Type Of Aphasia Research Articles

Neuropharmacology In Individual With Aphasia: A Review

Introduction: The neuropharmacology of aphasia is an area of cognitive neuroscience. In this article we review what is known about these domain, especially with regard to treating aphasia with drugs. Neurotransmitters can improve language function in certain patients with aphasia. We discuss which neurotransmitters work for which language functions in which patients.Method: PubMed and Science databases were searched to identify studies investigated effects of drugs on language function in aphasia in peer-reviewed journals between 2000 and 2015. Results: Studies show that Catecholamines seem especially promising for nonfluent aphasias. Dopamine agonists, in particular bromocriptine, improve verbal fluency in transcortical motor aphasia. Norepinephrine affects prefrontal functions and seems to relieve symptoms of depression and improve overall recovery of function, including language, following stroke. Amphetamines potentiate norepinephrine to promote general recovery, and have been shown to improve language performance in some patients with nonfluent aphasia.Conclusion: studies have been looking at the possibility of manipulating brain chemistry for functional gain in patients with aphasia, but, to date, no overwhelming evidence has emerged to support routine use of drugs as either a complementary or alternative treatment for aphasia. Studies have been largely anecdotal with small numbers of patients and varying types of aphasia. Improvements due to spontaneous recovery have been difficult to separate from treatment benefits.

Aphasia's quarrel

Aphasia's quarrel

Corpus-based transitivity biases in individuals with aphasia

ABSTRACTBackground: This study investigated whether individuals with aphasia (IWA) retain verb biases in expressive language. Verb biases refer to the likelihood that a given verb will occur in different sentence structures. We focused on the likelihood of verbs occurring in transitive and intransitive structures.Aims: The main goal of this study was to determine whether IWA and controls show similar verb biases or whether IWA show a preference for transitive or intransitive structures that supersedes individual verb biases. We also investigated whether IWA show a preference for intransitively or transitively biased verbs, whether verb biases differ as a function of aphasia type, and how verb bias affects errors in IWA’s speech production.Methods & Procedures: The current study analysed 236 transcribed interviews of IWA from AphasiaBank. All uses of 54 verbs were coded based on the sentence structure and the presence of errors. We report data from 11 transitively biased and 11 intransitively biased verbs.Outcomes & Results: IWA’s transitivity biases were indistinguishable from controls’ biases. In addition, IWA produced more intransitively biased verbs than transitively biased verbs overall. In ungrammatical productions, IWA’s error rates were higher in sentence structures that conflicted with verb bias and highest when an intransitively biased verb was attempted in a transitive structure.Conclusions: These findings indicate that IWA are sensitive to verb bias and verb complexity within expressive language. The effects are consistent with previous literature concerning IWA’s sensitivity to verb bias in receptive language tasks and to verb complexity in verb retrieval tasks.

The computerized version of the Hong Kong Oxford Cognitive Screen for dementia (HK-OCSd): Estimates of concurrent validity and reliability

The computerized version of the Hong Kong Oxford Cognitive Screen for dementia (HK-OCSd): Estimates of concurrent validity and reliability

Cognitive deficits revealed with the Rus-BCoS and their relationships with language comprehension in fluent and nonfluent aphasia

Cognitive deficits revealed with the Rus-BCoS and their relationships with language comprehension in fluent and nonfluent aphasia

The Russian version of the Oxford Cognitive Screen: validation with stroke survivors

The Russian version of the Oxford Cognitive Screen: validation with stroke survivors

Pure motor aphasia: An uncommon presentation of left middle cerebral artery territory infarct

Middle cerebral artery (MCA) occlusion commonly causes sensory and motor deficits on contralateral side of the body. Aphasia is a common consequence of left hemispheric lesion with a prevalence of one-third of all stroke patients in acute phase. The course and outcome of aphasia depend greatly on the type of aphasia and as in present case, the conservative management including early intensive speech therapy results in spontaneous recovery in speech functions. We report a 35 year old male patient presented with sudden onset of speech abnormality in the form of lack of clarity three days without any improvement or deterioration.

