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Quique YM, Evans WS, Ortega-Llebaría M, Zipse L, Dickey MW. Get in Sync: Active Ingredients and Patient Profiles in Scripted-Sentence Learning in Spanish Speakers With Aphasia. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1478-1493. [PMID: 35230881 DOI: 10.1044/2021_jslhr-21-00060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Script training is a well-established treatment for aphasia, but its evidence comes almost exclusively from monolingual English speakers with aphasia. Furthermore, its active ingredients and profiles of people with aphasia (PWA) that respond to this treatment remain understudied. This study aimed to adapt a scripted-sentence learning protocol to Colombian Spanish speakers with aphasia, investigate speech entrainment (i.e., unison production of sentences) as an active ingredient for scripted-sentence learning, and identify patient profiles associated with better scripted-sentence learning. METHOD Fourteen monolingual Spanish speakers with aphasia learned a set of 30 sentences. To examine speech entrainment as an active ingredient for scripted-sentence learning, we investigated whether sentences containing externally added rhythmic cues (involving stress-aligned vs. metronomic rhythmic cues) would result in better scripted-sentence learning compared with control sentences. Learning was measured via postsession probes and analyzed using mixed-effects logistic regression models. The relationship between scripted-sentence learning and baseline language and rhythmic processing measures was also examined. RESULTS Significant scripted-sentence learning over time indicated a successful adaptation of a script-training protocol to Spanish. PWA learned significantly more scripted sentences in the rhythmically enhanced conditions compared with the control condition. There were no differences between rhythmically enhanced conditions (stress-aligned vs. metronomic). In terms of patient profiles, it was found that PWA with more severe aphasia demonstrated larger learning gains, but rhythmic processing showed little association with learning estimates. CONCLUSIONS To our knowledge, this study provides the first adaptation of a scripted-sentence learning protocol for monolingual Spanish speakers with aphasia, demonstrating cross-linguistic benefits of script training interventions. Highlighting rhythmic features during speech entrainment facilitated scripted-sentence learning in Spanish speakers with aphasia, suggesting that speech entrainment may be an active ingredient for scripted-sentence learning. More severe aphasia was associated with better scripted-sentence learning, suggesting that more severely impaired individuals are likely to benefit most from this treatment. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19241847.
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Affiliation(s)
- Yina M Quique
- Center for Education in Health Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - William S Evans
- Department of Communication Sciences and Disorders, University of Pittsburgh, PA
| | | | - Lauryn Zipse
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
| | - Michael Walsh Dickey
- Department of Communication Sciences and Disorders, University of Pittsburgh, PA
- VA Healthcare System, Pittsburgh, PA
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Tábuas-Pereira M, Beato-Coelho J, Ribeiro J, Nogueira AR, Cruz L, Silva F, Sargento-Freitas J, Cordeiro G, Santana I. Single Word Repetition Predicts Long-Term Outcome of Aphasia Caused by an Ischemic Stroke. J Stroke Cerebrovasc Dis 2019; 29:104566. [PMID: 31836358 DOI: 10.1016/j.jstrokecerebrovasdis.2019.104566] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 11/03/2019] [Accepted: 11/21/2019] [Indexed: 12/01/2022] Open
Abstract
PURPOSE Better understanding of clinical predictors of aphasia outcome is of the utmost importance, in patients' rehabilitation planning, expectation management, and further physiopathology understanding. We aimed to identify clinical predictors of long-term poststroke aphasia's outcome. METHODS We conducted a prospective longitudinal observation study of patients with left-Middle Cerebral Artery stroke with aphasia. Patients were evaluated at baseline, day 7 and 6 months with National Institutes of Health Stroke Scale (NIHSS) and Aphasia Rapid Test Other demographic variables and vascular risk factors were collected. A linear regression was performed to identify best predictors of aphasia at 6 months. FINDINGS We included 113 patients with a left hemisphere stroke, with 81 reaching the final evaluation. Aphasia Handicap Score at 6 months was predicted by baseline total NIHSS (β = .077, 95%CI = [.026, .127]. P = .004), infarct volume on CT-scan (β = .009, 95%CI = [.003, .015]. P = .003), single word repetition at baseline (β = .188, 95%CI = [.040, .335]. P = .013), and infection during hospitalization (β = .759, 95%CI = [.263, 1.255]. P = .003). CONCLUSIONS Aphasia's outcome in patients with stroke is predicted by a single word repetition task at baseline. Infection during hospitalization has a negative impact on aphasia's outcome at 6 months.
