Paraphasias Research Articles

Phonetic and phonological aspects of speech in Alzheimer’s disease

ABSTRACTBackground: Alzheimer’s disease (AD) can involve changes in communication and can lead to mutism in severe cases. Oral communication may be impaired by phonetic-motor disorders, such as apraxia of speech (AOS), or by language disorders, such as aphasia. Therefore, the identification of manifestations of AOS and phonemic paraphasias in patients with AD is critical to understanding the communication changes and determining the therapeutic planning.Aims: To identify the distribution of phonetic–phonological manifestations in older patients with AD and healthy older subjects and assess whether these manifestations indicate the origin of the changes, including a predominantly phonetic-motor origin, a predominantly phonological–linguistic origin, or both.Methods & Procedures: This cross-sectional study evaluated 90 patients with AD and 30 healthy older volunteers. All of the participants underwent the same repetition task for phonetic and phonological assessments using the current classification of phonetic–phonological manifestations; this classification distinguishes characteristics that are mostly related to AOS from other signs that are mostly related to aphasia. Negative binomial regression analysis was conducted to compare the amount of each manifestation presented by the two groups.Outcomes & Results: The patients with AD showed significantly more signs of aphasia (self-correction, and vowel and consonant substitutions), AOS (prolonged intervals and extended vowel duration), and AOS or aphasia (distortion, omission, attempts at the syllable level, distorted substitutions, and additions) than the healthy older volunteers.Conclusions: Older adults with AD presented phonetic and phonological changes of aphasia and AOS and, consequently, limitations in symbolic–linguistic planning and motor planning.

Current Controversies on Wernicke’s Area and its Role in Language

The aim of the study is to assess historical anatomical and functional definitions of Wernicke's area in light of modern lesion and neuroimaging data. "Wernicke's area" has become an anatomical label usually applied to the left posterior superior temporal gyrus and adjacent supramarginal gyrus. Recent evidence shows that this region is not critical for speech perception or for word comprehension. Rather, it supports retrieval of phonological forms (mental representations of phoneme sequences), which are used for speech output and short-term memory tasks. Focal damage to this region produces phonemic paraphasia without impairing word comprehension, i.e., conduction aphasia. Neuroimaging studies in recent decades provide evidence for a widely distributed temporal, parietal, and frontal network supporting language comprehension, which does not include the anatomically defined Wernicke area. The term Wernicke's area, if used at all, should not be used to refer to a zone critical for speech comprehension.

Abstract WP169: Patients With Aphasia Demonstrate Variability in Regional Functional Recruitment in Correct Naming Task

Approximately 20-40% of stroke survivors suffer from aphasia, the partial or complete loss of language processing. It has been observed that patients with aphasia will typically make the same number of naming errors every time tested, but the objects that are named correctly or incorrectly will vary. These errors are therefore not linked to specific objects, but are instead related to faulty language processing. It remains poorly understood how the language processing can vary between right or wrong to enable correct naming. Here, we use functional imaging to identify processing patterns that lead to successful language production in patients with chronic aphasia. This could provide a potentially meaningful target for future rehabilitation methods. Methods: We analyzed data from 36 individuals with chronic aphasia who completed a picture-naming task while undergoing functional neuroimaging. After mapping the functional data to the AICHA atlas, regional activation signal was analyzed for each response type (correct, semantic paraphasia, or phonemic paraphasia). We performed a ttest looking for significant differences in activation at particular regions of interest for correct naming compared to semantic and phonemic paraphasias for each individual. Results: Individuals recruit variable regions for correctly named objects. There are some regions that stand out as being statistically significant (p ≤ 0.05) for correct productions compared to semantic and phonemic paraphasias across several subjects (e.g., insular regions were statistically significant for 8/36 subjects and superior temporal sulcus for 9/36 subjects). Also, there is variability in whether the regions that were statistically different were peri-lesional or in unaffected, healthy tissue. Discussion: There is evidence that individualized functional recruitment utilized by people with chronic aphasia allows for correctly naming objects. This pattern is unique and widely variable across subjects, due in large part to differences in lesion size and location. However, individuals recruit a particular network of peri-lesional and preserved brain tissue that is different for correctly naming objects compared to incorrectly naming objects (with semantic or phonemic paraphasias)

(Dis)fluency markers in dementia: how much can errors tell us?

(Dis)fluency markers in dementia: how much can errors tell us?