Investigating the Efficiency of Group Therapy on Improving Conversational Skills in People with Aphasia

Investigating the Efficiency of Group Therapy on Improving Conversational Skills in People with Aphasia

Role of Left Hemisphere Language Areas in Visuospatial Working Memory

Role of Left Hemisphere Language Areas in Visuospatial Working Memory

Clinical impression and Western Aphasia Battery classification of aphasia in acute ischemic stroke: Is there a discrepancy?

Background:Language disturbance is a common symptom of stroke, a prompt identifier of the event, and can cause devastating cognitive impairments. There are many inconsistencies and discrepancies between the different methods used for its evaluation. The relationship between Western Aphasia Battery (WAB) and a simple bedside clinical examination is not clear.Aim:The aim of this study is to determine if bedside clinical impression of aphasia type can reliably predict WAB classification of aphasia and to describe the discrepancies between them.Materials and Methods:Eighty-two consecutive cases of acute ischemic stroke and aphasia were evaluated with bedside aphasia assessment, handedness by Edinburgh Handedness Inventory and WAB scoring was done. Kappa statistics was used to find the overall agreement of clinical impression and WAB.Results:Disagreement was seen predominantly for the nonfluent aphasias when the clinical impression was compared with WAB classification. WAB also had diagnosed three cases as having anomic aphasia using taxonomic classification, but same cases had normal language by aphasia quotient scoring of WAB. There was an overall agreement of 63.4% between patient's bedside clinical impression and WAB classification of aphasia, with a P < 0.001.Conclusion:Clinical impression was fairly reliable, as compared to WAB in assessing the type of aphasia. Clinical impression was appropriate in an acute setting, but WAB was required to quantify the severity of deficit, which may help in accessing prognosis, monitoring progression, and rehabilitation planning. Along with WAB, a bedside clinical impression should be done for all the patients to strengthen the description of aphasic deficit.

Subcortical Aphasia After Stroke.

ObjectiveTo evaluate the types and severity of subcortical aphasia after stroke and to determine the predictors of the degree of aphasic impairment.MethodsMedical records of 38 patients with post-stroke subcortical aphasia (19 males; mean age, 61.7±13.8 years) were reviewed retrospectively with respect to the following tests: the Korean version of the Western Aphasia Battery (K-WAB), the Korean version of the Modified Barthel Index (K-MBI), and the Fugl-Meyer Index (FMI). The severity of aphasia was evaluated by the aphasia quotient (AQ) and the language quotient (LQ).ResultsAnomic aphasia was the most frequent type of aphasia (n=15, 39.5%), and the lesion most frequently observed in subcortical aphasia was located in the basal ganglia (n=19, 50.0%). Patients with lesions in the basal ganglia exhibited the lowest scores on the FMI for the upper extremities (p=0.04). Severity of aphasia was significantly correlated with the K-MBI (Pearson correlation coefficient: γ=0.45, p=0.01 for AQ and γ=0.53, p=0.01 for LQ) and FMI scores for the lower extremities (γ=0.43, p=0.03 for AQ and γ=0.49, p=0.05 for LQ). In a multivariate logistic regression analysis, K-MBI remained the only explanatory variable closely associated with aphasia severity.ConclusionThis study showed the general characteristics of post-stroke subcortical aphasia, and it revealed that K-MBI was an associated and explanatory factor for aphasia severity.

