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Li TT, Zhang PP, Zhang MC, Zhang H, Wang HY, Yuan Y, Wu SL, Wang XW, Sun ZG. Meta-analysis and systematic review of the relationship between sex and the risk or incidence of poststroke aphasia and its types. BMC Geriatr 2024; 24:220. [PMID: 38438862 PMCID: PMC10910787 DOI: 10.1186/s12877-024-04765-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/31/2024] [Indexed: 03/06/2024] Open
Abstract
OBJECTIVE To analyse and discuss the association of gender differences with the risk and incidence of poststroke aphasia (PSA) and its types, and to provide evidence-based guidance for the prevention and treatment of poststroke aphasia in clinical practice. DATA SOURCES Embase, PubMed, Cochrane Library and Web of Science were searched from January 1, 2002, to December 1, 2023. STUDY SELECTION Including the total number of strokes, aphasia, the number of different sexes or the number of PSA corresponding to different sex. DATA EXTRACTION Studies with missing data, aphasia caused by nonstroke and noncompliance with the requirements of literature types were excluded. DATA SYNTHESIS 36 papers were included, from 19 countries. The analysis of 168,259 patients with stroke and 31,058 patients with PSA showed that the risk of PSA was 1.23 times higher in female than in male (OR = 1.23, 95% CI = 1.19-1.29, P < 0.001), with a prevalence of PSA of 31% in men and 36% in women, and an overall prevalence of 34% (P < 0.001). Analysis of the risk of the different types of aphasia in 1,048 patients with PSA showed a high risk in females for global, broca and Wenicke aphasia, and a high risk in males for anomic, conductive and transcortical aphasia, which was not statistically significant by meta-analysis. The incidence of global aphasia (males vs. females, 29% vs. 32%) and broca aphasia (17% vs 19%) were higher in females, and anomic aphasia (19% vs 14%) was higher in males, which was statistically significant (P < 0.05). CONCLUSIONS There are gender differences in the incidence and types of PSA. The risk of PSA in female is higher than that in male.
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Affiliation(s)
- Ting-Ting Li
- School of Rehabilitation Medicine, Shandong Second Medical University, Weifang, China
| | - Ping-Ping Zhang
- Shanghai University of Medicine & Health Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ming-Chen Zhang
- School of Rehabilitation Medicine, Shandong Second Medical University, Weifang, China
| | - Hui Zhang
- School of Rehabilitation Medicine, Shandong Second Medical University, Weifang, China
| | - Hong-Ying Wang
- School of Rehabilitation Medicine, Shandong Second Medical University, Weifang, China
| | - Ying Yuan
- School of Rehabilitation Medicine, Shandong Second Medical University, Weifang, China
| | - Shan-Lin Wu
- School of Rehabilitation Medicine, Shandong Second Medical University, Weifang, China
| | - Xiao-Wen Wang
- School of Rehabilitation Medicine, Shandong Second Medical University, Weifang, China.
| | - Zhong-Guang Sun
- School of Rehabilitation Medicine, Shandong Second Medical University, Weifang, China.
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Okazaki K, Nakamura S, Koyano K, Konishi Y, Kondo M, Kusaka T. Neonatal asphyxia as an inflammatory disease: Reactive oxygen species and cytokines. Front Pediatr 2023; 11:1070743. [PMID: 36776908 PMCID: PMC9911547 DOI: 10.3389/fped.2023.1070743] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 01/10/2023] [Indexed: 01/28/2023] Open
Abstract
Neonatologists resuscitate asphyxiated neonates by every available means, including positive ventilation, oxygen therapy, and drugs. Asphyxiated neonates sometimes present symptoms that mimic those of inflammation, such as fever and edema. The main pathophysiology of the asphyxia is inflammation caused by hypoxic-ischemic reperfusion. At birth or in the perinatal period, neonates may suffer several, hypoxic insults, which can activate inflammatory cells and inflammatory mediator production leading to the release of larger quantities of reactive oxygen species (ROS). This in turn triggers the production of oxygen stress-induced high mobility group box-1 (HMGB-1), an endogenous damage-associated molecular patterns (DAMPs) protein bound to toll-like receptor (TLR) -4, which activates nuclear factor-kappa B (NF-κB), resulting in the production of excess inflammatory mediators. ROS and inflammatory mediators are produced not only in activated inflammatory cells but also in non-immune cells, such as endothelial cells. Hypothermia inhibits pro-inflammatory mediators. A combination therapy of hypothermia and medications, such as erythropoietin and melatonin, is attracting attention now. These medications have both anti-oxidant and anti-inflammatory effects. As the inflammatory response and oxidative stress play a critical role in the pathophysiology of neonatal asphyxia, these drugs may contribute to improving patient outcomes.
