divided into 2 groups, responders and nonresponders, based on ±5-point change score on the Western Aphasia Battery-Revised…

  8. Acquired dyslexia in Serbian speakers with Broca's and Wernicke's aphasia.

    Science.gov (United States)

    Vuković, Mile; Vuković, Irena; Miller, Nick

    2016-01-01

    This study examined patterns of acquired dyslexia in Serbian aphasic speakers, comparing profiles of groups with Broca's versus Wernicke's aphasia. The study also looked at the relationship of reading and auditory comprehension and between reading comprehension and reading aloud in these groups. Participants were 20 people with Broca's and 20 with Wernicke's aphasia. They were asked to read aloud and to understand written material from the Serbian adaptation of the Boston Diagnostic Aphasia Examination. A Serbian Word Reading Aloud Test was also used. The people with Broca's aphasia achieved better results in reading aloud and in reading comprehension than those with Wernicke's aphasia. Those with Wernicke's aphasia showed significantly more semantic errors than those with Broca's aphasia who had significantly more morphological and phonological errors. From the data we inferred that lesion sites accorded with previous work on networks associated with Broca's and Wernicke's aphasia and with a posterior-anterior axis for reading processes centred on (left) parietal-temporal-frontal lobes. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Retrospective analysis of outcomes from two intensive comprehensive aphasia programs.

    Science.gov (United States)

    Persad, Carol; Wozniak, Linda; Kostopoulos, Ellina

    2013-01-01

    Positive outcomes from intensive therapy for individuals with aphasia have been reported in the literature. Little is known about the characteristics of individuals who attend intensive comprehensive aphasia programs (ICAPs) and what factors may predict who makes clinically significant changes when attending such programs. Demographic data on participants from 6 ICAPs showed that individuals who attend these programs spanned the entire age range (from adolescence to late adulthood), but they generally tended to be middle-aged and predominantly male. Analysis of outcome data from 2 of these ICAPs found that age and gender were not significant predictors of improved outcome on measures of language ability or functional communication. However, time post onset was related to clinical improvement in functional communication as measured by the Communication Activities of Daily Living, second edition (CADL-2). In addition, for one sample, initial severity of aphasia was related to outcome on the Western Aphasia Battery-Revised, such that individuals with more severe aphasia tended to show greater recovery compared to those with mild aphasia. Initial severity of aphasia also was highly correlated with changes in CADL-2 scores. These results suggest that adults of all ages with aphasia in either the acute or chronic phase of recovery can continue to show positive improvements in language ability and functional communication with intensive treatment.

  10. Brain Perfusion in Corticobasal Syndrome with Progressive Aphasia

    Directory of Open Access Journals (Sweden)

    Yoshitake Abe

    2016-04-01

    Full Text Available Background: Brain perfusion may differ between patients with corticobasal syndrome (CBS with and without aphasia. Methods: Twenty-six (9 males and 17 females; mean age 76 ± 5.3 years patients with CBS were enrolled in the study. Brain MRI and single-photon emission computed tomography were performed in all subjects. Language was evaluated using the Standard Language Test of Aphasia. The patients were divided into two subgroups according to the presence or absence of progressive aphasia. Differences in the regional cerebral blood flow (rCBF between the two groups were detected based on voxel-by-voxel group analysis using Statistical Parametric Mapping 8. Results: All patients exhibited asymmetric motor symptoms and signs, including limb apraxia, bradykinesia, and akinetic rigidity. Of 26 patients, 9 had a clinically obvious language disturbance, characterized as nonfluent aphasia. Almost all CBS patients with aphasia exhibited cortical atrophy predominantly in the left frontal and temporal lobes with widening of the Sylvian fissure on MRI. The rCBF in the left middle frontal gyrus differed significantly between CBS patients with and without aphasia. Conclusion: CBS patients with aphasia exhibit motor symptoms predominantly on the right side and cortical atrophy mainly in the left perisylvian cortices. In particular, left frontal dysfunction might be related to nonfluent aphasia in CBS.

  11. From individual to global: Human rights and aphasia.

    Science.gov (United States)

    Hersh, Deborah

    2018-02-01

    This commentary marks the 70th anniversary of the Universal Declaration of Human Rights by examining Article 19 and its application to people with aphasia. This group of people still face lack of access, stigmatisation, exclusion, disadvantage and social withdrawal as well as poor public awareness of aphasia and inadequate prioritisation of support and resources. Nevertheless, a range of creative initiatives at individual, healthcare, local community, national and global levels have helped to connect and empower people with aphasia. Such initiatives include provision of accessible information in a range of media, inclusion of people with aphasia in decision-making and as research partners, awareness raising campaigns to counter attitudinal barriers, organisation of community aphasia groups, development of guidelines for best practice, national aphasia associations and international collaborations such as Aphasia United. While ongoing work and resourcing is needed to expand these efforts further, they have helped people with aphasia to be heard and to protect their sense of dignity which underlies human rights. A human rights approach can unite, politicise and refocus these efforts, and highlight the essential role of communication in fostering a better quality of life.

  12. Diagnosis of aphasia using neural and fuzzy techniques

    DEFF Research Database (Denmark)

    Jantzen, Jan; Axer, H.; Keyserlingk, D. Graf von

    2000-01-01

    The language disability Aphasia has several sub-diagnoses such as Amnestic, Broca, Global, and Wernicke. Data concerning 265 patients is available in the form of test scores and diagnoses, made by physicians according to the Aachen Aphasia Test. A neural network model has been built, which...

  13. Principles Underlying the Bilingual Aphasia Test (BAT) and Its Uses

    Science.gov (United States)

    Paradis, Michel

    2011-01-01

    The Bilingual Aphasia Test (BAT) is designed to be objective (so it can be administered by a lay native speaker of the language) and equivalent across languages (to allow for a comparison between the languages of a given patient as well as across patients from different institutions). It has been used not only with aphasia but also with any…

  14. Diagnosis Of Aphasia Using Neural And Fuzzy Techniques

    DEFF Research Database (Denmark)

    Jantzen, Jan; Axer, Hubertus; Keyserlingk, Diedrich Graf von

    2002-01-01

    The language disability aphasia has several sub-diagnoses such as Amnestic, Broca, Global, and Wernicke. Data concerning 265 patients is available in the form of test scores and diagnoses, made by physicians according to the Aachen Aphasia Test. A neural network model has been built, which...

  15. Adaptation of the bilingual aphasia test [BAT] English-Bemba

    NARCIS (Netherlands)

    Kankinza, N.; Jonkers, Roel

    Background: The BAT (Paradis, 1987) is an assessment tool for Aphasia, an acquired language disorder caused by focal brain lesion which affects comprehension, production, spoken and written lan-guage.Despite extensive works in the field of aphasia, there has to date been no work undertaken on

  16. Atomoxetine administration combined with intensive speech therapy for post-stroke aphasia: evaluation by a novel SPECT method.

    Science.gov (United States)

    Yamada, Naoki; Kakuda, Wataru; Yamamoto, Kazuma; Momosaki, Ryo; Abo, Masahiro

    2016-09-01

    We clarified the safety, feasibility, and efficacy of atomoxetine administration combined with intensive speech therapy (ST) for patients with post-stroke aphasia. In addition, we investigated the effect of atomoxetine treatment on neural activity of surrounding lesioned brain areas. Four adult patients with motor-dominant aphasia and a history of left hemispheric stroke were studied. We have registered on the clinical trials database (ID: JMA-IIA00215). Daily atomoxetine administration of 40 mg was initiated two weeks before admission and raised to 80 mg 1 week before admission. During the subsequent 13-day hospitalization, administration of atomoxetine was raised to 120 mg and daily intensive ST (120 min/day, one-on-one training) was provided. Language function was assessed using the Japanese version of The Western Aphasia Battery (WAB) and the Token test two weeks prior to admission, on the day of admission, and at discharge. At two weeks prior to admission and at discharge, each patient's cortical blood flow was measured using (123)I-IMP-single photon emission computed tomography (SPECT). This protocol was successfully completed by all patients without any adverse effects. Four patients showed improved language function with the median of the Token Test increasing from 141 to 149, and the repetition score of WAB increasing from 88 to 99. In addition, cortical blood flow surrounding lesioned brain areas was found to increase following intervention in all patients. Atomoxetine administration and intensive ST were safe and feasible for post-stroke aphasia, suggesting their potential usefulness in the treatment of this patient population.

  17. What People Living with Aphasia Think about the Availability of Aphasia Resources

    Science.gov (United States)

    Hinckley, Jacqueline J.; Hasselkus, Amy; Ganzfried, Ellayne

    2013-01-01

    Purpose: Obtaining health information and resources can influence an individual's (a) access to services, (b) interactions with health care providers, and (c) ability to manage one's own health needs. The purpose of this study was to gather the perceptions of consumers living with aphasia about resource availability and information needs. Method:…

  18. Constraint-induced aphasia therapy versus intensive semantic treatment in fluent aphasia.

    Science.gov (United States)

    Wilssens, Ineke; Vandenborre, Dorien; van Dun, Kim; Verhoeven, Jo; Visch-Brink, Evy; Mariën, Peter

    2015-05-01

    The authors compared the effectiveness of 2 intensive therapy methods: Constraint-Induced Aphasia Therapy (CIAT; Pulvermüller et al., 2001) and semantic therapy (BOX; Visch-Brink & Bajema, 2001). Nine patients with chronic fluent aphasia participated in a therapy program to establish behavioral treatment outcomes. Participants were randomly assigned to one of two groups (CIAT or BOX). Intensive therapy significantly improved verbal communication. However, BOX treatment showed a more pronounced improvement on two communication-namely, a standardized assessment for verbal communication, the Amsterdam Nijmegen Everyday Language Test (Blomert, Koster, & Kean, 1995), and a subjective rating scale, the Communicative Effectiveness Index (Lomas et al., 1989). All participants significantly improved on one (or more) subtests of the Aachen Aphasia Test (Graetz, de Bleser, & Willmes, 1992), an impairment-focused assessment. There was a treatment-specific effect. BOX treatment had a significant effect on language comprehension and semantics, whereas CIAT treatment affected language production and phonology. The findings indicate that in patients with fluent aphasia, (a) intensive treatment has a significant effect on language and verbal communication, (b) intensive therapy results in selective treatment effects, and (c) an intensive semantic treatment shows a more striking mean improvement on verbal communication in comparison with communication-based CIAT treatment.

  19. Word finding deficitsin aphasia: diagnosis and treatment. Rotterdam Aphasia Therapy Study-2

    NARCIS (Netherlands)

    M. Jong-Hagelstein (Marjolein)

    2011-01-01

    textabstractAphasia Imagine finding yourself all of a sudden alone in a Chinese city and not speaking or understanding Chinese. How do you ask for the way or read the signs, buy food and other necessities, watch tv or listen to the news, let alone have a social conversation with someone? This

  20. Temporal acoustic measures distinguish primary progressive apraxia of speech from primary progressive aphasia.

    Science.gov (United States)

    Duffy, Joseph R; Hanley, Holly; Utianski, Rene; Clark, Heather; Strand, Edythe; Josephs, Keith A; Whitwell, Jennifer L

    2017-05-01

    The purpose of this study was to determine if acoustic measures of duration and syllable rate during word and sentence repetition, and a measure of within-word lexical stress, distinguish speakers with primary progressive apraxia of speech (PPAOS) from nonapraxic speakers with the agrammatic or logopenic variants of primary progressive aphasia (PPA), and control speakers. Results revealed that the PPAOS group had longer durations and reduced rate of syllable production for most words and sentences, and the measure of lexical stress. Sensitivity and specificity indices for the PPAOS versus the other groups were highest for longer multisyllabic words and sentences. For the PPAOS group, correlations between acoustic measures and perceptual ratings of AOS were moderately high to high. Several temporal measures used in this study may aid differential diagnosis and help quantify features of PPAOS that are distinct from those associated with PPA in which AOS is not present. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Clinical impression and western aphasia battery classification of aphasia in acute ischemic stroke: Is there a discrepancy?

    Directory of Open Access Journals (Sweden)

    Aju Abraham John

    2017-01-01

    Full Text Available Background: Language disturbance is a common symptom of stroke, a prompt identifier of the event, and can cause devastating cognitive impairments. There are many inconsistencies and discrepancies between the different methods used for its evaluation. The relationship between Western Aphasia Battery (WAB and a simple bedside clinical examination is not clear. Aim: The aim of this study is to determine if bedside clinical impression of aphasia type can reliably predict WAB classification of aphasia and to describe the discrepancies between them. Materials and Methods: Eighty-two consecutive cases of acute ischemic stroke and aphasia were evaluated with bedside aphasia assessment, handedness by Edinburgh Handedness Inventory and WAB scoring was done. Kappa statistics was used to find the overall agreement of clinical impression and WAB. Results: Disagreement was seen predominantly for the nonfluent aphasias when the clinical impression was compared with WAB classification. WAB also had diagnosed three cases as having anomic aphasia using taxonomic classification, but same cases had normal language by aphasia quotient scoring of WAB. There was an overall agreement of 63.4% between patient's bedside clinical impression and WAB classification of aphasia, with a P< 0.001. Conclusion: Clinical impression was fairly reliable, as compared to WAB in assessing the type of aphasia. Clinical impression was appropriate in an acute setting, but WAB was required to quantify the severity of deficit, which may help in accessing prognosis, monitoring progression, and rehabilitation planning. Along with WAB, a bedside clinical impression should be done for all the patients to strengthen the description of aphasic deficit.

  2. Prediction during sentence comprehension in aphasia

    Directory of Open Access Journals (Sweden)

    Michael Walsh Dickey

    2014-04-01

    Full Text Available Much recent psycholinguistic work has focused on prediction in language comprehension (Altmann & Kamide, 1999; Federmeier, 2007; Levy, 2008. Unimpaired adults predict upcoming words and phrases based on material in the preceding context, like verbs (Altmann & Kamide, 1999 or constraining sentence contexts (Federmeier, 2007. Several models have tied rapid prediction to the language production system (Federmeier, 2007; Pickering & Garrod, 2013; Dell & Chang, 2014. Evidence for this link comes from that fact that older adults with lower verbal fluency show less predictive behavior (Federmeier, et al., 2010; DeLong, et al., 2012. Prediction in aphasic language comprehension has not been widely investigated, even though constraining sentence contexts are strongly facilitative for naming in aphasia (e.g., Love & Webb, 1977. Mack, et al. (2013 found in a visual-world task that people with aphasia (PWA do not predict upcoming objects based on verbs (cf. Altmann & Kamide, 1999. This finding suggests that prediction may be reduced in aphasia. However, it is unclear whether reduced prediction was caused by language-production impairments: all the PWA in their study had non-fluent aphasia. The current study examined whether PWA show evidence of prediction based on constraining sentence contexts (e.g., Federmeier, 2007. Specifically, it tested whether they exhibited facilitation for highly predictable words in reading, using materials that have previously demonstrated strong predictability effects for unimpaired adults (Rayner, et al., 2004. In addition, it tested whether differences in language-production ability among PWA accounted for differences in predictive behavior (viz. Pickering & Garrod, 2013; Dell & Chang, 2014. Eight PWA read sentences adapted from Rayner, et al. (2004 in a self-paced reading task. The materials crossed word frequency with predictability: high- vs. low-frequency words (bottle/diaper were preceded by contexts which made them

  3. [Acupuncture for aphasia: a retrospective analysis of clinical literature].

    Science.gov (United States)

    Tan, Jie; Zhang, Hong; Han, Guodong; Ai, Kun; Deng, Shifeng

    2016-04-01

    With the Meta-analysis method, the clinical efficacy of acupuncture and other regular methods for aphasia was evaluated, and the acupoints selection for aphasia was explored. The acupuncture literature of clinical randomized control trials for aphasia published in CNKI, WANFANG, VIP and CBM database was searched; the statistical analysis of clinical efficacy of acupuncture and other regular methods for aphasia was performed by using software Revman 5. 2 provided by Cochrane library. A file of Microsoft Excel was established to perform the analysis of acupoints selection based on frequency analysis method, so as to summarize the characteristics and rules. Totally 385 articles were searched, and 37 articles those met the inclusive criteria was included, involving 1,260 patients in the acupuncture group and 1 238 patients in the control group. The Meta-analysis results showed OR = 3.82, 95% Cl [3.01, 4.85]; rhombus was located on the right side and the funnel plot was nearly symmetry, indicating the treatment effect of the acupuncture group for aphasia was superior to the control group (Z = 11.04, P aphasia is superior to that of speech rehabilitation training and medication treatment alone. The clinical treatment for aphasia focuses on its local effect; the main acupoints are in the head and face, and the meridians are governor vessel, extra channels and conception vessel.

  4. Integrative intervention: a new perspective and brief review in aphasia.

    Science.gov (United States)

    Marshall, Rebecca Shisler; Mohapatra, Bijoyaa

    2017-09-01

    While integrative treatment practices have become a popular treatment in different areas of study, its use in the field of aphasiology is still limited. The following paper is an attempt to address the different alternative practices that could potentially be used to remediate aphasia. A narrative review was completed regarding integrative intervention that could potentially apply to aphasia population. Through this article we have explored various treatment options for integrative health care in aphasiology. Integrative treatments including brain specific antioxidants, progesterone and estradiol therapy, nutrition, synbiotic treatment, exercise, yoga, meditation and positive mood states have demonstrated positive changes in health and behavior in healthy aging or disorders such as stroke and aphasia. Offering integrative treatment for people with aphasia allows potential for high impact gains when combined with current speech language therapeutic practices. This paper highlights the rehabilitation possibilities for aphasia therapy. Combining complementary and traditional treatment approaches could be viewed as one of the contemporary approaches to clinical practice and research for practitioners and health care systems. Implications for Rehabilitation There has been very little research that explores the potential of various types of integrative treatment for individuals with aphasia. An integrative approach to the treatment of aphasia has potential for future clinical application. Combining treatment approaches could be viewed as a viable approach to clinical practice and in the health care system.

  5. Visual analog rating of mood by people with aphasia.

    Science.gov (United States)

    Haley, Katarina L; Womack, Jennifer L; Harmon, Tyson G; Williams, Sharon W

    2015-08-01

    Considerable attention has been given to the identification of depression in stroke survivors with aphasia, but there is more limited information about other mood states. Visual analog scales are often used to collect subjective information from people with aphasia. However, the validity of these methods for communicating about mood has not been established in people with moderately to severely impaired language. The dual purposes of this study were to characterize the relative endorsement of negative and positive mood states in people with chronic aphasia after stroke and to examine congruent validity for visual analog rating methods for people with a range of aphasia severity. Twenty-three left-hemisphere stroke survivors with aphasia were asked to indicate their present mood by using two published visual analog rating methods. The congruence between the methods was estimated through correlation analysis, and scores for different moods were compared. Endorsement was significantly stronger for "happy" than for mood states with negative valence. At the same time, several participants displayed pronounced negative mood compared to previously published norms for neurologically healthy adults. Results from the two rating methods were moderately and positively correlated. Positive mood is prominent in people with aphasia who are in the chronic stage of recovery after stroke, but negative moods can also be salient and individual presentations are diverse. Visual analog rating methods are valid methods for discussing mood with people with aphasia; however, design optimization should be explored.

  6. The anterior temporal lobes support residual comprehension in Wernicke's aphasia.

    Science.gov (United States)

    Robson, Holly; Zahn, Roland; Keidel, James L; Binney, Richard J; Sage, Karen; Lambon Ralph, Matthew A

    2014-03-01

    Wernicke's aphasia occurs after a stroke to classical language comprehension regions in the left temporoparietal cortex. Consequently, auditory-verbal comprehension is significantly impaired in Wernicke's aphasia but the capacity to comprehend visually presented materials (written words and pictures) is partially spared. This study used functional magnetic resonance imaging to investigate the neural basis of written word and picture semantic processing in Wernicke's aphasia, with the wider aim of examining how the semantic system is altered after damage to the classical comprehension regions. Twelve participants with chronic Wernicke's aphasia and 12 control participants performed semantic animate-inanimate judgements and a visual height judgement baseline task. Whole brain and region of interest analysis in Wernicke's aphasia and control participants found that semantic judgements were underpinned by activation in the ventral and anterior temporal lobes bilaterally. The Wernicke's aphasia group displayed an 'over-activation' in comparison with control participants, indicating that anterior temporal lobe regions become increasingly influential following reduction in posterior semantic resources. Semantic processing of written words in Wernicke's aphasia was additionally supported by recruitment of the right anterior superior temporal lobe, a region previously associated with recovery from auditory-verbal comprehension impairments. Overall, the results provide support for models in which the anterior temporal lobes are crucial for multimodal semantic processing and that these regions may be accessed without support from classic posterior comprehension regions.

  7. Topographic Evaluation of Aphasia in 100 Stroke Patients

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    S Ghandehari

    2005-07-01

    Full Text Available Introduction: Aphasia is a common manifestation of stroke and evaluation of relationships of aphasia and brain topography could lead to better understanding of cognitive neurophysiology. Methods: 100 stroke patients with aphasia admitted in Valie-Asr hospital, Khorasan since April 2003 were enrolled in this prospective cross-sectional study. Diagnosis of stroke and aphasia was made by a neurologist and topography of involved cerebrovascular territories confirmed by topographic maps of brain in CT scan. Results: Global, Broca and Wernicke subtypes of aphasia constituted 52%, 40% and 6% of the cases, respectively. Based on the usual nourishment of Broca and Wernicke areas by anterior and posterior cortical branches of the middle cerebral artery, 79% of Global, 47% of Broca and 50% of Wernicke aphasias had compatible infarct topography. The infarct topography in other cases was not congruent with the involved linguistic areas of their brain. Conclusion: Specific cerebrovascular topography for subtypes of aphasia in stroke patients was not found. The effects of cerebrovascular lesions on linguistic functions are not predictable by their topography in CT scan.

  8. Relationship of Aphasia and Topography of Cerebrovascular Territories

    Directory of Open Access Journals (Sweden)

    K. Ghandehari

    2004-10-01

    Full Text Available Aphasia is a common manifestation of stroke and evaluation of relationships of aphasia and brain topography could lead to better understanding of cognitive neurophysiology.Consecutive 100 stroke patients with aphasia admitted in Valie Asr hospital, Khorasan in 2003 enrulled in this prospective study. Diagnosis of stroke and aphasia was made by a neurolosist and topography of involved cerebrovascular territories confirmed by topographic maps of brain in CT scan. Global, Broca and Wernicke subtypes of aphasia constituted 52%, 40% and 6% of the cases respectively. Based on the usual nourishment of Broca and Wernicke areas by anterior and posterior cortical branches of the middle cerebral artery, 79% of Global, 47% of Broca and 50% of Wernicke aphasias had a compatible infarct topography. Other cases had no congruent infarct topography with involved linguistic area of their brain. Specific cerebrovascular topography for subtypes of aphasia in stroke patients was not found. The effects of cerebrovascular lesions on linguistic functions are not predictable by their topography in CT scan.

  9. Agnosia for accents in primary progressive aphasia.

    Science.gov (United States)

    Fletcher, Phillip D; Downey, Laura E; Agustus, Jennifer L; Hailstone, Julia C; Tyndall, Marina H; Cifelli, Alberto; Schott, Jonathan M; Warrington, Elizabeth K; Warren, Jason D

    2013-08-01

    As an example of complex auditory signal processing, the analysis of accented speech is potentially vulnerable in the progressive aphasias. However, the brain basis of accent processing and the effects of neurodegenerative disease on this processing are not well understood. Here we undertook a detailed neuropsychological study of a patient, AA with progressive nonfluent aphasia, in whom agnosia for accents was a prominent clinical feature. We designed a battery to assess AA's ability to process accents in relation to other complex auditory signals. AA's performance was compared with a cohort of 12 healthy age and gender matched control participants and with a second patient, PA, who had semantic dementia with phonagnosia and prosopagnosia but no reported difficulties with accent processing. Relative to healthy controls, the patients showed distinct profiles of accent agnosia. AA showed markedly impaired ability to distinguish change in an individual's accent despite being able to discriminate phonemes and voices (apperceptive accent agnosia); and in addition, a severe deficit of accent identification. In contrast, PA was able to perceive changes in accents, phonemes and voices normally, but showed a relatively mild deficit of accent identification (associative accent agnosia). Both patients showed deficits of voice and environmental sound identification, however PA showed an additional deficit of face identification whereas AA was able to identify (though not name) faces normally. These profiles suggest that AA has conjoint (or interacting) deficits involving both apperceptive and semantic processing of accents, while PA has a primary semantic (associative) deficit affecting accents along with other kinds of auditory objects and extending beyond the auditory modality. Brain MRI revealed left peri-Sylvian atrophy in case AA and relatively focal asymmetric (predominantly right sided) temporal lobe atrophy in case PA. These cases provide further evidence for the

  10. An analysis of topics and vocabulary in Chinese oral narratives by normal speakers and speakers with fluent aphasia.

    Science.gov (United States)

    Law, Sam-Po; Kong, Anthony Pak-Hin; Lai, Christy

    2018-01-01

    This study analysed the topic and vocabulary of Chinese speakers based on language samples of personal recounts in a large spoken Chinese database recently made available in the public domain, i.e. Cantonese AphasiaBank ( http://www.speech.hku.hk/caphbank/search/ ). The goal of the analysis is to offer clinicians a rich source for selecting ecologically valid training materials for rehabilitating Chinese-speaking people with aphasia (PWA) in the design and planning of culturally and linguistically appropriate treatments. Discourse production of 65 Chinese-speaking PWA of fluent types (henceforth, PWFA) and their non-aphasic controls narrating an important event in their life were extracted from Cantonese AphasiaBank. Analyses of topics and vocabularies in terms of part-of-speech, word frequency, lexical semantics, and diversity were conducted. There was significant overlap in topics between the two groups. While the vocabulary was larger for controls than that of PWFA as expected, they were similar in distribution across parts-of-speech, frequency of occurrence, and the ratio of concrete to abstract items in major open word classes. Moreover, proportionately more different verbs than nouns were employed at the individual level for both speaker groups. The findings provide important implications for guiding directions of aphasia rehabilitation not only of fluent but also non-fluent Chinese aphasic speakers.

  11. Parallel Recovery in a Trilingual Speaker: The Use of the Bilingual Aphasia Test as a Diagnostic Complement to the Comprehensive Aphasia Test

    Science.gov (United States)

    Green, David W.; Ruffle, Louise; Grogan, Alice; Ali, Nilufa; Ramsden, Sue; Schofield, Tom; Leff, Alex P.; Crinion, Jenny; Price, Cathy J.

    2011-01-01

    We illustrate the value of the Bilingual Aphasia Test in the diagnostic assessment of a trilingual speaker post-stroke living in England for whom English was a non-native language. The Comprehensive Aphasia Test is routinely used to assess patients in English, but only in combination with the Bilingual Aphasia Test is it possible and practical to…

  12. Cognitive deficits in post-stroke aphasia

    Directory of Open Access Journals (Sweden)

    Milena V. Bonini

    2015-10-01

    Full Text Available The assessment of aphasics’ cognitive performance is challenging and such patients are generally excluded from studies that describe cognitive deficits after stroke. We evaluated aphasics’ performance in cognitive tasks compared to non-aphasic subjects. A sample of 47 patients (21 aphasics, 17 non-aphasics with left hemisphere lesions and 9 non-aphasics with right hemisphere lesions performed cognitive tasks (attention, verbal and visual memory, executive functions, visuospatial skills and praxis. Aphasic patients performed poorer than all non-aphasics in Digit Span (p < 0.001, Clock-Drawing Test (p = 0.006, Verbal memory (p = 0.002, Visual Memory (p < 0.01, Verbal Fluency (p < 0.001, and Gesture Praxis (p < 0.001. Aphasia severity correlated with performance in Trail Making test part B (p = 0.004, Digit Span forward (p < 0.001 and backwards (p = 0.011, and Gesture Praxis (p = 0.002. Aphasia is accompanied by deficits not always easy to be evaluated by cognitive tests due to speech production and motor impairments. Assessment of cognitive functions in aphasics might contribute to optimize therapeutic intervention.

  13. Processing of metaphors in transcortical motor aphasia

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    Renata Mancopes

    Full Text Available Abstract Great emphasis has been placed on the right hemisphere, due to its possible selective contribution, in the processing of metaphorical statements. Objectives: To describe the processing of metaphors in the case of a patient with transcortical motor aphasia, using specific tests for patients with encephalic injuries of the right hemisphere, and to contribute to the discussion on the inter-hemispheric relationships associated with this function. Methods: A 54 year-old man with transcortical motor aphasia was evaluated three years after a left hemisphere stroke. The tasks of comprehension of metaphors were based on the subtest Metaphor Comprehension Task of the Montreal Evaluation of Communications Scale (MEC. Two metaphor comprehension tests were applied, in 45-minute sessions with a 48 hour interval between each. Test 1 involved comprehension of the metaphors according to the options offered, and Test 2 the comprehension of metaphors measured by response time and visual field. Results: Although the right hemisphere was not affected by the stroke in this case, difficulties were observed in the processing of metaphors. Conclusions: This study suggests that the left hemisphere participates in the processing of figurative meanings. The adaptability of the brain can also re-accommodate the uninjured areas of the brain, causing the dynamic of the brain to be modified. As a result, deducing cerebral functions based on clinical data can be problematic. The value of this study is that it can contribute to clinical aspects of language rehabilitation.

  14. Conditional and future tense impairment in non-fluent aphasia

    DEFF Research Database (Denmark)

    Rofes, Adrià; Bastiaanse, Roelien; Martínez-Ferreiro, Silvia

    2014-01-01

    Background:Morphological errors of tense and agreement are salient in agrammatic aphasia. The PADILIH predicts impairments in discourse linking that translate to greater difficulties in referring to a past event time than to a future or a present event time. In Catalan, the Periphrastic conditional...... between verb forms that refer to an irrealis future event (Simple conditional and Future). We also assessed whether problems in time reference extend to individuals with non-fluent aphasia that are not typical agrammatic Broca aphasia. Methods & Procedures:A sentence completion task that included 60...... sentences (20 per type) of equal length in a Conditional structure (if-sentences) was designed. We tested three sentence types: Periphrastic conditional, Simple conditional and Future. The task was administered to nine participants with non-fluent aphasia and nine age-matched non-brain-damaged participants...

  15. Temporoparietal cortex in aphasia. Evidence from positron emission tomography

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    Metter, E.J.; Hanson, W.R.; Jackson, C.A.; Kempler, D.; van Lancker, D.; Mazziotta, J.C.; Phelps, M.E. (National Institute of Aging, Baltimore, MD (USA))

    1990-11-01

    Forty-four aphasic patients were examined with (F18)-fluorodeoxyglucose positron emission tomography in a resting state to determine whether consistent glucose metabolic abnormalities were present. Ninety-seven percent of subjects showed metabolic abnormalities in the angular gyrus, 89% in the supramarginal gyrus, and 87% in the lateral and transverse superior temporal gyrus. Pearson product moment correlations were calculated between regional metabolic measures and performance on the Western Aphasia Battery. No significant correlations were found between the Western Aphasia Battery scores and right hemisphere metabolic measures. Most left hemisphere regions correlated with more than one score from the Western Aphasia Battery. Temporal but not frontal regions had significant correlations to the comprehension score. The left temporoparietal region was consistently affected in these subjects, suggesting that common features in the aphasias were caused by left temporoparietal dysfunction, while behavioral differences resulted from (1) the extent of temporoparietal changes, and (2) dysfunction elsewhere in the brain, particularly the left frontal and subcortical areas.

  16. Short-term and working memory impairments in aphasia.

    Science.gov (United States)

    Potagas, Constantin; Kasselimis, Dimitrios; Evdokimidis, Ioannis

    2011-08-01

    The aim of the present study is to investigate short-term memory and working memory deficits in aphasics in relation to the severity of their language impairment. Fifty-eight aphasic patients participated in this study. Based on language assessment, an aphasia score was calculated for each patient. Memory was assessed in two modalities, verbal and spatial. Mean scores for all memory tasks were lower than normal. Aphasia score was significantly correlated with performance on all memory tasks. Correlation coefficients for short-term memory and working memory were approximately of the same magnitude. According to our findings, severity of aphasia is related with both verbal and spatial memory deficits. Moreover, while aphasia score correlated with lower scores in both short-term memory and working memory tasks, the lack of substantial difference between corresponding correlation coefficients suggests a possible primary deficit in information retention rather than impairment in working memory. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. Temporoparietal cortex in aphasia. Evidence from positron emission tomography

    International Nuclear Information System (INIS)

    Metter, E.J.; Hanson, W.R.; Jackson, C.A.; Kempler, D.; van Lancker, D.; Mazziotta, J.C.; Phelps, M.E.

    1990-01-01

    Forty-four aphasic patients were examined with (F18)-fluorodeoxyglucose positron emission tomography in a resting state to determine whether consistent glucose metabolic abnormalities were present. Ninety-seven percent of subjects showed metabolic abnormalities in the angular gyrus, 89% in the supramarginal gyrus, and 87% in the lateral and transverse superior temporal gyrus. Pearson product moment correlations were calculated between regional metabolic measures and performance on the Western Aphasia Battery. No significant correlations were found between the Western Aphasia Battery scores and right hemisphere metabolic measures. Most left hemisphere regions correlated with more than one score from the Western Aphasia Battery. Temporal but not frontal regions had significant correlations to the comprehension score. The left temporoparietal region was consistently affected in these subjects, suggesting that common features in the aphasias were caused by left temporoparietal dysfunction, while behavioral differences resulted from (1) the extent of temporoparietal changes, and (2) dysfunction elsewhere in the brain, particularly the left frontal and subcortical areas

  18. Using the International Classification of Functioning, Disability, and Health to identify outcome domains for a core outcome set for aphasia: a comparison of stakeholder perspectives.

    Science.gov (United States)

    Wallace, Sarah J; Worrall, Linda; Rose, Tanya; Le Dorze, Guylaine

    2017-11-12

    This study synthesised the findings of three separate consensus processes exploring the perspectives of key stakeholder groups about important aphasia treatment outcomes. This process was conducted to generate recommendations for outcome domains to be included in a core outcome set for aphasia treatment trials. International Classification of Functioning, Disability, and Health codes were examined to identify where the groups of: (1) people with aphasia, (2) family members, (3) aphasia researchers, and (4) aphasia clinicians/managers, demonstrated congruence in their perspectives regarding important treatment outcomes. Codes were contextualized using qualitative data. Congruence across three or more stakeholder groups was evident for ICF chapters: Mental functions; Communication; and Services, systems, and policies. Quality of life was explicitly identified by clinicians/managers and researchers, while people with aphasia and their families identified outcomes known to be determinants of quality of life. Core aphasia outcomes include: language, emotional wellbeing, communication, patient-reported satisfaction with treatment and impact of treatment, and quality of life. International Classification of Functioning, Disability, and Health coding can be used to compare stakeholder perspectives and identify domains for core outcome sets. Pairing coding with qualitative data may ensure important nuances of meaning are retained. Implications for rehabilitation The outcomes measured in treatment research should be relevant to stakeholders and support health care decision making. Core outcome sets (agreed, minimum set of outcomes, and outcome measures) are increasingly being used to ensure the relevancy and consistency of the outcomes measured in treatment studies. Important aphasia treatment outcomes span all components of the International Classification of Functioning, Disability, and Health. Stakeholders demonstrated congruence in the identification of important

  19. A study on regional cerebral circulation in stroke patients with aphasia

    International Nuclear Information System (INIS)

    Kudo, Ryozo

    1985-01-01

    To study the pathophysiology of aphasia due to cerebral stroke, regional cerebral blood flow (rCBF) was measured by the 133 Xe clearance method and the volume of low density area (LDA) was estimated on the basis of computerized tomography in 43 thrombotic (24 aphasia and 19 non-aphasia), 30 hemorrhagic (16 aphasia and 14 non-aphasia) and 6 non-stroke cases. 1) In the healthy hemisphere, rCBF showed no significant difference between aphasia and non-aphasia in both thrombotic and hemorrhagic cases. In the affected hemisphere, thrombotic cases showed significantly decreased rCBF in aphasic cases as compared to non-aphasic, however, hemorrhagic cases revealed no difference. 2) LDA volume showed no significant difference between aphasia and non-aphasia in cerebral thrombosis, however, LDA volume in non-aphasia was smaller than that in aphasia in cerebral hemorrage. 3) Significant differences in the pathophysiology of aphasia due to cerebral stroke were recognized between cerebral thrombosis and cerebral hemorrhage. Such differences should be taken into consideration in the management and treatment of aphasia caused by cerebral stroke. (author)

  20. Type of aphasia and regional cerebral blood flow

    International Nuclear Information System (INIS)

    Tagawa, Koichi; Sugimoto, Keiko; Minematsu, Kazuo; Yamaguchi, Takenori; Naritomi, Hiroaki; Sawada, Tohru

    1982-01-01

    In 40 patients with aphasia due to cerebral infarction, regional cerebral blood flow (rCBF) was measured after 2 months of ictus with 133 Xe inhalation method. There were 18 cases with motor aphasia and 22 with sensory aphasia. On the measurements of rCBF, 3 detectors were placed over frontal region (group F), 3 over temporal region (group T), and remaining 3 over parietal region (group P), of the dominant hemisphere. The flow values were compared with the rCBF values obtained from 21 control subjects who had no abnormality in CT scan and on neurological examinations. The control subjects revealed the hyperfrontal pattern of flow distribution; rCBF values in groups F, T and P, which were expressed as an initial slope index, were 50.0 +- 4.8, 48.0 +- 5.1 and 47.4 +- 4.5, respectively. The hyperfrontal pattern was absent in cases with motor aphasia. In this group, rCBF in groups F, T and P were 42.0 +- 8.3, 44.7 +- 8.4 and 41.0 +- 8.5, respectively, and rCBF in frontal region was significantly reduced compared with that in the control group. In sensory aphasia, rCBF values in groups F, T and P were all significantly reduced compared to the controls showing 44.0 +- 5.7, 42.8 +- 5.1 and 40.6 +- 5.4, respectively. In this group, the hyperfrontal pattern was maintained at a low flow level. When absolute rCBF values were compared between motor and sensory aphasia, there was no significant difference between these 2 groups. However, regional flow distribution in motor aphasia was significantly different from that of sensory aphasia, and the cases having the lowest value in group F were more frequently found in the former than in the latter. (J.P.N.)

