Mixed Transcortical Aphasia Research Articles

Combination of Transcranial Direct Current Stimulation and Action Imitation Training in Post- Stroke Aphasia Rehabilitation: Implications from a Single Case Study.

Background. One of the most used non-invasive brain stimulation (NIBS) techniques in aphasia rehabilitation is Anodal Transcranial Direct Current Stimulation (A-tDCS). Its application is supported by the fact that brain plasticity, when facilitated by language intervention, can be improved by non-invasive brain stimulation. The effects of neuromodulation combined with various language and communication therapies have led to promising results in the rehabilitation of patients presenting with acquired aphasia. An Action Observation Therapy such as IMITAF seems to contribute to improvements in language skills, mainly in naming. This experimental clinical protocol aims to investigate the rehabilitative potential of A-tDCS on perilesional areas, combined with computerized neuropsychological training. Method. Participant: Mr. V., 66-year old right-handed male, Italian native speaker. The patient suffered an ischemic stroke due to left carotid artery dissection which resulted in right hemiparesis, mixed transcortical aphasia, characterized by non-fluent speech and dysarthric and disfluent speech. Treatment: The subject underwent unipolar montage stimulation, with anode placed in F5 and intra-cephalic reference on Fp2. For safety reasons, a stimulation intensity of 1.5 mA was applied for 20 minutes once a day in combination with IMITAF level I, which required the subject to repeat bisyllabic words. Procedure: The stimulation protocol lasted a total of 4 weeks and was divided into 2 different modes. Clinical Training: 40-minute treatments (no.10 sessions) and involved the combined administration of a-tDCS (20-minute online mode) and 40-minute training. Home-Based Training: 40-minutes trainig carried out at the patient’s home, via PC (no. 8 sessions). Results. Mr. V. completed the protocol treatment sessions without reporting any adverse effects, such as scalp redness, tingling or headache. The results showed an improvement in the auditory/visual comprehension of words/sentences after A-tDCS and Action Observation Therapy, which has maintained one month after treatment. Conclusions. Together with IMTAF neuropsychological training, the constant and repeated use of A-tDCS, on the perilesional areas, contributed to improvements in language skills thus promoting an overall recovery of communicative skills in an individual with chronic post-stroke non-fluent aphasia.

Brain structural and functional correlates of the heterogenous progression of mixed transcortical aphasia

Mixed transcortical aphasia (MTCA) is characterized by non-fluent speech and comprehension deficits coexisting with preserved repetition. MTCA may evolve to less severe variants of aphasias or even to full language recovery. Mechanistically, MCTA has traditionally been attributed to a disconnection between the spared left perisylvian language network (PSLN) responsible for preserved verbal repetition, and damaged left extrasylvian networks, which are responsible for language production and comprehension impairments. However, despite significant advances in in vivo neuroimaging, the structural and functional status of the PSLN network in MTCA and its evolution has not been investigated. Thus, the aim of the present study is to examine the status of the PSLN, both in terms of its functional activity and structural integrity, in four cases who developed acute post-stroke MTCA and progressed to different types of aphasia. For it, we conducted a neuroimaging-behavioral study performed in the chronic stage of four patients. The behavioral profile of MTCA persisted in one patient, whereas the other three patients progressed to less severe types of aphasias. Neuroimaging findings suggest that preserved verbal repetition in MTCA does not always depend on the optimal status of the PSLN and its dorsal connections. Instead, the right hemisphere or the left ventral pathway may also play a role in supporting verbal repetition. The variability in the clinical evolution of MTCA may be explained by the varying degree of PSLN alteration and individual premorbid neuroanatomical language substrates. This study offers a fresh perspective of MTCA through the lens of modern neuroscience and unveils novel insights into the neural underpinnings of repetition.

Motor rehabilitation of aphasic stroke patient: the possibility of Rood's approach.

Motor rehabilitation of aphasic stroke patient: the possibility of Rood's approach.

