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Sample records for semantic aphasia patients

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

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    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

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

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    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

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

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    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…

  4. 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

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    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…

  5. Selectivity of lexical-semantic disorders in Polish-speaking patients with aphasia: evidence from single-word comprehension.

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    Jodzio, Krzysztof; Biechowska, Daria; Leszniewska-Jodzio, Barbara

    2008-09-01

    Several neuropsychological studies have shown that patients with brain damage may demonstrate selective category-specific deficits of auditory comprehension. The present paper reports on an investigation of aphasic patients' preserved ability to perform a semantic task on spoken words despite severe impairment in auditory comprehension, as shown by failure in matching spoken words to pictured objects. Twenty-six aphasic patients (11 women and 15 men) with impaired speech comprehension due to a left-hemisphere ischaemic stroke were examined; all were right-handed and native speakers of Polish. Six narrowly defined semantic categories for which dissociations have been reported are colors, body parts, animals, food, objects (mostly tools), and means of transportation. An analysis using one-way ANOVA with repeated measures in conjunction with the Lambda-Wilks Test revealed significant discrepancies among these categories in aphasic patients, who had much more difficulty comprehending names of colors than they did comprehending names of other objects (F((5,21))=13.15; pexplanation in terms of word frequency and/or visual complexity was ruled out. Evidence from the present study support the position that so called "global" aphasia is an imprecise term and should be redefined. These results are discussed within the connectionist and modular perspectives on category-specific deficits in aphasia.

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

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    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.

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

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    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.

  8. Verbal and non-verbal semantic impairment: From fluent primary progressive aphasia to semantic dementia

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    Mirna Lie Hosogi Senaha

    Full Text Available Abstract Selective disturbances of semantic memory have attracted the interest of many investigators and the question of the existence of single or multiple semantic systems remains a very controversial theme in the literature. Objectives: To discuss the question of multiple semantic systems based on a longitudinal study of a patient who presented semantic dementia from fluent primary progressive aphasia. Methods: A 66 year-old woman with selective impairment of semantic memory was examined on two occasions, undergoing neuropsychological and language evaluations, the results of which were compared to those of three paired control individuals. Results: In the first evaluation, physical examination was normal and the score on the Mini-Mental State Examination was 26. Language evaluation revealed fluent speech, anomia, disturbance in word comprehension, preservation of the syntactic and phonological aspects of the language, besides surface dyslexia and dysgraphia. Autobiographical and episodic memories were relatively preserved. In semantic memory tests, the following dissociation was found: disturbance of verbal semantic memory with preservation of non-verbal semantic memory. Magnetic resonance of the brain revealed marked atrophy of the left anterior temporal lobe. After 14 months, the difficulties in verbal semantic memory had become more severe and the semantic disturbance, limited initially to the linguistic sphere, had worsened to involve non-verbal domains. Conclusions: Given the dissociation found in the first examination, we believe there is sufficient clinical evidence to refute the existence of a unitary semantic system.

  9. Beyond the temporal pole: limbic memory circuit in the semantic variant of primary progressive aphasia.

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    Tan, Rachel H; Wong, Stephanie; Kril, Jillian J; Piguet, Olivier; Hornberger, Michael; Hodges, John R; Halliday, Glenda M

    2014-07-01

    von Economo neurons in behavioural variant frontotemporal dementia. We also show that by end-stage these neurons selectively degenerate in the semantic variant of primary progressive aphasia with preservation of neurons in the posterior cingulate cortex. Overall, our findings demonstrate for the first time, severe atrophy, although not necessarily neuronal loss, across all relay nodes of Papez circuit with the exception of the mammillary bodies and hippocampal body and tail in the semantic variant of primary progressive aphasia. Despite the longer disease course in the semantic variant of primary progressive aphasia compared with behavioural variant frontotemporal dementia, we suggest here that the neural preservation of crucial memory relays (hippocampal→mammillary bodies and posterior cingulate→hippocampus) likely reflects the conservation of specific episodic memory components observed in most patients with semantic variant of primary progressive aphasia. © The Author (2014). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. The contribution of executive control to semantic cognition: Convergent evidence from semantic aphasia and executive dysfunction.

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    Thompson, Hannah E; Almaghyuli, Azizah; Noonan, Krist A; Barak, Ohr; Lambon Ralph, Matthew A; Jefferies, Elizabeth

    2018-01-03

    Semantic cognition, as described by the controlled semantic cognition (CSC) framework (Rogers et al., , Neuropsychologia, 76, 220), involves two key components: activation of coherent, generalizable concepts within a heteromodal 'hub' in combination with modality-specific features (spokes), and a constraining mechanism that manipulates and gates this knowledge to generate time- and task-appropriate behaviour. Executive-semantic goal representations, largely supported by executive regions such as frontal and parietal cortex, are thought to allow the generation of non-dominant aspects of knowledge when these are appropriate for the task or context. Semantic aphasia (SA) patients have executive-semantic deficits, and these are correlated with general executive impairment. If the CSC proposal is correct, patients with executive impairment should not only exhibit impaired semantic cognition, but should also show characteristics that align with those observed in SA. This possibility remains largely untested, as patients selected on the basis that they show executive impairment (i.e., with 'dysexecutive syndrome') have not been extensively tested on tasks tapping semantic control and have not been previously compared with SA cases. We explored conceptual processing in 12 patients showing symptoms consistent with dysexecutive syndrome (DYS) and 24 SA patients, using a range of multimodal semantic assessments which manipulated control demands. Patients with executive impairments, despite not being selected to show semantic impairments, nevertheless showed parallel patterns to SA cases. They showed strong effects of distractor strength, cues and miscues, and probe-target distance, plus minimal effects of word frequency on comprehension (unlike semantic dementia patients with degradation of conceptual knowledge). This supports a component process account of semantic cognition in which retrieval is shaped by control processes, and confirms that deficits in SA patients reflect

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

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    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…

  12. 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.

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

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    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

  14. The Role of Executive Function in the Semantic Comprehension Deficits of Stroke Aphasia and Semantic Dementia

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    Curtiss Chapman

    2015-05-01

    Results from 5 SD patients and 4 SA patients in our ongoing study suggest similar patterns of impairment on both semantic and executive function tasks for both patient groups. Both showed multi-modal semantic deficits via poor performance on at least 3 out of 5 semantic tasks tapping different modalities. Also, SA and SD patients showed no difference in consistency across semantic tasks (see Fig. 1a & b. Both groups also showed consistently poor performance on trail-making and verbal Stroop tasks compared to controls (see Figs. 1c & 1d. SD patients seem to be less impaired on both span measures (word span range: 2.17 – 4.43; digit span: 3.17 – 5.5 than SA patients (word span range: 1.63 – 3.75; digit span: 1.17 – 4.17, and performance was variable for both groups on non-verbal Stroop and picture-word interference. SD patients found many executive tasks too difficult to understand, which may be the reason for limited prior data for them on EF tasks.. These findings suggest that the use of syndrome categories like semantic dementia and comprehension-impaired stroke aphasia are not useful in distinguishing between storage and access deficits. Patients classified as having SD seem as likely as SA patients to have certain kinds of executive deficits and SA patients may be as likely as SD patients to show consistency across semantic tasks. The results imply that some other behavioral or neuroanatomical basis rather than syndrome classification should be used to address the hypothesized separation of storage vs. control aspects of semantic memory.

  15. Verbal creativity in semantic variant primary progressive aphasia.

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    Wu, Teresa Q; Miller, Zachary A; Adhimoolam, Babu; Zackey, Diana D; Khan, Baber K; Ketelle, Robin; Rankin, Katherine P; Miller, Bruce L

    2015-02-01

    Emergence of visual and musical creativity in the setting of neurologic disease has been reported in patients with semantic variant primary progressive aphasia (svPPA), also called semantic dementia (SD). It is hypothesized that loss of left anterior frontotemporal function facilitates activity of the right posterior hemispheric structures, leading to de novo creativity observed in visual artistic representation. We describe creativity in the verbal domain, for the first time, in three patients with svPPA. Clinical presentations are carefully described in three svPPA patients exhibiting verbal creativity, including neuropsychology, neurologic exam, and structural magnetic resonance imaging (MRI). Voxel-based morphometry (VBM) was performed to quantify brain atrophy patterns in these patients against age-matched healthy controls. All three patients displayed new-onset creative writing behavior and produced extensive original work during the course of disease. Patient A developed interest in wordplay and generated a large volume of poetry. Patient B became fascinated with rhyming and punning. Patient C wrote and published a lifestyle guidebook. An overlap of their structural MR scans showed uniform sparing in the lateral portions of the language-dominant temporal lobe (superior and middle gyri) and atrophy in the medial temporal cortex (amygdala, limbic cortex). New-onset creativity in svPPA may represent a paradoxical functional facilitation. A similar drive for production is found in visually artistic and verbally creative patients. Mirroring the imaging findings in visually artistic patients, verbal preoccupation and creativity may be associated with medial atrophy in the language-dominant temporal lobe, but sparing of lateral dominant temporal and non-dominant posterior cortices.

  16. C-Speak Aphasia alternative communication program for people with severe aphasia: importance of executive functioning and semantic knowledge.

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    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.

  17. When the Wedding March becomes sad: Semantic memory impairment for music in the semantic variant of primary progressive aphasia.

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    Macoir, Joël; Berubé-Lalancette, Sarah; Wilson, Maximiliano A; Laforce, Robert; Hudon, Carol; Gravel, Pierre; Potvin, Olivier; Duchesne, Simon; Monetta, Laura

    2016-12-01

    Music can induce particular emotions and activate semantic knowledge. In the semantic variant of primary progressive aphasia (svPPA), semantic memory is impaired as a result of anterior temporal lobe (ATL) atrophy. Semantics is responsible for the encoding and retrieval of factual knowledge about music, including associative and emotional attributes. In the present study, we report the performance of two individuals with svPPA in three experiments. NG with bilateral ATL atrophy and ND with atrophy largely restricted to the left ATL. Experiment 1 assessed the recognition of musical excerpts and both patients were unimpaired. Experiment 2 studied the emotions conveyed by music and only NG showed impaired performance. Experiment 3 tested the association of semantic concepts to musical excerpts and both patients were impaired. These results suggest that the right ATL seems essential for the recognition of emotions conveyed by music and that the left ATL is involved in binding music to semantics. They are in line with the notion that the ATLs are devoted to the binding of different modality-specific properties and suggest that they are also differentially involved in the processing of factual and emotional knowledge associated with music.

  18. Communication activity in stroke patients with aphasia.

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    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.

  19. The Use of a Modified Semantic Features Analysis Approach in Aphasia

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    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…

  20. The functional connectivity of semantic task changes in the recovery from stroke aphasia

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    Lu, Jie; Wu, Xia; Yao, Li; Li, Kun-Cheng; Shu, Hua; Dong, Qi

    2007-03-01

    Little is known about the difference of functional connectivity of semantic task between the recovery aphasic patients and normal subject. In this paper, an fMRI experiment was performed in a patient with aphasia following a left-sided ischemic lesion and normal subject. Picture naming was used as semantic activation task in this study. We compared the preliminary functional connectivity results of the recovery aphasic patient with the normal subject. The fMRI data were separated by independent component analysis (ICA) into 90 components. According to our experience and other papers, we chose a region of interest (ROI) of semantic (x=-57, y=15, z=8, r=11mm). From the 90 components, we chose one component as the functional connectivity of the semantic ROI according to one criterion. The criterion is the mean value of the voxels in the ROI. So the component of the highest mean value of the ROI is the functional connectivity of the ROI. The voxel with its value higher than 2.4 was thought as activated (pgyrus and inferior/middle temporal gyrus are larger than the ones of normal. The activated area of the right inferior frontal gyrus is smaller than the ones of normal. The functional connectivity of stroke aphasic patient under semantic condition is different with the normal one. The focus of the stroke aphasic patient can affect the functional connectivity.

  1. The Impact of Semantic Impairment on Verbal Short-Term Memory in Stroke Aphasia and Semantic Dementia: A Comparative Study

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    Jefferies, Elizabeth; Hoffman, Paul; Jones, Roy; Lambon Ralph, Matthew A.

    2008-01-01

    This study presents the first direct comparison of immediate serial recall in semantic dementia (SD) and transcortical sensory aphasia (TSA). Previous studies of the effect of semantic impairment on verbal short-term memory (STM) have led to important theoretical advances. However, different conclusions have been drawn from these two groups. This…

  2. An adaptive semantic matching paradigm for reliable and valid language mapping in individuals with aphasia.

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    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.

  3. Verbal Description of Concrete Objects: A Method for Assessing Semantic Circumlocution in Persons With Aphasia.

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    Antonucci, Sharon M; MacWilliam, Colleen

    2015-11-01

    We investigated from a theoretically motivated perspective what information differentiated sufficient from insufficient descriptions of objects provided by persons with aphasia. Twenty-one adults with aphasia consequent to single left-hemisphere stroke verbally described 9 living and 9 nonliving objects. Responses were scored for accuracy (i.e., sufficiency) and tallied for type and quantity of semantic feature information provided. Main effects and interactions were identified using repeated measures analyses of variance, with significant findings followed up with planned comparisons. Differences between correct and incorrect descriptions were identified with respect to both feature type and feature distinctiveness for living and nonliving items, in particular highlighting the importance of distinctive features in descriptions of both domains. These findings add to the relatively small body of literature investigating semantic feature processing in adults with aphasia. This is a critical gap to close when considered in light of the preponderance of semantically based treatments for word-retrieval impairment in stroke-aphasia. Our findings provide preliminary support for the notion that semantically guided treatments for word-retrieval impairment in stroke-aphasia may be geared toward increasing specificity of semantic circumlocution to increase semantic self-cueing and to improve communication of information to conversation partners.

  4. Role of Importance and Distinctiveness of Semantic Features in People with Aphasia: A Replication Study

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    Mason-Baughman, Mary Beth; Wallace, Sarah E.

    2014-01-01

    Previous studies suggest that people with aphasia have incomplete lexical-semantic representations with decreased low-importance distinctive (LID) feature knowledge. In addition, decreased LID feature knowledge correlates with ability to discriminate among semantically related words. The current study seeks to replicate and extend previous…

  5. Aphasia

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    ... 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. ...

  6. Neuroimaging and neurorehabilitation for aphasia patients

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    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)

  7. The semantic variant of primary progressive aphasia: clinical and neuroimaging evidence in single subjects.

    Directory of Open Access Journals (Sweden)

    Leonardo Iaccarino

    Full Text Available We present a clinical-neuroimaging study in a series of patients with a clinical diagnosis of semantic variant of primary progressive aphasia (svPPA, with the aim to provide clinical-functional correlations of the cognitive and behavioral manifestations at the single-subject level.We performed neuropsychological investigations, 18F-FDG-PET single-subject and group analysis, with an optimized SPM voxel-based approach, and correlation analyses. A measurement of white matter integrity by means of diffusion tensor imaging (DTI was also available for a subgroup of patients.Cognitive assessment confirmed the presence of typical semantic memory deficits in all patients, with a relative sparing of executive, attentional, visuo-constructional, and episodic memory domains. 18F-FDG-PET showed a consistent pattern of cerebral hypometabolism across all patients, which correlated with performance in semantic memory tasks. In addition, a majority of patients also presented with behavioral disturbances associated with metabolic dysfunction in limbic structures. In a subgroup of cases the DTI analysis showed FA abnormalities in the inferior longitudinal and uncinate fasciculi.Each svPPA individual had functional derangement involving an extended, connected system within the left temporal lobe, a crucial part of the verbal semantic network, as well as an involvement of limbic structures. The latter was associated with behavioral manifestations and extended beyond the area of atrophy shown by CT scan.Single-subject 18F-FDG-PET analysis can account for both cognitive and behavioral alterations in svPPA. This provides useful support to the clinical diagnosis.

  8. What Does a Cue Do? Comparing Phonological and Semantic Cues for Picture Naming in Aphasia

    Science.gov (United States)

    Meteyard, Lotte; Bose, Arpita

    2018-01-01

    Purpose: Impaired naming is one of the most common symptoms in aphasia, often treated with cued picture naming paradigms. It has been argued that semantic cues facilitate the reliable categorization of the picture, and phonological cues facilitate the retrieval of target phonology. To test these hypotheses, we compared the effectiveness of…

  9. 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.

  10. “Pre-semantic” cognition revisited: Critical differences between semantic aphasia and semantic dementia

    OpenAIRE

    Jefferies, Elizabeth; Rogers, Timothy T.; Hopper, Samantha; Lambon Ralph, Matthew A.

    2010-01-01

    Patients with semantic dementia show a specific pattern of impairment on both verbal and non-verbal "pre-semantic" tasks, e.g., reading aloud, past tense generation, spelling to dictation, lexical decision, object decision, colour decision and delayed picture copying. All seven tasks are characterised by poorer performance for items that are atypical of the domain and "regularisation errors" (irregular/atypical items are produced as if they were domain-typical). The emergence of this pattern ...

  11. 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

  12. Comparative Effectiveness of Semantic Feature Analysis (SFA and Phonological Components Analysis (PCA for Anomia Treatment in Persian Speaking Patients With Aphasia

    Directory of Open Access Journals (Sweden)

    Zahra Sadeghi

    2017-09-01

    Discussion: While PCA is more effective for participants with phonological impairments, SFA is more effective for participants with semantic impairments. Therefore, a direct relationship between underlying functional deficit and response to specific treatment was established for all participants.

  13. 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 ...

  14. Phonological and semantic processing during comprehension in Wernicke's aphasia: An N400 and Phonological Mapping Negativity Study.

    Science.gov (United States)

    Robson, Holly; Pilkington, Emma; Evans, Louise; DeLuca, Vincent; Keidel, James L

    2017-06-01

    Comprehension impairments in Wernicke's aphasia are thought to result from a combination of impaired phonological and semantic processes. However, the relationship between these cognitive processes and language comprehension has only been inferred through offline neuropsychological tasks. This study used ERPs to investigate phonological and semantic processing during online single word comprehension. EEG was recorded in a group of Wernicke's aphasia n=8 and control participants n=10 while performing a word-picture verification task. The N400 and Phonological Mapping Negativity/Phonological Mismatch Negativity (PMN) event-related potential components were investigated as an index of semantic and phonological processing, respectively. Individuals with Wernicke's aphasia displayed reduced and inconsistent N400 and PMN effects in comparison to control participants. Reduced N400 effects in the WA group were simulated in the control group by artificially degrading speech perception. Correlation analyses in the Wernicke's aphasia group found that PMN but not N400 amplitude was associated with behavioural word-picture verification performance. The results confirm impairments at both phonological and semantic stages of comprehension in Wernicke's aphasia. However, reduced N400 responses in Wernicke's aphasia are at least partially attributable to earlier phonological processing impairments. The results provide further support for the traditional model of Wernicke's aphasia which claims a causative link between phonological processing and language comprehension impairments. Copyright © 2017 Elsevier Ltd. 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. Electrophysiology of prosodic and lexical-semantic processing during sentence comprehension in aphasia.

    Science.gov (United States)

    Sheppard, Shannon M; Love, Tracy; Midgley, Katherine J; Holcomb, Phillip J; Shapiro, Lewis P

    2017-12-01

    Event-related potentials (ERPs) were used to examine how individuals with aphasia and a group of age-matched controls use prosody and themattic fit information in sentences containing temporary syntactic ambiguities. Two groups of individuals with aphasia were investigated; those demonstrating relatively good sentence comprehension whose primary language difficulty is anomia (Individuals with Anomic Aphasia (IWAA)), and those who demonstrate impaired sentence comprehension whose primary diagnosis is Broca's aphasia (Individuals with Broca's Aphasia (IWBA)). The stimuli had early closure syntactic structure and contained a temporary early closure (correct)/late closure (incorrect) syntactic ambiguity. The prosody was manipulated to either be congruent or incongruent, and the temporarily ambiguous NP was also manipulated to either be a plausible or an implausible continuation for the subordinate verb (e.g., "While the band played the song/the beer pleased all the customers."). It was hypothesized that an implausible NP in sentences with incongruent prosody may provide the parser with a plausibility cue that could be used to predict syntactic structure. The results revealed that incongruent prosody paired with a plausibility cue resulted in an N400-P600 complex at the implausible NP (the beer) in both the controls and the IWAAs, yet incongruent prosody without a plausibility cue resulted in an N400-P600 at the critical verb (pleased) only in healthy controls. IWBAs did not show evidence of N400 or P600 effects at the ambiguous NP or critical verb, although they did show evidence of a delayed N400 effect at the sentence-final word in sentences with incongruent prosody. These results suggest that IWAAs have difficulty integrating prosodic cues with underlying syntactic structure when lexical-semantic information is not available to aid their parse. IWBAs have difficulty integrating both prosodic and lexical-semantic cues with syntactic structure, likely due to a

  17. Tense and aspect in aphasia and semantic dementia

    Directory of Open Access Journals (Sweden)

    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.

  18. 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.

  19. 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

  20. Frontal lobe damage impairs process and content in semantic memory: evidence from category-specific effects in progressive non-fluent aphasia.

    Science.gov (United States)

    Reilly, Jamie; Rodriguez, Amy D; Peelle, Jonathan E; Grossman, Murray

    2011-06-01

    Portions of left inferior frontal cortex have been linked to semantic memory both in terms of the content of conceptual representation (e.g., motor aspects in an embodied semantics framework) and the cognitive processes used to access these representations (e.g., response selection). Progressive non-fluent aphasia (PNFA) is a neurodegenerative condition characterized by progressive atrophy of left inferior frontal cortex. PNFA can, therefore, provide a lesion model for examining the impact of frontal lobe damage on semantic processing and content. In the current study we examined picture naming in a cohort of PNFA patients across a variety of semantic categories. An embodied approach to semantic memory holds that sensorimotor features such as self-initiated action may assume differential importance for the representation of manufactured artifacts (e.g., naming hand tools). Embodiment theories might therefore predict that patients with frontal damage would be differentially impaired on manufactured artifacts relative to natural kinds, and this prediction was borne out. We also examined patterns of naming errors across a wide range of semantic categories and found that naming error distributions were heterogeneous. Although PNFA patients performed worse overall on naming manufactured artifacts, there was no reliable relationship between anomia and manipulability across semantic categories. These results add to a growing body of research arguing against a purely sensorimotor account of semantic memory, suggesting instead a more nuanced balance of process and content in how the brain represents conceptual knowledge. Copyright © 2010 Elsevier Srl. All rights reserved.

  1. A Dextral Primary Progressive Aphasia Patient with Right Dominant Hypometabolism and Tau Accumulation and Left Dominant Amyloid Accumulation

    Directory of Open Access Journals (Sweden)

    Young Kyoung Jang

    2016-04-01

    Full Text Available Background: Primary progressive aphasia (PPA is a degenerative disease that presents as progressive decline of language ability with preservation of other cognitive functions in the early stages. Three subtypes of PPA are known: progressive nonfluent aphasia, semantic dementia, and logopenic aphasia (LPA. Patients and Methods: We report the case of a 77-year-old patient with PPA whose clinical findings did not correspond to the three subtypes but mainly fit LPA. Unlike other LPA patients, however, this patient showed a right hemisphere predominant glucose hypometabolism and tau accumulation and a left hemisphere predominant amyloid deposition. The right-handed patient presented with comprehension difficulty followed by problems naming familiar objects. This isolated language problem had deteriorated rapidly for 2 years, followed by memory difficulties and impairment of daily activities. Using a Korean version of the Western Aphasia Battery, aphasia was consistent with a severe form of Wernicke's aphasia. According to the brain magnetic resonance imaging and 18F-fludeoxyglucose positron emission tomography results, right hemisphere atrophy and hypometabolism, more predominant on the right hemisphere than the left, were apparent despite the fact that Edinburgh Handedness Questionnaire scores indicated strong right-handedness. On Pittsburgh compound B-PET, amyloid accumulation was asymmetrical with the left hemisphere being more predominant than the right, whereas 18F-T807-PET showed a right dominant tau accumulation. Conclusions: This is the first report of atypical PPA, in which the patient exhibited crossed aphasia and asymmetrical amyloid accumulation.

  2. The contribution of executive control to semantic cognition: Convergent evidence from semantic aphasia and executive dysfunction

    OpenAIRE

    Thompson, Hannah E; Almaghyuli, Azizah; Noonan, Krist A.; Barak, Ohr; Lambon Ralph, Matthew; Jefferies, Elizabeth

    2018-01-01

    Semantic cognition, as described by the Controlled Semantic Cognition (CSC) framework (Rogers, Patterson, Jefferies, & Lambon Ralph, 2015), involves two key components: activation of coherent, generalizable concepts within a heteromodal ‘hub’ in combination with modality-specific features (spokes), and a constraining mechanism that manipulates and gates this knowledge to generate time- and task- appropriate behaviour. Executive-semantic goal representations, largely supported by executive...

  3. The contribution of executive control to semantic cognition: Convergent evidence from semantic aphasia and executive dysfunction

    OpenAIRE

    Thompson, Hannah; Almaghyuli, Azizah; Noonan, Krist A.; barak, Ohr; Lambon Ralph, Matthew A.; Jefferies, Elizabeth

    2018-01-01

    Semantic cognition, as described by the controlled semantic cognition (CSC) framework (Rogers et al., 2015, Neuropsychologia, 76, 220), involves two key components: activation of coherent, generalizable concepts within a heteromodal ‘hub’ in combination with modality-specific features (spokes), and a constraining mechanism that manipulates and gates this knowledge to generate time- and task-appropriate behaviour. Executive–semantic goal representations, largely supported by executive regions ...

  4. Comprehension of concrete and abstract words in semantic variant primary progressive aphasia and Alzheimer's disease: A behavioral and neuroimaging study.

    Science.gov (United States)

    Joubert, Sven; Vallet, Guillaume T; Montembeault, Maxime; Boukadi, Mariem; Wilson, Maximiliano A; Laforce, Robert Jr; Rouleau, Isabelle; Brambati, Simona M

    2017-07-01

    The aim of this study was to investigate the comprehension of concrete, abstract and abstract emotional words in semantic variant primary progressive aphasia (svPPA), Alzheimer's disease (AD), and healthy elderly adults (HE) Three groups of participants (9 svPPA, 12 AD, 11 HE) underwent a general neuropsychological assessment, a similarity judgment task, and structural brain MRI. The three types of words were processed similarly in the group of AD participants. In contrast, patients in the svPPA group were significantly more impaired at processing concrete words than abstract words, while comprehension of abstract emotional words was in between. VBM analyses showed that comprehension of concrete words relative to abstract words was significantly correlated with atrophy in the left anterior temporal lobe. These results support the view that concrete words are disproportionately impaired in svPPA, and that concrete and abstract words may rely upon partly dissociable brain regions. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Semantic Feature Analysis (SFA in the Treatment of Naming Deficits: Evidence from a Malay Speaker with Non-Fluent Aphasia

    Directory of Open Access Journals (Sweden)

    Mohd Azmarul A Aziz

    2015-04-01

    Full Text Available Introduction Semantic Feature Analysis (SFA is a treatment for lexical retrieval impairment in which participants are cued by providing semantic information regarding concepts they have difficulty with in naming tasks in an effort to facilitate accurate lexical retrieval (Boyle & Coelho, 1995. People with aphasia are commonly found to have naming deficits and speech-language therapists (SLTs face difficulties in providing an effective treatment method to treat this deficit. This study aims to examine the use of SFA to address naming deficits for nouns and verbs in a Malay patient (KM with non-fluent aphasia. Methods The following tests were administered to the subject pre- and post- treatment: 1 Boston Diagnostic Aphasia Examination (BDAE; 2 Malay Object and Action Test (MOAT; and 3 A series of comprehension and production assessments in Malay. Subject was asked to name 101 and 50 pictures from MOAT. The stimuli were coloured photograph pictures. Treatment and probe (untrained stimuli were selected from pictures that a subject could not name, yielding 40 nouns and 30 verbs. From these, 20 stimuli were randomly chosen as probe items and 20 as treatment stimuli (nouns, 15 treatment and 15 probes (verbs. For the treatment study, single subject A-B-A design was implemented. Three baseline sessions were completed prior to treatment initiation naming for both probe and treatment pictures. Subject attended once-weekly therapy sessions over 8 months. Probes assessing generalizations to untrained pictures were presented at 4th, 8th, and 12th and so on until the end of the programme. Results Results showed that KM’s ability to name trained and untrained picture stimuli improved for both nouns and verbs. KM demonstrated steady improvement in the SFA treatment of trained nouns and verbs: from 5% baseline accuracy to over 90% accuracy at treatment end for nouns and from 0% baseline accuracy to 90% accuracy at treatment end for verbs. Generalizations to

  6. For a new look at 'lexical errors': evidence from semantic approximations with verbs in aphasia.

    Science.gov (United States)

    Duvignau, Karine; Tran, Thi Mai; Manchon, Mélanie

    2013-08-01

    The ability to understand the similarity between two phenomena is fundamental for humans. Designated by the term analogy in psychology, this ability plays a role in the categorization of phenomena in the world and in the organisation of the linguistic system. The use of analogy in language often results in non-standard utterances, particularly in speakers with aphasia. These non-standard utterances are almost always studied in a nominal context and considered as errors. We propose a study of the verbal lexicon and present findings that measure, by an action-video naming task, the importance of verb-based non-standard utterances made by 17 speakers with aphasia ("la dame déshabille l'orange"/the lady undresses the orange, "elle casse la tomate"/she breaks the tomato). The first results we have obtained allow us to consider these type of utterances from a new perspective: we propose to eliminate the label of "error", suggesting that they may be viewed as semantic approximations based upon a relationship of inter-domain synonymy and are ingrained in the heart of the lexical system.

  7. Topographic Evaluation of Aphasia in 100 Stroke Patients

    Directory of Open Access Journals (Sweden)

    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. A Patient with Difficulty of Object Recognition: Semantic Amnesia for Manipulable Objects

    Directory of Open Access Journals (Sweden)

    A. Yamadori

    1992-01-01

    Full Text Available We studied a patient who had recognition difficulty for manipulable objects. MRI showed a lesion in the left occipito-parietotemporal area. Differential diagnosis of agnosia, aphasia and apraxia is discussed. We believe this “object meaning amnesia” constitutes a distinct subtype of semantic amnesia.

  9. The relationships between the amount of spared tissue, percent signal change, and accuracy in semantic processing in aphasia.

    Science.gov (United States)

    Sims, Jordyn A; Kapse, Kushal; Glynn, Peter; Sandberg, Chaleece; Tripodis, Yorghos; Kiran, Swathi

    2016-04-01

    Recovery from aphasia, loss of language following a cerebrovascular incident (stroke), is a complex process involving both left and right hemispheric regions. In our study, we analyzed the relationships between semantic processing behavioral data, lesion size and location, and percent signal change from functional magnetic resonance imaging (fMRI) data. This study included 14 persons with aphasia in the chronic stage of recovery (six or more months post stroke), along with normal controls, who performed semantic processing tasks of determining whether a written semantic feature matched a picture or whether two written words were related. Using region of interest (ROI) analysis, we found that left inferior frontal gyrus pars opercularis and pars triangularis, despite significant damage, were the only regions to correlate with behavioral accuracy. Additionally, bilateral frontal regions including superior frontal gyrus, middle frontal gyrus, and anterior cingulate appear to serve as an assistive network in the case of damage to traditional language regions that include inferior frontal gyrus, middle temporal gyrus, supramarginal gyrus, and angular gyrus. Right hemisphere posterior regions including right middle temporal gyrus, right supramarginal gyrus, and right angular gyrus are engaged in the case of extensive damage to left hemisphere language regions. Additionally, right inferior frontal gyrus pars orbitalis is presumed to serve a monitoring function. These results reinforce the importance of the left hemisphere in language processing in aphasia, and provide a framework for the relative importance of left and right language regions in the brain. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. 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 ...

  11. 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

  12. 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

  13. 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...

  14. The career success of an adult with a learning disability: a psychosocial study of amnesic-semantic aphasia.

    Science.gov (United States)

    Kershner, J; Kirkpatrick, T; McLaren, D

    1995-02-01

    B.I. is a 39-year-old, intellectually gifted (IQ = 130) man with learning disabilities who, without known cause, demonstrated symptoms of amnesic-semantic aphasia at age 13. This led to placement in a public school class for students with mild mental retardation and to his dropping out of school after repeating Grade 9. His aphasia is associated with a severe deficit in speech comprehension, poor reading and writing, spatial confusion, and episodic memory loss. We studied the remarkable behavioral and cognitive adjustments that have enabled him to lead a fulfilling life and become a highly successful business executive. Implications are discussed in the context of patterns of successful functioning and current views of the neuropsychological and neurological bases of such disorders.

  15. 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.

  16. Changes of right-hemispheric activation after constraint-induced, intensive language action therapy in chronic aphasia: fMRI evidence from auditory semantic processing1

    Science.gov (United States)

    Mohr, Bettina; Difrancesco, Stephanie; Harrington, Karen; Evans, Samuel; Pulvermüller, Friedemann

    2014-01-01

    The role of the two hemispheres in the neurorehabilitation of language is still under dispute. This study explored the changes in language-evoked brain activation over a 2-week treatment interval with intensive constraint induced aphasia therapy (CIAT), which is also called intensive language action therapy (ILAT). Functional magnetic resonance imaging (fMRI) was used to assess brain activation in perilesional left hemispheric and in homotopic right hemispheric areas during passive listening to high and low-ambiguity sentences and non-speech control stimuli in chronic non-fluent aphasia patients. All patients demonstrated significant clinical improvements of language functions after therapy. In an event-related fMRI experiment, a significant increase of BOLD signal was manifest in right inferior frontal and temporal areas. This activation increase was stronger for highly ambiguous sentences than for unambiguous ones. These results suggest that the known language improvements brought about by intensive constraint-induced language action therapy at least in part relies on circuits within the right-hemispheric homologs of left-perisylvian language areas, which are most strongly activated in the processing of semantically complex language. PMID:25452721

  17. 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

  18. A patient with aphasia using the nonsemantic lexical route for Kanji reading.

    Science.gov (United States)

    Hashimoto, Kosei; Uno, Akira; Sambai, Ami; Mizumoto, Go

    We report a patient with aphasia, caused by cerebral hemorrhage, who probably used the nonsemantic lexical route when reading words aloud. To investigate the mechanisms underlying her reading dysfunction, we analyzed her reading abilities using the Dual-Route Cascaded Model. Language tests resulted in low correct percentages for both reading comprehension and reading nonwords aloud, suggesting problems in the semantic system and the nonlexical route. Conversely, the patient showed high scores on the reading words aloud task. Although she failed to understand many inconsistent-atypical words in the reading comprehension test, she correctly read most words aloud, suggesting that she used the nonsemantic lexical route. In addition, the lexical reading route was analyzed in detail by using inconsistent-atypical Kanji words as stimuli. Finally, we analyzed her reading dysfunction compared with previous cases.

