Type Of Aphasia Research Articles

REHABILITATION OF PATIENTS WITH SPEECH DISORDERS OCCURRING FROM POSTERIOR CORTICAL LESIONS

Актуальность. Накопившиеся в последнее время научные данные о механизмах компенсации у больных с последствиями нарушения мозгового кровообращения позволяют пересмотреть традиционные методики восстановления афазии.

Verb Argument Structure in Narrative Speech: Mining AphasiaBank.

Previous research has found that verb argument structure characteristics (such as the number of participant roles in the situation described by the verb) can facilitate or hinder aphasic language production and comprehension in constrained laboratory tasks. This research needs to be complemented by studies of narrative or unrestricted speech, which can capture the spontaneous selection of verbs and grammatical structures by people with aphasia and may be particularly sensitive to the relative cost of access to different verb types in more natural conditions. Focusing on the number of subcategorization options, we investigated verb argument structure effects in a large sample of narratives from AphasiaBank, by speakers with aphasia, as well as control speakers without brain damage. Verb argument structure complexity did not negatively affect verb selection in any type of aphasia. However, people with aphasia, particularly with Broca's aphasia, used verbs in less complex and diverse ways, with fewer arguments and less diverse subcategorization options. In line with previous research, this suggests that deficits in verb use in aphasia are likely due to difficulties with the online application of or partial damage to verb argument structure knowledge.

Higher Brain Dysfunction in Mitochondrial Myopathy, Encephalopathy, Lactic Acidosis and Stroke-Like Episodes (MELAS)

Stroke-like episodes are one of the cardinal features of mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS), and occur in 84-99% of the patients. The affected areas detected on neuroimaging do not have classical vascular distribution, and involve predominantly the temporal, parietal and occipital lobes. Thus, the neurological symptoms including higher brain dysfunction correlate with this topographical distribution. In association with the occipital lobe involvement, the most frequent symptom is cortical blindness. Other symptoms have been occasionally reported in case reports: visual agnosia, prosopagnosia, cortical deafness, auditory agnosia, topographical disorientation, various types of aphasia, hemispatial neglect, and so on. On the other hand, cognitive decline associated with more diffuse brain impairment rather than with focal stroke-like lesions has been postulated. This condition is also known as mitochondrial dementia. Domains of cognitive dysfunction include abstract reasoning, verbal memory, visual memory, language (naming and fluency), executive or constructive functions, attention, and visuospatial function. Cognitive functions and intellectual abilities may decline from initially minimal cognitive impairment to dementia. To date, the neuropsychological and neurologic impairment has been reported to be associated with cerebral lactic acidosis as estimated by ventricular spectroscopic lactate levels.

Health science students' perceptions of motor and sensory aphasia caused by stroke.

[Purpose] This study explored health science students’ perceptions of motor aphasia and sensory aphasia caused by stroke to provide basic material for the improvement of rehabilitation practitioners’ perceptions of aphasia. [Subjects and Methods] The subjects of this study were 642 freshmen and sophomores majoring in health science. Perceptions of aphasia were surveyed on a semantic differential scale using the Anchoring Vignette Method and the difference in perception of the two types of aphasia was analyzed using multi-dimensional scaling. [Results] The analysis revealed that motor aphasia and sensory aphasia have mutually corresponding images. Motor aphasia had high levels of ‘quiet’, ‘passive’ ‘dumb’, ‘unstable’ and ‘gloomy’ images, while sensory aphasia had high levels of ‘noisy’, ‘unstable’, ‘cheerful’, ‘sensitive’, ‘fluctuating in emotions’, ‘active’, ‘dumb’ and ‘gloomy’ images. [Conclusion] A systematic education is required to be implemented in the future to improve health science students’ negative perceptions of the aftereffects of stroke such as aphasia.