The Therapeutic Effect of Schuell’s Stimulation Approach for Severe Chronic Aphasia

ABSTRACT Background Hildred Schuell’s approach to aphasia therapy was developed in the 1960’s based on her vast clinical experience. Though few refer to the treatment as “Schuell’s”, her stimulation techniques remain widely used and the variables she describes as important (e.g., intensity and salience) are those that now have empirical evidence in promoting adaptive neuroplasticity. Schuell’s Stimulation Approach (SSA) was designed to be applicable to all severity types. This is compelling given the paucity of treatment options for people with particularly severe aphasia. Aims The aim of the current study is to investigate the viability and efficacy of SSA for individuals with chronic severe aphasia, reported as having “plateaued” following other treatments. Methods One participant with severe Wernicke’s and one with severe mixed transcortical aphasia participated in 30 hours of treatment over ten days. A single subject multiple baseline design across behaviours was employed. The treatment design was based on the SSA guidelines outlined by Coelho et al. (2012), and participant performance was compared pre- and post-treatment on language probes, discourse probes, standardised assessment and caregiver ratings. Results Both participants demonstrated improvement on standardised assessment and trained items; generalisation to untrained items and discourse was limited. Both participants also made subjective improvements according to caregivers and others, and one participant showed a decrease in anosognosia. Conclusions Intensively administered SAA may be a feasible treatment option for motivated individuals with chronic severe aphasia who have ceased to benefit from other therapies.

Marchiafava-Bignami disease presenting as mixed transcortical aphasia

Marchiafava-Bignami disease (MBD) is a rare demyelinating and necrotic disorder of the corpus callosum, classically presenting with altered mental status. Increasing evidence shows that lesions can localize also in the subcortical white matter, presenting with focal symptoms and carrying a poorer prognosis. We describe the clinical and radiological findings of a patient with MBD presenting as mixed transcortical aphasia (MTA), remarkably improving after thiamine treatment.

Lesion-aphasia discordance in acute stroke among Bengali-speaking patients: Frequency, pattern, and effect on aphasia recovery

Abstract Introduction Contemporary research papers have highlighted the issue of lesion-aphasia discordance in reference to the classic ‘associationist’ model provided by Wernicke-Lichtheim. The objective of the present study is to explore frequency, pattern and evolution of lesion-discordant aphasia following first ever acute stroke in Bengali-speaking subjects. Methods Bengali version of Western Aphasia Battery, a validated scale, was used for language assessment in our study subjects. Lesion localization was done by using Magnetic resonance imaging (MRI) (3T) for ischemic stroke (if not contraindicated) and computed tomography (CT) for hemorrhagic stroke. Among 515 screened cases of first-ever acute stroke, 208 presented aphasia. Language assessment was done between 7 and 14 days in all study subjects and was repeated between 90 and 100 days in patients available for follow-up. Ischemic stroke cases with contraindication for MRI underwent CT imaging. Discordance between lesion and aphasic phenotype was determined only for right-handed subjects with cortical involvement (isolated or in combination with sub-cortical white matter) in the left hemisphere. Appropriate statistical tests were used to analyze the collected data. Results Lesion-aphasia discordance was found in 20 out of 134 patients with aphasia who were dextral and had cortical involvement in the left hemisphere (14.92%). The pattern of discordance observed were- posterior lesion with Broca's aphasia (4; 20%); posterior lesion with global aphasia (8; 40%); anterior lesion with global aphasia (4; 20%), and posterior lesion with mixed transcortical aphasia (4; 20%). On univariate analysis, the factors significantly associated with lesion-aphasia discordance were hemorrhagic stroke (p = 0.000); posterior perisylvian location (p = 0.002), and higher education (p = 0.048). After adjusting for all other variables, hemorrhagic stroke was found to have strong association with lesion-aphasia discordance (p = 0.001, OR = 11.764, 95% CI, 2.83–50.0). Discordant cases were more likely to recover or change to a milder type compared to concordant cases (p = 0.007, OR = 11.393, 95% CI, 1.960–66.231), after adjusting for all other variables including initial severity of aphasia (p = 0.006, OR = 8.388, 95% CI, 1.816–38.749). Conclusion Lesion-aphasia discordance following acute stroke is not uncommon among Bengali-speaking subjects. In the discordant group, preponderance towards non-fluent aphasia was observed. Discordance occurred more frequently after hemorrhagic stroke. Subjects with lesion-discordant aphasia presented better recovery during early post-stroke phase.

Language as a Threat: Multimodal Evaluation and Interventions for Overwhelming Linguistic Anxiety in Severe Aphasia.

