Aphasia Research Articles

Perioperative nursing for patients undergoing extracranial-Intracrainal bypass for Moyamoya disease

Objective To investigate the perioperative nursing for patients undergoing extracranial-intracranial bypass for treatment of Moyamoya disease.Methods Twenty-eight patients with Moyamoya disease who were refractory to maximal medical therapy were recruited in our hospital from March, 2011 to December, 2012, for extracranial-intracranial bypass surgery.Results For the twenty-eight patients with Moyamoya disease, twenty-three had improved in clinical symptoms after EC-IC bypass, the incidence of TIA and cerebral hemorrhage were reduced;postoperative aphasia occurred in four cases;one patient was comatose after operation and complicated with pneumonia.Under appropriate treatment and nursing,twenty-seven patients recovered in two weeks without complications like pneumonia or Deep Venous Thrombosis （ DVT ） .The only patient with complications recovered and was discharged in three weeks under careful nursing.Conclusions For Moyamoya disease patients undergoing EC-IC bypass surgery, timely and intensively perioperative nursing care, prevention and early management of complications, are the key factors of improving clinical outcome and ensuring patient recovery. Key words: Extracranial-intracranial bypass; Moyamoya disease; Perioperative nursing care

The research of the application of motor imagery therapy on the recovery of the stroke patients with aphasia

Objective To discuss the influence of motor imagery therapy on the recovery of the stroke patients with aphasia.Methods Sixty cases of stroke patients with aphasia were divided into the treatment group and the control group according to the odd and even of last number.The single number was set into the control group.The double number was given to the treatment group.There were thirty patients in each group.Both groups received the conventional drug treatment and routine care of the Department of Neurology.On this basis,from the second day in hospital,the treatment group received the speech rehabili tation training with motor imagery therapy.Aphasia assessment was done for the two groups on the first day in hospital with CRRCAE.On the first day and after receiving ten-day treatment with motor imagery therapy,the grade of the severity for aphasia of Boston Diagnostic Aphasia Examination (BDAE) was done to assess the severity of aphasia in two groups.The scores of the two groups were compared.Results Before the treatment,there was no significant difference between the two groups.After receiving ten times treatment,both the two groups were improved.Compared with the control group,the treatment group became better.There was statistically significant difference between the two groups.Conclusions For the stroke patients with aphasia,motor imagery therapy has significant effect on their recovery. Key words: Motor imagery; Stroke; Aphasia; Recovery; Research

The effects of transcranial magnetic stimulations on non-fluent aphasia following stroke

Objective To explore the effects and mechanism of repetitive transcranial magnetic stimulation (rTMS) applied to the right Broca's homologue of stroke patients with non-fluent aphasia.Methods One stroke patient with non-fluent aphasia received rTMS at 1 Hz and another received the same treatment at 10 Hz.The western aphasia battery (WAB) and functional magnetic resonance imaging (fMRI) were used to evaluate their language function before and after the intervention.Results After treatment,language function in both patients had improved significantly.The aphasia quotient (AQ) score of patient 1 had improved from 37.2 to 66.6,and the AQ score of patient 2 had improved from 36.2 to 60.8.Before treatment,patient 1's activated brain areas during a vocabulary reading task were the left anterior central gyrus and the left gyrus frontalis medius.After the 1 Hz rTMS treatment the activated brain areas were the left medial surface of the lobus frontalis,the left gyrus frontalis inferior,the left prefrontal area,the left preinsula,the left lobulus parietalis inferior,and the left middle/inferior temporal gyrus.Before the 10 Hz rTMS treatment,patient 2's activated brain areas with the same vocabulary reading task were the bilateral medial surface of the temporal lobe,and the bilateral anterior central gyrus.After treatment the bilateral medial surface gyrus,the frontalis medius and lobus frontalis,the right gyrus frontalis inferior,the left prefrontal area,the bilateral lobulus parietalis superior,and the right superior/middle temporal gyrus were activated.Conclusion rTMS can significantly improve language function in stroke patients with non-fluent aphasia.Patients with smaller lesions in the left hemisphere language area can achieve hemisphere function restructuring.Larger lesions in the left hemisphere language area will probably yield bilateral restructuring in both hemispheres. Key words: Stroke; Transcranial magnetic stimulation; Non-fluent aphasia

No. 77 Frenchay Aphasia Screening Test Validity in Post Stroke Colombian Patients

