Naming In Aphasia Research Articles

Evolution of word production errors after typicality-based semantic naming treatment in individuals with aphasia

ABSTRACT Background The Complexity Account for Treatment Efficacy (CATE) has been applied to semantic typicality in aphasia naming therapy, i.e. training atypical items of a category would improve naming of typical untrained-related items. However, most aphasia treatment studies have implemented a binary scoring system to measure response accuracy, which may not thoroughly reveal linguistic mechanisms underlying aphasia recovery. Aims The current study investigated the evolution of error patterns following typicality-based Semantic Features Analysis (SFA) treatment in individuals with post-stroke aphasia. Methods & Procedures Thirty individuals with chronic aphasia participated in a typicality-based SFA treatment, and ten individuals with chronic aphasia served as controls. The treatment participants and controls completed a naming screener before and after either a treatment period or a no-treatment period, respectively. Responses were coded using an error coding scale and analyzed with mixed-effects models. Outcomes & Results Treatment participants demonstrated significant treatment and generalization effects, as captured by significant improvements on the error coding system for both trained and untrained items. However, the group-level analysis did not reveal significant generalization from training atypical items to untrained typical items. Subgroup analyses based on participants’ performance in treatment showed significant gains in naming untrained typical items from training atypical items in responders, but improved naming of untrained atypical items from training typical items in nonresponders. Conclusions These findings suggest different linguistic mechanisms underlying aphasia recovery and highlight the importance of investigating treatment and generalization effects using a fine-grained error coding system as a complement to a binary scoring system.

Response Latencies During Confrontation Picture Naming in Aphasia: Are Proxy Measurements Sufficient?

Anomia, or word-finding difficulty, is a prevalent and persistent feature of aphasia, a neurogenic language disorder affecting millions of people in the United States. Anomia assessments are essential for measuring performance and monitoring outcomes in clinical settings. This study aims to evaluate the reliability of response time (RT) annotation based on spectrograms and assess the predictive utility of proxy RTs collected during computerized naming tests. Archival data from 10 people with aphasia were used. Trained research assistants phonemically transcribed participants' responses, and RTs were generated from the onset of picture stimulus to the initial phoneme of the first complete attempt. RTs were measured in two ways: hand-generated RTs (from spectrograms) and proxy RTs (automatically extracted online). Interrater agreement was evaluated based on interclass correlation coefficients and generalizability theory tools including variance partitioning and the φ-coefficient. The predictive utility of proxy RTs was evaluated within a linear mixed-effects framework. RT annotation reliability showed near-perfect agreement across research assistants (φ-coefficient = .93), and the variance accounted for by raters was negligible. Furthermore, proxy RTs significantly and strongly predicted hand-annotated RTs (R2 = ~0.82), suggesting their utility as an alternative measure. The study confirms the reliability of RT annotation and demonstrates the predictive utility of proxy RTs in estimating RTs during computerized naming tests. Incorporating proxy RTs can enhance clinical assessments, providing additional information for cognitive measurement. Further research with larger samples and exploring the impact of using proxy RTs in different psychometric models could optimize clinical protocols and improve communication interventions for individuals with aphasia.

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.

Theory-driven treatment modifications: A discussion on meeting the linguistic, cognitive, and psychosocial needs of individual clients with aphasia

There is a growing body of literature demonstrating that language rehabilitation can improve naming impairments for individuals with aphasia. However, there are challenges applying evidence-based research to clinical practice. Well-controlled clinical studies often consist of homogenous samples and exclude individuals who may confound group-level results. Consequently, the findings may not generalize to the diverse clients serviced by speech-language therapists. Within evidence-based guidelines, clinicians can leverage their experiences and theoretical rationale to adapt interventions to meet the needs of individual clients. However, modifications to evidence-based interventions should not alter aspects of treatment that are necessary to produce change within the treatment target. The current discussion paper uses errorless learning, errorful learning, and retrieval practice for naming in aphasia to model how treatment theories can guide clinicians in making theory-informed modifications to interventions. First, we briefly describe the learning mechanisms hypothesized to underlie errorless learning, errorful learning, and retrieval practice. Next, we identify ways clinicians can provide targeted supports to optimize learning for individual clients. The paper ends with a reflection on how well-defined treatment theories can facilitate the generation of practice-based evidence and clinically relevant decision making.