  19. 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.

  20. 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,…

  1. White matter disease correlates with lexical retrieval deficits in primary progressive aphasia

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    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.

  2. 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.

  3. The behavioural patterns and neural correlates of concrete and abstract verb processing in aphasia: A novel verb semantic battery

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    Reem S.W. Alyahya

    2018-01-01

    Full Text Available Typically, processing is more accurate and efficient for concrete than abstract concepts in both healthy adults and individuals with aphasia. While, concreteness effects have been thoroughly documented with respect to noun processing, other words classes have received little attention despite tending to be less concrete than nouns. The aim of the current study was to explore concrete-abstract differences in verbs and identify their neural correlates in post-stroke aphasia. Given the dearth of comprehension tests for verbs, a battery of neuropsychological tests was developed in this study to assess the comprehension of concrete and abstract verbs. Specifically, a sensitive verb synonym judgment test was generated that varied both the items' imageability and frequency, and a picture-to-word matching test with numerous concrete verbs. Normative data were then collected and the tests were administered to a cohort of 48 individuals with chronic post-stroke aphasia to explore the behavioural patterns and neural correlates of verb processing. The results revealed significantly better comprehension of concrete than abstract verbs, aligning with the existing aphasiological literature on noun processing. In addition, the patients performed better during verb comprehension than verb production. Lesion-symptom correlational analyses revealed common areas that support processing of concrete and abstract verbs, including the left anterior temporal lobe, posterior supramarginal gyrus and superior lateral occipital cortex. A direct contrast between them revealed additional regions with graded differences. Specifically, the left frontal regions were associated with processing abstract verbs; whereas, the left posterior temporal and occipital regions were associated with processing concrete verbs. Moreover, overlapping and distinct neural correlates were identified in association with the comprehension and production of concrete verbs. These patient findings

  4. The behavioural patterns and neural correlates of concrete and abstract verb processing in aphasia: A novel verb semantic battery.

    Science.gov (United States)

    Alyahya, Reem S W; Halai, Ajay D; Conroy, Paul; Lambon Ralph, Matthew A

    2018-01-01

    Typically, processing is more accurate and efficient for concrete than abstract concepts in both healthy adults and individuals with aphasia. While, concreteness effects have been thoroughly documented with respect to noun processing, other words classes have received little attention despite tending to be less concrete than nouns. The aim of the current study was to explore concrete-abstract differences in verbs and identify their neural correlates in post-stroke aphasia. Given the dearth of comprehension tests for verbs, a battery of neuropsychological tests was developed in this study to assess the comprehension of concrete and abstract verbs. Specifically, a sensitive verb synonym judgment test was generated that varied both the items' imageability and frequency, and a picture-to-word matching test with numerous concrete verbs. Normative data were then collected and the tests were administered to a cohort of 48 individuals with chronic post-stroke aphasia to explore the behavioural patterns and neural correlates of verb processing. The results revealed significantly better comprehension of concrete than abstract verbs, aligning with the existing aphasiological literature on noun processing. In addition, the patients performed better during verb comprehension than verb production. Lesion-symptom correlational analyses revealed common areas that support processing of concrete and abstract verbs, including the left anterior temporal lobe, posterior supramarginal gyrus and superior lateral occipital cortex. A direct contrast between them revealed additional regions with graded differences. Specifically, the left frontal regions were associated with processing abstract verbs; whereas, the left posterior temporal and occipital regions were associated with processing concrete verbs. Moreover, overlapping and distinct neural correlates were identified in association with the comprehension and production of concrete verbs. These patient findings align with data from

  5. Using principal component analysis to capture individual differences within a unified neuropsychological model of chronic post-stroke aphasia: Revealing the unique neural correlates of speech fluency, phonology and semantics.

    Science.gov (United States)

    Halai, Ajay D; Woollams, Anna M; Lambon Ralph, Matthew A

    2017-01-01

    Individual differences in the performance profiles of neuropsychologically-impaired patients are pervasive yet there is still no resolution on the best way to model and account for the variation in their behavioural impairments and the associated neural correlates. To date, researchers have generally taken one of three different approaches: a single-case study methodology in which each case is considered separately; a case-series design in which all individual patients from a small coherent group are examined and directly compared; or, group studies, in which a sample of cases are investigated as one group with the assumption that they are drawn from a homogenous category and that performance differences are of no interest. In recent research, we have developed a complementary alternative through the use of principal component analysis (PCA) of individual data from large patient cohorts. This data-driven approach not only generates a single unified model for the group as a whole (expressed in terms of the emergent principal components) but is also able to capture the individual differences between patients (in terms of their relative positions along the principal behavioural axes). We demonstrate the use of this approach by considering speech fluency, phonology and semantics in aphasia diagnosis and classification, as well as their unique neural correlates. PCA of the behavioural data from 31 patients with chronic post-stroke aphasia resulted in four statistically-independent behavioural components reflecting phonological, semantic, executive-cognitive and fluency abilities. Even after accounting for lesion volume, entering the four behavioural components simultaneously into a voxel-based correlational methodology (VBCM) analysis revealed that speech fluency (speech quanta) was uniquely correlated with left motor cortex and underlying white matter (including the anterior section of the arcuate fasciculus and the frontal aslant tract), phonological skills with

  6. 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 ...

  7. 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.

  8. Semantic Feature Analysis Treatment for Anomia of Two Nonfluent Persian-Speaking Aphasic Patients

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    Mozhgan Asadi

    2014-09-01

    Full Text Available Objectives: Semantic Feature Analysis was designed to improve lexical retrieval of aphasic patients via activation of semantic networks of the words. In this approach, the anomic patients are cured with semantic information to assist oral naming. The purpose of this study was to examine the effects of Semantic Feature Analysis treatment on anomia of two nonfluent aphasic patients. Methods: A single-subject study with ABA design was applied to two Persian-speaking patients with chronic nonfluent aphasia. Assessment, baseline, ntervention and maintenance phases were carried out respectively during 6 weeks. A picture naming task which was made up of pictures with high name- agreement comprising 12 target, 18 non-treated control and 5 easy words was used for probes and intervention. Intervention was performed in 5 successive days, 60 minutes per session. Descriptive statistics, level, trend & slope analyses, C and d statistics were used for data analysis. Results: Both participants revealed statistically significant improvements in naming target words. Some generalizations to control words was also occured. A minimal decrease in naming of target words was observed in maintenance phase but the naming ability was still above the baseline. The therapy maintenance effect size for both patients were obtained as medium. Discussion: The findings of the current study seems to confirm Semantic Feature Analysis as an effective intervention for improving naming ability of Persian-speaking aphasic patients.

  9. 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...

  10. 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)

  11. A Case Report of A Persian Patient with Crossed Aphasia: Agrammatism after Right Hemisphere Lesion

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    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.

  12. Comprehension of derivational morphemes in words and pseudo-words in semantic variant primary progressive aphasia

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    Noémie Auclair-Ouellet

    2014-04-01

    The results of the word condition alone cannot rule out the possibility that errors in the svPPA group were caused by difficulty in understanding words rather than in processing derivational morphemes. However, the lexical context provided in this condition did not speed-up the performance of svPPA individuals as it did in the control group. Most importantly, results from the pseudo-word condition showed that in the svPPA group, the association between the morpheme and its meaning was not performed as readily and reliably as in the control group. These results support the involvement of semantic memory in morphological processing.

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

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    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

  14. Semantic Priming for Coordinate Distant Concepts in Alzheimer's Disease Patients

    Science.gov (United States)

    Perri, R.; Zannino, G. D.; Caltagirone, C.; Carlesimo, G. A.

    2011-01-01

    Semantic priming paradigms have been used to investigate semantic knowledge in patients with Alzheimer's disease (AD). While priming effects produced by prime-target pairs with associative relatedness reflect processes at both lexical and semantic levels, priming effects produced by words that are semantically related but not associated should…

  15. 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

  16. Cerebral blood flow and metabolism in patients with aphasia due to basal ganglionic lesion

    Energy Technology Data Exchange (ETDEWEB)

    Kitamura, Shin; Kato, Toshiaki; Ujike, Takashi; Kuroki, Soemu; Terashi, Akiro

    1987-03-01

    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/sub 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/sub 2/, and oxygen extraction fraction were measured by the positron emission tomography using /sup 15/O/sub 2/, C/sup 15/O/sub 2/ inhalation technique. In addition to reduction of CBF and CMRO/sub 2/ in the basal ganglionic region, CBF and CMRO/sub 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/sub 2/ decreased in the basal ganglionic region and the left temporal cortex. In a globally aphasic patient, marked reduction of CBF and CMRO/sub 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/sub 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.

  17. 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

  18. Context-sensitive grapheme-phoneme conversion rules impairment in the semantic variant of primary progressive aphasia.

    Directory of Open Access Journals (Sweden)

    Joël Macoir

    2014-04-01

    Results. As shown in Table 1, NG and ND's performance was well preserved in tasks with words and nonwords with n-cGPC rules. However, ND was impaired in all tasks with c-sGPC rules, whilst NG's performance was affected for c-sGPC stimuli only in the rhyming task. Discussion. The processing of regular words and nonwords is assumed to be unimpaired in svPPA since their production do not necessary rely on the lexical-semantic route of reading and spelling. In the present study, this hypothesis was confirmed for n-cGPC rules only. However, both patients presented with difficulty in c-sGPC stimuli. This pattern of performance, never reported before in svPPA, questions the possible role of semantic memory in the reading and spelling of stimuli comprising consistent but contextual GPC rules.

  19. Audiovisual Integration of Speech in a Patient with Broca’s Aphasia

    Directory of Open Access Journals (Sweden)

    Tobias Søren Andersen

    2015-04-01

    Full Text Available Lesions to Broca’s area cause aphasia characterised 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.

  20. Audiovisual Integration of Speech in a Patient with Broca’s Aphasia

    DEFF Research Database (Denmark)

    Andersen, Tobias; Starrfelt, Randi

    2015-01-01

    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......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......'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...

  1. 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...

  2. Effects of Dual Transcranial Direct Current Stimulation for Aphasia in Chronic Stroke Patients

    OpenAIRE

    Lee, Seung Yeol; Cheon, Hee-Jung; Yoon, Kyoung Jae; Chang, Won Hyuk; Kim, Yun-Hee

    2013-01-01

    Objective To investigate any additional effect of dual transcranial direct current stimulation (tDCS) compared with single tDCS in chronic stroke patients with aphasia. Methods Eleven chronic stroke patients (aged 52.6?13.4 years, nine men) with aphasia were enrolled. Single anodal tDCS was applied over the left inferior frontal gyrus (IFG) and a cathodal electrode was placed over the left buccinator muscle. Dual tDCS was applied as follows: 1) anodal tDCS over the left IFG and cathodal tDCS ...

  3. Audiovisual Integration of Speech in a Patient with Broca’s Aphasia

    DEFF Research Database (Denmark)

    Andersen, Tobias; Starrfelt, Randi

    2015-01-01

    '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...

  4. 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.

  5. Variations in the Presentation of Aphasia in Patients with Closed Head Injuries

    Directory of Open Access Journals (Sweden)

    Dara Oliver Kavanagh

    2010-01-01

    Full Text Available Impairments of speech and language are important consequences of head injury as they compromise interaction between the patient and others. A large spectrum of communication deficits can occur. There are few reports in the literature of aphasia following closed head injury despite the common presentation of closed head injury. Herein we report two cases of closed head injuries with differing forms of aphasia. We discuss their management and rehabilitation and present a detailed literature review on the topic. In a busy acute surgical unit one can dismiss aphasia following head injury as behaviour related to intoxication. Early recognition with prolonged and intensive speech and language rehabilitation therapy yields a favourable outcome as highlighted in our experience. These may serve as a reference for clinicians faced with this unusual outcome.

  6. Variations in the presentation of aphasia in patients with closed head injuries.

    LENUS (Irish Health Repository)

    Kavanagh, Dara Oliver

    2012-01-31

    Impairments of speech and language are important consequences of head injury as they compromise interaction between the patient and others. A large spectrum of communication deficits can occur. There are few reports in the literature of aphasia following closed head injury despite the common presentation of closed head injury. Herein we report two cases of closed head injuries with differing forms of aphasia. We discuss their management and rehabilitation and present a detailed literature review on the topic. In a busy acute surgical unit one can dismiss aphasia following head injury as behaviour related to intoxication. Early recognition with prolonged and intensive speech and language rehabilitation therapy yields a favourable outcome as highlighted in our experience. These may serve as a reference for clinicians faced with this unusual outcome.

  7. 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

  8. Effects of Syntactic Complexity, Semantic Reversibility, and Explicitness on Discourse Comprehension in Persons with Aphasia and in Healthy Controls

    Science.gov (United States)

    Levy, Joshua; Hoover, Elizabeth; Waters, Gloria; Kiran, Swathi; Caplan, David; Berardino, Alex; Sandberg, Chaleece

    2012-01-01

    Purpose: Prior studies of discourse comprehension have concluded that the deficits of persons with aphasia (PWA) in syntactically based comprehension of sentences in isolation are not predictive of deficits in comprehension of sentences in discourse (Brookshire & Nicholas, 1984; Caplan & Evans, 1990). However, these studies used semantically…

  9. Motor recovery in post-stroke patients with aphasia: the role of specific linguistic abilities.

    Science.gov (United States)

    Ginex, Valeria; Veronelli, Laura; Vanacore, Nicola; Lacorte, Eleonora; Monti, Alessia; Corbo, Massimo

    2017-09-01

    Aphasia is a serious consequence of stroke but aphasics patients have been routinely excluded from participation in some areas of stroke research. To assess the role of specific linguistic and non-verbal cognitive abilities on the short-term motor recovery of patients with aphasia due to first-ever stroke to the left hemisphere after an intensive rehabilitation treatment. 48 post-acute aphasic patients, who underwent physiotherapy and speech language therapy, were enrolled for this retrospective cohort-study. Four types of possible predictive factors were taken into account: clinical variables, functional status, language and non-verbal cognitive abilities. The motor FIM at discharge was used as the main dependent variable. Patients were classified as follows: 6 amnestic, 9 Broca's, 7 Wernicke's, and 26 global aphasics. Motor FIM at admission (p = 0.003) and at discharge (p = 0.042), all linguistic subtests of Aachener AphasieTest (p = 0.001), and non-verbal reasoning abilities (Raven's CPM, p = 0.006) resulted significantly different across different types of aphasia. Post-hoc analyses showed differences only between global aphasia and the other groups. A Multiple Linear Regression shows that admission motor FIM (p = 0.001) and Token test (p = 0.040), adjusted for clinical, language, and non-verbal reasoning variables, resulted as independent predictors of motor FIM scores at discharge, while Raven's CPM resulted close to statistical significance. Motor function at admission resulted as the variable that most affects the motor recovery of post-stroke patients with aphasia after rehabilitation. A linguistic test requiring also non-linguistic abilities, including attention and working memory (i.e. Token test) is an independent predictor as well.

  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. Measurement of regional cerebral blood flow with single photon emission computed tomography in patients with aphasia

    International Nuclear Information System (INIS)

    Reischies, F.M.; Muellmann, A.; Hedde, J.P.; Freie Univ. Berlin; Christe, W.

    1984-01-01

    5 cases are demonstrated of patients with aphasia whose brain perfusion as measured regionally by SPECT using 133 Xe was correlated to the lesions seen in the CT study. Perfusion reductions exceeded the CT visible lesions, such as, that in cortical lesions perfusion in the region of basal ganglia is diminished and vice versa. The findings are discussed in relation to recent work on brain perfusion and metabolism. (orig.) [de

  12. [Functional neuroimaging of the brain structures associated with language in healthy individuals and patients with post-stroke aphasia].

    Science.gov (United States)

    Alferova, V V; Mayorova, L A; Ivanova, E G; Guekht, A B; Shklovskij, V M

    2017-01-01

    The introduction of non-invasive functional neuroimaging techniques such as functional magnetic resonance imaging (fMRI), in the practice of scientific and clinical research can increase our knowledge about the organization of cognitive processes, including language, in normal and reorganization of these cognitive functions in post-stroke aphasia. The article discusses the results of fMRI studies of functional organization of the cortex of a healthy adult's brain in the processing of various voice information as well as the main types of speech reorganization after post-stroke aphasia in different stroke periods. The concepts of 'effective' and 'ineffective' brain plasticity in post-stroke aphasia were considered. It was concluded that there was an urgent need for further comprehensive studies, including neuropsychological testing and several complementary methods of functional neuroimaging, to develop a phased treatment plan and neurorehabilitation of patients with post-stroke aphasia.

  13. Transcranial direct-current stimulation induced in stroke patients with aphasia: a prospective experimental cohort study

    Directory of Open Access Journals (Sweden)

    Michele Devido Santos

    Full Text Available 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 chronic aphasia received 10 transcranial direct current stimulation sessions lasting 20 minutes each on consecutive days, using a current of 2 mA. The anode was positioned over the supraorbital area and the cathode over the contralateral motor cortex. The following variables were analyzed before and after the 10 neuromodulation sessions: oral language comprehension, copying, dictation, reading, writing, naming and verbal fluency. RESULTS: There were no adverse effects in the study. We found statistically significant differences from before to after stimulation in relation to simple sentence comprehension (P = 0.034, naming (P = 0.041 and verbal fluency for names of animals (P = 0.038. Improved scores for performing these three tasks were seen after stimulation. CONCLUSIONS: We observed that excitability of the primary motor cortex through transcranial direct current stimulation was associated with effects on different aspects of language. This can contribute towards future testing in randomized controlled trials.

  14. Transcranial direct-current stimulation induced in stroke patients with aphasia: a prospective experimental cohort study.

    Science.gov (United States)

    Santos, Michele Devido; Gagliardi, Rubens José; Mac-Kay, Ana Paula Machado Goyano; Boggio, Paulo Sergio; Lianza, Roberta; Fregni, Felipe

    2013-01-01

    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. Prospective cohort study developed in a public university hospital. Nineteen patients with chronic aphasia received 10 transcranial direct current stimulation sessions lasting 20 minutes each on consecutive days, using a current of 2 mA. The anode was positioned over the supraorbital area and the cathode over the contralateral motor cortex. The following variables were analyzed before and after the 10 neuromodulation sessions: oral language comprehension, copying, dictation, reading, writing, naming and verbal fluency. There were no adverse effects in the study. We found statistically significant differences from before to after stimulation in relation to simple sentence comprehension (P = 0.034), naming (P = 0.041) and verbal fluency for names of animals (P = 0.038). Improved scores for performing these three tasks were seen after stimulation. We observed that excitability of the primary motor cortex through transcranial direct current stimulation was associated with effects on different aspects of language. This can contribute towards future testing in randomized controlled trials.

  15. 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.

  16. A review of Constraint-Induced Therapy applied to aphasia rehabilitation in stroke patients

    Directory of Open Access Journals (Sweden)

    Joana Bisol Balardin

    Full Text Available Abstract Constraint-induced aphasia therapy (CIAT is an intensive therapy model based on the forced use of verbal oral language as the sole channel of communication, while any alternative communication mode such as writing, gesturing or pointing are prevented. Objectives: This critical review involved the analysis of studies examining CIAT applied to stroke patients. Methods and Results: Using keywords, the Medline database was searched for relevant studies published between 2001 and 2008 (Medline 2001-2008. The critical evaluation of the articles was based on the classifications described by the ASNS (Cicerone adaptation. Two studies were categorized as level Ia, two as level II and one study as level IV. Conclusions: These recommendations should be interpreted with caution, given the small number of studies involved, but serve as a guideline for future studies in aphasia therapy.

  17. Patient-reported changes in communication after computer-based script training for aphasia.

    Science.gov (United States)

    Manheim, Larry M; Halper, Anita S; Cherney, Leora

    2009-04-01

    To evaluate changes in patient-reported communication difficulty after a home-based, computer-delivered intervention designed to improve conversational skills in adults with aphasia. Delayed treatment design with baseline, preintervention, postintervention, and follow-up observations. Outpatient rehabilitation. Twenty subjects with chronic aphasia. Sessions with the speech-language pathologist to develop personally relevant conversational scripts, followed by 9 weeks of intensive home practice using a computer program loaded on a laptop, and weekly monitoring visits with the speech-language pathologist. Communication Difficulty (CD) subscale of the Burden of Stroke Scale (BOSS). The intervention resulted in a statistically and clinically significant decrease of 6.79 points (P=.038) in the CD subscale of the BOSS during the intervention, maintained during the follow-up period. The findings of this study provide positive albeit preliminary and limited support for the use of a home-based, computer-delivered language intervention program for improving patient-reported communication outcomes in adults with chronic aphasia. Additional research will be required to examine the efficacy and effectiveness of this intervention.

  18. Personality differences among patients with chronic aphasia predict improvement in speech-language therapy.

    Science.gov (United States)

    Votruba, Kristen L; Rapport, Lisa J; Whitman, R Douglas; Johnson, Alex; Langenecker, Scott

    2013-01-01

    Negative affectivity and neurocognitive deficits including executive dysfunction have been shown to be detrimental to rehabilitation therapies. However, research on the relationship between neuropsychological deficits and improvement in speech-language therapy (SLT) for aphasia is sparse. To examine the relationships among neurocognitive and psychological functioning and improvement in SLT following aphasia due to stroke. Fifty patients who were ≥ 9 months post stroke and enrolled in outpatient SLT to treat aphasia participated. Using standard language assessment measures, the authors evaluated language functioning at initiation of the study and after participants completed various SLT protocols. Executive functioning, visuospatial skills, attention, and memory also were assessed to provide indices of convergent and discriminant validity. Participants' mood and affectivity were evaluated by self-report, and their functional abilities and recovery of function since stroke were assessed via caregiver report. A multiple regression model testing the combined powers of neurocognitive and psychological variables was significant (P = .004, R2 = 0.33), with psychological and neurocognitive functioning accounting for 15% of the variance in relative language change beyond that accounted for by stroke severity and gross cognitive functioning. Negative affectivity expressed on the Positive and Negative Affectivity Scale made unique contributions to the model. Improvement in SLT is substantially related to neurocognitive and psychological functioning, particularly affectivity. Assessment of these characteristics may assist in identifying patients who are likely to improve and in tailoring treatment programs to yield optimal outcomes.

  19. 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…

  20. Patient-centered communication strategies for patients with aphasia: discrepancies between what patients want and what physicians do.

    Science.gov (United States)

    Morris, Megan A; Clayman, Marla L; Peters, Kaitlin J; Leppin, Aaron L; LeBlanc, Annie

    2015-04-01

    Communication during clinical encounters can be challenging with patients with communication disabilities. Physicians have the potential to positively affect the encounter by using communication strategies that engage the patient in patient-centered communication. We engaged patients and their physicians in defining their preferences for patient-centered communication strategies, then evaluated the use of the identified strategies during observed clinical encounters. We video-recorded 25 clinical encounters with persons with aphasia. All encounters were previously scheduled with community physicians and a companion was present. Following each encounter, physicians completed a brief questionnaire and the person with aphasia and his or her companion participated in a video elicitation interview. While many of the communication strategies identified and described by physicians, patients and companions were similar, patients and companions identified three additional key communication strategies. These strategies included (1) using visual aids, (2) writing down key words while speaking, and (3) using gestures. In the video recorded clinical encounters, no physicians wrote down key words while speaking and only one used a visual aid during the clinical encounter. The frequency with which physicians used gestures varied greatly, even within the same patient, suggesting the use of gestures was independent of patient or companion characteristics. To maximize patient-centered communication with patients with communication disabilities, physicians should use "disability-specific" communication strategies. Our study suggests that physicians should routinely ask patients and companions about communication preferences and then incorporate identified communication strategies into their communication style. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Selective verbal recognition memory impairments are associated with atrophy of the language network in non-semantic variants of primary progressive aphasia.

    Science.gov (United States)

    Nilakantan, Aneesha S; Voss, Joel L; Weintraub, Sandra; Mesulam, M-Marsel; Rogalski, Emily J

    2017-06-01

    Primary progressive aphasia (PPA) is clinically defined by an initial loss of language function and preservation of other cognitive abilities, including episodic memory. While PPA primarily affects the left-lateralized perisylvian language network, some clinical neuropsychological tests suggest concurrent initial memory loss. The goal of this study was to test recognition memory of objects and words in the visual and auditory modality to separate language-processing impairments from retentive memory in PPA. Individuals with non-semantic PPA had longer reaction times and higher false alarms for auditory word stimuli compared to visual object stimuli. Moreover, false alarms for auditory word recognition memory were related to cortical thickness within the left inferior frontal gyrus and left temporal pole, while false alarms for visual object recognition memory was related to cortical thickness within the right-temporal pole. This pattern of results suggests that specific vulnerability in processing verbal stimuli can hinder episodic memory in PPA, and provides evidence for differential contributions of the left and right temporal poles in word and object recognition memory. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Anatomic, Clinical, and Neuropsychological Correlates of Spelling Errors in Primary Progressive Aphasia

    Science.gov (United States)

    Shim, HyungSub; Hurley, Robert S.; Rogalski, Emily; Mesulam, M.-Marsel

    2012-01-01

    This study evaluates spelling errors in the three subtypes of primary progressive aphasia (PPA): agrammatic (PPA-G), logopenic (PPA-L), and semantic (PPA-S). Forty-one PPA patients and 36 age-matched healthy controls were administered a test of spelling. The total number of errors and types of errors in spelling to dictation of regular words,…

  3. 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

  4. 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)

  5. 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

  6. A Randomized Controlled Trial on Very Early Speech and Language Therapy in Acute Stroke Patients with Aphasia

    Directory of Open Access Journals (Sweden)

    A.C. Laska

    2011-07-01

    Full Text Available Background: Aphasia affects one third of acute stroke patients. There is a considerable spontaneous recovery in aphasia, but impaired communication ability remains a great problem. Communication difficulties are an impediment to rehabilitation. Early treatment of the language deficits leading to increased communication ability would improve rehabilitation. The aim of this study is to elucidate the efficacy of very early speech and language therapy (SLT in acute stroke patients with aphasia. Methods: A prospective, open, randomized, controlled trial was carried out with blinded endpoint evaluation of SLT, starting within 2 days of stroke onset and lasting for 21 days. 123 consecutive patients with acute, first-ever ischemic stroke and aphasia were randomized. The SLT treatment was Language Enrichment Therapy, and the aphasia tests used were the Norsk grunntest for afasi (NGA and the Amsterdam-Nijmegen everyday language test (ANELT, both performed by speech pathologists, blinded for randomization. Results: The primary outcome, as measured by ANELT at day 21, was 1.3 in the actively treated patient group and 1.2 among controls. NGA led to similar results in both groups. Patients with a higher level of education (>12 years improved more on ANELT by day 21 than those with Conclusions: Very early intensive SLT with the Language Enrichment Therapy program over 21 days had no effect on the degree of aphasia in unselected acute aphasic stroke patients. In aphasic patients with more fluency, SLT resulted in a significant improvement as compared to controls. A higher educational level of >12 years was beneficial.

  7. Crossed aphasia following cerebral infarction in a right-handed patient with atypical cerebral language dominance.

    Science.gov (United States)

    Tan, Xiaoping; Guo, Yang; Dun, Saihong; Sun, Hongzan

    2018-05-18

    Crossed aphasia (CA), usually referred to as an acquired language disturbance, is caused by a lesion in the cerebral hemisphere ipsilateral to the dominant hand, and the exact mechanism is not clear. The development of handedness is influenced by education and training and the impact of habitualization, while language is more susceptible to the impact of speech habits, and it is not absolutely accurate to judge cerebral language dominance by the degree of hand preference. We describe a case of CA after right hemispheric stroke in a right-handed patient with atypical language dominance and attempt to analyze the mechanism of CA based on functional imaging methods, including arterial spin labeling (ASL) and positron emission tomography/magnetic resonance imaging (PET-MRI). Brain MRI at 24 h after admission showed a large cerebral infarction in the right cerebral hemisphere, including the posteroinferior part of Broca's area in the right frontal lobe, the right temporal lobe, and the right occipital lobe. The patient exhibited a non-fluent aphasia on a standard language test (the Aphasia Battery of Chinese [ABC]) performed on the 7th day after onset. Thus, atypical language dominance was suspected. One week after admission, ASL imaging showed high perfusion in the infarct core zone and low perfusion in the left cerebellar hemisphere. Two months later, PET/MRI demonstrated low metabolism in the posterior frontal lobe, temporal lobe, temporal occipital junction area, and the right basal ganglia. The findings suggest that the patient has right-sided cerebral language dominance, or that both hemispheres have linguistic functions. Not all patients show linguistic capabilities on the side opposite hand preference. The language dominance should be predicted by a combination of clinical manifestations and functional imaging techniques.

  8. 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

  9. 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…

  10. 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.

  11. Speech entrainment enables patients with Broca’s aphasia to produce fluent speech

    Science.gov (United States)

    Hubbard, H. Isabel; Hudspeth, Sarah Grace; Holland, Audrey L.; Bonilha, Leonardo; Fromm, Davida; Rorden, Chris

    2012-01-01

    A distinguishing feature of Broca’s aphasia is non-fluent halting speech typically involving one to three words per utterance. Yet, despite such profound impairments, some patients can mimic audio-visual speech stimuli enabling them to produce fluent speech in real time. We call this effect ‘speech entrainment’ and reveal its neural mechanism as well as explore its usefulness as a treatment for speech production in Broca’s aphasia. In Experiment 1, 13 patients with Broca’s aphasia were tested in three conditions: (i) speech entrainment with audio-visual feedback where they attempted to mimic a speaker whose mouth was seen on an iPod screen; (ii) speech entrainment with audio-only feedback where patients mimicked heard speech; and (iii) spontaneous speech where patients spoke freely about assigned topics. The patients produced a greater variety of words using audio-visual feedback compared with audio-only feedback and spontaneous speech. No difference was found between audio-only feedback and spontaneous speech. In Experiment 2, 10 of the 13 patients included in Experiment 1 and 20 control subjects underwent functional magnetic resonance imaging to determine the neural mechanism that supports speech entrainment. Group results with patients and controls revealed greater bilateral cortical activation for speech produced during speech entrainment compared with spontaneous speech at the junction of the anterior insula and Brodmann area 47, in Brodmann area 37, and unilaterally in the left middle temporal gyrus and the dorsal portion of Broca’s area. Probabilistic white matter tracts constructed for these regions in the normal subjects revealed a structural network connected via the corpus callosum and ventral fibres through the extreme capsule. Unilateral areas were connected via the arcuate fasciculus. In Experiment 3, all patients included in Experiment 1 participated in a 6-week treatment phase using speech entrainment to improve speech production

  12. Changes in Resting-State Connectivity following Melody-Based Therapy in a Patient with Aphasia

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    Tali Bitan

    2018-01-01

    Full Text Available 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 injuries (TBI more than three years earlier received 48 sessions of melody-based intervention. Behavioral measures improved and were maintained at the 8-week posttreatment follow-up. Resting-state fMRI data collected before and after treatment showed an increase in connectivity between motor speech control areas (bilateral supplementary motor areas and insulae and RH language areas (inferior frontal gyrus pars triangularis and pars opercularis. This change, which was specific for the RH, was greater than changes in a baseline interval measured before treatment. No changes in RH connectivity were found in a matched control TBI patient scanned at the same intervals. These results are compatible with a compensatory role for RH language areas following melody-based intervention. They further suggest that this therapy intervenes at the level of the interface between language areas and speech motor control areas necessary for language production.

  13. Primary progressive aphasia patients evaluated using diffusion tensor imaging and voxel based volumetry-preliminary results

    Directory of Open Access Journals (Sweden)

    Fábio Pascotto de Oliveira

    2011-06-01

    Full Text Available There are individuals who have a progressive language deficit without presenting cognitive deficits in other areas. One of the diseases related to this presentation is primary progressive aphasia (PPA. OBJECTIVE: Identify by means of diffusion tensor imaging (DTI and measurements of cortical volume, brain areas that lead to dysphasia when presenting signs of impaired connectivity or reduced volume. METHOD: Four patients with PPA were evaluated using DTI, and measurements of cortical volumes in temporal areas. These patients were compared with two normal volunteers. RESULTS: There is a trend to a difference in the number and volume of related fibers between control group and patients with PPA. Comparing cortical volumes in temporal areas between groups yielded a trend to a smaller volume in PPA patients. CONCLUSION: Patients with PPA have a trend to impairment in cortical and subcortical levels regarding relevant areas.

  14. 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.

  15. The study of correlation between neurological function rehabilitation and dynamic change of rCBF in patients with aphasia

    International Nuclear Information System (INIS)

    Liu Haibo; Song Debiao; Kong Jun; Lv Junfeng; Tian Jing

    2004-01-01

    Objective: To evaluate the result of SPECT and CT in the patients with acute cerebral infarction and further more, to study the correlation between aphasia and dynamic change of regional cerebral blood flow (rCBF) in patients. Methods: Thirty cases with cerebral infarction of left basal ganglia were divided into two groups according to the presence or absence of aphasia; the vision and semi-ration analysis were used in photograph reading and region of interest (ROI) technology, respectively. Results: 1) Group A: there was a low rCBF in left basal ganglia, the dimension was larger than that in CT. There was also a low rCBF in frontal lobe and temporal lobe. Group B: there was only a low rCBF in left basal ganglia. 2) There were 6 cases with crossed cerebellar diaschisis (CCD) in the patients with aphasia. 3) The comparison about aphasia: the rCBF was higher in language center in the patients with improved language function than that in the patients without language function improvement and the difference between them was significant. Conclusions: The neurological function can be indirectly reflected through the study of the rCBF. At the same time, it may conduce to the locating of the damage in the central nervous system and to the differentiation diagnosis. It may also conduce to the programming of the therapeutic course and prognostication. (authors)

  16. 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.

  17. 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.

  18. Cognitive neuropsychological analysis of differential reading and spelling disorder mechanisms in a patient with aphasia.

    Science.gov (United States)

    Hashimoto, Kosei; Uno, Akira

    2016-06-01

    The purpose of this study was to determine if differential reading and spelling mechanisms were involved in a Japanese patient with aphasia. In our case, the patient scored low on all of the administered reading tasks, suggesting that both the reading lexical and non-lexical routes were impaired. In contrast, his writing-to-dictation score for Kana nonwords was high, suggesting that the spelling non-lexical route was intact. However, the patient scored low on a writing-to-dictation task comprised of high-familiarity Kanji words. The spelling lexical route was thought to be impaired. Therefore, the mechanism(s) involved in reading and spelling may differ in this case.