Linguistic anxiety (LA) is an abnormal stress response induced by situations that require the use of verbal behavior, and it is accentuated during language testing in persons with aphasia (PWA). The presence of LA in PWA may jeopardize the interpretation of cognitive evaluations, leading to biased conclusions about the severity of the language alteration and the effectiveness of the treatments. In the present study, we report the case of a woman (Mrs. A) with severe chronic mixed transcortical aphasia due to left frontal and parietal hemorrhages that partially spared the perisylvian area. Mrs. A was treated with the dopamine agonist Rotigotine alone and combined with Intensive Language-Action Therapy (ILAT). Complementary evaluations included autonomic reactivity during the performance of different language tasks, resting state functional magnetic resonance imaging (rs-fMRI) and [18F]-fluorodeoxyglucose positron emission tomography (18F-FDG-PET). We found that formal language testing in a clinical setting triggered a dramatic increase of automatic echolalia, perseverations and frustration, making the task completion difficult. The treatment improved aphasia, but gains were more robust when evaluation was performed by Mrs. A’s husband at home than by clinicians. Autonomic evaluation under Rotigotine revealed higher reactivity during tasks tapping an impaired function in comparison with a task evaluating a preserved function (verbal repetition). Baseline 18F-FDG-PET analysis showed decreased metabolic activity in left limbic-paralimbic areas, whereas rs-fMRI revealed compensatory activity in the right hemisphere. We also analyzed the different factors (e.g., premorbid personality traits, task difficulty) that may have contributed to LA in Mrs. A during language testing. Our findings emphasize the usefulness of implicating adequately trained laypersons in the evaluation and treatment of PWA showing LA. Further studies using multidimensional evaluations are needed to disentangle the interplay between anxiety and abnormal language as well as the neural mechanisms underpinning LA in PWA.

Mixed Transcortical Aphasia in Association with Neurodegenerative Disease (P6.080)

Mixed Transcortical Aphasia in Association with Neurodegenerative Disease (P6.080)

Transient Blood-Brain Barrier Disruption Induced by Cerebral Concussion

Received August 6, 2015 Revised November 3, 2015 Accepted November 3, 2015 Address for correspondence: Hyun Young Park, MD, PhD Department of Neurology, Wonkwang University School of Medicine, 895 Muwang-ro, Iksan 54538, Korea Tel: +82-63-859-1410 Fax: +82-63-842-7379 E-mail: hyppark@hanmail.net 63세 여자가 머리를 바닥에 부딪힌 후 피질경유혼합실어증 (transcortical mixed aphasia)과 우측 편마비(Medical Research Council grade IV)가 발생하였다. 수상 직후 의식소실이나 발작

A-Bar Scrambling in Repetition in a Case of Mixed Transcortical Aphasia: Hints for the Psychological Reality of the Syntax/Pragmatic Interface

The present study deals with sentence repetition in MB, an Italian patient with mixed transcortical aphasia. In preliminary testing, MB spontaneously resisted accurate repetition when presented with sentences featuring morphosyntactic violations (see Davis et al., 1978). MB also managed to repeat all the proposed phrasal chunks, even in complex sentences. Interestingly, MB tended to move the constituents with the violation (always oblique arguments/adjuncts) to the beginning of the sentence or to another non-canonical position (e.g., dislocating adjuncts immediately before verbs). Thus, he selectively performed “adjunct scrambling”. A detailed experimental task confirmed that MB only moved adjuncts or optional complements. Interestingly, most of the scrambled constituents were prosodically-marked by pitch-peaks as contrastive foci. We argue that MB resorts to scrambling as a syntactic strategy. In doing so, he activates projections that encode information related to the interface between syntax and discourse-pragmatics.

漢字音読課題にて錯読後の次課題で前課題の正答を表出した混合型超皮質性失語例

漢字単語の音読課題において錯読後の次課題で前課題の正答 (目標語) を表出した症例を報告した。症例は左前頭葉, 島に梗塞巣を認め, 混合型超皮質性失語を呈した 82 歳の右利き, 女性であった。漢字単語の音読課題において, 語性錯語および新造語様の錯読後の次課題で前課題の目標語を表出した反応が 4 回出現した。この時の前課題と次課題の目標語は音韻, 意味的にもまったく無関係であった。これは前課題で賦活された言語処理過程の概念─辞書レベルの抑制障害により生じる意味性保続の変形型として説明が可能であった。