Refining Semantic Similarity of Paraphasias Using a Contextual Language Model.

ParAlg (Paraphasia Algorithms) is a software that automatically categorizes a person with aphasia's naming error (paraphasia) in relation to its intended target on a picture-naming test. These classifications (based on lexicality as well as semantic, phonological, and morphological similarity to the target) are important for characterizing an individual's word-finding deficits or anomia. In this study, we applied a modern language model called BERT (Bidirectional Encoder Representations from Transformers) as a semantic classifier and evaluated its performance against ParAlg's original word2vec model. We used a set of 11,999 paraphasias produced during the Philadelphia Naming Test. We trained ParAlg with word2vec or BERT and compared their performance to humans. Finally, we evaluated BERT's performance in terms of word-sense selection and conducted an item-level discrepancy analysis to identify which aspects of semantic similarity are most challenging to classify. Compared with word2vec, BERT qualitatively reduced word-sense issues and quantitatively reduced semantic classification errors by almost half. A large percentage of errors were attributable to semantic ambiguity. Of the possible semantic similarity subtypes, responses that were associated with or category coordinates of the intended target were most likely to be misclassified by both models and humans alike. BERT outperforms word2vec as a semantic classifier, partially due to its superior handling of polysemy. This work is an important step for further establishing ParAlg as an accurate assessment tool.

The Severity-Calibrated Aphasia Naming Test.

We present a 20-item naming test, the Severity-Calibrated Aphasia Naming Test (SCANT), that can serve as a proxy measure for an aphasia severity scale that is derived from a thorough test battery of connected speech production, single-word production, speech repetition, and auditory verbal comprehension. We use lasso regression and cross-validation to identify an optimal subset from a set of 174 pictures to be named for prediction of aphasia severity, based on data from 200 participants with left-hemisphere stroke who were quasirandomly selected to represent the full impairment scale. Data from 20 healthy controls (i.e., participant caretakers/spouses) were also analyzed. We examine interrater reliability, test-retest reliability, sensitivity and specificity to the presence of aphasia, sensitivity to therapy gains, and external validity (i.e., correlation with aphasia severity measures) for the SCANT. The SCANT has extremely high interrater reliability, and it is sensitive and specific to the presence of aphasia. We demonstrate the superiority of predictions based on the SCANT over those based on the full set of naming items. We estimate a 15% reduction in power when using the SCANT score versus the full test battery's aphasia severity score as an outcome measure; for example, to maintain the same power to detect a significant group average change in aphasia severity, a study with 25 participants using the full test battery to measure treatment effectiveness would require 30 participants if the SCANT were to be used as the testing instrument instead. We provide a linear model to convert SCANT scores to aphasia severity scores, and we identify a change score cutoff of four SCANT items to obtain a high degree of confidence based on test-retest SCANT data and the modeled relation between SCANT and aphasia severity scores. https://doi.org/10.23641/asha.21476871.

Efficacy of repetitive transcranial magnetic stimulation in treating stroke aphasia: Systematic review and meta-analysis

ObjectiveThis meta-analysis examined the effectiveness of repetitive Transcranial Magnetic Stimulation (rTMS) in treating post-stroke aphasia with a goal to identify parameters that are associated with successful treatment outcomes. MethodsFollowing PRISMA guidelines, ten electronic databases were searched from inception till June 4th 2020. A total of 24 studies (out of 1971 records) with 567 participants met selection criteria and were included in the meta-analysis. ResultsThe overall pooled meta-analysis revealed a significant medium effect size in favor of rTMS treatment: Standard mean difference (SMD) of 0.655 (95% CI = [0.481, 0.830], z = 7.369, p < 0.001). Moderator subgroup analyses indicated that participants’ clinical characteristics and rTMS parameters moderated treatment effects. The strongest effects were observed for naming, followed by speech production, repetition and comprehension. The results indicate that with 10 to 15 sessions of 1-Hz rTMS administered 20–40 min per day over right BA45 (Brodmann’s area 45), significant language improvements can be observed for up to 12 months. ConclusionsOur findings suggest that the rTMS technique can enhance rehabilitation of language skills in post-stroke aphasia when administered according to the established safety parameters. SignificanceOur results have implications for treatment of post-stroke aphasia. In subacute aphasia, low frequency rTMS over right BA45 improved naming, repetition, speech fluency and writing but not comprehension, whereas in chronic aphasia naming and speech production improved, but repetition and comprehension showed smaller gains.