Role of cognitive control in language deficits in different types of aphasia

ABSTRACTBackground: Although studies show that different facets of cognitive control are impaired in persons with aphasia (PWA), the question how they impact language abilities in different types of aphasia remains open.Aims: Following the hypothesis that diminished attention contributes to language impairments in aphasia, we predicted that both fluent and non-fluent PWA would perform worse than neurologically intact individuals on verbal and non-verbal cognitive control tasks. Also, testing the view that linguistic disturbances in fluent and non-fluent PWA dissociate, we predicted differential relationships in performance on cognitive control tasks and language impairment.Methods & Procedures: Fluent PWA (N = 17) and non-fluent PWA (N = 14) were compared to unimpaired speakers (N = 21) on the non-verbal Flanker task tapping domain-general cognitive control, and Stroop task measuring verbal cognitive control, as well as subtests from the Russian version of the Birmingham Cognitive Screen, namely the Auditory Control task tapping verbal cognitive control and the Rule Finding task measuring domain-general cognitive control. All PWA completed picture naming and language comprehension tasks.Outcomes & Results: All PWA were more impaired on the Stroop and Auditory Control tasks, with no impairment on the non-verbal Flanker task compared to the controls. Non-fluent PWA also performed significantly worse on the Rule Finding that requires forming and updating non-verbal relational representations. Differences between aphasia groups were found on the Auditory Control task only, where non-fluent PWA were more vulnerable to task demands. Correlation analyses found that verbal and non-verbal cognitive control performance was correlated for the non-fluent group, whereas only correlations between verbal cognitive control tasks were significant for the fluent group. For all PWA, non-verbal cognitive control indexed by Flanker interference scores was related to language comprehension, whereas verbal cognitive control was related to picture naming. However, non-verbal relational reasoning as indexed by the Rule Finding task was significantly related to language comprehension in the non-fluent group only.Conclusions: All PWA had diminished verbal cognitive control. Non-fluent PWA demonstrated higher vulnerability to domain-general cognitive control deficits compared to fluent PWA. Performance on verbal and non-verbal cognitive control tasks significantly overlapped in the non-fluent group only. Both groups recruited non-verbal cognitive control during language comprehension and verbal cognitive control during picture naming. Only non-fluent PWA relied on domain-general relational reasoning during language comprehension. These findings reinforce the importance of cognitive assessment in aphasia.

Cross-Linguistic Differences in a Picture-Description Task Between Korean- and English-Speaking Individuals With Aphasia.

The purpose of the study was to examine cross-linguistic differences in a picture-description task between Korean- and English-speaking individuals with Broca's and anomic aphasia to determine whether a variation exists in the use of verbs and nouns across the language and aphasia groups. Forty-eight individuals (male = 29; female = 19) participated in the study (n = 28 for aphasic group and n = 20 healthy controls). Data for English speakers were obtained from the Aphasia Bank Project. We used the picture-description task to obtain connected speech samples and analyzed noun- and verb-related linguistic variables. Korean speakers with aphasia produced more verbs per utterance and a lower noun-to-verb ratio than English speakers with aphasia, whereas English speakers produced more nouns than Korean speakers. The Korean anomic group produced more verbs than Korean speakers with Broca's aphasia, whereas no effects were significant for English speakers with aphasia depending on the type of aphasia. Aphasia symptoms vary as a function of linguistic features of languages that individuals with aphasia used premorbidly. Furthermore, the linguistic characteristics of the individual's language influenced aphasia symptoms more strongly than the type of aphasia. It is theoretically and clinically important that this cross-linguistic study provides different perspectives, and that noun-verb deficits may vary depending on linguistic features.

The unbridged gap between clinical diagnosis and contemporary research on aphasia: A short discussion on the validity and clinical utility of taxonomic categories

Even if the traditional aphasia classification is continuously questioned by many scholars, it remains widely accepted among clinicians and included in textbooks as the gold standard. The present study aims to investigate the validity and clinical utility of this taxonomy. For this purpose, 65 left-hemisphere stroke patients were assessed and classified with respect to aphasia type based on performance on a Greek adaptation of the Boston Diagnostic Aphasia Examination. MRI and/or CT scans were obtained for each patient and lesions were identified and coded according to location. Results indicate that 26.5% of the aphasic profiles remained unclassified. More importantly, we failed to confirm the traditional lesion-to-syndrome correspondence for 63.5% of patients. Overall, our findings elucidate crucial vulnerabilities of the neo-associationist classification, and further support a deficit-rather than a syndrome-based approach. The issue of unclassifiable patients is also discussed.

