Transcortical Sensory Aphasia Research Articles

Current situation and trend of translational research of acupuncture-moxibustion in treatment of aphasia based on knowledge graph analysis.

To investigate the hot topics in acupuncture-moxibustion research for treatment of aphasia and explore the current situation and trend of technology transformation in this field through analyzing the relevant Chinese literatures in recent 30 years by means of knowledge graph technology. CiteSpace 6.1.R 2 and VOSviewer V1.6.16 software were used to collate the data, draw knowledge graphs and conduct visual analysis of the literatures related to acupuncture-moxibustion treatment of aphasia, searched from CNKI, WanFang and VIP databases.The time line view and strongest bursts of keywords were formed in the field of acupuncture-moxibustion treatment for aphasia. The treatment-based keyword networks were visualized. A total of 773 Chinese articles were included. Through visual analysis of the co-occurrence networks, the top 10 high-frequency overall keywords and the top 10 clusters of overall keywords were listed. The top 5 high-frequency aphasia categories were Broca aphasia, hysterical aphasia, transcortical motor aphasia, nominal aphasia and sensory aphasia. Regarding the keywords of the techniques of acupuncture-moxibustion, the occurrence frequencies of scalp acupuncture, tongue acupuncture, body acupuncture and electroacupuncture were ≥ 10 times.The occurrence frequencies of 16 acupoints were ≥25 times. After collation and cluster analysis of acupoints and techniques of acupuncture-moxibustion, 7 keyword clusters of "acupuncture techniques-acupoints" were obtained. The time line view showed that the strongest burst of keywords were transcranial magnatic stimulation, language rehabilitation training, acupuncture-medicine therapy and stroke, etc. in the recent 5 years. Acupuncture-moxibustion displays its unique advantage in treatment of aphasia. With the deepening of modern research, the hot topics for aphasia treated with acupuncture-moxibustion are present and the achievements enriched. In future, these therapeutic methods should be further investigated to explore a model of translational medicine for aphasia in line with the characteristics of acupuncture-moxibustion.

The impact of visual and motor skills on ideational apraxia and transcortical sensory aphasia

Background Patients with extensive left hemisphere damage frequently have ideational apraxia (IA) and transcortical sensory aphasia (TSA). Difficulty with action coordination, phonological processing, and complex motor planning may not be indicative of higher-order motor programming or higher-order complex formation. We report on the effects of IA and TSA on the visual and motor skill of stroke patients. Purpose The study aims to address the question of whether IA and TSA in bilingual individuals are the results of an error of motor function alone or due to a combined motor plus and cognitive dysfunction effect. Method Twelve bilingual patients (seven males, and five females) were diagnosed with IA and TSA, and are divided into two groups of six patients. Then, 12 healthy bilingual controls were evaluated for comparing with both groups. Bilingual aphasia testing (BAT) and appropriate behavioral evaluation were used to assess motor skills, including coordination, visual-motor testing, and phonological processing. Results Findings (pointing skills) show that the performance of the L1 and L2 languages are consistently significant (p < 0.001) in healthy individuals compared to the IA and TSA groups. Command skills for L1 and L2 languages were significantly higher in healthy individuals compared to IA and TSA controls (p < 0.001). Further, the orthographic skills of IA and TSA vs controls in both groups were significantly reduced (p < 0.01). Visual skills in the L1 language were significantly improved (p < 0.05) in IA and TSA patients compared to healthy controls after 2 months. Unlike orthographic skills which were improved in IA and TSA patients, languages in bilingual patients did not simultaneously improve. Conclusion Dyspraxia is a condition that affects both motor and visual cognitive functions, and patients who have it often have less referred motor skills. The current dataset shows that accurate visual cognition requires both cognitive-linguistic and sensory-motor processes. Motor issues should be highlighted, and skills and functionality should be reinforced along with the significance of treatment between IA and TSA corresponding to age and education. This can be a good indicator for treating semantic disorders.