Aphasia induced by gliomas growing in the ventrolateral frontal region: Assessment with diffusion MR tractography, functional MR imaging and neuropsychology

IntroductionLesions in the ventrolateral region of the dominant frontal lobe have been historically associated with aphasia. Recent imaging results suggest that frontal language regions extend beyond classically defined Broca’s area to include the ventral precentral gyrus (VPCG) and the arcuate fasciculus (AF). Frontal gliomas offer a unique opportunity to identify structures that are essential for speech production. The aim of this prospective study was to investigate the correlation between language deficits and lesion location in patients with gliomas. MethodsNineteen patients with glioma and 10 healthy subjects were evaluated with diffusion tensor imaging magnetic resonance (MR) tractography, functional MR (verb generation task) and the Aachener Aphasie Test. Patients were divided into two groups according to lesion location with respect to the ventral precentral sulcus: (i) anterior (n=8) with glioma growing in the inferior frontal gyrus (IFG) and underlying white matter; (ii) posterior (n=11) with glioma growing in the VPCG and underlying white matter. Virtual dissection of the AF, frontal intralobar tract, uncinate fasciculus (UF) and inferior frontal occipital fasciculus (IFOF) was performed with a deterministic approach. ResultsSeven posterior patients showed aphasia classified as conduction (4), Broca (1), transcortical motor (1) and an isolated deficit of semantic fluency; one anterior patient had transcortical mixed aphasia. All posterior patients had invasion of the VPCG, however only patients with aphasia had also lesion extension to the AF as demonstrated by tractography dissections. All patients with language deficits had high grade glioma. Groups did not differ regarding tumour volume. A functional pars opercularis was identified with functional MR imaging (fMRI) in 17 patients. ConclusionsGliomas growing in the left VPCG are much more likely to cause speech deficits than gliomas infiltrating the IFG, including Broca’s area. Lesion extension to the AF connecting frontal to parietal and temporal regions is an important mechanism for the appearance of aphasia.

Aphasia in border-zone infarcts has a specific initial pattern and good long-term prognosis

While border-zone infarcts (BZI) account for about 10% of strokes, studies on related aphasia are infrequent. The aim of this work was to redefine specifically their early clinical pattern and evolution. We prospectively studied consecutive patients referred to our stroke unit within a 2-year period. Cases of aphasia in right-handed patients associated with a MRI confirmed left-sided hemispheric BZI were included. These patients had a standardized language examination in the first 48 h, at discharge from stroke unit and between 6 and 18 months later. Eight patients were included. Three had anterior (MCA/ACA), two posterior (MCA/PCA), two both anterior and posterior, and one bilateral BZI. All our patients initially presented transcortical mixed aphasia, characterized by comprehension and naming difficulties associated with preserved repetition. In all patients, aphasia rapidly improved. It fully recovered within a few days in three patients. Initial improvement was marked, although incomplete in the five remaining patients: their aphasias specifically evolved according to the stroke location toward transcortical motor aphasia for the three patients with anterior BZI and transcortical sensory aphasia for the two patients with posterior BZI. All patients made a full language recovery within 18 months after stroke. We report a specific aphasic pattern associated with hemispheric BZI, including an excellent long-term outcome. These findings appear relevant to (i) clinically suspect BZI and (ii) plan rehabilitation and inform the patient and his family of likelihood of full language recovery.

The characteristics of post-stroke depression in patients with aphasia

Objective To compare the characteristics of post-stroke depression in patients with and without aphasia.Methods Seventy patients on the first infarction with aphasia and 70 stroke patients without aphasia were recruited.The aphasia deficits in patients were evaluated by using the Aphasia Battery of Chinese ( Aphasia Battery of Chinese, ABC) .The Stroke Aphasic Depression Questionnaire Hospital Version ( Stroke Aphasic Depression Questionnaire Hospital Version, SADQ-H) was applied to analyze the depression in the two groups.Results The sore in SADQ-H of the aphasia group was significantly higher than the control group( (22.03 ±9.55 )vs ( 16.81 ± 10.47 ), P ＜ 0.01 ) .Loss interest, anhedonia, social avoidance, irritability, depression, decreased attention were more serious in patients with aphasia after stroke than that without aphasia.Compared with control group ,the incidence of depression in aphasia group was higher(64.28% vs 50.00% ).The incidence in different types of aphasia: the complete aphasia ( 78.26% ), transcortical mixed aphasia ( 62.50% ), Broca ( 61.53% ),Werincke (62.50%).There was significantly correlation between the incidence of depression and the severity of aphasia.Conclusion The incidence of depression in stroke patients with aphasia is high,especially who have complete aphasia, transcortical mixed aphasia, Broca and Werincke, and it closely relate to the severity of aphasia. Key words: Stroke; Aphasia; Depression; Comparative study