  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. 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.

  1. Application of ERPs neuromarkers for assessment and treatment of a patient with chronic crossed aphasia after severe TBI and long-term coma – Case Report

    Directory of Open Access Journals (Sweden)

    Marzena Chantsoulis

    2017-03-01

    The application of ERP neuromarkers assists in the diagnosis, treatment, and academic success of an ambidextrous patient with chronic posttraumatic aphasia and sporadic ADHD. ERPs can be used to assess the functional brain changes induced by neurotherapeutical programmes

  2. Implementation of supported conversation for communication between nursing staff and in-hospital patients with aphasia

    DEFF Research Database (Denmark)

    Jensen, Lise Randrup; Løvholt, Annelise P.; Sørensen, Inger

    2015-01-01

    Background: Patients admitted with aphasia due to stroke may find it difficult to access information and participate in decision-making concerning their own treatment, care, and rehabilitation (O'Halloran, Worrall, & Hickson, 2012). An increased understanding of the importance of communicative...... available a set of shared communication tools. The present study reports the outcome of the training programme for nursing staff. Methods and Procedures: A stepwise adaptation and implementation procedure is described which led to the development of the guideline, tools, and training programme. A mixed......-methods design (Clarke, 2009) was used to measure changes pre- and post-training for nursing staff, including assessment of quantitative and qualitative outcomes. All nurses and nursing assistants received a questionnaire before and after their participation in an SCA workshop, and seven members from the nursing...

  3. 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.

  4. Preserved semantic priming effect in alexia.

    Science.gov (United States)

    Mimura, M; Goodglass, H; Milberg, W

    1996-09-01

    BH, a left-handed patient with alexia and nonfluent aphasia, was presented with a lexical-decision task in which words and pronounceable pseudowords were preceded by semantically related or unrelated picture primes (Experiment 1). In Experiment 2, BH was given an explicit reading task using the word lists from Experiment 1. Performance on Experiment 2 disclosed severe reading deficits in both oral reading and semantic matching of the words to pictures. However, in Experiment 1, BH demonstrated a significant semantic priming effect, responding more accurately and more quickly to words preceded by related primes than by unrelated primes. The present results suggest that even in a patient with severe alexia, implicit access to semantic information can be preserved in the absence of explicit identification. The possibility of categorical gradient in implicit activation (living vs. nonliving) in BH was also discussed, which, however, needs to be clarified in the further investigation.

  5. Comparison of the recovery patterns of language and cognitive functions in patients with post-traumatic language processing deficits and in patients with aphasia following a stroke.

    Science.gov (United States)

    Vukovic, Mile; Vuksanovic, Jasmina; Vukovic, Irena

    2008-01-01

    In this study we investigated the recovery patterns of language and cognitive functions in patients with post-traumatic language processing deficits and in patients with aphasia following a stroke. The correlation of specific language functions and cognitive functions was analyzed in the acute phase and 6 months later. Significant recovery of the tested functions was observed in both groups. However, in patients with post-traumatic language processing deficits the degree of recovery of most language functions and some cognitive functions was higher. A significantly greater correlation was revealed within language and cognitive functions, as well as between language functions and other aspects of cognition in patients with post-traumatic language processing deficits than in patients with aphasia following a stroke. Our results show that patients with post-traumatic language processing deficits have a different recovery pattern and a different pattern of correlation between language and cognitive functions compared to patients with aphasia following a stroke. (1) Better understanding of the differences in recovery of language and cognitive functions in patients who have suffered strokes and those who have experienced traumatic brain injury. (2) Better understanding of the relationship between language and cognitive functions in patients with post-traumatic language processing deficits and in patients with aphasia following a stroke. (3) Better understanding of the factors influencing recovery.

  6. 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.

  7. Type-specific proactive interference in patients with semantic and phonological STM deficits.

    Science.gov (United States)

    Harris, Lara; Olson, Andrew; Humphreys, Glyn

    2014-01-01

    Prior neuropsychological evidence suggests that semantic and phonological components of short-term memory (STM) are functionally and neurologically distinct. The current paper examines proactive interference (PI) from semantic and phonological information in two STM-impaired patients, DS (semantic STM deficit) and AK (phonological STM deficit). In Experiment 1 probe recognition tasks with open and closed sets of stimuli were used. Phonological PI was assessed using nonword items, and semantic and phonological PI was assessed using words. In Experiment 2 phonological and semantic PI was elicited by an item recognition probe test with stimuli that bore phonological and semantic relations to the probes. The data suggested heightened phonological PI for the semantic STM patient, and exaggerated effects of semantic PI in the phonological STM case. The findings are consistent with an account of extremely rapid decay of activated type-specific representations in cases of severely impaired phonological and semantic STM.

  8. Comparison of the Recovery Patterns of Language and Cognitive Functions in Patients with Post-Traumatic Language Processing Deficits and in Patients with Aphasia Following a Stroke

    Science.gov (United States)

    Vukovic, Mile; Vuksanovic, Jasmina; Vukovic, Irena

    2008-01-01

    In this study we investigated the recovery patterns of language and cognitive functions in patients with post-traumatic language processing deficits and in patients with aphasia following a stroke. The correlation of specific language functions and cognitive functions was analyzed in the acute phase and 6 months later. Significant recovery of the…

  9. How Justice Can Affect Jury Training Abstract Words Promotes Generalization to Concrete Words in Patients with Aphasia

    Science.gov (United States)

    Sandberg, Chaleece; Kiran, Swathi

    2014-01-01

    Developing language treatments that not only improve trained items but also promote generalization to untrained items is a major focus in aphasia research. This study is a replication and extension of previous work that found that training abstract words in a particular context-category promotes generalization to concrete words but not vice versa (Kiran, Sandberg, & Abbott, 2009). Twelve persons with aphasia (5 female) with varying types and degrees of severity participated in a generative naming treatment based on the complexity account of treatment efficacy (CATE; Thompson, Shapiro, Kiran, & Sobecks, 2003). All participants were trained to generate abstract words in a particular context-category by analyzing the semantic features of the target words. Two other context-categories were used as controls. Ten of the twelve participants improved on the trained abstract words in the trained context-category. Eight of the ten participants who responded to treatment also generalized to concrete words in the same context-category. These results suggest that this treatment is both efficacious and efficient. We discuss possible mechanisms of training and generalization effects. PMID:24805853

  10. Distinct loci of lexical and semantic access deficits in aphasia: Evidence from voxel-based lesion-symptom mapping and diffusion tensor imaging.

    Science.gov (United States)

    Harvey, Denise Y; Schnur, Tatiana T

    2015-06-01

    Naming pictures and matching words to pictures belonging to the same semantic category negatively affects language production and comprehension. By most accounts, semantic interference arises when accessing lexical representations in naming (e.g., Damian, Vigliocco, & Levelt, 2001) and semantic representations in comprehension (e.g., Forde & Humphreys, 1997). Further, damage to the left inferior frontal gyrus (LIFG), a region implicated in cognitive control, results in increasing semantic interference when items repeat across cycles in both language production and comprehension (Jefferies, Baker, Doran, & Lambon Ralph, 2007). This generates the prediction that the LIFG via white matter connections supports resolution of semantic interference arising from different loci (lexical vs semantic) in the temporal lobe. However, it remains unclear whether the cognitive and neural mechanisms that resolve semantic interference are the same across tasks. Thus, we examined which gray matter structures [using whole brain and region of interest (ROI) approaches] and white matter connections (using deterministic tractography) when damaged impact semantic interference and its increase across cycles when repeatedly producing and understanding words in 15 speakers with varying lexical-semantic deficits from left hemisphere stroke. We found that damage to distinct brain regions, the posterior versus anterior temporal lobe, was associated with semantic interference (collapsed across cycles) in naming and comprehension, respectively. Further, those with LIFG damage compared to those without exhibited marginally larger increases in semantic interference across cycles in naming but not comprehension. Lastly, the inferior fronto-occipital fasciculus, connecting the LIFG with posterior temporal lobe, related to semantic interference in naming, whereas the inferior longitudinal fasciculus (ILF), connecting posterior with anterior temporal regions related to semantic interference in

  11. Achievement report for fiscal 1998. Home rehabilitation system for aphasia patients; 1998 nendo seika hokokusho. Shitsugosho zaitaku rehabilitation shien system

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-05-01

    Development has been made on the element technologies for a home rehabilitation system for aphasia patients. First, studies were performed on an authoring procedure for aphasia patient training, and partial trial production and development were carried out on an authoring system for the training program formula. Then, studies were executed on a training simulation and analysis filter, and partial trial production and development were implemented on a home rehabilitation supporting and self-teaching system. Next, an input and output mechanism for voice signal processing was studied, and aphasia patient and caregiver human interface was partially fabricated on a trial basis. In addition, a remote rehabilitation communicating method was researched, and partial trial production was carried out on a remote rehabilitation evaluation and diagnosis support means. Finally, communication assisting means were researched, and a communication assisting system was partially produced on a trial basis. Good evaluation results were given on a demonstration system. Although partial indications were given on minute parts, practical agreement was obtained as a whole. Great expectation was given particularly on the remote rehabilitation system and the authoring system. (NEDO)

  12. 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.

  13. 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

  14. 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.

  15. Comparing the production of complex sentences in Persian patients with post-stroke aphasia and non-damaged people with normal speaking.

    Science.gov (United States)

    Mehri, Azar; Ghorbani, Askar; Darzi, Ali; Jalaie, Shohreh; Ashayeri, Hassan

    2016-01-05

    Cerebrovascular disease leading to stroke is the most common cause of aphasia. Speakers with agrammatic non-fluent aphasia have difficulties in production of movement-derived sentences such as passive sentences, topicalized constituents, and Wh-questions. To assess the production of complex sentences, some passive, topicalized and focused sentences were designed for patients with non-fluent Persian aphasic. Afterwards, patients' performance in sentence production was tested and compared with healthy non-damaged subjects. In this cross sectional study, a task was designed to assess the different types of sentences (active, passive, topicalized and focused) adapted to Persian structures. Seven Persian patients with post-stroke non-fluent agrammatic aphasia (5 men and 2 women) and seven healthy non-damaged subjects participated in this study. The computed tomography (CT) scan or magnetic resonance imaging (MRI) showed that all the patients had a single left hemisphere lesion involved middle cerebral artery (MCA), Broca`s area and in its white matter. In addition, based on Bedside version of Persian Western Aphasia Battery (P-WAB-1), all of them were diagnosed with moderate Broca aphasia. Then, the production task of Persian complex sentences was administered. There was a significant difference between four types of sentences in patients with aphasia [Degree of freedom (df) = 3, P Persian are very difficult to produce for patients with agrammatic non-fluent aphasia. It seems that sentences with A-movement are simpler for the patients than sentences involving A`-movement; since they include shorter movements in compare to topicalized and focused sentences.

  16. 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.

  17. Assessment of arcuate fasciculus with diffusion-tensor tractography may predict the prognosis of aphasia in patients with left middle cerebral artery infarcts

    International Nuclear Information System (INIS)

    Hosomi, Akiko; Nagakane, Yoshinari; Kuriyama, Nagato; Mizuno, Toshiki; Nakagawa, Masanori; Yamada, Kei; Nishimura, Tsunehiko

    2009-01-01

    It is often clinically difficult to assess the severity of aphasia in the earliest stage of cerebral infarction. A method enabling objective assessment of verbal function is needed for this purpose. We examined whether diffusion tensor (DT) tractography is of clinical value in assessing aphasia. Thirteen right-handed patients with left middle cerebral artery infarcts who were scanned within 2 days after stroke onset were enrolled in this study. Magnetic resonance data of ten control subjects were also examined by DT tractography. Based on the severity of aphasia at discharge, patients were divided into two groups: six patients in the aphasic group and seven in the nonaphasic group. Fractional anisotropy (FA) and number of arcuate fasciculus fibers were evaluated. Asymmetry index was calculated for both FA and number of fibers. FA values for the arcuate fasciculus fibers did not differ between hemispheres in either the patient groups or the controls. Number of arcuate fasciculus fibers exhibited a significant leftward asymmetry in the controls and the nonaphasic group but not in the aphasic group. Asymmetry index of number of fibers was significantly lower (rightward) in the aphasic group than in the nonaphasic (P = 0.015) and control (P = 0.005) groups. Loss of leftward asymmetry in number of AF fibers predicted aphasia at discharge with a sensitivity of 0.83 and specificity of 0.86. Asymmetry of arcuate fasciculus fibers by DT tractography may deserve to be assessed in acute infarction for predicting the fate of vascular aphasia. (orig.)

  18. Assessment of arcuate fasciculus with diffusion-tensor tractography may predict the prognosis of aphasia in patients with left middle cerebral artery infarcts

    Energy Technology Data Exchange (ETDEWEB)

    Hosomi, Akiko; Nagakane, Yoshinari; Kuriyama, Nagato; Mizuno, Toshiki; Nakagawa, Masanori [Kyoto Prefectural University of Medicine, Department of Neurology, Graduate School of Medical Science, Kyoto (Japan); Yamada, Kei; Nishimura, Tsunehiko [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science, Kyoto (Japan)

    2009-09-15

    It is often clinically difficult to assess the severity of aphasia in the earliest stage of cerebral infarction. A method enabling objective assessment of verbal function is needed for this purpose. We examined whether diffusion tensor (DT) tractography is of clinical value in assessing aphasia. Thirteen right-handed patients with left middle cerebral artery infarcts who were scanned within 2 days after stroke onset were enrolled in this study. Magnetic resonance data of ten control subjects were also examined by DT tractography. Based on the severity of aphasia at discharge, patients were divided into two groups: six patients in the aphasic group and seven in the nonaphasic group. Fractional anisotropy (FA) and number of arcuate fasciculus fibers were evaluated. Asymmetry index was calculated for both FA and number of fibers. FA values for the arcuate fasciculus fibers did not differ between hemispheres in either the patient groups or the controls. Number of arcuate fasciculus fibers exhibited a significant leftward asymmetry in the controls and the nonaphasic group but not in the aphasic group. Asymmetry index of number of fibers was significantly lower (rightward) in the aphasic group than in the nonaphasic (P = 0.015) and control (P = 0.005) groups. Loss of leftward asymmetry in number of AF fibers predicted aphasia at discharge with a sensitivity of 0.83 and specificity of 0.86. Asymmetry of arcuate fasciculus fibers by DT tractography may deserve to be assessed in acute infarction for predicting the fate of vascular aphasia. (orig.)

  19. Semantic memory is impaired in patients with unilateral anterior temporal lobe resection for temporal lobe epilepsy.

    Science.gov (United States)

    Lambon Ralph, Matthew A; Ehsan, Sheeba; Baker, Gus A; Rogers, Timothy T

    2012-01-01

    Contemporary clinical and basic neuroscience studies have increasingly implicated the anterior temporal lobe regions, bilaterally, in the formation of coherent concepts. Mounting convergent evidence for the importance of the anterior temporal lobe in semantic memory is found in patients with bilateral anterior temporal lobe damage (e.g. semantic dementia), functional neuroimaging and repetitive transcranial magnetic stimulation studies. If this proposal is correct, then one might expect patients with anterior temporal lobe resection for long-standing temporal lobe epilepsy to be semantically impaired. Such patients, however, do not present clinically with striking comprehension deficits but with amnesia and variable anomia, leading some to conclude that semantic memory is intact in resection for temporal lobe epilepsy and thus casting doubt over the conclusions drawn from semantic dementia and linked basic neuroscience studies. Whilst there is a considerable neuropsychological literature on temporal lobe epilepsy, few studies have probed semantic memory directly, with mixed results, and none have undertaken the same type of systematic investigation of semantic processing that has been conducted with other patient groups. In this study, therefore, we investigated the semantic performance of 20 patients with resection for chronic temporal lobe epilepsy with a full battery of semantic assessments, including more sensitive measures of semantic processing. The results provide a bridge between the current clinical observations about resection for temporal lobe epilepsy and the expectations from semantic dementia and other neuroscience findings. Specifically, we found that on simple semantic tasks, the patients' accuracy fell in the normal range, with the exception that some patients with left resection for temporal lobe epilepsy had measurable anomia. Once the semantic assessments were made more challenging, by probing specific-level concepts, lower frequency

  20. Development and standardization of Indian aphasia battery

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    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.

  1. 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.

  2. 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.

  3. Cerebral blood flow and metabolism in a patient with motor aphasia by positron emission tomography using 15O2 and C15O2

    International Nuclear Information System (INIS)

    Kitamura, Shin; Terashi, Akiro; Kato, Toshiaki; Soeda, Toshiyuki; Iio, Masaaki.

    1986-01-01

    Cerebral blood flow and metabolism, in a patient with motor aphasia due to cerebral infarction of the left basal ganglionic region, were studied by positron emission tomography (PET) using 15 O 2 and C 15 O 2 . A 62-year-old woman, right handed, was admitted with a complaint of right hemiparesis. Motor aphasia developed on the following day of hospitalization. CT scan showed low density area in the left caduate nucleus, putamen, internal capsule, and centrum semiovale, but the cortex was intact on the images of CT scan. PET studies were performed 22 days and 92 days after onset of stroke. The first PET study revealed marked reduction of CBF (cerebral blood flow) in the left cortex and subcortex, but CMRO 2 (cerebral oxygen consumption) was relatively preserved and OEF (oxygen extraction fraction) increased. The second PET study showed recovery of CBF in the left cortex and increase of OEF vanished. CMRO 2 decreased in the left posterior frontal region and subcortex. Motor aphasia still continued at the time of the second PET study. Therefore, the left posterior frontal cortex lesion as well as the left subcortex lesion might be related to the occurrence of motor aphasia in this case. The thresholds of CBF and CMRO 2 for developing clinical symptoms are higher than those for developing low density on the images of CT scan. These results suggest the importance of the study of cerebral blood flow and metabolism in the study of the responsible lesion for aphasia. (author)

  4. 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.)

  5. Predictability effect on N400 reflects the severity of reading comprehension deficits in aphasia.

    Science.gov (United States)

    Chang, Chih-Ting; Lee, Chia-Ying; Chou, Chia-Ju; Fuh, Jong-Ling; Wu, Hsin-Chi

    2016-01-29

    Predictability effect on N400, in which low predictability words elicited a larger N400 than high predictability words did over central to posterior electrodes, has been used to index difficulty of lexical retrieval and semantic integration of words in sentence comprehension. This study examined predictability effect on N400 in aphasic patients to determine if the properties of N400 are suited to indexing the severity of reading comprehension deficits. Patients with aphasia were divided into high and low ability groups based on scores on the reading comprehension subtest in the Chinese Concise Aphasia Test (CCAT). The two aphasia groups, a group of healthy elders who were age-matched to the aphasic participants, and a group of young adults, were requested to read sentences that either ended with highly predictable words or unexpected but plausible words, while undergoing electroencephalography (EEG). The young adult and healthy elderly groups exhibited the typical centro-parietal distributed effect of predictability on N400; however, healthy elders exhibited a reduced N400 effect in a delayed time window compared to the young adults. Compared with the elderly control, the high ability aphasia group exhibited a comparable N400 effect in a more restricted time window; by contrast, the low ability aphasia group exhibited a frontal distributed N400 in a much later time window (400-700 ms). These data suggest that the severity of reading comprehension deficits affects predictability effect on a set of N400 characteristics (i.e., amplitude, time window, and topographic distribution), which may be effective as ERP signatures in the evaluation of language recovery in aphasia. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Improvement of spontaneous language in stroke patients with chronic aphasia treated with music therapy: a randomized controlled trial.

    Science.gov (United States)

    Raglio, Alfredo; Oasi, Osmano; Gianotti, Marta; Rossi, Agnese; Goulene, Karine; Stramba-Badiale, Marco

    2016-01-01

    The aim of this research is to evaluate the effects of active music therapy (MT) based on free-improvisation (relational approach) in addition to speech language therapy (SLT) compared with SLT alone (communicative-pragmatic approach: Promoting Aphasic's Communicative Effectiveness) in stroke patients with chronic aphasia. The experimental group (n = 10) was randomized to 30 MT individual sessions over 15 weeks in addition to 30 SLT individual sessions while the control group (n = 10) was randomized to only 30 SLT sessions during the same period. Psychological and speech language assessment were made before (T0) and after (T1) the treatments. The study shows a significant improvement in spontaneous speech in the experimental group (Aachener Aphasie subtest: p = 0.020; Cohen's d = 0.35); the 50% of the experimental group showed also an improvement in vitality scores of Short Form Health Survey (chi-square test = 4.114; p = 0.043). The current trial highlights the possibility that the combined use of MT and SLT can lead to a better result in the rehabilitation of patients with aphasia than SLT alone.

  7. 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

  8. 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.

  9. 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.

  10. Identifying depression post-stroke in patients with aphasia : A systematic review of the reliability, validity and feasibility of available instruments

    NARCIS (Netherlands)

    van Dijk, Mariska J; de Man-van Ginkel, Janneke M; Hafsteinsdóttir, Thóra B; Schuurmans, Marieke J

    OBJECTIVE: To identify and critically appraise the evidence for instruments assessing depression in stroke patients with aphasia. METHODS: The PubMed, CINAHL, Web of Science, Psych Info and Cochrane databases were searched from inception until May 2015. RESULTS: Of the 383 titles found in the

  11. 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

  12. 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.

  13. Semantic memory assessment in 15 patients with amyotrophic lateral sclerosis.

    Science.gov (United States)

    Hervieu-Bègue, M; Rouaud, O; Graule Petot, A; Catteau, A; Giroud, M

    2016-01-01

    A total of 30 to 50% of amyotrophic lateral sclerosis patients suffer from cognitive disorders. The aim of the study is to characterize these disorders and to assess semantic memory in non-demented ALS patients. The secondary aim is to look for a link between disease type and neuropsychological characteristics. Patients were followed in an ALS center in Dijon. The following neuropsychological tests were used in this study: Folstein test, BREF test, verbal fluency, Isaac test, GRESEM test and TOP 30 test. Fifteen ALS patients were included. Nine of them (60%) were suffering from a semantic memory disorder. There was no correlation between ALS characteristics and the semantic memory disorder. This is the first study to reveal a semantic memory disorder in ALS. This result accentuates the hypothesis that ALS and semantic dementia are two phenotypes of the same degenerative process linked to TDP 43 proteinopathy. Copyright © 2016. Published by Elsevier Masson SAS.

  14. 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

  15. 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.

  16. Application of ERPs neuromarkers for assessment and treatment of a patient with chronic crossed aphasia after severe TBI and long-term coma - Case Report.

    Science.gov (United States)

    Chantsoulis, Marzena; Półrola, Paweł; Góral-Półrola, Jolanta; Hajdukiewicz, Anna; Supiński, Jan; Kropotov, Juri D; Pachalska, Maria

    2017-03-31

     Objective. The study aimed to evaluate the application of ERPs neuromarkers for the assessment and treatment of a patient with chronic crossed aphasia after severe TBI and a long-term coma. An ambidextrous female patient, aged 29, suffered from posttraumatic chronic crossed aphasia, severe TBI and a prolonged coma after a car accident. The patient took part in two differentiated rehabilitation programmes of neurotherapy included 20 sessions of relative beta training and 20 sessions of rTMS; both programmes were combined with behavioural training. The patient was tested 3 times: before the experiment, after completion of programme A, and after completion of programme B. In the 1st recording, the neuromarker of aphasia was found - an excess of the P2 wave over the left temporal area. There was a cognitive control deficit - an excess of omission errors and an increase of RT variability - all indexes of sporadic ADHD. In the 2nd recording, slight improvements in cognitive control, and language functions were found. In the 3rd recording, after the rTMS sessions most of her cognitive dysfunctions had been resolved, including language functions. It should be stressed that the activation (especially the increase in the ERP potential of the right side over the frontal lobe) was found. The neuromarker of aphasia did not change, only the location had slightly moved frontally. The application of ERP neuromarkers assists in the diagnosis, treatment, and academic success of an ambidextrous patient with chronic posttraumatic aphasia and sporadic ADHD. ERPs can be used to assess the functional brain changes induced by neurotherapeutical programmes.

  17. Semantically Induced Distortions of Visual Awareness in a Patient with Balint's Syndrome

    Science.gov (United States)

    Soto, David; Humphreys, Glyn W.

    2009-01-01

    We present data indicating that visual awareness for a basic perceptual feature (colour) can be influenced by the relation between the feature and the semantic properties of the stimulus. We examined semantic interference from the meaning of a colour word ("RED") on simple colour (ink related) detection responses in a patient with simultagnosia…

  18. 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.

  19. Emergence delirium with transient associative agnosia and expressive aphasia reversed by flumazenil in a pediatric patient.

    Science.gov (United States)

    Drobish, Julie K; Kelz, Max B; DiPuppo, Patricia M; Cook-Sather, Scott D

    2015-06-01

    Multiple factors may contribute to the development of emergence delirium in a child. We present the case of a healthy 12-year-old girl who received preoperative midazolam with the desired anxiolytic effect, underwent a brief general anesthetic, and then exhibited postoperative delirium, consisting of a transient associative agnosia and expressive aphasia. Administration of flumazenil led to immediate and lasting resolution of her symptoms. We hypothesize that γ-aminobutyric acid type A receptor-mediated effects, most likely related to an atypical offset of midazolam, are an important subset of emergence delirium that is amenable to pharmacologic therapy with flumazenil.

  20. 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

  1. 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.

  2. 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…

  3. 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…

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

    Science.gov (United States)

    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.

  5. Lexical learning in mild aphasia: gesture benefit depends on patholinguistic profile and lesion pattern.

    Science.gov (United States)

    Kroenke, Klaus-Martin; Kraft, Indra; Regenbrecht, Frank; Obrig, Hellmuth

    2013-01-01

    Gestures accompany speech and enrich human communication. When aphasia interferes with verbal abilities, gestures become even more relevant, compensating for and/or facilitating verbal communication. However, small-scale clinical studies yielded diverging results with regard to a therapeutic gesture benefit for lexical retrieval. Based on recent functional neuroimaging results, delineating a speech-gesture integration network for lexical learning in healthy adults, we hypothesized that the commonly observed variability may stem from differential patholinguistic profiles in turn depending on lesion pattern. Therefore we used a controlled novel word learning paradigm to probe the impact of gestures on lexical learning, in the lesioned language network. Fourteen patients with chronic left hemispheric lesions and mild residual aphasia learned 30 novel words for manipulable objects over four days. Half of the words were trained with gestures while the other half were trained purely verbally. For the gesture condition, rootwords were visually presented (e.g., Klavier, [piano]), followed by videos of the corresponding gestures and the auditory presentation of the novel words (e.g., /krulo/). Participants had to repeat pseudowords and simultaneously reproduce gestures. In the verbal condition no gesture-video was shown and participants only repeated pseudowords orally. Correlational analyses confirmed that gesture benefit depends on the patholinguistic profile: lesser lexico-semantic impairment correlated with better gesture-enhanced learning. Conversely largely preserved segmental-phonological capabilities correlated with better purely verbal learning. Moreover, structural MRI-analysis disclosed differential lesion patterns, most interestingly suggesting that integrity of the left anterior temporal pole predicted gesture benefit. Thus largely preserved semantic capabilities and relative integrity of a semantic integration network are prerequisites for successful use of

  6. 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 ...

  7. 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

  8. 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

  9. 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.)

  10. 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.

  11. 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.

  12. An Event Related Potentials Study of Semantic Coherence Effect during Episodic Encoding in Schizophrenia Patients

    Directory of Open Access Journals (Sweden)

    Lâle Battal Merlet

    2018-01-01

    Full Text Available The objective of this electrophysiological study was to investigate the processing of semantic coherence during encoding in relation to episodic memory processes promoted at test, in schizophrenia patients, by using the N400 paradigm. Eighteen schizophrenia patients and 15 healthy participants undertook a recognition memory task. The stimuli consisted of pairs of words either semantically related or unrelated to a given category name (context. During encoding, both groups exhibited an N400 external semantic coherence effect. Healthy controls also showed an N400 internal semantic coherence effect, but this effect was not present in patients. At test, related stimuli were accompanied by an FN400 old/new effect in both groups and by a parietal old/new effect in the control group alone. In the patient group, external semantic coherence effect was associated with FN400, while, in the control group, it was correlated to the parietal old/new effect. Our results indicate that schizophrenia patients can process the contextual information at encoding to enhance familiarity process for related stimuli at test. Therefore, cognitive rehabilitation therapies targeting the implementation of semantic encoding strategies can mobilize familiarity which in turn can overcome the recollection deficit, promoting successful episodic memory performance in schizophrenia patients.

  13. 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.

  14. 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

  15. Maintenance and Generalization Effects of Semantic and Phonological Treatments of Anomia: A Case Study

    Science.gov (United States)

    Macoir, Joel; Routhier, Sonia; Simard, Anne; Picard, Josee

    2012-01-01

    Anomia is one of the most frequent manifestations in aphasia. Model-based treatments for anomia usually focus on semantic and/or phonological levels of processing. This study reports treatment of anomia in an individual with chronic aphasia. After baseline testing, she received a training program in which semantic and phonological treatments were…

  16. 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.

  17. 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.

  18. Dissociations between word and picture naming in Persian speakers with aphasia

    Directory of Open Access Journals (Sweden)

    Mehdi Bakhtiar

    2014-04-01

    Full Text Available Studies of patients with aphasia have found dissociations in their ability to read words and name pictures (Hillis & Caramazza, 1995; Hillis & Caramazza, 1991. Persian orthography is characterised by nearly regular orthography-phonology (OP mappings however, the omission of some vowels in the script makes the OP mapping of many words less predictable. The aim of this study was to compare the predictive lexico-semantic variables across reading and picture naming tasks in Persian aphasia while considering the variability across participants and items using mixed modeling. Methods and Results A total of 21 brain-injured Persian-speaking patients suffering from aphasia were asked to name 200 normalized Snodgrass object pictures and words taken from Bakhtiar, Nilipour and Weekes (2013 in different sessions. The results showed that word naming performance was significantly better than object naming in Persian speakers with aphasia (p<0.0001. Applying McNemar’s test to examine individual differences found that 18 patients showed significantly better performance in word reading compared to picture naming, 2 patients showed no difference between naming and reading (i.e. case 1 and 10, and one patient (i.e. case 5 showed significantly better naming compared to reading χ (1=10.23, p< 0.01 (see also Figure 1. A mixed-effect logistic regression analysis revealed that the degree of spelling transparency (i.e. the number of letters in a word divided by the number of its phonemes had an effect on word naming (along with frequency, age of acquisition (AoA, and imageability and picture naming (along with image agreement, AoA, word length, frequency and name agreement with a much stronger effect on the word naming task (b= 1.67, SE= 0.41, z= 4.05, p< 0.0001 compared to the picture naming task (b= -0.64, SE= 0.32, z= 2, p< 0.05. Conclusion The dissociation between word naming and picture naming shown by many patients suggests at least two routes are available

  19. Piracetam for Aphasia in Post-stroke Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Zhang, Jie; Wei, Ruili; Chen, Zhongqin; Luo, Benyan

    2016-07-01

    Aphasia is a common symptom in post-stroke patients. Piracetam is a commonly used nootropic agent that promises various benefits to brain function, including language improvement. We performed a systematic review and meta-analysis to assess whether piracetam facilitates the rehabilitation of language performance in post-stroke patients. Randomized controlled trials (RCTs) of piracetam treatment in post-stroke patients published in any language were included, excluding those involving pre-existing cognitive disorders such as dementia and mood disturbances. We searched several databases including PubMed, EMBASE, Cochrane Central, CINAHL, Web of Science, and PsycINFO for RCTs published up to 31 December 2015. We conducted a meta-analysis using RevMan (version 5.3), with standardized mean differences (SMDs) and fixed-effect models, and used StataSE (version 13) for the detection of publication bias. This study has been submitted to PROSPERO, and its registration number is CRD42016034088. We identified 1180 titles and abstracts, and finally included seven RCTs in this meta-analysis. The number of participants in each study ranged from 19 to 66, summing up to 261 patients overall. The dose of piracetam was consistent while the frequency and time of therapy varied. The assessment of the language at the end of trials showed no significant improvement in overall severity of aphasia [SMD 0.23, 95 % confidence interval (CI) -0.03 to 0.49, P = 0.08], but written language (SMD 0.35, 95 % CI 0.04 to 0.66, P = 0.03) showed pronounced improvement. Subgroup analyses indicated a dissociation of effectiveness between short- and long-term assessment in overall severity (P = 0.008, I (2) = 85.6 %) in terms of tests for subgroup differences, and a mild trend toward dissociation in written subtests (P = 0.30, I (2) = 5.1 %). Funnel plots and Egger's test identified no obvious publication bias in the primary variable. Piracetam plays a limited role in the rehabilitation of

  20. 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.

  1. 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.)

  2. 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.

  3. 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…

  4. 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...

  5. 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

  6. Teaching nursing assistant students about aphasia and communication.

    Science.gov (United States)

    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.

  7. Semantic memory and depressive symptoms in patients with subjective cognitive decline, mild cognitive impairment, and Alzheimer's disease.

    Science.gov (United States)

    Lehrner, J; Coutinho, G; Mattos, P; Moser, D; Pflüger, M; Gleiss, A; Auff, E; Dal-Bianco, P; Pusswald, G; Stögmann, E

    2017-07-01

    Semantic memory may be impaired in clinically recognized states of cognitive impairment. We investigated the relationship between semantic memory and depressive symptoms (DS) in patients with cognitive impairment. 323 cognitively healthy controls and 848 patients with subjective cognitive decline (SCD), mild cognitive impairment (MCI), and Alzheimer's disease (AD) dementia were included. Semantic knowledge for famous faces, world capitals, and word vocabulary was investigated. Compared to healthy controls, we found a statistically significant difference of semantic knowledge in the MCI groups and the AD group, respectively. Results of the SCD group were mixed. However, two of the three semantic memory measures (world capitals and word vocabulary) showed a significant association with DS. We found a difference in semantic memory performance in MCI and AD as well as an association with DS. Results suggest that the difference in semantic memory is due to a storage loss rather than to a retrieval problem.

  8. Heterogeneity in semantic priming effect with a lexical decision task in patients after left hemisphere stroke

    Directory of Open Access Journals (Sweden)

    Candice Steffen Holderbaum

    Full Text Available ABSTRACT Investigations on the semantic priming effect (SPE in patients after left hemisphere (LH lesions have shown disparities that may be explained by the variability in performance found among patients. The aim of the present study was to verify the existence of subgroups of patients after LH stroke by searching for dissociations between performance on the lexical decision task based on the semantic priming paradigm and performance on direct memory, semantic association and language tasks. All 17 patients with LH lesions after stroke (ten non-fluent aphasics and seven non aphasics were analyzed individually. Results indicated the presence of three groups of patients according to SPE: one exhibiting SPE at both stimulus onset asynchronies (SOAs, one with SPE only at long SOA, and another, larger group with no SPE.