  1. [Are language disorders in Alzheimer's disease simply aphasia?

    Science.gov (United States)

    Hazif-Thomas, Cyril; Thomas, Philippe

    Alzheimer's disease is accompanied by gradual aphasia, becoming more severe when the cognitive disorders are more marked. However, the quality of care provided to the patient can modulate the evolution of these language difficulties. Aphasia is linked to a human communication deficiency and can be limited by taking into account the phatic function of language to keep the channels of communication open. Copyright © 2017. Published by Elsevier Masson SAS.

  2. A case of crossed aphasia with apraxia of speech

    Directory of Open Access Journals (Sweden)

    Yogesh Patidar

    2013-01-01

    Full Text Available Apraxia of speech (AOS is a rare, but well-defined motor speech disorder. It is characterized by irregular articulatory errors, attempts of self-correction and persistent prosodic abnormalities. Similar to aphasia, AOS is also localized to the dominant cerebral hemisphere. We report a case of Crossed Aphasia with AOS in a 48-year-old right-handed man due to an ischemic infarct in right cerebral hemisphere.

  3. Facilitation of speech repetition accuracy by theta burst stimulation of the left posterior inferior frontal gyrus.

    Science.gov (United States)

    Restle, Julia; Murakami, Takenobu; Ziemann, Ulf

    2012-07-01

    The posterior part of the inferior frontal gyrus (pIFG) in the left hemisphere is thought to form part of the putative human mirror neuron system and is assigned a key role in mapping sensory perception onto motor action. Accordingly, the pIFG is involved in motor imitation of the observed actions of others but it is not known to what extent speech repetition of auditory-presented sentences is also a function of the pIFG. Here we applied fMRI-guided facilitating intermittent theta burst transcranial magnetic stimulation (iTBS), or depressant continuous TBS (cTBS), or intermediate TBS (imTBS) over the left pIFG of healthy subjects and compared speech repetition accuracy of foreign Japanese sentences before and after TBS. We found that repetition accuracy improved after iTBS and, to a lesser extent, after imTBS, but remained unchanged after cTBS. In a control experiment, iTBS was applied over the left middle occipital gyrus (MOG), a region not involved in sensorimotor processing of auditory-presented speech. Repetition accuracy remained unchanged after iTBS of MOG. We argue that the stimulation type and stimulation site specific facilitating effect of iTBS over left pIFG on speech repetition accuracy indicates a causal role of the human left-hemispheric pIFG in the translation of phonological perception to motor articulatory output for repetition of speech. This effect may prove useful in rehabilitation strategies that combine repetitive speech training with iTBS of the left pIFG in speech disorders, such as aphasia after cerebral stroke. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Community Integration and Quality of Life in Aphasia after Stroke.

    Science.gov (United States)

    Lee, Hyejin; Lee, Yuna; Choi, Hyunsoo; Pyun, Sung-Bom

    2015-11-01

    To examine community integration and contributing factors in people with aphasia (PWA) following stroke and to investigate the relationship between community integration and quality of life (QOL). Thirty PWA and 42 age-and education-matched control subjects were involved. Main variables were as follows: socioeconomic status, mobility, and activity of daily living (ADL) (Modified Barthel Index), language function [Frenchay Aphasia Screening Test (FAST)], depression [Geriatric Depression Scale (GDS)], Community Integration Questionnaire (CIQ) and Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39). Differences between aphasia and control groups and factors affecting community integration and QOL were analyzed. Home and social integration and productive activity were significantly decreased in the aphasia group compared to the control group; 8.5 and 18.3 points in total CIQ score, respectively. Amount of time spent outside the home and frequency of social contact were also significantly reduced in the aphasia group. Total mean score on the SAQOL-39 was 2.75±0.80 points and was significantly correlated with economic status, gait performance, ADL, depressive mood, and social domain score on the CIQ. Depression score measured by GDS was the single most important factor for the prediction of QOL, but the FAST score was significantly correlated only with the communication domain of the SAQOL-39. Community activities of PWA were very limited, and depression was highly associated with decreased community integration and QOL. Enhancing social participation and reducing emotional distress should be emphasized for rehabilitation of PWA.

  5. Research with rTMS in the treatment of aphasia

    Science.gov (United States)

    Naeser, Margaret A.; Martin, Paula I; Treglia, Ethan; Ho, Michael; Kaplan, Elina; Bashir, Shahid; Hamilton, Roy; Coslett, H. Branch; Pascual-Leone, Alvaro

    2013-01-01

    This review of our research with rTMS to treat aphasia contains four parts: Part 1 reviews functional brain imaging studies related to recovery of language in aphasia with emphasis on nonfluent aphasia. Part 2 presents the rationale for using rTMS to treat nonfluent aphasia patients (based on results from functional imaging studies). Part 2 also reviews our current rTMS treatment protocol used with nonfluent aphasia patients, and our functional imaging results from overt naming fMRI scans, obtained pre- and post- a series of rTMS treatments. Part 3 presents results from a pilot study where rTMS treatments were followed immediately by constraint-induced language therapy (CILT). Part 4 reviews our diffusion tensor imaging (DTI) study that examined white matter connections between the horizontal, midportion of the arcuate fasciculus (hAF) to different parts within Broca’s area (pars triangularis, PTr; pars opercularis, POp), and the ventral premotor cortex (vPMC) in the RH and in the LH. Part 4 also addresses some of the possible mechanisms involved with improved naming and speech, following rTMS with nonfluent aphasia patients. PMID:20714075

  6. Some early cases of aphasia and the capacity to sing.

    Science.gov (United States)

    Johnson, Julene K; Graziano, Amy B

    2015-01-01

    This chapter examines early cases of aphasia that include observations of the capacity to sing. Although the majority of these cases were published in the late nineteenth century, earlier reports exist and provide insights into the early thinking about the capacity to sing in aphasia, a topic that continues to the present day. The observation that some patients with aphasia and limited speech output were able to sing the texts of songs inspired scholars to examine the relationship between music and language. Early ideas about the capacity to sing were provided by well-known neurologists, such as John Hughlings Jackson and Adolf Kussmaul. The work of Herbert Spencer about the origins and function of music heavily influenced Jackson and others in their thinking about aphasia. This work also led to an increased interest in understanding music abilities in persons with aphasia and, later, in the brain mechanisms of music. The chapter provides a background as to why there was an interest in the capacity to sing in persons with aphasia and what influenced early thinking on this topic. © 2015 Elsevier B.V. All rights reserved.

  7. [Specificities of the logopenic variant of primary progressive aphasia].

    Science.gov (United States)

    Magnin, E; Teichmann, M; Martinaud, O; Moreaud, O; Ryff, I; Belliard, S; Pariente, J; Moulin, T; Vandel, P; Démonet, J-F

    2015-01-01

    The logopenic variant of primary progressive aphasia is a syndrome with neuropsychological and linguistic specificities, including phonological loop impairment for which diagnosis is currently mainly based on the exclusion of the two other variants, semantic and nonfluent/agrammatic primary progressive aphasia. The syndrome may be underdiagnosed due (1) to mild language difficulties during the early stages of the disease or (2) to being mistaken for mild cognitive impairment or Alzheimer's disease when the evaluation of episodic memory is based on verbal material and (3) finally, it is not uncommon that the disorders are attributed to psychiatric co-morbidities such as, for example, anxiety. Moreover, compared to other variants of primary progressive aphasia, brain abnormalities are different. The left temporoparietal junction is initially affected. Neuropathology and biomarkers (cerebrospinal fluid, molecular amyloid nuclear imaging) frequently reveal Alzheimer's disease. Consequently this variant of primary progressive aphasia does not fall under the traditional concept of frontotemporal lobar degeneration. These distinctive features highlight the utility of correct diagnosis, classification, and use of biomarkers to show the neuropathological processes underlying logopenic primary progressive aphasia. The logopenic variant of primary progressive aphasia is a specific form of Alzheimer's disease frequently presenting a rapid decline; specific linguistic therapies are needed. Further investigation of this syndrome is needed to refine screening, improve diagnostic criteria and better understand the epidemiology and the biological mechanisms involved. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  8. Emotional response to musical repetition.

    Science.gov (United States)

    Livingstone, Steven R; Palmer, Caroline; Schubert, Emery

    2012-06-01

    Two experiments examined the effects of repetition on listeners' emotional response to music. Listeners heard recordings of orchestral music that contained a large section repeated twice. The music had a symmetric phrase structure (same-length phrases) in Experiment 1 and an asymmetric phrase structure (different-length phrases) in Experiment 2, hypothesized to alter the predictability of sensitivity to musical repetition. Continuous measures of arousal and valence were compared across music that contained identical repetition, variation (related), or contrasting (unrelated) structure. Listeners' emotional arousal ratings differed most for contrasting music, moderately for variations, and least for repeating musical segments. A computational model for the detection of repeated musical segments was applied to the listeners' emotional responses. The model detected the locations of phrase boundaries from the emotional responses better than from performed tempo or physical intensity in both experiments. These findings indicate the importance of repetition in listeners' emotional response to music and in the perceptual segmentation of musical structure.

  9. Future directions for ICT in aphasia therapy for older adults: enhancing current practices through interdisciplinary perspectives

    OpenAIRE

    Kötteritzsch, Anna; Gerling, Kathrin

    2015-01-01

    Growing numbers of older adults requiring aphasia therapy create challenges for the health care system. Information and communication technology (ICT) has the potential to provide computer-mediated, self-administered aphasia therapy that complements conventional therapy. We explore overlaps in ICT for older adults and aphasia therapy applications with the goal of integrating innovative ICT in aphasia therapy. Based on a case study, we explain how results of different disciplines developing IC...

  10. An exploration of the friendship experiences of working-age adults with aphasia

    OpenAIRE

    Pound, Carole

    2013-01-01

    This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University. Aphasia impairs using and understanding language, and thus impacts on communication, identity and relationships. However, little research has investigated how people with aphasia understand friends and friendship. This Participatory Action Research (PAR) study explored how younger adults with aphasia experience friendship. Participants were 28 people with aphasia, some of whom were m...

  11. Grammatical category dissociation in multilingual aphasia.

    Science.gov (United States)

    Faroqi-Shah, Yasmeen; Waked, Arifi N

    2010-03-01

    Word retrieval deficits for specific grammatical categories, such as verbs versus nouns, occur as a consequence of brain damage. Such deficits are informative about the nature of lexical organization in the human brain. This study examined retrieval of grammatical categories across three languages in a trilingual person with aphasia who spoke Arabic, French, and English. In order to delineate the nature of word production difficulty, comprehension was tested, and a variety of concomitant lexical-semantic variables were analysed. The patient demonstrated a consistent noun-verb dissociation in picture naming and narrative speech, with severely impaired production of verbs across all three languages. The cross-linguistically similar noun-verb dissociation, coupled with little evidence of semantic impairment, suggests that (a) the patient has a true "nonsemantic" grammatical category specific deficit, and (b) lexical organization in multilingual speakers shares grammatical class information between languages. The findings of this study contribute to our understanding of the architecture of lexical organization in bilinguals.

  12. Lexical priming in Alzheimer's disease and aphasia.

    Science.gov (United States)

    Arroyo-Anlló, Eva Maria; Beauchamps, Mireille; Ingrand, Pierre; Neau, Jean Philippe; Gil, Roger

    2013-01-01

    Lexical priming was examined in patients with Alzheimer's disease and in aphasic patients. Control participants were divided into young and elderly [cf. Arroyo-Anlló et al.: Eur J Cogn Psychol 2004;16:535-553]. For lexical priming, a word-stem completion task was used. Normal elderly participants had lexical priming scores that were significantly lower than those of young individuals. Analysis of covariance with age and educational level as covariates showed that the control participants, aphasic and Alzheimer patients did not differ significantly on the lexical priming task. Our results suggest that performance in the lexical priming task diminishes with physiological aging, but is not significantly affected by mild or moderate Alzheimer's disease or by fluent or non-fluent aphasia. Copyright © 2013 S. Karger AG, Basel.

  13. A review on primary progressive aphasia

    Directory of Open Access Journals (Sweden)

    Gabriel C Léger

    2007-01-01

    Full Text Available Gabriel C Léger1,2, Nancy Johnson31Neurology Service, Hôtel-Dieu du Centre Hospitalier de l’Univertité de Montréal, Montréal, Québec, Canada; 2Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada; 3Cognitive Neurology and Alzheimer’s Disease Center, Department of Psychiatry and Behavioral Science, Northwestern University Feinberg School of Medicine, Chicago, IL, USAAbstract: Primary progressive aphasia (PPA is a neurodegenerative disease of insidious onset presenting with progressive isolated loss of language function, without significant impairment in other cognitive domains. Current diagnostic criteria require the language dysfunction to remain isolated for at least two years, and to remain the salient feature as the disease progresses, usually to involve other domains such as behavior, executive functions, and judgment. Although PPA in its early stages can usually be differentiated from probable Alzheimer’s disease (PRAD and the behavioral variant of frontotemporal lobar degeneration by the absence of significant changes in memory and behavior, and the preservation of activities daily living, progression of the disease often leads to deficits more consistent with the latter. Underlying etiologies remain heterogeneous: the neuropathological characteristics associated with frontotemporal lobar degeneration, cortocobasal degeneration, and motor neuron disease are usually found. There is a strong genetic susceptibility with affliction of first-degree relatives with similar disease in up to 40 to 50% in some series. Pathogenic mutations in genes coding for the proteins tau and progranulin have been isolated. These are leading to a better understanding of the neuropathological mechanisms and hopefully targeted disease-modifying therapy. Current therapy is limited to improving mood symptoms and targeting behavior changes as they develop. Referral to specialized centers where speech therapy, counseling, and education

  14. Asymmetric inhibitory treatment effects in multilingual aphasia.

    Science.gov (United States)

    Goral, Mira; Naghibolhosseini, Maryam; Conner, Peggy S

    2013-01-01

    Findings from recent psycholinguistic studies of bilingual processing support the hypothesis that both languages of a bilingual are always active and that bilinguals continually engage in processes of language selection. This view aligns with the convergence hypothesis of bilingual language representation. Furthermore, it is hypothesized that when bilinguals perform a task in one language they need to inhibit their other, nontarget language(s) and that stronger inhibition is required when the task is performed in the weaker language than in the stronger one. The study of multilingual individuals who acquire aphasia resulting from a focal brain lesion offers a unique opportunity to test the convergence hypothesis and the inhibition asymmetry. We report on a trilingual person with chronic nonfluent aphasia who at the time of testing demonstrated greater impairment in her first acquired language (Persian) than in her third, later learned language (English). She received treatment in English followed by treatment in Persian. An examination of her connected language production revealed improvement in her grammatical skills in each language following intervention in that language, but decreased grammatical accuracy in English following treatment in Persian. The increased error rate was evident in structures that are used differently in the two languages (e.g., auxiliary verbs). The results support the prediction that greater inhibition is applied to the stronger language than to the weaker language, regardless of their age of acquisition. We interpret the findings as consistent with convergence theories that posit overlapping neuronal representation and simultaneous activation of multiple languages and with proficiency-dependent asymmetric inhibition in multilinguals.

  15. The Aphasia Communication Outcome Measure (ACOM): Dimensionality, Item Bank Calibration, and Initial Validation

    Science.gov (United States)

    Hula, William D.; Doyle, Patrick J.; Stone, Clement A.; Hula, Shannon N. Austermann; Kellough, Stacey; Wambaugh, Julie L.; Ross, Katherine B.; Schumacher, James G.; St. Jacque, Ann

    2015-01-01

    Purpose: The purpose of this study is to investigate the structure and measurement properties of the Aphasia Communication Outcome Measure (ACOM), a patient-reported outcome measure of communicative functioning for persons with aphasia. Method: Three hundred twenty-nine participants with aphasia responded to 177 items asking about communicative…

  16. A systematic review of nursing rehabilitation of stroke patients with aphasia

    NARCIS (Netherlands)

    Thóra Hafsteinsdóttir; Irina Poslawsky; Eline Lindeman; Prof. Dr. Marieke J. Schuurmans

    2010-01-01

    Patients with poststroke aphasia have higher mortality rates and worse functional outcome than patients without aphasia. Nurses are well aware of aphasia and the associated problems for patients with stroke because they have daily contact with them. The challenge is to provide evidence-based care

  17. An Examination of Strategy Implementation during Abstract Nonlinguistic Category Learning in Aphasia

    Science.gov (United States)

    Vallila-Rohter, Sofia; Kiran, Swathi

    2015-01-01

    Purpose: Our purpose was to study strategy use during nonlinguistic category learning in aphasia. Method: Twelve control participants without aphasia and 53 participants with aphasia (PWA) completed a computerized feedback-based category learning task consisting of training and testing phases. Accuracy rates of categorization in testing phases…

  18. Conversation therapy for aphasia: a qualitative review of the literature.

    Science.gov (United States)

    Simmons-Mackie, Nina; Savage, Meghan C; Worrall, Linda

    2014-01-01

    A diverse literature addresses elements of conversation therapy in aphasia including intervention rooted in conversation analysis, partner training, group therapy and behavioural intervention. Currently there is no resource for clinicians or researchers that defines and organizes this information into a coherent synopsis describing various conversation therapy practices. To organize information from varied sources into a descriptive overview of conversation therapy for aphasia. Academic search engines were employed to identify research articles published between 1950 and September 2013 reporting on conversation therapy for aphasia. Thirty articles met criteria for review and were identified as primary sources for the qualitative review. Using qualitative methodology, relevant data were extracted from articles and categories were identified to create a descriptive taxonomy of conversation therapy for aphasia. Conversation interventions were divided into descriptive categories including: treatment participants (person with aphasia, partner, dyad), primary guiding orientation (conversation analysis, social model, behavioural, relationship centred), service delivery (individual, group), focus of intervention (generic/individualized; problem/solution oriented; compensatory), training methods (explicit/implicit; external/embedded), activities or tasks, and outcomes measured. Finally, articles were categorized by research design. There was marked variation in conversation therapy approaches and outcome measures reported and a notable gap in information about one-on-one conversation therapy for individuals with aphasia. This review provides a description of various conversation therapy approaches and identified gaps in the existing literature. Valid measures of natural conversation, research on one-on-one conversation approaches for individuals with aphasia, and a systematic body of evidence consisting of high quality research are needed. © 2014 Royal College of Speech

  19. Bihemispheric stimulation over left and right inferior frontal region enhances recovery from apraxia of speech in chronic aphasia.

    Science.gov (United States)

    Marangolo, Paola; Fiori, Valentina; Cipollari, Susanna; Campana, Serena; Razzano, Carmelina; Di Paola, Margherita; Koch, Giacomo; Caltagirone, Carlo

    2013-11-01

    Several studies have already shown that transcranial direct current stimulation (tDCS) is a useful tool for enhancing recovery in aphasia. However, all tDCS studies have previously investigated the effects using unihemisperic stimulation. No reports to date have examined the role of bihemispheric tDCS on aphasia recovery. Here, eight aphasic persons with apraxia of speech underwent intensive language therapy in two different conditions: real bihemispheric anodic ipsilesional stimulation over the left Broca's area and cathodic contralesional stimulation over the right homologue of Broca's area, and a sham condition. In both conditions, patients underwent concurrent language therapy for their apraxia of speech. The language treatment lasted 10 days (Monday to Friday, then weekend off, then Monday to Friday). There was a 14-day intersession interval between the real and the sham conditions. In all patients, language measures were collected before (T0), at the end of (T10) and 1 week after the end of (F/U) treatment. Results showed that after simultaneous excitatory stimulation to the left frontal hemisphere and inhibitory stimulation to the right frontal hemisphere regions, patients exhibited a significant recovery not only in terms of better accuracy and speed in articulating the treated stimuli but also in other language tasks (picture description, noun and verb naming, word repetition, word reading) which persisted in the follow-up session. Taken together, these data suggest that bihemispheric anodic ipsilesional and cathodic contralesional stimulation in chronic aphasia patients may affect the treated function, resulting in a positive influence on different language tasks. © 2013 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  20. Relationship between Brain Lesion Location and Aphasia Type in Persian Speaking Patients with Stroke

    Directory of Open Access Journals (Sweden)

    Hossein Rezai

    2011-01-01

    Full Text Available Objective: It has been many years that brain lesion analysis of different aphasia Syndromes has led the foundation to investigate the language representation and organization in the brain. The aim of this study was to examine the relationship between brain lesion location and Broca's aphasia and Wernecke's aphasia in Persian speakers with stroke. Materials & Methods: In a single system design study, from 120 patients with stroke attending Emam Khomeyni and Loghman hospitals, Rofeyde, Karaj neurology, and Tabassom speech clinics and according to the Farsi Aphasia Test (FAT, syntactic comprehension subscale of Bilingual Aphasia Test (BAT, Farsi Aphasia Naming Test, and Apraxia Assessment inventory, only 9 patients with Broca’s aphasia and 2 with Wernicke’s aphasia were qualified to participate in this study. Patients’ brain lesion sites were determined by MRI. Patients with Broca’s aphasia were 5 male and 4 female Wernecke’s aphasia patients were 2 male. Results: External capsule-insula, rolandic operculum, inferior frontal gyrus, (precentral gyrus and postcentarl gyrus, and the anterior part of temporal gyrus were damaged in Broca’s aphasia patients (64±12.51 years old and the lesions of external capsule-insula, posterior part of temporal gyrus, anterior part of temporal gyrus, inferior parietal lobule were observed in Wernicke’s aphasia patients (66±8.48 years old. Conclusion: In no patient with Broca’s aphasia or Wernicke’s aphasia brain lesion confined only to Broca’s area or Wernicke’s area respectively. However, due to the limited number of participants in the present study, the extrapolation of the findings to other subjects with Broca’s or Wernicke’s aphasia would certainly be difficult.

  1. Repetition and lag effects in movement recognition.

    Science.gov (United States)

    Hall, C R; Buckolz, E

    1982-03-01

    Whether repetition and lag improve the recognition of movement patterns was investigated. Recognition memory was tested for one repetition, two-repetitions massed, and two-repetitions distributed with movement patterns at lags of 3, 5, 7, and 13. Recognition performance was examined both immediately afterwards and following a 48 hour delay. Both repetition and lag effects failed to be demonstrated, providing some support for the claim that memory is unaffected by repetition at a constant level of processing (Craik & Lockhart, 1972). There was, as expected, a significant decrease in recognition memory following the retention interval, but this appeared unrelated to repetition or lag.

  2. Chapter 36: history of aphasia: from brain to language.

    Science.gov (United States)

    Eling, Paul; Whitaker, Harry

    2010-01-01

    An historical overview is presented that focuses on the changes both in approach and topics with respect to language disturbances due to brain lesions. Early cases of language disorders were described without any theorizing about language or its relation to the brain. Also, three forms of speech disorder were distinguished: traulotes, psellotes and ischophonia, which are only marginally related to aphasia. In the 18th century some authors, in particular Gesner and Crichton, attempted to explain language disorders in terms of mental processes. The great debate on both the anatomical (Broca, Wernicke) and functional (Wernicke, Lichtheim) aspects of aphasia dominated late 19th century discussion of localization of function, leading to the development of what we now call the cognitive neurosciences. In this period, language processing was described in terms of a simple functional model of word recognition and production; linguistic principles played no role. At the beginning of the 20th century the discussion on language disorders waned due to a decrease of interest in the issue of localization; aphasia became primarily a clinical issue of how best to classify patients. In the second half of the 20th century, the field of aphasia developed rapidly due to studies performed at the Boston Aphasia Unit and, more importantly, to a change of orientation to linguistic notions of language structure, as introduced by Chomsky.

  3. Arnoldus Van Rhijn on aphasia: a forgotten thesis.

    Science.gov (United States)

    Eling, Paul

    2011-01-01

    Aphasia formed a central topic in the discussion on localization of function in the nineteenth century, in particular in France, Germany and Great Brittain. Little is known on contributions from the Netherlands. This paper aims to discuss the contents of Arnoldus Van Rhijn's dissertation on aphasia, written in 1868 and one of the very few Dutch contributions to aphasiology in the nineteenth century. Added to this paper is a translation of the "Physiological Part" of Van Rhijn's dissertation. Van Rhijn discussed three cases with acquired aphasia. He rejected Broca's notion of a cortical center for the articulation of speech and instead regarded the cortex as the site where the will exerted its influence. He argued that there is a certain form of specialization: the will to say something is localized at a different place than the will to write. According to Van Rhijn, the highest motor centers are localized in the subcortical gray areas. Van Rhijn concluded that aphasia may result from lesions to the cortical centers involved in speaking, or from a disconnection of the cortical and subcortical centers. Very little work was done on aphasia in the 19th century in the Netherlands. Van Rhijn's thesis, from an aphasiological point of view of limited value, does show that the notions of "centers", "connections", and "disorders due to disconnections" were generally known before Wernicke, also in the Netherlands. Copyright © 2011 Elsevier Srl. All rights reserved.

  4. A hierarchical fuzzy rule-based approach to aphasia diagnosis.

    Science.gov (United States)

    Akbarzadeh-T, Mohammad-R; Moshtagh-Khorasani, Majid

    2007-10-01

    Aphasia diagnosis is a particularly challenging medical diagnostic task due to the linguistic uncertainty and vagueness, inconsistencies in the definition of aphasic syndromes, large number of measurements with imprecision, natural diversity and subjectivity in test objects as well as in opinions of experts who diagnose the disease. To efficiently address this diagnostic process, a hierarchical fuzzy rule-based structure is proposed here that considers the effect of different features of aphasia by statistical analysis in its construction. This approach can be efficient for diagnosis of aphasia and possibly other medical diagnostic applications due to its fuzzy and hierarchical reasoning construction. Initially, the symptoms of the disease which each consists of different features are analyzed statistically. The measured statistical parameters from the training set are then used to define membership functions and the fuzzy rules. The resulting two-layered fuzzy rule-based system is then compared with a back propagating feed-forward neural network for diagnosis of four Aphasia types: Anomic, Broca, Global and Wernicke. In order to reduce the number of required inputs, the technique is applied and compared on both comprehensive and spontaneous speech tests. Statistical t-test analysis confirms that the proposed approach uses fewer Aphasia features while also presenting a significant improvement in terms of accuracy.

  5. Self- and surrogate-reported communication functioning in aphasia.

    Science.gov (United States)

    Doyle, Patrick J; Hula, William D; Austermann Hula, Shannon N; Stone, Clement A; Wambaugh, Julie L; Ross, Katherine B; Schumacher, James G

    2013-06-01

    To evaluate the dimensionality and measurement invariance of the aphasia communication outcome measure (ACOM), a self- and surrogate-reported measure of communicative functioning in aphasia. Responses to a large pool of items describing communication activities were collected from 133 community-dwelling persons with aphasia of ≥ 1 month post-onset and their associated surrogate respondents. These responses were evaluated using confirmatory and exploratory factor analysis. Chi-square difference tests of nested factor models were used to evaluate patient-surrogate measurement invariance and the equality of factor score means and variances. Association and agreement between self- and surrogate reports were examined using correlation and scatterplots of pairwise patient-surrogate differences. Three single-factor scales (Talking, Comprehension, and Writing) approximating patient-surrogate measurement invariance were identified. The variance of patient-reported scores on the Talking and Writing scales was higher than surrogate-reported variances on these scales. Correlations between self- and surrogate reports were moderate-to-strong, but there were significant disagreements in a substantial number of individual cases. Despite minimal bias and relatively strong association, surrogate reports of communicative functioning in aphasia are not reliable substitutes for self-reports by persons with aphasia. Furthermore, although measurement invariance is necessary for direct comparison of self- and surrogate reports, the costs of obtaining invariance in terms of scale reliability and content validity may be substantial. Development of non-invariant self- and surrogate report scales may be preferable for some applications.

  6. Participation and Social Inclusion in Adults with Aphasia: Bibliometric Analysis

    Directory of Open Access Journals (Sweden)

    Johanna Rodríguez Riaño

    2015-09-01

    Full Text Available Objective: To identify the scope and status of related research with the participation and social inclusion of adults with aphasia connected with the published literature. Materials and Methods: Descriptive analytic study on publications registered in Medline/PubMed, EBSCO and EMBASE from 2005 to 2013, 97 related documents were selected and classified into, eight common vari­ables for its study and were analyzed according to the article distribution by thematic core, year of publication and database. Results: The most represented core theme was inclusion, participa­tion, access and rights of persons with aphasia and their families and environments; production of these documents is increased between 2010 and 2011. Documents related to inclusive intern­ships for people with aphasia represented the second more representative thematic focus. Conclu­sions: Literature recognizes that elements related to family and their immediate environments are essential to ensure participation and independence of people with aphasia. The International Classification of Functioning, Disability and Health (ICF should become the rehabilitation log for professionals to guide therapeutic actions, aimed at the inclusion and participation of people with aphasia in different contexts, and mainly to promote a successful return to a productive daily life. This rehabilitation opportunity toward independence and autonomy promotes self-esteem, identity and inclusion opportunities.

  7. Yogic breathing and Ayurveda in aphasia: a case study.

    Science.gov (United States)

    Mohapatra, Bijoyaa; Marshall, Rebecca Shisler; Laures-Gore, Jacqueline

    2014-01-01

    We present a case study of a woman who used yogic breathing as Ayurvedic medicine in her recovery from poststroke aphasia. Ayurvedic medicine is one of the most ancient medicines of the world, but it is not widely used for aphasia rehabilitation in many Western countries. The description of this case aims to further the understanding of the benefits that this type of medicine may provide to poststroke patients living with aphasia. After her stroke, the patient received brief conventional language therapy for her aphasia. At 5 weeks post stroke, she received no further conventional rehabilitation; instead, she consulted with a Vedic priest. She followed a regimen of different body manipulations, yogic breathing techniques, and ingestion of coconut oil. Cognitive and language testing was performed throughout a 3-month period while she was involved in this therapy. Overall, improvement was noted in language, visual attention, and some mood measures. Although case studies lead to limited conclusions, changes were observed for this individual using Ayurvedic medicine. Given the changes in language and some aspects of cognition seen in this patient, further exploration of the effectiveness of yogic breathing and Ayurvedic medicine in the treatment of poststroke aphasia is warranted.

  8. Production and Comprehension of Time Reference in Korean Nonfluent Aphasia

    Science.gov (United States)

    Lee, Jiyeon; Kwon, Miseon; Na, Hae Ri; Bastiaanse, Roelien; Thompson, Cynthia K.

    2015-01-01

    Objectives Individuals with nonfluent agrammatic aphasia show impaired production and comprehension of time reference via verbal morphology. However, cross-linguistic findings to date suggest inconsistent evidence as to whether tense processing in general is impaired or time reference to the past is selectively difficult in this population. This study examined production and comprehension of time reference via verb morphology in Korean-speaking individuals with nonfluent aphasia. Methods A group of 9 healthy controls and 8 individuals with nonfluent aphasia (5 for the production task) participated in the study. Sentence priming production and auditory sentence to picture matching tasks were used, parallel with the previous cross-linguistic experiments in English, Chinese, Turkish, and others. Results The participants with nonfluent aphasia showed different patterns of impairment in production and comprehension. In production, they were impaired in all time references with errors being dominated by substitution of incorrect time references and other morpho-phonologically well-formed errors, indicating a largely intact morphological affixation process. In comprehension, they showed selective impairment of the past, consistent with the cross-linguistic evidence from English, Chinese, Turkish, and others. Conclusion The findings suggest that interpretation of past time reference poses particular difficulty in nonfluent aphasia irrespective of typological characteristics of languages; however, in production, language-specific morpho-semantic functions of verbal morphology may play a significant role in selective breakdowns of time reference. PMID:26290861

  9. Audiovisual integration of speech in a patient with Broca's Aphasia

    Science.gov (United States)

    Andersen, Tobias S.; Starrfelt, Randi

    2015-01-01

    Lesions to Broca's area cause aphasia characterized by a severe impairment of the ability to speak, with comparatively intact speech perception. However, some studies have found effects on speech perception under adverse listening conditions, indicating that Broca's area is also involved in speech perception. While these studies have focused on auditory speech perception other studies have shown that Broca's area is activated by visual speech perception. Furthermore, one preliminary report found that a patient with Broca's aphasia did not experience the McGurk illusion suggesting that an intact Broca's area is necessary for audiovisual integration of speech. Here we describe a patient with Broca's aphasia who experienced the McGurk illusion. This indicates that an intact Broca's area is not necessary for audiovisual integration of speech. The McGurk illusions this patient experienced were atypical, which could be due to Broca's area having a more subtle role in audiovisual integration of speech. The McGurk illusions of a control subject with Wernicke's aphasia were, however, also atypical. This indicates that the atypical McGurk illusions were due to deficits in speech processing that are not specific to Broca's aphasia. PMID:25972819

  10. The World Report on Disability as a blueprint for international, national, and local aphasia services.

    Science.gov (United States)

    Worrall, Linda E; Howe, Tami; O'Callaghan, Anna; Hill, Anne J; Rose, Miranda; Wallace, Sarah J; Rose, Tanya; Brown, Kyla; Power, Emma; O'Halloran, Robyn; Rohde, Alexia

    2013-02-01

    This commentary aims to extend the debate of the lead article authors (Wylie, McAllister, Davidson, and Marshall, 2013) by translating the nine recommendations of the World Report on Disability into a plan of action for the aphasia community. Solutions for the advancement of aphasia science and services are presented at international (macro), national (meso), and local (micro) levels. Implications for speech-language pathologists and aphasia service delivery are discussed. An overarching call to action is the need for speech-language pathologists to support a strong and vibrant aphasia community at all levels, so that the voices of people with aphasia can be heard.

  11. 'That doesn't translate': the role of evidence-based practice in disempowering speech pathologists in acute aphasia management.

    Science.gov (United States)

    Foster, Abby; Worrall, Linda; Rose, Miranda; O'Halloran, Robyn

    2015-07-01

    An evidence-practice gap has been identified in current acute aphasia management practice, with the provision of services to people with aphasia in the acute hospital widely considered in the literature to be inconsistent with best-practice recommendations. The reasons for this evidence-practice gap are unclear; however, speech pathologists practising in this setting have articulated a sense of dissonance regarding their limited service provision to this population. A clearer understanding of why this evidence-practice gap exists is essential in order to support and promote evidence-based approaches to the care of people with aphasia in acute care settings. To provide an understanding of speech pathologists' conceptualization of evidence-based practice for acute post-stroke aphasia, and its implementation. This study adopted a phenomenological approach, underpinned by a social constructivist paradigm. In-depth interviews were conducted with 14 Australian speech pathologists, recruited using a purposive sampling technique. An inductive thematic analysis of the data was undertaken. A single, overarching theme emerged from the data. Speech pathologists demonstrated a sense of disempowerment as a result of their relationship with evidence-based practice for acute aphasia management. Three subthemes contributed to this theme. The first described a restricted conceptualization of evidence-based practice. The second revealed speech pathologists' strained relationships with the research literature. The third elucidated a sense of professional unease over their perceived inability to enact evidence-based clinical recommendations, despite their desire to do so. Speech pathologists identified a current knowledge-practice gap in their management of aphasia in acute hospital settings. Speech pathologists place significant emphasis on the research evidence; however, their engagement with the research is limited, in part because it is perceived to lack clinical utility. A sense

  12. Transcortical mixed aphasia due to cerebral infarction in left inferior frontal lobe and temporo-parietal lobe

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    Maeshima, S.; Matsumoto, T.; Ueyoshi, A. [Department of Physical Medicine and Rehabilitation, Wakayama Medical University, Wakayama (Japan); Toshiro, H.; Sekiguchi, E.; Okita, R.; Yamaga, H.; Ozaki, F.; Moriwaki, H. [Department of Neurological Surgery, Hidaka General Hospital, Wakayama (Japan); Roger, P. [School of Communication Sciences and Disorders, University of Sydney, Sydney, NSW (Australia)

    2002-02-01

    We present a case of transcortical mixed aphasia caused by a cerebral embolism. A 77-year-old right-handed man was admitted to our hospital with speech disturbance and a right hemianopia. His spontaneous speech was remarkably reduced, and object naming, word fluency, comprehension, reading and writing were all severely disturbed. However, repetition of phonemes and sentences and reading aloud were fully preserved. Although magnetic resonance imaging (MRI) showed cerebral infarcts in the left frontal and parieto-occipital lobe which included the inferior frontal gyrus and angular gyrus, single photon emission CT revealed a wider area of low perfusion over the entire left hemisphere except for part of the left perisylvian language areas. The amytal (Wada) test, which was performed via the left internal carotid artery, revealed that the left hemisphere was dominant for language. Hence, it appears that transcortical mixed aphasia may be caused by the isolation of perisylvian speech areas, even if there is a lesion in the inferior frontal gyrus, due to disconnection from surrounding areas. (orig.)