AutoRAT at your fingertips: Introducing the new Russian Aphasia Test on a tablet

AutoRAT at your fingertips: Introducing the new Russian Aphasia Test on a tablet

Inhibition and language processing deficits in different types of aphasia

Inhibition and language processing deficits in different types of aphasia

Subject�Verb Agreement in Turkish Agrammatic Broca�s Aphasia: Comparison of Person and Number Features

Subject�Verb Agreement in Turkish Agrammatic Broca�s Aphasia: Comparison of Person and Number Features

Dynamic Recovery of Language Comprehension from Acute Wernicke�s Aphasia

Dynamic Recovery of Language Comprehension from Acute Wernicke�s Aphasia

"A lady of few words": Review of literature and report of a case of progressive nonfluent aphasia type of frontotemporal dementia

Frontotemporal dementia (FTD) is a clinically and pathologically heterogeneous syndrome. It can be classified into three clinical syndromes depending on the early and predominant symptoms: A behavioral variant FTD and two language variants namely, semantic dementia, and progressive nonfluent aphasia (PNFA) which are very rare and elude diagnosis. We report the case of an elderly homemaker who came to our institute with features of cognitive decline and behavioral problems with language deficits in the form of nonfluent speech, impaired vocabulary to three pairs of words, agrammatism, and impaired single sentence comprehension with corroborative magnetic resonance imaging findings. PNFA is a rare clinical variant of FTD and often underdiagnosed. It should be considered in elderly patients who apart from having cognitive decline, behavioral problems, and absent insight also develop limited vocabulary, especially using a set of nouns to express themselves. Speech therapy and behavioral therapy in the initial stages can be of utility.

Circadian Variation in the Incidence of Stroke-Induced Aphasia Types in Ahvaz, South-West of Iran

Background: The incidence of the stroke and its associated disorders has a multifactorial nature. Nowadays, researchers are looking for the relationship between circadian variations and the stroke incidence. Objectives: The current study aimed to compare the incidence of the different types of stroke-induced aphasia in Ahvaz, Iran, on seasonal, diurnal (weekly), and circadian variations. Patients and Methods: In this retrospective hospital-based study, the medical records of 1817 patients with stroke were reread in Ahvaz hospitals in 2011. Types of aphasia were diagnosed based on speech and language symptoms in their records. The data were transferred into the SPSS version 16, for statistical comparison. Results: According to the obtained results 39.9% of the studied patients had a stroke-induced aphasia. The highest incidence rates of aphasia due to the stroke in Ahvaz were, in the summer (38.2%), on Saturdays (16.1%), and 21.1% between 8:00 AM to noon. Chi-square test indicated a significant difference between the mentioned times and other time (P < 0.05). Conclusions: It seems that the incidence of different types of stroke-induced aphasia in Ahvaz is influenced by the calendar-temporal changes. According to the findings, to prevent the occurrence of stroke-induced aphasia, necessary counseling should be provided for lifestyle changes.

Structure, Processes, and Retrospective Outcomes From an Intensive Comprehensive Aphasia Program.

This study describes the structure, processes, and outcomes of an intensive comprehensive aphasia program (ICAP). The aim was to identify treatment gains and determine if outcomes were significantly different between participants grouped according to severity and type of aphasia, and time postonset. Data from 74 first-time ICAP participants were analyzed. Pre- and posttreatment scores on the Western Aphasia Battery-Revised and other impairment and participation measures were compared using paired t tests. Analyses of variance were used to compare outcomes related to aphasia severity (severe, moderate, and mild aphasia), aphasia type (fluent, nonfluent), and chronicity (0-6 months postonset, 7-12 months postonset, and 12+ months postonset). Participants made significant changes on all impairment and participation measures. Large effect sizes were noted for one participation and three impairment measures. Medium effect sizes were noted for one impairment and three participation measures. There was no significant difference among groups on any factor. ICAPs can have a significant effect on the language impairment and participation of people with aphasia, but further research is required to determine if the effect is comparable to other types of service delivery.

DIAGNOSTIC AND THERAPEUTIC POTENTIAL OF TRANSCRANIAL MAGNETIC STIMULATION IN APHASIC PATIENTS

Speech system is a widely spread and complexly organized system of human brain. Lately new data on morphology, brain cortex functioning and neuroplasticity of speech system have been obtained by using contemporary imaging techniques. Using functional MRI and positron emission tomography (PET) we revealed favorable patterns for recovery of damaged system. The recovery of base speech network realizes through activating perilesional zones and zones of tertiary associative cortex of the dominant hemisphere. The role of right hemispheric homologues of the speech areas in recovery of the communicative function remains equivocal. Transcranial magnetic stimulation (TMS) increased our knowledge about extent and processes of reorganization and functioning of speech system. Repetitive TMS (rTMS) has therapeutic potential. It is a very effective method for recovery of speech disorders. Most professionals use low-frequency inhibiting protocols of rTMS (1-4 Hz). Despite the broad use of this method the best brain areas for application and duration of rTMS procedure are still discussed. Assessment of the degree of brain damage, speech and cognitive status of a patient, type of aphasia, stage of poststroke period, refinement the area for therapeutic application and stimulation type (stimulating or inhibiting) are necessary for application rTMS in the rehabilitation course of patients with poststroke aphasia. Proper use of TMS may positively influence on neuroplasticity, providing functional reorganization of the damaged network and compensation of speech deficiency.