  9. Linked Registries: Connecting Rare Diseases Patient Registries through a Semantic Web Layer.

    Science.gov (United States)

    Sernadela, Pedro; González-Castro, Lorena; Carta, Claudio; van der Horst, Eelke; Lopes, Pedro; Kaliyaperumal, Rajaram; Thompson, Mark; Thompson, Rachel; Queralt-Rosinach, Núria; Lopez, Estrella; Wood, Libby; Robertson, Agata; Lamanna, Claudia; Gilling, Mette; Orth, Michael; Merino-Martinez, Roxana; Posada, Manuel; Taruscio, Domenica; Lochmüller, Hanns; Robinson, Peter; Roos, Marco; Oliveira, José Luís

    2017-01-01

    Patient registries are an essential tool to increase current knowledge regarding rare diseases. Understanding these data is a vital step to improve patient treatments and to create the most adequate tools for personalized medicine. However, the growing number of disease-specific patient registries brings also new technical challenges. Usually, these systems are developed as closed data silos, with independent formats and models, lacking comprehensive mechanisms to enable data sharing. To tackle these challenges, we developed a Semantic Web based solution that allows connecting distributed and heterogeneous registries, enabling the federation of knowledge between multiple independent environments. This semantic layer creates a holistic view over a set of anonymised registries, supporting semantic data representation, integrated access, and querying. The implemented system gave us the opportunity to answer challenging questions across disperse rare disease patient registries. The interconnection between those registries using Semantic Web technologies benefits our final solution in a way that we can query single or multiple instances according to our needs. The outcome is a unique semantic layer, connecting miscellaneous registries and delivering a lightweight holistic perspective over the wealth of knowledge stemming from linked rare disease patient registries.

  10. MRI-Based Neuroanatomical Predictors of Dysphagia, Dysarthria, and Aphasia in Patients with First Acute Ischemic Stroke
.

    Science.gov (United States)

    Flowers, Heather L; AlHarbi, Mohammed A; Mikulis, David; Silver, Frank L; Rochon, Elizabeth; Streiner, David; Martino, Rosemary

    2017-01-01

    Due to the high post-stroke frequency of dysphagia, dysarthria, and aphasia, we developed comprehensive neuroanatomical, clinical, and demographic models to predict their presence after acute ischemic stroke. The sample included 160 randomly selected first-ever stroke patients with confirmed infarction on magnetic resonance imaging from 1 tertiary stroke center. We documented acute lesions within 12 neuroanatomical regions and their associated volumes. Further, we identified concomitant chronic brain disease, including atrophy, white matter hyperintensities, and covert strokes. We developed predictive models using logistic regression with odds ratios (OR) and their 95% confidence intervals (95% CI) including demographic, clinical, and acute and chronic neuroanatomical factors. Predictors of dysphagia included medullary (OR 6.2, 95% CI 1.5-25.8), insular (OR 4.8, 95% CI 2.0-11.8), and pontine (OR 3.6, 95% CI 1.2-10.1) lesions, followed by brain atrophy (OR 3.0, 95% CI 1.04-8.6), internal capsular lesions (OR 2.9, 95% CI 1.2-6.6), and increasing age (OR 1.4, 95% CI 1.1-1.8). Predictors of dysarthria included pontine (OR 7.8, 95% CI 2.7-22.9), insular (OR 4.5, 95% CI 1.8-11.4), and internal capsular (OR 3.6, 95% CI 1.6-7.9) lesions. Predictors of aphasia included left hemisphere insular (OR 34.4, 95% CI 4.2-283.4), thalamic (OR 6.2, 95% CI 1.6-24.4), and cortical middle cerebral artery (OR 4.7, 95% CI 1.5-14.2) lesions. Predicting outcomes following acute stroke is important for treatment decisions. Determining the risk of major post-stroke impairments requires consideration of factors beyond lesion localization. Accordingly, we demonstrated interactions between localized and global brain function for dysphagia and elucidated common lesion locations across 3 debilitating impairments.
. © 2017 The Author(s)
. Published by S. Karger AG, Basel.

  11. 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.

  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. Vocabulary acquisition in aphasia: Modality can matter.

    Science.gov (United States)

    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

  14. 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

  15. 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.

  16. 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…

  17. 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…

  18. 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.

  19. 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…

  20. 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.

  1. Self-referential processing is distinct from semantic elaboration: evidence from long-term memory effects in a patient with amnesia and semantic impairments.

    Science.gov (United States)

    Sui, Jie; Humphreys, Glyn W

    2013-11-01

    We report data demonstrating that self-referential encoding facilitates memory performance in the absence of effects of semantic elaboration in a severely amnesic patient also suffering semantic problems. In Part 1, the patient, GA, was trained to associate items with the self or a familiar other during the encoding phase of a memory task (self-ownership decisions in Experiment 1 and self-evaluation decisions in Experiment 2). Tests of memory showed a consistent self-reference advantage, relative to a condition where the reference was another person in both experiments. The pattern of the self-reference advantage was similar to that in healthy controls. In Part 2 we demonstrate that GA showed minimal effects of semantic elaboration on memory for items he semantically classified, compared with items subject to physical size decisions; in contrast, healthy controls demonstrated enhanced memory performance after semantic relative to physical encoding. The results indicate that self-referential encoding, not semantic elaboration, improves memory in amnesia. Self-referential processing may provide a unique scaffold to help improve learning in amnesic cases. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. 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…

  3. Electrophysiological Correlates of Semantic Processing during Encoding of Neutral and Emotional Pictures in Patients with ADHD

    Science.gov (United States)

    Krauel, Kerstin; Duzel, Emrah; Hinrichs, Hermann; Lenz, Daniel; Herrmann, Christoph S.; Santel, Stephanie; Rellum, Thomas; Baving, Lioba

    2009-01-01

    The current study investigated the relevance of semantic processing and stimulus salience for memory performance in young ADHD patients and healthy control participants. 18 male ADHD patients and 15 healthy control children and adolescents participated in an ERP study during a visual memory paradigm with two different encoding tasks requiring…

  4. Semantic strategy training increases memory performance and brain activity in patients with prefrontal cortex lesions.

    Science.gov (United States)

    Miotto, Eliane C; Savage, Cary R; Evans, Jonathan J; Wilson, Barbara A; Martin, Maria G M; Balardin, Joana B; Barros, Fabio G; Garrido, Griselda; Teixeira, Manoel J; Amaro Junior, Edson

    2013-03-01

    Memory deficit is a frequent cognitive disorder following acquired prefrontal cortex lesions. In the present study, we investigated the brain correlates of a short semantic strategy training and memory performance of patients with distinct prefrontal cortex lesions using fMRI and cognitive tests. Twenty-one adult patients with post-acute prefrontal cortex (PFC) lesions, twelve with left dorsolateral PFC (LPFC) and nine with bilateral orbitofrontal cortex (BOFC) were assessed before and after a short cognitive semantic training using a verbal memory encoding paradigm during scanning and neuropsychological tests outside the scanner. After the semantic strategy training both groups of patients showed significant behavioral improvement in verbal memory recall and use of semantic strategies. In the LPFC group, greater activity in left inferior and medial frontal gyrus, precentral gyrus and insula was found after training. For the BOFC group, a greater activation was found in the left parietal cortex, right cingulated and precuneus after training. The activation of these specific areas in the memory and executive networks following cognitive training was associated to compensatory brain mechanisms and application of the semantic strategy. Copyright © 2012 Elsevier B.V. All rights reserved.

  5. 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.

  6. 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…

  7. Quantitative and qualitative analysis of semantic verbal fluency in patients with temporal lobe epilepsy.

    Science.gov (United States)

    Jaimes-Bautista, A G; Rodríguez-Camacho, M; Martínez-Juárez, I E; Rodríguez-Agudelo, Y

    2017-08-29

    Patients with temporal lobe epilepsy (TLE) perform poorly on semantic verbal fluency (SVF) tasks. Completing these tasks successfully involves multiple cognitive processes simultaneously. Therefore, quantitative analysis of SVF (number of correct words in one minute), conducted in most studies, has been found to be insufficient to identify cognitive dysfunction underlying SVF difficulties in TLE. To determine whether a sample of patients with TLE had SVF difficulties compared with a control group (CG), and to identify the cognitive components associated with SVF difficulties using quantitative and qualitative analysis. SVF was evaluated in 25 patients with TLE and 24 healthy controls; the semantic verbal fluency test included 5 semantic categories: animals, fruits, occupations, countries, and verbs. All 5 categories were analysed quantitatively (number of correct words per minute and interval of execution: 0-15, 16-30, 31-45, and 46-60seconds); the categories animals and fruits were also analysed qualitatively (clusters, cluster size, switches, perseverations, and intrusions). Patients generated fewer words for all categories and intervals and fewer clusters and switches for animals and fruits than the CG (Psize and number of intrusions and perseverations (P>.05). Our results suggest an association between SVF difficulties in TLE and difficulty activating semantic networks, impaired strategic search, and poor cognitive flexibility. Attention, inhibition, and working memory are preserved in these patients. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Intensive speech and language therapy in patients with chronic aphasia after stroke: a randomised, open-label, blinded-endpoint, controlled trial in a health-care setting.

    Science.gov (United States)

    Breitenstein, Caterina; Grewe, Tanja; Flöel, Agnes; Ziegler, Wolfram; Springer, Luise; Martus, Peter; Huber, Walter; Willmes, Klaus; Ringelstein, E Bernd; Haeusler, Karl Georg; Abel, Stefanie; Glindemann, Ralf; Domahs, Frank; Regenbrecht, Frank; Schlenck, Klaus-Jürgen; Thomas, Marion; Obrig, Hellmuth; de Langen, Ernst; Rocker, Roman; Wigbers, Franziska; Rühmkorf, Christina; Hempen, Indra; List, Jonathan; Baumgaertner, Annette

    2017-04-15

    Treatment guidelines for aphasia recommend intensive speech and language therapy for chronic (≥6 months) aphasia after stroke, but large-scale, class 1 randomised controlled trials on treatment effectiveness are scarce. We aimed to examine whether 3 weeks of intensive speech and language therapy under routine clinical conditions improved verbal communication in daily-life situations in people with chronic aphasia after stroke. In this multicentre, parallel group, superiority, open-label, blinded-endpoint, randomised controlled trial, patients aged 70 years or younger with aphasia after stroke lasting for 6 months or more were recruited from 19 inpatient or outpatient rehabilitation centres in Germany. An external biostatistician used a computer-generated permuted block randomisation method, stratified by treatment centre, to randomly assign participants to either 3 weeks or more of intensive speech and language therapy (≥10 h per week) or 3 weeks deferral of intensive speech and language therapy. The primary endpoint was between-group difference in the change in verbal communication effectiveness in everyday life scenarios (Amsterdam-Nijmegen Everyday Language Test A-scale) from baseline to immediately after 3 weeks of treatment or treatment deferral. All analyses were done using the modified intention-to-treat population (those who received 1 day or more of intensive treatment or treatment deferral). This study is registered with ClinicalTrials.gov, number NCT01540383. We randomly assigned 158 patients between April 1, 2012, and May 31, 2014. The modified intention-to-treat population comprised 156 patients (78 per group). Verbal communication was significantly improved from baseline to after intensive speech and language treatment (mean difference 2·61 points [SD 4·94]; 95% CI 1·49 to 3·72), but not from baseline to after treatment deferral (-0·03 points [4·04]; -0·94 to 0·88; between-group difference Cohen's d 0·58; p=0·0004). Eight patients had

  9. 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

  10. 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 ...

  11. 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...

  12. 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...

  13. 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

  14. Communication and Low Mood (CALM): a randomized controlled trial of behavioural therapy for stroke patients with aphasia.

    Science.gov (United States)

    Thomas, Shirley A; Walker, Marion F; Macniven, Jamie A; Haworth, Helen; Lincoln, Nadina B

    2013-05-01

    The aim was to evaluate behavioural therapy as a treatment for low mood in people with aphasia. A randomized controlled trial comparing behavioural therapy plus usual care with a usual care control. Potential participants with aphasia after stroke were screened for the presence of low mood. Those who met the criteria and gave consent were randomly allocated. Participants were recruited from hospital wards, community rehabilitation, speech and language therapy services and stroke groups. Of 511 people with aphasia identified, 105 had low mood and were recruited. Behavioural therapy was offered for up to three months. Outcomes were assessed three and six months after random allocation. Stroke Aphasic Depression Questionnaire, Visual Analog Mood Scales 'sad' item, and Visual Analogue Self-Esteem Scale. Participants were aged 29 to 94 years (mean 67.0, SD 13.5) and 66 (63%) were men. Regression analysis showed that at three months, when baseline values and communication impairment were controlled for, group allocation was a significant predictor of the Stroke Aphasic Depression Questionnaire (P aphasia.

  15. Semantic and visual determinants of face recognition in a prosopagnosic patient.

    Science.gov (United States)

    Dixon, M J; Bub, D N; Arguin, M

    1998-05-01

    Prosopagnosia is the neuropathological inability to recognize familiar people by their faces. It can occur in isolation or can coincide with recognition deficits for other nonface objects. Often, patients whose prosopagnosia is accompanied by object recognition difficulties have more trouble identifying certain categories of objects relative to others. In previous research, we demonstrated that objects that shared multiple visual features and were semantically close posed severe recognition difficulties for a patient with temporal lobe damage. We now demonstrate that this patient's face recognition is constrained by these same parameters. The prosopagnosic patient ELM had difficulties pairing faces to names when the faces shared visual features and the names were semantically related (e.g., Tonya Harding, Nancy Kerrigan, and Josee Chouinard -three ice skaters). He made tenfold fewer errors when the exact same faces were associated with semantically unrelated people (e.g., singer Celine Dion, actress Betty Grable, and First Lady Hillary Clinton). We conclude that prosopagnosia and co-occurring category-specific recognition problems both stem from difficulties disambiguating the stored representations of objects that share multiple visual features and refer to semantically close identities or concepts.

  16. 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

  17. Cost analysis of the Communication and Low Mood (CALM) randomised trial of behavioural therapy for stroke patients with aphasia.

    Science.gov (United States)

    Humphreys, Ioan; Thomas, Shirley; Phillips, Ceri; Lincoln, Nadina

    2015-01-01

    To evaluate the cost effectiveness of a behavioural therapy intervention shown to be clinically effective in comparison with usual care for stroke patients with aphasia. Randomised controlled trial with comparison of costs and calculation of incremental cost effectiveness ratio. Community. Participants identified as having low mood on either the Visual Analog Mood Scale sad item (≥50) or Stroke Aphasic Depression Questionnaire Hospital version 21 (SADQH21) (≥6) were recruited. Participants were randomly allocated to behavioural therapy or usual care using internet-based randomisation generated in advance of the study by a clinical trials unit. Outcomes were assessed at six months after randomisation, blind to group allocation. The costs were assessed from a service use questionnaire. Effectiveness was defined as the change in SADQH21 scores and a cost-effectiveness analysis was performed comparing the behavioural group with the usual care control group. The cost analysis was undertaken from the perspective of the UK NHS and Social Services. The greatest difference was in home help costs where there was a saving of £56.20 in the intervention group compared to an increase of £61.40 in the control group. At six months the SADQH21 score for the intervention group was 17.3 compared to the control group value of 20.4. This resulted in a mean increase of 0.7 in the control group, compared to a mean significant different decrease of 6 in the intervention group (P = 0.003). The Incremental Cost-Effectiveness Ratio indicated that the cost per point reduction on the SADQH21 was £263. Overall the behavioural therapy was found to improve mood and resulted in some encouraging savings in resource utilisation over the six months follow-up. © The Author(s) 2014.

  18. Meaningful Memory in Acute Anorexia Nervosa Patients-Comparing Recall, Learning, and Recognition of Semantically Related and Semantically Unrelated Word Stimuli.

    Science.gov (United States)

    Terhoeven, Valentin; Kallen, Ursula; Ingenerf, Katrin; Aschenbrenner, Steffen; Weisbrod, Matthias; Herzog, Wolfgang; Brockmeyer, Timo; Friederich, Hans-Christoph; Nikendei, Christoph

    2017-03-01

    It is unclear whether observed memory impairment in anorexia nervosa (AN) depends on the semantic structure (categorized words) of material to be encoded. We aimed to investigate the processing of semantically related information in AN. Memory performance was assessed in a recall, learning, and recognition test in 27 adult women with AN (19 restricting, 8 binge-eating/purging subtype; average disease duration: 9.32 years) and 30 healthy controls using an extended version of the Rey Auditory Verbal Learning Test, applying semantically related and unrelated word stimuli. Short-term memory (immediate recall, learning), regardless of semantics of the words, was significantly worse in AN patients, whereas long-term memory (delayed recall, recognition) did not differ between AN patients and controls. Semantics of stimuli do not have a better effect on memory recall in AN compared to CO. Impaired short-term versus long-term memory is discussed in relation to dysfunctional working memory in AN. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

  19. Somatic Symptom Disorder in Semantic Dementia: The Role of Alexisomia.

    Science.gov (United States)

    Gan, Joanna J; Lin, Andrew; Samimi, Mersal S; Mendez, Mario F

    Semantic dementia (SD) is a neurodegenerative disorder characterized by loss of semantic knowledge. SD may be associated with somatic symptom disorder due to excessive preoccupation with unidentified somatic sensations. To evaluate the frequency of somatic symptom disorder among patients with SD in comparison to comparably demented patients with Alzheimer׳s disease. A retrospective cohort study was conducted using clinical data from a referral-based behavioral neurology program. Fifty-three patients with SD meeting criteria for imaging-supported semantic variant primary progressive aphasia (another term for SD) were compared with 125 patients with clinically probable Alzheimer disease. Logistic regression controlled for sex, age, disease duration, education, overall cognitive impairment, and depression. The prevalence of somatic symptom disorder was significantly higher among patients with SD (41.5%) compared to patients with Alzheimer disease (11.2%) (odds ratio = 6:1; p Cotard syndrome or the delusion that unidentified somatic symptoms signify death or deterioration. SD, a disorder of semantic knowledge, is associated with somatic symptom disorder from impaired identification of somatic sensations. Their inability to read and name somatic sensations, or "alexisomia," results in disproportionate and persistent concern about somatic sensations with consequent significant disability. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  20. 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 ...

  1. [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.

  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. 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.)

  4. Longitudinal patterns of semantic and episodic memory in frontotemporal lobar degeneration and Alzheimer's disease.

    Science.gov (United States)

    Xie, Sharon X; Libon, David J; Wang, Xingmei; Massimo, Lauren; Moore, Peachie; Vesely, Luisa; Khan, Alea; Chatterjee, Anjan; Coslett, H Branch; Hurtig, Howard I; Liang, Tsao-Wei; Grossman, Murray

    2010-03-01

    The longitudinal assessment of episodic and semantic memory was obtained from 236 patients diagnosed with Alzheimer's disease (AD, n = 128) and with frontotemporal lobar degeneration (FTLD, n = 108), including patients with a social comportment/dysexecutive (SOC/EXEC) disorder, progressive nonfluent aphasia (PNFA), semantic dementia (SemD), and corticobasal syndrome (CBS). At the initial assessment, AD patients obtained a lower score on the delayed free recall test than other patients. Longitudinal analyses for delayed free recall found converging performance, with all patients reaching the same level of impairment as AD patients. On the initial evaluation for delayed recognition, AD patients also obtained lower scores than other groups. Longitudinal analyses for delayed recognition test performance found that AD patients consistently produced lower scores than other groups and no convergence between AD and other dementia groups was seen. For semantic memory, there were no initial between-group differences. However, longitudinal analyses for semantic memory revealed group differences over illness duration, with worse performance for SemD versus AD, PNFA, SOC/EXEC, and CBS patients. These data suggest the presence of specific longitudinal patterns of impairment for episodic and semantic memory in AD and FTLD patients suggesting that all forms of dementia do not necessarily converge into a single phenotype.

  5. Leveraging electronic healthcare record standards and semantic web technologies for the identification of patient cohorts.

    Science.gov (United States)

    Fernández-Breis, Jesualdo Tomás; Maldonado, José Alberto; Marcos, Mar; Legaz-García, María del Carmen; Moner, David; Torres-Sospedra, Joaquín; Esteban-Gil, Angel; Martínez-Salvador, Begoña; Robles, Montserrat

    2013-12-01

    The secondary use of electronic healthcare records (EHRs) often requires the identification of patient cohorts. In this context, an important problem is the heterogeneity of clinical data sources, which can be overcome with the combined use of standardized information models, virtual health records, and semantic technologies, since each of them contributes to solving aspects related to the semantic interoperability of EHR data. To develop methods allowing for a direct use of EHR data for the identification of patient cohorts leveraging current EHR standards and semantic web technologies. We propose to take advantage of the best features of working with EHR standards and ontologies. Our proposal is based on our previous results and experience working with both technological infrastructures. Our main principle is to perform each activity at the abstraction level with the most appropriate technology available. This means that part of the processing will be performed using archetypes (ie, data level) and the rest using ontologies (ie, knowledge level). Our approach will start working with EHR data in proprietary format, which will be first normalized and elaborated using EHR standards and then transformed into a semantic representation, which will be exploited by automated reasoning. We have applied our approach to protocols for colorectal cancer screening. The results comprise the archetypes, ontologies, and datasets developed for the standardization and semantic analysis of EHR data. Anonymized real data have been used and the patients have been successfully classified by the risk of developing colorectal cancer. This work provides new insights in how archetypes and ontologies can be effectively combined for EHR-driven phenotyping. The methodological approach can be applied to other problems provided that suitable archetypes, ontologies, and classification rules can be designed.

  6. Leveraging electronic healthcare record standards and semantic web technologies for the identification of patient cohorts

    Science.gov (United States)

    Fernández-Breis, Jesualdo Tomás; Maldonado, José Alberto; Marcos, Mar; Legaz-García, María del Carmen; Moner, David; Torres-Sospedra, Joaquín; Esteban-Gil, Angel; Martínez-Salvador, Begoña; Robles, Montserrat

    2013-01-01

    Background The secondary use of electronic healthcare records (EHRs) often requires the identification of patient cohorts. In this context, an important problem is the heterogeneity of clinical data sources, which can be overcome with the combined use of standardized information models, virtual health records, and semantic technologies, since each of them contributes to solving aspects related to the semantic interoperability of EHR data. Objective To develop methods allowing for a direct use of EHR data for the identification of patient cohorts leveraging current EHR standards and semantic web technologies. Materials and methods We propose to take advantage of the best features of working with EHR standards and ontologies. Our proposal is based on our previous results and experience working with both technological infrastructures. Our main principle is to perform each activity at the abstraction level with the most appropriate technology available. This means that part of the processing will be performed using archetypes (ie, data level) and the rest using ontologies (ie, knowledge level). Our approach will start working with EHR data in proprietary format, which will be first normalized and elaborated using EHR standards and then transformed into a semantic representation, which will be exploited by automated reasoning. Results We have applied our approach to protocols for colorectal cancer screening. The results comprise the archetypes, ontologies, and datasets developed for the standardization and semantic analysis of EHR data. Anonymized real data have been used and the patients have been successfully classified by the risk of developing colorectal cancer. Conclusions This work provides new insights in how archetypes and ontologies can be effectively combined for EHR-driven phenotyping. The methodological approach can be applied to other problems provided that suitable archetypes, ontologies, and classification rules can be designed. PMID:23934950

  7. Lexical-semantic knowledge about food in patients with different types of dementia

    Directory of Open Access Journals (Sweden)

    Raffaella Ida Rumiati

    2014-04-01

    Full Text Available While many theories agree that the conceptual knowledge is organized in categories, there is less agreement on the underlying organizational principle (e.g. Warrington & Shallice, 1984, Caramazza & Shelton, 1998; Capitani et al., 2003. Previous neuropsychological studies on semantic categories failed to clearly characterize the status of food as a category as they did not carefully distinguish between natural food and transformed food. Exploring how natural food and transformed food items are processed in patients suffering from primary dementia can allow us to test the theories of how semantic knowledge is organized in the brain. Thirty patients and 15 healthy controls matched for age and education took part in the study . Thirteen patients received a presumptive diagnosis of fronto-temporal dementia (FTD, 3 patients of Semantic Dementia (SD, and 14 of Alzheimer Dementia (AD. All participants performed 3 tasks tapping lexical-semantic knowledge about food and non-food items: confrontation naming (Task 1, categorization (Task 2, and word-to-picture matching (Task 3. Moreover, half food items were natural (e.g., apple and half transformed (e.g. grana cheese, while non-food items were half non edible natural items (e.g., plant and half kitchen implements. The results showed that, overall, patients performed poorer than controls on Tasks 1 and 3, with FTD-SD patients being more impaired than AD patients. When we compared performance on food versus non-food items, we observed that patients performed better on naming food than non-food items (Task 1. Specifically, FTD-SD patients displayed a significant difference between food and non-food items, while AD patients showed no difference. On Task 3 the same pattern was obtained. In addition, we observed that, across tasks, transformed food was processed better than natural food. These findings suggest that lexical-semantic processes are more prone to degradation in patients FTD-SD than in AD patients

  8. Implications of Subcortical structures in Aphasia.

    Directory of Open Access Journals (Sweden)

    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.

  9. 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.

  10. Language therapy effects in long term aphasia.

    Science.gov (United States)

    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.

  11. 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 ...

  12. 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.

  13. The right hemisphere supports but does not replace left hemisphere auditory function in patients with persisting aphasia.

    Science.gov (United States)

    Teki, Sundeep; Barnes, Gareth R; Penny, William D; Iverson, Paul; Woodhead, Zoe V J; Griffiths, Timothy D; Leff, Alexander P

    2013-06-01

    In this study, we used magnetoencephalography and a mismatch paradigm to investigate speech processing in stroke patients with auditory comprehension deficits and age-matched control subjects. We probed connectivity within and between the two temporal lobes in response to phonemic (different word) and acoustic (same word) oddballs using dynamic causal modelling. We found stronger modulation of self-connections as a function of phonemic differences for control subjects versus aphasics in left primary auditory cortex and bilateral superior temporal gyrus. The patients showed stronger modulation of connections from right primary auditory cortex to right superior temporal gyrus (feed-forward) and from left primary auditory cortex to right primary auditory cortex (interhemispheric). This differential connectivity can be explained on the basis of a predictive coding theory which suggests increased prediction error and decreased sensitivity to phonemic boundaries in the aphasics' speech network in both hemispheres. Within the aphasics, we also found behavioural correlates with connection strengths: a negative correlation between phonemic perception and an inter-hemispheric connection (left superior temporal gyrus to right superior temporal gyrus), and positive correlation between semantic performance and a feedback connection (right superior temporal gyrus to right primary auditory cortex). Our results suggest that aphasics with impaired speech comprehension have less veridical speech representations in both temporal lobes, and rely more on the right hemisphere auditory regions, particularly right superior temporal gyrus, for processing speech. Despite this presumed compensatory shift in network connectivity, the patients remain significantly impaired.

  14. Designing a patient monitoring system for bipolar disorder using Semantic Web technologies.

    Science.gov (United States)

    Thermolia, Chryssa; Bei, Ekaterini S; Petrakis, Euripides G M; Kritsotakis, Vangelis; Tsiknakis, Manolis; Sakkalis, Vangelis

    2015-01-01

    The new movement to personalize treatment plans and improve prediction capabilities is greatly facilitated by intelligent remote patient monitoring and risk prevention. This paper focuses on patients suffering from bipolar disorder, a mental illness characterized by severe mood swings. We exploit the advantages of Semantic Web and Electronic Health Record Technologies to develop a patient monitoring platform to support clinicians. Relying on intelligently filtering of clinical evidence-based information and individual-specific knowledge, we aim to provide recommendations for treatment and monitoring at appropriate time or concluding into alerts for serious shifts in mood and patients' non response to treatment.

  15. 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.

  16. Semantic Memory Organization in Japanese Patients With Schizophrenia Examined With Category Fluency

    Directory of Open Access Journals (Sweden)

    Chika Sumiyoshi

    2018-03-01

    Full Text Available BackgroundDisorganization of semantic memory in patients with schizophrenia has been studied by referring to their category fluency performance. Recently, data-mining techniques such as singular value decomposition (SVD analysis have been reported to be effective in elucidating the latent semantic memory structure in patients with schizophrenia. The aim of this study is to investigate semantic memory organization in patients with schizophrenia using a novel method based on data-mining approach.MethodCategory fluency data were collected from 181 patients with schizophrenia and 335 healthy controls at the Department of Psychiatry, Osaka University. The 20 most frequently reported animals were chosen for SVD analysis. In the two-dimensional (2D solution, item vectors (i.e., animal names were plotted in the 2D space of each group. In the six-dimensional (6D solution, inter-item similarities (i.e., cosines were calculated among items. Cosine charts were also created for the six most frequent items to show the similarities to other animal items.ResultsIn the 2D spatial representation, the six most frequent items were grouped in the same clusters (i.e., dog, cat as pet cluster, lion, tiger as wild/carnivorous cluster, and elephant, giraffe as wild/herbivorous cluster for patients and healthy adults. As for 6D spatial cosines, the correlations (Pearson’s r between 17 items commonly generated in the two groups were moderately high. However, cosine charts created for the three pairs from the six most frequent animals (dog–cat, lion–tiger, elephant–giraffe showed that pair-wise similarities between other animals were less salient in patients with schizophrenia.DiscussionSemantic memory organization in patients with schizophrenia, revealed by SVD analysis, did not appear to be seriously impaired in the 2D space representation, maintaining a clustering structure similar to that in healthy controls for common animals. However, the coherence of those

  17. 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

  18. Long Term Neuropsychological Follow-Up in Patients With Herpes Simplex Encephalitis and Predominantly Left-Sided Lesions

    Directory of Open Access Journals (Sweden)

    B. Laurent

    1991-01-01

    Full Text Available Five patients with predominantly dominant cerebral hemisphere lesions due to herpes simplex encephalitis are described. Verbal amnesia was the main deficit but amnesic aphasia sometimes associated with impairment of remote memory also occurred. Semantic and episodic memory deficits were also explored in one case and the role of the right cerebral hemisphere in facilitating recovery of learning is discussed.

  19. Virtual patients on the semantic Web: a proof-of-application study.

    Science.gov (United States)

    Dafli, Eleni; Antoniou, Panagiotis; Ioannidis, Lazaros; Dombros, Nicholas; Topps, David; Bamidis, Panagiotis D

    2015-01-22

    Virtual patients are interactive computer simulations that are increasingly used as learning activities in modern health care education, especially in teaching clinical decision making. A key challenge is how to retrieve and repurpose virtual patients as unique types of educational resources between different platforms because of the lack of standardized content-retrieving and repurposing mechanisms. Semantic Web technologies provide the capability, through structured information, for easy retrieval, reuse, repurposing, and exchange of virtual patients between different systems. An attempt to address this challenge has been made through the mEducator Best Practice Network, which provisioned frameworks for the discovery, retrieval, sharing, and reuse of medical educational resources. We have extended the OpenLabyrinth virtual patient authoring and deployment platform to facilitate the repurposing and retrieval of existing virtual patient material. A standalone Web distribution and Web interface, which contains an extension for the OpenLabyrinth virtual patient authoring system, was implemented. This extension was designed to semantically annotate virtual patients to facilitate intelligent searches, complex queries, and easy exchange between institutions. The OpenLabyrinth extension enables OpenLabyrinth authors to integrate and share virtual patient case metadata within the mEducator3.0 network. Evaluation included 3 successive steps: (1) expert reviews; (2) evaluation of the ability of health care professionals and medical students to create, share, and exchange virtual patients through specific scenarios in extended OpenLabyrinth (OLabX); and (3) evaluation of the repurposed learning objects that emerged from the procedure. We evaluated 30 repurposed virtual patient cases. The evaluation, with a total of 98 participants, demonstrated the system's main strength: the core repurposing capacity. The extensive metadata schema presentation facilitated user exploration

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

    Science.gov (United States)

    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.

  1. Validation of the language component of the Addenbrooke's Cognitive Examination--Revised (ACE-R) as a screening tool for aphasia in stroke patients.

    Science.gov (United States)

    Gaber, Tarek A-Z K; Parsons, Faye; Gautam, Vidushi

    2011-09-01

    Several tests are available for aphasia screening following stroke. However, some of them have shortcomings such as need of specialist knowledge, low sensitivity and/or specificity and lengthy administration time. Our study aims to evaluate the language component of the Addenbrooke's Cognitive Examination--Revised (ACE-R) as a screening tool for aphasia in stroke patients. The language component of ACE-R was administered to consecutive patients admitted to a post-acute stroke unit. Patients who were medically unstable or had a significant history of sensory impairment or mental health issues were excluded. The test was administered by two junior doctors with basic training in ACE-R administration. Patients recruited were also assessed by an experienced speech and language therapist (SLT). The results of the two assessments were documented by a different member of the team and the SLT results were used as the benchmark to calculate the ACE-R language component sensitivity and specificity.   Fifty-nine participants were recruited and 27 of them were women. The mean age was 72 (SD 11.9). Thirty-four participants had left and 11 right hemisphere stroke. Fourteen had bilateral affection. Six participants were left handed. A cut-off value of 22/26 of ACE-R language component showed 100% specificity and 83.1% sensitivity, while a cut-off value of 16/26 had 88.2% specificity and 100% sensitivity. Our results suggest that the language component of ACE-R has a satisfactory sensitivity and specificity compared with other screening tests used in strokes. It is easy to administer and free to use. © 2010 The Authors. Australasian Journal on Ageing © 2010 ACOTA.

  2. 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...

  3. 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

  4. [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.

  5. 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.

  6. Study on Language Rehabilitation for Aphasia.

    Science.gov (United States)

    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.

  7. The role of polarity in antonym and synonym conceptual knowledge: evidence from stroke aphasia and multidimensional ratings of abstract words.

