Aphasic Patients Research Articles

Multimodal brain-controlled system for rehabilitation training: Combining asynchronous online brain–computer interface and exoskeleton

Background:Traditional therapist-based rehabilitation training for patients with movement impairment is laborious and expensive. In order to reduce the cost and improve the treatment effect of rehabilitation, many methods based on human–computer interaction (HCI) technology have been proposed, such as robot-assisted therapy and functional electrical stimulation (FES). However, due to the lack of active participation of brain, these methods have limited effects on the promotion of damaged nerve remodeling. New method:Based on the neurofeedback training provided by the combination of brain–computer interface (BCI) and exoskeleton, this paper proposes a multimodal brain-controlled active rehabilitation system to help improve limb function. The joint control mode of steady-state visual evoked potential (SSVEP) and motor imagery (MI) is adopted to achieve self-paced control and thus maximize the degree of brain involvement, and a requirement selection function based on SSVEP design is added to facilitate communication with aphasia patients. Comparison with existing methods:In addition, the Transformer is introduced as the MI decoder in the asynchronous online BCI to improve the global perception of electroencephalogram (EEG) signals and maintain the sensitivity and efficiency of the system. Results:In two multi-task online experiments for left hand, right hand, foot and idle states, subject achieves 91.25% and 92.50% best accuracy, respectively. Conclusion:Compared with previous studies, this paper aims to establish a high-performance and low-latency brain-controlled rehabilitation system, and provide an independent and autonomous control mode of the brain, so as to improve the effect of neural remodeling. The performance of the proposed method is evaluated through offline and online experiments.

Effects of Lexical Priming on Priming Type and Presence of Distractors in Persons with Mild Cognitive Impairment

Objectives: The purpose of the study is to examine if the lexical priming effect is valid in persons with mild cognitive impairment (MCI). In addition, this study attempted to examine the correlation between working memory and sentence production ability for MCI and healthy adults (HA).Methods: Fifteen individuals with MCI and sixteen HA described action pictures in sentences following lexical (agent or theme) primes. Priming effect was analyzed in terms of priming type and presence of distractor.Results: 1) Persons with MCI did show significantly lower proportion of passive sentences compared to HA. Overall, the proportion of passives were significantly higher in the theme primed condition versus the agent primed condition. 2) The difference in the presence of distractor stimuli in the agent primed condition was significantly larger than in the theme primed condition. 3) It was observed that the better the working memory ability of MCI participants, the higher the production of active sentences when compared with passive sentences in the theme primed condition.Conclusion: Persons with MCI used word-driven information as a strategy of sentence production like HA did. In addition, MCI participants showed difficulty in production of complex structures such as passive sentences. In previous research, most of the studies examined the priming effect through structural priming tasks for HA and aphasia patients. The results of this study also showed the effect of lexical priming in persons with MCI, and the finding of lower production of passive sentences in persons with MCI compared to HA emphasized the linguistic deficits that may appear in individuals with MCI.

Correlation between Language Screening Test and Frenchay Aphasia Screening Test for Aphasia Screening in Ischemic Stroke

Aphasia is a communication disorder that occurs after brain damage. Delays in diagnosing aphasia can lead to depression, decrease quality of life, and raise hospital stays and costs. Ischemic stroke aphasia screening instruments have been widely developed but are still difficult to interpret. Nowadays, the Language Screening Test (LAST) is reportedly quick, easy to understand, straightforward, and suitable for use by nurses. However, the LAST subtests are different from the Frenchay Aphasia Screening Test (FAST), which has been used in the past to evaluate aphasia. This study aims to determine the relationship between LAST and FAST in ischemic stroke aphasic patients for aphasia screening. The study used an analytic observational method with a cross-sectional approach. The population in this study were stroke patients at Tugurejo Semarang Hospital who had their CT Scan checked. The sample was taken using a purposive sampling technique. Bivariate data analysis with Spearman Rank Correlation test. We obtained 50 samples 19 male patients and 31 female patients with the highest age range of 51-60 years as many as 26 patients. The highest Education and profession is primary school and housewife. Patients who experienced aphasia with LAST and FAST scored as many as 27 and 29 people, while the rest not have aphasia. The Spearman's Rank test obtained p-values of 0,000 and < 0,05 respectively. Meanwhile, the correlation coefficients of LAST and FAST on aphasia were 0,678 and 0,678 respectively. There is a positive correlation between the LAST and FAST in ischemic stroke aphasic patients for aphasia screening. Nurses can use the LAST instrument to collect data and establish nursing diagnoses of verbal communication disorders.