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Affiliation(s)
- Kaoru Okazaki
- Department of Neonatology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Shinji Nakamura
- Department of Pediatrics, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Kosuke Koyano
- Maternal Perinatal Center, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Yukihiko Konishi
- Department of Pediatrics, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Masatoshi Kondo
- Department of Neonatology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Takashi Kusaka
- Department of Pediatrics, Faculty of Medicine, Kagawa University, Kagawa, Japan
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Hounslow R, Rohde A, Finch E. What is the usage of the Brisbane Evidence Based Language Test in clinical practice?: A speech language therapy survey. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023. [PMID: 36703552 DOI: 10.1111/1460-6984.12847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 01/03/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND A number of practice barriers (e.g., time constraints, patient comorbidities and competing demands) exist as regards the evidence-based assessment of adult language within the acute hospital setting. There is need for an evidence-based, diagnostically validated, adaptable, comprehensive and efficient aphasia assessment. The Brisbane Evidence Based Language Test (EBLT) was developed to meet this need for a clinically appropriate and diagnostically robust assessment measure. Since the release of the EBLT, there has been no detailed investigation into speech and language therapists' (SLT) use and perceptions of the assessment. To inform future research and improvements to the EBLT, a better understanding of current language assessment practices, use and thoughts on the EBLT are required. AIMS To investigate SLTs' current language assessment practices; and to explore the current usage and future directions of the Brisbane EBLT. METHODS & PROCEDURES A convergent parallel mixed-methods study design with an electronic survey was utilized. The survey consisted of 16 multiple-choice, multiple-answer and free-text questions that explored respondents' perceptions of current language assessment measures, ideal language assessment features, Brisbane EBLT use, positives and negatives, and future directions for the EBLT. The survey was developed on Qualtrics and disseminated via email, social media and professional networks. Snowball sampling was used. Study inclusion criteria required participants to be qualified SLTs with clinical experience working with patients with aphasia. Quantitative data were analysed via descriptive and correlative statistics, and qualitative data were analysed via content analysis. OUTCOMES & RESULTS The survey was completed by 115 SLTs from Australia, New Zealand, the United States, the UK, Canada, France, Lebanon and Belgium. Many respondents identified that a range of assessments is required to meet SLT clinical needs in the assessment of aphasia. Key desirable assessment features reported were: comprehensive, efficient, evidence-based, responsive and flexible. The EBLT was the most frequently used standardized measure reported by respondents (used by 78.63%). The EBLT reportedly has many positive features; however, respondents indicated dislike of the form layout, scoring and responsiveness. The majority of respondents indicated that the development of additional EBLT tests (94.29%) and additional cut-off scores (95.15%) would benefit their clinical practice. CONCLUSIONS & IMPLICATIONS The study findings indicate that SLT assessment of language is complex and multifaceted. While the EBLT is reportedly used widely by SLTs, respondents identified areas for further research which would optimize the test's usability within their practice, to ultimately improve patient outcomes. WHAT THIS PAPER ADDS What is already known on the subject Previous studies have explored existing SLT adult language assessment practices within acute settings; however, the most recent comprehensive study was completed in 2010. In 2020, the development, diagnostic validation, intra- and interrater reliability of the Brisbane EBLT were published. As of yet there has not been an investigation into clinician use and perspectives of the assessment since its release. What this paper adds to existing knowledge This study provides contemporary data about international aphasia assessment practices, as well as descriptive and qualitative information on the current use of the Brisbane EBLT, and the positives, negatives, and future directions for the assessment measure. What are the potential or actual clinical implications of this work? The study suggests that no one language assessment currently satisfies all SLTs' assessment needs. It additionally implies that a large proportion of SLTs believe that it is best practice to use multiple language assessment measures and select these based on the patient's presentation and context. Further research is required to aid the development of additional EBLT test versions and cut-off scores to improve SLT adult language assessment practices.
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Affiliation(s)
- Rhiannon Hounslow
- School of Health and Rehabilitation Sciences, The University, of Queensland, Brisbane, QLD, Australia
| | - Alexia Rohde
- Australian Centre for Health Services Innovation, Kelvin Grove, QLD, Australia
- School of Public Health and Social Work, Brisbane, QLD, Australia
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Emma Finch
- School of Health and Rehabilitation Sciences, The University, of Queensland, Brisbane, QLD, Australia
- Speech Pathology Department Princess Alexandra Hospital, Brisbane, QLD, Australia
- Centre for Functioning and Health Research, Metro South Health, Brisbane, QLD, Australia
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Cross-validation of predictive models for functional recovery after post-stroke rehabilitation. J Neuroeng Rehabil 2022; 19:96. [PMID: 36071452 PMCID: PMC9454118 DOI: 10.1186/s12984-022-01075-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 07/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background Rehabilitation treatments and services are essential for the recovery of post-stroke patients’ functions; however, the increasing number of available therapies and the lack of consensus among outcome measures compromises the possibility to determine an appropriate level of evidence. Machine learning techniques for prognostic applications offer accurate and interpretable predictions, supporting the clinical decision for personalised treatment. The aim of this study is to develop and cross-validate predictive models for the functional prognosis of patients, highlighting the contributions of each predictor.
Methods A dataset of 278 post-stroke patients was used for the prediction of the class transition, obtained from the modified Barthel Index. Four classification algorithms were cross-validated and compared. On the best performing model on the validation set, an analysis of predictors contribution was conducted. Results The Random Forest obtained the best overall results on the accuracy (76.2%), balanced accuracy (74.3%), sensitivity (0.80), and specificity (0.68). The combination of all the classification results on the test set, by weighted voting, reached 80.2% accuracy. The predictors analysis applied on the Support Vector Machine, showed that a good trunk control and communication level, and the absence of bedsores retain the major contribution in the prediction of a good functional outcome. Conclusions Despite a more comprehensive assessment of the patients is needed, this work paves the way for the implementation of solutions for clinical decision support in the rehabilitation of post-stroke patients. Indeed, offering good prognostic accuracies for class transition and patient-wise view of the predictors contributions, it might help in a personalised optimisation of the patients’ rehabilitation path.