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

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

Transcortical sensory aphasia heralding SARS-Cov-2-induced autoimmune encephalitis with gyral restricted diffusion hyperintensities: a novel case report

BackgroundCoronavirus disease 2019 (CoVID-19), primarily thought of as a respiratory system disease is actually a multi-system disease with immunological implications. CNS involvement in COVID has been explained in recent literature mainly for stroke, encephalopathy, encephalitis, acute disseminated encephalomyelitis and myelopathy. There are few studies characterizing clinical spectrum of COVID autoimmune encephalitis. We present a unique case of post-COVID autoimmune encephalitis in a diabetic male presenting with language dysfunction and novel radiologic findings.Case presentationPatient admitted to inpatient department of a tertiary care hospital of India was evaluated by bedside clinical examination, routine blood tests, CSF study with intrathecal SARS-Cov-2 antibody detection, commercially available tests for autoimmune encephalitis, neuroviral panel with HSV PCR, EEG, 3-Tesla MRI and PET scan. Patient was found to have personality change and transcortical sensory aphasia in the outset of COVID encephalitis. MRI findings like temporal involvement and insular ribboning are also being reported. The patient was treated with IV immunoglobulin and is on an improving course.ConclusionsThis case reports dysphasia due to COVID-mediated injury to the language networks, with novel radiologic findings. Role of parainfectious versus immune etiology is also discussed. Further studies are needed to elucidate the mechanism and clinical spectrum of post-COVID autoimmune encephalitis.

Corrective Repetition of Ungrammatical Gender Agreement Stimuli: A Transcortical Sensory Aphasia Single Case Study

ABSTRACT Background Oral repetition in Transcortical Sensory Aphasia (TSA) has been shown to display linguistically informed altering of purposefully grammatically incorrect repetition stimuli, with a tendency to correct grammatical errors during repetition in spite of the absence of semantic comprehension. Aims The present TSA single-case study, conducted in Italian, investigated the processing of linguistic Gender agreement errors through a series of oral repetition tasks, with the purpose of (i) investigating whether grammatical and semantic Gender can be independently spared; and (ii) investigating whether Gender agreement errors are informative among the linguistic facts that the patient retains sensitivity towards, and if so, how. Methods and Procedures TST, a native speaker of Italian diagnosed with TSA, was administered 8 oral repetition tasks, each containing Gender agreement errors that occurred either in phrase condition (i.e., “definite article + noun”), or in sentence condition (i.e., “subject + nominal predicate”). These different conditions were formulated with the purpose of appreciating possible differences in the processing of the Gender feature in two different syntactic environments. A number of additional variables was introduced: singular/plural; feminine/masculine; Gender morphological (un)informativeness; common noun/proper name status; animate/inanimate noun referents. Outcomes and Results During repetition, the changes applied by the patient were almost exclusively corrective and mostly followed a left-to-right strategy. Among the introduced variables, those that gave significant effects were as follows: animate/inanimate noun referents and phrase/sentence agreement. Gender morphological (un)informativeness gave no significant effects, and neither did common noun/proper name status, singular/plural and feminine/masculine nouns. Implications for linguistic theory in terms of the Gender/Class pairing are discussed. Conclusions Findings indicate that (i) grammatical and semantic Gender can be independently spared; and (ii) in Italian, Gender is morphologically realized and could consequently be accessed for the purposes of agreement only in the case of nouns of the animate kind: Gender of animate nouns elicited corrective changes, while Gender of inanimate nouns was utterly ignored.

Unclassified fluent variants of primary progressive aphasia: distinction from semantic and logopenic variants.