PM&RVolume 6, Issue 8S2 p. S111-S111 Poster Presentation No. 77 Frenchay Aphasia Screening Test Validity in Post Stroke Colombian Patients Camilo Chaves, Camilo ChavesSearch for more papers by this authorMa. De Los Angeles Tamayo SLP, Ma. De Los Angeles Tamayo SLPSearch for more papers by this authorFernando Ortiz, Fernando OrtizSearch for more papers by this author Camilo Chaves, Camilo ChavesSearch for more papers by this authorMa. De Los Angeles Tamayo SLP, Ma. De Los Angeles Tamayo SLPSearch for more papers by this authorFernando Ortiz, Fernando OrtizSearch for more papers by this author First published: 18 September 2014 https://doi.org/10.1016/j.pmrj.2014.08.212Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume6, Issue8S28th World Congress of the International Society of Physical & Rehabilitation Medicine (ISPRM)August 2014Pages S111-S111 RelatedInformation

Functional connectivity in ischemia stroke motor aphasia patients during resting state

To investigate the changes of Broca's area functional connectivity in ischemia stroke patients with motor aphasia during resting state using functional magnetic resonance imaging (fMRI). The functional connectivity of Broca's area was analyzed by observing the correlation between low frequency signal fluctuations in Broca's area and those in all brain regions. In the normal controls group, there was multiple brain area positively correlated with Broca's area during resting state. The patients group compared with controls group, the functional connectivity between Broca's area and adjacent brain regions around its is most significant, and its controlateral brain area correlated with Broca's area reduced, but some cerebellum, occipital lobe, middle temporal gyrus and corpus callosum spenium correlated with Broca's area strengthened. There is a wide range of motor function of language network during resting state. The right anterior cingulate gyrus, knee of corpus callosum and hemisphere play an important part in motor language function network. The enhancement functional connectivity between the adjacent brain regions surrounding Broca's area, the right cerebellum, occipital lobe, middle temporal gyrus and spenium of corpus callosum and Broca's area may be one compensatory mechanism remodeling for the language recover of ischemia stroke patients with motor aphasia.

Blood oxygen level and the pathogenic mechanism of expressive aphasia after stroke

Objective To evaluate the activation patterns in the cortexes of expressive aphasics after stroke so as to explore the pathogenic mechanism of expressive aphasia.Methods Blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI) was the method of choice.It was administered to 9 subjects with expressive aphasia at 1 to 3 months post-stroke onset and to 10 healthy controls.Active areas in the patients' brains were observed using a block-designed picture-naming task,and language function was tested with the China Rehabilitation Research Center's aphasia examination (CRRCAE).The control group received BOLD-fMRI only.SPM8 software was used to process the fMRI data.Results Differences were observed in the mapping of activated areas between the two groups,but many activated areas showed no difference.Significant differences in activation were observed in areas associated with vision,language and cognition,including the bilateral inferior frontal gyrus,the bilateral superior temporal gyrus,the bilateral insula,the bilateral basal ganglia,the left superior frontal gyrus,the left middle frontal gyrus,the left precentral gyrus,the left thalamus,and the left middle temporal gyrus.All the patients had activated cortex regions associated with visual processing in the left and/or right hemisphere,such as the middle frontal gyrus,the middle temporal gyrus,the lingual gyrus and the fusiform gyrus.The activation volumes in the left hemisphere were significantly smaller than those in normal adults.Regions related to language such as the left inferior frontal gyrus (Broca's area),the left middle frontal gyrus,and the right inferior frontal gyrus (the mirror region of Broca's area) were activated in some of them.While the activation frequency,activated volume and activation intensity generally were all less in the patients than in the controls,the activation intensity in the right superior temporal gyrus,the bilateral superior parietal lobule and the left inferior temporal gyrus were stronger.Conclusions Language production may be associated with multiple,interconnected regions.The right hemisphere participates in natural language processing.Aphasia damages both linguistic and cognitive areas,reducing activation in Broca's aphasia.Activation areas in the left hemisphere and the right inferior frontal gyrus decrease significantly,while some regions in the right hemisphere are relatively more activated.The right inferior frontal gyrus may play a different role in language recovery at different periods of aphasia after stroke. Key words: Expressive aphasia; Functional magnetic resonance imaging; Brain activation; Language mechanisms

Resting-state functional connectivity in post-stroke expressive aphasia：a preliminary study