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A Comparative Analysis of Functional Status and Mobility in Stroke Patients with and without Aphasia. J Clin Med 2022; 11:jcm11123478. [PMID: 35743548 PMCID: PMC9225387 DOI: 10.3390/jcm11123478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/04/2022] [Accepted: 06/15/2022] [Indexed: 11/16/2022] Open
Abstract
All researchers agree that aphasia is a serious consequence of a stroke, but they also report contradictory data regarding the functional outcome. The aim of this study was, therefore, to assess the functional outcomes of stroke patients with and without aphasia, who were undertaking a regular rehabilitation programme. MATERIALS AND METHODS The study group consisted of 116 post-stroke patients, including 54 patients without aphasia (G1) and 62 patients with aphasia (G2). The following tests were used before (T1) and after (T2) rehabilitation measurement points: Barthel Index (BI), Sitting Assessment Scale (SAS), Berg Balance Scale (BBS), Trunk Control Test (TCT), Test Up & Go (TUG) and the Timed Walk Test (TWT). RESULTS The group of post-stroke patients with aphasia had a significantly longer time since a stroke on admission, a significantly longer length of stay in the ward and significantly worse SAS and TCT scores at T2, compared to patients without aphasia. Both groups achieved significant improvement in all studied parameters (SAS, TCT, BI, BBS, TUG and TWT). Aphasia was a predictor of functional status in the stroke patients group, but only at the time of admission to the ward. CONCLUSIONS Patients with and without aphasia have an equal likelihood of improving their functional status and returning to independence. Aphasia should not be an absolute factor that excludes stroke patients from research studies on their functional status.
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Xu S, Yan Z, Pan Y, Yang Q, Liu Z, Gao J, Yang Y, Wu Y, Zhang Y, Wang J, Zhuang R, Li C, Zhang Y, Jia J. Associations between Upper Extremity Motor Function and Aphasia after Stroke: A Multicenter Cross-Sectional Study. Behav Neurol 2021; 2021:9417173. [PMID: 34795804 PMCID: PMC8595012 DOI: 10.1155/2021/9417173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/08/2021] [Accepted: 10/18/2021] [Indexed: 12/21/2022] Open
Abstract
METHODS Patients with stroke were compared and correlated from overall and three periods (1-3 months, 4-6 months, and >6 months). Fugl-Meyer assessment for the upper extremity (FMA-UE) and action research and arm test (ARAT) were used to compare the UE motor status between patients with PSA and without PSA through a cross-sectional study among 435 patients. Then, the correlations between the evaluation scale scores of UE motor status and language function of patients with PSA were analyzed in various dimensions, and the language subfunction most closely related to UE motor function was analyzed by multiple linear regression analysis. RESULTS We found that the scores of FMA-UE and ARAT in patients with PSA were 14 points ((CI) 10 to 18, p < 0.001) and 11 points lower ((CI) 8 to 13, p < 0.001), respectively, than those without PSA. Their FMA-UE (r = 0.70, p < 0.001) and ARAT (r = 0.62, p < 0.001) scores were positively correlated with language function. Regression analysis demonstrated that spontaneous speech ability may account for UE motor function (R 2 = 0.51, p < 0.001; R 2 = 0.42, p < 0.001). Consistent results were also obtained from the analyses within the three time subgroups. CONCLUSION Stroke patients with PSA have worse UE motor performance. UE motor status and language function showed positive correlations, in which spontaneous speech ability significantly accounts for the associations.
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Affiliation(s)
- Shuo Xu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhijie Yan
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Xinxiang Medical University, Xinxiang, China
| | - Yongquan Pan
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Qing Yang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhilan Liu
- Department of Rehabilitation Medicine, Shanghai Fourth Rehabilitation Hospital, Shanghai, China
| | - Jiajia Gao
- Department of Neurorehabilitation, The Shanghai Third Rehabilitation Hospital, Shanghai, China
| | - Yanhui Yang
- Department of Rehabilitation Medicine, Shaanxi Provincial Rehabilitation Hospital, Shaanxi, China
| | - Yufen Wu
- Department of Rehabilitation Medicine, Liuzhou Traditional Chinese Medicine Hospital, Guangxi, China
| | - Yanan Zhang
- Department of Rehabilitation Medicine, The Third Affiliated Clinical Hospital of Changchun University of Chinese Medicine, Jilin, China
| | - Jianhui Wang
- Department of Rehabilitation Medicine, Nanshi Hospital Affiliated to Henan University, Henan, China
| | - Ren Zhuang
- Department of Rehabilitation Medicine, Changzhou Dean Hospital, Jiangsu, China
| | - Chong Li
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Shanghai University of Sport, Shanghai, China
| | - Yongli Zhang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Fujian University of Traditional Chinese Medicine, Fujian, China
| | - Jie Jia
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, China
- National Center for Neurological Disorders, Shanghai, China
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German Language Adaptation of the NAVS (NAVS-G) and of the NAT (NAT-G): Testing Grammar in Aphasia. Brain Sci 2021; 11:brainsci11040474. [PMID: 33918022 PMCID: PMC8069474 DOI: 10.3390/brainsci11040474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/02/2021] [Accepted: 04/04/2021] [Indexed: 11/17/2022] Open
Abstract
Grammar provides the framework for understanding and producing language. In aphasia, an acquired language disorder, grammatical deficits are diversified and widespread. However, the few assessments for testing grammar in the German language do not consider current linguistic, psycholinguistic, and functional imaging data, which have been shown to be crucial for effective treatment. This study developed German language versions of the Northwestern Assessment of Verbs and Sentences (NAVS-G) and the Northwestern Anagram Test (NAT-G) to examine comprehension and production of verbs, controlling for the number and optionality of verb arguments, and sentences with increasing syntactic complexity. The NAVS-G and NAT-G were tested in 27 healthy participants, 15 right hemispheric stroke patients without aphasia, and 15 stroke patients with mild to residual aphasia. Participants without aphasia showed near-perfect performance, with the exception of (object) relative sentences, where accuracy was associated with educational level. In each patient with aphasia, deficits in more than one subtest were observed. The within and between population-groups logistic mixed regression analyses identified significant impairments in processing syntactic complexity at the verb and sentence levels. These findings indicate that the NAVS-G and NAT-G have potential for testing grammatical competence in (German) stroke patients.