  13. Cross-cultural adaptation process of the "Conversation Analysis Profile for People with Aphasia" to the Portuguese language

    Directory of Open Access Journals (Sweden)

    Mariana Ferreira

    Full Text Available The Conversation Analysis Profile for People with Aphasia (CAPPA provides specific information about strengths and weaknesses of the communication between people with aphasia and their family caregiver within a conversational context.OBJECTIVE:The aim of this paper was to present the results of the first stages of cross-cultural adaptation of the CAPPA for the European Portuguese language.METHODS:This methodology study describes the translation and back-translation processes, following the recommended steps to that end. In addition, following the consent of one of the original authors, the process of content validation of the CAPPA commenced. The instrument was submitted for assessment before a panel of experts in the area, who constituted the population of this study.RESULTSAfter the translation and back-translation processes, a panel of experts was convened to adapt the Delphi technique. Some questions were excluded on the basis of ambiguity, relevance and potential repetition. Suggestions made by the expert panel were included in a revised version of the tool. 159 items obtained a 100% consensus in relevance, and 157 items were considered suitable by the expert panel, validating the content of the instrument.CONCLUSIONThe final version will now be applied to the target population in order to carry out the psychometric validation.

  14. Effects of transcranial direct current stimulation on language improvement and cortical activation in nonfluent variant primary progressive aphasia.

    Science.gov (United States)

    Wang, Jie; Wu, Dongyu; Chen, Yan; Yuan, Ying; Zhang, Meikui

    2013-08-09

    We investigate the effects of transcranial direct current stimulation (tDCS) on language improvement and cortical activation in nonfluent variant primary progressive aphasia (nfvPPA). A 67-year-old woman diagnosed as nfvPPA received sham-tDCS for 5 days over the left posterior perisylvian region (PPR) in the morning and over left Broca's area in the afternoon in Phases A1 and A2, and tDCS for 5 days with an anodal electrode over the left PPR in the morning and over left Broca's area in the afternoon in Phases B1 and B2. Auditory word comprehension, picture naming, oral word reading and word repetition subtests of the Psycholinguistic Assessment in Chinese Aphasia (PACA) were administered before and after each phase. The EEG nonlinear index of approximate entropy (ApEn) was calculated before Phase A1, and after Phases B1 and B2. Our findings revealed that the patient improved greatly in the four subtests after A-tDCS and ApEn indices increased in stimulated areas and non-stimulated areas. We demonstrated that anodal tDCS over the left PPR and Broca's area can improve language performance of nfvPPA. tDCS may be used as an alternative therapeutic tool for PPA. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. Transcortical mixed aphasia due to cerebral infarction in left inferior frontal lobe and temporo-parietal lobe

    International Nuclear Information System (INIS)

    Maeshima, S.; Matsumoto, T.; Ueyoshi, A.; Toshiro, H.; Sekiguchi, E.; Okita, R.; Yamaga, H.; Ozaki, F.; Moriwaki, H.; Roger, P.

    2002-01-01

    We present a case of transcortical mixed aphasia caused by a cerebral embolism. A 77-year-old right-handed man was admitted to our hospital with speech disturbance and a right hemianopia. His spontaneous speech was remarkably reduced, and object naming, word fluency, comprehension, reading and writing were all severely disturbed. However, repetition of phonemes and sentences and reading aloud were fully preserved. Although magnetic resonance imaging (MRI) showed cerebral infarcts in the left frontal and parieto-occipital lobe which included the inferior frontal gyrus and angular gyrus, single photon emission CT revealed a wider area of low perfusion over the entire left hemisphere except for part of the left perisylvian language areas. The amytal (Wada) test, which was performed via the left internal carotid artery, revealed that the left hemisphere was dominant for language. Hence, it appears that transcortical mixed aphasia may be caused by the isolation of perisylvian speech areas, even if there is a lesion in the inferior frontal gyrus, due to disconnection from surrounding areas. (orig.)

  16. Wernicke's Aphasia Reflects a Combination of Acoustic-Phonological and Semantic Control Deficits: A Case-Series Comparison of Wernicke's Aphasia, Semantic Dementia and Semantic Aphasia

    Science.gov (United States)

    Robson, Holly; Sage, Karen; Lambon Ralph, Matthew A.

    2012-01-01

    Wernicke's aphasia (WA) is the classical neurological model of comprehension impairment and, as a result, the posterior temporal lobe is assumed to be critical to semantic cognition. This conclusion is potentially confused by (a) the existence of patient groups with semantic impairment following damage to other brain regions (semantic dementia and…

  17. Repetitive Rockfall Trajectory Testing

    Directory of Open Access Journals (Sweden)

    Axel Volkwein

    2018-03-01

    Full Text Available Numerical simulations of rockfall trajectories are a standard procedure for evaluating rockfall hazards. For these simulations, corresponding software codes must be calibrated and evaluated based on field data. This study addresses methods of repeatable rockfall tests, and investigates whether it is possible to produce traceable and statistically analysable data. A testing series is described extensively covering how to conduct rockfall experiments and how certain elements of rockfall trajectories can be measured. The tests use acceleration and rotation sensors inside test blocks, a system to determine block positions over time, surveying measurements, and video recordings. All systems are evaluated regarding their usability in the field and for analyses. The highly detailed description of testing methods is the basis for sound understanding and reproducibility of the tests. This article serves as a reference for future publications and other rockfall field tests, both as a guide and as a basis for comparisons. First analyses deliver information on runout with a shadow angle ranging between 21 and 45 degrees for a slope consisting of homogeneous soft soil. A digital elevation model of the test site as well as point clouds of the used test blocks are part of this publication.

  18. A Multimodal Communication Aid for Global Aphasia Patients

    DEFF Research Database (Denmark)

    Pedersen, Jakob Schou; Dalsgaard, Paul; Lindberg, Børge

    2004-01-01

    This paper presents the basic rationale behind the development and testing of a multimodal communication aid especially designed for people suffering from global aphasia, and thus having severe expressive difficulties. The principle of the aid is to trigger patient associations by presenting...... various multimodal representations of communicative expressions. The aid can in this way be seen as a conceptual continuation of previous research within the field of communication aids based on uni-modal (pictorial) representations of communicative expressions. As patients suffering from global aphasia...... expressions can be used to support patients with global aphasia in communicating by means of short sentences with their surroundings. Only a limited evaluation is carried out, and as such no statistically significant results are obtained. The tests however indicate that the aid is capable of supporting...

  19. Frontotemporal dementia and primary progressive aphasia, a review

    Directory of Open Access Journals (Sweden)

    Kirshner HS

    2014-06-01

    Full Text Available Howard S KirshnerDepartment of Neurology, Vanderbilt University Medical Center, Nashville, TN, USAAbstract: Frontotemporal dementias are neurodegenerative diseases in which symptoms of frontal and/or temporal lobe disease are the first signs of the illness, and as the diseases progress, they resemble a focal left hemisphere process such as stroke or traumatic brain injury, even more than a neurodegenerative disease. Over time, some patients develop a more generalized dementia. Four clinical subtypes characterize the predominant presentations of this illness: behavioral or frontal variant FTD, progressive nonfluent aphasia, semantic dementia, and logopenic primary progressive aphasia. These clinical variants correlate with regional patterns of atrophy on brain imaging studies such as MRI and PET scanning, as well as with biochemical and molecular genetic variants of the disorder. The treatment is as yet only symptomatic, but advances in molecular genetics promise new therapies.Keywords: FTD, behavior variant or frontal variant FTD, pick's disease, PPA, progressive nonfluent aphasia

  20. Phonetic basis of phonemic paraphasias in aphasia: Evidence for cascading activation.

    Science.gov (United States)

    Kurowski, Kathleen; Blumstein, Sheila E

    2016-02-01

    Phonemic paraphasias are a common presenting symptom in aphasia and are thought to reflect a deficit in which selecting an incorrect phonemic segment results in the clear-cut substitution of one phonemic segment for another. The current study re-examines the basis of these paraphasias. Seven left hemisphere-damaged aphasics with a range of left hemisphere lesions and clinical diagnoses including Broca's, Conduction, and Wernicke's aphasia, were asked to produce syllable-initial voiced and voiceless fricative consonants, [z] and [s], in CV syllables followed by one of five vowels [i e a o u] in isolation and in a carrier phrase. Acoustic analyses were conducted focusing on two acoustic parameters signaling voicing in fricative consonants: duration and amplitude properties of the fricative noise. Results show that for all participants, regardless of clinical diagnosis or lesion site, phonemic paraphasias leave an acoustic trace of the original target in the error production. These findings challenge the view that phonemic paraphasias arise from a mis-selection of phonemic units followed by its correct implementation, as traditionally proposed. Rather, they appear to derive from a common mechanism with speech errors reflecting the co-activation of a target and competitor resulting in speech output that has some phonetic properties of both segments. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Global Repetition Influences Contextual Cueing

    Science.gov (United States)

    Zang, Xuelian; Zinchenko, Artyom; Jia, Lina; Li, Hong

    2018-01-01

    Our visual system has a striking ability to improve visual search based on the learning of repeated ambient regularities, an effect named contextual cueing. Whereas most of the previous studies investigated contextual cueing effect with the same number of repeated and non-repeated search displays per block, the current study focused on whether a global repetition frequency formed by different presentation ratios between the repeated and non-repeated configurations influence contextual cueing effect. Specifically, the number of repeated and non-repeated displays presented in each block was manipulated: 12:12, 20:4, 4:20, and 4:4 in Experiments 1–4, respectively. The results revealed a significant contextual cueing effect when the global repetition frequency is high (≥1:1 ratio) in Experiments 1, 2, and 4, given that processing of repeated displays was expedited relative to non-repeated displays. Nevertheless, the contextual cueing effect reduced to a non-significant level when the repetition frequency reduced to 4:20 in Experiment 3. These results suggested that the presentation frequency of repeated relative to the non-repeated displays could influence the strength of contextual cueing. In other words, global repetition statistics could be a crucial factor to mediate contextual cueing effect. PMID:29636716

  2. Repetitive elements in parasitic protozoa

    Directory of Open Access Journals (Sweden)

    Clayton Christine

    2010-05-01

    Full Text Available Abstract A recent paper published in BMC Genomics suggests that retrotransposition may be active in the human gut parasite Entamoeba histolytica. This adds to our knowledge of the various types of repetitive elements in parasitic protists and the potential influence of such elements on pathogenicity. See research article http://www.biomedcentral.com/1471-2164/11/321

  3. Degenerative Jargon Aphasia: Unusual Progression of Logopenic/Phonological Progressive Aphasia?

    Directory of Open Access Journals (Sweden)

    Paolo Caffarra

    2013-01-01

    Full Text Available Primary progressive aphasia (PPA corresponds to the gradual degeneration of language which can occur as nonfluent/agrammatic PPA, semantic variant PPA or logopenic variant PPA. We describe the clinical evolution of a patient with PPA presenting jargon aphasia as a late feature. At the onset of the disease (ten years ago the patient showed anomia and executive deficits, followed later on by phonemic paraphasias and neologisms, deficits in verbal short-term memory, naming, verbal and semantic fluency. At recent follow-up the patient developed an unintelligible jargon with both semantic and neologistic errors, as well as with severe deficit of comprehension which precluded any further neuropsychological assessment. Compared to healthy controls, FDG-PET showed a hypometabolism in the left angular and middle temporal gyri, precuneus, caudate, posterior cingulate, middle frontal gyrus, and bilaterally in the superior temporal and inferior frontal gyri. The clinical and neuroimaging profile seems to support the hypothesis that the patient developed a late feature of logopenic variant PPA characterized by jargonaphasia and associated with superior temporal and parietal dysfunction.

  4. Psycholinguistics of Aphasia Pharmacotherapy: Asking the Right Questions

    Science.gov (United States)

    Cahana-Amitay, Dalia; Albert, Martin L.; Oveis, Abigail

    2013-01-01

    Background Among the obstacles to demonstrating efficacy of pharmacological intervention for aphasia is quantifying patients’ responses to treatment in a statistically valid and reliable manner. In many of the review papers on this topic (e.g., Berthier et al., 2011; de Boissezon, Peran, de Boysson, & Démonet, 2007; Small & Llano, 2009), detailed discussions of various methodological problems are highlighted, with some suggestions on how these shortcomings should be addressed. Given this deep understanding of caveats associated with the experimental design of aphasia pharmacotherapy studies (e.g., Berthier et al., 2011), investigations continue to produce inconsistent results. Aim In this review paper we suggest that inclusion of theory-driven linguistic measures in aphasia pharmacotherapy studies would add an important step toward elucidating precise patterns of improvement in language performance resulting from pharmacotherapeutic intervention. Main Contribution We provide a brief review of the clinical approaches currently used in pharmacotherapy studies of aphasia, which often lack psycholinguistic grounding. We then present ways in which psycholinguistic models can complement this approach, offering a rationale for task selection, and as a result, lead to a better understanding of treatment effects. We then follow with an example of how such an integrative approach can be implemented in studies targeting stress reduction in people with aphasia, via beta-blocking agents, as a means to augment language performance, using the psycholinguistic framework of “linguistic anxiety” outlined in Cahana-Amitay et al, 2011 as our guideline. Conclusion We conclude that the incorporation of psycholinguistic models into aphasia pharmacotherapy studies can increase the resolution with which we can identify functional changes. PMID:24489425

  5. Properties of water surface discharge at different pulse repetition rates

    International Nuclear Information System (INIS)

    Ruma,; Yoshihara, K.; Hosseini, S. H. R.; Sakugawa, T.; Akiyama, H.; Akiyama, M.; Lukeš, P.

    2014-01-01

    The properties of water surface discharge plasma for variety of pulse repetition rates are investigated. A magnetic pulse compression (MPC) pulsed power modulator able to deliver pulse repetition rates up to 1000 Hz, with 0.5 J per pulse energy output at 25 kV, was used as the pulsed power source. Positive pulse with a point-to-plane electrode configuration was used for the experiments. The concentration and production yield of hydrogen peroxide (H 2 O 2 ) were quantitatively measured and orange II organic dye was treated, to evaluate the chemical properties of the discharge reactor. Experimental results show that the physical and chemical properties of water surface discharge are not influenced by pulse repetition rate, very different from those observed for under water discharge. The production yield of H 2 O 2 and degradation rate per pulse of the dye did not significantly vary at different pulse repetition rates under a constant discharge mode on water surface. In addition, the solution temperature, pH, and conductivity for both water surface and underwater discharge reactors were measured to compare their plasma properties for different pulse repetition rates. The results confirm that surface discharge can be employed at high pulse repetition rates as a reliable and advantageous method for industrial and environmental decontamination applications.

  6. Primary progressive aphasia: from syndrome to disease.

    Science.gov (United States)

    Matías-Guiu, J A; García-Ramos, R

    2013-01-01

    Primary progressive aphasia (PPA) is a clinical syndrome characterised by a progressive decline in language and speech of neurodegenerative origin. Major breakthroughs made in recent years have lent us a better understanding of this syndrome, which may be the first manifestation of any of a number of neurodegenerative diseases. We reviewed the main aspects of PPA epidemiology, clinical manifestations, diagnosis, aetiology and treatment. Most cases manifest sporadically and the typical age of onset is between 50 and 70 years. Three clinically distinct variants have been described: nonfluent or agrammatic PPA, semantic PPA and logopenic PPA. Each of these variants tends to be associated with specific histopathological findings, but clinical diagnostic methods are imperfect predictors of underlying pathology. Anatomical and functional neuroimaging can provide useful biomarkers. Several treatments have been proposed, and while no clear benefits have been demonstrated, acetylcholinesterase inhibitors may be useful, especially in the logopenic variant. PPA is an emerging syndrome which may be more prevalent than we might expect. It was previously listed as part of the frontotemporal dementia spectrum, and it is also related to Alzheimer disease. Clinical diagnosis, complemented by a biomarker evaluation, may predict the underlying pathology, which in turn will improve treatment possibilities. Copyright © 2012 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  7. Quality of life measurement and outcome in aphasia

    Directory of Open Access Journals (Sweden)

    Spaccavento S

    2013-12-01

    Full Text Available Simona Spaccavento, Angela Craca, Marina Del Prete, Rosanna Falcone, Antonia Colucci, Angela Di Palma, Anna Loverre IRCCS Salvatore Maugeri Foundation, Cassano Murge Bari, Italy Background: Quality of life (QL can be defined as the individual's perception of their own well-being. Aphasia is the most important potential consequence of stroke and has a profound effect on a patient's life, causing emotional distress, depression, and social isolation, due to loss of language functions. Aims: To draw up a QL questionnaire for aphasics (QLQA focusing particularly on difficulties in interpersonal relationships and on the loss of independence as a result of language disorders. We reported the results of a psychometric evaluation of this measure. Moreover, we experimentally focused on the differences in QLQA between patients affected only by neurological motor impairment and hemiparetic patients with aphasia (PWA in order to verify the specific role of aphasia on QL. We also explored if the QLQA is sensitive to the severity of aphasia and to the time elapsing from the stroke. Methods: A total of 146 consecutive PWA and 37 control subjects were enrolled to evaluate the reliability (internal consistency and test–retest reliability and validity of the QLQA, using standard psychometric methods. Patients were divided into acute (within 3 months since stroke and chronic (beyond 3 months groups, and into mild and severe according to the severity of aphasia. The experimental group of only acute PWA was compared to control subjects, with right hemispherical lesion and without aphasia in QLQA total and partial scores. Results: The QLQA had good internal consistency and test–retest reliability. Acute and chronic PWA and mild and severe ones differed in QLQA total, communication, and autonomy subscales. No differences were found in psychological condition. Between aphasic and control patients, significant differences were found in all QLQA subscales. Conclusion

  8. Deficits in Processing Case Markers in Individuals with Aphasia

    Directory of Open Access Journals (Sweden)

    Jee Eun Sung

    2015-04-01

    Individuals with aphasia demonstrated greater difficulties in the case marker assignment compared to their normal control group. Furthermore, noncanonical word-order and passive sentences elicited more errors on the task than canonical and active sentences. Passive sentences were the significant predictors for overall aphasia severity. The results suggested that PWA using a verb-final language with well-developed case-marking systems presented deficits in case marker processing. The syntactic structure and canonicity of word order need to be considered as critical linguistic features in testing their performance on dealing with case markers.

  9. The participants' perspective: how biographic-narrative intervention influences identity negotiation and quality of life in aphasia.

    Science.gov (United States)

    Corsten, Sabine; Schimpf, Erika J; Konradi, Jürgen; Keilmann, Annerose; Hardering, Friedericke

    2015-01-01

    People with aphasia experience a pronounced decrease in quality of life (QoL). Beyond that identity negotiation is hindered, which is crucial for QoL. Biographic-narrative approaches use life story telling to support identity (re)development after disruptive events like stroke. Because of the language deficits inherent in aphasia such 'talk-based' approaches have to be modified for an optimal use. To evaluate an adapted interdisciplinary biographic-narrative intervention using quantitative measures of health-related quality of life (HRQL) and mood. Additionally, semi-structured interviews were conducted to gain a deeper understanding of identity development processes in people with aphasia. Twenty-seven participants with various types of chronic aphasia were enrolled. The biographic narrative intervention consisted of five face-to-face in-depth interviews and seven group sessions conducted over 10 weeks in a mixed-method design with pre- and post-tests and a follow-up assessment 3 months post-intervention. For quantitative evaluation the Aachen Life Quality Inventory (ALQI), the Satisfaction with Life Scale (SWLS) and the Visual Analog Mood Scales (VAMS) were used. Semi-structured interviews were conducted post-treatment, including questions concerning the participants' experiences with the intervention and identity change. Results were analysed using interpretative principles from Grounded Theory. For all 27 participants, we found significant and stable growth in HRQL. Self-reported states of mood also improved. As expected, overall cognitively based life satisfaction did not change. The interviews revealed two main categories: 'evaluation of the face-to-face interviews' and 'evaluation of the group sessions'. Further analysis found four overlapping main themes which were identified as identity issues: agency, control, disease concept and doing things. Our quantitative and qualitative results demonstrated the benefits associated with the biographic

  10. Global aphasia without hemiparesis may be caused by blunt head trauma: An adolescent boy with transient aphasia.

    Science.gov (United States)

    Şahin, Sevim; Türkdoğan, Dilşad; Hacıfazlıoğlu, Nilüfer Eldeş; Yalçın, Emek Uyur; Eksen, Zehra Yılmaz; Ekinci, Gazanfer

    2017-05-01

    Global aphasia without hemiparesis is a rare condition often associated with embolic stroke. Posttraumatic causes have not been reported, in the literature, to our knowledge. We report a 15-year old boy with transient global aphasia without hemiparesis due to blunt head trauma. In our case, clinical findings occurred 1week later following head trauma. Emergence of the symptoms after a period of the first mechanical head trauma, draws attention to the importance of secondary process in traumatic brain injury. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Using technology to overcome the language barrier: the Cognitive Assessment for Aphasia App.

    Science.gov (United States)

    Wall, Kylie Janine; Cumming, Toby Borland; Koenig, Sebastian Thomas; Pelecanos, Anita Maria; Copland, David Andrew

    2018-06-01

    We developed and explored the feasibility and user acceptance of the Cognitive Assessment for Aphasia App: a non-immersive virtual reality cognitive assessment for stroke survivors, designed to be inclusive of individuals with aphasia. Participants were assessed on a battery of pen-and-paper cognitive tests and the Cognitive Assessment for Aphasia App. Feasibility was explored by quantifying missing data for test completion, determining user acceptance for the app by measuring participants' preferred testing method, enjoyment and perceived task difficulty and time-taken to complete the test. Sixty-four stroke participants (35 with aphasia, 29 without aphasia) and 32 controls were recruited. Only one participant with aphasia was unable to complete all the Cognitive Assessment for Aphasia App tasks, whereas 13 participants were unable to complete all pen-and-paper tasks. Only 14% of participants preferred the pen-and-paper tests, and preference did not significantly differ between groups. Ninety-five per cent of participants were neutral or enjoyed the app and 4% perceived it to be very difficult. Higher age was negatively associated with user acceptance measures. The study shows preliminary evidence for the Cognitive Assessment for Aphasia App to be a feasible cognitive assessment for stroke survivors with and without aphasia. The app is currently being validated in stroke. Implications for rehabilitation The Cognitive Assessment for Aphasia App is a feasible tool for assessing post-stroke cognition in acute, inpatient rehabilitation and community settings. In research trials examining cognition, individuals with aphasia are often excluded. The Cognitive Assessment for Aphasia App permits the inclusion of these individuals, enhancing generalizability. The Cognitive Assessment for Aphasia App provides an alternative method to assess cognition that is quicker and preferred over standard neuropsychological tests.

  12. Repetition code of 15 qubits

    Science.gov (United States)

    Wootton, James R.; Loss, Daniel

    2018-05-01

    The repetition code is an important primitive for the techniques of quantum error correction. Here we implement repetition codes of at most 15 qubits on the 16 qubit ibmqx3 device. Each experiment is run for a single round of syndrome measurements, achieved using the standard quantum technique of using ancilla qubits and controlled operations. The size of the final syndrome is small enough to allow for lookup table decoding using experimentally obtained data. The results show strong evidence that the logical error rate decays exponentially with code distance, as is expected and required for the development of fault-tolerant quantum computers. The results also give insight into the nature of noise in the device.

  13. Computer-Related Repetitive Stress Injuries

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Computer-Related Repetitive Stress Injuries KidsHealth / For Parents / Computer-Related Repetitive Stress Injuries What's in this article? ...

  14. Subcortical aphasia and cerebral blood flow using SPECT

    International Nuclear Information System (INIS)

    Celsis, P.; Puel, M.; Demonet, J.P.; Bonafe, A.; Cardebat, D.; Viallard, G.; Pujol, T.; Marc-Vergnes, J.P.; Rascol, A.

    1985-01-01

    Possible cerebral blood flow (CBF) alteration in subcortical aphasia was investigated by single-photon emission tomography (SPECT). The results confirm the capsulo-striatal lesions and also point to the high rate of ipsilateral thalamic and cortical dysfunction. (author). 8 refs.; 1 fig.; 1 tab

  15. Transient aphasia following spinal anaesthesia in an orthopaedic ...

    African Journals Online (AJOL)

    A 50-year-old male [American Society of Anesthesiologists (ASA) grade II] was scheduled for lower limb orthopaedic surgery. The subarachnoid space was localised with difficulty at L3/4 interspace and 3 ml of hyperbaric bupivacaine was given. Within a few minutes, the patient developed aphasia with a very high sensory ...

  16. Measuring and Inducing Brain Plasticity in Chronic Aphasia

    Science.gov (United States)

    Fridriksson, Julius

    2011-01-01

    Brain plasticity associated with anomia recovery in aphasia is poorly understood. Here, I review four recent studies from my lab that focused on brain modulation associated with long-term anomia outcome, its behavioral treatment, and the use of transcranial brain stimulation to enhance anomia treatment success in individuals with chronic aphasia…

  17. A Comparison between Written and Spoken Narratives in Aphasia

    Science.gov (United States)

    Behrns, Ingrid; Wengelin, Asa; Broberg, Malin; Hartelius, Lena

    2009-01-01

    The aim of the present study was to explore how a personal narrative told by a group of eight persons with aphasia differed between written and spoken language, and to compare this with findings from 10 participants in a reference group. The stories were analysed through holistic assessments made by 60 participants without experience of aphasia…

  18. Aphasia and Literacy--The Insider's Perspective

    Science.gov (United States)

    Kjellén, Emma; Laakso, Katja; Henriksson, Ingrid

    2017-01-01

    Background: Few studies have investigated how people with aphasia (PWA) experience literacy skills. Taking the insider's perspective is a way to increase understanding of the individual experiences of literacy among PWA, which may have clinical implications. Aims: To describe how literacy, i.e., reading and writing, is experienced in everyday life…

  19. Script Templates: A Practical Approach to Script Training in Aphasia

    Science.gov (United States)

    Kaye, Rosalind C.; Cherney, Leora R.

    2016-01-01

    Purpose: Script training for aphasia involves repeated practice of relevant phrases and sentences that, when mastered, can potentially be used in other communicative situations. Although an increasingly popular approach, script development can be time-consuming. We provide a detailed summary of the evidence supporting this approach. We then…

  20. Crossed Wernicke's aphasia after aneurysmal subarachnoid hemorrhage: a case report.

    Science.gov (United States)

    Seçkin, Hakan; Yiğitkanli, Kazim; Kapucu, Ozlem; Bavbek, Murad

    2009-01-01

    Crossed aphasia (CA) refers to aphasia occurring after right brain damage in right handers. In the literature, numerous CA cases following cerebral ischemia have been reported, but few met the criteria for a prompt diagnosis. The authors present the case of a 52-year-old woman with SAH caused by a right middle cerebral artery (MCA) saccular aneurysm who developed non-fluent aphasia characterized by reduced verbal output, word-finding disturbances and phonemic paraphasias in both oral and written language. 99mTc-HMPAO SPECT was also consistent with right parieto-temporal and frontoparietal ischemia with crossed cerebellar diaschisis on the right cerebellum. A diagnosis of CA was made. One year follow-up showed improvement in communication skills but persistent right fronto-temporo-parietal ischemia. Cerebral vasospasm after aneurysmal SAH symptomatology may vary from motor and sensory disturbances to cognitive disabilities. Aphasia developing after cerebral ischemia of the right hemisphere in a right-hand dominant patient following vasospasm may be a misleading symptom for the localization of the insult. Keeping a high index of suspicion may help in making the correct diagnosis. The changes in the perfusion patterns of cerebellum as assessed by SPECT study during the acute and recovery phases suggests the involvement of cerebellum in language functions.

  1. Arnoldus Van Rhijn on aphasia: A forgotten thesis

    NARCIS (Netherlands)

    Eling, P.A.T.M.

    2011-01-01

    Background: Aphasia formed a central topic in the discussion on localization of function in the nineteenth century, in particular in France, Germany and Great Brittain. Little is known on contributions from the Netherlands. Aim: This paper aims to discuss the contents of Arnoldus Van Rhijn's

  2. [The origins of language: an analysis from the aphasia perspective].

    Science.gov (United States)

    Ardila, A

    Different areas of knowledge have contributed to a better understanding of the origins of human language. AIM. To relate our current knowledge about the origins of language with the language pathology found in the case of brain injuries (aphasia). There are two fundamental forms of aphasia, which linked to defects in the lexico-semantic and grammatical systems of language (Wernicke-type aphasia and Broca-type aphasia, respectively). From observations made on children's development of language and experiments with primates, it has been shown that language initially appears as a lexico-semantic system. Grammar correlates with the ability to represent actions (verbs) and depends on what is known as Broca's area and its related brain circuits, but it is also related to the ability to quickly carry out the sequencing of the articulatory movements required for speaking (speech praxis). Language may have appeared as a lexico-semantic system much earlier than language as a syntactic system. The former may have developed around 200,000-300,000 years ago, coinciding with the increase in the temporal lobe, and would have existed in other hominids. Language as a grammatical system appeared perhaps as recently as 50,000 years ago and seems to be exclusive to Homo sapiens.

  3. Pantomime production by people with aphasia. What are influencing factors?

    NARCIS (Netherlands)

    van Nispen, Karin; van de Sandt-Koenderman, Mieke; Mol, Elisabeth; Krahmer, Emiel

    2016-01-01

    Purpose: The present paper aimed to inform clinical practice on whether people with aphasia (PWA) deploy pantomime techniques similarly to non-brain damaged participants (NBDP) and if not, what factors influence these differences. Method: We compared 38 PWA to 20 NBDP in their use of six

  4. Speech Errors in Progressive Non-Fluent Aphasia

    Science.gov (United States)

    Ash, Sharon; McMillan, Corey; Gunawardena, Delani; Avants, Brian; Morgan, Brianna; Khan, Alea; Moore, Peachie; Gee, James; Grossman, Murray

    2010-01-01

    The nature and frequency of speech production errors in neurodegenerative disease have not previously been precisely quantified. In the present study, 16 patients with a progressive form of non-fluent aphasia (PNFA) were asked to tell a story from a wordless children's picture book. Errors in production were classified as either phonemic,…

  5. Measuring Lexical Diversity in Narrative Discourse of People with Aphasia

    Science.gov (United States)

    Fergadiotis, Gerasimos; Wright, Heather H.; West, Thomas M.

    2013-01-01

    Purpose: A microlinguistic content analysis for assessing lexical semantics in people with aphasia (PWA) is lexical diversity (LD). Sophisticated techniques have been developed to measure LD. However, validity evidence for these methodologies when applied to the discourse of PWA is lacking. The purpose of this study was to evaluate four measures…

  6. The Comprehensibility of Pantomimes Produced by People with Aphasia

    Science.gov (United States)

    Nispen, Karin; Mieke, W. M. E.; van de Sandt-Koenderman, E.; Krahmer, Emiel

    2018-01-01

    Background: People with aphasia (PWA) use pantomime, gesture in absence of speech, differently from non-brain-damaged people (NBDP). Aims: To evaluate through an exploratory study the comprehensibility of PWA's pantomimes and to find out whether they can compensate for information PWA are unable to convey in speech. Methods & Procedures: A…

  7. Collaborative Referencing between Individuals with Aphasia and Routine Communication Partners.

    Science.gov (United States)

    Hengst, Julie A.

    2003-01-01

    This study examined how four adults with aphasia collaborated with routine communication partners. Overall, these pairs completed the referencing task trials with accuracy and displayed referencing processes that conformed to the collaborative referencing model of communication. However, the pairs also used diverse verbal and nonverbal resources,…

  8. Communicative Effectiveness of Pantomime Gesture in People with Aphasia

    Science.gov (United States)

    Rose, Miranda L.; Mok, Zaneta; Sekine, Kazuki

    2017-01-01

    Background: Human communication occurs through both verbal and visual/motoric modalities. Simultaneous conversational speech and gesture occurs across all cultures and age groups. When verbal communication is compromised, more of the communicative load can be transferred to the gesture modality. Although people with aphasia produce meaning-laden…

  9. Spousal Recollections of Early Signs of Primary Progressive Aphasia

    Science.gov (United States)

    Pozzebon, Margaret; Douglas, Jacinta; Ames, David

    2018-01-01

    Background: Although primary progressive aphasia (PPA) is characterized by progressive loss of language and communication skills, knowledge about the earliest emerging signs announcing the onset of this condition is limited. Aims: To explore spousal recollections regarding the earliest signs of PPA and to compare the nature of the earliest…

  10. The comprehensibility of pantomimes produced by people with aphasia

    NARCIS (Netherlands)

    van Nispen, Karin; van de Sandt-Koenderman, M.; Krahmer, Emiel

    2018-01-01

    BACKGROUND: People with aphasia (PWA) use pantomime, gesture in absence of speech, differently from non-brain-damaged people (NBDP). AIMS: To evaluate through an exploratory study the comprehensibility of PWA's pantomimes and to find out whether they can compensate for information PWA are unable to

  11. Gesturing by Speakers with Aphasia: How Does It Compare?

    Science.gov (United States)

    Mol, Lisette; Krahmer, Emiel; van de Sandt-Koenderman, Mieke

    2013-01-01

    Purpose: To study the independence of gesture and verbal language production. The authors assessed whether gesture can be semantically compensatory in cases of verbal language impairment and whether speakers with aphasia and control participants use similar depiction techniques in gesture. Method: The informativeness of gesture was assessed in 3…

  12. Does gesture add to the comprehensibility of people with aphasia?

    NARCIS (Netherlands)

    van Nispen, Karin; Sekine, Kazuki; Rose, Miranda; Ferré, Gaëlle; Tutton, Mark

    2015-01-01

    Gesture can convey information co-occurring with and in the absence of speech. As such, it seems a useful strategy for people with aphasia (PWA) to compensate for their impaired speech. To find out whether gestures used by PWA add to the comprehensibility of their communication we looked at the

  13. Progranulin-Associated Primary Progressive Aphasia: A Distinct Phenotype?

    Science.gov (United States)

    Rohrer, Jonathan D.; Crutch, Sebastian J.; Warrington, Elizabeth K.; Warren, Jason D.

    2010-01-01

    The neuropsychological features of the primary progressive aphasia (PPA) syndromes continue to be defined. Here we describe a detailed neuropsychological case study of a patient with a mutation in the progranulin ("GRN") gene who presented with progressive word-finding difficulty. Key neuropsychological features in this case included gravely…

  14. Effects of Mindfulness Meditation on Three Individuals with Aphasia

    Science.gov (United States)

    Orenstein, Ellen; Basilakos, Alexandra; Marshall, Rebecca Shisler

    2012-01-01

    Background: There is evidence to suggest that people with aphasia (PWA) may have deficits in attention stemming from the inefficient allocation of resources. The inaccurate perception of task demand, or sense of effort, may underlie the misallocation of the available attention resources. Given the lack of treatment options for improving attention…

  15. A Computational Evaluation of Sentence Processing Deficits in Aphasia

    Science.gov (United States)

    Patil, Umesh; Hanne, Sandra; Burchert, Frank; De Bleser, Ria; Vasishth, Shravan

    2016-01-01

    Individuals with agrammatic Broca's aphasia experience difficulty when processing reversible non-canonical sentences. Different accounts have been proposed to explain this phenomenon. The Trace Deletion account (Grodzinsky, 1995, 2000, 2006) attributes this deficit to an impairment in syntactic representations, whereas others (e.g., Caplan,…

  16. Verb and auxiliary movement in agrammatic Broca's aphasia

    NARCIS (Netherlands)

    Bastiaanse, Y.R.M.; Thompson, C.K.

    Verb production in agrammatic Broca's aphasia has repeatedly been shown to be impaired by a number of investigators. Not only is the number of verbs produced often significantly reduced, but verb inflections and auxiliaries are often omitted as well (e.g., Bastiaanse, Jonkers, & Moltmaker-Osinga,

  17. Rehabilitation Treatment In Aphasia Caused By Stroke(Review

    Directory of Open Access Journals (Sweden)

    Parvane Rahimifar

    2017-02-01

    Full Text Available Aphasia is a relatively common language disorder, occurring in about 25% of all stroke patients. The ultimate aim of aphasia treatment is to improve patients oral and written language abilities and to facilitate their participation in everyday communication. Over the last decades, a range of approaches in aphasia therapy have been introduced, based on cognitive neuropsychological models, psycholinguistic theories, and socio-pragmatic approaches. In view of the range of different approaches and findings of therapy studies, the challenge for therapists is to decide which approach is the most appropriate one for an aphasic individual at a specific stage of recovery. The Findings showed that, therapy plan for aphasic individuals involves selecting the therapeutic approach most appropriate for dealing with a particular type of disorder, degree of severity, stage of recovery and the extent of the patient's participation in social life. A framework of aphasia treatment is outlined which considers the rehabilitation process at the various stages of recovery, and Different approaches are combined into a comprehensive treatment regimen which differentiates three stages of recovery: the acute, post-acute, and chronic stage. Also ,The intensive therapy in the treatment of language disorders have a great effect, and Brain imaging studies have shown that the linguistic reorganization of a damaged brain is aided by intensive speech therapy even in the chronic phase.

  18. Comparison of Animal, Action and Phonemic Fluency in Aphasia

    Science.gov (United States)

    Faroqi-Shah, Yasmeen; Milman, Lisa

    2018-01-01

    Background: The ability to generate words that follow certain constraints, or verbal fluency, is a sensitive indicator of neurocognitive impairment, and is impacted by a variety of variables. Aims: To investigate the effect of post-stroke aphasia, elicitation category and linguistic variables on verbal fluency performance. Methods &…

  19. Conditional and future tense impairment in non-fluent aphasia

    NARCIS (Netherlands)

    Rofes, Adria; Bastiaanse, Roelien; Martinez-Ferreiro, Silvia

    2014-01-01

    Background: Morphological errors of tense and agreement are salient in agrammatic aphasia. The PADILIH predicts impairments in discourse linking that translate to greater difficulties in referring to a past event time than to a future or a present event time. In Catalan, the Periphrastic conditional

  20. Patterns of Dysgraphia in Primary Progressive Aphasia Compared to Post-Stroke Aphasia

    Directory of Open Access Journals (Sweden)

    Andreia V. Faria

    2013-01-01

    Full Text Available We report patterns of dysgraphia in participants with primary progressive aphasia that can be explained by assuming disruption of one or more cognitive processes or representations in the complex process of spelling. These patterns are compared to those described in participants with focal lesions (stroke. Using structural imaging techniques, we found that damage to the left extrasylvian regions, including the uncinate, inferior fronto-occipital fasciculus, and sagittal stratum (including geniculostriate pathway and inferior longitudinal fasciculus, as well as other deep white and grey matter structures, was significantly associated with impairments in access to orthographic word forms and semantics (with reliance on phonology-to-orthography to produce a plausible spelling in the spelling to dictation task. These results contribute not only to our understanding of the patterns of dysgraphia following acquired brain damage but also the neural substrates underlying spelling.