Primary progressive aphasia, a neurodegenerative syndrome, presents mainly with language impairment. Both semantic and logopenic variants are fluent variants of primary progressive aphasia. Before the research criteria of primary progressive aphasia were proposed, progressive fluent aphasias, such as progressive anomic aphasia, transcortical sensory aphasia and Wernicke’s aphasia, were reported as classical progressive fluent aphasias seen in Alzheimer’s disease. However, since the research criteria of primary progressive aphasia were established, classical fluent variants (other than semantic and logopenic variants) have been neglected and have not been included in the current classification of primary progressive aphasia. This study aimed to determine whether unclassified fluent variants (other than semantic and logopenic variants) can be manifestations of primary progressive aphasia. This study also reconfirmed the characteristics of classical progressive fluent aphasia, such as progressive anomic aphasia, progressive transcortical sensory aphasia and progressive Wernicke’s aphasia as unclassified fluent variants of primary progressive aphasia, using comparison with the current model of primary progressive aphasia. Twelve consecutive patients with an unclassified fluent variant other than semantic or logopenic variant underwent language, neurological, neuropsychological and neuroimaging (MRI and single-photon emission computed tomography) testing. Based on comprehensive language tests, we redefined the diagnoses as primary progressive anomic aphasia (n = 8), primary progressive transcortical sensory aphasia (n = 3) and primary progressive Wernicke’s aphasia (n = 1). Anomic aphasia was characterized by anomia but preserved repetition and comprehension; transcortical sensory aphasia by relatively preserved repetition but poor word comprehension; and Wernicke’s aphasia by poor repetition and word comprehension. In patients with anomic aphasia, voxel-based morphometry of MRI data revealed cortical atrophy, which was most prominent in the temporoparietal lobes, with no obvious lateralization; in two-thirds of patients with transcortical sensory aphasia and in one patient with Wernicke’s aphasia, it revealed atrophy, predominantly in the left temporoparietal lobe. Statistical analysis of single-photon emission computed tomography using three-dimensional stereotactic surface projections revealed patterns of left-sided hypoperfusion in the majority of patients. The temporal and parietal lobes were involved in all cases; the degree of hypoperfusion was higher in patients with transcortical sensory aphasia or Wernicke’s aphasia than in patients with anomic aphasia. The present study demonstrated the clinical and imaging features of 12 patients with an unclassified fluent variant of primary progressive aphasia, which we redefined as primary progressive anomic aphasia, primary progressive transcortical sensory aphasia and primary progressive Wernicke’s aphasia. Classical fluent variants other than semantic and logopenic variants can be found in primary progressive aphasia.

TRANSCORTICAL SENSORY APHASIA AS A MANIFESTATION OF ISCHEMIC STROKE WITH INTRACARDIAC THROMBUS

Transcortical sensory aphasia is characterized by impaired auditory comprehension, with intact repetition and uent speech. A 44-year-old right-handed patient with a history of hypertension on amlodipine and ischemic heart disease on aspirin was admitted to the neurology department for sudden onset of language impairment that started 2 days ago. The patient had features of transcortical sensory aphasia. Brain MRI showed an infarct in the territory of the left middle cerebral artery involving the tempo-parietal region. An apical thrombus was observed in the left ventricle on transthoracic echocardiography. This language impairment is thought to be caused by a disconnection between sensory language processes and semantic knowledge of objects. The prognosis is generally guarded and depends on the etiology and severity of the presentation

Transcortical Sensory Aphasia Sonnet

A sonnet about transcortical sensory aphasia, a disorder in which comprehension remains intact, but language production is primarily constrained to repetition. Much like the mythical Echo, this sonnet is a reflection upon personal expression when one's words are not one's own.

Non-linguistic abilities in aphasia

Abstract Background Understanding the pattern of non-linguistic abilities in aphasia has been a controversial question. We hypothesized that only some aphasia patients, particularly patients with fluent forms of aphasia and global aphasia, would present deficits in non-linguistic abilities. Methods & procedures We studied 200 vascular aphasia patients (119 men and 81 women; mean age = 57.37 years, SD = 15.56) at the Cognitive Communicative Speech Language Pathology Unit at the Clinical Hospital University of Chile (Santiago, Chile). The mean time post onset was 6.57 months (SD = 12.94). The Spanish versions of Western Aphasia Battery Revised (SWAB-R) and the Spanish version of the Boston Diagnostic Aphasia Examination (SBDAE) were administered. We used the SWAB-R Part 1 to determine the aphasia severity (Aphasia Quotient: AQ). SWAB-R Part 2 was used to study nonverbal abilities; a Non-Linguistic Quotient (NLQ) was calculated. The SBDAE was used in determining the type of aphasia. Outcomes & results Deficits were particularly evident in Global, Mixed non-fluent, and Transcortical Motor aphasia, followed by Wernicke and Transcortical Sensory aphasia. Deficits were mildest in Amnesic, Conduction, and Broca aphasia. Correlation between linguistic and non-linguistic deficits were found to be statistically significant. Conclusion Our results support previous studies: non-linguistic abilities can be affected in aphasia, but there is an important variability. Some aphasia patients can present non-linguistic deficits. Verbal and nonverbal deficits are significantly correlated, suggesting some communality in their brain organization.