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Huang J, Qin X, Shen M, Huang Y. An overview of systematic reviews and meta-analyses on acupuncture for post-stroke aphasia. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Aravantinou-Fatorou K, Fotakopoulos G. Efficacy of exercise rehabilitation program accompanied by experiential music for recovery of aphasia in single cerebrovascular accidents: a randomized controlled trial. Ir J Med Sci 2020; 190:771-778. [PMID: 32740716 DOI: 10.1007/s11845-020-02328-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 07/23/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The current study aims to evaluate the effects of daily traditional experiential music listening for clinical recovery of post-stroke aphasia. METHODS This was a prospective randomized trial with seventy-nine stroke survivors who suffered from post-stroke aphasia. All patients underwent a neuropsychological evaluation, at time = 0 during the admission at the rehabilitation structure (baseline), and 6 months post-stroke. All cases received standard treatment for stroke and post-stroke aphasia in terms of medical care and rehabilitation. Furthermore, patients were randomized to receive either standard care only or standard care with daily traditional experiential music listening. Computer tomography perfusion and neurological examination were assessed to all patients. Recovery was measured by the score at Aachener Aphasie Test. RESULTS The statistically significant differences between the control group (CG) and the rest of the patients were the clinical characteristics (hemiparesis) (p = 0.002), the cerebral blood flow in affected areas (p = 0.000), and the Mini-Mental Test (mMT) (p = 0.000). Only group and mMT were independent predictor factors for recovery, according to multivariate analysis odd ratio (ΟR) (95% confidence interval) 0.022 (0.009-0.435) and 0.658 (0.142-0.224) respectively. CONCLUSIONS The results of this study are promising and suggest that an enriched sound environment is beneficial for patients with post-stroke aphasia since the recovery rate is higher when standard care was combined with daily music listening.
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Affiliation(s)
| | - George Fotakopoulos
- Department of Neurosurgery, General Hospital of Pyrgos 'Andreas Papandreou', Sintriada, 27100, Pyrgos Ilias, Greece. .,, Pyrgos Ilias, Greece.
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Øra HP, Kirmess M, Brady MC, Sørli H, Becker F. Technical Features, Feasibility, and Acceptability of Augmented Telerehabilitation in Post-stroke Aphasia-Experiences From a Randomized Controlled Trial. Front Neurol 2020; 11:671. [PMID: 32849176 PMCID: PMC7411384 DOI: 10.3389/fneur.2020.00671] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 06/05/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Post-stroke aphasia is a communication disorder where existing evidence favors intensive therapy methods. Telerehabilitation represents a service model for geographically remote settings, or other barriers to clinic attendance or to facilitate an augmentation of therapy across a continuum of care. Evidence to support efficiency, feasibility, and acceptability is however still scarce. Appraising aphasia telerehabilitation in controlled trials beyond its effectiveness, by investigating feasibility and acceptability, may facilitate implementation into clinical practice. Methods: In our pilot randomized controlled trial, we investigated the feasibility and acceptability of speech and language therapy by videoconference, in addition to usual care, in people with aphasia following stroke. To improve functional, expressive language, a tailored intervention was given 1 h per day, five times per week over four consecutive weeks. Feasibility measures included evaluation of technical setup using diary logs. Acceptability was investigated by examining adherence and satisfaction with therapy alongside evaluation of data safety and privacy. Results: Feasibility and acceptability data were collected in relation to 556.5 h of telerehabilitation delivered to 30 participants over a 2-years intervention period by three speech-language pathologists. Protocol adherence was high, with a tolerable technical fault rate; 86 faults were registered over 541 video sessions. Most (80%; n = 30) of the participants experienced zero to three faults. The main cause of technical failures was flawed internet connection, causing delayed or interrupted therapy. Total satisfaction with telerehabilitation was rated good or very good by 93.1% (n = 29) of participants and two of three speech-language pathologists. Within a moderate variance of technical failure, participants experiencing more faults were more satisfied. No serious events regarding security and privacy were reported. Our model is feasibly and ready to be implemented across a range of clinical settings and contexts. Conclusions: Synchronous telerehabilitation for post-stroke aphasia is feasible and acceptable and shows tolerable technical fault rates with high satisfaction among patients and pathologists. Within a low rate of faults, satisfaction was not negatively influenced by fault frequency. Access to clinical and technical expertise is needed when developing telerehabilitation services. Telerehabilitation may be a viable service delivery model for aphasia rehabilitation. Trial Registration: ClinicalTrials.gov, ID: NCT02768922.
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Affiliation(s)
- Hege Prag Øra
- Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Melanie Kirmess
- Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.,Department of Special Needs Education, University of Oslo, Oslo, Norway
| | - Marian C Brady
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Hilde Sørli
- Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Frank Becker
- Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Clinical and neuroimaging factors associated with aphasia severity in stroke patients: diffusion tensor imaging study. Sci Rep 2020; 10:12874. [PMID: 32733102 PMCID: PMC7393375 DOI: 10.1038/s41598-020-69741-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 07/13/2020] [Indexed: 11/24/2022] Open
Abstract
This study investigated factors associated with aphasia severity at both 2 weeks and 3 months after stroke using demographic and clinical variables, brain diffusion tensor imaging (DTI) parameters, and lesion volume measurements. Patients with left hemisphere stroke were assessed at 2 weeks (n = 68) and at 3 months (n = 20) after stroke. Demographic, clinical, and neuroimaging data were collected; language functions were assessed using the Western Aphasia Battery. For neuroimaging, DTI parameters, including the laterality index (LI) of fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity, mean diffusivity and fibre density (FD) of the arcuate fasciculus (AF), and lesion volume, were measured. Lesion volume, cortical involvement, and the National Institutes of Health Stroke Scale score significantly predicted aphasia severity at 2 weeks after stroke, whereas the aphasia quotient and presence of depression during the early subacute stage were significant predictors at 3 months after stroke. According to Pearson correlation, LI-AD and LI-FD were significantly correlated with the aphasia quotient 2 weeks after ischaemic stroke, and the LI-FA was significantly correlated with the aphasia quotient 2 weeks after haemorrhagic stroke, suggesting that the extent and mechanism of AF injuries differ between ischaemic and haemorrhagic strokes. These differences may contribute to aphasia severity.