Demographic, Clinical and Language Characteristics of Malaysian Patients with Aphasia: A Retrospective Study

Limited research has been conducted in Malaysia on the characteristics of patients with aphasia. To address this gap, a retrospective study was conducted at Hospital Rehabilitasi Cheras (HRC). The study aimed to profile the demographic, clinical, and language characteristics of patients who underwent speech therapy for aphasia. Medical records from 2014 to 2017 were reviewed, focusing on 1,259 adult patients who were referred to the Speech Therapy Unit. Analysis included demographics, clinical aspects, and linguistic features. The Western Battery of Aphasia-Revised (WAB-R), a comprehensive assessment tool, was used to evaluate the language abilities. Among the patients' files analysed, a total of 211 contained WAB-R test results. The demographic profile revealed a higher proportion of male patients compared to females, with Malay patients comprising the majority, followed by Chinese and Indians. Age distribution included 41.7% older adults (aged 55 and above), 37.9% middle-aged (aged 36-55), and 20.4% younger adults (aged 18- 35). Notably, 44.5% had completed high school education. Clinically, right- sided hemiparesis was prevalent as noted with 67.8% of patients, while 14.7% had left-sided hemiparesis. The primary cause of aphasia was stroke, accounting for 71.1% of cases, with ischemic stroke being the dominant subtype (56.9%). Fluent aphasia was presented in 50.2% of the cases, compared to 49.3% of non-fluent aphasia. Anomic aphasia was the most common subtype (35.5%), followed by global aphasia (27.5%) and Broca’s aphasia (17.5%). The language profile provided a detailed description, encompassing linguistic aspects relevant to different aphasia types. These preliminary findings yielded valuable insights and hold significant implications for the clinical management of aphasia patients in Malaysia.

Respiration-based human-machine interface for aphasic patients with limited physical mobility

Communication between aphasic patients and health care professionals (HCPs) is often difficult, which is even more complex for aphasic patients with limited physical mobility. In this study, we have proposed a C60-OH/PDDA/SiO2-based humidity sensor with an extremely short response/recovery time (13 ms/30 ms). This is closely related to the electrostatic adsorption of PDDA which effectively alleviates the aggregation of C60-OH and the introduction of SiO2 microspheres which increases the diffusion space of water molecules. The fast response and recovery rates gave the sensor good respiratory monitoring capability, which can be used to develop a human–machine interface (HMI) to assist aphasic patients for semantic expression. In this HMI, aphasia patients can generate different respiratory signals through the ultrafast humidity sensors to express specific semantics (such as thirst, hunger, etc.). In contrast to traditional semantic expression devices, this interface does not require the user to have vocal or physical movement, and therefore is extremely friendly to aphasic patients with limited mobility.

The role of cognitive control and naming in aphasia

The classical aphasia literature has placed considerable emphasis on the language-centered understanding of aphasia and failed to consider the role of executive functions (EFs) regarding different aspects of patients’ performance. Many current studies suggest deficits in EFs in individuals with aphasia, however, the available data is still limited. Here, our aim was to investigate the impairment of EFs and its potential negative effects on naming (slower performance, increased reaction time and/or decreased accuracy). We sought to determine whether the poor performance observed in word fluency task correlated with similar outcomes in naming. Our study involved five Hungarian post stroke aphasic patients (2 males and 3 females) between the ages of 60 and 70, as well as a control group matched for age and gender. The participants were diagnosed with different types of aphasia (global, Wernicke’s, anomic and conduction). This study employed various neuropsychological and linguistic batteries. By comparing the patients’ performance to that of the control group, we aimed to investigate the impacts of stroke. Within the aphasia group, we observed difficulties in following complex commands and a connection between general slowness and reduced accuracy in naming. We concluded that impairment of executive functions may have a negative impact on naming, comprehension, and fluency. Therefore, it is important to consider functional variations in neural networks, and to base our interpretations on the available psychophysiological data in literature. Our findings provide an alternative perspective to the traditional assessment of aphasia and highlight the importance of considering the role of executive functions.