Structural Characteristic of the Arcuate Fasciculus in Patients with Fluent Aphasia Following Intracranial Hemorrhage: A Diffusion Tensor Tractography Study.

This study investigated the relationship between the structural characteristics of the left arcuate fasciculus (AF) reconstructed using diffusion tensor image (DTI) and the type of fluent aphasia according to hemorrhage lesions in patients with fluent aphasia following intracranial hemorrhage (ICH). Five patients with fluent aphasia following ICH (three males, two females; mean age 55.0 years; range 47 to 60 years) and with sixteen age-matched heathy control subjects were involved in this study. The ICHs of patients 1 and 2 were located in the left parietal lobe and the left basal ganglia. ICHs were located in the left anterior temporal of patient 3, the left temporal lobe of patient 4, and the left frontal lobe of patient 5. We assessed patients’ language function using K-WAB (the Korean version of the Western Aphasia Battery) and reconstructed the AF using DTI. We measured DTI parameters including the fractional anisotropy (FA), tract volume (TV), fiber number (FN), and mean diffusivity (MD). All patients showed neural tract injury (the decrement of FA, TV, and FN and increment of MD). The left AFs in patients 1 and 2 were shifted from Broca’s and Wernicke’s territories. The destruction of Wernicke’s territory resulted in conduction or transcortical sensory aphasia in patients 3 and 4. The structural difference of the AF in patients following ICH in the left hemisphere was associated with various types of fluent aphasia.

Post-stroke Aphasia in Spanish language: the effect of demographic variables

ABSTRACT Background: The pattern of post-stroke aphasia in Spanish speakers has not previously been reported. Furthermore, the association between aphasia type and demographic variables is not clearly understood. Aims: To investigate the incidence and type of aphasia in first-ever acute stroke during the early chronic and later chronic periods in native Spanish speakers and the effect of demographic variables. Methods & Procedures: Spanish versions of Western Aphasia Battery and Boston Diagnostic Aphasia Examination were used for language assessment. Lesion localization was done by using computerized axial tomography and magnetic resonance imaging. Final simple included 243 (97.98%) right-handed, and five (2.02%) left-handed participants; 143 men and 105 women with a mean age of 58.68 years. Outcomes & Results: The types of aphasia included – 14.1% Broca’s, 15.3% Wernicke’s, 10.1% Conduction, 9.3% Transcortical Sensory, 1.6% Transcortical Motor, 28.2% Anomic, 4.8% Global, and 16.5% Mixed non-fluent. Wernicke’s aphasia, along with Transcortical Sensory aphasia was more frequently observed in older people. Broca’s aphasia was more prevalent but less severe in women than in men. Auditory Comprehension and Naming negatively correlated with age, while schooling positively correlated with Auditory Comprehension. Time since onset did not significantly affect the type of aphasia. Schooling correlated with the severity of Anomic aphasia. Conclusions: The most common type of aphasia in our sample was Anomic aphasia. Older people had an increased probability to present a fluent type of aphasia. Broca’s aphasia was more frequent but less severe in women.