Objective To analyze the resting-state functional connectivity of the left posterior inferior frontal gyrus in normal subjects with functional MRI and to investigate its preliminary application in post-stroke aphasia.Methods Eleven male patients with post-stroke aphasia and 11 male normal subjects were recruited in this study.Resting-state fMRI data were obtained with GE 1.5 T Twin speed MR Scanner.The fMRI data were processed with SPM2, AFNI and Matlab programs.Based on the results of previous fMRI study with category member generation task , the region of interest ( ROI ) was created in the left posterior inferior frontal gyrus The time course correlations between the ROI and other voxels within whole brain were analyzed.Intra-and inter-group analysis was performed with single sample t-test and two sample t-test.Results Brain regions showed positive resting-state functional connectivity with the ROI in normal subjects including left inferior/middle frontal gyrus , left premotor cortex , left precuneus , left insula , left putamen, right inferior frontal gyrus, right cerebellum and bilateral inferior parietal lobules (voxels 33-809, t=5.80-23.55,P<0.005,uncorrected).Brain regions functionally connected with the ROI in patients with post-stroke aphasia included left inferior/middle frontal gyrus , left premotor cortex , left precuneus , left inferior parietal lobules and right inferior frontal gyrus ( voxels 34-833, t =5.08-20.34, P<0.005, uncorrected ).The left fusiform gyrus was the only region showed significantly decreased functional connectivity with the ROI in the patients group (voxels 84,t=6.25,P<0.005, uncorrected).Conclusions The neural network related to language output exists in normal subjects at the resting-state.Resting-state functional connectivity can be used to investigate the neural mechanism of development and restoration of post-stroke aphasia. Key words: Stroke ; Aphasia ; Magnetic resonance imaging ;

The Relationship between Working Memory Capacity and the Abilities of Generative Naming in Persons with Aphasia

배경 및 목적: 전형적인 생성이름대기 능력은 주어진 단서에 의해 바르게 산출된 단어 수에 의해 평가되어 왔지만, 생성이름대기과제가 다요인적이기 때문에 이러한 방법으로는 충분하지 않다는 주장이 제기되어 왔다. 본 연구에서는 정상 집단과의 비교를 통하여 실어증 집단의 생성이름대기 능력을 군집과 전환을 중심으로 질적인 비교를 하고, 생성이름대기 능력과 작업기억...

Application of contrast-enhanced intraoperative ultrasound in insular tumors surgery

Objective To exploring the value of contrast-enhanced intraoperative ultrasound (CE-IOUS) in the surgery of insular tumors.Methods A total of 58 surgical patients with insular tumors were enrolled in this study.CE-IOUS was performed to detect the tumor and the vascular structure inside and around tumors,before opening dura matter and after craniotomy.Transfrontal or temporal approach was chosen if the tumor had a clear boundary with rich vessel supplying,and transsylvian approach was used if tumor shown an unclear boundary with less vessel.The primary resection finished when complete resection was judged by surgeons.Then repeated ultrasonography was performed to detect the residuals for a maximal resection of tumor.Results In this study,trans-frontal or temporal approach was used in 22 patients and trans-sylvian approach was adopted in 36 patients by the guide of CE-IOUS.Thirty-five out of 58 cases was observed residuals by ultrasonography after primary resection.And 21 cases of them were undergone expand resection.The gross total resection was achieved in 76％ patients with the application of CE-IOUS,comparing with 40％ of total resection on the primary resection before CE-IOUS.The surgical extent was improved significantly by CE-IOUS(P ＜ 0.001).And postoperative MR imaging revealed tumor residuals in 17 cases.The Kappa value for inter-method agreement was 0.868.The similar detection of tumor residuals was achieved both in intraoperative ultrasound and postoperative MR imaging.Five patients had motor dysfunction after operation,and two of them had a complete recovery on the one month postoperative follow-up.Four patients had transit dysfunction of language,and only one patient still had aphasia one month after surgery.Conclusion CE-IOUS could provide useful information about the boundary,consistence and vessel supplying of insular tumors,which help for the decision of surgical approach.And a maximal and safe resection would be achieved by the application of repeated ultrasounography in the operation. Key words: Intraoperative monitoring; Ultrasonography; Insular lobe; Neoplasms; Microsurgery

Working memory (WM) and executive functions (EF) in aphasic patients

CO37-003-e Working memory (WM) and executive functions (EF) in aphasic patients P. Quinette a,∗, M. Laisney a, J. Lambert b, S. Bocoyran c, F. Eustache a, B. Desgranges a a Inserm–EPHE–universite de Caen/Basse-Normandie, unite U1077, laboratoire de neuropsychologie, CHU Cote-de-Nacre, 14033 Caen cedex, France b Service de neurologie, CHU Cote-de-Nacre 14033 Caen cedex, France c Service de reeducation et de readaptation neurologique, CH, Aunay-sur-Odon, France ∗Corresponding author.