Increased interhemispheric functional connectivity after right anodal tDCS in chronic non-fluent aphasia: preliminary findings.

Anodal transcranial Direct Current Stimulation (tDCS) is a non-invasive, low-cost and environment-friendly brain neuromodulation technique that increases cortical excitability. In post-stroke aphasia, the role of the right hemisphere in language recovery remains debated. In this preliminary study, we aimed to investigate the efficacy of excitatory tDCS on the right hemisphere in chronic aphasic patients. We applied anodal tDCS to the right homologous region of Broca's area in four chronic aphasic patients while performing a one-month naming rehabilitation treatment. Longitudinal data on language assessment and naming performance were collected. Resting-state fMRI images were acquired before and after treatment to measure changes in functional connectivity. Results showed enhanced positive functional connectivity of the right Broca homologous with the left middle frontal and middle temporal gyri. Every patient showed improvements in language functions, but no major changes in naming performance. These preliminary findings suggest that tDCS applied over the unaffected hemisphere may result in longitudinal inter-hemispheric functional neuroplastic changes that could specifically improve language recovery and could potentially be included in therapeutic neurorehabilitative plans.

Abstract TP78: Characteristics of Verbal and Non-Verbal Cognitive Function in Post-Stroke Aphasia Based on Language-Cognition Neuropsychological Processing Model

Introduction: Post-stroke aphasia (PSA) patients have different levels of phonetic, lexical, semantic, syntactic, and other linguistic domain impairment, and accompanied by non-verbal cognitive impairment. However, the association between verbal and non-verbal cognitive functions is not fully understood.In this study, we used the Chinese Aphasia Language Battery (CALB) and Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) to fully evaluate the characteristics of verbal and non-verbal cognitive function impairment in PSA patients. Methods: A total of 105 stroke patients were recruited in this study. Language and non-linguistic cognitive impairments were evaluated by CALB and LOTCA, respectively. Patients in the PSA group were subdivided into the fluent aphasia group (FAG) and the non-FAG group. Potential confounders were adjusted in the analysis of covariance. Partial correlation analysis between the subscores of CALB and LOTCA was also performed. Results: This study showed that PSA patients had worse speech analysis ability, vocabulary processing ability, semantic processing ability, syntactic structure conversion ability, and non-verbal cognitive performance(P<0.001). Moreover, the scores of phonetic decoding, phonetic vocabulary production, noun category classification, total LOTCA, orientation, visual perception, motor use, and thinking operation were lower in the non-FAG compared with the FAG (p<0.05). The total score of LOTCA was positively correlated with the aphasia quotient (r=0.637, P<0.001) and scores of speech analysis ability, vocabulary processing ability, semantic processing ability, and syntactic structure conversion ability (r>0; P<0.0005). Conclusions: Based on the language-cognition neuropsychological processing model, this study adopted a comprehensive verbal and non-verbal cognitive assessment set of tests, and found that PSA patients have extensive phonological, lexical, semantic, syntactic, and grammatical processing disorders. Moreover, PSA patients often have more extensive and serious non-verbal cognitive impairments, and the severity of aphasia is significantly positively correlated with the degree of nonverbal cognitive impairment.