Syntactic cueing of spoken naming in jargon aphasia

ABSTRACT Background: Debate surrounds the relationships between the systems involved in spoken word production, the activation governing production, and the role of syntax in production. Jargon aphasia provides an opportunity to investigate the relationship between syntax and phonology as it often involves retained syntax, alongside phonological deficits shown through neologistic output. Models of spoken word production differ in terms of their accounts of the processing relationships between these two levels of representation, and the degree to which syntax is activated and affects phonology. Aims: We aimed to complete a single case study investigation of the impact of syntactic cues on spoken word production, and to compare data from this implicit task with data from an explicit syntax judgement task. The investigation aims to shed light on different theories of spoken word production, provide new evidence concerning the nature of the deficit in jargon aphasia, and identify potential intervention methods. Methods & Procedures: The participant DP presented with transcortical sensory aphasia, with fluent neologistic output, a comprehension deficit, anomia, and preserved repetition. The investigations into DP’s noun syntax processing included syntactic cueing of naming, and a syntactic judgement task. The cueing task compared cued and uncued naming, where cues provided syntactic information relevant to count or mass noun targets. The judgement task investigated DP’s knowledge of potential determiner plus noun combinations. Outcomes and results: Syntactic cues led to increased overall naming accuracy, increased numbers of nouns, more phonologically related errors, and fewer unrelated word errors. The cues had no effect on the proportion of lexical versus non-lexical responses, nor on rates of semantic errors. In contrast to the positive impact of cues, DP showed limited knowledge of the meanings of determiners via the explicit judgement task. Conclusions: The evidence supports a spoken word production theory that has feedforward only activation from the syntactic to the semantic level, but allows interaction between syntactic and phonological representations. This account explains the lack of semantic errors, and the increase in phonologically related errors in the cued condition. DP’s difficulties completing the explicit judgement task provide more evidence of the need for online tasks which address language processing directly. New evidence of positive effects of syntactic cues on word retrieval informs future interventions for speakers with jargon aphasia.

Do You Understand Me? An Aphasia Assessment Case Study in a Non-Native English Speaker

Abstract Objective We report on the assessment of a non-native, English speaking patient who presented for a comprehensive neuropsychological evaluation following an infarct with associated language deficits. Challenges in assessment and interpretation given language and cultural barriers are discussed. Case Description The patient presented for an evaluation of cognitive and emotional difficulties following a left internal carotid artery infarct. Brain MRI revealed multiple acute infarcts in the left hemisphere, including the left occipital, medial aspect of the left temporal, left frontal, and left parietal lobes. While the patient had lived in the U.S. for 30 years and spoke English fluently for work, he primarily spoke his native language (Tamil). Given the lack of medically certified interpreters in the region along with a lack of culturally sensitive tests, the patient was evaluated in English using English-based tests and norms. Diagnostic Impressions and Outcomes Results were suggestive of a transcortical sensory aphasia. Language comprehension deficits were observed in both oral and written formats, while simple oral expression and repetition remained intact. The lack of normative data that matched the patient’s demographic background in addition to the lack of available samples regarding the patient’s English language functioning prior to the stroke made assessing the severity of deficits challenging. The family’s cultural norms and the patient’s unawareness of his deficits may have resulted in underreporting of the patient’s symptoms to providers. These factors further complicated the selection of appropriate recommendations for short- versus long-term disability. Discussion Specific challenges included an inability to assess the patient in his native language while using culturally-sensitive measures; thus, shedding light on the current clinical need for increasing competency in the assessment of non-native English-speaking patients. Further directions and opportunities are discussed.

Speech and Language Dysfunctions in Patients with Cerebrocortical Disorders Admitted in a Neurosurgical Unit.

Introduction:Speech and language abnormality among brain injury patients are common, especially during the acute stage. The details of same from Andhra Pradesh (AP) state are limited. The present study provides details of speech and language abnormality among brain damage patients, from a tertiary care hospital AP.Materials and Methods:This study was conducted at tertiary care hospital, Nellore, AP. Patients with acute brain damage due to traumatic brain injury (TBI), cerebrovascular accident (CVA), and postoperative cases of brain tumors were selected for the study. Detail of speech and language disturbances was accessed using Western Aphasia Battery. All patients were right-handed and Telugu was their first language.Results:There were totally 38 patients, of them 28 had TBI, 8 patients were postoperative cases of brain tumor, and 2 cases were of CVA. The mean age was 45.6 years. A total of 22 patients were literate. TBI patients with left cerebral hemisphere damage manifested with anomic, conduction, transcortical sensory, global, and Wernicke's aphasia. Four patients of postoperative brain tumor manifested with anomic and transcortical sensory aphasia had left-sided brain damage and mild dysarthria had right-sided brain damage patient. CVA patients had anomic aphasia and subcortical aphasia having right and left cerebral hemisphere damage, respectively.Conclusions:This study reports that acute brain damage due to various causes manifest with speech and language abnormality, especially when the left cerebral hemisphere is involved.