Predicting aphasia type from brain damage measured with structural MRI

Chronic aphasia is a common consequence of a left-hemisphere stroke. Since the early insights by Broca and Wernicke, studying the relationship between the loci of cortical damage and patterns of language impairment has been one of the concerns of aphasiology. We utilized multivariate classification in a cross-validation framework to predict the type of chronic aphasia from the spatial pattern of brain damage. Our sample consisted of 98 patients with five types of aphasia (Broca's, Wernicke's, global, conduction, and anomic), classified based on scores on the Western Aphasia Battery (WAB). Binary lesion maps were obtained from structural MRI scans (obtained at least 6 months poststroke, and within 2 days of behavioural assessment); after spatial normalization, the lesions were parcellated into a disjoint set of brain areas. The proportion of damage to the brain areas was used to classify patients' aphasia type. To create this parcellation, we relied on five brain atlases; our classifier (support vector machine – SVM) could differentiate between different kinds of aphasia using any of the five parcellations. In our sample, the best classification accuracy was obtained when using a novel parcellation that combined two previously published brain atlases, with the first atlas providing the segmentation of grey matter, and the second atlas used to segment the white matter. For each aphasia type, we computed the relative importance of different brain areas for distinguishing it from other aphasia types; our findings were consistent with previously published reports of lesion locations implicated in different types of aphasia. Overall, our results revealed that automated multivariate classification could distinguish between aphasia types based on damage to atlas-defined brain areas.

Japanese Adaptation of the Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39): Comparative Study among Different Types of Aphasia

We have developed a Japanese version of the Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39), designated as SAQOL-39-J, and used psychometric methods to examine its acceptability and reliability. The acceptability and reliability of SAQOL-39-J, which was developed from the English version using a standard translation and back-translation method, were examined in 54 aphasia patients using standard psychometric methods. The acceptability and reliability of SAQOL-39-J were then compared among patients with different types of aphasia. SAQOL-39-J showed good acceptability, internal consistency (Cronbach's α score = .90), and test-retest reliability (intraclass correlation coefficient = .97). Broca's aphasia patients showed the lowest total scores and communication scores on SAQOL-39-J. The Japanese version of SAQOL-39, SAQOL-39-J, provides acceptable and reliable data in Japanese stroke patients with aphasia. Among different types of aphasia, Broca's aphasia patients had the lowest total and communication SAQOL-39-J scores. Further studies are needed to assess the effectiveness of health care interventions on health-related quality of life in this population.

Montreal–Toulouse Language Assessment Battery: Evidence of criterion validity from patients with aphasia

BackgroundThe Montreal–Toulouse Language Assessment Battery — Brazilian version (MTL-BR) provides a general description of language processing and related components in adults with brain injury. ObjectiveThe present study aimed at verifying the criterion-related validity of the Montreal–Toulouse Language Assessment Battery — Brazilian version (MTL-BR) by assessing its ability to discriminate between individuals with unilateral brain damage with and without aphasia. MethodsThe investigation was carried out in a Brazilian community-based sample of 104 adults, divided into four groups: 26 participants with left hemisphere damage (LHD) with aphasia, 25 participants with right hemisphere damage (RHD), 28 with LHD non-aphasic, and 25 healthy adults. ResultsThere were significant differences between patients with aphasia and the other groups on most total and subtotal scores on MTL-BR tasks. ConclusionsThe results showed strong criterion-related validity evidence for the MTL-BR Battery, and provided important information regarding hemispheric specialization and interhemispheric cooperation. Future research is required to search for additional evidence of sensitivity, specificity and validity of the MTL-BR in samples with different types of aphasia and degrees of language impairment.