Utilizing Music Therapy for Enhanced Recovery from Neurologic Disease Complications

Neurologic music therapy (NMT) has proven instrumental in aiding recovery from complications in patients with a diverse range of neurologic diseases. Integrating music and virtual reality with standard rehabilitation therapies enhances patient compliance and makes therapy more enjoyable. The act of listening to music not only reduces epileptiform discharges but also amplifies brain plasticity. Moreover, music induces discernible variations in brain anatomy between musicians and non-musicians. As a cost-effective intervention, music therapy significantly contributes to the accelerated and efficient recovery of post-stroke patients, particularly when applied promptly after the event. Substantial evidence supports the integration of music into rehabilitation programs, facilitating the recovery of hand function, dexterity, spatial movement, cognitive function, mood, coordination, stride length, and memory. Techniques such as learning words as lyrics, melodic intonation therapy, and singing play crucial roles in expediting recovery for aphasic patients. Recognized by the World Rehabilitation Federation, NMT therapists are valuable members of the rehabilitation team. The approval of NMT as an effective, evidence-based treatment method underscores its significance in enhancing patient outcomes.

Decoding Bilingual EEG Signals With Complex Semantics Using Adaptive Graph Attention Convolutional Network.

Decoding neural signals of silent reading with Brain-Computer Interface (BCI) techniques presents a fast and intuitive communication method for severely aphasia patients. Electroencephalogram (EEG) acquisition is convenient and easily wearable with high temporal resolution. However, existing EEG-based decoding units primarily concentrate on individual words due to their low signal-to-noise ratio, rendering them insufficient for facilitating daily communication. Decoding at the word level is less efficient than decoding at the phrase or sentence level. Furthermore, with the popularity of multilingualism, decoding EEG signals with complex semantics under multiple languages is highly urgent and necessary. To the best of our knowledge, there is currently no research on decoding EEG signals during silent reading of complex semantics, let alone decoding silent reading EEG signals with complex semantics for bilingualism. Moreover, the feasibility of decoding such signals remains to be investigated. In this work, we collect silent reading EEG signals of 9 English Phrases (EP), 7 English Sentences (ES), 10 Chinese Phrases (CP), and 7 Chinese Sentences (CS) from the subject within 26 days. We propose a novel Adaptive Graph Attention Convolution Network (AGACN) for classification. Experimental results demonstrate that our proposed method outperforms state-of-the-art methods, achieving the highest classification accuracy of 54.70%, 62.26%, 44.55%, and 57.14% for silent reading EEG signals of EP, ES, CP, and CS, respectively. Moreover, our results prove the feasibility of complex semantics EEG signal decoding. This work will aid aphasic patients in achieving regular communication while providing novel ideas for neural signal decoding research.

Efficacy of Script Training on Broca’s Aphasia Patients

Background: Broca’s Aphasia is a language disorder characterized by difficulties in speech production and fluency, significantly affecting communication. Script training, a language rehabilitation technique, has shown promise in treating this condition. However, its efficacy in a controlled clinical setting had yet to be fully explored. Objective: The objective of this study was to assess the effectiveness of script training in improving the expressive language abilities of individuals with Broca’s Aphasia. Methods: This case report study was conducted over a period of six months at the University of Lahore Teaching Hospital. Using purposive sampling, patients diagnosed with Broca’s Aphasia were selected. Participants underwent script training sessions, which involved repetitive practice of personalized scripts. The Mississippi Aphasia Screening Test (MAST) was employed for initial assessments and tracking progress. Ethical considerations were strictly adhered to, with informed consent obtained from all participants. The study included both quantitative and qualitative methods for data analysis. Results: The study demonstrated significant improvements in participants' expressive language abilities. Pre-therapy MAST scores averaged at 10/50, which increased to an average of 23/50 post-therapy. Notable areas of improvement included Naming (from 3/10 to 6/10), Automatic Speech (from 1/10 to 6/10), and Verbal Fluency (from 1/10 to 6/10). However, Repetition and Writing/Spelling showed minimal changes. Conclusion: Script training showed a significant positive impact on the expressive language skills of individuals with Broca’s Aphasia. This suggests that script training can be a beneficial therapeutic intervention in the language rehabilitation of Broca’s Aphasia patients, particularly in enhancing Naming, Automatic Speech, and Verbal Fluency. Future studies should investigate long-term effects and the integration of script training with other therapeutic approaches.