Predictors of object naming in aphasia: does cognitive control mediate the effects of psycholinguistic variables?

ABSTRACT Background and Aims Previous studies have shown that age of acquisition affects language production in persons with aphasia (PWA), specifically, earlier-acquired words are better preserved compared to later-learned ones (for review, see Brysbaert & Ellis, 2016). Also, it has been argued that naming objects with lower name agreement requires inhibition of alternative names (Alario et al., 2004), and therefore puts higher demands on cognitive control. Bose and Schafer (2017) showed that although both PWA and healthy controls performed better at naming words with high naming agreement, the difference between the naming conditions was significantly greater for PWA. This could be due to reduced ability to inhibit irrelevant information in PWA. The current study aims to investigate whether cognitive control mediates the effects of psycholinguistic variables on object naming accuracy in aphasia. Methods and Procedures Participants (N = 31, 32% female) were right-handed, native Russian speakers with preserved visual and hearing abilities diagnosed with mild to moderate post-stroke aphasia. They were aged 40–70 (mean = 59.5, SD = 8.6). The participants were tested on a picture-naming task including 247 items and 2 subtests from the Russian Birmingham Cognitive Screen, namely Auditory attention, and Rule Finding tasks. Outcomes and Results To define whether cognitive control mediates the effect of psycholinguistic variables on naming response accuracy, multiple linear regression was used. Significant main effects of log-transformed word frequency, AoA, and cognitive control were found, as well as a significant interaction between log-transformed word frequency and cognitive control. Conclusions Our findings suggest that cognitive control mediated the effect of word frequency in naming in aphasia. PWA with weaker cognitive control name pictures depicting less-frequent words less accurately than more frequent words. This points to the fact that PWA have difficulty in lexical access when producing language. The implications of the study are that the focus of aphasia rehabilitation should be on very frequent structures and words as these are usually more preserved in PWA with weaker cognitive control.

Multisensory cueing facilitates naming in aphasia

BackgroundImpaired naming is a ubiquitous symptom in all types of aphasia, which often adversely impacts independence, quality of life, and recovery of affected individuals. Previous research has demonstrated that naming can be facilitated by phonological and semantic cueing strategies that are largely incorporated into the treatment of anomic disturbances. Beneficial effects of cueing, whereby naming becomes faster and more accurate, are often attributed to the priming mechanisms occurring within the distributed language network.ObjectiveWe proposed and explored two novel cueing techniques: (1) Silent Visuomotor Cues (SVC), which provided articulatory information of target words presented in the form of silent videos, and (2) Semantic Auditory Cues (SAC), which consisted of acoustic information semantically relevant to target words (ringing for “telephone”). Grounded in neurophysiological evidence, we hypothesized that both SVC and SAC might aid communicative effectiveness possibly by triggering activity in perceptual and semantic language regions, respectively.MethodsTen participants with chronic non-fluent aphasia were recruited for a longitudinal clinical intervention. Participants were split into dyads (i.e., five pairs of two participants) and required to engage in a turn-based peer-to-peer language game using the Rehabilitation Gaming System for aphasia (RGSa). The objective of the RGSa sessions was to practice communicative acts, such as making a request. We administered SVCs and SACs in a pseudorandomized manner at the moment when the active player selected the object to be requested from the interlocutor. For the analysis, we compared the times from selection to the reception of the desired object between cued and non-cued trials.ResultsNaming accuracy, as measured by a standard clinical scale, significantly improved for all stimuli at each evaluation point, including the follow-up. Moreover, the results yielded beneficial effects of both SVC and SAC cues on word naming, especially at the early intervention sessions when the exposure to the target lexicon was infrequent.ConclusionsThis study supports the efficacy of the proposed cueing strategies which could be integrated into the clinic or mobile technology to aid naming even at the chronic stages of aphasia. These findings are consistent with sensorimotor accounts of language processing, suggesting a coupling between language, motor, and semantic brain regions.Trial registrationNCT02928822. Registered 30 May 2016.