Automated Proposition Density Analysis for Discourse in Aphasia.

This study evaluates how proposition density can differentiate between persons with aphasia (PWA) and individuals in a control group, as well as among subtypes of aphasia, on the basis of procedural discourse and personal narratives collected from large samples of participants. Participants were 195 PWA and 168 individuals in a control group from the AphasiaBank database. PWA represented 6 aphasia types on the basis of the Western Aphasia Battery-Revised (Kertesz, 2006). Narrative samples were stroke stories for PWA and illness or injury stories for individuals in the control group. Procedural samples were from the peanut-butter-and-jelly-sandwich task. Language samples were transcribed using Codes for the Human Analysis of Transcripts (MacWhinney, 2000) and analyzed using Computerized Language Analysis (MacWhinney, 2000), which automatically computes proposition density (PD) using rules developed for automatic PD measurement by the Computerized Propositional Idea Density Rater program (Brown, Snodgrass, & Covington, 2007; Covington, 2007). Participants in the control group scored significantly higher than PWA on both tasks. PD scores were significantly different among the aphasia types for both tasks. Pairwise comparisons for both discourse tasks revealed that PD scores for the Broca's group were significantly lower than those for all groups except Transcortical Motor. No significant quadratic or linear association between PD and severity was found. Proposition density is differentially sensitive to aphasia type and most clearly differentiates individuals with Broca's aphasia from the other groups.

Why Broca's Area Damage Does Not Result in Classical Broca's Aphasia

Why Broca's Area Damage Does Not Result in Classical Broca's Aphasia

Empowering Individuals with Aphasia and Visual Impairments through Effective Communication

Advances in medicine have enabled an aging population to survive neurological events such as strokes more frequently. Consequences of a stroke can be widespread and severe, and it is currently the leading cause of long-term disability in Canada (Public Health Agency of Canada [PHAC], 2011). The PHAC report indicated that in 2009 approximately 315,000 Canadians were living with the consequences of strokes (PHAC, 2011). Consequences of strokes may include hemiplegia, reduced cognition and emotional control, difficulty with language (aphasia), and visual impairment, to list a few of the impairments and disabilities that may occur (Warren, 2008). To address the needs of individuals with language impairments resulting from strokes, there is a need for low vision rehabilitation professionals (optometrists, ophthalmologists, low vision therapists, high technology assessors, orientation and mobility instructors, rehabilitation counsellors, independent living skills teachers, and occupational and physical therapists) to become familiar with the impact of neurological events on an individual's ability to communicate. An individual who has survived a stroke may be left with multiple impairments including those that affect vision and communication. Visual impairment is a possible result, and it may present as a defect of visual fields, impaired eye movements, and problems with perception or cortical blindness (Hillis, 2007; Jones & Shinton, 2006; Rowe et al., 2009). Up to a quarter of stroke survivors may have vision loss, according to the National Stroke Association (2012). It is not unusual to encounter patients who had a neurological event with multiple impairments (including vision loss) when assessing and implementing a low vision rehabilitation plan. This report describes some communication strategies that may be utilized to create a successful low vision rehabilitation assessment and plan for a patient with a coexisting visual impairment and aphasia following a stroke. WHAT IS APHASIA? Following a neurological event, some individuals experience aphasia, which is an acquired condition following damage to the speech and language areas in the brain and which affects a person's ability to communicate (Hillis, 2007). It is a problem with language, not intelligence (National Aphasia Association, 2015). The areas of the brain that are responsible for language are found on the left side (Damasio, 1992; Hillis, 2007). Individuals with aphasia may have difficulties speaking, understanding what others are saying, and problems with reading and writing. Due to the complex nature of communication, there are several different classifications of aphasia that are widely disputed (Ardila, 2010; Marshall, 2010). The broad and more classic classification used by the National Aphasia Association (2015), the Heart and Stroke Foundation (2013), the American Heart Association (2015), and the National Institute on Deafness and Other Communication Disorders (NIDCD, 2010) when discussing aphasia with the lay community includes three types: expressive aphasia, receptive aphasia, and global aphasia. Expressive aphasia Individuals with expressive aphasia are typically able to understand what is being communicated to them, but have difficulty or are unable to respond either verbally or in writing. This is also known as Broca's aphasia (attributed to the person who discovered the condition and the area of the brain that is thought to be affected) or nonfluent aphasia (as individuals with this type of aphasia exhibit great effort when attempting to speak). Any phrases that the individual uses are generally understood by their unaffected conversational partner, but speaking is very difficult, laborious, and slow. Individuals with expressive aphasia typically choose the correct nouns, but small words are often improperly used (Damasio, 1992; Hillis, 2007). There is a reduction in the length of the sentences expressed (Hillis, 2007). …