Transcortical Sensory Aphasia after Left Frontal Lobe Infarction: Loss of Functional Connectivity

Background: The underlying mechanism of transcortical sensory aphasia (TSA) caused by lesions occurring in the left frontal lobe remains unclear. We attempted to investigate the mechanism with the use of functional MRI (fMRI). Methods: We studied 2 patients with TSA after a left frontal infarction identified by diffusion-weighted MRI. As control subjects, a patient with transcortical motor aphasia and a healthy normal adult were chosen. The Korean version of Western Aphasia Battery was performed initially and at 3 months post stroke. We performed fMRI using verb generation and sentence completion tasks. Resting-state fMRI (rs-fMRI) was also obtained for network-level analysis initially and at 3 months post stroke. Results: The results of diffusion- and perfusion-weighted MRI revealed no diffusion-perfusion mismatch. Initial fMRI in patients with TSA showed no reversed inter-/intrahemispheric activation patterns. rs-fMRI showed significantly decreased resting-state functional connectivity in the language network in patients with TSA compared with the control subjects. Follow-up rs-fMRI studies showed improvement in functional connectivity along with the recovery of patients' language function. Conclusion: Our data showed that the auditory comprehension deficits in patients with frontal lobe infarcts is attributed to difficulty accessing the posterior language area due to functional disconnection between language centers in the acute stage of stroke.

Typical and atypical appearance of early‐onset Alzheimer's disease: A clinical, neuroimaging and neuropathological study

The International Working Group (IWG) has classified Alzheimer's disease (AD) as two different types, the typical form and the atypical form, but clinicopathological studies of atypical AD are limited. Because atypical AD cases usually present with early-onset dementia, we investigated 12 patients with early-onset AD, including two patients with typical AD and 10 patients with atypical AD. Of these patients, six had the posterior variant, three had the frontal variant and one had the logopenic variant mixed with semantic dementia. We reported MRI, single-photon emission CT and neuropathological findings in six representative cases. We also described a "left temporal variant" of AD presenting with transcortical cortical sensory aphasia, which has not been reported previously and is another subtype of the posterior variant of AD. We found a significant correlation between regional cerebral blood flow and counts of NFTs in the cerebral cortices. An atypical presentation with focal neuropsychological symptoms roughly correlated with the density of NFTs in the cerebral cortex and more directly related to spongiform changes in the superficial layers of these areas. In contrast, the distribution of amyloid depositions was diffuse and did not necessarily correlate with focal neuropsychological symptoms. Braak staging or ABC score is not necessarily appropriate to evaluate atypical AD, and instead, spongiform changes in addition to tau pathology in the association cortices better explain the diversity of atypical AD. Interestingly, another patient with a posterior variant of AD had a novel type of atypical plaque, which we referred to as "lucent plaque". They were recognizable with HE staining in the circumference and dystrophic neurites were abundant with Gallyas-Braak staining. These plaques demonstrated intense immunoreactivity to both tau AT-8 and amyloid β (Aβ), suggesting a peculiar coexistence pattern of amyloid and tau in these plaques. Clinicopathological studies of atypical AD will provide a new understanding of the pathophysiology of AD.