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Seo KC, Ko JY, Kim TU, Lee SJ, Hyun JK, Kim SY. Post-stroke Aphasia as a Prognostic Factor for Cognitive and Functional Changes in Patients With Stroke: Ischemic Versus Hemorrhagic. Ann Rehabil Med 2020; 44:171-180. [PMID: 32640781 PMCID: PMC7349037 DOI: 10.5535/arm.19096] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 09/20/2019] [Indexed: 12/15/2022] Open
Abstract
Objective To investigate the comprehensive outcomes in aphasic patients, including their cognitive and functional status after ischemic or hemorrhagic stroke. It also aimed to clarify whether aphasia is a prognostic factor for cognitive and functional improvements in stroke patients. Methods Sixty-seven ischemic or hemorrhagic stroke patients in the subacute stage who had been diagnosed with aphasia using the Korean version of Frenchay Aphasia Screening Test (K-FAST) were included in the study. Forty-six stroke patients without aphasia were used as controls. All patients were examined with the Korean version of the Western Aphasia Battery (K-WAB). Cognitive and functional assessments of the patients including the Korean version of Mini-Mental State Examination (K-MMSE), and the Korean version of Modified Barthel Index (K-MBI) were performed during admission and 4 weeks after the initial assessments. Results The initial and follow-up total K-MMSE and K-MBI scores were significantly lower in aphasic patients than in non-aphasic controls. The K-WAB scores highly correlated with the total K-MMSE scores at the follow-up stage in all aphasic stroke patients. The K-WAB scores moderately correlated with the follow-up scores of the K-MBI in ischemic stroke patients but not in hemorrhagic stroke patients. Conclusion Aphasia influences the cognitive and functional status of stroke patients and has a greater impact on cognitive improvement. Aphasia severity can be one of the prognostic factors for cognitive status in aphasic patients with stroke.
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Affiliation(s)
- Kyung Cheon Seo
- Department of Rehabilitation Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Joo Young Ko
- Department of Rehabilitation Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Tae Uk Kim
- Department of Rehabilitation Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Seong Jae Lee
- Department of Rehabilitation Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Jung Keun Hyun
- Department of Rehabilitation Medicine, Dankook University College of Medicine, Cheonan, Korea.,Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan, Korea.,Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan, Korea
| | - Seo Young Kim
- Department of Rehabilitation Medicine, Dankook University College of Medicine, Cheonan, Korea
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Ginex V, Gilardone G, Viganò M, Monti A, Judica E, Passaro I, Gilardone M, Vanacore N, Corbo M. Interaction Between Recovery of Motor and Language Abilities After Stroke. Arch Phys Med Rehabil 2020; 101:1367-1376. [PMID: 32417441 DOI: 10.1016/j.apmr.2020.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 03/27/2020] [Accepted: 04/17/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To analyze the nature of the interaction between motor and language recovery in patients with motor impairment and aphasia following left hemispheric stroke and to investigate prognostic factors of best recovery, that is, the significant recovery of both functions simultaneously. DESIGN Retrospective cohort study. SETTING Specialized inpatient rehabilitation facility. PARTICIPANTS Patients (N=435) with left hemispheric stroke in the postacute phase with motor impairment and aphasia. INTERVENTION Not applicable. MAIN OUTCOME MEASURE Patients who reached the minimal clinically important difference in the motor-FIM (M-FIM) were classified as motor responders, patients who reached a significant change in Aachen Aphasia Test were classified as language responders, and patients who reached a simultaneous and significant improvement in both functions were classified as motor and language responders. RESULTS Of the sample 45% were motor responders, 58% were language responders, and 35% were motor and language responders. Responder groups showed lower motor impairment and less severe aphasia at admission and greater improvement in both functions at discharge compared with nonresponder groups. Premorbid autonomy, dysphagia, apraxia, and number of rehabilitative sessions were also significantly different between groups. A logistic regression model identified M-FIM, repetition abilities, and number of sessions of speech and language therapy as independent predictors of best response (ie, motor and language responders). CONCLUSIONS This study provides evidence about a possible interaction between motor and language recovery after stroke. The improvement in one function was never associated with deterioration in the other. The results actually suggest a synergic effect between the amelioration of the 2 functions, with an overall increased efficiency when the 2 recovery pathways are combined.
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Affiliation(s)
- Valeria Ginex
- Casa Cura Policlinico, Department of Neurorehabilitation Sciences, Milan, Italy.