  1. Repetitive learning control of continuous chaotic systems

    International Nuclear Information System (INIS)

    Chen Maoyin; Shang Yun; Zhou Donghua

    2004-01-01

    Combining a shift method and the repetitive learning strategy, a repetitive learning controller is proposed to stabilize unstable periodic orbits (UPOs) within chaotic attractors in the sense of least mean square. If nonlinear parts in chaotic systems satisfy Lipschitz condition, the proposed controller can be simplified into a simple proportional repetitive learning controller

  2. Evaluating the Effectiveness of Intervention in Long-Term Aphasia Post-Stroke: The Experience from CHANT (Communication Hub for Aphasia in North Tyneside)

    Science.gov (United States)

    Mumby, Katharyn; Whitworth, Anne

    2012-01-01

    Background: Despite recognition of the need for increased long-term support for people with aphasia following stroke, there remains limited evidence for effective service-level interventions. Aims: To evaluate the outcomes and experiences of people participating in the Communication Hub for Aphasia in North Tyneside (CHANT), a 2-year partnership…

  3. Rotterdam Aphasia Therapy Study (RATS) - 3: " The efficacy of intensive cognitive-linguistic therapy in the acute stage of aphasia"; design of a randomised controlled trial

    NARCIS (Netherlands)

    F. Nouwens (Femke); D.W.J. Dippel (Diederik); M. Jong-Hagelstein (Marjolein); E.G. Visch-Brink (Evy); P.J. Koudstaal (Peter Jan); L. de Lau (Lonneke)

    2013-01-01

    textabstractBackground: Aphasia is a severely disabling condition occurring in 20 to 25% of stroke patients. Most patients with aphasia due to stroke receive speech and language therapy. Methodologically sound randomised controlled trials investigating the effect of specific interventions for

  4. Non-verbal communication in severe aphasia: influence of aphasia, apraxia, or semantic processing?

    Science.gov (United States)

    Hogrefe, Katharina; Ziegler, Wolfram; Weidinger, Nicole; Goldenberg, Georg

    2012-09-01

    Patients suffering from severe aphasia have to rely on non-verbal means of communication to convey a message. However, to date it is not clear which patients are able to do so. Clinical experience indicates that some patients use non-verbal communication strategies like gesturing very efficiently whereas others fail to transmit semantic content by non-verbal means. Concerns have been expressed that limb apraxia would affect the production of communicative gestures. Research investigating if and how apraxia influences the production of communicative gestures, led to contradictory outcomes. The purpose of this study was to investigate the impact of limb apraxia on spontaneous gesturing. Further, linguistic and non-verbal semantic processing abilities were explored as potential factors that might influence non-verbal expression in aphasic patients. Twenty-four aphasic patients with highly limited verbal output were asked to retell short video-clips. The narrations were videotaped. Gestural communication was analyzed in two ways. In the first part of the study, we used a form-based approach. Physiological and kinetic aspects of hand movements were transcribed with a notation system for sign languages. We determined the formal diversity of the hand gestures as an indicator of potential richness of the transmitted information. In the second part of the study, comprehensibility of the patients' gestural communication was evaluated by naive raters. The raters were familiarized with the model video-clips and shown the recordings of the patients' retelling without sound. They were asked to indicate, for each narration, which story was being told and which aspects of the stories they recognized. The results indicate that non-verbal faculties are the most important prerequisites for the production of hand gestures. Whereas results on standardized aphasia testing did not correlate with any gestural indices, non-verbal semantic processing abilities predicted the formal diversity

  5. Communication partner training in aphasia: a systematic review.

    Science.gov (United States)

    Simmons-Mackie, Nina; Raymer, Anastasia; Armstrong, Elizabeth; Holland, Audrey; Cherney, Leora R

    2010-12-01

    To describe the effects of communication partner training on persons with aphasia and their communication partners. Specifically the systematic review addressed 3 clinical questions regarding the impact of partner training on language, communication activity and participation, psychosocial adjustment, and quality of life for adults with aphasia and their communication partners. Twenty-three terms were used to search 12 electronic databases (eg, PubMed, CINAHL, PsychINFO, PsychArticles, CSA Linguistics and Language Behavior Abstracts, Social Sciences Citation Index [Web of Science], SUMSearch, TRIP, EMBASE, REHABDATA, National Library for Health, Cochrane Database of Systematic Reviews) and the journal "Aphasiology." References from all relevant articles were hand-searched. Two reviewers independently applied inclusion criteria to select potential relevant articles from the titles and abstracts of references retrieved by the literature search. The full text of the remaining articles was reviewed by a 5-member panel, resulting in a corpus of 31 studies that met the final inclusion criteria. Two independent reviewers extracted the descriptive data related to the participants, the intervention, the outcome measures, and the results. The 5-member review team by consensus classified the studies using the American Academy of Neurology system for classification of evidence (2004). Evidence shows that communication partner training is effective in improving communication activities and/or participation of the communication partner and is probably effective in improving communication activities and/or participation of persons with chronic aphasia when they are interacting with trained communication partners. There is insufficient evidence to make recommendations related to the impact of partner training on persons with acute aphasia or the impact of training on language impairment, psychosocial adjustment, or quality of life for either the person with aphasia or the

  6. Inner Speech's Relationship With Overt Speech in Poststroke Aphasia.

    Science.gov (United States)

    Stark, Brielle C; Geva, Sharon; Warburton, Elizabeth A

    2017-09-18

    Relatively preserved inner speech alongside poor overt speech has been documented in some persons with aphasia (PWA), but the relationship of overt speech with inner speech is still largely unclear, as few studies have directly investigated these factors. The present study investigates the relationship of relatively preserved inner speech in aphasia with selected measures of language and cognition. Thirty-eight persons with chronic aphasia (27 men, 11 women; average age 64.53 ± 13.29 years, time since stroke 8-111 months) were classified as having relatively preserved inner and overt speech (n = 21), relatively preserved inner speech with poor overt speech (n = 8), or not classified due to insufficient measurements of inner and/or overt speech (n = 9). Inner speech scores (by group) were correlated with selected measures of language and cognition from the Comprehensive Aphasia Test (Swinburn, Porter, & Al, 2004). The group with poor overt speech showed a significant relationship of inner speech with overt naming (r = .95, p speech and language and cognition factors were not significant for the group with relatively good overt speech. As in previous research, we show that relatively preserved inner speech is found alongside otherwise severe production deficits in PWA. PWA with poor overt speech may rely more on preserved inner speech for overt picture naming (perhaps due to shared resources with verbal working memory) and for written picture description (perhaps due to reliance on inner speech due to perceived task difficulty). Assessments of inner speech may be useful as a standard component of aphasia screening, and therapy focused on improving and using inner speech may prove clinically worthwhile. https://doi.org/10.23641/asha.5303542.

  7. Treatment for Apraxia of Speech in Nonfluent Variant Primary Progressive Aphasia

    Directory of Open Access Journals (Sweden)

    M. L. Henry

    2013-01-01

    Full Text Available There is a growing body of literature examining the utility of behavioral treatment in primary progressive aphasia (PPA. There are, however, no studies exploring treatment approaches to improve speech production in individuals with apraxia of speech (AOS associated with the nonfluent variant of PPA. The purpose of this study was to examine a novel approach to treatment of AOS in nonfluent PPA. We implemented a treatment method using structured oral reading as a tool for improving production of multisyllabic words in an individual with mild AOS and nonfluent variant PPA. Our participant showed a reduction in speech errors during reading of novel text that was maintained at one year post-treatment. Generalization of improved speech production was observed on repetition of words and sentences and the participant showed stability of speech production over time in connected speech. Results suggest that oral reading treatment may offer an efficient and effective means of addressing multisyllabic word production in AOS associated with nonfluent PPA, with lasting and generalized treatment effects.

  8. Neuroimaging Correlates of Post-Stroke Aphasia Rehabilitation in a Pilot Randomized Trial of Constraint-Induced Aphasia Therapy.

    Science.gov (United States)

    Nenert, Rodolphe; Allendorfer, Jane B; Martin, Amber M; Banks, Christi; Ball, Angel; Vannest, Jennifer; Dietz, Aimee R; Szaflarski, Jerzy P

    2017-07-18

    BACKGROUND Recovery from post-stroke aphasia is a long and complex process with an uncertain outcome. Various interventions have been proposed to augment the recovery, including constraint-induced aphasia therapy (CIAT). CIAT has been applied to patients suffering from post-stroke aphasia in several unblinded studies to show mild-to-moderate linguistic gains. The aim of the present study was to evaluate the neuroimaging correlates of CIAT in patients with chronic aphasia related to left middle cerebral artery stroke. MATERIAL AND METHODS Out of 24 patients recruited in a pilot randomized blinded trial of CIAT, 19 patients received fMRI of language. Eleven of them received CIAT (trained) and eight served as a control group (untrained). Each patient participated in three fMRI sessions (before training, after training, and 3 months later) that included semantic decision and verb generation fMRI tasks, and a battery of language tests. Matching healthy control participants were also included (N=38; matching based on age, handedness, and sex). RESULTS Language testing showed significantly improved performance on Boston Naming Test (BNT; paphasia with no specific effect from CIAT training.

  9. Bilateral brain reorganization with memantine and constraint-induced aphasia therapy in chronic post-stroke aphasia: An ERP study.

    Science.gov (United States)

    Barbancho, Miguel A; Berthier, Marcelo L; Navas-Sánchez, Patricia; Dávila, Guadalupe; Green-Heredia, Cristina; García-Alberca, José M; Ruiz-Cruces, Rafael; López-González, Manuel V; Dawid-Milner, Marc S; Pulvermüller, Friedemann; Lara, J Pablo

    2015-01-01

    Changes in ERP (P100 and N400) and root mean square (RMS) were obtained during a silent reading task in 28 patients with chronic post-stroke aphasia in a randomized, double-blind, placebo-controlled trial of both memantine and constraint-induced aphasia therapy (CIAT). Participants received memantine/placebo alone (weeks 0-16), followed by drug treatment combined with CIAT (weeks 16-18), and then memantine/placebo alone (weeks 18-20). ERP/RMS values (week 16) decreased more in the memantine group than in the placebo group. During CIAT application (weeks 16-18), improvements in aphasia severity and ERP/RMS values were amplified by memantine and changes remained stable thereafter (weeks 18-20). Changes in ERP/RMS occurred in left and right hemispheres and correlated with gains in language performance. No changes in ERP/RMS were found in a healthy group in two separated evaluations. Our results show that aphasia recovery induced by both memantine alone and in combination with CIAT is indexed by bilateral cortical potentials. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. The effectiveness of Speech-Music Therapy for Aphasia (SMTA) in five speakers with Apraxia of Speech and aphasia

    NARCIS (Netherlands)

    Hurkmans, Joost; Jonkers, Roel; de Bruijn, Madeleen; Boonstra, Anne M.; Hartman, Paul P.; Arendzen, Hans; Reinders - Messelink, Heelen

    2015-01-01

    Background: Several studies using musical elements in the treatment of neurological language and speech disorders have reported improvement of speech production. One such programme, Speech-Music Therapy for Aphasia (SMTA), integrates speech therapy and music therapy (MT) to treat the individual with

  11. Speech and language therapists' perspectives of therapeutic alliance construction and maintenance in aphasia rehabilitation post-stroke.

    Science.gov (United States)

    Lawton, Michelle; Sage, Karen; Haddock, Gillian; Conroy, Paul; Serrant, Laura

    2018-05-01

    Therapeutic alliance refers to the interactional and relational processes operating during therapeutic interventions. It has been shown to be a strong determinant of treatment efficacy in psychotherapy, and evidence is emerging from a range of healthcare and medical disciplines to suggest that the construct of therapeutic alliance may in fact be a variable component of treatment outcome, engagement and satisfaction. Although this construct appears to be highly relevant to aphasia rehabilitation, no research to date has attempted to explore this phenomenon and thus consider its potential utility as a mechanism for change. To explore speech and language therapists' perceptions and experiences of developing and maintaining therapeutic alliances in aphasia rehabilitation post-stroke. Twenty-two, in-depth, semi-structured interviews were conducted with speech and language therapists working with people with aphasia post-stroke. Qualitative data were analysed using inductive thematic analysis. Analysis resulted in the emergence of three overarching themes: laying the groundwork; augmenting cohesion; and contextual shapers. Recognizing personhood, developing shared expectations of therapy and establishing therapeutic ownership were central to laying the groundwork for therapeutic delivery. Augmenting cohesion was perceived to be dependent on the therapists' responsiveness and ability to resolve both conflict and resistance, as part of an ongoing active process. These processes were further moulded by contextual shapers such as the patient's family, relational continuity and organizational drivers. The findings suggest that therapists used multiple, complex, relational strategies to establish and manage alliances with people with aphasia, which were reliant on a fluid interplay of verbal and non-verbal skills. The data highlight the need for further training to support therapists to forge purposive alliances. Training should develop: therapeutic reflexivity; inclusivity in

  12. Creutzfeldt-Jakob Disease with Mixed Transcortical Aphasia: Insights into Echolalia

    OpenAIRE

    McPherson, S. E.; Kuratani, J. D.; Cummings, J. L.; Shih, J.; Mischel, P. S.; Vinters, H. V.

    1994-01-01

    Aphasia is a common manifestation of Creutzfeldt-Jakob disease (CJD), and investigation of the linguistic disorders of CJD patients may provide insights into the neurobiological mechanisms of language and aphasia. We report an autopsy-confirmed case of CJD in which the presenting symptom was change in language abilities. The patient ultimately evidenced mixed transcortical aphasia (MTA) with echolalia. Disruption of frontal-subcortical circuits with environmental dependency accounts for the s...

  13. Haben repetitive DNA-Sequenzen biologische Funktionen?

    Science.gov (United States)

    John, Maliyakal E.; Knöchel, Walter

    1983-05-01

    By DNA reassociation kinetics it is known that the eucaryotic genome consists of non-repetitive DNA, middle-repetitive DNA and highly repetitive DNA. Whereas the majority of protein-coding genes is located on non-repetitive DNA, repetitive DNA forms a constitutive part of eucaryotic DNA and its amount in most cases equals or even substantially exceeds that of non-repetitive DNA. During the past years a large body of data on repetitive DNA has accumulated and these have prompted speculations ranging from specific roles in the regulation of gene expression to that of a selfish entity with inconsequential functions. The following article summarizes recent findings on structural, transcriptional and evolutionary aspects and, although by no means being proven, some possible biological functions are discussed.

  14. Repetitively pulsed material testing facility

    International Nuclear Information System (INIS)

    Zucker, O.; Bostick, W.; Gullickson, R; Long, J.; Luce, J.; Sahlin, H.

    1975-01-01

    A continuously operated, 1 pps, dense-plasma-focus device capable of delivering a minimum of 10 15 neutrons per pulse for material testing purposes is described. Moderate scaling from existing results is sufficient to provide 2 x 10 13 n/cm 2 .s to a suitable target. The average power consumption, which has become a major issue as a result of the energy crisis, is analyzed with respect to other plasma devices and is shown to be highly favorable. A novel approach to the capacitor bank and switch design allowing repetitive operation is discussed. (U.S.)

  15. Repetitively pulsed material testing facility

    International Nuclear Information System (INIS)

    Zucker, O.; Bostick, W.; Gullickson, R.; Long, J.; Luce, J.; Sahlin, H.

    1975-01-01

    A continuously operated, 1 pps, dense-plasma-focus device capable of delivering a minimum of 10 15 neutrons per pulse for material testing purposes is described. Moderate scaling from existing results is sufficient to provide 2 x 10 13 n/cm 2 . s to a suitable target. The average power consumption, which has become a major issue as a result of the energy crisis, is analyzed with respect to other plasma devices and is shown to be highly favorable. A novel approach to the capacitor bank and switch design allowing repetitive operation is discussed

  16. Chronic Broca's Aphasia Is Caused by Damage to Broca's and Wernicke's Areas.

    Science.gov (United States)

    Fridriksson, Julius; Fillmore, Paul; Guo, Dazhou; Rorden, Chris

    2015-12-01

    Despite being perhaps the most studied form of aphasia, the critical lesion location for Broca's aphasia has long been debated, and in chronic patients, cortical damage often extends far beyond Broca's area. In a group of 70 patients, we examined brain damage associated with Broca's aphasia using voxel-wise lesion-symptom mapping (VLSM). We found that damage to the posterior portion of Broca's area, the pars opercularis, is associated with Broca's aphasia. However, several individuals with other aphasic patterns had considerable damage to pars opercularis, suggesting that involvement of this region is not sufficient to cause Broca's aphasia. When examining only individuals with pars opercularis damage, we found that patients with Broca's aphasia had greater damage in the left superior temporal gyrus (STG; roughly Wernicke's area) than those with other aphasia types. Using discriminant function analysis and logistic regression, based on proportional damage to the pars opercularis and Wernicke's area, to predict whether individuals had Broca's or another types of aphasia, over 95% were classified correctly. Our findings suggest that persons with Broca's aphasia have damage to both Broca's and Wernicke's areas, a conclusion that is incongruent with classical neuropsychology, which has rarely considered the effects of damage to both areas. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  17. Communication impairment and activity limitation in stroke patients with severe aphasia.

    Science.gov (United States)

    Darrigrand, Benedicte; Dutheil, Sabine; Michelet, Valerie; Rereau, Stephanie; Rousseaux, Marc; Mazaux, Jean-Michel

    2011-01-01

    This study investigated how patients with severe aphasia communicated in daily living, which verbal and non-verbal communication skills were spared and which were impaired, and whether activity limitations in communication are related to verbal impairments. Twenty-seven patients with severe aphasia and 9 with moderate aphasia originating from a sample of 102 aphasic persons followed up in a French regional survey were assessed with a communication test and a communication activity limitation questionnaire 12-18 months after a first stroke. Patients with severe aphasia suffered severe activity limitations in communication, with performance 3-fold lower than that of patients with moderate aphasia, and 4-fold lower than scores attained by normals. Both aphasia severity and communication disability at follow-up were related to the initial severity of aphasia. Using a phone, credit card and a chequebook, reading and filling in administrative documents, and communication behaviours involved in social life were the most severely impaired. Non-verbal communication performance was not related to aphasia severity. We conclude that there is a great need for speech therapy research to develop new compensatory or alternative strategies for patients with severe aphasia.

  18. "Making a good time": the role of friendship in living successfully with aphasia.

    Science.gov (United States)

    Brown, Kyla; Davidson, Bronwyn; Worrall, Linda E; Howe, Tami

    2013-04-01

    Loss of friendship post-onset of aphasia is well documented, with reduced social network size and social isolation commonly reported. Because friendship has strong links to psychological well-being and health, increased knowledge about friendships of individuals with aphasia will have important clinical implications. This study aimed to explore the perspectives of 25 community dwelling individuals with chronic aphasia on the role of friendship in living successfully with aphasia. Thematic analysis of transcripts from semi-structured in-depth interviews revealed three over-arching themes relating to the role of friendship in participants' experience of life with aphasia: living with changes in friendships, good times together and support from friends, and the importance of stroke and aphasia friends. Overall, findings highlighted the valued role of friendship in living successfully with aphasia, while also providing evidence of how friendships change and evolve in both negative and positive ways following onset of aphasia. Clinicians are challenged to work creatively to address the role of friendship in life post-stroke in partnership with individuals with aphasia, their families, and friends.

  19. Measuring prosodic deficits in oral discourse by speakers with fluent aphasia

    Directory of Open Access Journals (Sweden)

    Tan Lee

    2015-04-01

    applying three different algorithms, including PEFAC (Gonzales & Brookes, 2011, RAPT (Talkin, 1995, Voicebox (Brookes, 1997, and YIN (de Cheveigné & Kawahara, 2002, and combining their results. For each syllable, the F0 values of all voiced frames were considered. The median value was used as the representative F0 level of the syllable. This was motivated by our interest in intonation-related variation of F0 level over a sentence. Since Cantonese is rich in tones, the surface F0 measurement depends greatly on the tone identities. To address this problem, a novel method of tone normalization that attempts to produce a tone-independent F0 level for each syllable was applied (Li, 2003. Using the normalized F0 values, a sentence-level intonation curve was derived by performing linear regression. A positive slope of the intonation curve implied a trend of increasing pitch. Descriptive statistics on the slopes of intonation curves were conducted for both groups. Results Sentences in the aphasic group were significantly shorter than those by controls. Aphasic speech also contained significantly more sentences with rising intonation; this difference was more noticeable for shorter sentences. Concerning the effect of discourse task on speech prosody, story-telling discourses by speakers with aphasia tended to contain more rising intonation than descriptive discourses. Such a difference was absent in controls (see Table 1.

  20. Repetitive trauma and nerve compression.

    Science.gov (United States)

    Carragee, E J; Hentz, V R

    1988-01-01

    Repetitive movement of the upper extremity, whether recreational or occupational, may result in various neuropathies, the prototype of which is the median nerve neuropathic in the carpal canal. The pathophysiology of this process is incompletely understood but likely involves both mechanical and ischemic features. Experimentally increased pressures within the carpal canal produced reproducible progressive neuropathy. Changes in vibratory (threshold-type) sensibility appears to be more sensitive than two-point (innervation density-type) sensibility. The specific occupational etiologies of carpal neuropathy are obscured by methodologic and sociological difficulties, but clearly some occupations have high incidences of CTS. History and physical examination are usually sufficient for the diagnosis, but diagnostic assistance when required is available through electrophysiological testing, CT scanning, and possibly MRI. Each of these tests has limitations in both sensitivity and specificity. Treatment by usual conservative means should be combined with rest from possible provocative activities. Surgical release of the carpal canal is helpful in patients failing conservative therapy. Occupational modifications are important in both treatment and prevention of median neuropathy due to repetitive trauma.

  1. Test-Retest Reliability of fMRI During Nonverbal Semantic Decisions in Moderate-Severe Nonfluent Aphasia Patients

    Directory of Open Access Journals (Sweden)

    Jacquie Kurland

    2004-01-01

    Full Text Available Cortical reorganization in poststroke aphasia is not well understood. Few studies have investigated neural mechanisms underlying language recovery in severe aphasia patients, who are typically viewed as having a poor prognosis for language recovery. Although test-retest reliability is routinely demonstrated during collection of language data in single-subject aphasia research, this is rarely examined in fMRI studies investigating the underlying neural mechanisms in aphasia recovery.

  2. Japanese Adaptation of the Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39): Comparative Study among Different Types of Aphasia.

    Science.gov (United States)

    Kamiya, Akane; Kamiya, Kentaro; Tatsumi, Hiroshi; Suzuki, Makihiko; Horiguchi, Satoshi

    2015-11-01

    We have developed a Japanese version of the Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39), designated as SAQOL-39-J, and used psychometric methods to examine its acceptability and reliability. The acceptability and reliability of SAQOL-39-J, which was developed from the English version using a standard translation and back-translation method, were examined in 54 aphasia patients using standard psychometric methods. The acceptability and reliability of SAQOL-39-J were then compared among patients with different types of aphasia. SAQOL-39-J showed good acceptability, internal consistency (Cronbach's α score = .90), and test-retest reliability (intraclass correlation coefficient = .97). Broca's aphasia patients showed the lowest total scores and communication scores on SAQOL-39-J. The Japanese version of SAQOL-39, SAQOL-39-J, provides acceptable and reliable data in Japanese stroke patients with aphasia. Among different types of aphasia, Broca's aphasia patients had the lowest total and communication SAQOL-39-J scores. Further studies are needed to assess the effectiveness of health care interventions on health-related quality of life in this population. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  3. Conversation Therapy for Agrammatism: Exploring the Therapeutic Process of Engagement and Learning by a Person with Aphasia

    Science.gov (United States)

    Beckley, Firle; Best, Wendy; Johnson, Fiona; Edwards, Susan; Maxim, Jane; Beeke, Suzanne

    2013-01-01

    Background & Aims: A recent systematic review of conversation training for communication partners of people with aphasia has shown that it is effective, and improves participation in conversation for people with chronic aphasia. Other research suggests that people with aphasia are better able to learn communication strategies in an environment…

  4. Rehabilitation of language in expressive aphasias: a literature review

    Directory of Open Access Journals (Sweden)

    Denise Ren da Fontoura

    Full Text Available ABSTRACT Objective: This paper reviews the methodological characteristics of studies on rehabilitation of expressive aphasia, describing the techniques of rehabilitation used. Methods: The databases Medline, Science Direct and PubMed were searched for relevant articles (January 1999 to December 2011 using the keywords Expressive / Broca / Nonfluent Aphasia, combined with Language or Speech Rehabilitation / Therapy / Intervention. Results: A total of 56 articles were retrieved describing rehabilitation techniques, including 22 with a focus on lexical processing, 18 on syntax stimulation, seven with the aim of developing speech and nine with multiple foci. Conclusion: A variety of techniques and theoretical approaches are available, highlighting the heterogeneity of research in this area. This diversity can be justified by the uniqueness of patients' language deficits, making it difficult to generalize. In addition, there is a need to combine the formal measures of tests with measures of pragmatic and social skills of communication to determine the effect of rehabilitation on the patient's daily life.

  5. Integrating emotion in the case of aphasia after trauma

    DEFF Research Database (Denmark)

    Klemmensen, Charlotte Marie Bisgaard

    This study investigates routines and emotion displays mainly in a care home setting, where some of the participants have severe acquired brain injury. Aphasia is investigated in situations in which affect and emotion is relevant, for example cases of compliance and non-compliance to having...... memorized something “wrong” or ”correctly” and other cases of persuasion. The data excerpts presented are transcripts based on participant video observation. The main interest is to scrutinize the emotional consequences of arguing with aphasia. This study is part of a collaborative study of aphasic...... with acquired brain injury, ABI: Embodied talk, multimodal units such as gesturing, pointing, gazing and bodily posture, the handling of objects etc. However, critical emotional displays seem to depend on circumstantial factors - which situation, persons, purpose or the challenge there is at stake (to win...

  6. Web based aphasia test using service oriented architecture (SOA)

    International Nuclear Information System (INIS)

    Voos, J A; Vigliecca, N S; Gonzalez, E A

    2007-01-01

    Based on an aphasia test for Spanish speakers which analyze the patient's basic resources of verbal communication, a web-enabled software was developed to automate its execution. A clinical database was designed as a complement, in order to evaluate the antecedents (risk factors, pharmacological and medical backgrounds, neurological or psychiatric symptoms, brain injury -anatomical and physiological characteristics, etc) which are necessary to carry out a multi-factor statistical analysis in different samples of patients. The automated test was developed following service oriented architecture and implemented in a web site which contains a tests suite, which would allow both integrating the aphasia test with other neuropsychological instruments and increasing the available site information for scientific research. The test design, the database and the study of its psychometric properties (validity, reliability and objectivity) were made in conjunction with neuropsychological researchers, who participate actively in the software design, based on the patients or other subjects of investigation feedback

  7. Web based aphasia test using service oriented architecture (SOA)

    Energy Technology Data Exchange (ETDEWEB)

    Voos, J A [Clinical Engineering R and D Center, Universidad Tecnologica Nacional, Facultad Regional Cordoba, Cordoba (Argentina); Vigliecca, N S [Consejo Nacional de Investigaciones Cientificas y Tecnicas, CONICET, Cordoba (Argentina); Gonzalez, E A [Clinical Engineering R and D Center, Universidad Tecnologica Nacional, Facultad Regional Cordoba, Cordoba (Argentina)

    2007-11-15

    Based on an aphasia test for Spanish speakers which analyze the patient's basic resources of verbal communication, a web-enabled software was developed to automate its execution. A clinical database was designed as a complement, in order to evaluate the antecedents (risk factors, pharmacological and medical backgrounds, neurological or psychiatric symptoms, brain injury -anatomical and physiological characteristics, etc) which are necessary to carry out a multi-factor statistical analysis in different samples of patients. The automated test was developed following service oriented architecture and implemented in a web site which contains a tests suite, which would allow both integrating the aphasia test with other neuropsychological instruments and increasing the available site information for scientific research. The test design, the database and the study of its psychometric properties (validity, reliability and objectivity) were made in conjunction with neuropsychological researchers, who participate actively in the software design, based on the patients or other subjects of investigation feedback.

  8. REVIEW OF A CASE OF CHILD WITH ACQUIRED APHASIA

    Directory of Open Access Journals (Sweden)

    Silvana FILIPOVA

    2004-12-01

    Full Text Available Achieved children speech disabilities are manifested at certain level of development of speech from the age of 3 to 12 years. The speech disabilities with children from the age of one to three years have developmental and acquired characteristics. It is well-known when and why the disabilities occurr at acquired aphasia or disphasia.The child with acquired aphasia or disphasia has early brain impairements and a relative improvement happens with adequate treatment and prompt rehabilitation treatment. It is more obvious with children than with adults.This fast and complete rehabilitation happens due to the plastic character of child’s brain and the possibilities for intro-hemisphere and inter-hemisphere reorganization of speech functions in childhood.

  9. The roles of stimulus repetition and hemispheric activation in visual half-field asymmetries.

    Science.gov (United States)

    Sullivan, K F; McKeever, W F

    1985-10-01

    Hardyck, Tzeng, and Wang (1978, Brain and Language, 5, 56-71) hypothesized that ample repetition of a small number of stimuli is required in order to obtain VHF differences in tachistoscopic tasks. Four experiments, with varied levels of repetition, were conducted to test this hypothesis. Three experiments utilized the general task of object-picture naming and one utilized a word-naming task. Naming latencies constituted the dependent measure. The results demonstrate that for the object-naming paradigm repetition is required for RVF superiority to emerge. Repetition was found to be unnecessary for RVF superiority in the word-naming paradigm, with repetition actually reducing RVF superiority. Experiment I suggested the possibility that RVF superiority developed for the second half of the trials as a function of practice or hemispheric activation, regardless of repetition level. Subsequent experiments, better designed to assess this possibility, clearly refuted it. It was concluded that the effect of repetition depends on the processing requirements of the task. We propose that, for tasks which can be processed efficiently by one hemisphere, the effect of repetition will be to reduce VHF asymmetries; but tasks requiring substantial processing by both hemispheres will show shifts to RVF superiority as a function of repetition.

  10. Rapid recovery from aphasia after infarction of Wernicke's area.

    Science.gov (United States)

    Yagata, Stephanie A; Yen, Melodie; McCarron, Angelica; Bautista, Alexa; Lamair-Orosco, Genevieve; Wilson, Stephen M

    2017-01-01

    Aphasia following infarction of Wernicke's area typically resolves to some extent over time. The nature of this recovery process and its time course have not been characterized in detail, especially in the acute/subacute period. The goal of this study was to document recovery after infarction of Wernicke's area in detail in the first 3 months after stroke. Specifically, we aimed to address two questions about language recovery. First, which impaired language domains improve over time, and which do not? Second, what is the time course of recovery? We used quantitative analysis of connected speech and a brief aphasia battery to document language recovery in two individuals with aphasia following infarction of the posterior superior temporal gyrus. Speech samples were acquired daily between 2 and 16 days post stroke, and also at 1 month and 3 months. Speech samples were transcribed and coded using the CHAT system, in order to quantify multiple language domains. A brief aphasia battery was also administered at a subset of five time points during the 3 months. Both patients showed substantial recovery of language function over this time period. Most, but not all, language domains showed improvements, including fluency, lexical access, phonological retrieval and encoding, and syntactic complexity. The time course of recovery was logarithmic, with the greatest gains taking place early in the course of recovery. There is considerable potential for amelioration of language deficits when damage is relatively circumscribed to the posterior superior temporal gyrus. Quantitative analysis of connected speech samples proved to be an effective, albeit time-consuming, approach to tracking day-by-day recovery in the acute/subacute post-stroke period.

  11. Understanding significant others' experience of aphasia and rehabilitation following stroke.

    Science.gov (United States)

    Hallé, Marie-Christine; Le Dorze, Guylaine

    2014-01-01

    It is currently unknown how rehabilitation services contribute to significant others' adjustment to stroke with aphasia since their experience of rehabilitation has not been studied before. The purpose of this study was thus to understand significant others' experience of aphasia rehabilitation within the context of post-stroke rehabilitation. Individual interviews were carried out with 12 significant others of persons who became aphasic as a result of a stroke and were discharged from rehabilitation in the past 3 months. Data were analyzed with a grounded theory approach. "Being centered on the aphasic person" was the core category triggered by the significant other's perception of the stroke survivor's vulnerability and his/her feelings of attachment towards that person. Through their interactions with professionals, significant others assumed that rehabilitation was also centered on the aphasic person; a perspective that was reinforced. Consequently, significant others participated in rehabilitation as caregivers and expected rehabilitation to meet their caregiver needs but not other personal and relational needs. Their appraisal of rehabilitation was thus related to the satisfaction or not of caregiver needs. With a greater sensitivity to significant others who focus on the stroke survivor and disregard their own needs, rehabilitation professionals and especially speech-language therapists, can assist families in reestablishing communication and satisfying relationships which are affected because of aphasia. This qualitative study shows that significant others of aphasic stroke survivors experience rehabilitation as services focused on the person who had the stroke. Significant others' satisfaction with rehabilitation is not related to the fulfillment of their personal (e.g. resuming their activities) and relational needs (e.g. good communication with the person with aphasia). When offering interventions targeting significant others' needs, rehabilitation

  12. Aphasia in Persian: Implications for cognitive models of lexical processing.

    Science.gov (United States)

    Bakhtiar, Mehdi; Jafary, Reyhane; Weekes, Brendan S

    2017-09-01

    Current models of oral reading assume that different routes (sublexical, lexical, and semantic) mediate oral reading performance and reliance on different routes during oral reading depends on the characteristics of print to sound mappings. Studies of single cases of acquired dyslexia in aphasia have contributed to the development of such models by revealing patterns of double dissociation in object naming and oral reading skill that follow brain damage in Indo-European and Sino-Tibetan languages. Print to sound mapping in Persian varies in transparency because orthography to phonology translation depends uniquely on the presence or absence of vowel letters in print. Here a hypothesis is tested that oral reading in Persian requires a semantic reading pathway that is independent of a direct non-semantic reading pathway, by investigating whether Persian speakers with aphasia show selective impairments to object naming and reading aloud. A sample of 21 Persian speakers with aphasia ranging in age from 18 to 77 (mean = 53, SD = 16.9) was asked to name a same set of 200 objects and to read aloud the printed names of these objects in different sessions. As an additional measure of sublexical reading, patients were asked to read aloud 30 non-word stimuli. Results showed that oral reading is significantly more preserved than object naming in Persian speakers with aphasia. However, more preserved object naming than oral reading was also observed in some cases. There was a moderate positive correlation between picture naming and oral reading success (p Persian for the first time. © 2016 The British Psychological Society.

  13. [Aphasia without amusia in a blind organist. Verbal alexia-agraphia without musical alexia-agraphia in braille].

    Science.gov (United States)

    Signoret, J L; van Eeckhout, P; Poncet, M; Castaigne, P

    1987-01-01

    A 77 year old right handed male was blind since the age of 2. He presented with an infarction involving the territory of the left middle cerebral artery involving the temporal and the inferior parietal lobes. He had learned to read and write language as well as read and write music in braille, ultimately becoming a famous organist and composer. There were no motor or sensory deficits. Wernicke's aphasia with jargonaphasia, major difficulty in repetition, anomia and a significant comprehension deficit without word deafness was present; verbal alexia and agraphia in braille were also present. There was no evidence of amusia. He could execute in an exemplary fashion pieces of music for the organ in his repertory as well as improvise. All his musical capabilities: transposition, modulation, harmony, rythm, were preserved. The musical notation in braille remained intact: he could read by touch and play unfamiliar scores, he could also read and sing the musical notes, he could copy and write a score. Nine months after the stroke his aphasia remained unchanged. Nevertheless he composed pieces for the organ which were published. Such data highly suggest the independence of linguistic and musical competences, defined as the analysis and organization of sounds according to the rules of music. This independence in an extremely talented musician leads to a discussion of the role of the right hemisphere in the anatomical-functional processes at the origin of musical competence. The use of braille in which the same constellations of dots correspond either to letters of the alphabet or musical notes supports the independence between language and music.

  14. Systematic review of communication partner training in aphasia: methodological quality.

    Science.gov (United States)

    Cherney, Leora R; Simmons-Mackie, Nina; Raymer, Anastasia; Armstrong, Elizabeth; Holland, Audrey

    2013-10-01

    Twenty-three studies identified from a previous systematic review examining the effects of communication partner training on persons with aphasia and their communication partners were evaluated for methodological quality. Two reviewers rated the studies on defined methodological quality criteria relevant to each study design. There were 11 group studies, seven single-subject participant design studies, and five qualitative studies. Quality scores were derived for each study. The mean inter-rater reliability of scores for each study design ranged from 85-93%, with Cohen's Kappa indicating substantial agreement between raters. Methodological quality of research on communication partner training in aphasia was highly varied. Overall, group studies employed the least rigorous methodology as compared to single subject and qualitative research. Only two of 11 group studies complied with more than half of the quality criteria. No group studies reported therapist blinding and only one group study reported participant blinding. Across all types of studies, the criterion of treatment fidelity was most commonly omitted. Failure to explicitly report certain methodological quality criteria may account for low ratings. Using methodological rating scales specific to the type of study design may help improve the methodological quality of aphasia treatment studies, including those on communication partner training.