APPLICATION OF FUNCTIONAL NEUROMARKERS FOR CONSTRUCTING PROTOCOLS OF NEUROTHERAPY AND MONITORING THE SUCCESS OF TREATMENT IN CHRONIC CROSSED TRANSCORTICAL SENSORY APHASIA: A CASE STUDY

Background. The goal of the study was threefold: 1) to evaluate QEEG/ERPs in­dexes of functional brain impairment after a stroke associated with chronic crossed transcortical sensory aphasia, 2) to construct a neu­rotherapy protocol to compensate for this functional damage, and 3) to assess the changes in the functional neuromarkers induced by the neurotherapy sessions. Case study. A 72-year-old, strongly right-handed woman with atrial fibrillation sud­denly developed cerebral embolism of the right middle cerebral artery. She was treated conservatively, and the left hemiparesis, and aphasia – in a moderate degree, consequently existed. A CT-scan showed a large infarct lesion partially parallel to Wernicke’s area. After one year of ineffective aphasia therapy we constructed an experimental neuro­therapy protocol (TMS combined with comprehensive aphasia therapy) on the basis of an assessment of the spontaneous QEEG and event-related potentials (ERPs) in the cued GO/NOGO. The patient was assessed before and after the neurotherapy sessions by the same methodology. Conclusions.It was found that before the TMS treatment the temporal area (T6) generates a strong P2 wave in response to visual stimulus indicating a hyper-sensitivity of the neurons located at temporal areas of the right hemisphere. This was connected with crossed transcortical sensory aphasia found within the aphasia profile in the Polish version of the Western Aphasia Battery (K-WAB). The TMS sessions reduced this hyper-sensitivity substantially. The patient speech returned to the norm, she was to return to social life.

Language Symptoms of Alzheimer's Disease

Alzheimer's disease (AD) is a neurodegenerative disorder mainly characterized by progressive memory disturbance. Language symptoms are considered to be less disease specific and therefore did not attract many researchers, interest until recently. Typical patients with AD present amnesic aphasia in the early disease stage followed by transcortical sensory aphasia; however, their language symptoms are varied. Recently, the concept of logopenic variant of primary progressive aphasia (PPA) has been developed, which is reported to have Alzheimer's neuropathology. Clinicians should verify patients' language abilities, as language can be the key to reveal their true cognitive functions.

Eficacia del tratamiento para la afasia de Wernicke en pacientes con sintomatología grave

IntroductionAphasia is a language disorder which causes, in most cases, an inability to communicate, which implies a handicap not only for the patient but also for the family environment. Patient rehabilitation is considered vital to redress this communicative dysfunction. Conventional speech therapy is useful, but for cases of aphasia with severe disturbances it is too slow. To solve this problem, in the field of the Wernicke's aphasia was developed the Treatment for the Wernicke's aphasia (TWA), which it is showed effective in a specific set of candidates. ObjectiveTo assess TWA in Wernicke's aphasia patients who had severe symptoms, although they were not candidates for the original conventional treatment. Method12 sessions of TWA were performed with a Wernicke's patient, and pre- and post-treatment results of the patient were compared with a group of Wernicke's patients (one with the same etiology and location) and with a group of transcortical sensory aphasia's patients (Wernicke aphasia typeii). ResultsThe results show, in almost all the analyzed verbal areas, a greater improvement in the patient who completed the TWA compared to patients who followed conventional speech therapy. ConclusionsFrom the results obtained in this study it can be concluded that the TWA is an useful therapeutic treatment for all classes of patients with Wernicke's aphasia, and not just for the candidates in initial rehabilitation.

Posterior Cortical Atrophy with Acute Onset and Rapid Progressive Visual Symptoms: A Case Report

Posterior cortical atrophy (PCA) is a rare degenerative disease with unknown cause. In 1988, Benson et al.1 reported some patients whose cerebral images showed significant atrophy of the parieto-occipital region with progressive dementia and cortical visual dysfunction. They named this disease as PCA based on image findings. Since PCA is most often associated with the pathological findings of Alzheimer’s disease (AD), some people consider PCA as a visual variant of AD. Because PCA invades the posterior cerebral cortex, Gerstmann syndrome, Balint syndrome, and trans-cortical sensory aphasia may occur along with visual agnosia that occurs relatively early.2,3 Here we report a patient who visited our hospital with complaints of only visual symptom that rapidly progressed. We diagnosed it as PCA through clinical findings, image examinations, and other evidences. CASE REPORT