| | - Giulia Gilardone
- Casa Cura Policlinico, Department of Neurorehabilitation Sciences, Milan, Italy
| | - Mauro Viganò
- Casa Cura Policlinico, Department of Neurorehabilitation Sciences, Milan, Italy
| | - Alessia Monti
- Casa Cura Policlinico, Department of Neurorehabilitation Sciences, Milan, Italy
| | - Elda Judica
- Casa Cura Policlinico, Department of Neurorehabilitation Sciences, Milan, Italy
| | - Ilaria Passaro
- Casa Cura Policlinico, Department of Neurorehabilitation Sciences, Milan, Italy
| | - Marco Gilardone
- Casa Cura Policlinico, Department of Neurorehabilitation Sciences, Milan, Italy
| | - Nicola Vanacore
- National Institute of Health, National Centre for Epidemiology, Surveillance, and Health Promotion Italian, Rome, Italy
| | - Massimo Corbo
- Casa Cura Policlinico, Department of Neurorehabilitation Sciences, Milan, Italy
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Revet M, Immerzeel J, Voogt L, Paulis W. Patients with neuropsychological disorders short after stroke have worse functional outcome: a systematic review and meta-analysis. Disabil Rehabil 2019; 43:2233-2252. [PMID: 31766909 DOI: 10.1080/09638288.2019.1693642] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE To investigate if patients with neuropsychological disorders (neglect, aphasia, or cognitive dysfunction measured with the Mini-mental state examination) short after stroke have different functional outcome at follow-up compared to patients without these disorders. METHODS Embase, Medline-Ovid, PsycINFO, Cochrane CENTRAL, Web of Science and Google Scholar were systematically searched for cohort studies up to 3 March 2019. PRISMA guidelines were followed. Functional outcome had to be measured with the Barthel Index or the Functional Independence Measure. If at least three studies studying the same neuropsychological disorder reported functional outcome at comparable follow-up, meta-analysis were performed and the quality of evidence was assessed using GRADE. RESULTS The search resulted in 5398 unique articles and finally 27 articles were included. Pooled results show a standardized mean difference of -0.93 (95% confidence interval [-1.27 to -0.59]), indicating that the group with neglect short after stroke has significant lower functional outcome at follow-up. Regarding aphasia, the standardized mean difference was -0.50 (95% confidence interval [-0.72 to -0.28]). It appears in the limited articles available that patients with cognitive dysfunction have lower scores for functional outcome. CONCLUSIONS Patients with neglect or aphasia, especially aphasia with comprehension deficits, short after stroke have significant worse functional outcome.Implications for rehabilitationClinicians should perform an extensive screening for neglect, aphasia, and cognitive disorders to make sure to diagnose the different neuropsychological disorders correctly.When patients with neuropsychological disorders are referred for rehabilitation, it can be expected that they need a longer rehabilitation period or may never reach the same level of functioning.Clinicians should pay attention to instructions of training moments outside therapy and involve caregivers and patients family making these training moments more effective.
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Affiliation(s)
- Mirjam Revet
- Department of Physiotherapy Studies and Research Centre of Health Care Innovations, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Jeroen Immerzeel
- Department of Physiotherapy, De Zellingen - Rijckehove, Capelle aan den IJssel, The Netherlands
| | - Lennard Voogt
- Department of Physiotherapy Studies and Research Centre of Health Care Innovations, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Winifred Paulis
- Department of Physiotherapy Studies and Research Centre of Health Care Innovations, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
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Hiragami F, Hiragami S, Inoue Y. Effectiveness of Family-Engaged Multidimensional Team Planning and Management for Recovery in Patients With Severe Stroke and Low Functional Status. Ann Rehabil Med 2019; 43:581-591. [PMID: 31693848 PMCID: PMC6835136 DOI: 10.5535/arm.2019.43.5.581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 05/21/2019] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of family-engaged multidimensional team planning and management for patients with severe stroke and low functional status and to identify factors predictive of improved outcome at 1 month after admission. METHODS We retrospectively evaluated 50 patients who underwent family-engaged multidimensional rehabilitation for recovery from severe stroke due to primary unilateral cerebral lesions. The rehabilitation consisted of three phases: comprehensive multidimensional assessment, intensive rehabilitation, and evaluation. Functional Independence Measure (FIM) scores were calculated and used to predict the patients' status at discharge. RESULTS Although all FIM scores significantly improved after 1 month of rehabilitation, the motor FIM (mFIM) score improved the most (from 20.5±1.0 to 32.6±2.0). The total FIM (tFIM) and mFIM scores continued to improve from the first month to discharge (mean mFIM efficiency, 0.33). The high-efficiency patient group (mFIM efficiency ≥0.19) had a significantly higher discharge-to-home rate (44% vs. 13%), lower frequency of hemispatial neglect, and more severe finger numbness than the low-efficiency patient group (mFIM efficiency <0.19). The regression analyses revealed that besides lower mFIM and cognitive FIM scores at admission, unilateral spatial neglect, systemic comorbidities, and age were predictive of worse 1-month outcomes and tFIM scores (conformity, R2=0.78; predictive power, Akaike information criterion value=202). CONCLUSION Family-engaged multidimensional team planning and management are useful for patients with severe stroke and low functional status. Furthermore, FIM scores at admission, age, unilateral spatial neglect, and systemic comorbidities should be considered by rehabilitation teams when advising caregivers on the probability of favorable outcomes after rehabilitation.