Selective Scrambling in a Case of Mixed Transcortical Aphasia

Selective Scrambling in a Case of Mixed Transcortical Aphasia

Neuroanatomic correlation of the post-stroke aphasias studied with imaging

Background and purpose: Stroke is the leading cause of disability in many countries. Aphasia is a common sign of stroke that is observed in about one-third of stroke patients and contributes to disease morbidity. However, the relationship between anatomy and different forms of aphasia remains poorly understood. We intend to study the characteristics of aphasia in the acute stage of stroke and to identify neuroanatomical correlates using MRI.Methods: Lesion sites were selected from 1198 patients with cerebral infarction, who were hospitalized in the stroke unit of our hospital between March 2002 and March 2006. We enrolled 325 patients who fulfilled our criteria. All patients received an MRI examination within 1 week after admission and were evaluated with the Western battery aphasia (WAB) test, in order to determine what type of aphasia they had. The severity of their language deficit was further classified using the Boston diagnostic aphasia examination (BDAE) severity grading standard.Results: Among 1198 cases, five cases with Broca's areas and four cases with Wernicke's areas lesions on MRI works were free of language deficits. Within the 325 patients who demonstrated clinical signs of aphasia, the results of WAB showed that there were 83 Broca' aphasia cases, 48 Wernicke's aphasia cases, 12 conduction aphasia cases, 36 transcortical motor aphasia cases, 17 transcortical sensory aphasia cases, 19 transcortical mixed aphasia cases, 58 global aphasia cases and 52 anomic aphasia cases. Two hundred and eighty-eight cases were located within classical language centers while 37 cases were located at other sites. In 325 aphasia patients with grade criteria of BDAE of grades 0, 1, 2, 3 or 4, there were 84, 79, 77, 63 and 22 cases respectively. Many of cases with grades 0 and 1 were distributed within classical language centers.Conclusion: This study showed that it is possible to draw a neuroanatomical map of aphasia that encompasses the 95% of aphasia cases. It also demonstrates that the main determinant of aphasic disorders is the neuroanatomical location of the lesion. Furthermore, this study shows that most lesion locations associated with specific aphasic disorders fit classical data associated with previous aphasia research. More importantly, the language disorders of patients whose lesions were located at classical language centers were more serious. Consequently, this paper demonstrates the power of MRI in prognosticating the potential for a patient to recover from aphasia due to stroke.

Repeating through the insula: evidence from two consecutive strokes

Mixed transcortical aphasia is a very rare syndrome characterized by intact repetition, despite severe impairment in all other language modalities. In some cases, however, preservation of repetition is accompanied by intact reading. We report the case of a left-handed man who, after a subcortical stroke in the left hemisphere, showed the typical features of mixed transcortical aphasia with spared repetition and reading. After 10 days, a second stroke, involving the anterior insula and adjacent white matter bundles, markedly deteriorated repetition while his reading abilities recovered. By comparing features of repetition and reading before and after the second stroke, we provide evidence for the existence of a modular organization of language abilities, pointing to the primary role of the insula and surrounding white matter in phonological processing.