Constraint-induced aphasia therapy (CIAT): a randomised controlled trial in very early stroke rehabilitation

Background: Communication outcomes following stroke are improved when treatments for aphasia are administered early, within the first 3 months after stroke, and provided for more than 2 hours per week. However, uncertainty remains about the optimal type of aphasia therapy.Aims: We compared constraint-induced aphasia therapy (CIAT) with individual, impairment-based intervention, both administered early and daily after acute stroke.Methods & Procedures: This prospective, single-blinded, randomised, controlled trial recruited participants with mild to severe aphasia within 10 days of an acute stroke from acute/subacute Perth metropolitan hospitals (n = 20). Participants were allocated by computer-generated block randomisation method to either the CIAT (n = 12) or individual, impairment-based intervention group (n = 8) delivered at the same intensity (45–60 min, 5 days a week) for 20 sessions over 5 weeks (15–20 hours total). The primary outcome, measured after completing the intervention, was the Aphasia Quotient (AQ) from the Western Aphasia Battery. Secondary outcomes were the AQ at 12 and 26 weeks post stroke, a Discourse Analysis (DA) score and the Stroke and Aphasia Quality of Life Scale (SAQoL), measured at therapy completion, 12 and 26 weeks post stroke. There was a 10% (n = 2) dropout at the primary end point, both participants were in the CIAT group. The estimates for each treatment group were compared using repeated measures ANOVAs. Data from the 26-week follow-up assessment are presented, however, were not included in the between-group comparisons due to the low number of data points in each group.Outcomes & Results: Within groups analyses comparing performance at baseline, therapy completion, and 12 weeks post stroke revealed a statistically significant treatment effect for the AQ (p < .001), DA (p = .002), and SAQoL (p < .001). Between groups analysis found there was no significant difference between the CIAT and individual therapy groups on any outcome measure.Conclusions: CIAT and individual therapy produced comparable amounts of change in the very early phase of recovery suggesting a standard, intensive daily dose of therapy within this period of recovery is feasible and beneficial. There were no significant differences between the two groups demonstrating that CIAT, which is provided in a group format, may be a viable option in the very early phase of aphasia recovery. The study highlights the need for further research into the impact of therapy type in very early aphasia therapy.

Comprehension of reversible constructions in semantic aphasia

Background: Impairments in spatial processing show themselves not only in gnosis and praxis, but also in the language domain. Such deficit is a characteristic feature of so-called semantic aphasia. The impaired comprehension of semantically reversible constructions in those patients can be explained by a disorder of the common spatial neuropsychological factor grounded in the temporal-parietal-occipital (TPO) regions of the brain.Aims: The aim of the present study was to experimentally test the possibility that individuals with semantic aphasia experience specific difficulties in extracting spatial relations from a linguistic form and rely instead on basic sensorimotor stereotypes to interpret reversible linguistic constructions.Methods & Procedures: Six individuals with semantic aphasia, 12 people with motor aphasia, 12 people with sensory aphasia, and 12 non-brain-damaged individuals performed a sentence–picture matching task; all participants were native speakers of Russian. Two types of reversible sentences were tested, each representing a direct and an inverted word order: prepositional (The boy is putting the bag in the box vs. The boy is putting in the box the bag) and instrumental (The grandmother is covering the scarf with the hat vs. The grandmother is covering with the hat the scarf). Irreversible sentences (The boy is putting the apple in the bag) served as control stimuli.Outcomes & Results: Each group of participants performed better on irreversible than on reversible sentences. Within reversible sentences, an interaction between word order and construction type was found in individuals with semantic aphasia only. They performed more accurately in prepositional constructions with direct word order and in instrumental constructions with inverted word order—both are related to sensorimotor stereotypes reflecting interaction with objects in the real world. Although no such clear dissociation was found in other aphasia types, correlation analysis revealed the same effect in some participants with motor and sensory aphasia.Conclusions: The findings confirm the importance of situational context for linguistic processing. First, if knowledge of the real world supports the unique interpretation of grammatical markers, it enhances processing in all tested cohorts of participants. Second, people with semantic aphasia consistently use sensorimotor stereotypes to compensate for their linguistic deficits. Since this was also found in some participants with other aphasia types, such a sensorimotor strategy might depend not on the damage to TPO areas as such, but on the intactness and overuse of left premotor regions suggested to be critical for motor and symbolic sequential processing.

The participants' perspective: how biographic-narrative intervention influences identity negotiation and quality of life in aphasia.