German nominal number interpretation in an impaired mental lexicon

Abstract There is an ongoing debate on how speakers and listeners process and interpret information in a morphological system that is very complex and not very transparent. A well-known test case is the German nominal number system. In this paper we employ discriminative learning (e.g., Ramscar & Yarlett, 2007; Baayen et al., 2011, 2019) to test whether discriminative learning networks can be used to better understand the processing of German number. We analyse behavioral data obtained from a patient with primary progressive aphasia (Domahs et al., 2017), and the unimpaired system. We test a model that implements the traditional cues borrowed from the schema approach (Köpcke, 1988, 1993; Köpcke et al., 2021), and compare it to a model that uses segmental and phonotactic information only. Our results for the unimpaired system demonstrate that a model based on only biphones as cues is better able to predict the number of a given word-form than a model using structural phonological cues. We also test whether a discriminative learning model can predict the number decisions by the aphasic patient. The results demonstrate that a biphone-based discriminative model trained on the patient’s responses is superior to a structure-based model in approximating the patient’s behavior.

Factors predicting stroke specific quality of life in post stroke aphasia

Background: Understanding the factors that predict stroke-specific QoL in post-stroke aphasia patients in Pakistan is crucial for developing targeted interventions and improving the rehabilitation process. Objective: To determine the factors predicting the stroke-specific quality of life in post-stroke aphasia. Methodology: This cross-sectional analytical study was conducted over 18 months from June 2021 to December 2022 at RHS Rehabilitation Centre Islamabad Pakistan. A total of n=134 independent participants with fluent and non-fluent aphasia at least six months post-stroke, and able to follow one-step commands were included in the study through a non-probability convenient sampling technique. The stroke-specific quality of life (SS-QoL) scale was used to assess the quality of life in the participants, while the list of predictors was developed from the literature. SPSS version 21 was used for statistical analysis. Result: A multiple regression was run to predict the quality of life from marital status, gender, family status, patient's socioeconomic status, types of strokes, types of aphasia, and comorbidities. These variables statistically significantly predicted quality of life {F(13,120)=10.366, p<0.001}. All variables cause 47.8% (Adj. R2=0.478) variance in stroke-specific quality of life in aphasia patients. Conclusion: The male gender, married marital status, middle and upper socioeconomic status, ischemic stroke compared to hemorrhagic stroke, fluent aphasia, and cardiac disease compared to other comorbidities positively affect the quality of life in post-stroke aphasia patients. However, age and the family system did not show any impact on the quality of life. Keywords: aphasia; diabetes; quality of life; stroke

Validation préliminaire du SADQ-10 en français, outil de dépistage de la dépression post-AVC chez le patient aphasique pris en charge en ambulatoire.

Context: Post-stroke depression (PSD) affects about 60 % of aphasic patients during the first year after their stroke. However, there are only a few screening instruments of the PSD suited to this population and available in French. The SADQ-10, a hetero-questionnaire, is one of the most acceptable instruments for patients with aphasia but was developed in English. Objective: This study aims to provide ambulatory health professionals with a screening tool for PSD adapted to aphasic patients. The purpose is to find out if the french version of the SADQ-10 (SADQ-A10) allows a reliable and valid screening of depression in stroke patients with aphasia. Method and patients: This longitudinal study was conducted with Speech-Language Pathologists (SLP), in view of their close contact with aphasic patients. Each SLP had to complete the SADQ-A10 in regards to her patient(s) twice and the ADRS (the gold standard in this study) once. The correlations between the results of 23 study subjects were assessed. Results: The french adaptation of the SADQ-10 demonstrated good test-retest reliability (rs = 0.91, p < 0.0001) and a correct internal consistency (α = 0,77) that could be improved. Its validity was also demonstrated (rs = 0.73, p < 0.0001). Conclusion: This study provides elements supporting the validity and the reliability of the SADQ-A10. Still, it needs to be replicated in a larger and more representative sample of the target-population. The SADQ-A10 could then be used by health professionals and be the first instrument currently available in French, screening the presence of depression in ambulatory stroke patients with aphasia.