  15. Primary progressive aphasia: A dementia of the language network

    Directory of Open Access Journals (Sweden)

    Marsel Mesulam

    Full Text Available ABSTRACT Primary progressive aphasia (PPA is a clinical syndrome diagnosed when three core criteria are met. First, there should be a language impairment (i.e., aphasia that interferes with the usage or comprehension of words. Second, the neurological work-up should determine that the disease is neurodegenerative, and therefore progressive. Third, the aphasia should arise in relative isolation, without equivalent deficits of comportment or episodic memory. The language impairment can be fluent or non-fluent and may or may not interfere with word comprehension. Memory for recent events is preserved although memory scores obtained in verbally mediated tests may be abnormal. Minor changes in personality and behavior may be present but are not the leading factors that bring the patient to medical attention or that limit daily living activities. This distinctive clinical pattern is most conspicuous in the initial stages of the disease, and reflects a relatively selective atrophy of the language network, usually located in the left hemisphere. There are different clinical variants of PPA, each with a characteristic pattern of atrophy. The underlying neuropathological diseases are heterogeneous and can include Alzheimer's disease as well as frontotemporal lobar degeneration. The clinician's task is to recognize PPA and differentiate it from other neurodegenerative phenotypes, use biomarkers to surmise the nature of the underlying neuropathology, and institute the most fitting multimodal interventions.

  16. Clinician perspectives of an intensive comprehensive aphasia program.

    Science.gov (United States)

    Babbitt, Edna M; Worrall, Linda E; Cherney, Leora R

    2013-01-01

    Intensive comprehensive aphasia programs (ICAPs) have increased in number in recent years in the United States and abroad. To describe the experiences of clinicians working in an ICAP. A phenomenological approach was taken. Seven clinicians from 3 ICAPs were interviewed in person or on the phone. Their interviews were transcribed and coded for themes relating to their experiences. Clinicians described 3 major themes. The first theme related to the intensity component of the ICAP that allowed clinicians to provide in-depth treatment and gave them a different perspective with regard to providing treatment and the potential impact on the person with aphasia. The second theme of rewards for the clinicians included learning and support, seeing progress, and developing relationships with their clients and family members. Third, challenges were noted, including the time involved in learning new therapy techniques, patient characteristics such as chronicity of the aphasia, and the difficulty of returning to work in typical clinical settings after having experienced an ICAP. Although there is a potential for bias with the small sample size, this pilot study gives insight into the clinician perspective of what makes working in an ICAP both worthwhile and challenging.

  17. A second chance: Recovering language with aphasia (†).

    Science.gov (United States)

    Green, Christopher; Waks, Leonie

    2008-01-01

    Dr Christopher Green is a well-known paediatrician and parenting author, who appeared frequently on Australian radio and television and lectured in Australia and many countries around the world. In 1999, Dr Green had a stroke which left him with aphasia and ended his career. After the death of his wife in 2004, Dr Green used exercise and the goal of writing again to lift himself out of his grief. With the help of a gifted editor, he wrote a new edition of his best-selling book Toddler Taming (Green, 2006 ), and in the process recovered much of his language. Dr Green is the Patron of the Australian Aphasia Association, and has in recent years returned to public speaking. In this address, he shares his message that the language gains made with aphasia may occur over decades, not merely one or two years. This article is an edited version of the keynote speech Dr Green presented at the Speech Pathology Australia annual conference in 2007.

  18. Rates of Amyloid Imaging Positivity in Patients With Primary Progressive Aphasia

    Science.gov (United States)

    Santos-Santos, Miguel A.; Rabinovici, Gil D.; Iaccarino, Leonardo; Ayakta, Nagehan; Tammewar, Gautam; Lobach, Iryna; Henry, Maya L.; Hubbard, Isabel; Mandelli, Maria Luisa; Spinelli, Edoardo; Miller, Zachary A.; Pressman, Peter S.; O’Neil, James P.; Ghosh, Pia; Lazaris, Andreas; Meyer, Marita; Watson, Christa; Yoon, Soo Jin; Rosen, Howard J.; Grinberg, Lea; Seeley, William W.; Miller, Bruce L.; Jagust, William J.; Gorno-Tempini, Maria Luisa

    2018-01-01

    IMPORTANCE The ability to predict the pathology underlying different neurodegenerative syndromes is of critical importance owing to the advent of molecule-specific therapies. OBJECTIVE To determine the rates of positron emission tomography (PET) amyloid positivity in the main clinical variants of primary progressive aphasia (PPA). DESIGN, SETTING, AND PARTICIPANTS This prospective clinical-pathologic case series was conducted at a tertiary research clinic specialized in cognitive disorders. Patients were evaluated as part of a prospective, longitudinal research study between January 2002 and December 2015. Inclusion criteria included clinical diagnosis of PPA; availability of complete speech, language, and cognitive testing; magnetic resonance imaging performed within 6 months of the cognitive evaluation; and PET carbon 11–labeled Pittsburgh Compound-B or florbetapir F 18 brain scan results. Of 109 patients referred for evaluation of language symptoms who underwent amyloid brain imaging, 3 were excluded because of incomplete language evaluations, 5 for absence of significant aphasia, and 12 for presenting with significant initial symptoms outside of the language domain, leaving a cohort of 89 patients with PPA. MAIN OUTCOMES AND MEASURES Clinical, cognitive, neuroimaging, and pathology results. RESULTS Twenty-eight cases were classified as imaging-supported semantic variant PPA (11 women [39.3%]; mean [SD] age, 64 [7] years), 31 nonfluent/agrammatic variant PPA (22 women [71.0%]; mean [SD] age, 68 [7] years), 26 logopenic variant PPA (17 women [65.4%]; mean [SD] age, 63 [8] years), and 4 mixed PPA cases. Twenty-four of 28 patients with semantic variant PPA (86%) and 28 of 31 patients with nonfluent/agrammatic variant PPA (90%) had negative amyloid PET scan results, while 25 of 26 patients with logopenic variant PPA (96%) and 3 of 4 mixed PPA cases (75%) had positive scan results. The amyloid positive semantic variant PPA and nonfluent/agrammatic variant PPA cases

  19. Crossed aphasia: an analysis of the symptoms, their frequency, and a comparison with left-hemisphere aphasia symptomatology.

    Science.gov (United States)

    Coppens, Patrick; Hungerford, Suzanne; Yamaguchi, Satoshi; Yamadori, Atsushi

    2002-12-01

    This study presents a thorough analysis of published crossed aphasia (CA) cases, including for the first time the cases published in Japanese. The frequency of specific symptoms was determined, and symptomatology differences based on gender, familial sinistrality, and CA subtype were investigated. Results suggested that the CA population is comparable to the left-hemisphere patient population. However, male were significantly more likely than female CA subjects to show a positive history of familial sinistrality. Typical right-hemisphere (i.e., nonlanguage-dominant) symptoms were frequent but rarely carefully reported or assessed. Results are compared with previous CA reviews and left-hemisphere aphasia. Suggestions for a more systematic assessment of the CA symptomatology are presented.

  20. Sands subjected to repetitive vertical loading under zero lateral strain: accumulation models, terminal densities, and settlement

    KAUST Repository

    Chong, Song Hun; Santamarina, Carlos

    2016-01-01

    ). Repetitive vertical loading tests under zero lateral strain conditions are conducted using three different sands packed at initially low and high densities. Test results show that plastic strain accumulation for all sands and density conditions can

  1. Production Variability and Single Word Intelligibility in Aphasia and Apraxia of Speech

    Science.gov (United States)

    Haley, Katarina L.; Martin, Gwenyth

    2011-01-01

    This study was designed to estimate test-retest reliability of orthographic speech intelligibility testing in speakers with aphasia and AOS and to examine its relationship to the consistency of speaker and listener responses. Monosyllabic single word speech samples were recorded from 13 speakers with coexisting aphasia and AOS. These words were…

  2. Communication Difficulties and the Use of Communication Strategies: From the Perspective of Individuals with Aphasia

    Science.gov (United States)

    Johansson, Monica Blom; Carlsson, Marianne; Sonnander, Karin

    2012-01-01

    Background: To enhance communicative ability and thereby the possibility of increased participation of persons with aphasia, the use of communication strategies has been proposed. However, little is known about how persons with aphasia experience having conversations and how they perceive their own and their conversation partner's use of…

  3. Development of a Short Form of the Boston Naming Test for Individuals with Aphasia

    Science.gov (United States)

    del Toro, Christina M.; Bislick, Lauren P.; Comer, Matthew; Velozo, Craig; Romero, Sergio; Rothi, Leslie J. Gonzalez; Kendall, Diane L.

    2011-01-01

    Purpose: The purpose of this study was to develop a short form of the Boston Naming Test (BNT; Kaplan, Goodglass, & Weintraub, 2001) for individuals with aphasia and compare it with 2 existing short forms originally analyzed with responses from people with dementia and neurologically healthy adults. Method: Development of the new BNT-Aphasia Short…

  4. Correlative study between a serial changes of rCBF and aphasia in hypertensive intracerebral hemorrhage

    International Nuclear Information System (INIS)

    Shi Yizhen; He Guangren

    1998-01-01

    Purpose: To explore the dynamic changes of rCBF of aphasic patients and its correlation with clinical findings. Methods: 32 dominant lateral hypertensive intracerebral hemorrhagic patients underwent the language function evaluation, rCBF tomographic imaging and CT scans. Semiquantitative analysis was used. Results: 1) 19 of 32 cases were aphasia while 13 were not. 2) There was a close correlation between aphasia and the size and location of hematoma. 3) There was only hemonrrhagic foci demonstrated with CT while multiple and extensive cortical hypo-perfused area were found in SPECT, especially in aphasic cases. Frontal and temporal lobes of each aphasia were involved 100%. 4) The rCBF ratio in both Broca's and Wernicke's areas of aphasias were lower than those of non-aphasias (t = 4.31, 5.52, P < 0.001). The degree of rCBF decrement in Wernicke's area varied with different aphasic types, among which the rCBF of sensory aphasia was the lowest (t 2.53, P<0.05). 5) 10 aphasias were followed with SPECT, CT and clinic evaluation 1 week, 1 month and 3 months after hemorrhage respectively. The rCBF ratios in cerebral cortex of 5 recovery cases increased gradually, but not in 5 not recovered cases. Conclusions: SPECT was superior to CT, it can provide useful information for diagnosing and staging aphasias, especially in early stage, and can also assess the prognosis of the disease

  5. Facilitating the participation of people with aphasia in research : a description of strategies

    NARCIS (Netherlands)

    Dalemans, R.; Wade, D.T.; van den Heuvel, W.J.A.; de Witte, L.P.

    2009-01-01

    Background: People with aphasia are often excluded from research because of their communication impairments, especially when an investigation into the communication impairment is not the primary goal. In our research concerning social participation of people with aphasia, we wanted to include people

  6. Brief Mindfulness Meditation Group Training in Aphasia: Exploring Attention, Language and Psychophysiological Outcomes

    Science.gov (United States)

    Marshall, Rebecca Shisler; Laures-Gore, Jacqueline; Love, Kim

    2018-01-01

    Background: Stroke is currently the leading cause of long-term disability in adults in the United States. There is a need for accessible, low-cost treatments of stroke-related disabilities such as aphasia. Aims: To explore an intervention for aphasia utilizing mindfulness meditation (MM). This preliminary study examines the feasibility of teaching…

  7. "You Needed to Rehab...Families as Well": Family Members' Own Goals for Aphasia Rehabilitation

    Science.gov (United States)

    Howe, Tami; Davidson, Bronwyn; Worrall, Linda; Hersh, Deborah; Ferguson, Alison; Sherratt, Sue; Gilbert, Jocelyn

    2012-01-01

    Background: Aphasia affects family members in addition to the individuals with the communication disorder. In order to develop appropriate services for the relatives of people with aphasia post-stroke, their rehabilitation goals need to be identified. Aim: The aim of the current investigation was to identify the rehabilitation goals that family…

  8. Language Assessment of a Farsi-Norwegian Bilingual Speaker with Aphasia

    Science.gov (United States)

    Koumanidi Knoph, Monica I.

    2011-01-01

    The increased occurrence of strokes combined with the high incidence of bilingualism in many regions of the world has led to an increasing number of bilingual adults with aphasia. The literature on bilingual aphasia shows the need for valid, comprehensive and reliable assessment tools for diagnostic and treatment purposes. In spite of a growing…

  9. Revealing and Quantifying the Impaired Phonological Analysis Underpinning Impaired Comprehension in Wernicke's Aphasia

    Science.gov (United States)

    Robson, Holly; Keidel, James L.; Lambon Ralph, Matthew A.; Sage, Karen

    2012-01-01

    Wernicke's aphasia is a condition which results in severely disrupted language comprehension following a lesion to the left temporo-parietal region. A phonological analysis deficit has traditionally been held to be at the root of the comprehension impairment in Wernicke's aphasia, a view consistent with current functional neuroimaging which finds…

  10. Speech-Language Therapists' Process of Including Significant Others in Aphasia Rehabilitation

    Science.gov (United States)

    Hallé, Marie-Christine; Le Dorze, Guylaine; Mingant, Anne

    2014-01-01

    Background: Although aphasia rehabilitation should include significant others, it is currently unknown how this recommendation is adopted in speech-language therapy practice. Speech-language therapists' (SLTs) experience of including significant others in aphasia rehabilitation is also understudied, yet a better understanding of clinical…

  11. Isolated transient aphasia at emergency presentation is associated with a high rate of cardioembolic embolism.

    Science.gov (United States)

    Wasserman, Jason K; Perry, Jeffrey J; Dowlatshahi, Dar; Stotts, Grant; Sivilotti, Marco L A; Worster, Andrew; Emond, Marcel; Sutherland, Jane; Stiell, Ian G; Sharma, Mukul

    2015-11-01

    A cardiac source is often implicated in strokes where the deficit includes aphasia. However, less is known about the etiology of isolated aphasia during transient ischemic attack (TIA). Our objective was to determine whether patients with isolated aphasia are likely to have a cardioembolic etiology for their TIA. We prospectively studied a cohort of TIA patients in eight tertiary-care emergency departments. Patients with isolated aphasia were identified by the treating physician at the time of emergency department presentation. Patients with dysarthria (i.e., a phonation disturbance) were not included. Potential cardiac sources for embolism were defined as atrial fibrillation on history, electrocardiogram, Holter monitor, atrial fibrillation on echocardiography, or thrombus on echocardiography. Of the 2,360 TIA patients identified, 1,155 had neurological deficits at the time of the emergency physician assessment and were included in this analysis, and 41 had isolated aphasia as their only neurological deficit. Patients with isolated aphasia were older (73.9±10.0 v. 67.2±14.5 years; p=0.003), more likely to have a history of heart failure (9.8% v. 2.6%; p=0.027), and were twice as likely to have any cardiac source of embolism (22.0% v. 10.6%; p=0.037). Isolated aphasia is associated with a high rate of cardioembolic sources of embolism after TIA. Emergency patients with isolated aphasia diagnosed with a TIA warrant a rapid and thorough assessment for a cardioembolic source.

  12. A Comparison of Intention and Pantomime Gesture Treatment for Noun Retrieval in People with Aphasia

    Science.gov (United States)

    Ferguson, Neina F.; Evans, Kelli; Raymer, Anastasia M.

    2012-01-01

    Purpose: The effects of intention gesture treatment (IGT) and pantomime gesture treatment (PGT) on word retrieval were compared in people with aphasia. Method: Four individuals with aphasia and word retrieval impairments subsequent to left-hemisphere stroke participated in a single-participant crossover treatment design. Each participant viewed…

  13. Direct and indirect speech in aphasia : studies of spoken discourse production and comprehension

    NARCIS (Netherlands)

    Groenewold, Rimke

    2015-01-01

    Speakers with aphasia (a language impairment due to acquired brain damage) have difficulty processing grammatically complex sentences. In this dissertation we study the processing of direct speech constructions (e.g., John said: “I have to leave”) by people with and without aphasia. First, we study

  14. Releasing the Constraints on Aphasia Therapy: The Positive Impact of Gesture and Multimodality Treatments

    Science.gov (United States)

    Rose, Miranda L.

    2013-01-01

    Purpose: There is a 40-year history of interest in the use of arm and hand gestures in treatments that target the reduction of aphasic linguistic impairment and compensatory methods of communication (Rose, 2006). Arguments for constraining aphasia treatment to the verbal modality have arisen from proponents of constraint-induced aphasia therapy…

  15. The Use of a Modified Semantic Features Analysis Approach in Aphasia

    Science.gov (United States)

    Hashimoto, Naomi; Frome, Amber

    2011-01-01

    Several studies have reported improved naming using the semantic feature analysis (SFA) approach in individuals with aphasia. Whether the SFA can be modified and still produce naming improvements in aphasia is unknown. The present study was designed to address this question by using a modified version of the SFA approach. Three, rather than the…

  16. Effects of Word Frequency and Modality on Sentence Comprehension Impairments in People with Aphasia

    Science.gov (United States)

    DeDe, Gayle

    2012-01-01

    Purpose: It is well known that people with aphasia have sentence comprehension impairments. The present study investigated whether lexical factors contribute to sentence comprehension impairments in both the auditory and written modalities using online measures of sentence processing. Method: People with aphasia and non brain-damaged controls…

  17. Masked Priming Effects in Aphasia: Evidence of Altered Automatic Spreading Activation

    Science.gov (United States)

    Silkes, JoAnn P.; Rogers, Margaret A.

    2012-01-01

    Purpose: Previous research has suggested that impairments of automatic spreading activation may underlie some aphasic language deficits. The current study further investigated the status of automatic spreading activation in individuals with aphasia as compared with typical adults. Method: Participants were 21 individuals with aphasia (12 fluent, 9…

  18. White matter disease correlates with lexical retrieval deficits in primary progressive aphasia

    Directory of Open Access Journals (Sweden)

    John P. Powers

    2013-12-01

    Full Text Available Objective: To relate fractional anisotropy changes associated with the semantic and logopenic variants of primary progressive aphasia to measures of lexical retrieval.Methods: We collected neuropsychological testing, volumetric MRI, and diffusion-weighted imaging on semantic variant primary progressive aphasia (n=11 and logopenic variant primary progressive aphasia (n=13 patients diagnosed using published criteria. We also acquired neuroimaging data on a group of demographically comparable healthy seniors (n=34. Fractional anisotropy was calculated and analyzed using a white matter tract-specific analysis approach. This approach utilizes anatomically guided data reduction to increase sensitivity and localizes results within canonically defined tracts. We used non-parametric, cluster-based statistical analysis to relate language performance to fractional anisotropy and determine regions of reduced fractional anisotropy in patients. Results: We found widespread fractional anisotropy reductions in white matter for both variants of primary progressive aphasia. Fractional anisotropy was related to both confrontation naming and category naming fluency performance in left uncinate fasciculus and corpus callosum in semantic variant primary progressive aphasia and left superior and inferior longitudinal fasciculi in logopenic variant primary progressive aphasia. Conclusions: Semantic variant primary progressive aphasia and logopenic variant primary progressive aphasia are associated with distinct disruptions of a large-scale network implicated in lexical retrieval, and the white matter disease in each phenotype may contribute to language impairments including lexical retrieval.

  19. An Exploration of Factors Affecting Performance of Adults with Aphasia on a Functional Communication Task

    Science.gov (United States)

    Griffith, Luke Marcus

    2013-01-01

    In traditional aphasia testing and treatment, clinicians administer a standardized aphasia test that measures language impairment, followed by a linguistic approach to treatment. Many clinicians have argued the need for emphasis on functional communication, and third party payers desire functional information to determine patient progress. This…

  20. Gesture and Speech Integration: An Exploratory Study of a Man with Aphasia

    Science.gov (United States)

    Cocks, Naomi; Sautin, Laetitia; Kita, Sotaro; Morgan, Gary; Zlotowitz, Sally

    2009-01-01

    Background: In order to comprehend fully a speaker's intention in everyday communication, information is integrated from multiple sources, including gesture and speech. There are no published studies that have explored the impact of aphasia on iconic co-speech gesture and speech integration. Aims: To explore the impact of aphasia on co-speech…

  1. A Comparison of Aphasia Therapy Outcomes before and after a Very Early Rehabilitation Programme Following Stroke

    Science.gov (United States)

    Godecke, Erin; Ciccone, Natalie A.; Granger, Andrew S.; Rai, Tapan; West, Deborah; Cream, Angela; Cartwright, Jade; Hankey, Graeme J.

    2014-01-01

    Background: Very early aphasia rehabilitation studies have shown mixed results. Differences in therapy intensity and therapy type contribute significantly to the equivocal results. Aims: To compare a standardized, prescribed very early aphasia therapy regimen with a historical usual care control group at therapy completion (4-5 weeks post-stroke)…

  2. A 3-Year Evolution of Linguistic Disorders in Aphasia after Stroke

    Science.gov (United States)

    El Hachioui, Hanane; van de Sandt-Koenderman, Mieke W. M. E.; Dippel, Diederik W. J.; Koudstaal, Peter J.; Visch-Brink, Evy G.

    2011-01-01

    Aphasia recovery after stroke has been the subject of several studies, but in none the deficits on the various linguistic levels were examined, even though in the diagnosis and treatment of aphasia the emphasis lays more and more on these linguistic level disorders. In this observational prospective follow-up study, we explored whether it is…

  3. Singing Therapy Can Be Effective for a Patient with Severe Nonfluent Aphasia

    Science.gov (United States)

    Yamaguchi, Satoshi; Akanuma, Kyoko; Hatayama, Yuka; Otera, Masako; Meguro, Kenichi

    2012-01-01

    Patients with severe aphasia are rarely treated using speech therapy. We used music therapy to continue to treat a 79-year-old patient with chronic severe aphasia. Interventions 1, 2, and 3 were to practice singing a song that the patient knew, to practice singing a song with a therapist, and to practice saying a greeting using a song with lyrics,…

  4. The Auditory Comprehension of "Wh"-Questions in Aphasia: Support for the Intervener Hypothesis

    Science.gov (United States)

    Sheppard, Shannon M.; Walenski, Matthew; Love, Tracy; Shapiro, Lewis P.

    2015-01-01

    Purpose: This study examines 3 hypotheses about the processing of "wh"-questions in both neurologically healthy adults and adults with Broca's aphasia. Method: We used an eye tracking while listening method with 32 unimpaired participants (Experiment 1) and 8 participants with Broca's aphasia (Experiment 2). Accuracy, response time, and…

  5. Attention and Other Cognitive Deficits in Aphasia: Presence and Relation to Language and Communication Measures

    Science.gov (United States)

    Murray, Laura L.

    2012-01-01

    Purpose: This study was designed to further elucidate the relationship between cognition and aphasia, with a focus on attention. It was hypothesized that individuals with aphasia would display variable deficit patterns on tests of attention and other cognitive functions and that their attention deficits, particularly those of complex attention…

  6. Using mobile technology with individuals with aphasia: native iPad features and everyday apps.

    Science.gov (United States)

    Szabo, Gretchen; Dittelman, Janice

    2014-02-01

    The use of mobile technology, including smartphones and tablet devices, is a growing trend among adults nationwide, and its potential use in aphasia rehabilitation has generated widespread interest. Despite this trend, adults living with disability are less likely than other adults to go online. Complicating things further, most adults living with aphasia come from a generation where computers and technology were not an integral part of their lives. Additionally, training adults with aphasia requires a different approach than training those in the same age bracket without a disability. This article describes the mobile technology program at the Adler Aphasia Center in Maywood, New Jersey. The goal of this program is to improve access to mobile technology for people with aphasia. The use of mobile devices is the focus of the article. Mobile technology concepts and skills needed to establish a strong foundation for successful iPad (Apple Inc., Cupertino, CA) use are suggested. We discuss how apps may be used to support aphasia therapy with a focus on apps that are native to the iPad and on other apps that were not specifically developed for aphasia rehabilitation. Challenges in implementing a mobile technology program for people with aphasia and individual member success stories are included. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  7. The Relationship Between Confrontation Naming and Story Gist Production in Aphasia.

    Science.gov (United States)

    Richardson, Jessica D; Dalton, Sarah Grace; Fromm, Davida; Forbes, Margaret; Holland, Audrey; MacWhinney, Brian

    2018-03-01

    The purpose of this study was to examine the relationship between picture naming performance and the ability to communicate the gist, or essential elements, of a story. We also sought to determine if this relationship varied according to Western Aphasia Battery-Revised (WAB-R; Kertesz, 2007) aphasia subtype. Demographic information, test scores, and transcripts of 258 individuals with aphasia completing 3 narrative tasks were retrieved from the AphasiaBank database. Narratives were subjected to a main concept analysis to determine gist production. A correlation analysis was used to investigate the relationship between naming scores and main concept production for the whole group of persons with aphasia and for WAB-R subtypes separately. We found strong correlations between naming test scores and narrative gist production for the large sample of persons with aphasia. However, the strength of the correlations varied by WAB-R subtype. Picture naming may accurately predict gist production for individuals with Broca's and Wernicke's aphasia, but not for other WAB-R subtypes. Given the current reprioritization of outcome measurement, picture naming may not be an appropriate surrogate measure for functional communication for all persons with aphasia. https://doi.org/10.23641/asha.5851848.

  8. Amail : design and evaluation of an accessible email tool for persons with Aphasia

    NARCIS (Netherlands)

    Mahmud, Al A.; Martens, J.B.O.S.

    2013-01-01

    In this paper, we describe the iterative design and exploratory evaluation of 'Amail', an email tool designed for persons with aphasia. It is inspired by interviews with persons with aphasia and their partners and has been improved through discussions with experienced speech therapists. Our user

  9. Re-connect: designing accessible email communication support for persons with aphasia

    NARCIS (Netherlands)

    Mahmud, Al A.; Martens, J.B.O.S.

    2010-01-01

    In this paper we present some preliminary outcomes concerning the design of an email communication tool for persons with expressive aphasia. The purpose of our design is to make email accessible for aphasics. It is based on interviews with persons with aphasia and their partners and has been

  10. Speech-Like and Non-Speech Lip Kinematics and Coordination in Aphasia

    Science.gov (United States)

    Bose, Arpita; van Lieshout, Pascal

    2012-01-01

    Background: In addition to the well-known linguistic processing impairments in aphasia, oro-motor skills and articulatory implementation of speech segments are reported to be compromised to some degree in most types of aphasia. Aims: This study aimed to identify differences in the characteristics and coordination of lip movements in the production…

  11. Changes in N400 Topography Following Intensive Speech Language Therapy for Individuals with Aphasia

    Science.gov (United States)

    Wilson, K. Ryan; O'Rourke, Heather; Wozniak, Linda A.; Kostopoulos, Ellina; Marchand, Yannick; Newman, Aaron J.

    2012-01-01

    Our goal was to characterize the effects of intensive aphasia therapy on the N400, an electrophysiological index of lexical-semantic processing. Immediately before and after 4 weeks of intensive speech-language therapy, people with aphasia performed a task in which they had to determine whether spoken words were a "match" or a "mismatch" to…

  12. Using Text-to-Speech Reading Support for an Adult with Mild Aphasia and Cognitive Impairment

    Science.gov (United States)

    Harvey, Judy; Hux, Karen; Snell, Jeffry

    2013-01-01

    This single case study served to examine text-to-speech (TTS) effects on reading rate and comprehension in an individual with mild aphasia and cognitive impairment. Findings showed faster reading, given TTS presented at a normal speaking rate, but no significant comprehension changes. TTS may support reading in people with aphasia when time…

  13. Use of the BAT with a Cantonese-Putonghua Speaker with Aphasia

    Science.gov (United States)

    Kong, Anthony Pak-Hin; Weekes, Brendan Stuart

    2011-01-01

    The aim of this article is to illustrate the use of the Bilingual Aphasia Test (BAT) with a Cantonese-Putonghua speaker. We describe G, who is a relatively young Chinese bilingual speaker with aphasia. G's communication abilities in his L2, Putonghua, were impaired following brain damage. This impairment caused specific difficulties in…

  14. Default-Mode Network Functional Connectivity in Aphasia: Therapy-Induced Neuroplasticity

    Science.gov (United States)

    Marcotte, Karine; Perlbarg, Vincent; Marrelec, Guillaume; Benali, Habib; Ansaldo, Ana Ines

    2013-01-01

    Previous research on participants with aphasia has mainly been based on standard functional neuroimaging analysis. Recent studies have shown that functional connectivity analysis can detect compensatory activity, not revealed by standard analysis. Little is known, however, about the default-mode network in aphasia. In the current study, we studied…

  15. Social networking through email : studying email usage patterns of persons with aphasia

    NARCIS (Netherlands)

    Al Mahmud, A.; Martens, J.B.O.S.

    2016-01-01

    Background: A social networking program has been developed by the Aphasia Union Netherlands (AVN) to enhance communication between older persons with aphasia (PWA) mutually and with their therapists. The medium of communication is email. Aims: The aim of the paper is to understand the email usage

  16. Effect of Low-Frequency Repetitive Transcranial Magnetic Stimulation on Naming Abilities in Early-Stroke Aphasic Patients: A Prospective, Randomized, Double-Blind Sham-Controlled Study

    Directory of Open Access Journals (Sweden)

    Konrad Waldowski

    2012-01-01

    Full Text Available Background and Purpose. Functional brain imaging studies with aphasia patients have shown increased cortical activation in the right hemisphere language homologues, which hypothetically may represent a maladaptive strategy that interferes with aphasia recovery. The aim of this study was to investigate whether low-frequency repetitive transcranial magnetic stimulation (rTMS over the Broca’s homologues in combination with speech/language therapy improves naming in early-stroke aphasia patients. Methods. 26 right-handed aphasic patients in the early stage (up to 12 weeks of a first-ever left hemisphere ischemic stroke were randomized to receive speech and language therapy combined with real or sham rTMS. Prior to each 45-minute therapeutic session (15 sessions, 5 days a week, 30 minutes of 1-Hz rTMS was applied. Outcome measures were obtained at baseline, immediately after 3 weeks of experimental treatment and 15 weeks; posttreatment using the Computerized Picture Naming Test. Results. Although both groups significantly improved their naming abilities after treatment, no significant differences were noted between the rTMS and sham stimulation groups. The additional analyses have revealed that the rTMS subgroup with a lesion including the anterior part of language area showed greater improvement primarily in naming reaction time 15 weeks after completion of the therapeutic treatment. Improvement was also demonstrated in functional communication abilities. Conclusions. Inhibitory rTMS of the unaffected right inferior frontal gyrus area in combination with speech and language therapy cannot be assumed as an effective method for all poststroke aphasia patients. The treatment seems to be beneficial for patients with frontal language area damage, mostly in the distant time after finishing rTMS procedure.

  17. Correlation of severity of aphasia with cerebral blood flow

    International Nuclear Information System (INIS)

    Tagawa, Koichi; Sugimoto, Keiko; Sone, Noriaki; Yamaguchi, Takenori; Naritomi, Hiroaki; Sawada, Tohru

    1982-01-01

    In 46 patients with aphasia due to cerebral infarction, regional cerebral blood flow (rCBF) was measured by 133 Xe inhalation method, and relationship between severity of aphasia and degree of rCBF reduction was investigated. Measurements of rCBF were performed after 2 months of ictus in all patients. At the time of rCBF measurements, the severity of aphasia was mild in 13, moderate in 16 and severe in the other 17 patients. Control rCBF values were obtained from 16 subjects who had neither neurological deficits nor abnormal findings on CT scan. In control group, mean hemispheric rCBF values (mCBF), which were calculated from initial slope index, were 49.1 +- 3.8 and 49.4 +- 3.9 respectively in the right and left hemisphere. In all aphasic patients but two who had mild aphasia, mCBF in the left hemisphere showed lower values as compared to that in the right hemisphere. The mCBF in the left hemisphere was 46.5 +- 5.3 in the mild group, 41.3 +- 5.8 in the moderate group and 34.3 +- 5.0 in the severe group. The values in the moderate and severe groups were significantly reduced as compared to the control or those in the mild group. The mCBF in the severe group was also significantly lower than those in the moderate group. The mCBF in the right hemisphere was 48.4 +- 6.3 in the mild group, 45.6 +- 6.1 in the moderate group and 38.6 +- 4.9 in the severe group. The values in the severe group were significantly reduced as compared to those in the other groups as well as the control. The present study suggests that measurements of rCBF by 133 Xe inhalation method are valid for the evaluation of severity of aphasia in stroke patients. (author)

  18. C-Speak Aphasia alternative communication program for people with severe aphasia: importance of executive functioning and semantic knowledge.

    Science.gov (United States)

    Nicholas, Marjorie; Sinotte, Michele P; Helm-Estabrooks, Nancy

    2011-06-01

    Learning how to use a computer-based communication system can be challenging for people with severe aphasia even if the system is not word-based. This study explored cognitive and linguistic factors relative to how they affected individual patients' ability to communicate expressively using C-Speak Aphasia (CSA), an alternative communication computer program that is primarily picture-based. Ten individuals with severe non-fluent aphasia received at least six months of training with CSA. To assess carryover of training, untrained functional communication tasks (i.e., answering autobiographical questions, describing pictures, making telephone calls, describing a short video, and two writing tasks) were repeatedly probed in two conditions: (1) using CSA in addition to natural forms of communication, and (2) using only natural forms of communication, e.g., speaking, writing, gesturing, drawing. Four of the 10 participants communicated more information on selected probe tasks using CSA than they did without the computer. Response to treatment was also examined in relation to baseline measures of non-linguistic executive function skills, pictorial semantic abilities, and auditory comprehension. Only nonlinguistic executive function skills were significantly correlated with treatment response.

  19. C-Speak Aphasia Alternative Communication Program for People with Severe Aphasia: Importance of Executive Functioning and Semantic Knowledge

    Science.gov (United States)

    Nicholas, Marjorie; Sinotte, Michele P.; Helm-Estabrooks, Nancy

    2011-01-01

    Learning how to use a computer-based communication system can be challenging for people with severe aphasia even if the system is not word-based. This study explored cognitive and linguistic factors relative to how they affected individual patients’ ability to communicate expressively using C-Speak Aphasia, (CSA), an alternative communication computer program that is primarily picture-based. Ten individuals with severe non-fluent aphasia received at least six months of training with CSA. To assess carryover of training, untrained functional communication tasks (i.e., answering autobiographical questions, describing pictures, making telephone calls, describing a short video, and two writing tasks) were repeatedly probed in two conditions: 1) using CSA in addition to natural forms of communication, and 2) using only natural forms of communication, e.g., speaking, writing, gesturing, drawing. Four of the ten participants communicated more information on selected probe tasks using CSA than they did without the computer. Response to treatment also was examined in relation to baseline measures of non-linguistic executive function skills, pictorial semantic abilities, and auditory comprehension. Only nonlinguistic executive function skills were significantly correlated with treatment response. PMID:21506045

  20. Finding language in the matter of the brain: origins of the clinical aphasia examination.

    Science.gov (United States)

    Roth, Heidi L

    2002-12-01

    The origins of the aphasia examination can be traced back to the 19th century when physicians and scientists began to understand how higher mental functions such as language could be localized in the brain. Paul Broca, Carl Wernicke, and Hughlings Jackson developed different models of brain function, and each contributed important insights to the study of aphasia. Broca's contributions were influenced by the fundamental question of whether higher mental function could be localized in the brain at all; Wernicke's contributions were influenced by an attempt to unite more mechanistic and physiological principles to a model of higher brain functions; and Jackson's contributions were influenced by British association psychology. In addition to reviewing the origins of the aphasia examination, this article reviews the historical context in which these contributors worked, the factors that affected the reception of their views, and the manner in which their views have affected the aphasia examination and understanding of aphasia today.

  1. Crossed Aphasia in a Patient with Anaplastic Astrocytoma of the Non-Dominant Hemisphere.

    Science.gov (United States)

    Prater, Stephanie; Anand, Neil; Wei, Lawrence; Horner, Neil

    2017-09-01

    Aphasia describes a spectrum of speech impairments due to damage in the language centers of the brain. Insult to the inferior frontal gyrus of the dominant cerebral hemisphere results in Broca's aphasia - the inability to produce fluent speech. The left cerebral hemisphere has historically been considered the dominant side, a characteristic long presumed to be related to a person's "handedness". However, recent studies utilizing fMRI have shown that right hemispheric dominance occurs more frequently than previously proposed and despite a person's handedness. Here we present a case of a right-handed patient with Broca's aphasia caused by a right-sided brain tumor. This is significant not only because the occurrence of aphasia in right-handed-individuals with right hemispheric brain damage (so-called "crossed aphasia") is unusual but also because such findings support dissociation between hemispheric linguistic dominance and handedness.

  2. De-novo simple partial status epilepticus presenting as Wernicke's aphasia.

    Science.gov (United States)

    Patil, Bhimanagouda; Oware, Agyepong

    2012-04-01

    Language disturbances manifesting as brief periods of speech arrest occur with seizures originating in the frontal or temporal lobes. These language disturbances are usually present with other features of seizures or may occur in an episodic fashion suggesting their likely epileptic origin. Sustained but reversible aphasia as the sole manifestation of partial status epilepticus is rare, particularly without a history of prior seizures. A few cases have been described in the literature where Broca's or mixed aphasia seems to be more common than Wernicke's aphasia. Here we describe a patient who presented with Wernicke's aphasia secondary to simple partial status epilepticus but without any other features of seizures. The diagnosis was confirmed on EEG and the aphasia reversed after antiepileptic treatment. Copyright © 2011 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  3. Benefits and limitations of computer gesture therapy for the rehabilitation of severe aphasia

    Directory of Open Access Journals (Sweden)

    Abi Roper

    2016-11-01

    Full Text Available Aphasia intervention has made increasing use of technology in recent years. The evidence base, which is largely limited to the investigation of spoken language outcomes, indicates positive treatment effects for people with mild to moderate levels of aphasia. Outcomes for those with severe aphasia however, are less well documented and - where reported - present less consistent gains for measures of spoken output. This study investigates the effects of a purpose-built gesture therapy technology for people with severe aphasia: GeST+. Study outcomes show significant improvement in gesture production abilities for adults with severe aphasia following computer intervention. They indicate no transfer of effects into naming gains or interactive gesture. Outcomes offer encouraging results for computer therapy methods within this hitherto under-researched population but indicate a need for further refinement of interventions in order to maximize persistence of effects and generalization into everyday communication.