Common and divergent neural correlates of anomia in amnestic and logopenic presentations of Alzheimer's disease

The majority of logopenic variant primary progressive aphasia (lv-PPA) cases harbour Alzheimer pathology, suggesting that lv-PPA constitutes an atypical presentation of Alzheimer's disease (AD). However, even if caused by Alzheimer pathology, the clinical manifestations of lv-PPA differ from those observed in the typical or amnestic AD presentation: in lv-PPA, aphasia is the main feature while amnestic AD is characterised by impaired episodic memory. Anomia or impaired naming, however, is present in both AD presentations. Whether these presentations share anatomical and mechanistic processes of anomia has not been fully investigated. Accordingly, we studied naming performance and its relationship with regions of brain atrophy in 23 amnestic AD and 22 lv-PPA cases with presumed underlying Alzheimer pathology. Both AD groups displayed some degree of anomia and impaired word comprehension but these were particularly severe in lv-PPA and accompanied by a range of linguistic deficits, comprising phonological substitutions, superordinate semantic paraphasias and abnormal single-word repetition. Analysis of cortical thickness revealed that anomia was correlated with thinning in left superior temporal gyrus in both groups. In amnestic AD, however, anomia was also associated with thinning in right inferior temporal regions. Single-word comprehension (SWC), by contrast, was associated with cortical thinning involving bilateral fusiform gyri in both groups. These findings suggest that anomia in both amnestic AD and lv-PPA results from the involvement at multiple steps of word processing, in particular, semantic and lexical retrieval; in addition lv-PPA patients display a more marked involvement of phonological processing.

Structural and functional integration between dorsal and ventral language streams as revealed by blunt dissection and direct electrical stimulation.

The most accepted framework of language processing includes a dorsal phonological and a ventral semantic pathway, connecting a wide network of distributed cortical hubs. However, the cortico-subcortical connectivity and the reciprocal anatomical relationships of this dual-stream system are not completely clarified. We performed an original blunt microdissection of 10 hemispheres with the exposition of locoregional short fibers and six long-range fascicles involved in language elaboration. Special attention was addressed to the analysis of termination sites and anatomical relationships between long- and short-range fascicles. We correlated these anatomical findings with a topographical analysis of 93 functional responses located at the terminal sites of the language bundles, collected by direct electrical stimulation in 108 right-handers. The locations of phonological and semantic paraphasias, verbal apraxia, speech arrest, pure anomia, and alexia were statistically analyzed, and the respective barycenters were computed in the MNI space. We found that terminations of main language bundles and functional responses have a wider distribution in respect to the classical definition of language territories. Our analysis showed that dorsal and ventral streams have a similar anatomical layer organization. These pathways are parallel and relatively segregated over their subcortical course while their terminal fibers are strictly overlapped at the cortical level. Finally, the anatomical features of the U-fibers suggested a role of locoregional integration between the phonological, semantic, and executive subnetworks of language, in particular within the inferoventral frontal lobe and the temporoparietal junction, which revealed to be the main criss-cross regions between the dorsal and ventral pathways. Hum Brain Mapp 37:3858-3872, 2016. © 2016 Wiley Periodicals, Inc.

Confabulations without amnesia: Impact of dysexecutive syndrome

Confabulations are described as “a falsification of memory occurring in clear consciousness in association with an organically derived amnesia”. We describe production of confabulations in long-term memory in a 51-year-old woman who do not present amnesic syndrome typically associated. The patient was admitted in reanimation unit for septic shock. After 8 days of coma, she presented signs of encephalopathy of Gayet-Wernicke, without cerebral damage on T1 MRI. At 6 months of acute episode, the patient presents a severe cognitive and behavioural dysexecutive syndrome, with impulsivity, perseverations and environmental dependency. Capacities of encoding and learning are weakened in episodic memory, without storage alteration. Access to semantic memory is altered, with semantic paraphasias production. In categorical images matching, patient do visual errors in favour of low level processing. Confabulation battery shows that these productions are present in answers to questions concerning semantic memory, but absent in episodic memory. Their contents were characterised by perseverations on environment. Consciousness of memory alteration is partial. The scintigraphy revealed a functional alteration in left frontal areas. This clinical report surprises by dissociations between: – preserved memory capacity and presence of confabulation; – semantic and episodic confabulations. We discuss this case with frontal hypothesis of confabulation. Deficits of the patient can be attributed to a deficit in strategic recovery of information, especially on monitoring process, by left frontal functional alteration. Information would be recovered by associative process provoking wrong recollections by a trouble of information verification.