Effects of repetitive transcranial magnetic stimulation combined with music therapy in non-fluent aphasia after stroke: A randomised controlled study.

Although existing studies have shown that both repetitive transcranial magnetic stimulation (rTMS) and music therapy have advantages in the treatment of non-fluent aphasia, the efficacy of the combination of these two methods remains to be investigated. To investigate the clinical efficacy of low-frequency rTMS combined with music therapy on language function and depression in patients with non-fluent aphasia after stroke. A single-blind parallel randomised controlled trial was conducted. Sixty patients (mean duration = 93.78 days) with non-fluent aphasia after stroke were randomly divided into a traditional therapy group (n = 20), a music therapy group (n = 20) and a combined therapy group (n = 20, 1Hz). The language function and depression were evaluated before and 3 weeks after treatment with the Chinese version of the Western Aphasia Battery scale, Boston Diagnostic Aphasia Examination scale and Stroke Aphasic Depression Questionnaire Hospital Version scale. The combined therapy group was significantly better in all outcomes than the traditional therapy group and was significantly better in depression than the music therapy group. The music therapy group was significantly better in repetition and depression than the traditional therapy group. Language improvement was positively correlated with depression improvement. For adverse events, only two patients in the combined therapy group showed slight dizziness during rTMS treatment and their symptoms improved after rest. Our preliminary randomised controlled study indicates that low-frequency rTMS combined with music therapy is feasible and safe in improving language function and depression in non-fluent aphasia patients after stroke. What is already known on this subject Repetitive transcranial magnetic stimulation (rTMS) and music therapy respectively have advantages in the treatment of non-fluent aphasia after stroke, but whether the combination of the two methods is more effective is still unknown. What this paper adds to the existing knowledge This is one of the first randomised control trials to investigate whether the clinical efficacy of low-frequency rTMS combined music therapy for non-fluent aphasia is better. The findings show that low-frequency rTMS combined music therapy is superior to traditional therapy in spontaneous speech, auditory comprehension, repetition, naming, aphasia quotient, functional language level and depression, and superior to music therapy in depression, while music therapy is superior to traditional therapy in repetition and depression. What are the potential or actual clinical implications of this work? Low-frequency rTMS combined music therapy may be a better method for treatment of non-fluent aphasia.

Modeling pathological spread through the structural connectome in the FTLD spectrum

AbstractBackgroundTo explore the relationship between network vulnerability and longitudinal atrophy progression in FTLD spectrum, using Network Diffusion Model (NDM) of pathology spread.MethodThirty‐four behavioural‐variant frontotemporal dementia (bvFTD), 11 semantic‐variant primary progressive aphasia (svPPA) and 11 nonfluent/agrammatic‐variant primary progressive aphasia (nfvPPA) patients underwent longitudinal T1‐weighted MRI. Forty‐eight young controls underwent multi‐shell diffusion MRI scan. NDM was developed to assess the progression of FTLD pathology originating from a seed (right orbitofrontal cortex [bvFTD], left inferior temporal gyrus [svPPA], and left supplementary motor area [nfvPPA]) and proceeding through the healthy connectome. The connectivity measures were fractional anisotropy (FA) and intra‐cellular volume fraction (ICVF). Correlations were tested between atrophy estimated by NDM and those empirically obtained in FTLD patients over a follow‐up of 24 months.ResultIn bvFTD, NDM showed an early spread to frontal lobe and basal‐ganglia and to right sensorimotor, parietal, temporal and occipital lobes, with a subsequent involvement of the left hemisphere. In svPPA, NDM suggested an early spread of pathology to the left occipital and frontal lobes, while parietal lobe was reached later. In nfvPPA, NDM‐predicted spread through all brain regions, except for occipital lobe. NDM‐predicted atrophy of each region was positively correlated to longitudinal atrophy empirically observed in all three FTLD variants. Overall, NDM with ICVF connectome provided higher correlation values relative to NDM with FA maps.ConclusionThe NDM implementation to cross‐sectional structural connectome is a valuable tool to predict atrophy patterns and pathology spreading in FTLD variants.Supported‐by: European‐Research‐Council (StG‐2016_714388_NeuroTRACK); Foundation Research on Alzheimer’s Disease.