How Much Time Do People With Aphasia Need to Respond During Picture Naming? Estimating Optimal Response Time Cutoffs Using a Multinomial Ex-Gaussian Approach.

Purpose Aphasia is a language disorder caused by acquired brain injury, which generally involves difficulty naming objects. Naming ability is assessed by measuring picture naming, and models of naming performance have mostly focused on accuracy and excluded valuable response time (RT) information. Previous approaches have therefore ignored the issue of processing efficiency, defined here in terms of optimal RT cutoff, that is, the shortest deadline at which individual people with aphasia produce their best possible naming accuracy performance. The goals of this study were therefore to (a) develop a novel model of aphasia picture naming that could accurately account for RT distributions across response types; (b) use this model to estimate the optimal RT cutoff for individual people with aphasia; and (c) explore the relationships between optimal RT cutoff, accuracy, naming ability, and aphasia severity. Method A total of 4,021 naming trials across 10 people with aphasia were scored for accuracy and RT onset. Data were fit using a novel ex-Gaussian multinomial RT model, which was then used to characterize individual optimal RT cutoffs. Results Overall, the model fitted the empirical data well and provided reliable individual estimates of optimal RT cutoff in picture naming. Optimal cutoffs ranged between approximately 5 and 10 s, which has important implications for assessment and treatment. There was no direct relationship between aphasia severity, naming RT, and optimal RT cutoff. Conclusion The multinomial ex-Gaussian modeling approach appears to be a promising and straightforward way to estimate optimal RT cutoffs in picture naming in aphasia. Limitations and future directions are discussed.

Increased Functional Connectivity Within Intrinsic Neural Networks in Chronic Stroke Following Treatment with Red/Near-Infrared Transcranial Photobiomodulation: Case Series with Improved Naming in Aphasia.

Objective: To examine effects of four different transcranial, red/near-infrared (NIR), light-emitting diode (tLED) protocols on naming ability in persons with aphasia (PWA) due to left hemisphere (LH) stroke. This is the first study to report beneficial effects from tLED therapy in chronic stroke, and parallel changes on functional magnetic resonance imaging (fMRI). Materials and methods: Six PWA, 2-18 years poststroke, in whom 18 tLED treatments were applied (3 × /week, 6 weeks) using LED cluster heads: 500 mW, red (633 nm) and NIR (870 nm), 22.48 cm2, 22.2 mW/cm2. Results: After Protocol A with bilateral LED placements, including midline, at scalp vertex over left and right supplementary motor areas (L and R SMAs), picture naming was not improved. P1 underwent pre-/postovert, picture-naming task-fMRI scans; P2 could not. After Protocol A, P1 showed increased activation in LH and right hemisphere, including L and R SMAs. After Protocol B with LEDs only on ipsilesional, LH side, naming ability significantly improved for P1 and P2; the fMRI scans for P1 then showed activation only on the ipsilesional LH side. After Protocol C with LED placements on ipsilesional LH side, plus one midline placement over mesial prefrontal cortex (mPFC) at front hairline, a cortical node of the default mode network (DMN), P3 and P4 had only moderate/poor response, and no increase in functional connectivity on resting-state functional-connectivity MRI. After Protocol D, however, with LED placements on ipsilesional LH side, plus over two midline nodes of DMN, mPFC, and precuneus (high parietal) simultaneously, P5 and P6 each had good response with significant increase in functional connectivity within DMN, p < 0.0005; salience network, p < 0.0005; and central executive network, p < 0.05. Conclusions: NIR photons can affect surface brain cortex areas subjacent to where LEDs are applied on the scalp. Improved naming ability was present with optimal Protocol D. Transcranial photobiomodulation may be an additional noninvasive therapy for stroke.

Action Observation Treatment for Verb Naming in Aphasia: Picture vs. Video Stimuli

To determine the effects of picture and video stimuli on the outcomes of action observation treatment for verb naming in aphasia.