EP 66. Better tolerability and lower mean intensities favour higher-frequent stimulation as compared to 10 Hz online-rTMS for language mapping: A test-retest reliability study in healthy volunteers.

Objective Mapping the cortical language representation and associated networks is not only of basic scientific interest but can also help to maximize the extent of tumour resection whilst preserving important brain functions as language. The use of navigated repetitive transcranial magnetic stimulation (rTMS) to depict cortical sites crucially involved in language processing non-invasively is a rather novel approach, which has shown promising results. However, specificity is rather low and the level of pain and discomfort during stimulation seems to be rather high when applying the commonly used 10 Hz stimulation protocol. Therefore, we here compared different rTMS protocols in order to test for discomfort/pain, test-retest reliability, rate and site of distinct evoked language errors. Methods 13 right-handed, healthy volunteers were investigated in 3 consecutive sessions (short-term: 2–5 days, long-term: 21–40 days). 10 Hz, 30 Hz and 50 Hz rTMS were applied over the left hemisphere, continuously covering facial (pre-)motor and language-related cortical areas. First, stimulation intensity was adjusted to the lowest intensity required to disrupt rhythmic tongue movements when stimulating over the hotspot of the primary motor representation (M1) of the tongue. This parameter was titled “motor inhibition threshold” (MIT) and was regarded suitable to mirror the efficacy of cortical inhibition. Thereafter, online-rTMS was applied during a picture-naming task in a randomized sequence. Bursts were triggered to picture presentation without delay (picture-to-trigger interval = 0). Errors were rated by two independent raters using post-hoc video analysis and were categorised as follows: arrest, delay, anomia, dysarthria, speech motor disturbance, semantic and phonemic paraphasia. At the end of each exam, the volunteers were asked to rate the mean and maximum level of discomfort on a 0–10 numeric rating scale (NRS). Results Better tolerability was observed for the higher-frequency rTMS protocols (i.e., 30 & 50 Hz) than for 10 Hz rTMS. Moreover, 30 and 50 Hz rTMS reliably evoked tongue movement disruption (ICC = 0.65) at lower stimulation intensities compared to 10 Hz rTMS (p Conclusions Higher-frequency rTMS (i.e., 30 & 50 Hz) may allow for cortical inhibition at a more favourable pain-effect relationship as compared to 10 Hz.Despite good test-retest reliability of the event rates, the low repeatability of the cortical sites corresponding to distinct errors requires critical discussion.

A longitudinal linguistic analysis of written text production in a case of semantic variant primary progressive aphasia

Abstract The semantic variant of primary progressive aphasia (svPPA) presents with a degradation of semantic knowledge due to atrophy of the anterior temporal lobe and is characterized by impaired confrontation naming and impaired single-word comprehension. So far, little is known about the development of symptoms and their order of occurrence in the preclinical phase, and information regarding written text production is scarce. We had the unique opportunity to analyze the diary of a man written over a time span of 12 years before he was diagnosed with svPPA. We sought to identify the earliest indicators of cognitive change in his diary entries, and to track the important changes over time. Based on transcripts of the entries (one week every six months) we assessed the overall structure, vocabulary, surface dysgraphia and semantic paraphasia, syntax, and morphology. We found changes in all domains up to seven years before the clinical diagnosis. The earliest changes concerned the vocabulary, with decreased variety and increased use of high frequency words. This was followed by syntactic and morphological errors. We found no increase of surface dysgraphia. Semantic paraphasias increased only during the last three years but characterized the entries of the last year. We were therefore able to further corroborate recent findings regarding difficulties in the morpho-syntactic domain in this patient group. In this natural context for written text production, such errors seem, in addition to changes in vocabulary, to be the first error types to appear, possibly as a result of compensating for the degradation of semantic representations.

Maladaptive Plasticity in Aphasia: Brain Activation Maps Underlying Verb Retrieval Errors.

Anomia, or impaired word retrieval, is the most widespread symptom of aphasia, an acquired language impairment secondary to brain damage. In the last decades, functional neuroimaging techniques have enabled studying the neural basis underlying anomia and its recovery. The present study aimed to explore maladaptive plasticity in persistent verb anomia, in three male participants with chronic nonfluent aphasia. Brain activation maps associated with semantic verb paraphasia occurring within an oral picture-naming task were identified with an event-related fMRI paradigm. These maps were compared with those obtained in our previous study examining adaptive plasticity (i.e., successful verb naming) in the same participants. The results show that activation patterns related to semantic verb paraphasia and successful verb naming comprise a number of common areas, contributing to both maladaptive and adaptive neuroplasticity mechanisms. This finding suggests that the segregation of brain areas provides only a partial view of the neural basis of verb anomia and successful verb naming. Therefore, it indicates the importance of network approaches which may better capture the complexity of maladaptive and adaptive neuroplasticity mechanisms in anomia recovery.