Dyslexia phenotypes in Chinese‐speaking individuals with Primary Progressive Aphasia

AbstractBackgroundThere are more than 7,000 living languages worldwide with wide heterogeneities in their linguistic features. Varying dementia symptomatology has been noted across speakers of different languages. Chinese languages adopt logographic scripts that contrast greatly from Indo‐European languages with alphabetic writing systems. For instance, Chinese characters have weak grapheme‐phoneme correspondence, with only 19‐ 39% pronounced per their phonetic components. Chinese characters also have 20 different spatial configurations with varying visuospatial complexity and abundant heteronyms. Past literature has focused on the reading presentations of primary progressive aphasia (PPA) patients that adopt Indo‐European languages. This study outlined the reading presentations of Chinese‐speaking PPA patients.MethodThe CLAP (Chinese Language Assessment for PPA) battery is designed to characterize the neurolinguistics features of Chinese‐speaking PPA individuals. In CLAP character reading test, participants are tasked to read aloud 50 Chinese characters that vary in lexicality (pictographic, regular compound, and irregular compound characters), character frequency and concreteness. Voxel‐based morphometry(VBM) was performed to examine the neural basis of reading performance. Participants are also tasked with reading pairs of compound words with heteronyms (e.g., “bow tie” vs “bow down).ResultsA total of 15 Mandarin‐speaking controls and 38 PPA individuals [6 nonfluent variant (nfv) PPA, 9 semantic variant (sv) PPA and 23 logopenic variant (lv) PPA] completed CLAP reading task. In character reading test, svPPA scored significantly lower than controls and nfvPPA (pictographic: p = 0.026; regular compound: p = 0.007; irregular compound characters: p<0.001). Regardless of lexicality, the reading score significantly correlated with volumetric changes over left temporal pole. While over‐regularization errors/surface dyslexia was the most common reading error across control and PPA groups, it was not specific to svPPA (p = 0.109). Conversely, on heteronym word reading test, svPPA and lvPPA scored significantly lower in accuracy, with over‐regularization errors more frequently noted in svPPA group.ConclusionContrary to English svPPA patients that struggled specifically with irregular word reading and showed frequent surface dyslexia, Chinese PPA patients showed no variant‐specific differences across lexicality, and svPPA‐specific over‐regularization phenomenon were found at the lexical (i.e., heteronym‐reading) and not sub‐lexical reading. Diagnostic criteria for PPA syndrome vary with languages and should ideally be tailored linguistically.

The Minilinguistic State Examination for Primary Progressive Aphasia: validity evidences for the Argentinean version

AbstractBackgroundThis work presents a new brief language assessment tool for Primary Progressive aphasia: the Minilinguistic State Examination (MLSE). It has been developed with the intention to have equivalent version in different countries. We translated and adapted the test to Argentinean Spanish. Here we present the psychometric properties of the Argentinean Spanish version of the MLSE.MethodThe sample comprised 29 aphasic patients from different etiologies and 94 healthy community‐dwelling adults. All of them were native Argentinean Spanish speaking. The Argentinean MLSE was administered as well as the following equivalent subtests with validated Argentinean versions in order to analyze the concurrent validity through a Spearman´s Rho correlation coefficient: the Boston Aphasia Battery, the BEA (Batería de Evaluación de la Afasia), Pyramids and Palm tree test and Repeat and Point. Score´s reliability was analyzed according to K‐R 20 coefficient for each kind of possible error: motor, phonologic, semantic and working memory. Three independent clinicians scored a sub‐group of 16 patients in order to determine interraters reliability. Krippendorff´s alpha was calculated.ResultAll correlations with the equivalent tasks were statistically significant except for semantic association task that was near statistical significance (p = .061). Score´s reliability for motor errors was .825, for phonological errors .889, for semantic .841 and for working memory .874. Krippendorff´s alpha obtained for the total MLSE score was .877, while the following values were obtained for each type of error identified in the MLSE: motor = .398; phonological = .707; semantic = .729; syntactic = .831; working memory = .539; omissions = .672.ConclusionAll these analyses provide evidence of validity of the scores of the test and suggest that it can be used with confidence by clinicians. They also showed in general acceptable interrater reliability. However, some clarifications should be added to the motor and working memory scoring guide in order to avoid interrater´s divergencies, as the obtained values were low.