People with aphasia experience a pronounced decrease in quality of life (QoL). Beyond that identity negotiation is hindered, which is crucial for QoL. Biographic-narrative approaches use life story telling to support identity (re)development after disruptive events like stroke. Because of the language deficits inherent in aphasia such 'talk-based' approaches have to be modified for an optimal use. To evaluate an adapted interdisciplinary biographic-narrative intervention using quantitative measures of health-related quality of life (HRQL) and mood. Additionally, semi-structured interviews were conducted to gain a deeper understanding of identity development processes in people with aphasia. Twenty-seven participants with various types of chronic aphasia were enrolled. The biographic narrative intervention consisted of five face-to-face in-depth interviews and seven group sessions conducted over 10 weeks in a mixed-method design with pre- and post-tests and a follow-up assessment 3 months post-intervention. For quantitative evaluation the Aachen Life Quality Inventory (ALQI), the Satisfaction with Life Scale (SWLS) and the Visual Analog Mood Scales (VAMS) were used. Semi-structured interviews were conducted post-treatment, including questions concerning the participants' experiences with the intervention and identity change. Results were analysed using interpretative principles from Grounded Theory. For all 27 participants, we found significant and stable growth in HRQL. Self-reported states of mood also improved. As expected, overall cognitively based life satisfaction did not change. The interviews revealed two main categories: 'evaluation of the face-to-face interviews' and 'evaluation of the group sessions'. Further analysis found four overlapping main themes which were identified as identity issues: agency, control, disease concept and doing things. Our quantitative and qualitative results demonstrated the benefits associated with the biographic-narrative intervention. The participants' sense of self changed through the approach. The findings provide foundations for future work using biographic narrative interventions to influence QoL and identity renegotiation in people with aphasia.

Speech entrainment compensates for Broca's area damage

Speech entrainment (SE), the online mimicking of an audiovisual speech model, has been shown to increase speech fluency in patients with Broca's aphasia. However, not all individuals with aphasia benefit from SE. The purpose of this study was to identify patterns of cortical damage that predict a positive response SE's fluency-inducing effects. Forty-four chronic patients with left hemisphere stroke (15 female) were included in this study. Participants completed two tasks: 1) spontaneous speech production, and 2) audiovisual SE. Number of different words per minute was calculated as a speech output measure for each task, with the difference between SE and spontaneous speech conditions yielding a measure of fluency improvement. Voxel-wise lesion-symptom mapping (VLSM) was used to relate the number of different words per minute for spontaneous speech, SE, and SE-related improvement to patterns of brain damage in order to predict lesion locations associated with the fluency-inducing response to SE. Individuals with Broca's aphasia demonstrated a significant increase in different words per minute during SE versus spontaneous speech. A similar pattern of improvement was not seen in patients with other types of aphasia. VLSM analysis revealed damage to the inferior frontal gyrus predicted this response. Results suggest that SE exerts its fluency-inducing effects by providing a surrogate target for speech production via internal monitoring processes. Clinically, these results add further support for the use of SE to improve speech production and may help select patients for SE treatment.

CLINICAL SYMPTOMS ON PATIENTS WITH APHASIA CAUSED BY CEREBRAL HEMISPHERE HEMORRHAGE AFTER THE ACUTE PERIOD

Objective: To survey the clinical symptoms on patients with aphasia caused by cerebral hemisphere hemorrhage after the acute period. Subjects: 30 patients were diagnosed aphasia caused by cerebral hemisphere hemorrhage after the acute period in the Traditional Medicine Department of Bach Mai Hospital, from 12/2012 to 12/2013. Method: Cross – sectional descriptive study. Results: The average of age was 59.53 ± 11.19. Male/Female was 2.33. The most common symptoms: paralysis on one side of the body (100%), central facial nerve paralysis (66.7%), sensation disorders (36.7%), bladder or bowel control problems (23.3%). Type of aphasia: nonfluent aphasia/fluent aphasia: 2/1. The degree of damage: 66.7% of patients with severe aphasia (Goodglass and Kaplan) and 100% of patients with severe neurological damage (Orgogozo). The classification according to traditional medicine: Stroke involving the viscera is accounted for 56.7%, stroke involving the meredians type is accounted for 43.3%, excess type is accounted for 53.3%, deficiency type is accounted for 46.7%. Conclusion: Patients with aphasia caused by cerebral hemisphere hemorrhage after the acute period happen frequenty in 50 – 69 years old, men more than women, nonfluent aphasia (transcortical motor aphasia, Broca’s aphasia); stroke involving the viscera and excess type. Keywords: Aphasia, aphasia caused by cerebral hemisphere hemorrhage.