Engagement in training of aphasics’ family

Engagement in training of aphasics’ family

The effect of comprehensive nursing on swallowing function and prognosis of stroke patients with dysphasia

Objective To investigate the effect of comprehensive nursing on swallowing function and prognosis of stroke patients with dysphasia.Methods Eighty cases of stroke patients with dysphasia were divided into two groups , including the observation group of 40 patients with comprehensive care interventions , while the control group of 40 patients with routine care measures.Results After treatment, the total effective functional recovery in the observation group was 85%.It was significantly higher than that in the control group , and the difference between groups was statistically significant （χ2 =4.267 , P=0.038〈0.05 ） .Follow-up results showed in the observation group the rates of aspiration pneumonia and malnutrition were 30.0%and 15.0%, while the control group of those were respectively 57.5% and 35.0%, and the difference between groups was statistically significant （ P〈0.05 ） .Conclusions Comprehensive nursing on swallowing function and prognosis of stroke patients with dysphasia can improve the patient ＇s quality of life , and it is worthy of promotion and application. Key words: Comprehensive nursing; Stroke; Dysphasia; Prognosis

Clinical application of superficial temporal artery interposition graft in treatment of middle cerebral artery aneurysms

Objective To investigate the efficacy of interposition graft technique in the treatment of cerebral artery (MCA) aneurysms.Methods The clinical data of 7 patients with MCA aneurysm treated by interposition graft technique from May 2008 to October 2012 were analyzed retrospectively.The superficial temporal artery (STA) was selected as donate blood vessel.Single vessel graft was performed in five cases and double vessels graft in two.After the bypass procedure was successfully performed,the aneurysms were removed in 5 cases,trapped in one,and left alone and parent artery occluded in one.Results Temporary mouth angle convulsion and transient decline in contralateral limbs muscle strength were detected in 2 cases.Coma,bilateral oculomotor nerve palsy and contralateral hemiplegia were detected in 1 case.Postoperative intracranial hematoma,transient aphasia,memory and calculation ability loss were detected in 1 case.One patient left the left oculomotor nerve palsy after treatment,and the others were returned to normal.Confirmed by CTA,graft vessel was unobstructed in 6 patients,showed unclear in 1 patient but the distal arteries were developing well.DSA examination was performed in 3 patients,there was no narrowness in the bypass vessels and anastomosis and the aneurysms were undeveloped.Six cases scored 5 and 1 case scored 4 during the follow-up period (12 ～ 65 months) according to Glasgow outcome score.Conclusions Interposition artery bypass was an effective way for the treatment of unclippable MCA aneurysms. Key words: Intracranial aneurysm; Middle cerebral artery; Interposition graft; Trapping aneurysm

A clinical randomized case-control study of donepezil in the treatment of aphasia after stroke

Objective To explore the efficacy and safety of the donepezil hydrochloride in the treatment of post-stroke aphasia. Methods 60 patients with post-stroke aphasia were divided randomly into donepezil hydrochloride group (30 cases) and control group (30 cases). Trail group patients were received 5 mg per time, and once a day for oral administration of 2 weeks.From the third week they were received 10 mg per time, once a day, for continuous 10 weeks, and finally implemented four weeks washout period. The control group patients were received conventional treatment of neurology. The language function of patients were assessed with the Western Aphasia Battery (WAB) and the adverse reactions after treatment were evaluated by Treatment Emergent Symptom Scale (TESS). Assessments were implemented at the three time points, the start of trail, 12 weeks, a washout period of 4 weeks. Results After 12 weeks of treatment, the AQ, PQ, CQ scores of WAB in the experimental group were (91.35±8.14), (32.74±8.12), (91.53±7.89). After 4-week washout period, they were (94.69±5.21), (33.70±4.94), (93.33±5.59) respectively. After the trail for 12 and 16 weeks, the score of each WAB item in the trail group was significantly higher than that before treatment. Compared with the control group, there was significant difference between the two groups(P<0.01). The trail group had no significant adverse reactions. Conclusion Donepezil hydrochloride in the early treatment of post-stroke aphasia is safe, effective and the therapeutic effect is stable. Key words: Donepezil hydrochloride; Stroke; Aphasia

Treatment of severe expressive dysphasia with rTMS and language therapy after childhood stroke.

s / Brain Stimulation 7 (2014) e1ee16 e14 Alberta Children’s Hospital Research Institute, University of Calgary,

Inhibitory control, word retrieval and bilingual aphasia: is there a relationship?