    Science.gov (United States)

    Crutch, Sebastian J; Williams, Paul; Ridgway, Gerard R; Borgenicht, Laura

    2012-09-01

    This study describes an investigation of different types of semantic relationship among abstract words: antonyms (e.g. good-bad), synonyms (e.g. good-great), non-antonymous, non-synonymous associates (NANSAs; e.g. good-fun) and unrelated words (e.g. good-late). The comprehension and semantic properties of these words were examined using two distinct methodologies. Experiment 1 tested the comprehension of pairs of abstract words in three patients with global aphasia using a spoken word to written word matching paradigm. Contrary to expectations, all three patients showed superior antonym comprehension compared with synonyms or NANSAs, discriminating antonyms with a similar level of accuracy as unrelated words. Experiment 2 aimed to explore the content or semantic attributes of the abstract words used in Experiment 1 through the generation of control ratings across nine cognitive dimensions (sensation, action, thought, emotion, social interaction, space, time, quantity and polarity). Discrepancy analyses revealed that antonyms were as or more similar to one another than synonyms on all but one measure: polarity. The results of Experiment 2 provide a possible explanation for the novel pattern of neuropsychological data observed in Experiment 1, namely that polarity information is more important than other semantic attributes when discriminating the meaning of abstract words. It is argued that polarity is a critical semantic attribute of abstract words, and that simple 'dissimilarity' metrics mask fundamental consistencies in the semantic representation of antonyms. It is also suggested that mapping abstract semantic space requires the identification and quantification of the contribution made to abstract concepts by not only sensorimotor and emotional information but also a host of other cognitive dimensions. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. A Comparison of the BAT and BDAE-SF Batteries in Determining the Linguistic Ability in Greek-Speaking Patients with Broca's Aphasia

    Science.gov (United States)

    Peristeri, Eleni; Tsapkini, Kyrana

    2011-01-01

    The aim of this study is to test the validity and reliability of the Bilingual Aphasia Test as a measure of language impairment in a Greek-speaking Broca's aphasic population and to investigate relationships with the same aphasic group's performance on the Greek version of the short form of the Boston Diagnostic Aphasia Examination battery, mainly…

  9. 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...

  10. 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

  11. 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)

  12. 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.

  13. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  15. 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.

  16. 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 ...

  17. [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.

  18. Global aphasia without hemiparesis: A case series

    Directory of Open Access Journals (Sweden)

    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.

  19. Judgment of emotional information expressed by prosody and semantics in patients with unipolar depression

    Directory of Open Access Journals (Sweden)

    Sarah eSchlipf

    2013-07-01

    Full Text Available It was the aim of this study to investigate the impact of major depressive disorder (MDD on judgment of emotions expressed at the verbal (semantic content and non-verbal (prosody level and to assess whether evaluation of verbal content correlate with self-ratings of depression-related symptoms as assessed by Beck Depression Inventory (BDI. We presented positive, neutral, and negative words spoken in happy, neutral, and angry prosody to 23 MDD patients and 22 healthy controls (HC matched for age, sex, and education. Participants rated the valence of semantic content or prosody on a 9-point scale. MDD patients attributed significantly less intense ratings to positive words and happy prosody than HC. For judgment of words, this difference correlated significantly with BDI scores. No such correlation was found for prosody perception. MDD patients exhibited attenuated processing of positive information which generalized across verbal and non-verbal channels. These findings indicate that MDD is characterized by impairments of positive rather than negative emotional processing, a finding which could influence future psychotherapeutic strategies as well as provide straightforward hypotheses for neuroimaging studies investigating the neurobiological correlates of impaired emotional perception in MDD.

  20. 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

  1. 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

  2. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  4. 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

  5. Therapy-Induced Neuroplasticity of Language in Chronic Post Stroke Aphasia: A Mismatch Negativity Study of (A)Grammatical and Meaningful/less Mini-Constructions

    Science.gov (United States)

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

    2017-01-01

    Clinical language performance and neurophysiological correlates of language processing were measured before and after intensive language therapy in patients with chronic (time post stroke >1 year) post stroke aphasia (PSA). As event-related potential (ERP) measure, the mismatch negativity (MMN) was recorded in a distracted oddball paradigm to short spoken sentences. Critical ‘deviant’ sentence stimuli where either well-formed and meaningful, or syntactically, or lexico-semantically incorrect. After 4 weeks of speech-language therapy (SLT) delivered with high intensity (10.5 h per week), clinical language assessment with the Aachen Aphasia Test battery demonstrated significant linguistic improvements, which were accompanied by enhanced MMN responses. More specifically, MMN amplitudes to grammatically correct and meaningful mini-constructions and to ‘jabberwocky’ sentences containing a pseudoword significantly increased after therapy. However, no therapy-related changes in MMN responses to syntactically incorrect strings including agreement violations were observed. While MMN increases to well-formed meaningful strings can be explained both at the word and construction levels, the neuroplastic change seen for ‘jabberwocky’ sentences suggests an explanation in terms of constructions. The results confirm previous reports that intensive SLT leads to improvements of linguistic skills in chronic aphasia patients and now demonstrate that this clinical improvement is associated with enhanced automatic brain indexes of construction processing, although no comparable change is present for ungrammatical strings. Furthermore, the data confirm that the language-induced MMN is a useful tool to map functional language recovery in PSA. PMID:28111545

  6. Effect of low-rTMS in combined with edaravone on the inflammatory cytokines and cerebral metabolites in patients with cerebral infarction and aphasia

    Directory of Open Access Journals (Sweden)

    Lei Ge

    2017-05-01

    Full Text Available Objective: To explore the effect of low-repetitive transcranial magnetic stimulation (low-rTMS in combined with edaravone on the inflammatory cytokines and cerebral metabolites in patients with cerebral infarction and aphasia. Methods: A total of 70 patients with acute cerebral infarction (ACI and motor aphasia who were admitted in our hospital from March, 2015 to March, 2016 were included in the study and randomized into the observation group and the control group, 35 in each group. The patients in the control group were given blood pressure reduction, intracranial pressure reduction, blood lipid regulation, anti-platelet aggregation, symptomatic and supportive treatments, edaravone (30 mg + normal saline (100 mL, ivdrip, 2 times/d, continuously for 2 weeks. On this basis, the patients in the observation group were given additional rTMS, continuously for 10 d. Hs-CRP, IL-6, IL-8, and TNF-α levels before treatment, 1 week and 2 weeks after treatment in the two groups were detected. MRS was used to detect NAA and Cho in Broca district before treatment, 1 week and 2 weeks after treatment in the two groups. ABC was used to evaluate the linguistic function before treatment, 2 weeks, 3 months, and 6 months in the two groups. Results: Hs-CRP, IL-6, IL-8, and TNF-α levels 1 week and 2 weeks after treatment in the observation group were significantly lower than those in the control group (P<0.05. NAA value on the left side 1 week and 2 weeks after treatment in the observation group was significantly higher than that in the control group (P<0.05, while Cho value was significantly lower than that in the control group (P<0.05. ABC score 2 weeks, 3 months, and 6 months after treatment in the observation group was significantly higher than that in the control group (P<0.05. Conclusions: Edaravone in combined with low-rTMS in the treatment of ACI can effectively inhibit the inflammatory reaction, improve the neurological deficit degree, and promote the

  7. 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.

  8. Semantic Advertising

    OpenAIRE

    Zamanzadeh, Ben; Ashish, Naveen; Ramakrishnan, Cartic; Zimmerman, John

    2013-01-01

    We present the concept of Semantic Advertising which we see as the future of online advertising. Semantic Advertising is online advertising powered by semantic technology which essentially enables us to represent and reason with concepts and the meaning of things. This paper aims to 1) Define semantic advertising, 2) Place it in the context of broader and more widely used concepts such as the Semantic Web and Semantic Search, 3) Provide a survey of work in related areas such as context matchi...

  9. 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.

  10. Nonverbal oral apraxia in primary progressive aphasia and apraxia of speech.

    Science.gov (United States)

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

    2014-05-13

    The goal of this study was to explore the prevalence of nonverbal oral apraxia (NVOA), its association with other forms of apraxia, and associated imaging findings in patients with primary progressive aphasia (PPA) and progressive apraxia of speech (PAOS). Patients with a degenerative speech or language disorder were prospectively recruited and diagnosed with a subtype of PPA or with PAOS. All patients had comprehensive speech and language examinations. Voxel-based morphometry was performed to determine whether atrophy of a specific region correlated with the presence of NVOA. Eighty-nine patients were identified, of which 34 had PAOS, 9 had agrammatic PPA, 41 had logopenic aphasia, and 5 had semantic dementia. NVOA was very common among patients with PAOS but was found in patients with PPA as well. Several patients exhibited only one of NVOA or apraxia of speech. Among patients with apraxia of speech, the severity of the apraxia of speech was predictive of NVOA, whereas ideomotor apraxia severity was predictive of the presence of NVOA in those without apraxia of speech. Bilateral atrophy of the prefrontal cortex anterior to the premotor area and supplementary motor area was associated with NVOA. Apraxia of speech, NVOA, and ideomotor apraxia are at least partially separable disorders. The association of NVOA and apraxia of speech likely results from the proximity of the area reported here and the premotor area, which has been implicated in apraxia of speech. The association of ideomotor apraxia and NVOA among patients without apraxia of speech could represent disruption of modules shared by nonverbal oral movements and limb movements.

  11. Noun and verb processing in aphasia: Behavioural profiles and neural correlates

    Directory of Open Access Journals (Sweden)

    Reem S.W. Alyahya

    Full Text Available The behavioural and neural processes underpinning different word classes, particularly nouns and verbs, have been a long-standing area of interest in psycholinguistic, neuropsychology and aphasiology research. This topic has theoretical implications concerning the organisation of the language system, as well as clinical consequences related to the management of patients with language deficits. Research findings, however, have diverged widely, which might, in part, reflect methodological differences, particularly related to controlling the psycholinguistic variations between nouns and verbs. The first aim of this study, therefore, was to develop a set of neuropsychological tests that assessed single-word production and comprehension with a matched set of nouns and verbs. Secondly, the behavioural profiles and neural correlates of noun and verb processing were explored, based on these novel tests, in a relatively large cohort of 48 patients with chronic post-stroke aphasia. A data-driven approach, principal component analysis (PCA, was also used to determine how noun and verb production and comprehension were related to the patients' underlying fundamental language domains. The results revealed no performance differences between noun and verb production and comprehension once matched on multiple psycholinguistic features including, most critically, imageability. Interestingly, the noun-verb differences found in previous studies were replicated in this study once un-matched materials were used. Lesion-symptom mapping revealed overlapping neural correlates of noun and verb processing along left temporal and parietal regions. These findings support the view that the neural representation of noun and verb processing at single-word level are jointly-supported by distributed cortical regions. The PCA generated five fundamental language and cognitive components of aphasia: phonological production, phonological recognition, semantics, fluency, and

  12. 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.)

  13. 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).

  14. 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).

  15. 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.

  16. Rehabilitation Of Stroke Aphasia: Topics Of Research

    Directory of Open Access Journals (Sweden)

    Fariba Yadegari

    2017-02-01

    in the assessment and treatment of aphasia are being researched currently. This model provides a comprehensive functional communicative lookout of the patient. Conclusion: There is no prescribed intervention for different types of aphasia. Customized therapeutic programs which are tailored to the unique needs of the patients and incorporate primary impairment, functional limitations and social restrictions of the patient are needed. This therapy should be intensive enough and be administered as early as possible.

  17. Memory for the perceptual and semantic attributes of information in pure amnesic and severe closed-head injured patients.

    Science.gov (United States)

    Carlesimo, Giovanni A; Bonanni, Rita; Caltagirone, Carlo

    2003-05-01

    This study investigated the hypothesis that brain damaged patients with memory disorder are poorer at remembering the semantic than the perceptual attributes of information. Eight patients with memory impairment of different etiology and 24 patients with chronic consequences of severe closed-head injury were compared to similarly sized age- and literacy-matched normal control groups on recognition tests for the physical aspect and the semantic identity of words and pictures lists. In order to avoid interpretative problems deriving from different absolute levels of performance, study conditions were manipulated across subjects to obtain comparable accuracy on the perceptual recognition tests in the memory disordered and control groups. The results of the Picture Recognition test were consistent with the hypothesis. Indeed, having more time for the stimulus encoding, the two memory disordered groups performed at the same level as the normal subjects on the perceptual test but significantly lower on the semantic test. Instead, on the Word Recognition test, following study condition manipulation, patients and controls performed similarly on both the perceptual and the semantic tests. These data only partially support the hypothesis of the study; rather they suggest that in memory disordered patients there is a reduction of the advantage, exhibited by normal controls, of retrieving pictures over words (picture superiority effect).

  18. [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.

  19. 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

  20. 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-.

  1. 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.

  2. 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…

  3. 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.

  4. 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.

  5. White matter disease correlates with lexical retrieval deficits in primary progressive aphasia.

    Science.gov (United States)

    Powers, John P; McMillan, Corey T; Brun, Caroline C; Yushkevich, Paul A; Zhang, Hui; Gee, James C; Grossman, Murray

    2013-01-01

    To relate fractional anisotropy (FA) changes associated with the semantic and logopenic variants of primary progressive aphasia (PPA) to measures of lexical retrieval. We collected neuropsychological testing, volumetric magnetic resonance imaging, and diffusion-weighted imaging on semantic variant PPA (svPPA) (n = 11) and logopenic variant PPA (lvPPA) (n = 13) patients diagnosed using published criteria. We also acquired neuroimaging data on a group of demographically comparable healthy seniors (n = 34). FA was calculated and analyzed using a white matter (WM) 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 FA and determine regions of reduced FA in patients. We found widespread FA reductions in WM for both variants of PPA. FA was related to both confrontation naming and category naming fluency performance in left uncinate fasciculus and corpus callosum in svPPA and left superior and inferior longitudinal fasciculi in lvPPA. SvPPA and lvPPA are associated with distinct disruptions of a large-scale network implicated in lexical retrieval, and the WM disease in each phenotype may contribute to language impairments including lexical retrieval.

  6. 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.

  7. A potential protective effect in multilingual patients with semantic dementia: two case reports of patients speaking Taiwanese and Japanese.

    Science.gov (United States)

    Liu, Yi-Chien; Yip, Ping-Keung; Fan, Yu-Ming; Meguro, Kenichi

    2012-03-01

    Several reports have suggested that multilingualism has a protective effect against semantic dementia. Here, we provide further evidence for this effect. The patient was a 75-year-old right-handed Taiwanese woman who had retired after working as a tailor. She was able to speak Taiwanese, Japanese and Mandarin Chinese fluently until 5 years ago. She gradually developed symptoms of profound anomia and difficulty with word-finding. Her mother tongue was Taiwanese and she had learned Japanese as her first symbolized language. She had used Mandarin Chinese for most of her life, but depended on Japanese to read and write (such as reading a newspaper and keeping accounts). However, she could now speak only very simple Taiwanese and Japanese, and could recognize only simple Japanese characters. SECOND: The patient was a 62-year-old right-handed man who had worked as an ironworker. He could speak Taiwanese and Mandarin Chinese fluently until 5 years ago. His mother tongue was Taiwanese. After 5 years of language deterioration, he was unable to communicate with his family members or recognize any characters, including numbers. SPECT RESULTS: Brain perfusion ECD SPECT (Tc-99m-ethyl cysteinate dimer single-photon emission computed tomography) showed less perfusion in the multilingual patient (Case #1) than in the bilingual patient (Case #2). Neuropsychological tests also demonstrated a slower rate of degeneration in the multilingual patient. We speculate that reading and writing in Japanese had a greater impact on the semantic system in Case #1. Thus, this patient showed relatively less degeneration or functional inactivity, as shown by perfusion in the frontal lobe, and this might be due to the persistent activation involved in multilingualism.

  8. [A case of crossed aphasia with echolalia after the resection of tumor in the right medial frontal lobe].

    Science.gov (United States)

    Endo, K; Suzuki, K; Yamadori, A; Kumabe, T; Seki, K; Fujii, T

    2001-03-01

    We report a right-handed woman, who developed a non-fluent aphasia after resection of astrocytoma (grade III) in the right medial frontal lobe. On admission to the rehabilitation department, neurological examination revealed mild left hemiparesis, hyperreflexia on the left side and grasp reflex on the left hand. Neuropsychologically she showed general inattention, non-fluent aphasia, acalculia, constructional disability, and mild buccofacial apraxia. No other apraxia, unilateral spatial neglect or extinction phenomena were observed. An MRI demonstrated resected areas in the right superior frontal gyrus, subcortical region in the right middle frontal gyrus, anterior part of the cingulate gyrus, a part of supplementary motor area. Surrounding area in the right frontal lobe showed diffuse signal change. She demonstrated non-fluent aprosodic speech with word finding difficulty. No phonemic paraphasia, or anarthria was observed. Auditory comprehension was fair with some difficulty in comprehending complex commands. Naming was good, but verbal fluency tests for a category or phonemic cuing was severely impaired. She could repeat words but not sentences. Reading comprehension was disturbed by semantic paralexia and writing words was poor for both Kana (syllabogram) and Kanji(logogram) characters. A significant feature of her speech was mitigated echolalia. In both free conversation and examination setting, she often repeated phrases spoken to her which she used to start her speech. In addition, she repeated words spoken to others which were totally irrelevant to her conversation. She was aware of her echoing, which always embarrassed her. She described her echolalic tendency as a great nuisance. However, once echoing being forbidden, she could not initiate her speech and made incorrect responses after long delay. Thus, her compulsive echolalia helped to start her speech. Only four patients with crossed aphasia demonstrated echolalia in the literature. They showed severe

  9. 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.

  10. 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

  11. Semantic memory in object use.

    Science.gov (United States)

    Silveri, Maria Caterina; Ciccarelli, Nicoletta

    2009-10-01

    We studied five patients with semantic memory disorders, four with semantic dementia and one with herpes simplex virus encephalitis, to investigate the involvement of semantic conceptual knowledge in object use. Comparisons between patients who had semantic deficits of different severity, as well as the follow-up, showed that the ability to use objects was largely preserved when the deficit was mild but progressively decayed as the deficit became more severe. Naming was generally more impaired than object use. Production tasks (pantomime execution and actual object use) and comprehension tasks (pantomime recognition and action recognition) as well as functional knowledge about objects were impaired when the semantic deficit was severe. Semantic and unrelated errors were produced during object use, but actions were always fluent and patients performed normally on a novel tools task in which the semantic demand was minimal. Patients with severe semantic deficits scored borderline on ideational apraxia tasks. Our data indicate that functional semantic knowledge is crucial for using objects in a conventional way and suggest that non-semantic factors, mainly non-declarative components of memory, might compensate to some extent for semantic disorders and guarantee some residual ability to use very common objects independently of semantic knowledge.

  12. Electrophysiological correlates of semantic memory retrieval in Gulf War Syndrome 2 patients.

    Science.gov (United States)

    Tillman, Gail D; Calley, Clifford S; Buhl, Virginia I; Chiang, Hsueh-Sheng; Haley, Robert W; Hart, John; Kraut, Michael A

    2017-02-15

    Gulf War veterans meeting criteria for Haley Syndrome 2 of Gulf War illness endorse a particular constellation of symptoms that include difficulty with processing information, word-finding, and confusion. To explore the neural basis of their word-finding difficulty, we assessed event-related potentials (ERPs) associated with semantic memory retrieval in 22 veterans classified as Syndrome 2 and 28 veterans who served as controls. We recorded EEGs while subjects judged whether pairs of words that represented object features combined to elicit a retrieval of an object memory or no retrieval. Syndrome 2 subjects' responses were significantly slower, and those participants were less accurate than controls on the retrieval trials, but they performed similarly on the nonretrieval trials. Analysis of the ERPs revealed a difference between retrievals and nonretrievals that has previously been detected around 750ms at the left temporal region was present in both the Syndrome 2 patients and controls. However, the Syndrome 2 patients also showed an ERP difference between retrievals and nonretrievals at the midline parietal region that had a scalp voltage polarity opposite from that recorded at the left temporal area. We hypothesize that the similarities between task performance and ERP patterns in Syndrome 2 veterans and in patients with amnestic mild cognitive impairment reflect disordered thalamic cholinergic neural activity, possibly in the dorsomedial nucleus. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Primary progressive aphasia and the evolving neurology of the language network.

    Science.gov (United States)

    Mesulam, M-Marsel; Rogalski, Emily J; Wieneke, Christina; Hurley, Robert S; Geula, Changiz; Bigio, Eileen H; Thompson, Cynthia K; Weintraub, Sandra

    2014-10-01

    Primary progressive aphasia (PPA) is caused by selective neurodegeneration of the language-dominant cerebral hemisphere; a language deficit initially arises as the only consequential impairment and remains predominant throughout most of the course of the disease. Agrammatic, logopenic and semantic subtypes, each reflecting a characteristic pattern of language impairment and corresponding anatomical distribution of cortical atrophy, represent the most frequent presentations of PPA. Such associations between clinical features and the sites of atrophy have provided new insights into the neurology of fluency, grammar, word retrieval, and word comprehension, and have necessitated modification of concepts related to the functions of the anterior temporal lobe and Wernicke's area. The underlying neuropathology of PPA is, most commonly, frontotemporal lobar degeneration in the agrammatic and semantic forms, and Alzheimer disease (AD) pathology in the logopenic form; the AD pathology often displays atypical and asymmetrical anatomical features consistent with the aphasic phenotype. The PPA syndrome reflects complex interactions between disease-specific neuropathological features and patient-specific vulnerability. A better understanding of these interactions might help us to elucidate the biology of the language network and the principles of selective vulnerability in neurodegenerative diseases. We review these aspects of PPA, focusing on advances in our understanding of the clinical features and neuropathology of PPA and what they have taught us about the neural substrates of the language network.

  14. 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.

  15. Querying phenotype-genotype relationships on patient datasets using semantic web technology: the example of Cerebrotendinous xanthomatosis.

    Science.gov (United States)

    Taboada, María; Martínez, Diego; Pilo, Belén; Jiménez-Escrig, Adriano; Robinson, Peter N; Sobrido, María J

    2012-07-31

    Semantic Web technology can considerably catalyze translational genetics and genomics research in medicine, where the interchange of information between basic research and clinical levels becomes crucial. This exchange involves mapping abstract phenotype descriptions from research resources, such as knowledge databases and catalogs, to unstructured datasets produced through experimental methods and clinical practice. This is especially true for the construction of mutation databases. This paper presents a way of harmonizing abstract phenotype descriptions with patient data from clinical practice, and querying this dataset about relationships between phenotypes and genetic variants, at different levels of abstraction. Due to the current availability of ontological and terminological resources that have already reached some consensus in biomedicine, a reuse-based ontology engineering approach was followed. The proposed approach uses the Ontology Web Language (OWL) to represent the phenotype ontology and the patient model, the Semantic Web Rule Language (SWRL) to bridge the gap between phenotype descriptions and clinical data, and the Semantic Query Web Rule Language (SQWRL) to query relevant phenotype-genotype bidirectional relationships. The work tests the use of semantic web technology in the biomedical research domain named cerebrotendinous xanthomatosis (CTX), using a real dataset and ontologies. A framework to query relevant phenotype-genotype bidirectional relationships is provided. Phenotype descriptions and patient data were harmonized by defining 28 Horn-like rules in terms of the OWL concepts. In total, 24 patterns of SWQRL queries were designed following the initial list of competency questions. As the approach is based on OWL, the semantic of the framework adapts the standard logical model of an open world assumption. This work demonstrates how semantic web technologies can be used to support flexible representation and computational inference mechanisms

  16. Semantic Multimedia

    NARCIS (Netherlands)

    S. Staab; A. Scherp; R. Arndt; R. Troncy (Raphael); M. Grzegorzek; C. Saathoff; S. Schenk; L. Hardman (Lynda)

    2008-01-01

    htmlabstractMultimedia constitutes an interesting field of application for Semantic Web and Semantic Web reasoning, as the access and management of multimedia content and context depends strongly on the semantic descriptions of both. At the same time, multimedia resources constitute complex objects,

  17. Generative Semantics.

    Science.gov (United States)

    King, Margaret

    The first section of this paper deals with the attempts within the framework of transformational grammar to make semantics a systematic part of linguistic description, and outlines the characteristics of the generative semantics position. The second section takes a critical look at generative semantics in its later manifestations, and makes a case…

  18. [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.

  19. 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.

  20. 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 ...

  1. 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 ...

  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. ALTERNATIVE FORMS OF COMMUNICATION AMONG PERSONS WITH APHASIA

    Directory of Open Access Journals (Sweden)

    Elena TASHKOVA

    2012-03-01

    Full Text Available The aphasia is the most complicated and the most difficult form of disorder of speaking and language. Most often it appears as a consequence of a brain stroke. The occurrence of aphasias is in about one third of the patients suffering from a brain stroke in an acute phase, or from 21% to 24%, and there are data for even bigger frequency. In a certain number of patients the aphasia withdraws spontaneously, but in a bigger number of patients it takes over all four models of language activity; phoneme pronunciation, carrying out a discussion, writing a letter of a full text. It spreads from the automatic to the creative expression. The process of rehabilitation of the spoken communication at the persons with aphasia is complicated, multidisciplinary and long lasting.Around the World, a big accent is placed on the use of methods and strategies of alternative communication methods (AAK for the persons with aphasia. Although the augmentative and the AAK methods for the persons with aphasia are relatively novel in the speech therapy, their applicability deserves an attention as well as the fact that they are promising new paths for researching.The master thesis is written on 104 pages, which include 35 tables and 48 graphics, as well as a glossary with 114 biographical units. The content is divided into introduction, grounding theory and methodology of research. The introduction shows the meaning and the necessity for research of alternative methods in the therapy and the treatment of persons with aphasia. The section with the theoretical grounds contains several mutually connected chapters (parts. In methodology of research section are described the subject of the research, the aim and the character of the research. Further the text contains the tasks, hypothesis, research variables, methods and techniques of the research, as well as the sample and the organization of the research. The end of the section consist the analysis and interpretation of the

  4. 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

  5. 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

  6. A Role for Semantic Web Technologies in Patient Record Data Collection

    Science.gov (United States)

    Ogbuji, Chimezie

    Business Process Management Systems (BPMS) are a component of the stack of Web standards that comprise Service Oriented Architecture (SOA). Such systems are representative of the architectural framework of modern information systems built in an enterprise intranet and are in contrast to systems built for deployment on the larger World Wide Web. The REST architectural style is an emerging style for building loosely coupled systems based purely on the native HTTP protocol. It is a coordinated set of architectural constraints with a goal to minimize latency, maximize the independence and scalability of distributed components, and facilitate the use of intermediary processors.Within the development community for distributed, Web-based systems, there has been a debate regarding themerits of both approaches. In some cases, there are legitimate concerns about the differences in both architectural styles. In other cases, the contention seems to be based on concerns that are marginal at best. In this chapter, we will attempt to contribute to this debate by focusing on a specific, deployed use case that emphasizes the role of the Semantic Web, a simple Web application architecture that leverages the use of declarative XML processing, and the needs of a workflow system. The use case involves orchestrating a work process associated with the data entry of structured patient record content into a research registry at the Cleveland Clinic's Clinical Investigation department in the Heart and Vascular Institute.

  7. Distinctive Structural and Effective Connectivity Changes of Semantic Cognition Network across Left and Right Mesial Temporal Lobe Epilepsy Patients

    Directory of Open Access Journals (Sweden)

    Xiaotong Fan

    2016-01-01

    Full Text Available Occurrence of language impairment in mesial temporal lobe epilepsy (mTLE patients is common and left mTLE patients always exhibit a primary problem with access to names. To explore different neuropsychological profiles between left and right mTLE patients, the study investigated both structural and effective functional connectivity changes within the semantic cognition network between these two groups and those from normal controls. We found that gray matter atrophy of left mTLE patients was more severe than that of right mTLE patients in the whole brain and especially within the semantic cognition network in their contralateral hemisphere. It suggested that seizure attacks were rather targeted than random for patients with hippocampal sclerosis (HS in the dominant hemisphere. Functional connectivity analysis during resting state fMRI revealed that subregions of the anterior temporal lobe (ATL in the left HS patients were no longer effectively connected. Further, we found that, unlike in right HS patients, increased causal linking between ipsilateral regions in the left HS epilepsy patients cannot make up for their decreased contralateral interaction. It suggested that weakened contralateral connection and disrupted effective interaction between subregions of the unitary, transmodal hub of the ATL may be the primary cause of anomia in the left HS patients.

  8. Distinctive Structural and Effective Connectivity Changes of Semantic Cognition Network across Left and Right Mesial Temporal Lobe Epilepsy Patients

    Science.gov (United States)

    Fan, Xiaotong; Shang, Kun; Wang, Xiaocui; Wang, Peipei; Shan, Yongzhi; Lu, Jie

    2016-01-01

    Occurrence of language impairment in mesial temporal lobe epilepsy (mTLE) patients is common and left mTLE patients always exhibit a primary problem with access to names. To explore different neuropsychological profiles between left and right mTLE patients, the study investigated both structural and effective functional connectivity changes within the semantic cognition network between these two groups and those from normal controls. We found that gray matter atrophy of left mTLE patients was more severe than that of right mTLE patients in the whole brain and especially within the semantic cognition network in their contralateral hemisphere. It suggested that seizure attacks were rather targeted than random for patients with hippocampal sclerosis (HS) in the dominant hemisphere. Functional connectivity analysis during resting state fMRI revealed that subregions of the anterior temporal lobe (ATL) in the left HS patients were no longer effectively connected. Further, we found that, unlike in right HS patients, increased causal linking between ipsilateral regions in the left HS epilepsy patients cannot make up for their decreased contralateral interaction. It suggested that weakened contralateral connection and disrupted effective interaction between subregions of the unitary, transmodal hub of the ATL may be the primary cause of anomia in the left HS patients. PMID:28018680

  9. 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.

  10. 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

  11. Unification of behavioural, computational and neural accounts of word production errors in post-stroke aphasia

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    Marija Tochadse

    Full Text Available Neuropsychological assessment, brain imaging and computational modelling have augmented our understanding of the multifaceted functional deficits in people with language disorders after stroke. Despite the volume of research using each technique, no studies have attempted to assimilate all three approaches in order to generate a unified behavioural-computational-neural model of post-stroke aphasia.The present study included data from 53 participants with chronic post-stroke aphasia and merged: aphasiological profiles based on a detailed neuropsychological assessment battery which was analysed with principal component and correlational analyses; measures of the impairment taken from Dell's computational model of word production; and the neural correlates of both behavioural and computational accounts analysed by voxel-based correlational methodology.As a result, all three strands coincide with the separation of semantic and phonological stages of aphasic naming, revealing the prominence of these dimensions for the explanation of aphasic performance. Over and above three previously described principal components (phonological ability, semantic ability, executive-demand, we observed auditory working memory as a novel factor. While the phonological Dell parameter was uniquely related to phonological errors/factor, the semantic parameter was less clear-cut, being related to both semantic errors and omissions, and loading heavily with semantic ability and auditory working memory factors. The close relationship between the semantic Dell parameter and omission errors recurred in their high lesion-correlate overlap in the anterior middle temporal gyrus. In addition, the simultaneous overlap of the lesion correlate of omission errors with more dorsal temporal regions, associated with the phonological parameter, highlights the multiple drivers that underpin this error type. The novel auditory working memory factor was located along left superior

  12. Structural prediction in aphasia

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    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

  13. Primary Progressive Aphasia in the Network of French Alzheimer Plan Memory Centers.

    Science.gov (United States)

    Magnin, Eloi; Démonet, Jean-François; Wallon, David; Dumurgier, Julien; Troussière, Anne-Cécile; Jager, Alain; Duron, Emmanuelle; Gabelle, Audrey; de la Sayette, Vincent; Volpe-Gillot, Lisette; Tio, Gregory; Evain, Sarah; Boutoleau-Bretonnière, Claire; Enderle, Adeline; Mouton-Liger, François; Robert, Philippe; Hannequin, Didier; Pasquier, Florence; Hugon, Jacques; Paquet, Claire

    2016-10-18

    Few demographical data about primary progressive aphasia (PPA) are available, and most knowledge regarding PPA is based on tertiary centers' results. Our aims were to describe demographical characteristics of the PPA population in a large sample of PPA patients from the network of French Alzheimer plan memory centers (Sample 1), and to describe the stratification of cerebrospinal fluid (CSF) biomarkers in two different samples of PPA patients (Samples 2 and 3). All registered PPA patients in the French Alzheimer's disease (AD) databank (Sample 1: n = 2,035) and a subsample (Sample 2: n = 65) derived from a multicentric prospective cohort with CSF biomarker analysis were analyzed. A multicentric retrospective cohort from language expert tertiary centers (Sample 3: n = 97) with CSF biomarker analysis was added. Sample 3 was added to replicate the CSF results of the Sample 2 and to evaluate repartition of AD pathology in the three variant of PPA according to the latest classification. Non-Fluent/Agrammatic, Logopenic, and Unclassifiable PPA patients (NF/A-Logo-Unclass PPA) were older and more frequent than Semantic PPA patients (2.2 versus 0.8/100,000 inhabitants; p < 0.00001). Male predominance occurred after the age of 80 (p < 0.00001). A higher level of education was observed in the PPA population compared to a typical amnesic AD group. No demographical significant difference between PPA due to AD and not due to AD was observed. The Logopenic variant was most frequent with 85% of AD CSF biomarker profiles (35% in NF/A PPA; 20% in Semantic PPA). PPA occurs also in an elderly population, especially in male patients over 80. CSF biomarkers are useful to stratify PPA. The epidemiology of PPA should be further investigated to confirm gender and cognitive reserve role in PPA to better understand the factors and mechanisms leading to this language-predominant deficit during neurodegenerative diseases.