Acquisition and Generalization Responses in Aphasia Naming Treatment: A Meta-Analysis of Semantic Feature Analysis Outcomes.

Purpose This meta-analysis synthesizes results from published studies that used semantic feature analysis (SFA) treatment to improve naming for people with aphasia. It examines how both person- and treatment-related variables affected the likelihood of correct naming responses in individual probe sessions for both acquisition (treated) and generalization (untreated) stimuli. Method The meta-analysis compiled data from 12 studies analyzing a total of 35 participants with aphasia. It used mixed-effects models as a novel statistical tool to examine the effects of 2 sets of variables on naming performance: treatment-related variables, including treatment phase (baseline vs. treatment), dosage (number of treatment sessions), and stimulus type (treated vs. untreated, semantically related vs. unrelated items), and person-specific variables, including degree of language impairment and demographic variables (age, time poststroke). Results Results of the meta-analysis revealed that SFA intervention promoted increased naming accuracy during naming probes when comparing baseline and treatment phases. In addition, increased dosages of SFA were associated with increased naming accuracy, and treatment-related gains were larger for acquisition (treated) than generalization (untreated) stimuli, likewise for related versus unrelated generalization stimuli. Furthermore, a subset of person-specific variables was predictive of SFA-related gains: Language impairment variables were related to treatment-related changes in naming performance, but demographic variables were not. Conclusion These results provide group-level evidence for the efficacy of SFA as well as preliminary estimates of how much naming performance benefit is engendered by varying dosages of SFA. The results also provide promising and previously unobserved evidence of potential person-level predictors of SFA treatment response.

Modelling picture naming in aphasia: The relationship between consistency and predictability of responses.

Two aspects of aphasic picture naming were examined: response consistency, that is, the extent to which the accuracy of the response to the same stimulus is replicated in a successive examination, and response predictability, that is, the extent to which accuracy depends on the characteristics of each stimulus. Thirty-eight aphasic participants were examined twice. The response pattern was the same across the 2 presentations (response stability) for 36 participants, who were classified into 3 groups according to the prevailing error-type (lexical-semantic, phonological, or a balance between the two error-types): Their item-consistency was quantified with Cohen's kappa. In each case the roles played by lexical frequency, precocity of acquisition and length of the target word, and visual complexity and image agreement of the stimulus picture were examined; the ability to predict response accuracy of a model simultaneously including these 5 variables was quantified by means of the McFadden index. Finally, the relationship between predictability (McFadden index) and consistency (Cohen's kappa) was analyzed. For 34 of 36 participants, consistency was higher than chance. Consistency was directly correlated to the prevalence of lexical-semantic errors. On regression analysis, the relationship between consistency and predictability was significant. Response consistency reflects the existence of a clear difficulty gradient within the items of a battery. The significant relationship between consistency and error type suggests that, in principle, lexical-semantic errors might be more predictable than phonological errors based on the characteristics of each stimulus. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A Study of Brain Damage and Compensation in Anomic Aphasia Patients in the Acute Stage Post Stroke, Based on Functional Magnetic Resonance Imaging of a Picture Naming Task

A Study of Brain Damage and Compensation in Anomic Aphasia Patients in the Acute Stage Post Stroke, Based on Functional Magnetic Resonance Imaging of a Picture Naming Task

Neural correlates of speech error monitoring and awareness

Neural correlates of speech error monitoring and awareness

Supplemental Material for Modelling Picture Naming in Aphasia: The Relationship Between Consistency and Predictability of Responses

Supplemental Material for Modelling Picture Naming in Aphasia: The Relationship Between Consistency and Predictability of Responses

Revisiting the dual-nature account of homophony: Evidence from picture naming in aphasia

Revisiting the dual-nature account of homophony: Evidence from picture naming in aphasia

The footprint of semantic and phonological interference in picture naming in aphasia: Preliminary evidence from ERP

The footprint of semantic and phonological interference in picture naming in aphasia: Preliminary evidence from ERP

A novel eye tracking paradigm for assessing semantic and phonologic activation in aphasia

A novel eye tracking paradigm for assessing semantic and phonologic activation in aphasia