Phonetic basis of phonemic paraphasias in aphasia: Evidence for cascading activation

Phonemic paraphasias are a common presenting symptom in aphasia and are thought to reflect a deficit in which selecting an incorrect phonemic segment results in the clear-cut substitution of one phonemic segment for another. The current study re-examines the basis of these paraphasias. Seven left hemisphere-damaged aphasics with a range of left hemisphere lesions and clinical diagnoses including Broca's, Conduction, and Wernicke's aphasia, were asked to produce syllable-initial voiced and voiceless fricative consonants, [z] and [s], in CV syllables followed by one of five vowels [i e a o u] in isolation and in a carrier phrase. Acoustic analyses were conducted focusing on two acoustic parameters signaling voicing in fricative consonants: duration and amplitude properties of the fricative noise. Results show that for all participants, regardless of clinical diagnosis or lesion site, phonemic paraphasias leave an acoustic trace of the original target in the error production. These findings challenge the view that phonemic paraphasias arise from a mis-selection of phonemic units followed by its correct implementation, as traditionally proposed. Rather, they appear to derive from a common mechanism with speech errors reflecting the co-activation of a target and competitor resulting in speech output that has some phonetic properties of both segments.

Diagnosis of crossed aphasia, a case report

The purpose was to back up on all the arguments [1] , for to diagnose crossed aphasia (CA) our patient and improve rehabilitation. A man of 45 years, right-handed, presented a dysarthria accompanied by a loss of verbal fluency, lack of word and paraphasias, after a parietal-temporal hematoma in right hemisphere. The interrogatory did not find a familial history on a left handedness. Brain imaging confirmed the integrity of the left hemisphere in the initial MRI and CT scan. The speech therapist assessment showed the oral picture naming test alack of the word (61/80, decreased lexical background, non-response, breaks) and semantic paraphasias. The questionnaire of the Boston Diagnostic Aphasia Examination of the repetition of sentences showed an effect of length and omissions of words. Reading words and sentences aloud contained substitutions, additions and paralexies. Listening was average (11/15: order execution, 6/12: understanding sentences and texts). Reading comprehension was average, 6/10. The writing contained many errors (perseveration, paragraphies literal and neologisms). The copy was altered. Automatic series were not preserved (Transcript of the alphabet). Brain lateralization test found an ocular dominance right and right lower limb (20/20). Neuropsychological assessment found disorders of attention (Stroop and Trail Making Test [TMT] with 4.12 standard deviation [sd] and the corrected T score 1.9 and 2.4 sd) and mental flexibility (TMT: 3.41 sd). An impaired working memory (WAIS: span = 7 and to place = 3) and logical reasoning (WAIS-III: 5). A deficit in verbal episodic memory (learning the verbal list of BEM 144: 1.31 sd) affect the encoding and retrieval processes. We have thus confirmed the diagnosis of crossed aphasia by eliminating a left handedness and a lesion in the left hemisphere. The speech therapist and neuropsychological allowed to assert the diagnosis of aphasia associated with cognitive disorders [2] . Therefore we associated the language rehabilitation in a targeted program on cognitive function and gained better results.

Speech sound distortions in aphasia and apraxia of speech: reliability and diagnostic significance

Background: The differential diagnosis between apraxia of speech (AOS) and aphasia with phonemic paraphasia is challenging because the disorders share similar speech characteristics. Quantification of the speech profile of AOS is needed.Aims: To characterise the relative frequency of sound distortion errors in speakers with aphasia with and without AOS and to evaluate inter-observer reliability for this metric among independent listeners.Methods & Procedures: Fourteen adults with left hemisphere lesions were recruited from a consecutive clinical sample. They were assigned to groups of probable apraxia of speech (P-AOS) or probable aphasia with phonemic paraphasia (P-APP), based on the multisyllabic word production rate and perceptually evident sound errors. Four listeners generated independent phonetic transcriptions from an audio-recorded motor speech evaluation. The percentage of distorted segments and inter-observer reliability were calculated.Outcomes & Results: Inter-observer reliability was satisfactory for frequency of the overall distortion errors (ICC = 0.73, p < .001). Distortion frequencies were greater in the P-AOS group than in the P-APP group, but varied along on a continuum. Severity effects could not be ruled out, as the overall sound error frequencies were higher in the P-AOS group.Conclusions: With narrow phonetic transcription, independent clinicians can expect to code relative distortion frequency reliably, even though they may differ in the type of distortions they favour and in the absolute rates they observe. Distortion errors are present in speech produced by speakers with aphasia whose speech is characterised by sound error production, and rates are generally higher in stroke survivors who meet prosodic criteria for AOS. The relationship between phonemically salient sound errors and sound distortion frequency should be addressed in future research.