  14. SU-D-207B-02: Early Grade Classification in Meningioma Patients Combining Radiomics and Semantics Data

    International Nuclear Information System (INIS)

    Coroller, T; Bi, W; Abedalthagafi, M; Aizer, A; Wu, W; Greenwald, N; Beroukhim, R; Al-Mefty, O; Santagata, S; Dunn, I; Alexander, B; Huang, R; Aerts, H

    2016-01-01

    Purpose: The clinical management of meningioma is guided by its grade and biologic behavior. Currently, diagnosis of tumor grade follows surgical resection and histopathologic review. Reliable techniques for pre-operative determination of tumor behavior are needed. We investigated the association between imaging features extracted from preoperative gadolinium-enhanced T1-weighted MRI and meningioma grade. Methods: We retrospectively examined the pre-operative MRI for 139 patients with de novo WHO grade I (63%) and grade II (37%) meningiomas. We investigated the predictive power of ten semantic radiologic features as determined by a neuroradiologist, fifteen radiomic features, and tumor location. Conventional (volume and diameter) imaging features were added for comparison. AUC was computed for continuous and χ 2 for discrete variables. Classification was done using random forest. Performance was evaluated using cross validation (1000 iterations, 75% training and 25% validation). All p-values were adjusted for multiple testing. Results: Significant association was observed between meningioma grade and tumor location (p<0.001) and two semantic features including intra-tumoral heterogeneity (p<0.001) and overt hemorrhage (p=0.01). Conventional (AUC 0.61–0.67) and eleven radiomic (AUC 0.60–0.70) features were significant from random (p<0.05, Noether test). Median AUC values for classification of tumor grade were 0.57, 0.71, 0.72 and 0.77 respectively for conventional, radiomic, location, and semantic features after using random forest. By combining all imaging data (semantic, radiomic, and location), the median AUC was 0.81, which offers superior predicting power to that of conventional imaging descriptors for meningioma as well as radiomic features alone (p<0.05, permutation test). Conclusion: We demonstrate a strong association between radiologic features and meningioma grade. Pre-operative prediction of tumor behavior based on imaging features offers promise

  15. SU-D-207B-02: Early Grade Classification in Meningioma Patients Combining Radiomics and Semantics Data

    Energy Technology Data Exchange (ETDEWEB)

    Coroller, T; Bi, W; Abedalthagafi, M; Aizer, A; Wu, W; Greenwald, N; Beroukhim, R; Al-Mefty, O; Santagata, S; Dunn, I; Alexander, B; Huang, R; Aerts, H [Dana Farber Cancer Institute, Brigham and Womens Hospital, Harvard Medical School (United States)

    2016-06-15

    Purpose: The clinical management of meningioma is guided by its grade and biologic behavior. Currently, diagnosis of tumor grade follows surgical resection and histopathologic review. Reliable techniques for pre-operative determination of tumor behavior are needed. We investigated the association between imaging features extracted from preoperative gadolinium-enhanced T1-weighted MRI and meningioma grade. Methods: We retrospectively examined the pre-operative MRI for 139 patients with de novo WHO grade I (63%) and grade II (37%) meningiomas. We investigated the predictive power of ten semantic radiologic features as determined by a neuroradiologist, fifteen radiomic features, and tumor location. Conventional (volume and diameter) imaging features were added for comparison. AUC was computed for continuous and χ{sup 2} for discrete variables. Classification was done using random forest. Performance was evaluated using cross validation (1000 iterations, 75% training and 25% validation). All p-values were adjusted for multiple testing. Results: Significant association was observed between meningioma grade and tumor location (p<0.001) and two semantic features including intra-tumoral heterogeneity (p<0.001) and overt hemorrhage (p=0.01). Conventional (AUC 0.61–0.67) and eleven radiomic (AUC 0.60–0.70) features were significant from random (p<0.05, Noether test). Median AUC values for classification of tumor grade were 0.57, 0.71, 0.72 and 0.77 respectively for conventional, radiomic, location, and semantic features after using random forest. By combining all imaging data (semantic, radiomic, and location), the median AUC was 0.81, which offers superior predicting power to that of conventional imaging descriptors for meningioma as well as radiomic features alone (p<0.05, permutation test). Conclusion: We demonstrate a strong association between radiologic features and meningioma grade. Pre-operative prediction of tumor behavior based on imaging features offers

  16. 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.

  17. 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 ...

  18. 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,…

  19. 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…

  20. Semantic Feature Training in Combination with Transcranial Direct Current Stimulation (tDCS for Progressive Anomia

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    Jinyi Hung

    2017-05-01

    Full Text Available We examined the effectiveness of a 2-week regimen of a semantic feature training in combination with transcranial direct current stimulation (tDCS for progressive naming impairment associated with primary progressive aphasia (N = 4 or early onset Alzheimer’s Disease (N = 1. Patients received a 2-week regimen (10 sessions of anodal tDCS delivered over the left temporoparietal cortex while completing a language therapy that consisted of repeated naming and semantic feature generation. Therapy targets consisted of familiar people, household items, clothes, foods, places, hygiene implements, and activities. Untrained items from each semantic category provided item level controls. We analyzed naming accuracies at multiple timepoints (i.e., pre-, post-, 6-month follow-up via a mixed effects logistic regression and individual differences in treatment responsiveness using a series of non-parametric McNemar tests. Patients showed advantages for naming trained over untrained items. These gains were evident immediately post tDCS. Trained items also showed a shallower rate of decline over 6-months relative to untrained items that showed continued progressive decline. Patients tolerated stimulation well, and sustained improvements in naming accuracy suggest that the current intervention approach is viable. Future implementation of a sham control condition will be crucial toward ascertaining whether neurostimulation and behavioral treatment act synergistically or alternatively whether treatment gains are exclusively attributable to either tDCS or the behavioral intervention.

  1. Semantic metrics

    OpenAIRE

    Hu, Bo; Kalfoglou, Yannis; Dupplaw, David; Alani, Harith; Lewis, Paul; Shadbolt, Nigel

    2006-01-01

    In the context of the Semantic Web, many ontology-related operations, e.g. ontology ranking, segmentation, alignment, articulation, reuse, evaluation, can be boiled down to one fundamental operation: computing the similarity and/or dissimilarity among ontological entities, and in some cases among ontologies themselves. In this paper, we review standard metrics for computing distance measures and we propose a series of semantic metrics. We give a formal account of semantic metrics drawn from a...

  2. Patient Safety in Medication Nomenclature: Orthographic and Semantic Properties of International Nonproprietary Names.

    Directory of Open Access Journals (Sweden)

    Rachel Bryan

    Full Text Available Confusion between look-alike and sound-alike (LASA medication names (such as mercaptamine and mercaptopurine accounts for up to one in four medication errors, threatening patient safety. Error reduction strategies include computerized physician order entry interventions, and 'Tall Man' lettering. The purpose of this study is to explore the medication name designation process, to elucidate properties that may prime the risk of confusion.We analysed the formal and semantic properties of 7,987 International Non-proprietary Names (INNs, in relation to naming guidelines of the World Health Organization (WHO INN programme, and have identified potential for errors. We explored: their linguistic properties, the underlying taxonomy of stems to indicate pharmacological interrelationships, and similarities between INNs. We used Microsoft Excel for analysis, including calculation of Levenshtein edit distance (LED. Compliance with WHO naming guidelines was inconsistent. Since the 1970s there has been a trend towards compliance in formal properties, such as word length, but longer names published in the 1950s and 1960s are still in use. The stems used to show pharmacological interrelationships are not spelled consistently and the guidelines do not impose an unequivocal order on them, making the meanings of INNs difficult to understand. Pairs of INNs sharing a stem (appropriately or not often have high levels of similarity (<5 LED, and thus have greater potential for confusion.We have revealed a tension between WHO guidelines stipulating use of stems to denote meaning, and the aim of reducing similarities in nomenclature. To mitigate this tension and reduce the risk of confusion, the stem system should be made clear and well ordered, so as to avoid compounding the risk of confusion at the clinical level. The interplay between the different WHO INN naming principles should be further examined, to better understand their implications for the problem of LASA

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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

  9. 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.

  10. Montague semantics

    NARCIS (Netherlands)

    Janssen, T.M.V.

    2012-01-01

    Montague semantics is a theory of natural language semantics and of its relation with syntax. It was originally developed by the logician Richard Montague (1930-1971) and subsequently modified and extended by linguists, philosophers, and logicians. The most important features of the theory are its

  11. 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

  12. 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.

  13. Processing of metaphors in transcortical motor aphasia

    Directory of Open Access Journals (Sweden)

    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. Contrasting patterns of comprehension for superordinate, basic-level, and subordinate names in semantic dementia and aphasic stroke patients.

    Science.gov (United States)

    Crutch, Sebastian J; Warrington, Elizabeth K

    2008-06-01

    It is well established that patients with semantic memory impairment show a relative sparing of general superordinate information as compared with more detailed item-specific information. The objective of the current study was to examine whether or not this superordinate superiority effect is also reliably observed in individuals with stroke. The participants were 3 patients with a diagnosis of semantic dementia (SD) and 4 left middle cerebral artery stroke patients. In the first experiment, participants were administered a series of spoken-word-picture matching tasks, in which picture identity was probed under two conditions: item name (e.g., goose, beetle, shark, hedgehog) and superordinate name (e.g., bird, insect, fish, mammal). The SD patients showed the predicted pattern of performance, identifying stimuli significantly more accurately by their superordinate term than by their specific name. By contrast, the stroke patients showed the reverse pattern of inferior performance in the superordinate condition in all versions of the experimental task. In a second experiment comparing comprehension ofbasic-level names (e.g., dog, bird, fish) and subordinate-level names (e.g., Dalmatian, sparrow, trout), stroke patients also showed a reversal of the normal basic-level effect, showing less accurate comprehension of basic-level names. The pattern of results documented among the stroke patients cannot be accommodated obviously or readily by existing models of conceptual knowledge. These contrasting abilities of SD patients, stroke patients, and normal healthy participants to process subordinate, basic-level, and superordinate names are considered in relation to disorders of executive processing and taxonomic categorization.

  15. 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

  16. 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.

  17. 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.

  18. 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.)

  19. 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.

  20. 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.

  1. "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.

  2. 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.

  3. 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…

  4. 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…

  5. Semantic Desktop

    Science.gov (United States)

    Sauermann, Leo; Kiesel, Malte; Schumacher, Kinga; Bernardi, Ansgar

    In diesem Beitrag wird gezeigt, wie der Arbeitsplatz der Zukunft aussehen könnte und wo das Semantic Web neue Möglichkeiten eröffnet. Dazu werden Ansätze aus dem Bereich Semantic Web, Knowledge Representation, Desktop-Anwendungen und Visualisierung vorgestellt, die es uns ermöglichen, die bestehenden Daten eines Benutzers neu zu interpretieren und zu verwenden. Dabei bringt die Kombination von Semantic Web und Desktop Computern besondere Vorteile - ein Paradigma, das unter dem Titel Semantic Desktop bekannt ist. Die beschriebenen Möglichkeiten der Applikationsintegration sind aber nicht auf den Desktop beschränkt, sondern können genauso in Web-Anwendungen Verwendung finden.

  6. Characteristics of gray matter morphological change in Parkinson's disease patients with semantic abstract reasoning deficits.

    Science.gov (United States)

    Wang, Li; Nie, Kun; Zhao, Xin; Feng, Shujun; Xie, Sifen; He, Xuetao; Ma, Guixian; Wang, Limin; Huang, Zhiheng; Huang, Biao; Zhang, Yuhu; Wang, Lijuan

    2018-04-23

    Semantic abstract reasoning(SAR) is an important executive domain that is involved in semantic information processing and enables one to make sense of the attributes of objects, facts and concepts in the world. We sought to investigate whether Parkinson's disease subjects(PDs) have difficulty in SAR and to examine the associated pattern of gray matter morphological changes. Eighty-six PDs and 30 healthy controls were enrolled. PDs were grouped into PD subjects with Similarities preservation(PDSP, n = 62) and PD subjects with Similarities impairment(PDSI, n = 24)according to their performance on the Similarities subtest of the Wechsler Adult Intelligence Scale. Brain structural images were captured with a 3T MRI scanner. Surface-based investigation of cortical thickness and automated segmentation of deep gray matter were conducted using FreeSurfer software. PDs performed notably worse on the Similarities test than controls(F = 13.56, P < 0.001).In the PDSI group, cortical thinning associated with Similarities scores was found in the left superior frontal, left superior parietal and left rostral middle frontal regions. Notable atrophy of the bilateral hippocampi was observed, but only the right hippocampus volume was positively correlated with the Similarities scores of the PDSI group. PDs have difficulty in SAR, and this limitation may be associated with impaired conceptual abstraction and generalization along with semantic memory deficits. Cortical thinning in the left frontal and parietal regions and atrophy in the right hippocampus may explain these impairments among Chinese PDs. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. 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...

  8. 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.

  9. 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

  10. 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.

  11. Cerebellar induced differential polyglot aphasia: A neurolinguistic and fMRI study.

    Science.gov (United States)

    Mariën, Peter; van Dun, Kim; Van Dormael, Johanna; Vandenborre, Dorien; Keulen, Stefanie; Manto, Mario; Verhoeven, Jo; Abutalebi, Jubin

    2017-12-01

    Research has shown that linguistic functions in the bilingual brain are subserved by similar neural circuits as in monolinguals, but with extra-activity associated with cognitive and attentional control. Although a role for the right cerebellum in multilingual language processing has recently been acknowledged, a potential role of the left cerebellum remains largely unexplored. This paper reports the clinical and fMRI findings in a strongly right-handed (late) multilingual patient who developed differential polyglot aphasia, ataxic dysarthria and a selective decrease in executive function due to an ischemic stroke in the left cerebellum. fMRI revealed that lexical-semantic retrieval in the unaffected L1 was predominantly associated with activations in the left cortical areas (left prefrontal area and left postcentral gyrus), while naming in two affected non-native languages recruited a significantly larger bilateral functional network, including the cerebellum. It is hypothesized that the left cerebellar insult resulted in decreased right prefrontal hemisphere functioning due to a loss of cerebellar impulses through the cerebello-cerebral pathways. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. The regional neuronal activity in left posterior middle temporal gyrus is correlated with the severity of chronic aphasia.

    Science.gov (United States)

    Li, Jianlin; Du, Dunren; Gao, Wei; Sun, Xichun; Xie, Haizhu; Zhang, Gang; Li, Jian; Li, Honglun; Li, Kefeng

    2017-01-01

    Aphasia is one of the most disabling cognitive deficits affecting >2 million people in the USA. The neuroimaging characteristics of chronic aphasic patients (>6 months post onset) remain largely unknown. The objective of this study was to investigate the regional signal changes of spontaneous neuronal activity of brain and the inter-regional connectivity in chronic aphasia. Resting-state blood oxygenation level-dependent functional magnetic resonance imaging (fMRI) was used to obtain fMRI data from 17 chronic aphasic patients and 20 healthy control subjects in a Siemens Verio 3.0T MR Scanner. The amplitude of low-frequency fluctuation (ALFF) was determined, which directly reflects the regional neuronal activity. The functional connectivity (FC) of fMRI was assessed using a seed voxel linear correlation approach. The severity of aphasia was evaluated by aphasia quotient (AQ) scores obtained from Western Aphasia Battery test. Compared with normal subjects, aphasic patients showed decreased ALFF values in the regions of left posterior middle temporal gyrus (PMTG), left medial prefrontal gyrus, and right cerebellum. The ALFF values in left PMTG showed strong positive correlation with the AQ score (coefficient r =0.79, P temporal gyrus (BA20), fusiform gyrus (BA37), and inferior frontal gyrus (BA47\\45\\44). Left PMTG might play an important role in language dysfunction of chronic aphasia, and ALFF value might be a promising indicator to evaluate the severity of aphasia.

  13. 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.

  14. [sup 99m]Tc-ECD SPECT study in dementia and aphasia

    Energy Technology Data Exchange (ETDEWEB)

    Kuwabara, Yasuo; Ichiya, Yuichi; Otsuka, Makoto; Sasaki, Masayuki; Akashi, Yuko; Fukumura, Toshimitsu; Yoshida, Tsuyoshi; Masuda, Kouji; Ichimiya, Atsushi (Kyushu Univ., Fukuoka (Japan). Faculty of Medicine)

    1993-09-01

    We studied clinical significance of [sup 99m]Tc-L,L,-ethyl cysteine dimer ([sup 99m]Tc-ECD) SPECT study in dementia and aphasia, and compared it with [sup 99m]Tc-HMPAO SPECT study. The subjects consisted of 13 patients, including 10 patients with dementia and 3 patients with aphasia. Hypoperfusion areas were detected in 5 out of 10 patients with dementia and 2 out of 3 patients with aphasia in [sup 99m]Tc-ECD SPECT, and in 4 out of 10 patients with dementia and all of 3 patients with aphasia in [sup 99m]Tc-HMPAO SPECT. The count rate ratios in [sup 99m]Tc-ECD and [sup 99m]Tc-HMPAO SPECT were correlated well with each other, and the contrast of the [sup 99m]Tc-ECD SPECT image was equivalent or slightly higher as compared with [sup 99m]Tc-HMPAO. Therefore, [sup 99m]Tc-ECD SPECT study was considered to be useful for the evaluation of cerebral perfusion in dementia and aphasia. (author).

  15. 99mTc-ECD SPECT study in dementia and aphasia

    International Nuclear Information System (INIS)

    Kuwabara, Yasuo; Ichiya, Yuichi; Otsuka, Makoto; Sasaki, Masayuki; Akashi, Yuko; Fukumura, Toshimitsu; Yoshida, Tsuyoshi; Masuda, Kouji; Ichimiya, Atsushi

    1993-01-01

    We studied clinical significance of 99m Tc-L,L,-ethyl cysteine dimer ( 99m Tc-ECD) SPECT study in dementia and aphasia, and compared it with 99m Tc-HMPAO SPECT study. The subjects consisted of 13 patients, including 10 patients with dementia and 3 patients with aphasia. Hypoperfusion areas were detected in 5 out of 10 patients with dementia and 2 out of 3 patients with aphasia in 99m Tc-ECD SPECT, and in 4 out of 10 patients with dementia and all of 3 patients with aphasia in 99m Tc-HMPAO SPECT. The count rate ratios in 99m Tc-ECD and 99m Tc-HMPAO SPECT were correlated well with each other, and the contrast of the 99m Tc-ECD SPECT image was equivalent or slightly higher as compared with 99m Tc-HMPAO. Therefore, 99m Tc-ECD SPECT study was considered to be useful for the evaluation of cerebral perfusion in dementia and aphasia. (author)

  16. The relationship between novel word learning and anomia treatment success in adults with chronic aphasia.

    Science.gov (United States)

    Dignam, Jade; Copland, David; Rawlings, Alicia; O'Brien, Kate; Burfein, Penni; Rodriguez, Amy D

    2016-01-29

    Learning capacity may influence an individual's response to aphasia rehabilitation. However, investigations into the relationship between novel word learning ability and response to anomia therapy are lacking. The aim of the present study was to evaluate the novel word learning ability in post-stroke aphasia and to establish the relationship between learning ability and anomia treatment outcomes. We also explored the influence of locus of language breakdown on novel word learning ability and anomia treatment response. 30 adults (6F; 24M) with chronic, post-stroke aphasia were recruited to the study. Prior to treatment, participants underwent an assessment of language, which included the Comprehensive Aphasia Test and three baseline confrontation naming probes in order to develop sets of treated and untreated items. We also administered the novel word learning paradigm, in which participants learnt novel names associated with unfamiliar objects and were immediately tested on recall (expressive) and recognition (receptive) tasks. Participants completed 48 h of Aphasia Language Impairment and Functioning Therapy (Aphasia LIFT) over a 3 week (intensive) or 8 week (distributed) schedule. Therapy primarily targeted the remediation of word retrieval deficits, so naming of treated and untreated items immediately post-therapy and at 1 month follow-up was used to determine therapeutic response. Performance on recall and recognition tasks demonstrated that participants were able to learn novel words; however, performance was variable and was influenced by participants' aphasia severity, lexical-semantic processing and locus of language breakdown. Novel word learning performance was significantly correlated with participants' response to therapy for treated items at post-therapy. In contrast, participants' novel word learning performance was not correlated with therapy gains for treated items at 1 month follow-up or for untreated items at either time point. Therapy intensity

  17. 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.

  18. Reading words and other people: A comparison of exception word, familiar face and affect processing in the left and right temporal variants of primary progressive aphasia.

    Science.gov (United States)

    Binney, Richard J; Henry, Maya L; Babiak, Miranda; Pressman, Peter S; Santos-Santos, Miguel A; Narvid, Jared; Mandelli, Maria Luisa; Strain, Paul J; Miller, Bruce L; Rankin, Katherine P; Rosen, Howard J; Gorno-Tempini, Maria Luisa

    2016-09-01

    Semantic variant primary progressive aphasia (svPPA) typically presents with left-hemisphere predominant rostral temporal lobe (rTL) atrophy and the most significant complaints within the language domain. Less frequently, patients present with right-hemisphere predominant temporal atrophy coupled with marked impairments in processing of famous faces and emotions. Few studies have objectively compared these patient groups in both domains and therefore it is unclear to what extent the syndromes overlap. Clinically diagnosed svPPA patients were characterized as left- (n = 21) or right-predominant (n = 12) using imaging and compared along with 14 healthy controls. Regarding language, our primary focus was upon two hallmark features of svPPA; confrontation naming and surface dyslexia. Both groups exhibited naming deficits and surface dyslexia although the impairments were more severe in the left-predominant group. Familiarity judgments on famous faces and affect processing were more profoundly impaired in the right-predominant group. Our findings suggest that the two syndromes overlap significantly but that early cases at the tail ends of the continuum constitute a challenge for current clinical criteria. Correlational neuroimaging analyses implicated a mid portion of the left lateral temporal lobe in exception word reading impairments in line with proposals that this region is an interface between phonology and semantic knowledge. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. 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.

  20. 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)

  1. 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…

  2. 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…

  3. Relearning and Retaining Personally-Relevant Words using Computer-Based Flashcard Software in Primary Progressive Aphasia

    Directory of Open Access Journals (Sweden)

    William Streicher Evans

    2016-11-01

    Full Text Available Although anomia treatments have often focused on training small sets of words in the hopes of promoting generalization to untrained items, an alternative is to directly train a larger set of words more efficiently. The current case report study reports on a novel treatment for a patient with semantic variant Primary Progressive Aphasia (svPPA, in which the patient was taught to make and practice flashcards for personally-relevant words using an open-source computer program (Anki. Results show that the patient was able to relearn and retain a large subset of her studied words over a 20-month period. At the end of treatment, she showed good retention for 139 studied words, far more than the number typically treated in svPPA studies. Furthermore, she showed evidence of stimulus generalization to confrontation-naming tasks for studied items, and of relearning forgotten items with additional practice. This case represents a successful example of patient-centered computer-based asynchronous telepractice. It also illustrates how data captured from computer-based treatments can provide powerful practice-based evidence, obtained during routine clinical care.

  4. Application of Addenbrooke's cognitive examination to diagnosis and monitoring of progressive primary aphasia.

    Science.gov (United States)

    Leyton, Cristian E; Hornberger, Michael; Mioshi, Eneida; Hodges, John R

    2010-01-01

    Primary progressive aphasia (PPA) comprises 2 main variants: semantic dementia (SD) and progressive nonfluent aphasia (PNFA). Addenbrooke's Cognitive Examination (ACE) has become widely used for the diagnosis of dementias. Less information, however, is available about its ability to detect and monitor changes in cognition in PPA. We aimed to analyse the sensitivity and longitudinal changes of ACE scores in 2 subforms of PPA. We included 63 SD and 45 PNFA cases, all of whom had at least 2 assessments. Sensitivity levels, annualised rates of change and difference in scores over time on repeated ACE measurements were calculated. A cut-off of 88 points detected 95% of the PNFA and SD cases. Longitudinal analysis showed an average annual decline of 10 points per year, with no significant difference between groups. The ACE is a useful tool for detecting and tracking the evolution of PPA. Copyright 2010 S. Karger AG, Basel.

  5. 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.

  6. Theories of inter-hemispheric interactions in aphasia: the role of tDCS in rehabilitation of post-stroke aphasia

    Directory of Open Access Journals (Sweden)

    Roy H Hamilton

    2014-04-01

    . Based on our prior findings using functional imaging meta-analysis and TMS in patients with aphasia1-2, we will make the case that these mechanisms are not mutually exclusive, and that multiple patterns of plastic change in language systems are observed across and even within individuals with aphasia. We will then the review the growing body of literature in which tDCS has been explored as a treatment for aphasia and argue that the heterogeneity of stimulation approaches speaks to the influence of multiple mechanisms of language plasticity. Moreover, based on our initial findings in a pilot study of tDCS in persons with chronic nonfluent aphasia3, we will argue that current and future approaches to aphasia treatment with tDCS should focus on identifying the influence of different mechanisms of aphasia recovery at the individual level. Future studies in this area will need to determine the relationship between clinical features such as lesion size, lesion distribution, and aphasia symptomotology and the hemispheric neuroplastic mechanisms that individual patients will preferentially employ to recover language ability, in order to optimally modulate these mechanisms using brain stimulation.

  7. Elucidating semantic disorganisation from a word comprehension task: do patients with schizophrenia and bipolar disorder show differential processing of nouns, verbs and adjectives?

    Science.gov (United States)

    Rossell, Susan L; Batty, Rachel A

    2008-07-01

    Memory deficits have been reported in schizophrenia and bipolar disorder. However, the precise impact of semantic memory deficits on word comprehension, particularly across grammatical categories, has not been adequately investigated in these disorders. Furthermore, previous studies examining semantic memory have predominantly been designed so that most healthy controls perform at ceiling, questioning the validity of observed differences between patient and control groups. A new word definition task examined word comprehension across grammatical categories, i.e. nouns, verbs and adjectives, and was designed to overcome the ceiling effect. It was administered to 32 schizophrenia patients, 28 bipolar disorder patients and 32 matched healthy controls. Schizophrenia patients had a global impairment on the task but bipolar patients were only impaired on a recognition memory component. Word comprehension, however, across grammatical categories was comparable across groups.

  8. Generative Semantics

    Science.gov (United States)

    Bagha, Karim Nazari

    2011-01-01

    Generative semantics is (or perhaps was) a research program within linguistics, initiated by the work of George Lakoff, John R. Ross, Paul Postal and later McCawley. The approach developed out of transformational generative grammar in the mid 1960s, but stood largely in opposition to work by Noam Chomsky and his students. The nature and genesis of…

  9. Inferentializing Semantics

    Czech Academy of Sciences Publication Activity Database

    Peregrin, Jaroslav

    2010-01-01

    Roč. 39, č. 3 (2010), s. 255-274 ISSN 0022-3611 R&D Projects: GA ČR(CZ) GA401/07/0904 Institutional research plan: CEZ:AV0Z90090514 Keywords : inference * proof theory * model theory * inferentialism * semantics Subject RIV: AA - Philosophy ; Religion

  10. A review on primary progressive aphasia

    Directory of Open Access Journals (Sweden)

    Gabriel C Léger

    2007-01-01

    for both patient and caregiver are available may be helpful.Keywords: primary progressive aphasia

  11. Neuroimaging in the Differential Diagnosis of Primary Progressive Aphasia – Illustrative Case Series in the Light of New Diagnostic Criteria

    International Nuclear Information System (INIS)

    Sitek, Emilia J.; Narożańska, Ewa; Brockhuis, Bogna; Muraszko-Klaudel, Anna; Lass, Piotr; Harciarek, Michał; Sławek, Jarosław

    2014-01-01

    Primary progressive aphasia (PPA) is a progressive language disorder associated with atrophy of the dominant language hemisphere, typically left. Current PPA criteria divide PPA into three variants: non-fluent (nfvPPA), semantic (svPPA) and logopenic (lvPPA). The classification of PPA into one of the three variants may be performed at 3 levels: I) clinical, II) imaging-supported, III) definite pathologic diagnosis. This paper aimed at assessing the feasibility of the imaging-supported diagnostics of PPA variants in the Polish clinical setting with access to magnetic resonance imaging (MRI) and single-photon emission computed tomography (SPECT) examinations. We present the clinical and neuroimaging data on 6 patients (4 women, 2 men) clinically diagnosed with PPA (3 with nfvPPA and 3 with lvPPA) in whom MRI and SPECT were performed in order to determine if imaging-supported diagnosis could be established in those cases. In 4 individuals (2 with nfvPPA and 2 with lvPPA) clinical diagnosis was supported by neuroimaging (SPECT, albeit not MRI), thus level II of PPA diagnosis could be established in those cases. MRI results were either inconsistent with the clinical diagnosis (Patients 1 and 2) or a mixed pattern of atrophy was observed (Patients 3–6). Imaging-supported diagnosis of PPA variant is more feasible with quantitative analysis of SPECT images than with purely qualitative visual analysis of MRI. Hypoperfusion abnormalities evidenced by SPECT are more variant-specific than patterns of atrophy

  12. 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.

  13. Standardization, Validity and Reliability Study of Gülhane Aphasia Test-2 (GAT-2

    Directory of Open Access Journals (Sweden)

    İlknur Maviş

    2007-04-01

    Full Text Available OBJECTIVE: Gülhane Aphasia Test-2 (GAT-2 has been developed to show the presence of a language disorder ‘aphasia’ and to give the clinician implications for the accompanying speech disorders such as apraxia and dysarthria. OBJECTIVE: The aim of the study was to report standardization, validity and reliability study of GAT-2. METHODS: : 10 healthy individuals were tested initially for the pilot study. 134 healthy individual was included to the standardization study and 30 individuals with aphasia and 11 individuals with right brain injury was included to the validation study. The inter group GAT-2 score differentiations and the effects of age, years of education, sex variances were observed. GAT-2 cut-off scores were calculated by the scores of healthy individuals. GAT-2 test-retest reliability and inter-observer reliability was calculated. RESULTS: Healthy individuals’ GAT-2 scores were significantly different from the GAT-2 scores of aphasic patients, but not from right brain injured patients’. Healthy individuals’ GAT-2 scores were not affected from the sex, age variances but from years of education, so cut-off scores were calculated by this variance. GAT-2 scores of aphasic patients were not affected from age, sex and years of education. Test-retest and inter-observer reliability and internal consistency results showed that GAT-2 is a highly reliable aphasia screening test. CONCLUSION: GAT-2 was found to be a standardized, highly reliable and a valid aphasia test for Turkish stroke patients with aphasia

  14. 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)

  15. Behavioural and neuroanatomical correlates of auditory speech analysis in primary progressive aphasias.

    Science.gov (United States)

    Hardy, Chris J D; Agustus, Jennifer L; Marshall, Charles R; Clark, Camilla N; Russell, Lucy L; Bond, Rebecca L; Brotherhood, Emilie V; Thomas, David L; Crutch, Sebastian J; Rohrer, Jonathan D; Warren, Jason D

    2017-07-27

    Non-verbal auditory impairment is increasingly recognised in the primary progressive aphasias (PPAs) but its relationship to speech processing and brain substrates has not been defined. Here we addressed these issues in patients representing the non-fluent variant (nfvPPA) and semantic variant (svPPA) syndromes of PPA. We studied 19 patients with PPA in relation to 19 healthy older individuals. We manipulated three key auditory parameters-temporal regularity, phonemic spectral structure and prosodic predictability (an index of fundamental information content, or entropy)-in sequences of spoken syllables. The ability of participants to process these parameters was assessed using two-alternative, forced-choice tasks and neuroanatomical associations of task performance were assessed using voxel-based morphometry of patients' brain magnetic resonance images. Relative to healthy controls, both the nfvPPA and svPPA groups had impaired processing of phonemic spectral structure and signal predictability while the nfvPPA group additionally had impaired processing of temporal regularity in speech signals. Task performance correlated with standard disease severity and neurolinguistic measures. Across the patient cohort, performance on the temporal regularity task was associated with grey matter in the left supplementary motor area and right caudate, performance on the phoneme processing task was associated with grey matter in the left supramarginal gyrus, and performance on the prosodic predictability task was associated with grey matter in the right putamen. Our findings suggest that PPA syndromes may be underpinned by more generic deficits of auditory signal analysis, with a distributed cortico-subcortical neuraoanatomical substrate extending beyond the canonical language network. This has implications for syndrome classification and biomarker development.

  16. 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

  17. Early aphasia rehabilitation is associated with functional reactivation of the left inferior frontal gyrus: a pilot study.

    Science.gov (United States)

    Mattioli, Flavia; Ambrosi, Claudia; Mascaro, Lorella; Scarpazza, Cristina; Pasquali, Patrizia; Frugoni, Marina; Magoni, Mauro; Biagi, Laura; Gasparotti, Roberto

    2014-02-01

    Early poststroke aphasia rehabilitation effects and their functional MRI (fMRI) correlates were investigated in a pilot, controlled longitudinal study. Twelve patients with mild/moderate aphasia (8 Broca, 3 anomic, and 1 Wernicke) were randomly assigned to daily language rehabilitation for 2 weeks (starting 2.2 [mean] days poststroke) or no rehabilitation. The Aachen Aphasia Test and fMRI recorded during an auditory comprehension task were performed at 3 time intervals: mean 2.2 (T1), 16.2 (T2), and 190 (T3) days poststroke. Groups did not differ in terms of age, education, aphasia severity, lesions volume, baseline fMRI activations, and in task performance during fMRI across examinations. Rehabilitated patients significantly improved in naming and written language tasks (Paphasia treatment is useful, has durable effects, and may lead to early enhanced recruitment of brain areas, particularly the left inferior frontal gyrus, which persists in the chronic phase.

  18. 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.

  19. 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.

  20. Semantic Blogging : Spreading the Semantic Web Meme

    OpenAIRE

    Cayzer, Steve

    2004-01-01

    This paper is about semantic blogging, an application of the semantic web to blogging. The semantic web promises to make the web more useful by endowing metadata with machine processable semantics. Blogging is a lightweight web publishing paradigm which provides a very low barrier to entry, useful syndication and aggregation behaviour, a simple to understand structure and decentralized construction of a rich information network. Semantic blogging builds upon the success and clear network valu...

  1. Achievement report for fiscal 1999 on research and development of technologies for medical welfare equipment. Home rehabilitation system for aphasia patients; 1999 nendo iryo fukushi kiki gijutsu kenkyu kaihatsu seika hokokusho. Shitsugosho zaitaku rehabilitation shien system

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-05-01

    Element technologies under development involve (1) an authoring system for assistance program processing, (2) self-training system for supporting home rehabilitation, (3) human interface for aphasia patients and caregivers, (4) remote rehabilitation evaluation and diagnosis supporting system, and (5) a communication assisting system. Under item (1), a material incorporating interface, training contents layout and combination function, and general-purpose interface specifications are determined, and a one-piece system is designed and developed. Under item (2), a self-training player that behaves in compliance with the authoring specifications is designed and developed. Under item (3), a secondary unit is fabricated on the assumption of its use at an actual treatment scene. Under item (4), remotely controlled two-way face-to-face communication, camera control, shared operation of a training player, training scenario transfer component, etc., are developed and, furthermore, a one-piece system is designed and developed to support the therapist's rehabilitation assessment and diagnosis in coordination with the above-mentioned remotely controlled functions. Under item (5), a network communication component and an auxiliary function using voice synthesis are added for designing and developing a one-piece system that enables long-distance communication between the therapist and patients. (NEDO)

  2. The responsible region and the symptomatic threshold of cerebral blood flow and oxygen metabolism for Broca's aphasia using positron emission tomography

    International Nuclear Information System (INIS)

    Kato, Toshiaki; Ujike, Takashi; Kitamura, Shin; Soeda, Toshiyuki; Terashi, Akiro

    1987-01-01

    This study was designed to investigate the responsible region and the symptomatic flow and metabolism threshold for Broca's aphasia. Regional cerebral blood flow (CBF) and oxygen metabolism (CMRO 2 ) were measured by positron emission tomography (PET) using 15 O steady state method in eight patients with Broca's aphasia due to cerebral infarction and thirty patients without aphasia. During scanning, patients closed their eyes and were kept free from any stimuration. X-CT scan revealed abnormal low density in Broca's area which includes cortex and subcortex in the anterior region to Sylvian fissure in three patients with aphasia. In the other five patients with aphasia X-CT scan showed no abnormal low density in Broca's area, showed it in basal ganglionic region and subcortex. PET study revealed reduction of CBF and CMRO 2 in Broca's area in all cases with Broca's aphasia. CBF and CMRO 2 of Broca's area of aphasic patients were compared to those of non aphasic patients to obtain the symptomatic threshold in CBF and CMRO 2 . The values of symptomatic threshold were 20 - 27 ml/100 g/min in CBF and 2.0 ml/100 g/min in CMRO 2 . The symptomatic threshold differed from the threshold for development of abnormal low density on X-CT, therefore the measurement of CBF and CMRO 2 were useful in studying the responsible region for aphasia. (author)

  3. Study of conduction aphasia by positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    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.