  4. A Nonword Repetition Task for Speakers with Misarticulations: The Syllable Repetition Task (SRT)

    Science.gov (United States)

    Shriberg, Lawrence D.; Lohmeier, Heather L.; Campbell, Thomas F.; Dollaghan, Christine A.; Green, Jordan R.; Moore, Christopher A.

    2009-01-01

    Purpose: Conceptual and methodological confounds occur when non(sense) word repetition tasks are administered to speakers who do not have the target speech sounds in their phonetic inventories or who habitually misarticulate targeted speech sounds. In this article, the authors (a) describe a nonword repetition task, the Syllable Repetition Task…

  5. Repetitive switching for an electromagnetic rail gun

    Science.gov (United States)

    Gruden, J. M.

    1983-12-01

    Previous testing on a repetitive opening switch for inductive energy storage has proved the feasibility of the rotary switch concept. The concept consists of a rotating copper disk (rotor) with a pie-shaped insulator section and brushes which slide along each of the rotor surfaces. While on top of the copper surface, the brushes and rotor conduct current allowing the energy storage inductor to charge. When the brushes slide onto the insulator section, the current cannot pass through the rotor and is diverted into the load. This study investigates two new brush designs and a rotor modification designed to improve the current commutating capabilities of the switch. One brush design (fringe fiber) employs carbon fibers on the leading and trailing edge of the brush to increase the resistive commutating action as the switch opens and closes. The other brush design uses fingers to conduct current to the rotor surface, effectively increasing the number of brush contact points. The rotor modification was the placement of tungsten inserts at the copper-insulator interfaces.

  6. The Developmental Trajectory of Nonword Repetition

    Science.gov (United States)

    Chiat, Shula

    2006-01-01

    In line with the original presentation of nonword repetition as a measure of phonological short-term memory (Gathercole & Baddeley, 1989), the theoretical account Gathercole (2006) puts forward in her Keynote Article focuses on phonological storage as the key capacity common to nonword repetition and vocabulary acquisition. However, evidence that…

  7. Grade Repetition in Queensland State Prep Classes

    Science.gov (United States)

    Anderson, Robyn

    2012-01-01

    The current study considers grade repetition rates in the early years of schooling in Queensland state schools with specific focus on the pre-schooling year, Prep. In particular, it provides empirical evidence of grade repetition in Queensland state schools along with groups of students who are more often repeated. At the same time, much of the…

  8. Intensive Versus Distributed Aphasia Therapy: A Nonrandomized, Parallel-Group, Dosage-Controlled Study.

    Science.gov (United States)

    Dignam, Jade; Copland, David; McKinnon, Eril; Burfein, Penni; O'Brien, Kate; Farrell, Anna; Rodriguez, Amy D

    2015-08-01

    Most studies comparing different levels of aphasia treatment intensity have not controlled the dosage of therapy provided. Consequently, the true effect of treatment intensity in aphasia rehabilitation remains unknown. Aphasia Language Impairment and Functioning Therapy is an intensive, comprehensive aphasia program. We investigated the efficacy of a dosage-controlled trial of Aphasia Language Impairment and Functioning Therapy, when delivered in an intensive versus distributed therapy schedule, on communication outcomes in participants with chronic aphasia. Thirty-four adults with chronic, poststroke aphasia were recruited to participate in an intensive (n=16; 16 hours per week; 3 weeks) versus distributed (n=18; 6 hours per week; 8 weeks) therapy program. Treatment included 48 hours of impairment, functional, computer, and group-based aphasia therapy. Distributed therapy resulted in significantly greater improvements on the Boston Naming Test when compared with intensive therapy immediately post therapy (P=0.04) and at 1-month follow-up (P=0.002). We found comparable gains on measures of participants' communicative effectiveness, communication confidence, and communication-related quality of life for the intensive and distributed treatment conditions at post-therapy and 1-month follow-up. Aphasia Language Impairment and Functioning Therapy resulted in superior clinical outcomes on measures of language impairment when delivered in a distributed versus intensive schedule. The therapy progam had a positive effect on participants' functional communication and communication-related quality of life, regardless of treatment intensity. These findings contribute to our understanding of the effect of treatment intensity in aphasia rehabilitation and have important clinical implications for service delivery models. © 2015 American Heart Association, Inc.

  9. Mechanism study of recovery from aphasia with 99Tcm-ECD SPECT brain imaging after oral reading test

    International Nuclear Information System (INIS)

    Chen Jian; Xu Hao; Wang Hong; Chen Zhuoming; Wu Qiulian

    2007-01-01

    Objective: There may be two mechanisms for recovery from aphasia----repair of dam- aged left hemisphere language network and(or) activation of compensatory areas in right hemisphere. It is, however, still controversial on which mechanism plays a more important role. The goal of this study was to compare the regional cerebral blood flow (rCBF) between baseline and during oral reading in aphasic patients who had shown definite recovery from a focal lesion in left hemisphere. It also aimed at exploring the role of the two hemispheres in recovery from aphasia, thus providing theoretic basis for rehabilitation therapy. Methods: Baseline and oral reading 99 Tc m -ethylcysteinate dimer (ECD) brain SPECT imaging were performed in 7 patients with aphasia separately in one-day interval. Semi-quantitative analysis of rCBF was conducted on 26 symmetrical ROIs in bilateral hemispheres on the transverse slices. The rCBF was estimated by the ratio of the counts per pixel of each ROI to the average counts per pixel of the whole encephalon. The change in blood flow was represented by the difference in rCBF between oral reading and baseline. Results: The activated perfusion pattern of brain region was different in all 7 aphasic patients. In 5 of the 7 patients, whose reading capacity were relatively preserved, the brain perfusion pattern was mainly left lateralized, while the other two patients who had poor performance in reading showed bilateral activation foci with fight-sided dominance. Conclusion: Oral reading activated SPECT brain imaging may be a useful tool for monitoring the progress of speech recovery in the treatment of aphasic patients. (authors)

  10. Clinical and MRI models predicting amyloid deposition in progressive aphasia and apraxia of speech.

    Science.gov (United States)

    Whitwell, Jennifer L; Weigand, Stephen D; Duffy, Joseph R; Strand, Edythe A; Machulda, Mary M; Senjem, Matthew L; Gunter, Jeffrey L; Lowe, Val J; Jack, Clifford R; Josephs, Keith A

    2016-01-01

    Beta-amyloid (Aβ) deposition can be observed in primary progressive aphasia (PPA) and progressive apraxia of speech (PAOS). While it is typically associated with logopenic PPA, there are exceptions that make predicting Aβ status challenging based on clinical diagnosis alone. We aimed to determine whether MRI regional volumes or clinical data could help predict Aβ deposition. One hundred and thirty-nine PPA (n = 97; 15 agrammatic, 53 logopenic, 13 semantic and 16 unclassified) and PAOS (n = 42) subjects were prospectively recruited into a cross-sectional study and underwent speech/language assessments, 3.0 T MRI and C11-Pittsburgh Compound B PET. The presence of Aβ was determined using a 1.5 SUVR cut-point. Atlas-based parcellation was used to calculate gray matter volumes of 42 regions-of-interest across the brain. Penalized binary logistic regression was utilized to determine what combination of MRI regions, and what combination of speech and language tests, best predicts Aβ (+) status. The optimal MRI model and optimal clinical model both performed comparably in their ability to accurately classify subjects according to Aβ status. MRI accurately classified 81% of subjects using 14 regions. Small left superior temporal and inferior parietal volumes and large left Broca's area volumes were particularly predictive of Aβ (+) status. Clinical scores accurately classified 83% of subjects using 12 tests. Phonological errors and repetition deficits, and absence of agrammatism and motor speech deficits were particularly predictive of Aβ (+) status. In comparison, clinical diagnosis was able to accurately classify 89% of subjects. However, the MRI model performed well in predicting Aβ deposition in unclassified PPA. Clinical diagnosis provides optimum prediction of Aβ status at the group level, although regional MRI measurements and speech and language testing also performed well and could have advantages in predicting Aβ status in unclassified PPA subjects.

  11. Arterial spin labelling shows functional depression of non-lesion tissue in chronic Wernicke's aphasia.

    Science.gov (United States)

    Robson, Holly; Specht, Karsten; Beaumont, Helen; Parkes, Laura M; Sage, Karen; Lambon Ralph, Matthew A; Zahn, Roland

    2017-07-01

    Behavioural impairment post-stroke is a consequence of structural damage and altered functional network dynamics. Hypoperfusion of intact neural tissue is frequently observed in acute stroke, indicating reduced functional capacity of regions outside the lesion. However, cerebral blood flow (CBF) is rarely investigated in chronic stroke. This study investigated CBF in individuals with chronic Wernicke's aphasia (WA) and examined the relationship between lesion, CBF and neuropsychological impairment. Arterial spin labelling CBF imaging and structural MRIs were collected in 12 individuals with chronic WA and 13 age-matched control participants. Joint independent component analysis (jICA) investigated the relationship between structural lesion and hypoperfusion. Partial correlations explored the relationship between lesion, hypoperfusion and language measures. Joint ICA revealed significant differences between the control and WA groups reflecting a large area of structural lesion in the left posterior hemisphere and an associated area of hypoperfusion extending into grey matter surrounding the lesion. Small regions of remote cortical hypoperfusion were observed, ipsilateral and contralateral to the lesion. Significant correlations were observed between the neuropsychological measures (naming, repetition, reading and semantic association) and the jICA component of interest in the WA group. Additional ROI analyses found a relationship between perfusion surrounding the core lesion and the same neuropsychological measures. This study found that core language impairments in chronic WA are associated with a combination of structural lesion and abnormal perfusion in non-lesioned tissue. This indicates that post-stroke impairments are due to a wider disruption of neural function than observable on structural T1w MRI. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. Clinical and MRI models predicting amyloid deposition in progressive aphasia and apraxia of speech

    Directory of Open Access Journals (Sweden)

    Jennifer L. Whitwell

    2016-01-01

    Full Text Available Beta-amyloid (Aβ deposition can be observed in primary progressive aphasia (PPA and progressive apraxia of speech (PAOS. While it is typically associated with logopenic PPA, there are exceptions that make predicting Aβ status challenging based on clinical diagnosis alone. We aimed to determine whether MRI regional volumes or clinical data could help predict Aβ deposition. One hundred and thirty-nine PPA (n = 97; 15 agrammatic, 53 logopenic, 13 semantic and 16 unclassified and PAOS (n = 42 subjects were prospectively recruited into a cross-sectional study and underwent speech/language assessments, 3.0 T MRI and C11-Pittsburgh Compound B PET. The presence of Aβ was determined using a 1.5 SUVR cut-point. Atlas-based parcellation was used to calculate gray matter volumes of 42 regions-of-interest across the brain. Penalized binary logistic regression was utilized to determine what combination of MRI regions, and what combination of speech and language tests, best predicts Aβ (+ status. The optimal MRI model and optimal clinical model both performed comparably in their ability to accurately classify subjects according to Aβ status. MRI accurately classified 81% of subjects using 14 regions. Small left superior temporal and inferior parietal volumes and large left Broca's area volumes were particularly predictive of Aβ (+ status. Clinical scores accurately classified 83% of subjects using 12 tests. Phonological errors and repetition deficits, and absence of agrammatism and motor speech deficits were particularly predictive of Aβ (+ status. In comparison, clinical diagnosis was able to accurately classify 89% of subjects. However, the MRI model performed well in predicting Aβ deposition in unclassified PPA. Clinical diagnosis provides optimum prediction of Aβ status at the group level, although regional MRI measurements and speech and language testing also performed well and could have advantages in predicting Aβ status in unclassified

  13. The Effect of Errorless Naming Treatment on Anomia in an Elderly Patient With Aphasia

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    Atefe Yousefi

    2015-10-01

    Full Text Available Objectives: Anomia is one of the most common problems that aphasic patients and therapists are involved with it. Because of the disruptive effect of anomia on communicative efficiency of aphasic patients, this study aimed at examining the effect of errorless naming treatment on naming ability in an aphasic patient. Methods & Materials: The subject was selected using purposeful sampling method. This interventional single-subject study with ABA design was implemented on a 69-year-old woman with moderate Broca’s aphasia and phonological errors. The participant was a literate, right-handed Persian speaking patient with neither severe motor speech disorder nor significant auditory comprehension deficits. The patient underwent 10 sessions of treatment using errorless naming treatment protocol (Raymer et al., 2012. Based on this method, the patient was given multiple opportunities to rehearse the correct name of a picture supported by repetition and oral reading, while avoiding production of errors during training. Results: The effect size in confrontational naming task after intervention in this patient for trained and control words were 5.42 and 2.38, respectively. The linear trend line of correct responses percentage of trained and control words were 7.6 and 4.15, respectively. Improvements in the trained and control word sets remained at a higher level than baseline, one week later. Also improvements in Persian WAB and naming tests were noticed in posttreatment period. Conclusion: As a result of errorless naming treatment in the current study, the patient showed significant improvements in naming of trained words but generalization was not noticeable for control words. Based on this finding, this method might be useful as a therapeutic protocol in Persian speaking aphasic patients with anomia.

  14. Subjective duration distortions mirror neural repetition suppression.

    Science.gov (United States)

    Pariyadath, Vani; Eagleman, David M

    2012-01-01

    Subjective duration is strongly influenced by repetition and novelty, such that an oddball stimulus in a stream of repeated stimuli appears to last longer in duration in comparison. We hypothesize that this duration illusion, called the temporal oddball effect, is a result of the difference in expectation between the oddball and the repeated stimuli. Specifically, we conjecture that the repeated stimuli contract in duration as a result of increased predictability; these duration contractions, we suggest, result from decreased neural response amplitude with repetition, known as repetition suppression. Participants viewed trials consisting of lines presented at a particular orientation (standard stimuli) followed by a line presented at a different orientation (oddball stimulus). We found that the size of the oddball effect correlates with the number of repetitions of the standard stimulus as well as the amount of deviance from the oddball stimulus; both of these results are consistent with a repetition suppression hypothesis. Further, we find that the temporal oddball effect is sensitive to experimental context--that is, the size of the oddball effect for a particular experimental trial is influenced by the range of duration distortions seen in preceding trials. Our data suggest that the repetition-related duration contractions causing the oddball effect are a result of neural repetition suppression. More generally, subjective duration may reflect the prediction error associated with a stimulus and, consequently, the efficiency of encoding that stimulus. Additionally, we emphasize that experimental context effects need to be taken into consideration when designing duration-related tasks.

  15. Logopenic and nonfluent variants of primary progressive aphasia are differentiated by acoustic measures of speech production.

    Directory of Open Access Journals (Sweden)

    Kirrie J Ballard

    Full Text Available Differentiation of logopenic (lvPPA and nonfluent/agrammatic (nfvPPA variants of Primary Progressive Aphasia is important yet remains challenging since it hinges on expert based evaluation of speech and language production. In this study acoustic measures of speech in conjunction with voxel-based morphometry were used to determine the success of the measures as an adjunct to diagnosis and to explore the neural basis of apraxia of speech in nfvPPA. Forty-one patients (21 lvPPA, 20 nfvPPA were recruited from a consecutive sample with suspected frontotemporal dementia. Patients were diagnosed using the current gold-standard of expert perceptual judgment, based on presence/absence of particular speech features during speaking tasks. Seventeen healthy age-matched adults served as controls. MRI scans were available for 11 control and 37 PPA cases; 23 of the PPA cases underwent amyloid ligand PET imaging. Measures, corresponding to perceptual features of apraxia of speech, were periods of silence during reading and relative vowel duration and intensity in polysyllable word repetition. Discriminant function analyses revealed that a measure of relative vowel duration differentiated nfvPPA cases from both control and lvPPA cases (r(2 = 0.47 with 88% agreement with expert judgment of presence of apraxia of speech in nfvPPA cases. VBM analysis showed that relative vowel duration covaried with grey matter intensity in areas critical for speech motor planning and programming: precentral gyrus, supplementary motor area and inferior frontal gyrus bilaterally, only affected in the nfvPPA group. This bilateral involvement of frontal speech networks in nfvPPA potentially affects access to compensatory mechanisms involving right hemisphere homologues. Measures of silences during reading also discriminated the PPA and control groups, but did not increase predictive accuracy. Findings suggest that a measure of relative vowel duration from of a polysyllable word

  16. Non-linguistic learning and aphasia: Evidence from a paired associate and feedback-based task

    Science.gov (United States)

    Vallila-Rohter, Sofia; Kiran, Swathi

    2013-01-01

    Though aphasia is primarily characterized by impairments in the comprehension and/or expression of language, research has shown that patients with aphasia also show deficits in cognitive-linguistic domains such as attention, executive function, concept knowledge and memory (Helm-Estabrooks, 2002 for review). Research in aphasia suggests that cognitive impairments can impact the online construction of language, new verbal learning, and transactional success (Freedman & Martin, 2001; Hula & McNeil, 2008; Ramsberger, 2005). In our research, we extend this hypothesis to suggest that general cognitive deficits influence progress with therapy. The aim of our study is to explore learning, a cognitive process that is integral to relearning language, yet underexplored in the field of aphasia rehabilitation. We examine non-linguistic category learning in patients with aphasia (n=19) and in healthy controls (n=12), comparing feedback and non-feedback based instruction. Participants complete two computer-based learning tasks that require them to categorize novel animals based on the percentage of features shared with one of two prototypes. As hypothesized, healthy controls showed successful category learning following both methods of instruction. In contrast, only 60% of our patient population demonstrated successful non-linguistic category learning. Patient performance was not predictable by standardized measures of cognitive ability. Results suggest that general learning is affected in aphasia and is a unique, important factor to consider in the field of aphasia rehabilitation. PMID:23127795

  17. The anterior temporal lobes support residual comprehension in Wernicke’s aphasia

    Science.gov (United States)

    Robson, Holly; Zahn, Roland; Keidel, James L.; Binney, Richard J.; Sage, Karen; Lambon Ralph, Matthew A.

    2014-01-01

    Wernicke’s aphasia occurs after a stroke to classical language comprehension regions in the left temporoparietal cortex. Consequently, auditory–verbal comprehension is significantly impaired in Wernicke’s aphasia but the capacity to comprehend visually presented materials (written words and pictures) is partially spared. This study used functional magnetic resonance imaging to investigate the neural basis of written word and picture semantic processing in Wernicke’s aphasia, with the wider aim of examining how the semantic system is altered after damage to the classical comprehension regions. Twelve participants with chronic Wernicke’s aphasia and 12 control participants performed semantic animate–inanimate judgements and a visual height judgement baseline task. Whole brain and region of interest analysis in Wernicke’s aphasia and control participants found that semantic judgements were underpinned by activation in the ventral and anterior temporal lobes bilaterally. The Wernicke’s aphasia group displayed an ‘over-activation’ in comparison with control participants, indicating that anterior temporal lobe regions become increasingly influential following reduction in posterior semantic resources. Semantic processing of written words in Wernicke’s aphasia was additionally supported by recruitment of the right anterior superior temporal lobe, a region previously associated with recovery from auditory-verbal comprehension impairments. Overall, the results provide support for models in which the anterior temporal lobes are crucial for multimodal semantic processing and that these regions may be accessed without support from classic posterior comprehension regions. PMID:24519979

  18. The lived experience of engaging in everyday occupations in persons with mild to moderate aphasia.

    Science.gov (United States)

    Niemi, Tuuli; Johansson, Ulla

    2013-10-01

    Impairment of language ability, aphasia, can cause barriers to communication and hence impact on participation in many life situations. This study aimed to describe and explore how persons with aphasia following stroke experience engaging in everyday occupations. Six persons from Southwest Finland who had aphasia due to stroke one to four years previously were interviewed for the study. A modified form of the empirical phenomenological psychological method was used for data analysis. Three main characteristics of experiences of engaging in everyday occupations were identified: (1) encountering new experiences in everyday occupations, (2) striving to handle everyday occupations and (3) going ahead with life. The participants had experienced an altering life-world. Engagement in occupations affected their perceptions of competence and identity, and experiences of belonging and well-being. It was also through engagement in everyday occupations that they had discovered and learnt to handle changes in their everyday life. Aphasia can have a long-term impact on engagement in everyday occupations and participation in society, but conversely, engagement in meaningful occupations can also contribute to adaptation to disability and life changes. Aphasia can have a long-term impact on engagement in everyday occupations and participation in society. Health care professionals need to determine what clients with aphasia think about their occupations and life situations in spite of difficulties they may have verbalizing their thoughts. Experiences of engaging in meaningful occupations can help clients with aphasia in reconstructing their life stories, thereby contributing to adaptation to disability and life changes.

  19. Expert versus proxy rating of verbal communicative ability of people with aphasia after stroke.

    Science.gov (United States)

    de Jong-Hagelstein, Marjolein; Kros, Lieke; Lingsma, Hester F; Dippel, Diederik W J; Koudstaal, Peter J; Visch-Brink, Evy G

    2012-11-01

    In randomized clinical trials of aphasia treatment, a functional outcome measure like the Amsterdam-Nijmegen Everyday Language Test (ANELT), administered by speech-language therapists, is often used. However, the agreement between this expert rating and the judgment of the proxy about the quality of the daily life communication of the person with aphasia is largely unknown. We examined the association between ANELT scores by speech-language therapists and proxy judgments on the Partner Communication Questionnaire both at 3 and 6 months in 39 people with aphasia after stroke. We also determined which factors affected the level of agreement between expert and proxy judgment of the communicative ability at 6 months in 53 people with aphasia. We found moderate agreement (at 3 months r = .662; p = aphasia, measured with the Aphasia Severity Rating Scale, was associated with better agreement. In conclusion, although proxies were slightly more positive than experts, we found moderate agreement between expert and proxy rating of verbal communicative ability of people with aphasia after stroke, especially in milder cases.

  20. Online Sentence Reading in People With Aphasia: Evidence From Eye Tracking.

    Science.gov (United States)

    Knilans, Jessica; DeDe, Gayle

    2015-11-01

    There is a lot of evidence that people with aphasia have more difficulty understanding structurally complex sentences (e.g., object clefts) than simpler sentences (subject clefts). However, subject clefts also occur more frequently in English than object clefts. Thus, it is possible that both structural complexity and frequency affect how people with aphasia understand these structures. Nine people with aphasia and 8 age-matched controls participated in the study. The stimuli consisted of 24 object cleft and 24 subject cleft sentences. The task was eye tracking during reading, which permits a more fine-grained analysis of reading performance than measures such as self-paced reading. As expected, controls had longer reading times for critical regions in object cleft sentences compared with subject cleft sentences. People with aphasia showed the predicted effects of structural frequency. Effects of structural complexity in people with aphasia did not emerge on their first pass through the sentence but were observed when they were rereading critical regions of complex sentences. People with aphasia are sensitive to both structural complexity and structural frequency when reading. However, people with aphasia may use different reading strategies than controls when confronted with relatively infrequent and complex sentence structures.

  1. Structure, Processes, and Retrospective Outcomes From an Intensive Comprehensive Aphasia Program.

    Science.gov (United States)

    Babbitt, Edna M; Worrall, Linda; Cherney, Leora R

    2015-11-01

    This study describes the structure, processes, and outcomes of an intensive comprehensive aphasia program (ICAP). The aim was to identify treatment gains and determine if outcomes were significantly different between participants grouped according to severity and type of aphasia, and time postonset. Data from 74 first-time ICAP participants were analyzed. Pre- and posttreatment scores on the Western Aphasia Battery-Revised and other impairment and participation measures were compared using paired t tests. Analyses of variance were used to compare outcomes related to aphasia severity (severe, moderate, and mild aphasia), aphasia type (fluent, nonfluent), and chronicity (0-6 months postonset, 7-12 months postonset, and 12+ months postonset). Participants made significant changes on all impairment and participation measures. Large effect sizes were noted for one participation and three impairment measures. Medium effect sizes were noted for one impairment and three participation measures. There was no significant difference among groups on any factor. ICAPs can have a significant effect on the language impairment and participation of people with aphasia, but further research is required to determine if the effect is comparable to other types of service delivery.

  2. Reversible global aphasia as a side effect of quetiapine: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Chien CF

    2017-08-01

    Full Text Available Ching-Fang Chien,1 Poyin Huang,1,2 Sun-Wung Hsieh1,2 1Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; 2Department of Neurology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan Abstract: Quetiapine is an atypical antipsychotic agent which is also prescribed for delirium due to its anti-dopaminergic effects; aphasia is an unusual side effect associated with the drug. Here, we report the case of an 83-year-old woman who was prescribed quetiapine (50 mg per day for delirium. Unexpected, global aphasia occurred 3 days after treatment began. Complete recovery occurred following discontinuation of the drug. A brain computed tomography scan excluded intracranial hemorrhage and the laboratory results confirmed that no exacerbation of infection or electrolyte imbalances were present. During the aphasic episode, the patient’s condition did not deteriorate and no new neurological symptoms occurred. We suspect that the occurrence of aphasia was directly due to an adverse reaction to quetiapine. To our knowledge, this is the first case report of reversible, global aphasia as a side effect of quetiapine. We propose that this occurrence of aphasia may be due to the action of quetiapine as a dopamine receptor antagonist. Clinicians should use quetiapine with caution, especially in elderly patients. On observation of aphasia, a review of the patient’s medical history is required to assess for the usage of quetiapine. Keywords: aphasia, quetiapine, insomnia, delirium

  3. Quality and readability of English-language internet information for aphasia.

    Science.gov (United States)

    Azios, Jamie H; Bellon-Harn, Monica; Dockens, Ashley L; Manchaiah, Vinaya

    2017-08-14

    Little is known about the quality and readability of treatment information in specific neurogenic disorders, such as aphasia. The purpose of this study was to assess quality and readability of English-language Internet information available for aphasia treatment. Forty-three aphasia treatment websites were aggregated using five different country-specific search engines. Websites were then analysed using quality and readability assessments. Statistical calculations were employed to examine website ratings, differences between website origin and quality and readability scores, and correlations between readability instruments. Websites exhibited low quality with few websites obtaining Health On the Net (HON) certification or clear, thorough information as measured by the DISCERN. Regardless of website origin, readability scores were also poor. Approximate educational levels required to comprehend information on aphasia treatment websites ranged from 13 to 16 years of education. Significant differences were found between website origin and readability measures with higher levels of education required to understand information on websites of non-profit organisations. Current aphasia treatment websites were found to exhibit low levels of quality and readability, creating potential accessibility problems for people with aphasia and significant others. Websites including treatment information for aphasia must be improved in order to increase greater information accessibility.

  4. [Transcortical aphasia and echolalia; problems of speech initiative].

    Science.gov (United States)

    Környey, E

    1975-05-01

    Transcortical aphasia accompanied by echolalia occurs with malacias involving the postero-median part of the frontal lobe which includes the supplementary motor field of Penfield and is nourished by the anterior cerebral artery. The syndrome manifests itself in such cases even in fine detials in the same form as does in Pick's atrophy. The same also holds true for cases in which a tumour involves the region mentioned. Sentences or fragments of sentences are echolalised; tendency to perseveration is very marked. It is hardly, if at all, possible to evaluate the verbal understanding of these patients. Analysis of their behaviour supports the assumption that they have not lost the adaptation to some situations. Echolalia is often associated with forced grasping and other compulsory phenomena. Therefore, it may be interpreted as a sign of disinhibition of the acusticomotor reflex present during the development of the speech. Competition between the intentionality and the appearance of compulsory phenomena greatly depends on the general condition of the patient, particularly on the clarity of consciousness. The integrity of the postero-median part of the frontal lobe is indespensable for a normal reaction by speech to stimuli received from the sensory areas. The influence of the supplementary motor field on speech intention seems to be linked to the dominant hemisphere. In case lesions of the territory of the anterior cerebral artery and the cortico-bulbar neuron system are coexisting in the dominant hemisphere, the speech disturbance shifts to complete motor aphasia. In such cases the pathomechanism is analogous to that of the syndrome of Liepmann, i.e., right-sided hemiparesis with left-sided apraxia. So-called transcortical motor aphasia without echolalia can be caused by loss of stimuli from the sensory fields.

  5. Changes in dynamic resting state network connectivity following aphasia therapy.

    Science.gov (United States)

    Duncan, E Susan; Small, Steven L

    2017-10-24

    Resting state magnetic resonance imaging (rsfMRI) permits observation of intrinsic neural networks produced by task-independent correlations in low frequency brain activity. Various resting state networks have been described, with each thought to reflect common engagement in some shared function. There has been limited investigation of the plasticity in these network relationships after stroke or induced by therapy. Twelve individuals with language disorders after stroke (aphasia) were imaged at multiple time points before (baseline) and after an imitation-based aphasia therapy. Language assessment using a narrative production task was performed at the same time points. Group independent component analysis (ICA) was performed on the rsfMRI data to identify resting state networks. A sliding window approach was then applied to assess the dynamic nature of the correlations among these networks. Network correlations during each 30-second window were used to cluster the data into ten states for each window at each time point for each subject. Correlation was performed between changes in time spent in each state and therapeutic gains on the narrative task. The amount of time spent in a single one of the (ten overall) dynamic states was positively associated with behavioral improvement on the narrative task at the 6-week post-therapy maintenance interval, when compared with either baseline or assessment immediately following therapy. This particular state was characterized by minimal correlation among the task-independent resting state networks. Increased functional independence and segregation of resting state networks underlies improvement on a narrative production task following imitation-based aphasia treatment. This has important clinical implications for the targeting of noninvasive brain stimulation in post-stroke remediation.

  6. Photocathodes for High Repetition Rate Light Sources

    Energy Technology Data Exchange (ETDEWEB)

    Ben-Zvi, Ilan [Stony Brook Univ., NY (United States). Dept. of Physics and Astronomy. Center for Accelerator Science and Education

    2014-04-20

    This proposal brought together teams at Brookhaven National Laboratory (BNL), Lawrence Berkeley National Laboratory (LBNL) and Stony Brook University (SBU) to study photocathodes for high repetition rate light sources such as Free Electron Lasers (FEL) and Energy Recovery Linacs (ERL). Below details the Principal Investigators and contact information. Each PI submits separately for a budget through his corresponding institute. The work done under this grant comprises a comprehensive program on critical aspects of the production of the electron beams needed for future user facilities. Our program pioneered in situ and in operando diagnostics for alkali antimonide growth. The focus is on development of photocathodes for high repetition rate Free Electron Lasers (FELs) and Energy Recovery Linacs (ERLs), including testing SRF photoguns, both normal-­conducting and superconducting. Teams from BNL, LBNL and Stony Brook University (SBU) led this research, and coordinated their work over a range of topics. The work leveraged a robust infrastructure of existing facilities and the support was used for carrying out the research at these facilities. The program concentrated in three areas: a) Physics and chemistry of alkali-­antimonide cathodes (BNL – LBNL) b) Development and testing of a diamond amplifier for photocathodes (SBU -­ BNL) c) Tests of both cathodes in superconducting RF photoguns (SBU) and copper RF photoguns (LBNL) Our work made extensive use of synchrotron radiation materials science techniques, such as powder-­ and single-­crystal diffraction, x-­ray fluorescence, EXAFS and variable energy XPS. BNL and LBNL have many complementary facilities at the two light sources associated with these laboratories (NSLS and ALS, respectively); use of these will be a major thrust of our program and bring our understanding of these complex materials to a new level. In addition, CHESS at Cornell will be used to continue seamlessly throughout the NSLS dark period and

  7. Aphasia and right hemiplegia after cervical myelography with metrizamide

    International Nuclear Information System (INIS)

    Angiari, P.; Merli, G.A.; Crisi, G.

    1984-01-01

    We report a case of aphasia and right hemiplegia, developing after myelography with metrizamide and lasting for an unusually long time. The neurological disorders, manifested 1 h after the examination was completed, were due to accidental passage of contrast medium into the basal cisterns. In the light of analogous case reports in the literature, as well as experimental data concerning the biochemical activity of metrizamide, possible aetiopathogenetic mechanisms responsible for such disturbances are indicated. The authors underline the lack of effective therapeutic measures after the onset of the disorders, and thus the importance of preventing such complications that behave functionally as true ictuses although with no anatomic substratum. (orig.)

  8. Repetitive transcranial magnetic stimulation for hallucination in schizophrenia spectrum disorders: A meta-analysis.

    Science.gov (United States)

    Zhang, Yingli; Liang, Wei; Yang, Shichang; Dai, Ping; Shen, Lijuan; Wang, Changhong

    2013-10-05

    This study assessed the efficacy and tolerability of repetitive transcranial magnetic stimulation for treatment of auditory hallucination of patients with schizophrenia spectrum disorders. Online literature retrieval was conducted using PubMed, ISI Web of Science, EMBASE, Medline and Cochrane Central Register of Controlled Trials databases from January 1985 to May 2012. Key words were "transcranial magnetic stimulation", "TMS", "repetitive transcranial magnetic stimulation", and "hallucination". Selected studies were randomized controlled trials assessing therapeutic efficacy of repetitive transcranial magnetic stimulation for hallucination in patients with schizophrenia spectrum disorders. Experimental intervention was low-frequency repetitive transcranial magnetic stimulation in left temporoparietal cortex for treatment of auditory hallucination in schizophrenia spectrum disorders. Control groups received sham stimulation. The primary outcome was total scores of Auditory Hallucinations Rating Scale, Auditory Hallucination Subscale of Psychotic Symptom Rating Scale, Positive and Negative Symptom Scale-Auditory Hallucination item, and Hallucination Change Scale. Secondary outcomes included response rate, global mental state, adverse effects and cognitive function. Seventeen studies addressing repetitive transcranial magnetic stimulation for treatment of schizophrenia spectrum disorders were screened, with controls receiving sham stimulation. All data were completely effective, involving 398 patients. Overall mean weighted effect size for repetitive transcranial magnetic stimulation versus sham stimulation was statistically significant (MD = -0.42, 95%CI: -0.64 to -0.20, P = 0.000 2). Patients receiving repetitive transcranial magnetic stimulation responded more frequently than sham stimulation (OR = 2.94, 95%CI: 1.39 to 6.24, P = 0.005). No significant differences were found between active repetitive transcranial magnetic stimulation and sham stimulation for

  9. Where are aphasia theory and management “headed”? [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Donna C. Tippett

    2017-07-01

    Full Text Available The sequelae of post-stroke aphasia are considerable, necessitating an understanding of the functional neuroanatomy of language, cognitive processes underlying various language tasks, and the mechanisms of recovery after stroke. This knowledge is vital in providing optimal care of individuals with aphasia and counseling to their families and caregivers. The standard of care in the rehabilitation of aphasia dictates that treatment be evidence-based and person-centered. Promising techniques, such as cortical stimulation as an adjunct to behavioral therapy, are just beginning to be explored. These topics are discussed in this review.

  10. Repetitive Bibliographical Information in Relational Databases.

    Science.gov (United States)

    Brooks, Terrence A.

    1988-01-01

    Proposes a solution to the problem of loading repetitive bibliographic information in a microcomputer-based relational database management system. The alternative design described is based on a representational redundancy design and normalization theory. (12 references) (Author/CLB)

  11. Asking the Stakeholders: Perspectives of Individuals With Aphasia, Their Family Members, and Physicians Regarding Communication in Medical Interactions.

    Science.gov (United States)

    Burns, Michael; Baylor, Carolyn; Dudgeon, Brian J; Starks, Helene; Yorkston, Kathryn

    2015-08-01

    The purpose of this study was to explore the experiences of patients with aphasia, their family members, and physicians related to communication during medical interactions. Face-to-face, semistructured interviews were conducted with 18 participants—6 patients with aphasia, 6 family members involved in patient care, and 6 practicing physicians. A qualitative description approach was used to collect and summarize narratives from participants' perspectives and experiences. Participants were asked about experiences with communication during medical interactions in which the family member accompanied the patient. Interviews were audio- and/or video-recorded, transcribed, and then coded to identify main themes. Patients and family members generally described their communication experiences as positive, yet all participants discussed challenges and frustrations. Three themes emerged: (a) patients and family members work as a team, (b) patients and family members want physicians to "just try" to communicate with the patient, and (c) physicians want to interact with patients but may not know how. Participants discussed the need for successful accommodation, or changing how one communicates, to help facilitate the patients' increased understanding and ability to express themselves. Over- and underaccommodation with communication were commonly reported as problems. Speech-language pathologists have a role to play in helping to improve communication during medical interactions. Implications for current speech-language pathologist practice and future directions of research are discussed.

  12. Phonological length, phonetic duration and aphasia

    NARCIS (Netherlands)

    Gilbers, D.G.; Bastiaanse, Y.R.M.; van der Linde, K.J.