P156. Good long-term error rate retest reliability of 10 Hz neuronavigated repetitive TMS speech/language mapping in healthy volunteers

Introduction Maximizing the extent of resection whilst preserving important brain functions is a major goal in the surgical treatment of brain tumours. For primary motor functions, the presurgical diagnostic techniques such as functional MRI (fMRI) and navigated transcranial magnetic stimulation (TMS) have improved a lot over the last decades and are extremely useful for preoperative risk evaluation and planning of the surgical approach. By contrast, presurgical mapping techniques for language-relevant areas are regarded poorly reliable (fMRI) and/or rather unspecific (repetitive TMS, rTMS). Methods We investigated the retest reliability of neuronavigated rTMS for speech/language mapping in 11 right-handed healthy volunteers in 3 consecutive sessions, spaced by 2–5 (short term) and 21–40 (long term) days. Navigated 10 Hz rTMS (Nexstim eXimia 4.2) was applied over the dominant hemisphere after determination of the individual inhibition threshold over the primary motor representation of the face/tongue. The bursts were triggered to picture presentation (naming task) without delay (picture-to-trigger interval = 0). Errors were categorised as follows: arrest, delay, anomia, dysarthria, semantic and phonematic paraphasia. Results As shown in Table 1 , a good feasibility in terms of the evocation of errors was observed. Per session, speech delays occurred most frequently (9.2 ± 2.1), followed by dysarthria (5.1 ± 2.4) and speech arrests (3.8 ± 1.8) whilst paraphasias were rather rare. There was a high variability in the distribution and the frequency of speech errors between the subjects. The reliability of the error frequency was rather good regarding long-term comparisons (Cohen’s weighted Kappa k = 0.41 [session 1–3]/k = 0.42 [session 2–3]) and still fair for the short-term (k = 0.29 [session 1–2]). Analyses of the spatial reliability of error representation are ongoing. Conclusions Presurgical speech/language mapping by neuronavigated rTMS is a promising tool to improve the risk evaluation and the planning of the surgical approach. In this preclinical study a rather satisfactory retest reliability of rTMS mapping at 10 Hz could be shown. However, since the method is still young, optimisation of the stimulation protocol and further intraoperative validation in clinical trials are required.

How ‘some garlic’ becomes ‘a garlic’ or ‘some onion’: Mass and count processing in aphasia

This paper informs our understanding of the representation and processing of mass and count nouns through an investigation of the underlying causes of mass/count specific impairments in in two people with aphasia, DEH and GEC. The factors influencing the production of mass and count nouns and noun phrases was comprehensively assessed. The results showed that GEC's impairment affected mass noun naming, resulting in the production of semantic paraphasias and no responses. In contrast, DEH frequently substituted mass determiners with count determiners leading to ungrammatical noun phrases. In comparison to younger control group, a control group of older adults showed similar difficulties to DEH with mass noun phrases, although less severe, indicating effects of cognitive ageing on lexical and semantic processing. DEH and the elderly controls' results replicate and support previous findings regarding the lexical-syntactic representation of mass/count information. GEC's difficulties extend these findings by providing additional evidence for a semantic component in the representation of countability (e.g., a semantic feature/concept COUNTABLE for count nouns, UNCOUNTABLE for mass nouns) which contributes to mass and count noun selection. GEC's mass noun difficulties are suggested to result from weaker connection strength between noun lemmas and mass concepts compared to count concepts as a result of the overall lower frequency distribution of mass nouns.

Naming ability in patients with mild to moderate Alzheimer's disease: what changes occur with the evolution of the disease?