Who Benefits From an Intensive Comprehensive Aphasia Program?

Purpose: This article summarizes current outcomes from intensive comprehensive aphasia programs (ICAPs) and examines data from one ICAP to identify those who respond and do not respond to treatment. Methods: Participants were divided into 2 groups, responders and nonresponders, based on ±5-point change score on the Western Aphasia Battery–Revised Aphasia Quotient. Independent-samples t tests and χ2 tests were performed to identify differences between groups on demographic (age and gender) and aphasia-related factors (months postonset, type of aphasia, aphasia severity, naming, nonverbal cognition measure, and self-rating of communication confidence). Logistic regression determined if factors contributed to a treatment response. Results: There were significant differences between the groups on age and months postonset. Gender, type of aphasia, naming, nonverbal cognitive measure, and communication confidence were not significantly different. Logistic regression indicated that age was the only predictive factor contributing to treatment response. Conclusions: This study only identified age as a predictor of responders. Future research may need to examine a broader scope of variables that can impact recovery in aphasia.

A Review of Verb Network Strengthening Treatment

This article examines Verb Network Strengthening Treatment (VNeST), a relatively new treatment approach for anomia in people with aphasia. The VNeST protocol aims to promote generalization to increased lexical retrieval of untrained words across a hierarchy of linguistic tasks, including single-word naming of nouns and verbs, sentence production, and discourse. The concept of the verb network relates to the centrality of the verb to the semantics and syntax of a sentence. The VNeST protocol elicits diverse agents (e.g., musician) and patients (e.g., tambourine) around trained verbs (e.g., shake) to activate a range of semantic concepts and personal responses to potentially facilitate generalization to a multitude of lexical items. The pre- and posttreatment generalization results for the 19 participants reported in English are analyzed. Participants represent a range of aphasia severities and types, including Broca's, transcortical motor, anomic, Wernicke's, and conduction aphasia. A previous study that evaluated 3 monolingual Korean speakers on a modified version of VNeST that accommodated Korean's verb final word order is also summarized. The findings across the 5 English studies and the Korean study revealed increased noun and verb naming and lexical retrieval in sentences and discourse on untrained items and tasks for more than half of the participants, suggesting preliminary efficacy for VNeST. Potential predictors and mechanisms of improvement are explored, and clinical implications, including consideration of goals, outcome measures, dosage, inclusion and evaluation of writing, and verb selection, are discussed.

Nursing research progress of early language rehabilitation training in patients with motor aphasia

Motor aphasia, known as Broca aphasia, is a common type of aphasia. Early language rehabilitation training can maximumly improve language function and have a positive impact on patients′ daily life. This paper would review the aphasia language characteristics, classification, diagnosis and early language rehabilitation training and nursing care of patients. Key words: Reviews; Motor aphasia; Early language rehabilitation training; Nursing