    1997-01-01

    This study discusses an error type that is expected to occur in aphasics suffering from a phonological disorder, i.e. Wernicke's and conduction aphasics, but not in aphasics suffering from a phonetic disorder, i.e. Broca's aphasics. The critical notion is 'phonological length'. It will be argued

  13. Document retrieval on repetitive string collections.

    Science.gov (United States)

    Gagie, Travis; Hartikainen, Aleksi; Karhu, Kalle; Kärkkäinen, Juha; Navarro, Gonzalo; Puglisi, Simon J; Sirén, Jouni

    2017-01-01

    Most of the fastest-growing string collections today are repetitive, that is, most of the constituent documents are similar to many others. As these collections keep growing, a key approach to handling them is to exploit their repetitiveness, which can reduce their space usage by orders of magnitude. We study the problem of indexing repetitive string collections in order to perform efficient document retrieval operations on them. Document retrieval problems are routinely solved by search engines on large natural language collections, but the techniques are less developed on generic string collections. The case of repetitive string collections is even less understood, and there are very few existing solutions. We develop two novel ideas, interleaved LCPs and precomputed document lists , that yield highly compressed indexes solving the problem of document listing (find all the documents where a string appears), top- k document retrieval (find the k documents where a string appears most often), and document counting (count the number of documents where a string appears). We also show that a classical data structure supporting the latter query becomes highly compressible on repetitive data. Finally, we show how the tools we developed can be combined to solve ranked conjunctive and disjunctive multi-term queries under the simple [Formula: see text] model of relevance. We thoroughly evaluate the resulting techniques in various real-life repetitiveness scenarios, and recommend the best choices for each case.

  14. Abnormal language-related oscillatory responses in primary progressive aphasia

    Directory of Open Access Journals (Sweden)

    A. Kielar

    Full Text Available Patients with Primary Progressive Aphasia (PPA may react to linguistic stimuli differently than healthy controls, reflecting degeneration of language networks and engagement of compensatory mechanisms. We used magnetoencephalography (MEG to evaluate oscillatory neural responses in sentence comprehension, in patients with PPA and age-matched controls. Participants viewed sentences containing semantically and syntactically anomalous words that evoke distinct oscillatory responses. For age-matched controls, semantic anomalies elicited left-lateralized 8–30 Hz power decreases distributed along ventral brain regions, whereas syntactic anomalies elicited bilateral power decreases in both ventral and dorsal regions. In comparison to controls, patients with PPA showed altered patterns of induced oscillations, characterized by delayed latencies and attenuated amplitude, which were correlated with linguistic impairment measured offline. The recruitment of right hemisphere temporo-parietal areas (also found in controls was correlated with preserved semantic processing abilities, indicating that preserved neural activity in these regions was able to support successful semantic processing. In contrast, syntactic processing was more consistently impaired in PPA, regardless of neural activity patterns, suggesting that this domain of language is particularly vulnerable to the neuronal loss. In addition, we found that delayed peak latencies of oscillatory responses were associated with lower accuracy for detecting semantic anomalies, suggesting that language deficits observed in PPA may be linked to delayed or slowed information processing. Keywords: MEG oscillations, Primary progressive aphasia (PPA, Sentence comprehension

  15. Tense and aspect in aphasia and semantic dementia

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    Vasiliki Koukoulioti

    2014-04-01

    There was no difference between past perfective and present imperfective for neither group, but there was an interaction between verb class and tense for the aphasic participants, as performance in unaccusative verbs in past perfective (unmarked condition was significantly better than in unergatives in past perfective (marked condition (Z=2.512, p=0.012 but performance in unaccusatives in present imperfective (marked condition was significantly worse than performance in unergatives in present imperfective (unmarked condition (Z=2.680, p=0.004. In sum, aphasic participants performed significantly better in the unmarked than in the marked conditions. Such an interaction was not found for the SD group. Aphasic participants performed significantly worse than the SD subjects in past perfective tense (M-W U= 7.5, p=0.029 in total, and the difference was significant only for unaccusative verbs (M-W U= 6.5, p=0.021, although both groups performed very well in this condition. There was no difference in present, neither for each verb class separately nor for the total score. A general past tense deficit cannot be upheld for either group. Rather, SD participants appear relatively impaired in producing present tense. We argue for slight morphosyntactic impairment in SD, although with a different underlying cause than in aphasia. Moreover, our data suggest an effect of aspectual markedness in aphasia but not in SD. We discuss this finding in the light of the different neuropathology of the two populations.

  16. Enhancement of naming in nonfluent aphasia through gesture.

    Science.gov (United States)

    Hanlon, R E; Brown, J W; Gerstman, L J

    1990-02-01

    In a number of studies that have examined the gestural disturbance in aphasia and the utility of gestural interventions in aphasia therapy, a variable degree of facilitation of verbalization during gestural activity has been reported. The present study examined the effect of different unilateral gestural movements on simultaneous oral-verbal expression, specifically naming to confrontation. It was hypothesized that activation of the phylogenetically older proximal motor system of the hemiplegic right arm in the execution of a communicative but nonrepresentational pointing gesture would have a facilitatory effect on naming ability. Twenty-four aphasic patients, representing five aphasic subtypes, including Broca's, Transcortical Motor, Anomic, Global, and Wernicke's aphasics were assessed under three gesture/naming conditions. The findings indicated that gestures produced through activation of the proximal (shoulder) musculature of the right paralytic limb differentially facilitated naming performance in the nonfluent subgroup, but not in the Wernicke's aphasics. These findings may be explained on the view that functional activation of the archaic proximal motor system of the hemiplegic limb, in the execution of a communicative gesture, permits access to preliminary stages in the formative process of the anterior action microgeny, which ultimately emerges in vocal articulation.

  17. Impaired Interoceptive Accuracy in Semantic Variant Primary Progressive Aphasia

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    Charles R. Marshall

    2017-11-01

    Full Text Available BackgroundInteroception (the perception of internal bodily sensations is strongly linked to emotional experience and sensitivity to the emotions of others in healthy subjects. Interoceptive impairment may contribute to the profound socioemotional symptoms that characterize frontotemporal dementia (FTD syndromes, but remains poorly defined.MethodsPatients representing all major FTD syndromes and healthy age-matched controls performed a heartbeat counting task as a measure of interoceptive accuracy. In addition, patients had volumetric MRI for voxel-based morphometric analysis, and their caregivers completed a questionnaire assessing patients’ daily-life sensitivity to the emotions of others.ResultsInteroceptive accuracy was impaired in patients with semantic variant primary progressive aphasia relative to healthy age-matched individuals, but not in behavioral variant frontotemporal dementia and nonfluent variant primary progressive aphasia. Impaired interoceptive accuracy correlated with reduced daily-life emotional sensitivity across the patient cohort, and with atrophy of right insula, cingulate, and amygdala on voxel-based morphometry in the impaired semantic variant group, delineating a network previously shown to support interoceptive processing in the healthy brain.ConclusionInteroception is a promising novel paradigm for defining mechanisms of reduced emotional reactivity, empathy, and self-awareness in neurodegenerative syndromes and may yield objective measures for these complex symptoms.

  18. Intrahemispheric Perfusion in Chronic Stroke-Induced Aphasia

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    Cynthia K. Thompson

    2017-01-01

    Full Text Available Stroke-induced alterations in cerebral blood flow (perfusion may contribute to functional language impairments and recovery in chronic aphasia. Using MRI, we examined perfusion in the right and left hemispheres of 35 aphasic and 16 healthy control participants. Across 76 regions (38 per hemisphere, no significant between-subjects differences were found in the left, whereas blood flow in the right was increased in the aphasic compared to the control participants. Region-of-interest (ROI analyses showed a varied pattern of hypo- and hyperperfused regions across hemispheres in the aphasic participants; however, there were no significant correlations between perfusion values and language abilities in these regions. These patterns may reflect autoregulatory changes in blood flow following stroke and/or increases in general cognitive effort, rather than maladaptive language processing. We also examined blood flow in perilesional tissue, finding the greatest hypoperfusion close to the lesion (within 0–6 mm, with greater hypoperfusion in this region compared to more distal regions. In addition, hypoperfusion in this region was significantly correlated with language impairment. These findings underscore the need to consider cerebral perfusion as a factor contributing to language deficits in chronic aphasia as well as recovery of language function.

  19. Aphasia and herpes virus encephalitis: a case study

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    Ellen Cristina Siqueira Soares-Ishigaki

    Full Text Available CONTEXT: Meningoencephalitis early in life, of any etiology, is a risk factor for development of subsequent sequelae, which may be of physical, psychiatric, behavioral or cognitive origin. Anomia is a language abnormality frequently found in such cases, and other language deficits are rarely described. The aim of this study was to describe the cognitive and linguistic manifestations following a case of herpetic meningoencephalitis in a 13-year-old patient with eight years of schooling. CASE REPORT: The patient underwent a speech-language audiology assessment nine months after the neurological diagnosis. The battery of tests included the Montreal-Toulouse Language Assessment test protocol (MT Beta-86, modified, the description from the Cookie Theft task of the Boston Diagnostic Aphasia Examination (BDAE, an informal assessment of the patient's logical and mathematical reasoning, and the neuropsychological subtests from the WAIS-III scale, which assess working memory. The patient presented mixed aphasia, impairment of short-term memory and working memory, and dyscalculia. This case also presented severe cognitive and linguistic deficits. Prompt diagnosis is crucial, in order to enable timely treatment and rehabilitation of this neurological infection and minimize the cognitive deficits caused by the disease.

  20. Dystypia: isolated typing impairment without aphasia, apraxia or visuospatial impairment.

    Science.gov (United States)

    Otsuki, Mika; Soma, Yoshiaki; Arihiro, Shoji; Watanabe, Yoshimasa; Moriwaki, Hiroshi; Naritomi, Hiroaki

    2002-01-01

    We report a 60-year-old right-handed Japanese man who showed an isolated persistent typing impairment without aphasia, agraphia, apraxia or any other neuropsychological deficit. We coined the term 'dystypia' for this peculiar neuropsychological manifestation. The symptom was caused by an infarction in the left frontal lobe involving the foot of the second frontal convolution and the frontal operculum. The patient's typing impairment was not attributable to a disturbance of the linguistic process, since he had no aphasia or agraphia. The impairment was not attributable to the impairment of the motor execution process either, since he had no apraxia. Thus, his typing impairment was deduced to be based on a disturbance of the intermediate process where the linguistic phonological information is converted into the corresponding performance. We hypothesized that there is a specific process for typing which branches from the motor programming process presented in neurolinguistic models. The foot of the left second frontal convolution and the operculum may play an important role in the manifestation of 'dystypia'. Copyright 2002 S. Karger AG, Basel

  1. Theories of inter-hemispheric interactions in aphasia: the role of tDCS in rehabilitation of post-stroke aphasia

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    Roy H Hamilton

    2014-04-01

    Full Text Available Mounting data from behavioral and neuroimaging studies have shown that the process of recovery from aphasia is largely driven by the reorganization of brain networks related to language. Evidence implicates a variety of potential mechanisms in this reorganization, some of which involve substantive changes in brain functional activity within and between cerebral hemispheres. These changes include intrahemispheric recruitment of perilesional left-hemisphere regions and transcallosal interhemispheric interactions between lesioned left-hemisphere language areas and homologous regions in the right hemisphere. With respect to the role of the right hemisphere, it is debated whether interhemispheric interactions are beneficial or deleterious to recovering language networks. Recent years have also seen the emergence of noninvasive brain stimulation techniques such as transcranial magnetic stimulation (TMS and transcranial direct current stimulation (tDCS as potential novel treatments for post-stroke aphasia. Because these techniques are predicated on either focal excitation or inhibition of brain areas, characterization of the functional roles of the left and right hemispheres and transcallosal interactions in aphasia recovery is of central importance to the development and refinement of stimulation-based therapies. However, most treatment studies involving noninvasive brain stimulation in aphasia have tacitly accepted the interhemispheric inhibition model, in which right hemisphere activity interferes with language recovery that is mediated by left hemisphere perisylvian regions. Based on this account, many studies in aphasia involving TMS and tDCS have adopted one of two approaches consistent with the model: left hemisphere excitation or right hemisphere inhibition. In this presentation, we will review both clinical and cognitive neuroscience evidence that elucidates different hemispheric mechanisms that influence recovery from aphasia after stroke

  2. Corpus-based Transitivity Biases in Individuals with Aphasia

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    Gayle DeDe

    2015-04-01

    Full Text Available Introduction Spontaneous speech samples in individuals with aphasia (IWA have been analyzed to examine many different psycholinguistic features. The present study focused on how IWA use verbs in spontaneous speech. Some verbs can occur in more than one argument structure, but are biased to occur more frequently in one frame than another. For example, "watch" appears in transitive and intransitive structures, but is usually used transitively. This is known as a transitivity bias. It is unknown whether IWA show the same transitivity biases in production as those reported in previous corpus studies with unimpaired individuals. Studies of sentence comprehension have shown that IWA are sensitive to verb biases (e.g., DeDe, 2013. In addition, IWA have shown an overall preference for transitive structures, which are the most frequent structures in English (Roland, Dick, & Elman, 2007. The present study investigated whether IWA show the same pattern of transitive and intransitive biases in spontaneous speech as unimpaired individuals. Method Participants: 278 interviews with IWA were taken from AphasiaBank. The IWA represented a range of aphasia types. Participants were omitted if they spoke English as a second language. Materials: 54 verbs were coded. We chose verbs with the goal of representing different bias types (e.g., transitive, intransitive, sentential complement. Of these, data from 11 transitively biased and 11 intransitively biased verbs (matched for frequency of use and number of syllables are presented here. Coding: All productions of the 54 verbs were coded. The coding protocol was based on Gahl, Jurafsky, and Roland (2004. We implemented an additional level of coding to indicate erroneous verb productions, such as ungrammatical structures and verb agreement errors. Results The (intransitivity biases for IWA were compared to biases from a previously published corpus study (Gahl et al., 2004. The IWA used transitively biased verbs in

  3. Speech and language therapy for aphasia following stroke.

    Science.gov (United States)

    Brady, Marian C; Kelly, Helen; Godwin, Jon; Enderby, Pam; Campbell, Pauline

    2016-06-01

    Aphasia is an acquired language impairment following brain damage that affects some or all language modalities: expression and understanding of speech, reading, and writing. Approximately one third of people who have a stroke experience aphasia. To assess the effects of speech and language therapy (SLT) for aphasia following stroke. We searched the Cochrane Stroke Group Trials Register (last searched 9 September 2015), CENTRAL (2015, Issue 5) and other Cochrane Library Databases (CDSR, DARE, HTA, to 22 September 2015), MEDLINE (1946 to September 2015), EMBASE (1980 to September 2015), CINAHL (1982 to September 2015), AMED (1985 to September 2015), LLBA (1973 to September 2015), and SpeechBITE (2008 to September 2015). We also searched major trials registers for ongoing trials including ClinicalTrials.gov (to 21 September 2015), the Stroke Trials Registry (to 21 September 2015), Current Controlled Trials (to 22 September 2015), and WHO ICTRP (to 22 September 2015). In an effort to identify further published, unpublished, and ongoing trials we also handsearched the International Journal of Language and Communication Disorders (1969 to 2005) and reference lists of relevant articles, and we contacted academic institutions and other researchers. There were no language restrictions. Randomised controlled trials (RCTs) comparing SLT (a formal intervention that aims to improve language and communication abilities, activity and participation) versus no SLT; social support or stimulation (an intervention that provides social support and communication stimulation but does not include targeted therapeutic interventions); or another SLT intervention (differing in duration, intensity, frequency, intervention methodology or theoretical approach). We independently extracted the data and assessed the quality of included trials. We sought missing data from investigators. We included 57 RCTs (74 randomised comparisons) involving 3002 participants in this review (some appearing in

  4. Word Recognition during Reading: The Interaction between Lexical Repetition and Frequency

    Science.gov (United States)

    Lowder, Matthew W.; Choi, Wonil; Gordon, Peter C.

    2013-01-01

    Memory studies utilizing long-term repetition priming have generally demonstrated that priming is greater for low-frequency words than for high-frequency words and that this effect persists if words intervene between the prime and the target. In contrast, word-recognition studies utilizing masked short-term repetition priming typically show that the magnitude of repetition priming does not differ as a function of word frequency and does not persist across intervening words. We conducted an eye-tracking while reading experiment to determine which of these patterns more closely resembles the relationship between frequency and repetition during the natural reading of a text. Frequency was manipulated using proper names that were high-frequency (e.g., Stephen) or low-frequency (e.g., Dominic). The critical name was later repeated in the sentence, or a new name was introduced. First-pass reading times and skipping rates on the critical name revealed robust repetition-by-frequency interactions such that the magnitude of the repetition-priming effect was greater for low-frequency names than for high-frequency names. In contrast, measures of later processing showed effects of repetition that did not depend on lexical frequency. These results are interpreted within a framework that conceptualizes eye-movement control as being influenced in different ways by lexical- and discourse-level factors. PMID:23283808

  5. Co-verbal gestures among speakers with aphasia: Influence of aphasia severity, linguistic and semantic skills, and hemiplegia on gesture employment in oral discourse.

    Science.gov (United States)

    Kong, Anthony Pak-Hin; Law, Sam-Po; Wat, Watson Ka-Chun; Lai, Christy

    2015-01-01

    The use of co-verbal gestures is common in human communication and has been reported to assist word retrieval and to facilitate verbal interactions. This study systematically investigated the impact of aphasia severity, integrity of semantic processing, and hemiplegia on the use of co-verbal gestures, with reference to gesture forms and functions, by 131 normal speakers, 48 individuals with aphasia and their controls. All participants were native Cantonese speakers. It was found that the severity of aphasia and verbal-semantic impairment was associated with significantly more co-verbal gestures. However, there was no relationship between right-sided hemiplegia and gesture employment. Moreover, significantly more gestures were employed by the speakers with aphasia, but about 10% of them did not gesture. Among those who used gestures, content-carrying gestures, including iconic, metaphoric, deictic gestures, and emblems, served the function of enhancing language content and providing information additional to the language content. As for the non-content carrying gestures, beats were used primarily for reinforcing speech prosody or guiding speech flow, while non-identifiable gestures were associated with assisting lexical retrieval or with no specific functions. The above findings would enhance our understanding of the use of various forms of co-verbal gestures in aphasic discourse production and their functions. Speech-language pathologists may also refer to the current annotation system and the results to guide clinical evaluation and remediation of gestures in aphasia. None. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Co-verbal gestures among speakers with aphasia: Influence of aphasia severity, linguistic and semantic skills, and hemiplegia on gesture employment in oral discourse

    Science.gov (United States)

    Kong, Anthony Pak-Hin; Law, Sam-Po; Wat, Watson Ka-Chun; Lai, Christy

    2015-01-01

    The use of co-verbal gestures is common in human communication and has been reported to assist word retrieval and to facilitate verbal interactions. This study systematically investigated the impact of aphasia severity, integrity of semantic processing, and hemiplegia on the use of co-verbal gestures, with reference to gesture forms and functions, by 131 normal speakers, 48 individuals with aphasia and their controls. All participants were native Cantonese speakers. It was found that the severity of aphasia and verbal-semantic impairment was associated with significantly more co-verbal gestures. However, there was no relationship between right-sided hemiplegia and gesture employment. Moreover, significantly more gestures were employed by the speakers with aphasia, but about 10% of them did not gesture. Among those who used gestures, content-carrying gestures, including iconic, metaphoric, deictic gestures, and emblems, served the function of enhancing language content and providing information additional to the language content. As for the non-content carrying gestures, beats were used primarily for reinforcing speech prosody or guiding speech flow, while non-identifiable gestures were associated with assisting lexical retrieval or with no specific functions. The above findings would enhance our understanding of the use of various forms of co-verbal gestures in aphasic discourse production and their functions. Speech-language pathologists may also refer to the current annotation system and the results to guide clinical evaluation and remediation of gestures in aphasia. PMID:26186256

  7. Which outcomes are most important to people with aphasia and their families?

    DEFF Research Database (Denmark)

    Wallace, Sarah J.; Worrall, Linda; Rose, Tanya

    2017-01-01

    Purpose: To identify important treatment outcomes from the perspective of people with aphasia and their families using the ICF as a frame of reference. Methods: The nominal group technique was used with people with aphasia and their family members in seven countries to identify and rank important...... for research outcome measurement and clinical service provision which currently focuses on the measurement of body function outcomes. The wide range of desired outcomes generated by both people with aphasia and their family members, highlights the importance of collaborative goal setting within a family...... function components of the ICF. • The outcomes identified in this study suggest a broad role for clinicians working in aphasia rehabilitation. The categories of identified outcomes may be used clinically as a starting point in goal-setting discussions with clients and their families....

  8. "Waiting on the words": procedures and outcomes of a drama class for individuals with aphasia.

    Science.gov (United States)

    Cherney, Leora R; Oehring, Ann K; Whipple, Keith; Rubenstein, Ted

    2011-08-01

    Drama therapy offers an authentic medium through which people with aphasia can interact and share their experiences. We describe the rationale and procedures of a drama class, informed by the principles and practices of drama therapy, in which individuals with chronic aphasia conceptualized, wrote, and produced a play addressing their experiences of having, living with, and coping with the effects of aphasia. Sessions were cofacilitated by a speech-language pathologist and a drama therapist. We describe the drama activities and techniques in each of four distinct stages of a drama therapy process through which the group transitioned. We also summarize patient-reported outcomes of a representational group of seven participants. Subscales of the Burden of Stroke Scale and the Communication Confidence Rating Scale for Aphasia were administered before and after participation in the 18-week class. Means, standard deviations, and effect sizes were computed. Results indicated perceived improvements in both communication and mood. © Thieme Medical Publishers.

  9. Improving Production of Treated and Untreated Verbs in Aphasia : A Meta-Analysis

    NARCIS (Netherlands)

    de Aguiar, Vânia; Bastiaanse, Roelien; Miceli, Gabriele

    2016-01-01

    Background: Demographic and clinical predictors of aphasia recovery have been identified in the literature. However, little attention has been devoted to identifying and distinguishing predictors of improvement for different outcomes, e.g., production of treated vs. untreated materials. These

  10. Does Handedness Affect the Cerebral Organization of Speech and Language in Individuals with Aphasia?

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    Juliana Baldo

    2014-04-01

    Although some earlier studies suggested distinct cerebral organizations for right- versus non-right-handed individuals, the neural correlates of fluency and comprehension were greatly overlapping between these groups in our sample of left hemisphere patients with aphasia.

  11. Objective support for subjective reports of successful inner speech in two people with aphasia.

    Science.gov (United States)

    Hayward, William; Snider, Sarah F; Luta, George; Friedman, Rhonda B; Turkeltaub, Peter E

    2016-01-01

    People with aphasia frequently report being able to say a word correctly in their heads, even if they are unable to say that word aloud. It is difficult to know what is meant by these reports of "successful inner speech". We probe the experience of successful inner speech in two people with aphasia. We show that these reports are associated with correct overt speech and phonologically related nonword errors, that they relate to word characteristics associated with ease of lexical access but not ease of production, and that they predict whether or not individual words are relearned during anomia treatment. These findings suggest that reports of successful inner speech are meaningful and may be useful to study self-monitoring in aphasia, to better understand anomia, and to predict treatment outcomes. Ultimately, the study of inner speech in people with aphasia could provide critical insights that inform our understanding of normal language.

  12. Subjective duration distortions mirror neural repetition suppression.

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    Vani Pariyadath

    Full Text Available Subjective duration is strongly influenced by repetition and novelty, such that an oddball stimulus in a stream of repeated stimuli appears to last longer in duration in comparison. We hypothesize that this duration illusion, called the temporal oddball effect, is a result of the difference in expectation between the oddball and the repeated stimuli. Specifically, we conjecture that the repeated stimuli contract in duration as a result of increased predictability; these duration contractions, we suggest, result from decreased neural response amplitude with repetition, known as repetition suppression.Participants viewed trials consisting of lines presented at a particular orientation (standard stimuli followed by a line presented at a different orientation (oddball stimulus. We found that the size of the oddball effect correlates with the number of repetitions of the standard stimulus as well as the amount of deviance from the oddball stimulus; both of these results are consistent with a repetition suppression hypothesis. Further, we find that the temporal oddball effect is sensitive to experimental context--that is, the size of the oddball effect for a particular experimental trial is influenced by the range of duration distortions seen in preceding trials.Our data suggest that the repetition-related duration contractions causing the oddball effect are a result of neural repetition suppression. More generally, subjective duration may reflect the prediction error associated with a stimulus and, consequently, the efficiency of encoding that stimulus. Additionally, we emphasize that experimental context effects need to be taken into consideration when designing duration-related tasks.

  13. A quick aphasia battery for efficient, reliable, and multidimensional assessment of language function.

    Science.gov (United States)

    Wilson, Stephen M; Eriksson, Dana K; Schneck, Sarah M; Lucanie, Jillian M

    2018-01-01

    This paper describes a quick aphasia battery (QAB) that aims to provide a reliable and multidimensional assessment of language function in about a quarter of an hour, bridging the gap between comprehensive batteries that are time-consuming to administer, and rapid screening instruments that provide limited detail regarding individual profiles of deficits. The QAB is made up of eight subtests, each comprising sets of items that probe different language domains, vary in difficulty, and are scored with a graded system to maximize the informativeness of each item. From the eight subtests, eight summary measures are derived, which constitute a multidimensional profile of language function, quantifying strengths and weaknesses across core language domains. The QAB was administered to 28 individuals with acute stroke and aphasia, 25 individuals with acute stroke but no aphasia, 16 individuals with chronic post-stroke aphasia, and 14 healthy controls. The patients with chronic post-stroke aphasia were tested 3 times each and scored independently by 2 raters to establish test-retest and inter-rater reliability. The Western Aphasia Battery (WAB) was also administered to these patients to assess concurrent validity. We found that all QAB summary measures were sensitive to aphasic deficits in the two groups with aphasia. All measures showed good or excellent test-retest reliability (overall summary measure: intraclass correlation coefficient (ICC) = 0.98), and excellent inter-rater reliability (overall summary measure: ICC = 0.99). Sensitivity and specificity for diagnosis of aphasia (relative to clinical impression) were 0.91 and 0.95 respectively. All QAB measures were highly correlated with corresponding WAB measures where available. Individual patients showed distinct profiles of spared and impaired function across different language domains. In sum, the QAB efficiently and reliably characterized individual profiles of language deficits.

  14. An adaptive semantic matching paradigm for reliable and valid language mapping in individuals with aphasia.

    Science.gov (United States)

    Wilson, Stephen M; Yen, Melodie; Eriksson, Dana K

    2018-04-17

    Research on neuroplasticity in recovery from aphasia depends on the ability to identify language areas of the brain in individuals with aphasia. However, tasks commonly used to engage language processing in people with aphasia, such as narrative comprehension and picture naming, are limited in terms of reliability (test-retest reproducibility) and validity (identification of language regions, and not other regions). On the other hand, paradigms such as semantic decision that are effective in identifying language regions in people without aphasia can be prohibitively challenging for people with aphasia. This paper describes a new semantic matching paradigm that uses an adaptive staircase procedure to present individuals with stimuli that are challenging yet within their competence, so that language processing can be fully engaged in people with and without language impairments. The feasibility, reliability and validity of the adaptive semantic matching paradigm were investigated in sixteen individuals with chronic post-stroke aphasia and fourteen neurologically normal participants, in comparison to narrative comprehension and picture naming paradigms. All participants succeeded in learning and performing the semantic paradigm. Test-retest reproducibility of the semantic paradigm in people with aphasia was good (Dice coefficient = 0.66), and was superior to the other two paradigms. The semantic paradigm revealed known features of typical language organization (lateralization; frontal and temporal regions) more consistently in neurologically normal individuals than the other two paradigms, constituting evidence for validity. In sum, the adaptive semantic matching paradigm is a feasible, reliable and valid method for mapping language regions in people with aphasia. © 2018 Wiley Periodicals, Inc.

  15. Crossed Aphasia in a Dextral without “Minor” Hemisphere Signs

    Directory of Open Access Journals (Sweden)

    J. C. Marshall

    1992-01-01

    Full Text Available A case of severe aphasia after right hemisphere stroke, confirmed by CT, in an unambiguously dextral patient is reported. The patient showed no limb apraxia, and performed well on a test of “closure” (Mooney faces. Extensive testing revealed no signs of visuo-spatial neglect. We conclude that “pure” crossed aphasia can occur in the absence of symptoms normally associated with right hemisphere lesions.

  16. Transcranial direct-current stimulation induced in stroke patients with aphasia: a prospective experimental cohort study

    OpenAIRE

    Santos,Michele Devido; Gagliardi,Rubens José; Mac-Kay,Ana Paula Machado Goyano; Boggio,Paulo Sergio; Lianza,Roberta; Fregni,Felipe

    2013-01-01

    CONTEXT AND OBJECTIVE: Previous animal and human studies have shown that transcranial direct current stimulation can induce significant and lasting neuroplasticity and may improve language recovery in patients with aphasia. The objective of the study was to describe a cohort of patients with aphasia after stroke who were treated with transcranial direct current stimulation. DESIGN AND SETTING: Prospective cohort study developed in a public university hospital. METHODS: Nineteen patients with ...

  17. Damage to the anterior arcuate fasciculus predicts non-fluent speech production in aphasia

    OpenAIRE

    Fridriksson, Julius; Guo, Dazhou; Fillmore, Paul; Holland, Audrey; Rorden, Chris

    2013-01-01

    Non-fluent aphasia implies a relatively straightforward neurological condition characterized by limited speech output. However, it is an umbrella term for different underlying impairments affecting speech production. Several studies have sought the critical lesion location that gives rise to non-fluent aphasia. The results have been mixed but typically implicate anterior cortical regions such as Broca’s area, the left anterior insula, and deep white matter regions. To provide a clearer pictur...

  18. Type of aphasia and regional cerebral blood flow. A study with /sup 133/Xe inhalation method

    Energy Technology Data Exchange (ETDEWEB)

    Tagawa, Koichi; Sugimoto, Keiko; Minematsu, Kazuo; Yamaguchi, Takenori; Naritomi, Hiroaki; Sawada, Tohru (National Cardiovascular Center, Suita, Osaka (Japan))

    1982-11-01

    In 40 patients with aphasia due to cerebral infarction, regional cerebral blood flow (rCBF) was measured after 2 months of ictus with /sup 133/Xe inhalation method. There were 18 cases with motor aphasia and 22 with sensory aphasia. On the measurements of rCBF, 3 detectors were placed over frontal region (group F), 3 over temporal region (group T), and remaining 3 over parietal region (group P), of the dominant hemisphere. The flow values were compared with the rCBF values obtained from 21 control subjects who had no abnormality in CT scan and on neurological examinations. The control subjects revealed the hyperfrontal pattern of flow distribution; rCBF values in groups F, T and P, which were expressed as an initial slope index, were 50.0 +- 4.8, 48.0 +- 5.1 and 47.4 +- 4.5, respectively. The hyperfrontal pattern was absent in cases with motor aphasia. In this group, rCBF in groups F, T and P were 42.0 +- 8.3, 44.7 +- 8.4 and 41.0 +- 8.5, respectively, and rCBF in frontal region was significantly reduced compared with that in the control group. In sensory aphasia, rCBF values in groups F, T and P were all significantly reduced compared to the controls showing 44.0 +- 5.7, 42.8 +- 5.1 and 40.6 +- 5.4, respectively. In this group, the hyperfrontal pattern was maintained at a low flow level. When absolute rCBF values were compared between motor and sensory aphasia, there was no significant difference between these 2 groups. However, regional flow distribution in motor aphasia was significantly different from that of sensory aphasia, and the cases having the lowest value in group F were more frequently found in the former than in the latter.

  19. Changes in Resting-State Connectivity following Melody-Based Therapy in a Patient with Aphasia

    OpenAIRE

    Bitan, Tali; Simic, Tijana; Saverino, Cristina; Jones, Cheryl; Glazer, Joanna; Collela, Brenda; Wiseman-Hakes, Catherine; Green, Robin; Rochon, Elizabeth

    2018-01-01

    Melody-based treatments for patients with aphasia rely on the notion of preserved musical abilities in the RH, following left hemisphere damage. However, despite evidence for their effectiveness, the role of the RH is still an open question. We measured changes in resting-state functional connectivity following melody-based intervention, to identify lateralization of treatment-related changes. A patient with aphasia due to left frontal and temporal hemorrhages following traumatic brain injuri...

  20. A Case Report of A Persian Patient with Crossed Aphasia: Agrammatism after Right Hemisphere Lesion

    Directory of Open Access Journals (Sweden)

    Zahra Sadat Ghoreishi

    2012-10-01

    Full Text Available Crossed aphasia in dextral (CAD refers to aphasia occurring after right brain damage in dextral persons. CAD is a rare phenomenon in the world and there has not been any report of crossed aphasia in Persian, that is why we measured to report a Persian patient with crossed aphasia and this is a first report of incidence of CA in Persian. In this case report study, we offered a complete report of a 31-year-oldright handed man with right hemisphere lesion who experienced aphasia after his brain injury. We assessed the patient with Persian version of Bilingual Aphasia Test (BAT, Test of Anomia and Apraxia. In addition, more than 100 utterances of connected speech were gathered and analyzed. According to the results of anomia and apraxia tests, he was at normal level in both of them, but he couldn’t get complete score in BAT, the worst score was achieved in making sentence subtest of BAT. He also had deficits in the syntactic comprehension, grammaticality judgments, lexical decision, verbal fluency and reading comprehension subtests of BAT. Linguistic analysis of his connected speech indicated low speech rate and deficit in using prepositions, compound nouns and verbs. The results confirmed the existence of aphasia and incoherent and non-cohesive speech. The reason of the latter could be deficit in using complex sentences and discourse marker (grammatical problems and circumlocution, deficit in topic maintenance , using pronoun ambiguouslyand selecting inappropriate words for convey meaning (pragmatic problems related to right hemisphere problem .In sum, this patient showed combination of aphasia, agrammatism, and right hemisphere damage( pragmatic deficit together.

  1. Aphasia and unilateral spatial neglect due to acute thalamic hemorrhage: clinical correlations and outcomes.

    Science.gov (United States)

    Osawa, Aiko; Maeshima, Shinichiro

    2016-04-01

    Thalamic hemorrhages are associated with a variety of cognitive dysfunctions, and it is well known that such cognitive changes constitute a limiting factor of recovery of the activities of daily living (ADL). The relationship between cognitive dysfunction and hematomas is unclear. In this study, we investigated the relationship between aphasia/neglect and hematoma volume, hematoma type, and the ADL. One hundred fifteen patients with thalamic hemorrhage (70 men and 45 women) were studied. Their mean age was 68.9 ± 10.3 years, and patients with both left and right lesions were included. We calculated hematoma volume and examined the presence or absence of aphasia/neglect and the relationships between these dysfunctions and hematoma volume, hematoma type, and the ADL. Fifty-nine patients were found to have aphasia and 35 were found to have neglect. Although there was no relationship between hematoma type and cognitive dysfunction, hematoma volume showed a correlation with the severity of cognitive dysfunction. The ADL score and ratio of patient discharge for patients with aphasia/neglect were lower than those for patients without aphasia/neglect. We observed a correlation between the hematoma volume in thalamic hemorrhage and cognitive dysfunction. Aphasia/neglect is found frequently in patients with acute thalamic hemorrhage and may influence the ADL.

  2. An fMRI investigation of the effects of attempted naming on word retrieval in aphasia

    Science.gov (United States)

    Heath, Shiree; McMahon, Katie L.; Nickels, Lyndsey A.; Angwin, Anthony; MacDonald, Anna D.; van Hees, Sophia; McKinnon, Eril; Johnson, Kori; Copland, David A.

    2015-01-01

    In healthy controls, picture naming performance can be facilitated by a single prior exposure to the same picture (“priming”). This priming phenomenon is utilized in the treatment of aphasia, which often includes repeated picture naming as part of a therapeutic task. The current study sought to determine whether single and/or multiple exposures facilitate subsequent naming in aphasia and whether such facilitatory effects act through normal priming mechanisms. A functional magnetic resonance imaging paradigm was employed to explore the beneficial effects of attempted naming in two individuals with aphasia and a control group. The timing and number of prior exposures was manipulated, with investigation of both short-term effects (single prior exposure over a period of minutes) and long-term effects (multiple presentations over a period of days). Following attempted naming, both short-term and long-term facilitated items showed improvement for controls, while only the long-term condition showed benefits at a behavioral level for the participants with aphasia. At a neural level, effects of long-term facilitation were noted in the left precuneus for one participant with aphasia, a result also identified for the equivalent contrast in controls. It appears that multiple attempts are required to improve naming performance in the presence of anomia and that for some individuals with aphasia the source of facilitation may be similar to unimpaired mechanisms engaged outside the language network. PMID:26074801

  3. Accent on communication: the impact of regional and foreign accent on comprehension in adults with aphasia.

    Science.gov (United States)

    Bruce, Carolyn; To, Cinn-Teng; Newton, Caroline

    2012-01-01

    This study explored whether an unfamiliar non-native accent, differing in both segmental and prosodic features was more difficult for individuals with aphasia to understand than an unfamiliar native accent, which differed in segmental features only. Comprehension, which was determined by accuracy judgments on true/false sentences, and speed of response were assessed in the following three conditions: a familiar Southern Standard British English (SSBE) accent, an unfamiliar native Grimsby accent, and an unfamiliar non-native Chinese accent. Thirty-four English speaking adults (17 people with and 17 people without aphasia) served as listeners for this study. All listeners made significantly more errors in the unfamiliar non-native accent, although this difficulty was more marked for those with aphasia. While there was no affect of speaker accent on the response times of listeners with aphasia, listeners without aphasia were significantly slower with the unfamiliar non-native accent. The results indicate that non-native accented speech affects comprehension even on simple tasks in ideal listening conditions. The findings suggest that speaker accent, especially accents varying in both segmental and prosodic features, can be a barrier to successful interactions between non-native accented speakers and native listeners, particularly those with aphasia.