  4. 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.

  5. 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)

  6. 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.

  7. 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.

  8. Neural mechanisms underlying transcranial direct current stimulation in aphasia: A feasibility study.

    Directory of Open Access Journals (Sweden)

    Lena eUlm

    2015-10-01

    Full Text Available Little is known about the neural mechanisms by which transcranial direct current stimulation (tDCS impacts on language processing in post-stroke aphasia. This was addressed in a proof-of-principle study that explored the effects of tDCS application in aphasia during simultaneous functional magnetic resonance imaging (fMRI. We employed a single subject, cross-over, sham-tDCS controlled design and the stimulation was administered to an individualized perilesional stimulation site that was identified by a baseline fMRI scan and a picture naming task. Peak activity during the baseline scan was located in the spared left inferior frontal gyrus (IFG and this area was stimulated during a subsequent cross-over phase. tDCS was successfully administered to the target region and anodal- vs. sham-tDCS resulted in selectively increased activity at the stimulation site. Our results thus demonstrate that it is feasible to precisely target an individualized stimulation site in aphasia patients during simultaneous fMRI which allows assessing the neural mechanisms underlying tDCS application. The functional imaging results of this case report highlight one possible mechanism that may have contributed to beneficial behavioural stimulation effects in previous clinical tDCS trials in aphasia. In the future, this approach will allow identifying distinct patterns of stimulation effects on neural processing in larger cohorts of patients. This may ultimately yield information about the variability of tDCS-effects on brain functions in aphasia.

  9. 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

  10. Damage to the anterior arcuate fasciculus predicts non-fluent speech production in aphasia.

    Science.gov (United States)

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

    2013-11-01

    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 picture of cortical damage in non-fluent aphasia, the current study examined brain damage that negatively influences speech fluency in patients with aphasia. It controlled for some basic speech and language comprehension factors in order to better isolate the contribution of different mechanisms to fluency, or its lack. Cortical damage was related to overall speech fluency, as estimated by clinical judgements using the Western Aphasia Battery speech fluency scale, diadochokinetic rate, rudimentary auditory language comprehension, and executive functioning (scores on a matrix reasoning test) in 64 patients with chronic left hemisphere stroke. A region of interest analysis that included brain regions typically implicated in speech and language processing revealed that non-fluency in aphasia is primarily predicted by damage to the anterior segment of the left arcuate fasciculus. An improved prediction model also included the left uncinate fasciculus, a white matter tract connecting the middle and anterior temporal lobe with frontal lobe regions, including the pars triangularis. Models that controlled for diadochokinetic rate, picture-word recognition, or executive functioning also revealed a strong relationship between anterior segment involvement and speech fluency. Whole brain analyses corroborated the findings from the region of interest analyses. An additional exploratory analysis revealed that involvement of the uncinate fasciculus adjudicated between Broca's and global aphasia

  11. 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.

  12. 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.

  13. 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...

  14. From DTCA-PD to patient information to health information: the complex politics and semantics of EU health policy.

    Science.gov (United States)

    Brooks, Eleanor; Geyer, Robert

    2012-12-01

    Between 2001 and 2011 the pharmaceutical industry, supported by DG Enterprise, was engaged in an ongoing campaign to repeal/amend the European Union (EU) ban on direct-to-consumer advertising of prescription drugs (DTCA-PD). As it became increasingly clear that the ban would not be repealed, DTCA-PD supporters tried to shift the debate away from advertising and towards the provision of 'patient information' and the rights of patients to access such information. Meanwhile, a variety of national and European health organizations, supported by DG SANCO, sought to maintain the ban and oppose the industry-supported 'patient information' campaign. Instead, they promoted a concept of 'health information' that included all aspects of citizens' health, not just pharmaceuticals. This article aims to analyse the transition from DTCA-PD to patient information to health information and examine its implications for EU health policy as a complex policy space. The article examines the emergence and development of EU health policy and the evolution of the DTCA-PD debate through the lens of complexity theory. It analyses the nature of the semantic, political and policy transition and asks why it occurred, what it tells us about EU health policy and future EU health legislation and how it may be understood from a complexity perspective. The article concludes that the complexity framework is ideally suited for the field of public health and, in particular, the DTCA-PD debate. Having successfully shifted the policy-focus of the debate to patients' rights and health information, opponents of the legislation are likely to face their next battle in the realm of cyberspace, where regulatory issues change the nature of advertising. © 2012 Blackwell Publishing Ltd.

  15. Episodic aphasia associated with tumor active multiple sclerosis: a correlative SPECT study utilising image fusion

    International Nuclear Information System (INIS)

    Roff, G.; Campbell, A.; Lawn, N.; Henderson, A.; McCarthy, M.; Lenzo, N.

    2003-01-01

    Full text: Cerebral perfusion imaging is a common technique to assess cerebral perfusion and metabolism. It can complement anatomical imaging in assessing a number of neurological conditions. At times it can better define the clinical manifestations of a disease process than anatomical imaging alone. We present a clinical case whereby cerebral SPECT imaging helped define the physiological reason for intermittent aphasia in a patient with tumor active multiple sclerotic white matter plaques. Cerebral SPECT studies were performed during a period of aphasia and when the patient had recovered. We utilised subtraction analyses and image fusion techniques to better define the changes seen on SPECT. We discuss the neuroanatomical relationship of aphasia and the automatic fusion technique that allows accurate co-registration of the MRI and SPECT data. Copyright (2003) The Australian and New Zealand Society of Nuclear Medicine Inc

  16. A warning to the Brazilian Speech-Language Pathology and Audiology community about the importance of scientific and clinical activities in primary progressive aphasia.

    Science.gov (United States)

    Beber, Bárbara Costa; Brandão, Lenisa; Chaves, Márcia Lorena Fagundes

    2015-01-01

    This article aims to warn the Brazilian Speech-Language Pathology and Audiology scientific community about the importance and necessity of scientific and clinical activities regarding Primary Progressive Aphasia. This warning is based on a systematic literature review of the scientific production on Primary Progressive Aphasia, from which nine Brazilian articles were selected. It was observed that there is an obvious lack of studies on the subject, as all the retrieved articles were published in medical journals and much of it consisted of small samples; only two articles described the effectiveness of speech-language therapy in patients with Primary Progressive Aphasia. A perspective for the future in the area and characteristics of Speech-Language Therapy for Primary Progressive Aphasia are discussed. As a conclusion, it is evident the need for greater action by Speech-Language Pathology and Audiology on Primary Progressive Aphasia.

  17. Topographical, autobiographical and semantic memory in a patient with bilateral mesial temporal and retrosplenial infarction.

    Science.gov (United States)

    Hepner, Ilana J; Mohamed, Armin; Fulham, Michael J; Miller, Laurie A

    2007-04-01

    According to Consolidation Theory (Squire, 1992, Psychological Review, 99, 195; Squire & Alvarez, 1995, Current Opinion in Neurobiology, 5, 169), the mesial temporal lobes have a time-limited role in the maintenance, storage and retrieval of retrograde declarative memories, such that they are not necessary for recalling remote memories. In contrast, proponents of the Multiple Trace Theory (Fuji, Moscovitch, & Nadel, 2000, Handbook of neuropsychology, 2nd ed., p 223, Amsterdam, New York: Elsevier; Nadel & Moscovitch, 1999, Current Opinion in Neurobiology, 7, 217) posit that the mesial temporal lobe (MTL) is necessary for remembering detailed autobiographical and topographical material from all time periods. A third theory of hippocampal function, the Cognitive Map Theory (O'Keefe & Nadel, 1978, The hippocampus as a cognitive map. Oxford: Clarendon), states that the hippocampus is involved in the processing of allocentric spatial representations. The precise role of the MTL in remote memory has been difficult to elucidate, as the majority of studies present cases with widespread brain damage that often occurred many years prior to testing. We investigated retrograde autobiographical, semantic and topographical memories in a subject (SG) who had recently sustained infarctions confined to the MTL and retrosplenial region bilaterally. Inconsistent with the predictions of Cognitive Map Theory, memory for spatial maps that were learned in the past was preserved. Additional testing indicated that SG suffered from a landmark agnosia, which affected remotely and recently acquired information equally. SG was also poor at imagining which direction he would have to turn his body to move from one landmark to another. In accordance with Consolidation Theory, SG performed similarly to control subjects for remote time periods on various measures of retrograde autobiographical memory and demonstrated intact knowledge regarding famous faces and vocabulary terms that were acquired in

  18. Jigsaw Semantics

    Directory of Open Access Journals (Sweden)

    Paul J. E. Dekker

    2010-12-01

    Full Text Available In the last decade the enterprise of formal semantics has been under attack from several philosophical and linguistic perspectives, and it has certainly suffered from its own scattered state, which hosts quite a variety of paradigms which may seem to be incompatible. It will not do to try and answer the arguments of the critics, because the arguments are often well-taken. The negative conclusions, however, I believe are not. The only adequate reply seems to be a constructive one, which puts several pieces of formal semantics, in particular dynamic semantics, together again. In this paper I will try and sketch an overview of tasks, techniques, and results, which serves to at least suggest that it is possible to develop a coherent overall picture of undeniably important and structural phenomena in the interpretation of natural language. The idea is that the concept of meanings as truth conditions after all provides an excellent start for an integrated study of the meaning and use of natural language, and that an extended notion of goal directed pragmatics naturally complements this picture. None of the results reported here are really new, but we think it is important to re-collect them.ReferencesAsher, Nicholas & Lascarides, Alex. 1998. ‘Questions in Dialogue’. Linguistics and Philosophy 23: 237–309.http://dx.doi.org/10.1023/A:1005364332007Borg, Emma. 2007. ‘Minimalism versus contextualism in semantics’. In Gerhard Preyer & Georg Peter (eds. ‘Context-Sensitivity and Semantic Minimalism’, pp. 339–359. Oxford: Oxford University Press.Cappelen, Herman & Lepore, Ernest. 1997. ‘On an Alleged Connection between Indirect Quotation and Semantic Theory’. Mind and Language 12: pp. 278–296.Cappelen, Herman & Lepore, Ernie. 2005. Insensitive Semantics. Oxford: Blackwell.http://dx.doi.org/10.1002/9780470755792Dekker, Paul. 2002. ‘Meaning and Use of Indefinite Expressions’. Journal of Logic, Language and Information 11: pp. 141–194

  19. Exploring Aphasia in Kalhori

    Directory of Open Access Journals (Sweden)

    Fateme Hasani Jalilian

    2017-09-01

    Discussion: While impairments to do with prepositions and parts of speech are expected features of aphasic patients, as far as the assessment of verbal morphology of Kalhori is concerned, results seem to replicate the results achieved by Nilipour et al. (2001 researching Persian bilingual aphasics. 

  20. Selective Short-Term Memory Deficits Arise from Impaired Domain-General Semantic Control Mechanisms

    Science.gov (United States)

    Hoffman, Paul; Jefferies, Elizabeth; Ehsan, Sheeba; Hopper, Samantha; Lambon Ralph, Matthew A.

    2009-01-01

    Semantic short-term memory (STM) patients have a reduced ability to retain semantic information over brief delays but perform well on other semantic tasks; this pattern suggests damage to a dedicated buffer for semantic information. Alternatively, these difficulties may arise from mild disruption to domain-general semantic processes that have…

  1. The Effects of Modified Melodic Intonation Therapy on Nonfluent Aphasia: A Pilot Study

    Science.gov (United States)

    Conklyn, Dwyer; Novak, Eric; Boissy, Adrienne; Bethoux, Francois; Chemali, Kamal

    2012-01-01

    Objective: Positive results have been reported with melodic intonation therapy (MIT) in nonfluent aphasia patients with damage to their left-brain speech processes, using the patient's intact ability to sing to promote functional language. This pilot study sought to determine the immediate effects of introducing modified melodic intonation therapy…

  2. Tracking the development of agrammatic aphasia: A tensor-based morphometry study.

    Science.gov (United States)

    Whitwell, Jennifer L; Duffy, Joseph R; Machulda, Mary M; Clark, Heather M; Strand, Edythe A; Senjem, Matthew L; Gunter, Jeffrey L; Spychalla, Anthony J; Petersen, Ronald C; Jack, Clifford R; Josephs, Keith A

    2017-05-01

    Agrammatic aphasia can be observed in neurodegenerative disorders and has been traditionally linked with damage to Broca's area, although there have been disagreements concerning whether damage to Broca's area is necessary or sufficient for the development of agrammatism. We aimed to investigate the neuroanatomical correlates of the emergence of agrammatic aphasia utilizing a unique cohort of patients with primary progressive apraxia of speech (PPAOS) that did not have agrammatism at baseline but developed agrammatic aphasia over time. Twenty PPAOS patients were recruited and underwent detailed speech/language assessments and 3T MRI at two visits, approximately two years apart. None of the patients showed evidence of agrammatism in writing or speech at baseline. Eight patients developed aphasia at follow-up (progressors) and 12 did not (non-progressors). Tensor-based morphometry utilizing symmetric normalization (SyN) was used to assess patterns of grey matter atrophy and voxel-based morphometry was used to assess patterns of grey matter loss at baseline. The progressors were younger at onset and more likely to show distorted sound substitutions or additions compared to non-progressors. Both groups showed change over time in premotor and motor cortices, posterior frontal lobe, basal ganglia, thalamus and midbrain, but the progressors showed greater rates of atrophy in left pars triangularis, thalamus and putamen compared to non-progressors. The progressors also showed greater grey matter loss in pars triangularis and putamen at baseline. This cohort provided a unique opportunity to assess the anatomical changes that accompany the development of agrammatic aphasia. The results suggest that damage to a network of regions including Broca's area, thalamus and basal ganglia are responsible for the development of agrammatic aphasia in PPAOS. Clinical and neuroimaging abnormalities were also present before the onset of agrammatism that could help improve prognosis in

  3. Artificial grammar learning in vascular and progressive non-fluent aphasias.

    Science.gov (United States)

    Cope, Thomas E; Wilson, Benjamin; Robson, Holly; Drinkall, Rebecca; Dean, Lauren; Grube, Manon; Jones, P Simon; Patterson, Karalyn; Griffiths, Timothy D; Rowe, James B; Petkov, Christopher I

    2017-09-01

    Patients with non-fluent aphasias display impairments of expressive and receptive grammar. This has been attributed to deficits in processing configurational and hierarchical sequencing relationships. This hypothesis had not been formally tested. It was also controversial whether impairments are specific to language, or reflect domain general deficits in processing structured auditory sequences. Here we used an artificial grammar learning paradigm to compare the abilities of controls to participants with agrammatic aphasia of two different aetiologies: stroke and frontotemporal dementia. Ten patients with non-fluent variant primary progressive aphasia (nfvPPA), 12 with non-fluent aphasia due to stroke, and 11 controls implicitly learned a novel mixed-complexity artificial grammar designed to assess processing of increasingly complex sequencing relationships. We compared response profiles for otherwise identical sequences of speech tokens (nonsense words) and tone sweeps. In all three groups the ability to detect grammatical violations varied with sequence complexity, with performance improving over time and being better for adjacent than non-adjacent relationships. Patients performed less well than controls overall, and this was related more strongly to aphasia severity than to aetiology. All groups improved with practice and performed well at a control task of detecting oddball nonwords. Crucially, group differences did not interact with sequence complexity, demonstrating that aphasic patients were not disproportionately impaired on complex structures. Hierarchical cluster analysis revealed that response patterns were very similar across all three groups, but very different between the nonsense word and tone tasks, despite identical artificial grammar structures. Overall, we demonstrate that agrammatic aphasics of two different aetiologies are not disproportionately impaired on complex sequencing relationships, and that the learning of phonological and non

  4. 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

  5. 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.

  6. Designing a Patient Monitoring System Using Cloud and Semantic Web Technologies

    OpenAIRE

    Chryssa Thermolia; Ekaterini S. Bei; Stelios Sotiriadis; Kostas Stravoskoufos; Euripides G.M. Petrakis

    2015-01-01

    Moving into a new era of healthcare, new tools and devices are developed to extend and improve health services, such as remote patient monitoring and risk prevention. In this concept, Internet of Things (IoT) and Cloud Computing present great advantages by providing remote and efficient services, as well as cooperation between patients, clinicians, researchers and other health professionals. This paper focuses on patients suffering from bipolar disorder, a brain disorder ...

  7. Patterns of poststroke brain damage that predict speech production errors in apraxia of speech and aphasia dissociate.

    Science.gov (United States)

    Basilakos, Alexandra; Rorden, Chris; Bonilha, Leonardo; Moser, Dana; Fridriksson, Julius

    2015-06-01

    Acquired apraxia of speech (AOS) is a motor speech disorder caused by brain damage. AOS often co-occurs with aphasia, a language disorder in which patients may also demonstrate speech production errors. The overlap of speech production deficits in both disorders has raised questions on whether AOS emerges from a unique pattern of brain damage or as a subelement of the aphasic syndrome. The purpose of this study was to determine whether speech production errors in AOS and aphasia are associated with distinctive patterns of brain injury. Forty-three patients with history of a single left-hemisphere stroke underwent comprehensive speech and language testing. The AOS Rating Scale was used to rate speech errors specific to AOS versus speech errors that can also be associated with both AOS and aphasia. Localized brain damage was identified using structural magnetic resonance imaging, and voxel-based lesion-impairment mapping was used to evaluate the relationship between speech errors specific to AOS, those that can occur in AOS or aphasia, and brain damage. The pattern of brain damage associated with AOS was most strongly associated with damage to cortical motor regions, with additional involvement of somatosensory areas. Speech production deficits that could be attributed to AOS or aphasia were associated with damage to the temporal lobe and the inferior precentral frontal regions. AOS likely occurs in conjunction with aphasia because of the proximity of the brain areas supporting speech and language, but the neurobiological substrate for each disorder differs. © 2015 American Heart Association, Inc.

  8. Impact of aphasia on consciousness assessment: a cross-sectional study.

    Science.gov (United States)

    Schnakers, Caroline; Bessou, Helene; Rubi-Fessen, Ilona; Hartmann, Alexander; Fink, Gereon R; Meister, Ingo; Giacino, Joseph T; Laureys, Steven; Majerus, Steve

    2015-01-01

    Previous findings suggest that language disorders may occur in severely brain-injured patients and could interfere with behavioral assessments of consciousness. However, no study investigated to what extent language impairment could affect patients' behavioral responses. Objective. To estimate the impact of receptive and/or productive language impairments on consciousness assessment. Twenty-four acute and subacute stroke patients with different types of aphasia (global, n = 11; Broca, n = 4; Wernicke, n = 3; anomic, n = 4; mixed, n = 2) were recruited in neurology and neurosurgery units as well as in rehabilitation centers. The Coma Recovery Scale-Revised (CRS-R) was administered. We observed that 25% (6 out of 24) of stroke patients with a diagnosis of aphasia and 54% (6 out of 11) of patients with a diagnosis of global aphasia did not reach the maximal CRS-R total score of 23. An underestimation of the consciousness level was observed in 3 patients with global aphasia who could have been misdiagnosed as being in a minimally conscious state, even in the absence of any documented period of coma. More precisely, lower subscores were observed on the communication, motor, oromotor, and arousal subscales. Consciousness assessment may be complicated by the co-occurrence of severe language deficits. This stresses the importance of developing new tools or identifying items in existing scales, which may allow the detection of language impairment in severely brain-injured patients. © The Author(s) 2014.

  9. Rate and rhythm control strategies for apraxia of speech in nonfluent primary progressive aphasia.

    Science.gov (United States)

    Beber, Bárbara Costa; Berbert, Monalise Costa Batista; Grawer, Ruth Siqueira; Cardoso, Maria Cristina de Almeida Freitas

    2018-01-01

    The nonfluent/agrammatic variant of primary progressive aphasia is characterized by apraxia of speech and agrammatism. Apraxia of speech limits patients' communication due to slow speaking rate, sound substitutions, articulatory groping, false starts and restarts, segmentation of syllables, and increased difficulty with increasing utterance length. Speech and language therapy is known to benefit individuals with apraxia of speech due to stroke, but little is known about its effects in primary progressive aphasia. This is a case report of a 72-year-old, illiterate housewife, who was diagnosed with nonfluent primary progressive aphasia and received speech and language therapy for apraxia of speech. Rate and rhythm control strategies for apraxia of speech were trained to improve initiation of speech. We discuss the importance of these strategies to alleviate apraxia of speech in this condition and the future perspectives in the area.

  10. Transcranial brain stimulation (TMS and tDCS for post-stroke aphasia rehabilitation: Controversies

    Directory of Open Access Journals (Sweden)

    Lucia Iracema Zanotto de Mendonça

    Full Text Available Transcranial brain stimulation (TS techniques have been investigated for use in the rehabilitation of post-stroke aphasia. According to previous reports, functional recovery by the left hemisphere improves recovery from aphasia, when compared with right hemisphere participation. TS has been applied to stimulate the activity of the left hemisphere or to inhibit homotopic areas in the right hemisphere. Various factors can interfere with the brain's response to TS, including the size and location of the lesion, the time elapsed since the causal event, and individual differences in the hemispheric language dominance pattern. The following questions are discussed in the present article: [a] Is inhibition of the right hemisphere truly beneficial?; [b] Is the transference of the language network to the left hemisphere truly desirable in all patients?; [c] Is the use of TS during the post-stroke subacute phase truly appropriate? Different patterns of neuroplasticity must occur in post-stroke aphasia.

  11. Rate and rhythm control strategies for apraxia of speech in nonfluent primary progressive aphasia

    Directory of Open Access Journals (Sweden)

    Bárbara Costa Beber

    Full Text Available ABSTRACT The nonfluent/agrammatic variant of primary progressive aphasia is characterized by apraxia of speech and agrammatism. Apraxia of speech limits patients' communication due to slow speaking rate, sound substitutions, articulatory groping, false starts and restarts, segmentation of syllables, and increased difficulty with increasing utterance length. Speech and language therapy is known to benefit individuals with apraxia of speech due to stroke, but little is known about its effects in primary progressive aphasia. This is a case report of a 72-year-old, illiterate housewife, who was diagnosed with nonfluent primary progressive aphasia and received speech and language therapy for apraxia of speech. Rate and rhythm control strategies for apraxia of speech were trained to improve initiation of speech. We discuss the importance of these strategies to alleviate apraxia of speech in this condition and the future perspectives in the area.

  12. Predicting clinical decline in progressive agrammatic aphasia and apraxia of speech.

    Science.gov (United States)

    Whitwell, Jennifer L; Weigand, Stephen D; Duffy, Joseph R; Clark, Heather M; Strand, Edythe A; Machulda, Mary M; Spychalla, Anthony J; Senjem, Matthew L; Jack, Clifford R; Josephs, Keith A

    2017-11-28

    To determine whether baseline clinical and MRI features predict rate of clinical decline in patients with progressive apraxia of speech (AOS). Thirty-four patients with progressive AOS, with AOS either in isolation or in the presence of agrammatic aphasia, were followed up longitudinally for up to 4 visits, with clinical testing and MRI at each visit. Linear mixed-effects regression models including all visits (n = 94) were used to assess baseline clinical and MRI variables that predict rate of worsening of aphasia, motor speech, parkinsonism, and behavior. Clinical predictors included baseline severity and AOS type. MRI predictors included baseline frontal, premotor, motor, and striatal gray matter volumes. More severe parkinsonism at baseline was associated with faster rate of decline in parkinsonism. Patients with predominant sound distortions (AOS type 1) showed faster rates of decline in aphasia and motor speech, while patients with segmented speech (AOS type 2) showed faster rates of decline in parkinsonism. On MRI, we observed trends for fastest rates of decline in aphasia in patients with relatively small left, but preserved right, Broca area and precentral cortex. Bilateral reductions in lateral premotor cortex were associated with faster rates of decline of behavior. No associations were observed between volumes and decline in motor speech or parkinsonism. Rate of decline of each of the 4 clinical features assessed was associated with different baseline clinical and regional MRI predictors. Our findings could help improve prognostic estimates for these patients. © 2017 American Academy of Neurology.

  13. Non-linguistic learning in aphasia: Effects of training method and stimulus characteristics

    Science.gov (United States)

    Vallila-Rohter, Sofia; Kiran, Swathi

    2013-01-01

    Purpose The purpose of the current study was to explore non-linguistic learning ability in patients with aphasia, examining the impact of stimulus typicality and feedback on success with learning. Method Eighteen patients with aphasia and eight healthy controls participated in this study. All participants completed four computerized, non-linguistic category-learning tasks. We probed learning ability under two methods of instruction: feedback-based (FB) and paired-associate (PA). We also examined the impact of task complexity on learning ability, comparing two stimulus conditions: typical (Typ) and atypical (Atyp). Performance was compared between groups and across conditions. Results Results demonstrated that healthy controls were able to successfully learn categories under all conditions. For our patients with aphasia, two patterns of performance arose. One subgroup of patients was able to maintain learning across task manipulations and conditions. The other subgroup of patients demonstrated a sensitivity to task complexity, learning successfully only in the typical training conditions. Conclusions Results support the hypothesis that impairments of general learning are present in aphasia. Some patients demonstrated the ability to extract category information under complex training conditions, while others learned only under conditions that were simplified and emphasized salient category features. Overall, the typical training condition facilitated learning for all participants. Findings have implications for therapy, which are discussed. PMID:23695914

  14. COTARD SYNDROME IN SEMANTIC DEMENTIA

    Science.gov (United States)

    Mendez, Mario F.; Ramírez-Bermúdez, Jesús

    2011-01-01

    Background Semantic dementia is a neurodegenerative disorder characterized by the loss of meaning of words or concepts. semantic dementia can offer potential insights into the mechanisms of content-specific delusions. Objective The authors present a rare case of semantic dementia with Cotard syndrome, a delusion characterized by nihilism or self-negation. Method The semantic deficits and other features of semantic dementia were evaluated in relation to the patient's Cotard syndrome. Results Mrs. A developed the delusional belief that she was wasting and dying. This occurred after she lost knowledge for her somatic discomforts and sensations and for the organs that were the source of these sensations. Her nihilistic beliefs appeared to emerge from her misunderstanding of her somatic sensations. Conclusion This unique patient suggests that a mechanism for Cotard syndrome is difficulty interpreting the nature and source of internal pains and sensations. We propose that loss of semantic knowledge about one's own body may lead to the delusion of nihilism or death. PMID:22054629

  15. 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.

  16. 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

  17. The neural basis for simulated drawing and the semantic implications.

    Science.gov (United States)

    Harrington, Greg S; Farias, Dana; Davis, Christine H

    2009-03-01

    This functional magnetic resonance imaging (fMRI) study of the mental simulation of drawing (1) investigated the neural substrates of drawing and (2) delineated the semantic aspects of drawing. The goal was to advance our understanding of how drawing a familiar object is linked to lexical semantics and therefore a viable method to use to rehabilitate aphasia. We hypothesized that the semantic aspects of drawing familiar objects compared to drawing non-objects would yield greater activation in the inferior temporal cortex and the inferior frontal cortex of the left hemisphere. To test this hypothesis, eight right-handed subjects performed an fMRI experiment that directly contrasted drawing familiar objects to non-objects using mental imagery. Simulated drawing recruited a large, distributed network of frontal, parietal, and temporal structures. In the contrast comparing drawing familiar objects to non-objects there was stronger activation in the left hemisphere within the inferior temporal, anterior inferior frontal, inferior parietal and superior frontal cortices. The activation within the inferior temporal cortex was associated with visual semantic processing and semantic mediated naming. We suggest that the anterior inferior frontal activation is linked to the inferior temporal cortex and is involved in the selection of specific semantic features of the object as well as retrieval of information regarding the perceptual aspects of the object.

  18. Semantic Feature Training for the Treatment of Anomia in Alzheimer Disease: A Preliminary Investigation.

    Science.gov (United States)

    Flanagan, Kieran J; Copland, David A; van Hees, Sophia; Byrne, Gerard J; Angwin, Anthony J

    2016-03-01

    This is a preliminary investigation into the effectiveness of semantic feature training for the treatment of anomia in Alzheimer disease (AD). Anomia is a common clinical characteristic of AD. It is widely held that anomia in AD is caused by the combination of cognitive deficits and progressive loss of semantic feature information. Therapy that aims to help participants relearn or retain semantic features should, therefore, help treat anomia in AD. Two men with AD and one man with progressive nonfluent aphasia received 10 treatment sessions focused on relearning the names of 20 animals and 20 fruits. Within each category, half of the items were of high and half were of low typicality. We individualized treatment items to each participant, using items that each had not named correctly at baseline. Treatment sessions consisted of naming, category sorting, and semantic feature verification tasks. Both participants with AD showed post-treatment improvements in naming, and one maintained the treatment effects at 6-week follow-up. The semantic category of the treatment items influenced post-treatment outcomes, but typicality did not. In contrast to the participants with AD, the man with progressive nonfluent aphasia had no improvement in naming ability. Our results suggest the potential viability of semantic feature training to treat anomia in AD and, therefore, the need for further research.

  19. The timing of spontaneous detection and repair of naming errors in aphasia.

    Science.gov (United States)

    Schuchard, Julia; Middleton, Erica L; Schwartz, Myrna F

    2017-08-01

    This study examined the timing of spontaneous self-monitoring in the naming responses of people with aphasia. Twelve people with aphasia completed a 615-item naming test twice, in separate sessions. Naming attempts were scored for accuracy and error type, and verbalizations indicating detection were coded as negation (e.g., "no, not that") or repair attempts (i.e., a changed naming attempt). Focusing on phonological and semantic errors, we measured the timing of the errors and of the utterances that provided evidence of detection. The effects of error type and detection response type on error-to-detection latencies were analyzed using mixed-effects regression modeling. We first asked whether phonological errors and semantic errors differed in the timing of the detection process or repair planning. Results suggested that the two error types primarily differed with respect to repair planning. Specifically, repair attempts for phonological errors were initiated more quickly than repair attempts for semantic errors. We next asked whether this difference between the error types could be attributed to the tendency for phonological errors to have a high degree of phonological similarity with the subsequent repair attempts, thereby speeding the programming of the repairs. Results showed that greater phonological similarity between the error and the repair was associated with faster repair times for both error types, providing evidence of error-to-repair priming in spontaneous self-monitoring. When controlling for phonological overlap, significant effects of error type and repair accuracy on repair times were also found. These effects indicated that correct repairs of phonological errors were initiated particularly quickly, whereas repairs of semantic errors were initiated relatively slowly, regardless of their accuracy. We discuss the implications of these findings for theoretical accounts of self-monitoring and the role of speech error repair in learning. Copyright

  20. 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…

  1. Failure to Recover from Proactive Semantic Interference and Abnormal Limbic Connectivity in Asymptomatic, Middle-Aged Offspring of Patients with Late-Onset Alzheimer's Disease.

    Science.gov (United States)

    Sánchez, Stella M; Abulafia, Carolina; Duarte-Abritta, Barbara; de Guevara, M Soledad Ladrón; Castro, Mariana N; Drucaroff, Lucas; Sevlever, Gustavo; Nemeroff, Charles B; Vigo, Daniel E; Loewenstein, David A; Villarreal, Mirta F; Guinjoan, Salvador M

    2017-01-01

    We have obtained previous evidence of limbic dysfunction in middle-aged, asymptomatic offspring of late-onset Alzheimer's disease (LOAD) patients, and failure to recover from proactive semantic interference has been shown to be a sensitive cognitive test in other groups at risk for LOAD. To assess the effects of specific proactive semantic interference deficits as they relate to functional magnetic resonance imaging (fMRI) neocortical and limbic functional connectivity in middle aged offspring of individuals with LOAD (O-LOAD) and age-equivalent controls. We examined 21 O-LOAD and 20 controls without family history of neurodegenerative disorders (CS) on traditional measures of cognitive functioning and the LASSI-L, a novel semantic interference test uniquely sensitive to the failure to recover from proactive interference (frPSI). Cognitive tests then were correlated to fMRI connectivity of seeds located in entorhinal cortex and anterodorsal thalamic nuclei among O-LOAD and CS participants. Relative to CS, O-LOAD participants evidenced lower connectivity between entorhinal cortex and orbitofrontal, anterior cingulate, and anterior temporal cortex. In the offspring of LOAD patients, LASSI-L measures of frPSI were inversely associated with connectivity between anterodorsal thalamus and contralateral posterior cingulate. Intrusions on the task related to frPSI were inversely correlated with a widespread connectivity network involving hippocampal, insular, posterior cingulate, and dorsolateral prefrontal cortices, along with precunei and anterior thalamus in this group. Different patterns of connectivity associated with frPSI were observed among controls. The present results suggest that both semantic interference deficits and connectivity abnormalities might reflect limbic circuit dysfunction as a very early clinical signature of LOAD pathology, as previously demonstrated for other limbic phenotypes, such as sleep and circadian alterations.

  2. Preserved musical semantic memory in semantic dementia.

    Science.gov (United States)

    Weinstein, Jessica; Koenig, Phyllis; Gunawardena, Delani; McMillan, Corey; Bonner, Michael; Grossman, Murray

    2011-02-01

    To understand the scope of semantic impairment in semantic dementia. Case study. Academic medical center. A man with semantic dementia, as demonstrated by clinical, neuropsychological, and imaging studies. Music performance and magnetic resonance imaging results. Despite profoundly impaired semantic memory for words and objects due to left temporal lobe atrophy, this semiprofessional musician was creative and expressive in demonstrating preserved musical knowledge. Long-term representations of words and objects in semantic memory may be dissociated from meaningful knowledge in other domains, such as music.