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Affiliation(s)
- Fukumi Hiragami
- Research Institute of Health and Welfare, Kibi International University, Takahashi, Japan
| | - Shogo Hiragami
- Department of Occupational Therapy, School of Rehabilitation, Hyogo University of Health Sciences, Kobe, Japan
| | - Yu Inoue
- Research Institute of Health and Welfare, Kibi International University, Takahashi, Japan
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Zhang B, Han Y, Huang X, Liu Z, Li S, Chang J, Gao Y. Acupuncture is effective in improving functional communication in post-stroke aphasia. Wien Klin Wochenschr 2019; 131:221-232. [DOI: 10.1007/s00508-019-1478-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 03/01/2019] [Indexed: 10/27/2022]
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Harwood RH, O’Brien R, Goldberg SE, Allwood R, Pilnick A, Beeke S, Thomson L, Murray M, Parry R, Kearney F, Baxendale B, Sartain K, Schneider J. A staff training intervention to improve communication between people living with dementia and health-care professionals in hospital: the VOICE mixed-methods development and evaluation study. HEALTH SERVICES AND DELIVERY RESEARCH 2018. [DOI: 10.3310/hsdr06410] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundTwenty-five per cent of hospital beds are occupied by a person living with dementia. Dementia affects expressive communication and understanding. Health-care professionals report a lack of communication skills training.ObjectivesTo identify teachable, effective strategies for communication between health-care professionals and people living with dementia, and to develop and evaluate a communication skills training course.DesignWe undertook a systematic literature review, video-recorded 41 encounters between staff and people with dementia, and used conversation analysis to investigate communication problems and solutions. We designed a communication skills training course using coproduction and multiple pedagogic approaches. We ran a pilot, followed by six courses for health-care professionals. We measured knowledge, confidence and communication behaviours before, immediately after and 1 month after the course, and undertook interviews with participants and managers. Behaviours were measured using blind-rated videos of simulations.SettingGeneral hospital acute geriatric medical wards and two hospital clinical skills centres.ParticipantsWe video-recorded 26 people with dementia and 26 professionals. Ten experts in dementia care, education, simulation and communication contributed to intervention development. Six health-care professionals took part in a pilot course, and 45 took part in the training.ResultsThe literature review identified 26 studies describing 10 communication strategies, with modest evidence of effectiveness. Health-care professional-initiated encounters followed a predictable phase structure. Problems were apparent in requests (with frequent refusals) and in closings. Success was more likely when requests were made directly, with high entitlement (authority to ask) and with lowered contingencies (made to sound less difficult, by minimising the extent or duration of the task, asking patients ‘to try’, offering help or proposing collaborative action). Closings were more successful if the health-care professional announced the end of the task, made a specific arrangement, body language matched talk, and through use of ‘closing idioms’. The training course comprised 2 days, 1 month apart, using experiential learning, including lectures, video workshops, small group discussions, simulations (with specially trained actors) and reflections. We emphasised the incorporation of previous expertise and commitment to person-centred care. Forty-four participants returned for the second training day and 43 provided complete evaluation data. Knowledge and confidence both increased. Some behaviours, especially relating to closings, were more commonly used after training. The course was rated highly in interviews, especially the use of simulations, real-life video clips and interdisciplinary learning. Participants reported that they found the methods useful in practice and were using them 1 month after the course finished.LimitationsData were from people with moderate to severe dementia, in an acute hospital, during health-care professional-initiated interactions. Analysis was limited to problems and solutions that were likely to be ‘trainable’. Actors required careful preparation to simulate people with dementia. Communication skills training course participants were volunteers, unlikely to be representative of the general workforce, who displayed high levels of baseline knowledge, confidence and skills. Before-and-after evaluations, and qualitative interviews, are prone to bias.ConclusionsRequests and closings pose particular difficulties for professionals communicating with people with dementia. We identified solutions to these problems and incorporated them into communication skills training, which improved knowledge, confidence and some communication behaviours. Simulation was an effective training modality.Future workFurther research should investigate a wider range of health, social care and family carers. Conversation analysis should be used to investigate other aspects of health-care communication.Study registrationThe systematic literature review is registered as CRD42015023437.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Rowan H Harwood
- Nottingham University Hospitals NHS Trust, Nottingham, UK
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Rebecca O’Brien
- School of Health Sciences, University of Nottingham, Nottingham, UK
- CityCare Partnership CIC, Nottingham, UK
| | - Sarah E Goldberg
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Rebecca Allwood
- School of Health Sciences, University of Nottingham, Nottingham, UK
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Alison Pilnick
- School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
| | - Suzanne Beeke
- Language and Cognition Research, University College London, London, UK
| | - Louise Thomson
- Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Megan Murray
- Trent Simulation and Clinical Skills Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Ruth Parry
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Fiona Kearney
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Bryn Baxendale
- Nottingham University Hospitals NHS Trust, Nottingham, UK
- Trent Simulation and Clinical Skills Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Kate Sartain
- Patient and Public Contributor, Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK
| | - Justine Schneider
- School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
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Audiovisual Lexical Retrieval Deficits Following Left Hemisphere Stroke. Brain Sci 2018; 8:brainsci8120206. [PMID: 30486517 PMCID: PMC6316523 DOI: 10.3390/brainsci8120206] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 11/18/2018] [Accepted: 11/27/2018] [Indexed: 11/27/2022] Open
Abstract
Binding sensory features of multiple modalities of what we hear and see allows formation of a coherent percept to access semantics. Previous work on object naming has focused on visual confrontation naming with limited research in nonverbal auditory or multisensory processing. To investigate neural substrates and sensory effects of lexical retrieval, we evaluated healthy adults (n = 118) and left hemisphere stroke patients (LHD, n = 42) in naming manipulable objects across auditory (sound), visual (picture), and multisensory (audiovisual) conditions. LHD patients were divided into cortical, cortical–subcortical, or subcortical lesions (CO, CO–SC, SC), and specific lesion location investigated in a predictive model. Subjects produced lower accuracy in auditory naming relative to other conditions. Controls demonstrated greater naming accuracy and faster reaction times across all conditions compared to LHD patients. Naming across conditions was most severely impaired in CO patients. Both auditory and visual naming accuracy were impacted by temporal lobe involvement, although auditory naming was sensitive to lesions extending subcortically. Only controls demonstrated significant improvement over visual naming with the addition of auditory cues (i.e., multisensory condition). Results support overlapping neural networks for visual and auditory modalities related to semantic integration in lexical retrieval and temporal lobe involvement, while multisensory integration was impacted by both occipital and temporal lobe lesion involvement. The findings support modality specificity in naming and suggest that auditory naming is mediated by a distributed cortical–subcortical network overlapping with networks mediating spatiotemporal aspects of skilled movements producing sound.