  4. Intensive Communicative Therapy Reduces Symptoms of Depression in Chronic Nonfluent Aphasia

    Science.gov (United States)

    Mohr, Bettina; Stahl, Benjamin; Berthier, Marcelo L.; Pulvermüller, Friedemann

    2017-01-01

    Background. Patients with brain lesions and resultant chronic aphasia frequently suffer from depression. However, no effective interventions are available to target neuropsychiatric symptoms in patients with aphasia who have severe language and communication deficits. Objective. The present study aimed to investigate the efficacy of 2 different methods of speech and language therapy in reducing symptoms of depression in aphasia on the Beck Depression Inventory (BDI) using secondary analysis (BILAT-1 trial). Methods. In a crossover randomized controlled trial, 18 participants with chronic nonfluent aphasia following left-hemispheric brain lesions were assigned to 2 consecutive treatments: (1) intensive language-action therapy (ILAT), emphasizing communicative language use in social interaction, and (2) intensive naming therapy (INT), an utterance-centered standard method. Patients were randomly assigned to 2 groups, receiving both treatments in counterbalanced order. Both interventions were applied for 3.5 hours daily over a period of 6 consecutive working days. Outcome measures included depression scores on the BDI and a clinical language test (Aachen Aphasia Test). Results. Patients showed a significant decrease in symptoms of depression after ILAT but not after INT, which paralleled changes on clinical language tests. Treatment-induced decreases in depression scores persisted when controlling for individual changes in language performance. Conclusions. Intensive training of behaviorally relevant verbal communication in social interaction might help reduce symptoms of depression in patients with chronic nonfluent aphasia. PMID:29192534

  5. Releasing the constraints on aphasia therapy: the positive impact of gesture and multimodality treatments.

    Science.gov (United States)

    Rose, Miranda L

    2013-05-01

    There is a 40-year history of interest in the use of arm and hand gestures in treatments that target the reduction of aphasic linguistic impairment and compensatory methods of communication (Rose, 2006). Arguments for constraining aphasia treatment to the verbal modality have arisen from proponents of constraint-induced aphasia therapy (Pulvermüller et al., 2001). Confusion exists concerning the role of nonverbal treatments in treating people with aphasia. The central argument of this paper is that given the state of the empirical evidence and the strong theoretical accounts of modality interactions in human communication, gesture-based and multimodality aphasia treatments are at least as legitimate an option as constraint-based aphasia treatment. Theoretical accounts of modality interactions in human communication and the gesture production abilities of individuals with aphasia that are harnessed in treatments are reviewed. The negative effects on word retrieval of restricting gesture production are also reviewed, and an overview of the neurological architecture subserving language processing is provided as rationale for multimodality treatments. The evidence for constrained and unconstrained treatments is critically reviewed. Together, these data suggest that constraint treatments and multimodality treatments are equally efficacious, and there is limited support for constraining client responses to the spoken modality.

  6. Attentive Reading With Constrained Summarization Adapted to Address Written Discourse in People With Mild Aphasia.

    Science.gov (United States)

    Obermeyer, Jessica A; Edmonds, Lisa A

    2018-03-01

    The purpose of this study was to examine the preliminary efficacy of Attentive Reading and Constrained Summarization-Written (ARCS-W) in people with mild aphasia. ARCS-W adapts an existing treatment, ARCS (Rogalski & Edmonds, 2008), to address discourse level writing in mild aphasia. ARCS-W focuses on the cognitive and linguistic skills required for discourse production. This study was a within-subject pre-postdesign. Three people with mild aphasia participated. ARCS-W integrates attentive reading or listening with constrained summarization of discourse level material in spoken and written modalities. Outcomes included macro- (main concepts) and microlinguistic (correct information units, complete utterances) discourse measures, confrontation naming, aphasia severity, and functional communication. All 3 participants demonstrated some generalization to untrained spoken and written discourse at the word, sentence, and text levels. Reduced aphasia severity and/or increased functional communication and confrontation naming were also observed in some participants. The findings of this study provide preliminary evidence of the efficacy of ARCS-W to improve spoken and written discourse in mild aphasia. Different generalization patterns suggest different mechanisms of improvement. Further research and replication are required to better understand how ARCS-W can impact discourse abilities.

  7. The development and feasibility of an online aphasia group intervention and networking program - TeleGAIN.

    Science.gov (United States)

    Pitt, Rachelle; Theodoros, Deborah; Hill, Anne J; Russell, Trevor

    2017-09-04

    Aphasia group therapy offers many benefits, however people with aphasia report difficulty accessing groups and speech-language pathologists are faced with many challenges in providing aphasia group therapy. Telerehabilitation may offer an alternative service delivery option. An online aphasia group therapy program - Telerehabilitation Group Aphasia Intervention and Networking (TeleGAIN) - has been developed according to the guidelines of the Medical Research Council (MRC) framework for complex interventions. The purpose of this paper is to describe the development of TeleGAIN and the results of a pilot trial to determine feasibility and acceptability. The development of TeleGAIN was informed through literature reviews in relevant topic areas, consideration of expert opinion and application of the social cognitive theory. TeleGAIN was then modelled through a feasibility pilot trial with four people with aphasia. TeleGAIN appeared to be feasible and acceptable to participants and able to be implemented as planned. Participant satisfaction with treatment was high and results suggested some potential for improvements in language functioning and communication-related quality of life. TeleGAIN appeared to be feasible and acceptable, however the study highlighted issues related to technology, clinical implementation and participant-specific factors that should be addressed prior to a larger trial.

  8. A new modified listening span task to enhance validity of working memory assessment for people with and without aphasia

    Science.gov (United States)

    Ivanova, Maria V.; Hallowell, Brooke

    2014-01-01

    Deficits in working memory (WM) are an important subset of cognitive processing deficits associated with aphasia. However, there are serious limitations to research on WM in aphasia largely due to the lack of an established valid measure of WM impairment for this population. The aim of the current study was to address shortcomings of previous measures by developing and empirically evaluating a novel WM task with a sentence-picture matching processing component designed to circumvent confounds inherent in existing measures of WM in aphasia. The novel WM task was presented to persons with (n = 27) and without (n = 33) aphasia. Results demonstrated high concurrent validity of a novel WM task. Individuals with aphasia performed significantly worse on all conditions of the WM task compared to individuals without aphasia. Different patterns of performance across conditions were observed for the two groups. Additionally, WM capacity was significantly related to auditory comprehension abilities in individuals with mild aphasia but not those with moderate aphasia. Strengths of the novel WM task are that it allows for differential control for length versus complexity of verbal stimuli and indexing of the relative influence of each, minimizes metalinguistic requirements, enables control for complexity of processing components, allows participants to respond with simple gestures or verbally, and eliminates reading requirements. Results support the feasibility and validity of using a novel task to assess WM in individuals with and without aphasia. PMID:24986153

  9. Dissociating mere exposure and repetition priming as a function of word type.

    Science.gov (United States)

    Butler, Laurie T; Berry, Dianne C; Helman, Shaun

    2004-07-01

    The mere exposure effect is defined as enhanced attitude toward a stimulus that has been repeatedly exposed. Repetition priming is defined as facilitated processing of a previously exposed stimulus. We conducted a direct comparison between the two phenomena to test the assumption that the mere exposure effect represents an example of repetition priming. In two experiments, having studied a set of words or nonwords, participants were given a repetition priming task (perceptual identification) or one of two mere exposure (affective liking or preference judgment) tasks. Repetition priming was obtained for both words and nonwords, but only nonwords produced a mere exposure effect. This demonstrates a key boundary for observing the mere exposure effect, one not readily accommodated by a perceptual representation systems (Tulving & Schacter, 1990) account, which assumes that both phenomena should show some sensitivity to nonwords and words.

  10. The development of interactive multimedia based on auditory, intellectually, repetition in repetition algorithm learning to increase learning outcome

    Science.gov (United States)

    Munir; Sutarno, H.; Aisyah, N. S.

    2018-05-01

    This research aims to find out how the development of interactive multimedia based on auditory, intellectually, and repetition can improve student learning outcomes. This interactive multimedia is developed through 5 stages. Analysis stages include the study of literature, questionnaire, interviews and observations. The design phase is done by the database design, flowchart, storyboards and repetition algorithm material while the development phase is done by the creation of web-based framework. Presentation material is adapted to the model of learning such as auditory, intellectually, repetition. Auditory points are obtained by recording the narrative material that presented by a variety of intellectual points. Multimedia as a product is validated by material and media experts. Implementation phase conducted on grade XI-TKJ2 SMKN 1 Garut. Based on index’s gain, an increasing of student learning outcomes in this study is 0.46 which is fair due to interest of student in using interactive multimedia. While the multimedia assessment earned 84.36% which is categorized as very well.

  11. Localization of lesions in aphasia, (2)

    International Nuclear Information System (INIS)

    Hojo, Kei; Watanabe, Shunzo; Tasaki, Hiroichi; Sato, Tokijiro; Metoki, Hirofumi.

    1985-01-01

    The relationship between the focus and the extent of the lesions and the various symptoms was investigated. 1. Broca aphasics: More than 80% of the group with obvious anarthric components had lesions of the third frontal gyrus involving Broca's area and the lower part of the precental gyrus as well as opercular and insular regions. The size of the lesions of this group was significantly larger than that of the group without marked anarthric components, and the latter was proved to have little localizing value. 2. Wernicke aphasics: The group with poor reading comprehension had cortical and/or subcortical lesions, involving posterior parts of both superior and middle temporal gyri as well as the supramarginal gyrus. On the other hand, lesions of the group with poor auditory comprehension were more anteriorly located and localized in the deep structures. Lesions of the group with poor Token test scores were large and scattered more anteriorly and/or posteriorly compared with those of the group with good Token test scores. 3. Amnestic aphaiscs: The group with poor naming scores had somewhat larger lesions than the group with good naming scores, and the lesions were scattered about the left hemisphere. The finding has proved that both groups had little localizing value. 4. Conduction aphasics: Lesions of the non-fluent type were significantly larger than those of the fluent type and distributed more anteriorly. However, highly involved lesions were located in the supramarginal gyrus and posterior parts of superior and/or middle temporal gyri. 5. Global aphasics: Lesions of the group with good articulation and prosody were observed to distribute more posteriorly in comparison with those of the other global aphasics. (J.P.N.)

  12. Naming abilities: Differentiation between objects and verbs in aphasia

    Directory of Open Access Journals (Sweden)

    Luisa Carmen Spezzano

    Full Text Available Abstract Cognitive Neuropsychology aims to understand the processing mechanisms of normal and injured brain, by means of functional architectural models of information processing. Naming is one of the most important abilities in linguistic processing. Naming of different semantic and grammatical categories differ in their lexical properties and have distinct neuroanatomical substrates. We reviewed literature data on the differences between nouns and verbs in aphasic subjects reported by scientific publications in the form of indexed articles. Studies on naming abilities tended to emphasize the differentiation between nouns and verbs both in their lexical properties and neuroanatomical substrates. Functional neuroimaging studies have improved the state of knowledge regarding category-specific naming abilities, but further studies on different types of aphasia and the use of naming abilities in different contexts are warranted.

  13. Sentence comprehension in aphasia: A noisy channel approach

    Directory of Open Access Journals (Sweden)

    Michael Walsh Dickey

    2014-04-01

    Full Text Available Probabilistic accounts of language understanding assume that comprehension involves determining the probability of an intended message (m given an input utterance (u (P(m|u; e.g. Gibson et al, 2013a; Levy et al, 2009. One challenge is that communication occurs within a noisy channel; i.e. the comprehender’s representation of u may have been distorted, e.g., by a typo or by impairment associated with aphasia. Bayes’ rule provides a model of how comprehenders can combine the prior probability of m (P(m with the probability that m would have been distorted to u (P(mu to calculate the probability of m given u (P(m|u  P(mP(mu. This formalism can capture the observation that people with aphasia (PWA rely more on semantics than syntax during comprehension (e.g., Caramazza & Zurif, 1976: given the high probability that their representation of the input is unreliable, they weigh message likelihood more heavily. Gibson et al. (2013a showed that unimpaired adults are sensitive to P(m and P(mu: they more often chose interpretations that increased message plausibility or involved distortions requiring fewer changes, and/or deletions instead of insertions (see Figure 1a for examples. Gibson et al. (2013b found PWA were also sensitive to both P(m and P(mu in an act-out task, but relied more heavily than unimpaired controls on P(m. This shows group-level optimization towards the less noisy (semantic channel in PWA. The current experiment (8 PWA; 7 age-matched controls investigated noisy channel optimization at the level of individual PWA. It also included active/passive items with a weaker plausibility manipulation to test whether P(m is higher for implausible than impossible strings. The task was forced-choice sentence-picture matching (Figure 1b. Experimental sentences crossed active versus passive (A-P structures with plausibility (Set 1 or impossibility (Set 2, and prepositional-object versus double-object structures (PO-DO: Set 3 with

  14. Neurobehavioral response to increased treatment dosage in chronic, severe aphasia

    Directory of Open Access Journals (Sweden)

    Jennifer L Mozeiko

    2014-04-01

    •\tIncreased activation in S2’s bilateral inferior frontal gyrus following the second treatment session indicates that a second Treatment Period can influence continued neuroplastic change in severe, chronic aphasia. •\tS1 appears to show the most activation following Treatment Period I. It is possible that his greater lesion volume or site did not allow for benefit from a second dose to the same degree as S2. •\tActivation changes (or lack thereof in both cases corresponded with performance on the naming task in the scanner, reflecting the effect of treatment. •\tFor S2, neuroimaging supported the behavioral results which favor a second dose of ILAT. For S1, behavioral results, particularly in his consistent increases on the BNT, are not supported by either the behavioral results in the scanner or the BOLD response.

  15. Effective music therapy techniques in the treatment of nonfluent aphasia.

    Science.gov (United States)

    Tomaino, Concetta M

    2012-04-01

    In music therapy for nonfluent aphasia patients who have difficulty producing meaningful words, phrases, and sentences, various benefits of singing have been identified: strengthened breathing and vocal ability, improved articulation and prosody of speech, and increased verbal and nonverbal communicative behaviors. This paper will introduce these various techniques used in clinical music therapy, and summarize findings based on our recent study to illustrate the strength of different techniques emphasizing rhythm, pitch, memory, and vocal/oral motor components dealing with different symptoms. The efficacy of each component is enhanced or diminished by the choice of music and the way it is interactively delivered. This indicates that neural mechanisms underlying speech improvement vary greatly with available acoustic and social cues in aphasic brain. © 2012 New York Academy of Sciences.

  16. Beyond the temporal pole: limbic memory circuit in the semantic variant of primary progressive aphasia.

    Science.gov (United States)

    Tan, Rachel H; Wong, Stephanie; Kril, Jillian J; Piguet, Olivier; Hornberger, Michael; Hodges, John R; Halliday, Glenda M

    2014-07-01

    Despite accruing evidence for relative preservation of episodic memory in the semantic variant of primary progressive aphasia (previously semantic dementia), the neural basis for this remains unclear, particularly in light of their well-established hippocampal involvement. We recently investigated the Papez network of memory structures across pathological subtypes of behavioural variant frontotemporal dementia and demonstrated severe degeneration of all relay nodes, with the anterior thalamus in particular emerging as crucial for intact episodic memory. The present study investigated the status of key components of Papez circuit (hippocampus, mammillary bodies, anterior thalamus, cingulate cortex) and anterior temporal cortex using volumetric and quantitative cell counting methods in pathologically-confirmed cases with semantic variant of primary progressive aphasia (n = 8; 61-83 years; three males), behavioural variant frontotemporal dementia with TDP pathology (n = 9; 53-82 years; six males) and healthy controls (n = 8, 50-86 years; four males). Behavioural variant frontotemporal dementia cases with TDP pathology were selected because of the association between the semantic variant of primary progressive aphasia and TDP pathology. Our findings revealed that the semantic variant of primary progressive aphasia and behavioural variant frontotemporal dementia show similar degrees of anterior thalamic atrophy. The mammillary bodies and hippocampal body and tail were preserved in the semantic variant of primary progressive aphasia but were significantly atrophic in behavioural variant frontotemporal dementia. Importantly, atrophy in the anterior thalamus and mild progressive atrophy in the body of the hippocampus emerged as the main memory circuit regions correlated with increasing dementia severity in the semantic variant of primary progressive aphasia. Quantitation of neuronal populations in the cingulate cortices confirmed the selective loss of anterior cingulate

  17. Electrical stimulation of the motor cortex enhances treatment outcome in post-stroke aphasia.

    Science.gov (United States)

    Meinzer, Marcus; Darkow, Robert; Lindenberg, Robert; Flöel, Agnes

    2016-04-01

    Transcranial direct current stimulation has shown promise to improve recovery in patients with post-stroke aphasia, but previous studies have only assessed stimulation effects on impairment parameters, and evidence for long-term maintenance of transcranial direct current stimulation effects from randomized, controlled trials is lacking. Moreover, due to the variability of lesions and functional language network reorganization after stroke, recent studies have used advanced functional imaging or current modelling to determine optimal stimulation sites in individual patients. However, such approaches are expensive, time consuming and may not be feasible outside of specialized research centres, which complicates incorporation of transcranial direct current stimulation in day-to-day clinical practice. Stimulation of an ancillary system that is functionally connected to the residual language network, namely the primary motor system, would be more easily applicable, but effectiveness of such an approach has not been explored systematically. We conducted a randomized, parallel group, sham-controlled, double-blind clinical trial and 26 patients with chronic aphasia received a highly intensive naming therapy over 2 weeks (8 days, 2 × 1.5 h/day). Concurrently, anodal-transcranial direct current stimulation was administered to the left primary motor cortex twice daily at the beginning of each training session. Naming ability for trained items (n = 60 pictures that could not be named during repeated baseline assessments), transfer to untrained items (n = 284 pictures) and generalization to everyday communication were assessed immediately post-intervention and 6 months later. Naming ability for trained items was significantly improved immediately after the end of the intervention in both the anodal (Cohen's d = 3.67) and sham-transcranial direct current stimulation groups (d = 2.10), with a trend for larger gains in the anodal-transcranial direct current stimulation group (d

  18. Prognosis in aphasia and CT localization and lesion size

    International Nuclear Information System (INIS)

    Hojo, Kei; Watanabe, Shunzo; Tasaki, Hiroichi; Sato, Tokijiro; Metoki, Hirofumi.

    1985-01-01

    The influence of CT localization and lesion size on the prognosis of aphasia was studied in 76 right-handed aphasic patients who had had a cerebrovascular accident. On the basis of the results of the accumulated lesions with many Broca and Wernicke aphasics, the highly involved sites were determined to be the Broca area and the Wernicke area. The CT lesions of 76 aphasics were traced in the total area, the Broca area, and the Wernicke area; these were termed the total lesion, the Broca lesion, and the Wernicke lesion respectively. The digitizer program was used to determine the size of the lesions by tracing them onto standardized martrices, which were divided into 3000 points and which corresponded to the CT slices. The recovery rates were determined by comparing the scores of 2 SLTA (Standard Language Test of Aphasia) tests given at 3-month intervals in order to coincide with the clinical impressions. These recovery rates were used as an indication of the prognosis. The results obtained were as follows: (1) Negative correlations between the sizes of the total area and the Broca area and the recovery rates were observed, while no correlation was observed between the size of the Wernicke area and the recovery rates. These findings indicate that the larger the lesions in the total area and the Broca area, the less overall recovery occurs in the total language deficit. (2) Negative correlations between the size of each area and the recovery rates in expressive aspects, namely, ''speaking'' and ''writing,'' were observed, but not in the receptive aspects, namely, ''hearing'' and ''reading,'' or in ''calculation.'' (author)

  19. A new modified listening span task to enhance validity of working memory assessment for people with and without aphasia.

    Science.gov (United States)

    Ivanova, Maria V; Hallowell, Brooke

    2014-01-01

    Deficits in working memory (WM) are an important subset of cognitive processing deficits associated with aphasia. However, there are serious limitations to research on WM in aphasia largely due to the lack of an established valid measure of WM impairment for this population. The aim of the current study was to address shortcomings of previous measures by developing and empirically evaluating a novel WM task with a sentence-picture matching processing component designed to circumvent confounds inherent in existing measures of WM in aphasia. The novel WM task was presented to persons with (n=27) and without (n=33) aphasia. Results demonstrated high concurrent validity of a novel WM task. Individuals with aphasia performed significantly worse on all conditions of the WM task compared to individuals without aphasia. Different patterns of performance across conditions were observed for the two groups. Additionally, WM capacity was significantly related to auditory comprehension abilities in individuals with mild aphasia but not those with moderate aphasia. Strengths of the novel WM task are that it allows for differential control for length versus complexity of verbal stimuli and indexing of the relative influence of each, minimizes metalinguistic requirements, enables control for complexity of processing components, allows participants to respond with simple gestures or verbally, and eliminates reading requirements. Results support the feasibility and validity of using a novel task to assess WM in individuals with and without aphasia. Readers will be able to (1) discuss the limitations of current working memory measures for individuals with aphasia; (2) describe how task design features of a new working memory task for people with aphasia address shortcomings of existing measures; (3) summarize the evidence supporting the validity of the novel working memory task. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Storytelling and Repetitive Narratives for Design Empathy

    DEFF Research Database (Denmark)

    Fritsch, Jonas; Judice, Andrea; Soini, Katja

    2007-01-01

    study. In this paper, we show how we attained an empathic understanding through storytelling and aroused empathy to others using repetitive narratives in an experimental presentation bringing forth factual, reflective and experiential aspects of the user information. Taking as a starting point our...

  1. Universal data compression and repetition times

    NARCIS (Netherlands)

    Willems, Frans M J

    1989-01-01

    A new universal data compression algorithm is described. This algorithm encodes L source symbols at a time. For the class of binary stationary sources, its rate does not exceed [formula omitted] [formula omitted] bits per source symbol. In our analysis, a property of repetition times turns out to be

  2. Matriculation Research Report: Course Repetition Data & Analysis.

    Science.gov (United States)

    Gerda, Joe

    Due to concerns that its policy on class repetition was not promoting student success, California's College of the Canyons (CoC) undertook a project to analyze student course-taking patterns and make recommendations to modify the policy. Existing college policy did not follow Section 58161 of the State Educational Code that allows colleges to…

  3. Reducing Repetitive Speech: Effects of Strategy Instruction.

    Science.gov (United States)

    Dipipi, Caroline M.; Jitendra, Asha K.; Miller, Judith A.

    2001-01-01

    This article describes an intervention with an 18-year-old young woman with mild mental retardation and a seizure disorder, which focused on her repetitive echolalic verbalizations. The intervention included time delay, differential reinforcement of other behaviors, and self-monitoring. Overall, the intervention was successful in facilitating…

  4. Neurobehavioural Correlates of Abnormal Repetitive Behaviour

    Directory of Open Access Journals (Sweden)

    R. A. Ford

    1991-01-01

    Full Text Available Conditions in which echolalia and echopraxia occur are reviewed, followed by an attempt to elicit possible mechanisms of these phenomena. A brief description of stereotypical and perseverative behaviour and obsessional phenomena is given. It is suggested that abnormal repetitive behaviour may occur partly as a result of central dopaminergic dysfunction.

  5. Verbal Repetitions and Echolalia in Alzheimer's Discourse

    Science.gov (United States)

    Da Cruz, Fernanda Miranda

    2010-01-01

    This article reports on an investigation of echolalic repetition in Alzheimer's disease (AD). A qualitative analysis of data from spontaneous conversations with MHI, a woman with AD, is presented. The data come from the DALI Corpus, a corpus of spontaneous conversations involving subjects with AD. This study argues that echolalic effects can be…

  6. Bystanders' Reactions to Witnessing Repetitive Abuse Experiences

    Science.gov (United States)

    Janson, Gregory R.; Carney, JoLynn V.; Hazler, Richard J.; Oh, Insoo

    2009-01-01

    The Impact of Event Scale-Revised (D. S. Weiss & C. R. Marmar, 1997) was used to obtain self-reported trauma levels from 587 young adults recalling childhood or adolescence experiences as witnesses to common forms of repetitive abuse defined as bullying. Mean participant scores were in a range suggesting potential need for clinical assessment…

  7. Action observation as a tool for neurorehabilitation to moderate motor deficits and aphasia following stroke

    Science.gov (United States)

    Ertelt, Denis; Binkofski, Ferdinand

    2012-01-01

    The mirror neuron system consists of a set of brain areas capable of matching action observation with action execution. One core feature of the mirror neuron system is the activation of motor areas by action observation alone. This unique capacity of the mirror neuron system to match action perception and action execution stimulated the idea that mirror neuron system plays a crucial role in the understanding of the content of observed actions and may participate in procedural learning. These features bear a high potential for neurorehabilitation of motor deficits and of aphasia following stroke. Since the first articles exploring this principle were published, a growing number of follow-up studies have been conducted in the last decade. Though, the combination of action observation with practice of the observed actions seems to constitute the most powerful approach. In the present review, we present the existing studies analyzing the effects of this neurorehabilitative approach in clinical settings especially in the rehabilitation of stroke associated motor deficits and give a perspective on the ongoing trials by our research group. The data obtained up to date showed significant positive effect of action observation on recovery of motor functions of the upper limbs even in the chronic state after stroke, indicating that our approach might become a new standardized add-on feature of modern neurorehabilitative treatment schemes. PMID:25624838

  8. Cerebral blood flow and metabolism in patients with aphasia due to basal ganglionic lesion

    International Nuclear Information System (INIS)

    Kitamura, Shin; Kato, Toshiaki; Ujike, Takashi; Kuroki, Soemu; Terashi, Akiro

    1987-01-01

    Cerebral blood flow and metabolism in right handed eight patients with subcortical lesion and aphasia were measured to investigate the correlation between aphasia and functional changes in cerebral blood flow (CBF) and cerebral oxygen consumption (CMRO 2 ) in the cortex and the basal ganglionic region. All patients had no lesion in the cortex, but in the basal ganglionic region (putamen, caudate nucleus, internal capsule, and periventricular white matter) on CT images. Patients with bilateral lesion were excluded in this study. Six patients with cerebral infarction in the left basal ganglionic region and two patients with the left putammal hemorrhage were examined. Five patients had non fluent Broca's type speech, two patients had poor comprehension, fluent Wernicke-type speech and one patient was globally aphasic. CBF, CMRO 2 , and oxygen extraction fraction were measured by the positron emission tomography using 15 O 2 , C 15 O 2 inhalation technique. In addition to reduction of CBF and CMRO 2 in the basal ganglionic region, CBF and CMRO 2 decreased in the left frontal cortex especially posterior part in four patients with Broca's aphasia. In two patients with Wernicke type aphasia, CBF and CMRO 2 decreased in the basal ganglionic region and the left temporal cortex. In a globally aphasic patient, marked reduction of CBF and CMRO 2 was observed in the left frontal and temporal cortex, in addition to the basal ganglionic region. These results suggest that dysfunction of cortex as well as that of basal ganglionic region might be related to the occurence of aphasia. However, in one patient with Broca's ahasia, CBF and CMRO 2 were preserved in the cortex and metabolic reduction was observed in only basal ganglia. This case indicates the relation between basal ganglionic lesion and the occurrence of aphasia. These results suggest that measurements of cerebral blood flow and metabolism were necessary to study the responsible lesion for aphasia. (author)

  9. Seizure-associated aphasia has good lateralizing but poor localizing significance.

    Science.gov (United States)

    Loesch, Anna Mira; Steger, Hannah; Losher, Claudia; Hartl, Elisabeth; Rémi, Jan; Vollmar, Christian; Noachtar, Soheyl

    2017-09-01

    To investigate the occurrence of ictal and postictal aphasia in different focal epilepsy syndromes. We retrospectively analyzed the video-electroencephalographic monitoring data of 1,118 patients with focal epilepsy for seizure-associated aphasia (SAA). Statistical analysis included chi-square analysis and Fisher's exact test. We identified 102 of 1,118 patients (9.1%) in whom ictal or postictal aphasia (SAA) was part of their recorded seizures (n = 59 of 102; 57.8%) or who reported aphasia by history (n = 43; 42.2% only reported aphasia by history). Postictal aphasia was present in 18 patients (30.5%). Six of the 59 patients had both ictal and postictal aphasia (10.2%). SAA occurred either with left hemisphere seizure onset or with seizures spreading from the right to the left hemisphere. SAA was most common in patients with parieto-occipital epilepsy (10.9%; five of 46 patients), followed by patients with temporal (6.7%; 28 of 420 patients), focal (not further localized; 4.8%; 22 of 462 patients), and frontal epilepsy (2.1%; four of 190 patients; p = 0.04). SAA was more common in parieto-occipital epilepsy than in frontal epilepsy (p = 0.02). In contrast, there was no significant difference in SAA between temporal and parieto-occipital epilepsy (p = 0.36). SAA has a high lateralizing but limited localizing value, as it often reflects spread of epileptic activity into speech-harboring brain regions. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  10. Transcranial direct current stimulation (tDCS) to improve naming ability in post-stroke aphasia: A critical review.

    Science.gov (United States)

    ALHarbi, Mohammed F; Armijo-Olivo, Susan; Kim, Esther S

    2017-08-14

    Transcranial Direct Current Stimulation (tDCS) is a non-invasive neuromodulation tool that can be used to influence cortical brain activity to induce measurable behavioral changes. Although there is growing evidence that tDCS combined with behavioural language therapy could boost language recovery in patients with post-stroke aphasia, there is great variability in patient characteristics, treatment protocols, and outcome measures in these studies that poses challenges for analyzing the evidence. The purpose of this study is to critically analyze the methodological rigor of the evidence regarding the use of tDCS for post-stroke anomia. This critical review was conducted by searching four databases (MEDLINE, EMBase, PsycINFO, and CINAHL). Nineteen studies fully met the inclusion criteria. Three critical appraisal tools and Robey and Schultz's (1998) five- phase model for conducting clinical outcome research were adopted to evaluate and analyze the current level of evidence. Methodological issues of the studies were also identified. The current level of evidence for using tDCS for anomia is at the pre-efficacy level with emerging evidence at the efficacy level. Lack of proper evaluation of carry-over effects in cross-over studies, lack of or unclear randomization, allocation concealment, and incomplete data handling were the main methodological issues that could threaten the validity of the tDCS for anomia studies. Several methodological issues have been identified in pre-efficacy studies that pose challenges in determining whether tDCS is a beneficial adjunct to behavioral aphasia therapy. Future studies need to improve the quality of the methods used to investigate the effect of tDCS for anomia. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Neural Correlates of Verbal Episodic Memory and Lexical Retrieval in Logopenic Variant Primary Progressive Aphasia.

    Science.gov (United States)

    Win, Khaing T; Pluta, John; Yushkevich, Paul; Irwin, David J; McMillan, Corey T; Rascovsky, Katya; Wolk, David; Grossman, Murray

    2017-01-01

    Objective: Logopenic variant primary progressive aphasia (lvPPA) is commonly associated with Alzheimer's disease (AD) pathology. But lvPPA patients display different cognitive and anatomical profile from the common clinical AD patients, whose verbal episodic memory is primarily affected. Reports of verbal episodic memory difficulty in lvPPA are inconsistent, and we hypothesized that their lexical retrieval impairment contributes to verbal episodic memory performance and is associated with left middle temporal gyrus atrophy. Methods: We evaluated patients with lvPPA ( n = 12) displaying prominent word-finding and repetition difficulties, and a demographically-matched cohort of clinical Alzheimer's disease (AD, n = 26), and healthy seniors ( n = 16). We assessed lexical retrieval with confrontation naming and verbal episodic memory with delayed free recall. Whole-brain regressions related naming and delayed free recall to gray matter atrophy. Medial temporal lobe (MTL) subfields were examined using high in-plane resolution imaging. Results: lvPPA patients had naming and delayed free recall impairments, but intact recognition memory. In lvPPA, delayed free recall was related to naming; both were associated with left middle temporal gyrus atrophy but not MTL atrophy. Despite cerebrospinal fluid evidence consistent with AD pathology, examination of MTL subfields revealed no atrophy in lvPPA. While AD patients displayed impaired delayed free recall, this deficit did not correlate with naming. Regression analyses related delayed free recall deficits in clinical AD patients to MTL subfield atrophy, and naming to left middle temporal gyrus atrophy. Conclusion: Unlike amnestic AD patients, MTL subfields were not affected in lvPPA patients. Verbal episodic memory deficit observed in lvPPA was unlikely to be due to a hippocampal-mediated mechanism but appeared to be due to poor lexical retrieval. Relative sparing of MTL volume and intact recognition memory are consistent with

  12. A feasible repetitive transcranial magnetic stimulation clinical protocol in migraine prevention.

    Science.gov (United States)

    Zardouz, Shawn; Shi, Lei; Leung, Albert

    2016-01-01

    This case series was conducted to determine the clinical feasibility of a repetitive transcranial magnetic stimulation protocol for the prevention of migraine (with and without aura). Five patients with migraines underwent five repetitive transcranial magnetic stimulation sessions separated in 1- to 2-week intervals for a period of 2 months at a single tertiary medical center. Repetitive transcranial magnetic stimulation was applied to the left motor cortex with 2000 pulses (20 trains with 1s inter-train interval) delivered per session, at a frequency of 10 Hz and 80% resting motor threshold. Pre- and post-treatment numerical rating pain scales were collected, and percent reductions in intensity, frequency, and duration were generated. An average decrease in 37.8%, 32.1%, and 31.2% were noted in the intensity, frequency, and duration of migraines post-repetitive transcranial magnetic stimulation, respectively. A mean decrease in 1.9±1.0 (numerical rating pain scale ± standard deviation; range: 0.4-2.8) in headache intensity scores was noted after the repetitive transcranial magnetic stimulation sessions. The tested repetitive transcranial magnetic stimulation protocol is a well-tolerated, safe, and effective method for migraine prevention.

  13. The Participants' Perspective: How Biographic-Narrative Intervention Influences Identity Negotiation and Quality of Life in Aphasia

    Science.gov (United States)

    Corsten, Sabine; Schimpf, Erika J.; Konradi, Jürgen; Keilmann, Annerose; Hardering, Friedericke

    2015-01-01

    Background: People with aphasia experience a pronounced decrease in quality of life (QoL). Beyond that identity negotiation is hindered, which is crucial for QoL. Biographic-narrative approaches use life story telling to support identity (re)development after disruptive events like stroke. Because of the language deficits inherent in aphasia such…

  14. The Influence of Phonomotor Treatment on Word Retrieval Abilities in 26 Individuals with Chronic Aphasia: An Open Trial

    Science.gov (United States)

    Kendall, Diane L.; Oelke, Megan; Brookshire, Carmel Elizabeth; Nadeau, Stephen E.

    2015-01-01

    Purpose: The ultimate goal of aphasia therapy should be to achieve gains in function that generalize to untrained exemplars and daily conversation. Anomia is one of the most disabling features of aphasia. The predominantly lexical/semantic approaches used to treat anomia have low potential for generalization due to the orthogonality of semantic…

  15. "That Doesn't Translate": The Role of Evidence-Based Practice in Disempowering Speech Pathologists in Acute Aphasia Management

    Science.gov (United States)

    Foster, Abby; Worrall, Linda; Rose, Miranda; O'Halloran, Robyn

    2015-01-01

    Background: An evidence-practice gap has been identified in current acute aphasia management practice, with the provision of services to people with aphasia in the acute hospital widely considered in the literature to be inconsistent with best-practice recommendations. The reasons for this evidence-practice gap are unclear; however, speech…

  16. Communication Supports and Best Practices: Ensuring People with Aphasia Have an Effective Means of Expressing Needs and Wishes

    Science.gov (United States)

    King, Julia M.; Simmons-Mackie, Nina

    2017-01-01

    When people with aphasia have difculty communicating, there is a risk for miscommunication and negative outcomes related to medical care and safety (Blacksone, Beukelman, & Yorkson, 2015). This risk can be reduced by ensuring that each person with aphasia can communicate efectively when using diferent types of discourse and at diferent points…

  17. An Integrated Approach for Treating Discourse in Aphasia: Bridging the Gap between Language Impairment and Functional Communication

    Science.gov (United States)

    Milman, Lisa

    2016-01-01

    Purpose: A primary goal of aphasia intervention is to improve everyday communication. Although a large body of research focuses on treatment generalization, transfer of learning to real-world interactions involving discourse does not always occur. The goal of an integrated discourse treatment for aphasia (IDTA) approach is to facilitate such…

  18. Improved Vocabulary Production after Naming Therapy in Aphasia: Can Gains in Picture Naming Generalise to Connected Speech?

    Science.gov (United States)

    Conroy, Paul; Sage, Karen; Ralph, Matt Lambon

    2009-01-01

    Background: Naming accuracy for nouns and verbs in aphasia can vary across different elicitation contexts, for example, simple picture naming, composite picture description, narratives, and conversation. For some people with aphasia, naming may be more accurate to simple pictures as opposed to naming in spontaneous, connected speech; for others,…

  19. The effects of direct and indirect speech on discourse comprehension in Dutch listeners with and without aphasia

    NARCIS (Netherlands)

    Groenewold, Rimke; Bastiaanse, Roelien; Nickels, Lyndsey; Wieling, Martijn; Huiskes, Mike

    2014-01-01

    Background: Research on language comprehension in aphasia has primarily focused on comprehension of isolated words and sentences. Even though previous studies have provided insights into comprehension abilities of individuals with aphasia at the word and grammatical level, our understanding of the

  20. Using Computers to Enable Self-Management of Aphasia Therapy Exercises for Word Finding: The Patient and Carer Perspective

    Science.gov (United States)

    Palmer, Rebecca; Enderby, Pam; Paterson, Gail

    2013-01-01

    Background: Speech and language therapy (SLT) for aphasia can be difficult to access in the later stages of stroke recovery, despite evidence of continued improvement with sufficient therapeutic intensity. Computerized aphasia therapy has been reported to be useful for independent language practice, providing new opportunities for continued…