1. Kertesz, A. (2006) Western Aphasia BatteryRevised. San Antonio, TX: Pearson 2. Stroop, J. R. (1935) J Experimental Psychology. 3. Golden, C.J. (1978) Stroop test. Chicago, IL. Stoelting Company. 4. Eriksen, B. A. & Eriksen, C. W. (1974) Perception and Psychophysics. 5. Green, D. W. (2010) Aphasiology. Bialystok, E. et al. (2008) J. Exp Psy: Learn, Memory & Cognition Braver, T. S. (2012) Trends in Cogn Science Costa et al. (2006) Bilingualism: Language and Cognition Dell, G. (1986) Psychological Review Green, D. W. (1998) Bilingualism: Language and Cognition Green, D. W. et al. (2010) Aphasiology Hamilton, C. Martin, R. (2005) Cognitive, Affective, Behr Neuroscience Paap. K. R. & Greenberg , Z. I. (2013) Cognitive Psychol Schade, U., & Berg, T. (1992) J Psycholinguistic Research Shao, Z. et al. (2012) Quat. J Exp Psy Only in BPWAL1, • Word fluency strongly correlated with linguistic inhibition (both r > .6) • Object naming’s correlations approached significance (both r > .4) • BPWA show a definite connection between inhibitory control and word retrieval in L1 Significance threshold, p < 0.05

Clinical analysis of the technique of puncture and drainage guided by neuronavigation in treatment of brain abscesses

To study the techniques and efficacy of neuronavigation-guided puncture and drainage in the treatment of brain abscesses. From February 2006 to December 2012, 31 patients with brain abscesses treated by the technique of neuronavigation-guided puncture and drainage were retrospectively analyzed. There were 27 male and 4 female patients, age ranged from 10 months to 69 years, average (34 ± 19) years.Single brain abscesses were found in 26 patients, multiple abscesses in 5 patients. The abscesses were located in eloquent regions in 19 patients. The mean diameter of the abscess was 4.1 cm (2.5-6.7 cm). The first follow-up visit was on the first month after surgery, and if residual was observed on enhanced MRI, then the patient was followed up every 3 months until the abscess disappeared completely. After residual absorbed, the patient was followed up every year. Incisions of all patients were healed well and no infection. The length of hospital stay after surgery was 6-42 days, mean (14 ± 9) days. Bacterial culture of pus was performed regularly including aerobic, anaerobic and fungal culture after surgery. Thirteen patients had positive culture whereas the other 18 patients had negative culture. The duration of antibiotic use was 18-42 days, mean (22 ± 5) days. All the patients were followed up for 3 months to 3 years. Twenty-nine patients recovered well postoperatively, 1 case died 2 months after operation.One case was performed the second drainage after 10 days from the first surgery.Eighteen patients showed the improvement of neurological status within the first day following surgery, 4 patients got improvement in the next day, 1 patient with hemiplegia showed improvement in 10 days postoperatively, 1 patient with aphasia recovered gradually after 1 month, 1 patient with hemiplegia showed deterioration temporarily after surgery, and recovered gradually after 15 days. The technique of puncture and drainage guided by neuronavigation has many advantages to treat brain abscesses, such as small trauma, short operation time, high accuracy and safety, simple surgical procedures and good prognosis.

Activity and participation assessment of people with Aphasia

Activity and participation assessment of people with Aphasia

Landau–Kleffner syndrome: A study of 29 patients

PurposeThe aim of the study was to retrospectively analyze the electroclinical features, etiology, treatment, and prognosis of 29 patients with Landau–Kleffner syndrome (LKS) with a long-term follow-up. MethodsInclusion criteria were a diagnosis of LKS with: (1) acquired aphasia or verbal auditory aphasia; (2) with or without focal seizures, secondarily generalized tonic-clonic seizures, absences, or atonic seizures. ResultsMean follow-up was 12 years. All cases except six had seizures. Before the onset of aphasia, developmental language and behavioral disturbances were present in 19 and 14 patients, respectively. All patients had verbal auditory agnosia. Aphasia was severe in 24 patients and moderate in five. Nonlinguistic cognitive dysfunctions were moderate in 14 patients. Behavioral disturbances were found in 16 patients. During the continuous spike-and-wave discharges during slow sleep phase, the spike-wave index was >85% in 15, 50–85% in eight, and 30–50% in four. In two patients, the EEG recording showed occasional bilateral spikes, without continuous spike-and-wave discharges during slow sleep. In this phase, the awake EEG recording showed more frequent interictal abnormalities, predominantly in the temporal regions. Eight patients recovered language completely, but the remaining patients continue to have language deficits of different degrees. ConclusionLandau–Kleffner syndrome is an epileptic encephalopathy characterized by acquired verbal auditory aphasia and seizures in most of the patients associated with continuous or almost continuous spike-and-wave discharges during slow wave sleep. The most commonly used treatments were clobazam, ethosuximide, sulthiame. High-dose steroids were also administered. Adequate and early management may avoid language and cognitive deterioration.

Academy of Aphasia 2013

Academy of Aphasia 2013