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Mole JA, Demeyere N. The relationship between early post-stroke cognition and longer term activities and participation: A systematic review. Neuropsychol Rehabil 2018; 30:346-370. [DOI: 10.1080/09602011.2018.1464934] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Joseph A. Mole
- Oxford Institute of Clinical Psychology Training, University of Oxford, Oxford, UK
- Cognitive Neuropsychology Centre, Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Nele Demeyere
- Cognitive Neuropsychology Centre, Department of Experimental Psychology, University of Oxford, Oxford, UK
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20
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Ginex V, Veronelli L, Vanacore N, Lacorte E, Monti A, Corbo M. Motor recovery in post-stroke patients with aphasia: the role of specific linguistic abilities. Top Stroke Rehabil 2017; 24:428-434. [DOI: 10.1080/10749357.2017.1305654] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Valeria Ginex
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milan, Italy
| | - Laura Veronelli
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milan, Italy
| | - Nicola Vanacore
- National Centre for Epidemiology, Surveillance, and Health Promotion Italian, National Institute of Health, Rome, Italy
| | - Eleonora Lacorte
- National Centre for Epidemiology, Surveillance, and Health Promotion Italian, National Institute of Health, Rome, Italy
| | - Alessia Monti
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milan, Italy
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milan, Italy
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Choi YH, Park HK, Paik NJ. A Telerehabilitation Approach for Chronic Aphasia Following Stroke. Telemed J E Health 2016; 22:434-40. [DOI: 10.1089/tmj.2015.0138] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Yoon-Hee Choi
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University College of Medicine, Soonchunhyang University Hospital, Seoul, South Korea
| | - Hae Kyung Park
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Nam-Jong Paik
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
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Pagliarin KC, Ortiz KZ, Barreto SDS, Pimenta Parente MADM, Nespoulous JL, Joanette Y, Fonseca RP. Montreal–Toulouse Language Assessment Battery: Evidence of criterion validity from patients with aphasia. J Neurol Sci 2015; 357:246-51. [DOI: 10.1016/j.jns.2015.07.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 07/28/2015] [Accepted: 07/29/2015] [Indexed: 10/23/2022]
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23
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Choi YH, Park HK, Ahn KH, Son YJ, Paik NJ. A Telescreening Tool to Detect Aphasia in Patients with Stroke. Telemed J E Health 2015; 21:729-34. [DOI: 10.1089/tmj.2014.0207] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Yoon-Hee Choi
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Physical and Rehabilitation Medicine, Soonchunhyang University College of Medicine, Soonchunhyang University Hospital, Seoul, South Korea
| | - Hae Kyung Park
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ki-hwan Ahn
- Technology Development Office, Advanced Institute of Technology, KT R&D Center, Seoul, South Korea
| | - Yeon-joo Son
- Technology Development Office, Advanced Institute of Technology, KT R&D Center, Seoul, South Korea
| | - Nam-Jong Paik
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
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Schleiger E, Sheikh N, Rowland T, Wong A, Read S, Finnigan S. Frontal EEG delta/alpha ratio and screening for post-stroke cognitive deficits: The power of four electrodes. Int J Psychophysiol 2014; 94:19-24. [DOI: 10.1016/j.ijpsycho.2014.06.012] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 05/13/2014] [Accepted: 06/17/2014] [Indexed: 11/26/2022]
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Mylius V, Zouari HG, Ayache SS, Farhat WH, Lefaucheur JP. Stroke rehabilitation using noninvasive cortical stimulation: aphasia. Expert Rev Neurother 2014; 12:973-82. [DOI: 10.1586/ern.12.76] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
Patients with neurologic illness or injury benefit from early interventions to increase physical activity and mobility, but they also have special needs related to hemodynamic stability and intracranial pressure dynamics. After brain injury, moving paralyzed limbs--even passively--helps promote neural plasticity, "rerouting" signals around the injured area and forming new connections, resulting in improved functional recovery. Neurologic deficits may impede a patient's functional and language abilities, so a mobility program must take into account the need for assistive devices, communication strategies, and additional personnel. Because cerebral autoregulation may be impaired, stability of blood pressure and intracranial pressure must be considered when planning mobility activities. The clinical team must consider the full spectrum of mobility for the neuroscience patient, from having the bed in the chair position for a comatose patient to ambulation of the patient with ventriculostomy whose intracranial pressure will tolerate having drainage clamped for a short period of time. Those involved with mobility need to understand the patient's disease process, the implications of increasing activity levels, and the monitoring required during activity.
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Heiss WD, Hartmann A, Rubi-Fessen I, Anglade C, Kracht L, Kessler J, Weiduschat N, Rommel T, Thiel A. Noninvasive Brain Stimulation for Treatment of Right- and Left-Handed Poststroke Aphasics. Cerebrovasc Dis 2013; 36:363-72. [PMID: 24217362 DOI: 10.1159/000355499] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 09/05/2013] [Indexed: 11/19/2022] Open
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Abstract
Learning and memory functions are crucial in the interaction of an individual with the environment and involve the interplay of large, distributed brain networks. Recent advances in technologies to explore neurobiological correlates of neuropsychological paradigms have increased our knowledge about human learning and memory. In this chapter we first review and define memory and learning processes from a neuropsychological perspective. Then we provide some illustrations of how noninvasive brain stimulation can play a major role in the investigation of memory functions, as it can be used to identify cause-effect relationships and chronometric properties of neural processes underlying cognitive steps. In clinical medicine, transcranial magnetic stimulation may be used as a diagnostic tool to understand memory and learning deficits in various patient populations. Furthermore, noninvasive brain stimulation is also being applied to enhance cognitive functions, offering exciting translational therapeutic opportunities in neurology and psychiatry.
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Affiliation(s)
- Anna-Katharine Brem
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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