Abstract

Given the frequency of naming errors in aphasia, a common aim of speech and language rehabilitation is the improvement of naming. Based on evidence of significant word recall improvements in patients with memory impairments, errorless learning methods have been successfully applied to naming therapy in aphasia; however, other evidence suggests that although errorless learning can lead to better performance during treatment sessions, retrieval practice may be the key to lasting improvements. Task performance may vary with brain state (e.g., level of arousal, degree of task focus), and changes in brain state can be detected using EEG. With the ultimate goal of designing a system that monitors patient brain state in real time during therapy, we sought to determine whether errors could be predicted using spectral features obtained from an analysis of EEG. Thus, this study aimed to investigate the use of individual EEG responses to predict error production in aphasia. Eight participants with aphasia each completed 900 object-naming trials across three sessions while EEG was recorded and response accuracy scored for each trial. Analysis of the EEG response for seven of the eight participants showed significant correlations between EEG features and response accuracy (correct vs. incorrect) and error correction (correct, self-corrected, incorrect). Furthermore, upon combining the training data for the first two sessions, the model generalized to predict accuracy for performance in the third session for seven participants when accuracy was used as a predictor, and for five participants when error correction category was used as a predictor. With such ability to predict errors during therapy, it may be possible to use this information to intervene with errorless learning strategies only when necessary, thereby allowing patients to benefit from both the high within-session success of errorless learning as well as the longer-term improvements associated with retrieval practice.

Highlights

  • Individuals with aphasia commonly demonstrate deficits in lexical retrieval ability, which can manifest as difficulty naming objects and generating specific words in conversation

  • The severity of word retrieval impairment varies widely, and individuals present with unique error patterns; word retrieval impairment is typically observed across all aphasia subtypes

  • Given the EEG Error Prediction pervasiveness of lexical retrieval impairments in persons with aphasia, improving object naming is a typical focus in speech and language therapy for this population

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Summary

Introduction

Individuals with aphasia commonly demonstrate deficits in lexical retrieval ability, which can manifest as difficulty naming objects and generating specific words in conversation. Given the EEG Error Prediction pervasiveness of lexical retrieval impairments in persons with aphasia, improving object naming is a typical focus in speech and language therapy for this population. Many different treatment protocols for object naming have shown to effectively improve naming ability in persons with aphasia. The specifics of each treatment protocol differ, many fall under one of two general treatment philosophies – the retrieval approach or the errorless learning approach. Both approaches have evidence to support their efficacy, but results are mixed as to which works better. Recent work has suggested that naming improvement occurs with both approaches (reviewed in Fillingham et al, 2003), but that retrieval practice is needed for more lasting improvements (e.g., Middleton et al, 2015)

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