The auditory phenotype of behavioural variant frontotemporal dementia

AbstractBackgroundPatients with behavioural variant frontotemporal dementia commonly exhibit abnormal hedonic and other behavioural responses to sounds, however hearing dysfunction in this disorder is poorly characterised. Here we addressed this issue using the Queen Square Tests of Auditory Cognition (QSTAC) – a neuropsychological battery for the systematic assessment of central auditory functions (including pitch pattern perception, environmental sound recognition, sound localisation and emotion processing) in cognitively impaired people.MethodThe QSTAC was administered to 15 patients with behavioural variant frontotempoal dementia, 24 patients with comparator dementia syndromes (primary progressive aphasia and typical Alzheimer’s disease) and 15 healthy age‐matched individuals. Participants also had pure tone audiometry to assess peripheral hearing function and a comprehensive general neuropsychological assessment.ResultAfter accounting for nonverbal executive and peripheral hearing performance, patients with behavioural variant frontotemporal dementia showed deficits of environmental sound and auditory emotion recognition and sound localisation, compared both with healthy controls and patients with Alzheimer’s disease. Patients with behavioural variant frontotemporal dementia were further differentiated from primary progressive aphasia patients on their performance across QSTAC (sound recognition and localisation) subtests.ConclusionBehavioural variant frontotemporal dementia has a distinct phenotype of auditory cognitive dysfunction which likely contributes to the hearing alterations that many patients with this diagnosis experience in daily life. Our findings call attention to an under‐recognised issue in frontotemporal dementia that warrants further clinical interpretation and the development of management strategies tailored to real‐world acoustic environments.

Social cognition and behavioral changes in patients with posterior cortical atrophy.

Posterior cortical atrophy (PCA) is a rare neurodegenerative condition characterized by progressive visual and visuospatial dysfunction. The consensus criteria state that patients should present "relatively spared behavior and personality" in early stages. However, limited research has focused on these symptoms in PCA. This study compared 157 patients with PCA in early stages of the disease with 352 healthy controls (HC), 202 typical AD (tAD), and 177 logopenic variant primary progressive aphasia (lvPPA) patients from the National Alzheimer's Coordinating Center (NACC) dataset. They were compared using clinician ratings of behavioral symptoms, informant- and clinician-filled questionnaires and patient-facing tests of behavior and social cognition. Results showed that PCA individuals exhibited many behavioral symptoms, the more frequently reported being anxiety, depression, apathy, and irritability. During cognitive testing, clinicians observed disorganized and reactive behaviors, but no insensitive behaviors. Informant reports indicated that PCA patients exhibited higher levels of inhibition and anxiety in response to stimuli associated with non-reward, novelty, and punishment. Social norms knowledge and empathy were overall preserved, although slight decreases in perspective-taking and socioemotional sensitivity were observed on informant-rated questionnaires. Except for more elevated neuropsychiatric symptoms in tAD, the three AD variants had similar profiles. Our findings provide insights into the social cognition and behavioral profiles of PCA, highlighting patterns of preservations and mild impairments, even in the early stages of the disease. These results contribute to a more complete understanding of non-visual symptoms in PCA and have implications for diagnostic and intervention strategies.