OBJECTIVES:Naming deficit is a linguistic symptom that appears in the initial phase of Alzheimer's disease, but the types of naming errors and the ways in which this deficit changes over the course of the disease are unclear. We analyzed the performance of patients with Alzheimer's disease on naming tasks during the mild and moderate phases and verified how this linguistic skill deteriorates over the course of the disease.METHODS:A reduced version of the Boston Naming Test was administered to 30 patients with mild Alzheimer's disease, 30 patients with moderate Alzheimer's disease and 30 healthy controls. Errors were classified as verbal semantic paraphasia, verbal phonemic paraphasia, no response (pure anomia), circumlocution, unrelated verbal paraphasia, visual errors or intrusion errors.RESULTS:The patients with moderate Alzheimer's disease had significantly fewer correct answers than did both the control group and the group with mild Alzheimer's disease. With regard to the pattern of errors, verbal semantic paraphasia errors were the most frequent errors in all three groups. Additionally, as the disease severity increased, there was an increase in the number of no-response errors (pure anomia). The group with moderate Alzheimer's disease demonstrated a greater incidence of visual errors and unrelated verbal paraphasias compared with the other two groups and presented a more variable pattern of errors.CONCLUSIONS:Performance on nominative tasks worsened as the disease progressed in terms of both the quantity and the type of errors encountered. This result reflects impairment at different levels of linguistic processing.

Phonological facilitation effects on naming latencies and viewing times during noun and verb naming in agrammatic and anomic aphasia

Background: Phonological priming has been shown to facilitate naming in individuals with aphasia, as well as healthy speakers, resulting in faster naming latencies. However, the mechanisms of phonological facilitation (PF) in aphasia remain unclear.Aims: Within discrete vs. interactive models of lexical access, this study examined whether PF occurs via the sub-lexical or lexical route during noun and verb naming in agrammatic and anomic aphasia.Methods & Procedures: Thirteen participants with agrammatic aphasia and 10 participants with anomic aphasia and their young and age-matched controls (n = 20/each) were tested. Experiment 1 examined noun and verb naming deficit patterns in an off-line confrontation naming task. Experiment 2 examined PF effects on naming both word categories using eyetracking priming paradigm.Outcomes & Results: Results of Experiment 1 showed greater naming difficulty for verbs than for nouns in the agrammatic group, with no difference between the two word categories in the anomic group. For both participant groups, errors were dominated by semantic paraphasias, indicating impaired lexical selection. In the phonological priming task (Experiment 2), young and age-matched control groups showed PF in both noun and verb naming. Interestingly, the agrammatic group showed PF when naming verbs, but not nouns, whereas the anomic group showed PF for nouns only.Conclusions: Consistent with lexically mediated PF in interactive models of lexical access, selective PF for different word categories in our agrammatic and anomic groups suggest that phonological primes facilitate lexical selection via feedback activation, resulting in greater PF for more difficult (i.e., verbs in agrammatic and possibly nouns in anomic group) lexical items.

Positive impact of speech therapy in progressive non-fluent aphasia.

The aim of this paper is to analyze the effects of intensive speech therapy intervention in a case of progressive non-fluent aphasia (PNFA). This is a dementia syndrome characterized by a progressive deficit in expressive language fluency and syntactic analysis, and by agrammatism and phonemic paraphasias. Although in the early stages there are no alterations in memory, comprehension, or visual processing, personality changes can slightly occur. To analyze the effects of speech therapy in this syndrome, a single case design with pre- and post-test was used. The participant was a male patient of 84 years with PNFA, who for twelve months received weekly speech therapy to stimulate the phonological, lexical and syntactic processing. He underwent neuropsychological assessment in three stages: six months before the onset of therapy, six months after therapy started and after completing 12 months of intervention. Assessment involved linguistic processing, general cognition, neuropsychiatric symptoms, quality of life (QOL) and activities of daily living (ADL). As a result of therapy, the patient showed a slight improvement in language prosody, fluency, and content of spontaneous speech, and a significant improvement in repetition, reading aloud, and oral-phonatory praxis. Other aspects of cognitive functioning (orientation, verbal naming, praxis, and memory) remained stable; ADLs and QoL improved. It is concluded that prolonged speech therapy can improve language processing and have a positive impact on other cognitive and socio-emotional processes in PNFA. This 12-month therapeutic stimulation not only slowed cognitive decline, but allowed to see maintenance of achievements and improvement of symptoms, which can be regarded as a success in PNFA treatment, considering the rapid progression of the disease.

Jargon in reading aloud sparing Arabic digits but not number words

Jargon in reading aloud sparing Arabic digits but not number words

Phonological rehabilitation in acquired aphasia

Phonological rehabilitation in acquired aphasia