Perseveration and Other Repetitive Verbal Behaviors: Functional Dissociations

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

Prominent Echolalia From Isolation of the Speech Area

Back to table of contents Previous article Next article LetterFull AccessProminent Echolalia From Isolation of the Speech AreaMario F. Mendez, M.D., Ph.D., Mario F. MendezSearch for more papers by this author, M.D., Ph.D., Departments of Neurology and Psychiatry & Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, CAPublished Online:1 Aug 2002AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail SIR: Isolation of the speech area, or mixed transcortical aphasia, is a rare language disorder with unusual manifestations.1 Patients with this condition have sparse, nonfluent verbal output and are unable to comprehend spoken language. In contrast, these patients retain the ability to repeat. Occasionally their repetition is prominent, marked by significant echoing or repetition of comments by others. The differential diagnosis of prominent echolalia includes psychosis and vocal tic disorders. We present a patient who developed acute echolalia without other definite neurological changes.Case ReportA 58-year-old man became suddenly verbally unresponsive. He was unable to communicate and did not otherwise indicate any discomfort or impairment. His past medical history was significant for hypertension, diabetes mellitus, and smoking, but not for known psychiatric disease. On examination, he was alert and attentive but had little spontaneous verbal output. He attempted to reply to questions but uttered only brief hypophonic and poorly intelligible phrases. The patient was unable to comprehend simple commands and could not name on confrontational naming tasks. Despite this, he frequently repeated back what was spoken to him in an automatic fashion. The rest of his neurological examination was remarkable only for a slight right upper extremity pronation and an equivocal Babinski sign on the right.Magnetic resonance imaging revealed a left middle cerebral artery stroke that spared the left perisylvian region. Wernicke's area and the pars triangularis and opercularis of the inferior frontal gyrus were spared. Further evaluation revealed a 95% to 98% occlusion of the left internal carotid, and he underwent carotid endarterectomy.The patient underwent further speech assessment one month after his surgery. He remained near-mute with little spontaneous verbal output, but he retained the ability to repeat phrases and sentences fluently. At unpredictable moments he would lapse into an echolalic mode, parroting the comments of the examiner. He was given portions of several aphasia tests and was able to repeat and perform automatic speech, but he remained impaired in spontaneous fluency and comprehension.CommentIsolation of the speech area is an unusual stroke syndrome that is of particular interest because of the preservation of repetition despite impaired language fluency and comprehension. This condition has particular neuropsychiatric significance because prominent echolalia must be differentiated from the language of psychosis, tic disorders including Tourette's syndrome, and some frontal disorders such as frontotemporal dementia.The acute onset in this patient, without other symptoms, suggests a stroke syndrome. As probably occurred in our patient, a common cause for this syndrome is left internal carotid artery occlusion with simultaneous anterior pial territory infarction (precentral-central sulcus) and posterior watershed infarction.1 Other stroke causes include watershed infarctions involving both anterior and posterior cerebral border zones, left thalamomesencephalic infarctions affecting frontal-subcortical circuits, vasospasm, and functional isolation of the speech area evident on functional neuroimaging.2–4 Other evidence indicates a possible role of the intact right hemisphere in spared repetition.5 This unusual patient illustrates the need to perform careful language examinations and stroke evaluations in patients presenting with echolalia.References1 Bogousslavsky J, Regli F, Assal G: Acute transcortical mixed aphasia: a carotid occlusion syndrome with pial and watershed infarcts. Brain 1988; 111:631-641Crossref, Medline, Google Scholar2 Maeshima S, Uematsu Y, Terada T, et al: Transcortical mixed aphasia with left frontoparietal lesions. Neuroradiology 1996; 38(suppl 1):S78-S79Google Scholar3 Nagaratnam N, McNeil C, Gilhotra JS: Akinetic mutism and mixed transcortical aphasia following left thalamo-mesencephalic infarction. J Neurol Sci 1999; 163:70-73Crossref, Medline, Google Scholar4 Rapcsak SZ, Krupp LB, Rubens AB, et al: Mixed transcortical aphasia without anatomic isolation of the speech area. Stroke 1990; 21:953-956Crossref, Medline, Google Scholar5 Berthier ML, Starkstein SE, Leiguarda R, et al: Transcortical aphasia: importance of the nonspeech dominant hemisphere in language repetition. Brain 1991; 114:1409-1427Crossref, Medline, Google Scholar FiguresReferencesCited byDetailsCited byFrontiers in Neuroscience, Vol. 10 Volume 14Issue 3 August 2002Pages 356-357 Metrics History Published online 1 August 2002 Published in print 1 August 2002

Mixed transcortical aphasia from demyelinating disease: Neuropsychologic, MRI, and neuropathologic data : Lazar, R.M., Vas, G.A., Hotson, G.C., & Sher, J. SUNY/Health Science Center at Brooklyn

Mixed transcortical aphasia from demyelinating disease: Neuropsychologic, MRI, and neuropathologic data : Lazar, R.M., Vas, G.A., Hotson, G.C., & Sher, J. SUNY/Health Science Center at Brooklyn