  3. 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.

  4. Inquisitive semantics and pragmatics

    NARCIS (Netherlands)

    Groenendijk, J.; Roelofsen, F.; Larrazabal, J.M.; Zubeldia, L.

    2009-01-01

    This paper starts with an informal introduction to inquisitive semantics. After that, we present a formal definition of the semantics, and introduce the basic semantic notions of inquisitiveness and informativeness, in terms of wich we define the semantic categories of questions, assertions, and

  5. Semantic Web

    Directory of Open Access Journals (Sweden)

    Anna Lamandini

    2011-06-01

    Full Text Available The semantic Web is a technology at the service of knowledge which is aimed at accessibility and the sharing of content; facilitating interoperability between different systems and as such is one of the nine key technological pillars of TIC (technologies for information and communication within the third theme, programme specific cooperation of the seventh programme framework for research and development (7°PQRS, 2007-2013. As a system it seeks to overcome overload or excess of irrelevant information in Internet, in order to facilitate specific or pertinent research. It is an extension of the existing Web in which the aim is for cooperation between and the computer and people (the dream of Sir Tim Berners –Lee where machines can give more support to people when integrating and elaborating data in order to obtain inferences and a global sharing of data. It is a technology that is able to favour the development of a “data web” in other words the creation of a space in both sets of interconnected and shared data (Linked Data which allows users to link different types of data coming from different sources. It is a technology that will have great effect on everyday life since it will permit the planning of “intelligent applications” in various sectors such as education and training, research, the business world, public information, tourism, health, and e-government. It is an innovative technology that activates a social transformation (socio-semantic Web on a world level since it redefines the cognitive universe of users and enables the sharing not only of information but of significance (collective and connected intelligence.

  6. Effect of Donepezil on Wernicke Aphasia After Bilateral Middle Cerebral Artery Infarction: Subtraction Analysis of Brain F-18 Fluorodeoxyglucose Positron Emission Tomographic Images.

    Science.gov (United States)

    Yoon, Seo Yeon; Kim, Je-Kyung; An, Young-Sil; Kim, Yong Wook

    2015-01-01

    Aphasia is one of the most common neurologic deficits occurring after stroke. Although the speech-language therapy is a mainstream option for poststroke aphasia, pharmacotherapy is recently being tried to modulate different neurotransmitter systems. However, the efficacy of those treatments is still controversial. We present a case of a 53-year-old female patient with Wernicke aphasia, after the old infarction in the territory of left middle cerebral artery for 8 years and the recent infarction in the right middle cerebral artery for 4 months. On the initial evaluation, the Aphasia Quotient in Korean version of the Western Aphasia Battery was 25.6 of 100. Baseline brain F-18 fluorodeoxyglucose positron emission tomographic images demonstrated a decreased cerebral metabolism in the left temporoparietal area and right temporal lobe. Donepezil hydrochloride, a reversible acetylcholinesterase inhibitor, was orally administered 5 mg/d for 6 weeks after the initial evaluation and was increased to 10 mg/d for the following 6 weeks. After the donepezil treatment, the patient showed improvement in language function, scoring 51.0 of 100 on Aphasia Quotient. A subtraction analysis of the brain F-18 fluorodeoxyglucose positron emission tomographic images after donepezil medication demonstrated increased uptake in both middle temporal gyri, extended to the occipital area and the left cerebellum. Thus, we suggest that donepezil can be an effective therapeutic choice for the treatment of Wernicke aphasia.

  7. Geospatial semantic web

    CERN Document Server

    Zhang, Chuanrong; Li, Weidong

    2015-01-01

    This book covers key issues related to Geospatial Semantic Web, including geospatial web services for spatial data interoperability; geospatial ontology for semantic interoperability; ontology creation, sharing, and integration; querying knowledge and information from heterogeneous data source; interfaces for Geospatial Semantic Web, VGI (Volunteered Geographic Information) and Geospatial Semantic Web; challenges of Geospatial Semantic Web; and development of Geospatial Semantic Web applications. This book also describes state-of-the-art technologies that attempt to solve these problems such as WFS, WMS, RDF, OWL, and GeoSPARQL, and demonstrates how to use the Geospatial Semantic Web technologies to solve practical real-world problems such as spatial data interoperability.

  8. Mechanisms of Aphasia Recovery after Stroke and the Role of Noninvasive Brain Stimulation

    Science.gov (United States)

    Hamilton, Roy H.; Chrysikou, Evangelia G.; Coslett, Branch

    2011-01-01

    One of the most frequent symptoms of unilateral stroke is aphasia, the impairment or loss of language functions. Over the past few years, behavioral and neuroimaging studies have shown that rehabilitation interventions can promote neuroplastic changes in aphasic patients that may be associated with the improvement of language functions. Following…

  9. Jean-Martin Charcot's Role in the 19th Century Study of Music Aphasia

    Science.gov (United States)

    Johnson, Julene K.; Lorch, Marjorie; Nicolas, Serge; Graziano, Amy

    2013-01-01

    Jean-Martin Charcot (1825-93) was a well-known French neurologist. Although he is widely recognized for his discovery of several neurological disorders and his research into aphasia, Charcot's ideas about how the brain processes music are less well known. Charcot discussed the music abilities of several patients in the context of his "Friday…

  10. BROCAS APHASIA - A SYNTACTIC AND/OR A MORPHOLOGICAL DISORDER - A CASE-STUDY

    NARCIS (Netherlands)

    BASTIAANSE, R

    The patient described here suffers from Broca's aphasia without a comprehension disorder. She is unique, since she has two speech styles available and she shifts between them spontaneously. One style is characterized by a mild syntactic disorder and the other by a quite severe morphological and

  11. The Effect of a Therapy Dog on the Communication Skills of an Adult with Aphasia

    Science.gov (United States)

    LaFrance, Caroline; Garcia, Linda J.; Labreche, Julianne

    2007-01-01

    Little evidence-based research has been published within the field of communication disorders on the role of dogs as catalysts for human communication. This single participant study, a point of entry into this realm of research, explores the effects of a therapy dog on the communication skills of a patient with aphasia receiving intensive speech…

  12. A rational inference approach to group and individual-level sentence comprehension performance in aphasia.

    Science.gov (United States)

    Warren, Tessa; Dickey, Michael Walsh; Liburd, Teljer L

    2017-07-01

    The rational inference, or noisy channel, account of language comprehension predicts that comprehenders are sensitive to the probabilities of different interpretations for a given sentence and adapt as these probabilities change (Gibson, Bergen & Piantadosi, 2013). This account provides an important new perspective on aphasic sentence comprehension: aphasia may increase the likelihood of sentence distortion, leading people with aphasia (PWA) to rely more on the prior probability of an interpretation and less on the form or structure of the sentence (Gibson, Sandberg, Fedorenko, Bergen & Kiran, 2015). We report the results of a sentence-picture matching experiment that tested the predictions of the rational inference account and other current models of aphasic sentence comprehension across a variety of sentence structures. Consistent with the rational inference account, PWA showed similar sensitivity to the probability of particular kinds of form distortions as age-matched controls, yet overall their interpretations relied more on prior probability and less on sentence form. As predicted by rational inference, but not by other models of sentence comprehension in aphasia, PWA's interpretations were more faithful to the form for active and passive sentences than for direct object and prepositional object sentences. However contra rational inference, there was no evidence that individual PWA's severity of syntactic or semantic impairment predicted their sensitivity to form versus the prior probability of a sentence, as cued by semantics. These findings confirm and extend previous findings that suggest the rational inference account holds promise for explaining aphasic and neurotypical comprehension, but they also raise new challenges for the account. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. The neurolinguistic statute of perseveration in aphasia O estatuto neurolinguístico da perseveração na afasia

    Directory of Open Access Journals (Sweden)

    Silvia Saraiva Pereira Lima

    2009-01-01

    Full Text Available The aim of this study was to investigate perseveration in two contexts: spontaneous language and linguistic tasks. It points toward perseveration as a theoretical linguistic conception, that is, sociointeractionist. This presupposes language activity produced in an interlocutive space and it does not neglect pragmatic aspects and contextual use of language. Four patients presenting the following types of aphasia were analyzed: motor transcortical, amnestic, semantic and sensory. The results point out different aspects between pathological perseveration and perseveration as a normal expression in the process of language activity. This study might imply another theoretical perspective of language therapy to perseveration in aphasia.O propósito deste estudo foi investigar a perseveração em dois contextos: linguagem espontânea e tarefas linguísticas. Esta pesquisa aponta para a perseveração como sendo uma concepção teórico-linguística, qual seja, sociointeracionista. Isto abrange atividade linguística produzida em um espaço interlocutivo e não negligencia aspectos pragmáticos e o uso contextual da língua. Quatro pacientes, apresentando os seguintes tipos de afasia, foram analisados: transcortical motora, amnéstica, semântica e sensorial. Os resultados apontam para diferentes aspectos entre perseveração patológica e perseveração, como expressão normal do processo de atividade de linguagem. Este estudo poderá implicar outra perspectiva teórica de terapia de linguagem na afasia.

  14. What Does the Sleeping Brain Say? Syntax and Semantics of Sleep Talking in Healthy Subjects and in Parasomnia Patients.

    Science.gov (United States)

    Arnulf, Isabelle; Uguccioni, Ginevra; Gay, Frederick; Baldayrou, Etienne; Golmard, Jean-Louis; Gayraud, Frederique; Devevey, Alain

    2017-11-01

    Speech is a complex function in humans, but the linguistic characteristics of sleep talking are unknown. We analyzed sleep-associated speech in adults, mostly (92%) during parasomnias. The utterances recorded during night-time video-polysomnography were analyzed for number of words, propositions and speech episodes, frequency, gaps and pauses (denoting turn-taking in the conversation), lemmatization, verbosity, negative/imperative/interrogative tone, first/second person, politeness, and abuse. Two hundred thirty-two subjects (aged 49.5 ± 20 years old; 41% women; 129 with rapid eye movement [REM] sleep behavior disorder and 87 with sleepwalking/sleep terrors, 15 healthy subjects, and 1 patient with sleep apnea speaking in non-REM sleep) uttered 883 speech episodes, containing 59% nonverbal utterance (mumbles, shouts, whispers, and laughs) and 3349 understandable words. The most frequent word was "No": negations represented 21.4% of clauses (more in non-REM sleep). Interrogations were found in 26% of speech episodes (more in non-REM sleep), and subordinate clauses were found in 12.9% of speech episodes. As many as 9.7% of clauses contained profanities (more in non-REM sleep). Verbal abuse lasted longer in REM sleep and was mostly directed toward insulting or condemning someone, whereas swearing predominated in non-REM sleep. Men sleep-talked more than women and used a higher proportion of profanities. Apparent turn-taking in the conversation respected the usual language gaps. Sleep talking parallels awake talking for syntax, semantics, and turn-taking in conversation, suggesting that the sleeping brain can function at a high level. Language during sleep is mostly a familiar, tensed conversation with inaudible others, suggestive of conflicts. © Sleep Research Society 2017. Published by Oxford University Press [on behalf of the Sleep Research Society]. All rights reserved. For permissions, please email: journals.permissions@oup.com

  15. 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.

  16. Aphasia and herpes virus encephalitis: a case study

    Directory of Open Access Journals (Sweden)

    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.

  17. [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.

  18. 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.)

  19. 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.

  20. 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.

  1. Computer tomographic localization and lesion size in aphasia

    International Nuclear Information System (INIS)

    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)

  2. Effects of a Tablet-Based Home Practice Program With Telepractice on Treatment Outcomes in Chronic Aphasia.

    Science.gov (United States)

    Kurland, Jacquie; Liu, Anna; Stokes, Polly

    2018-05-17

    The aim of this study was to determine if a tablet-based home practice program with weekly telepractice support could enable long-term maintenance of recent treatment gains and foster new language gains in poststroke aphasia. In a pre-post group study of home practice outcomes, 21 individuals with chronic aphasia were examined before and after a 6-month home practice phase and again at follow-up 4 months later. The main outcome measure studied was change in naming previously treated or untreated, practiced or unpracticed pictures of objects and actions. Individualized home practice programs were created in iBooks Author with semantic, phonemic, and orthographic cueing in pictures, words, and videos in order to facilitate naming of previously treated or untreated pictures. Home practice was effective for all participants with severity moderating treatment effects, such that individuals with the most severe aphasia made and maintained fewer gains. There was a negative relationship between the amount of training required for iPad proficiency and improvements on practiced and unpracticed pictures and a positive relationship between practice compliance and same improvements. Unsupervised home practice with weekly video teleconferencing support is effective. This study demonstrates that even individuals with chronic severe aphasia, including those with no prior smart device or even computer experience, can attain independent proficiency to continue practicing and improving their language skills beyond therapy discharge. This could represent a low-cost therapy option for individuals without insurance coverage and/or those for whom mobility is an obstacle to obtaining traditional aphasia therapy.

  3. 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.

  4. 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.

  5. Programming the semantic web

    CERN Document Server

    Segaran, Toby; Taylor, Jamie

    2009-01-01

    With this book, the promise of the Semantic Web -- in which machines can find, share, and combine data on the Web -- is not just a technical possibility, but a practical reality Programming the Semantic Web demonstrates several ways to implement semantic web applications, using current and emerging standards and technologies. You'll learn how to incorporate existing data sources into semantically aware applications and publish rich semantic data. Each chapter walks you through a single piece of semantic technology and explains how you can use it to solve real problems. Whether you're writing

  6. Short-Term Memory and Aphasia: From Theory to Treatment.

    Science.gov (United States)

    Minkina, Irene; Rosenberg, Samantha; Kalinyak-Fliszar, Michelene; Martin, Nadine

    2017-02-01

    This article reviews existing research on the interactions between verbal short-term memory and language processing impairments in aphasia. Theoretical models of short-term memory are reviewed, starting with a model assuming a separation between short-term memory and language, and progressing to models that view verbal short-term memory as a cognitive requirement of language processing. The review highlights a verbal short-term memory model derived from an interactive activation model of word retrieval. This model holds that verbal short-term memory encompasses the temporary activation of linguistic knowledge (e.g., semantic, lexical, and phonological features) during language production and comprehension tasks. Empirical evidence supporting this model, which views short-term memory in the context of the processes it subserves, is outlined. Studies that use a classic measure of verbal short-term memory (i.e., number of words/digits correctly recalled in immediate serial recall) as well as those that use more intricate measures (e.g., serial position effects in immediate serial recall) are discussed. Treatment research that uses verbal short-term memory tasks in an attempt to improve language processing is then summarized, with a particular focus on word retrieval. A discussion of the limitations of current research and possible future directions concludes the review. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  7. Friends and foes in the lexicon: homophone naming in aphasia.

    Science.gov (United States)

    Middleton, Erica L; Chen, Qi; Verkuilen, Jay

    2015-01-01

    The study of homophones--words with different meanings that sound the same--has great potential to inform models of language production. Of particular relevance is a phenomenon termed frequency inheritance, where a low-frequency word (e.g., deer) is produced more fluently than would be expected based on its frequency characteristics, presumably because of shared phonology with a high-frequency homophone counterpart (e.g., dear). However, prior studies have been inconsistent in showing frequency inheritance. To explain this inconsistency, we propose a dual nature account of homophony: a high-frequency counterpart exerts 2 counterposing effects on a low-frequency homophone target during the 2 main stages of naming: (a) a detrimental impact during semantically driven lexical retrieval; (b) a beneficial impact during phonological retrieval. In a study of naming in participants with chronic aphasia followed by computational investigations, we find strong evidence for the dual nature account of homophony. PsycINFO Database Record (c) 2015 APA, all rights reserved.

  8. Family Ratings of Communication Largely Reflect Expressive Language and Conversation-Level Ability in People With Aphasia.

    Science.gov (United States)

    Fucetola, Robert; Tabor Connor, Lisa

    2015-11-01

    Family ratings of communication and social interactions represent an important source of information about people with aphasia. Because of the reliance on family/partner ratings as an outcome measure in many aphasia treatment studies and in the clinic, there is a great need for the validation of commonly used family/partner rating measures, and a better understanding of predictors of family ratings of communication. The communication ability of 130 individuals with aphasia due to neurologic illness was rated by family members/partners on the Communicative Effectiveness Index (CETI; Lomas et al., 1989). Information on aphasia severity, mood, quality of life, nonverbal cognitive functioning, and various demographic factors was collected. Principal component analysis confirmed a 2-factor model best represents the relationships among CETI rating items, and this model largely consists of a conversation-level ability factor. Family ratings were largely predicted by the patient's expressive (not receptive) language but also patient self-perceived quality of communication life. Family/partners typically rate the effectiveness of communication based largely on expressive language, despite the fact that other aspects of the aphasia (e.g., listening comprehension) are as important for everyday communication.

  9. Snapshots for Semantic Maps

    National Research Council Canada - National Science Library

    Nielsen, Curtis W; Ricks, Bob; Goodrich, Michael A; Bruemmer, David; Few, Doug; Walton, Miles

    2004-01-01

    .... Semantic maps are a relatively new approach to information presentation. Semantic maps provide more detail about an environment than typical maps because they are augmented by icons or symbols that provide meaning for places or objects of interest...

  10. A Multimodal Communication Program for Aphasia during Inpatient Rehabilitation: A Case Study

    Science.gov (United States)

    Wallace, Sarah E.; Purdy, Mary; Skidmore, Elizabeth

    2014-01-01

    BACKGROUND Communication is essential for successful rehabilitation, yet few aphasia treatments have been investigated during the acute stroke phase. Alternative modality use including gesturing, writing, or drawing has been shown to increase communicative effectiveness in people with chronic aphasia. Instruction in alternative modality use during acute stroke may increase patient communication and participation, therefore resulting in fewer adverse situations and improved rehabilitation outcomes. OBJECTIVE The study purpose was to explore a multimodal communication program for aphasia (MCPA) implemented during acute stroke rehabilitation. MCPA aims to improve communication modality production, and to facilitate switching among modalities to resolve communication breakdowns. METHODS Two adults with severe aphasia completed MCPA beginning at 2 and 3 weeks post onset a single left-hemisphere stroke. Probes completed during each session allowed for evaluation of modality production and modality switching accuracy. RESULTS Participants completed MCPA (10 and 14 treatment sessions respectively) and their performance on probes suggested increased accuracy in the production of various alternate communication modalities. However, increased switching to an alternate modality was noted for only one participant. CONCLUSIONS Further investigation of multimodal treatment during inpatient rehabilitation is warranted. In particular, comparisons between multimodal and standard treatments would help determine appropriate interventions for this setting. PMID:25227547

  11. A multimodal communication program for aphasia during inpatient rehabilitation: A case study.

    Science.gov (United States)

    Wallace, Sarah E; Purdy, Mary; Skidmore, Elizabeth

    2014-01-01

    Communication is essential for successful rehabilitation, yet few aphasia treatments have been investigated during the acute stroke phase. Alternative modality use including gesturing, writing, or drawing has been shown to increase communicative effectiveness in people with chronic aphasia. Instruction in alternative modality use during acute stroke may increase patient communication and participation, therefore resulting in fewer adverse situations and improved rehabilitation outcomes. The study purpose was to explore a multimodal communication program for aphasia (MCPA) implemented during acute stroke rehabilitation. MCPA aims to improve communication modality production, and to facilitate switching among modalities to resolve communication breakdowns. Two adults with severe aphasia completed MCPA beginning at 2 and 3 weeks post onset a single left-hemisphere stroke. Probes completed during each session allowed for evaluation of modality production and modality switching accuracy. Participants completed MCPA (10 and 14 treatment sessions respectively) and their performance on probes suggested increased accuracy in the production of various alternate communication modalities. However, increased switching to an alternate modality was noted for only one participant. Further investigation of multimodal treatment during inpatient rehabilitation is warranted. In particular, comparisons between multimodal and standard treatments would help determine appropriate interventions for this setting.

  12. 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

  13. Mindfulness meditation in aphasia: A case report.

    Science.gov (United States)

    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.

  14. Accent Identification by Adults with Aphasia

    Science.gov (United States)

    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…

  15. Further Evidence of Auditory Extinction in Aphasia

    Science.gov (United States)

    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)…

  16. Counseling and Aphasia Treatment: Missed Opportunities

    Science.gov (United States)

    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…

  17. 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

  18. Writing Treatment for Aphasia: A Texting Approach

    Science.gov (United States)

    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…

  19. Measuring Working Memory Deficits in Aphasia

    Science.gov (United States)

    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…

  20. Genetics Home Reference: epilepsy-aphasia spectrum

    Science.gov (United States)

    ... 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( ...

  1. Phonological learning in semantic dementia.

    Science.gov (United States)

    Jefferies, Elizabeth; Bott, Samantha; Ehsan, Sheeba; Lambon Ralph, Matthew A

    2011-04-01

    Patients with semantic dementia (SD) have anterior temporal lobe (ATL) atrophy that gives rise to a highly selective deterioration of semantic knowledge. Despite pronounced anomia and poor comprehension of words and pictures, SD patients have well-formed, fluent speech and normal digit span. Given the intimate connection between phonological STM and word learning revealed by both neuropsychological and developmental studies, SD patients might be expected to show good acquisition of new phonological forms, even though their ability to map these onto meanings is impaired. In contradiction of these predictions, a limited amount of previous research has found poor learning of new phonological forms in SD. In a series of experiments, we examined whether SD patient, GE, could learn novel phonological sequences and, if so, under which circumstances. GE showed normal benefits of phonological knowledge in STM (i.e., normal phonotactic frequency and phonological similarity effects) but reduced support from semantic memory (i.e., poor immediate serial recall for semantically degraded words, characterised by frequent item errors). Next, we demonstrated normal learning of serial order information for repeated lists of single-digit number words using the Hebb paradigm: these items were well-understood allowing them to be repeated without frequent item errors. In contrast, patient GE showed little learning of nonsense syllable sequences using the same Hebb paradigm. Detailed analysis revealed that both GE and the controls showed a tendency to learn their own errors as opposed to the target items. Finally, we showed normal learning of phonological sequences for GE when he was prevented from repeating his errors. These findings confirm that the ATL atrophy in SD disrupts phonological processing for semantically degraded words but leaves the phonological architecture intact. Consequently, when item errors are minimised, phonological STM can support the acquisition of new phoneme

  2. 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.

  3. Retrieval from semantic memory.

    NARCIS (Netherlands)

    Noordman-Vonk, Wietske

    1977-01-01

    The present study has been concerned with the retrieval of semantic information. Retrieving semantic information is a fundamental process in almost any kind of cognitive behavior. The introduction presented the main experimental paradigms and results found in the literature on semantic memory as

  4. Towards Universal Semantic Tagging

    NARCIS (Netherlands)

    Abzianidze, Lasha; Bos, Johan

    2017-01-01

    The paper proposes the task of universal semantic tagging---tagging word tokens with language-neutral, semantically informative tags. We argue that the task, with its independent nature, contributes to better semantic analysis for wide-coverage multilingual text. We present the initial version of

  5. 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.

  6. 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

  7. Effectiveness of speech language therapy either alone or with add-on computer-based language therapy software (Malayalam version) for early post stroke aphasia: A feasibility study.

    Science.gov (United States)

    Kesav, Praveen; Vrinda, S L; Sukumaran, Sajith; Sarma, P S; Sylaja, P N

    2017-09-15

    This study aimed to assess the feasibility of professional based conventional speech language therapy (SLT) either alone (Group A/less intensive) or assisted by novel computer based local language software (Group B/more intensive) for rehabilitation in early post stroke aphasia. Comprehensive Stroke Care Center of a tertiary health care institute situated in South India, with the study design being prospective open randomised controlled trial with blinded endpoint evaluation. This study recruited 24 right handed first ever acute ischemic stroke patients above 15years of age affecting middle cerebral artery territory within 90days of stroke onset with baseline Western Aphasia Battery (WAB) Aphasia Quotient (AQ) score of aphasia. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Principles of proportional recovery after stroke generalize to neglect and aphasia.

    Science.gov (United States)

    Marchi, N A; Ptak, R; Di Pietro, M; Schnider, A; Guggisberg, A G

    2017-08-01

    Motor recovery after stroke can be characterized into two different patterns. A majority of patients recover about 70% of initial impairment, whereas some patients with severe initial deficits show little or no improvement. Here, we investigated whether recovery from visuospatial neglect and aphasia is also separated into two different groups and whether similar proportions of recovery can be expected for the two cognitive functions. We assessed 35 patients with neglect and 14 patients with aphasia at 3 weeks and 3 months after stroke using standardized tests. Recovery patterns were classified with hierarchical clustering and the proportion of recovery was estimated from initial impairment using a linear regression analysis. Patients were reliably clustered into two different groups. For patients in the first cluster (n = 40), recovery followed a linear model where improvement was proportional to initial impairment and achieved 71% of maximal possible recovery for both cognitive deficits. Patients in the second cluster (n = 9) exhibited poor recovery (aphasia after stroke shows the same dichotomy and proportionality as observed in motor recovery. This is suggestive of common underlying principles of plasticity, which apply to motor and cognitive functions. © 2017 EAN.

  11. Explaining Semantic Short-Term Memory Deficits: Evidence for the Critical Role of Semantic Control

    Science.gov (United States)

    Hoffman, Paul; Jefferies, Elizabeth; Lambon Ralph, Matthew A.

    2011-01-01

    Patients with apparently selective short-term memory (STM) deficits for semantic information have played an important role in developing multi-store theories of STM and challenge the idea that verbal STM is supported by maintaining activation in the language system. We propose that semantic STM deficits are not as selective as previously thought…

  12. Episodic memory, semantic memory, and amnesia.

    Science.gov (United States)

    Squire, L R; Zola, S M

    1998-01-01

    Episodic memory and semantic memory are two types of declarative memory. There have been two principal views about how this distinction might be reflected in the organization of memory functions in the brain. One view, that episodic memory and semantic memory are both dependent on the integrity of medial temporal lobe and midline diencephalic structures, predicts that amnesic patients with medial temporal lobe/diencephalic damage should be proportionately impaired in both episodic and semantic memory. An alternative view is that the capacity for semantic memory is spared, or partially spared, in amnesia relative to episodic memory ability. This article reviews two kinds of relevant data: 1) case studies where amnesia has occurred early in childhood, before much of an individual's semantic knowledge has been acquired, and 2) experimental studies with amnesic patients of fact and event learning, remembering and knowing, and remote memory. The data provide no compelling support for the view that episodic and semantic memory are affected differently in medial temporal lobe/diencephalic amnesia. However, episodic and semantic memory may be dissociable in those amnesic patients who additionally have severe frontal lobe damage.

  13. Biomedical semantics in the Semantic Web.

    Science.gov (United States)

    Splendiani, Andrea; Burger, Albert; Paschke, Adrian; Romano, Paolo; Marshall, M Scott

    2011-03-07

    The Semantic Web offers an ideal platform for representing and linking biomedical information, which is a prerequisite for the development and application of analytical tools to address problems in data-intensive areas such as systems biology and translational medicine. As for any new paradigm, the adoption of the Semantic Web offers opportunities and poses questions and challenges to the life sciences scientific community: which technologies in the Semantic Web stack will be more beneficial for the life sciences? Is biomedical information too complex to benefit from simple interlinked representations? What are the implications of adopting a new paradigm for knowledge representation? What are the incentives for the adoption of the Semantic Web, and who are the facilitators? Is there going to be a Semantic Web revolution in the life sciences?We report here a few reflections on these questions, following discussions at the SWAT4LS (Semantic Web Applications and Tools for Life Sciences) workshop series, of which this Journal of Biomedical Semantics special issue presents selected papers from the 2009 edition, held in Amsterdam on November 20th.

  14. Semantically Interoperable XML Data.

    Science.gov (United States)

    Vergara-Niedermayr, Cristobal; Wang, Fusheng; Pan, Tony; Kurc, Tahsin; Saltz, Joel

    2013-09-01

    XML is ubiquitously used as an information exchange platform for web-based applications in healthcare, life sciences, and many other domains. Proliferating XML data are now managed through latest native XML database technologies. XML data sources conforming to common XML schemas could be shared and integrated with syntactic interoperability. Semantic interoperability can be achieved through semantic annotations of data models using common data elements linked to concepts from ontologies. In this paper, we present a framework and software system to support the development of semantic interoperable XML based data sources that can be shared through a Grid infrastructure. We also present our work on supporting semantic validated XML data through semantic annotations for XML Schema, semantic validation and semantic authoring of XML data. We demonstrate the use of the system for a biomedical database of medical image annotations and markups.

  15. Semantically Interoperable XML Data

    Science.gov (United States)

    Vergara-Niedermayr, Cristobal; Wang, Fusheng; Pan, Tony; Kurc, Tahsin; Saltz, Joel

    2013-01-01

    XML is ubiquitously used as an information exchange platform for web-based applications in healthcare, life sciences, and many other domains. Proliferating XML data are now managed through latest native XML database technologies. XML data sources conforming to common XML schemas could be shared and integrated with syntactic interoperability. Semantic interoperability can be achieved through semantic annotations of data models using common data elements linked to concepts from ontologies. In this paper, we present a framework and software system to support the development of semantic interoperable XML based data sources that can be shared through a Grid infrastructure. We also present our work on supporting semantic validated XML data through semantic annotations for XML Schema, semantic validation and semantic authoring of XML data. We demonstrate the use of the system for a biomedical database of medical image annotations and markups. PMID:25298789

  16. Intensive speech and language therapy in patients with chronic aphasia after stroke: a randomised, open-label, blinded-endpoint, controlled trial in a health-care setting:A randomised, open-label, blinded-endpoint, controlled trial in a health-care setting

    OpenAIRE

    Caterina, Breitenstein; Grewe, Tanja; Flöel, Agnes; Ziegler, Wolfram; Springer, Luise; Martus, Peter; Huber, Walter; Willmes, Klaus; Ringelstein, E. Bernd; Haeusler, Karl Georg; Abel, Steffie; Glindemann, Ralf; Domahs, Frank; Regenbrecht, Frank; Schlenck, Klaus-Jürgen

    2017-01-01

    BackgroundTreatment guidelines for aphasia recommend intensive speech and language therapy for chronic (≥6 months) aphasia after stroke, but large-scale, class 1 randomised controlled trials on treatment effectiveness are scarce. We aimed to examine whether 3 weeks of intensive speech and language therapy under routine clinical conditions improved verbal communication in daily-life situations in people with chronic aphasia after stroke.MethodsIn this multicentre, parallel group, superiority, ...

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

    Science.gov (United States)

    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.

  18. 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

    more than one comparison). Twenty-seven randomised comparisons (1620 participants) assessed SLT versus no SLT; SLT resulted in clinically and statistically significant benefits to patients' functional communication (standardised mean difference (SMD) 0.28, 95% confidence interval (CI) 0.06 to 0.49, P = 0.01), reading, writing, and expressive language, but (based on smaller numbers) benefits were not evident at follow-up. Nine randomised comparisons (447 participants) assessed SLT with social support and stimulation; meta-analyses found no evidence of a difference in functional communication, but more participants withdrew from social support interventions than SLT. Thirty-eight randomised comparisons (1242 participants) assessed two approaches to SLT. Functional communication was significantly better in people with aphasia that received therapy at a high intensity, high dose, or over a long duration compared to those that received therapy at a lower intensity, lower dose, or over a shorter period of time. The benefits of a high intensity or a high dose of SLT were confounded by a significantly higher dropout rate in these intervention groups. Generally, trials randomised small numbers of participants across a range of characteristics (age, time since stroke, and severity profiles), interventions, and outcomes. Our review provides evidence of the effectiveness of SLT for people with aphasia following stroke in terms of improved functional communication, reading, writing, and expressive language compared with no therapy. There is some indication that therapy at high intensity, high dose or over a longer period may be beneficial. HIgh-intensity and high dose interventions may not be acceptable to all.

  19. Integration of speech and gesture in aphasia.

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  1. Patterns of Post-Stroke Brain Damage that Predict Speech Production Errors in Apraxia of Speech and Aphasia Dissociate

    Science.gov (United States)

    Basilakos, Alexandra; Rorden, Chris; Bonilha, Leonardo; Moser, Dana; Fridriksson, Julius

    2015-01-01

    Background and Purpose Acquired apraxia of speech (AOS) is a motor speech disorder caused by brain damage. AOS often co-occurs with aphasia, a language disorder in which patients may also demonstrate speech production errors. The overlap of speech production deficits in both disorders has raised questions regarding if AOS emerges from a unique pattern of brain damage or as a sub-element of the aphasic syndrome. The purpose of this study was to determine whether speech production errors in AOS and aphasia are associated with distinctive patterns of brain injury. Methods Forty-three patients with history of a single left-hemisphere stroke underwent comprehensive speech and language testing. The Apraxia of Speech Rating Scale was used to rate speech errors specific to AOS versus speech errors that can also be associated with AOS and/or aphasia. Localized brain damage was identified using structural MRI, and voxel-based lesion-impairment mapping was used to evaluate the relationship between speech errors specific to AOS, those that can occur in AOS and/or aphasia, and brain damage. Results The pattern of brain damage associated with AOS was most strongly associated with damage to cortical motor regions, with additional involvement of somatosensory areas. Speech production deficits that could be attributed to AOS and/or aphasia were associated with damage to the temporal lobe and the inferior pre-central frontal regions. Conclusion AOS likely occurs in conjunction with aphasia due to the proximity of the brain areas supporting speech and language, but the neurobiological substrate for each disorder differs. PMID:25908457

  2. Communicative-Pragmatic Assessment Is Sensitive and Time-Effective in Measuring the Outcome of Aphasia Therapy

    Directory of Open Access Journals (Sweden)

    Benjamin Stahl

    2017-05-01

    Full Text Available A range of methods in clinical research aim to assess treatment-induced progress in aphasia therapy. Here, we used a crossover randomized controlled design to compare the suitability of utterance-centered and dialogue-sensitive outcome measures in speech-language testing. Fourteen individuals with post-stroke chronic non-fluent aphasia each received two types of intensive training in counterbalanced order: conventional confrontation naming, and communicative-pragmatic speech-language therapy (Intensive Language-Action Therapy, an expanded version of Constraint-Induced Aphasia Therapy. Motivated by linguistic-pragmatic theory and neuroscience data, our dependent variables included a newly created diagnostic instrument, the Action Communication Test (ACT. This diagnostic instrument requires patients to produce target words in two conditions: (i utterance-centered object naming, and (ii communicative-pragmatic social interaction based on verbal requests. In addition, we administered a standardized aphasia test battery, the Aachen Aphasia Test (AAT. Composite scores