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Affiliation(s)
- Miguel Tábuas-Pereira
- Memory Clinic, Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
| | - José Beato-Coelho
- Stroke Unit, Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal MD, Stroke Unit, Neurology Department, Coimbra, Portugal
| | - Joana Ribeiro
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Ana Rita Nogueira
- Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Luis Cruz
- Neuroradiology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Fernando Silva
- Stroke Unit, Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - João Sargento-Freitas
- Stroke Unit, Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Gustavo Cordeiro
- Stroke Unit, Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Isabel Santana
- Head of the Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Professor of Neurology, Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
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Radanovic M, Mansur LL. Aphasia in vascular lesions of the basal ganglia: A comprehensive review. BRAIN AND LANGUAGE 2017; 173:20-32. [PMID: 28570947 DOI: 10.1016/j.bandl.2017.05.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 02/24/2017] [Accepted: 05/09/2017] [Indexed: 06/07/2023]
Abstract
Between 1970 and 1990, the study of aphasia secondary to subcortical lesions (including the basal ganglia - BG) was largely driven by the advent of modern neuroimaging techniques such as MRI and PET. However, attempts to characterize a pattern of language abnormalities in patients with basal ganglia lesions proved unfruitful. We conducted a comprehensive review of language disturbances after vascular lesions in the BG. Literature search in Medline and LILACS (1966-2016) and PsychINFO (last 25years) was conducted, and returned 145 articles, with 57 eligible for the review yielding data on 303 patients. We report the clinical and neuroimaging features of these cases. Results showed that aphasias caused by BG lesions are heterogeneous with weak clinicoanatomical correlations. Data derived from follow-up and flow/metabolism studies suggest that subcortical aphasia caused by BG lesions involves hypoperfusion in the cortical territories of the middle cerebral/internal carotid arteries (MCA/ICA) and their branches.
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Affiliation(s)
- Marcia Radanovic
- Department of Neurology, Faculty of Medicine, University of Sao Paulo, Rua Dr. Eneas de Carvalho Aguiar, 225, 5th Floor, Sao Paulo, SP 05403-010, Brazil.
| | - Leticia Lessa Mansur
- Department of Physiotherapy, Speech Therapy, and Occupational Therapy, Faculty of Medicine, University of Sao Paulo, Rua Cipotânea, 51, Cidade Universitaria, Sao Paulo, SP 05360-160, Brazil.
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Bakheit A, Shaw S, Carrington S, Griffiths S. The rate and extent of improvement with therapy from the different types of aphasia in the first year after stroke. Clin Rehabil 2016; 21:941-9. [DOI: 10.1177/0269215507078452] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To examine the rate and extent of improvement from the different types of aphasia in the first year after stroke. Design: A prospective longitudinal study. Setting: A specialist stroke unit. Participants: Seventy-five aphasic patients with first-ever stroke. Intervention: The type of aphasia was classified according to the criteria of the Western Aphasia Battery. The Western Aphasia Battery aphasia quotient was used to measure the initial severity and the rate and extent of improvement from aphasia. Assessments were made at baseline and 4, 8, 12 and 24 weeks later. Results: The median percentage increase in the Western Aphasia Battery aphasia quotient was statistically higher in patients with Broca's aphasia than in the other groups at all weeks. Patients with Wernicke's aphasia had a significantly greater median percentage increase in their aphasia quotient than those with conduction and anomic aphasia at weeks 12 and 24, but less than patients with global aphasia at week 24. Conclusions: Patients with Broca's aphasia appear to have the best prognosis for improvement of language function in the first year of stroke. The extent of improvement in patients with global aphasia is better than that of patients with Wernicke's aphasia.
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Affiliation(s)
- A.M.O. Bakheit
- Peninsula Medical School, Universities of Exeter & Plymouth, UK and Plymouth Primary Care Trust,
| | - S. Shaw
- School of Mathematics & Statistics, University of Plymouth
| | - S. Carrington
- Peninsula Medical School, Universities of Exeter & Plymouth, UK and Plymouth Primary Care Trust
| | - S. Griffiths
- Peninsula Medical School, Universities of Exeter & Plymouth, UK and Plymouth Primary Care Trust
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A new choice of minimally invasive surgery for intracerebral hemorrhage in the striatocapsular regions based on computed tomography scans. J Craniofac Surg 2015; 25:1195-9. [PMID: 25006896 DOI: 10.1097/scs.0000000000000839] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Currently, minimally invasive surgery is considered as a beneficial treatment of supratentorial spontaneous intracerebral hemorrhage (SICH). A new choice of minimally invasive surgery, translower-Rolandic-point approach (TLRPA) with modified craniotomy, is described in this study. A modified classification of striatocapsular SICH based on the computed tomography scans is also described. The surgical strategy of striatocapsular SICH based on the neuroimaging evaluation is proposed. METHODS Clinical data from 60 patients with striatocapsular SICH were used in the study. On the basis of the preoperative computed tomography scans, the hematomas were divided into 4 types and 3 subtypes in the axial slices. The surgical approach was used according to the classification. Effect of surgical treatment was evaluated by Glasgow Outcome Scale score. RESULTS The mixed type was the most common (31.7%) and was followed by posteromiddle (21.7%), middle (20.0%), posterolateral (11.7%), posteromedial (8.3%), and anterior (6.6%) types in decreasing order of frequency. The transanterior-Sylvian-point approach was used in 25 patients (41.7%), and TLRPA was used in 35 patients (58.3%). Forty-six patients (76.7%) made a relatively good recovery (Glasgow Outcome Scale scores of 4 and 5), and two (3.3%) were dead. CONCLUSIONS The modified classification would help to decide the optimal surgical strategy. The TLRPA with modified craniotomy is a minimally invasive, effective, and safe method to remove the hematoma. The choice of the surgical approach should be tailored for each patient based on preoperative neuroimaging evaluation.
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Komiya K, Sakai Y, Horikoshi T, Naganuma H. Recovery process and prognosis of aphasic patients with left putaminal hemorrhage: relationship between hematoma type and language modalities. J Stroke Cerebrovasc Dis 2011; 22:132-42. [PMID: 21903420 DOI: 10.1016/j.jstrokecerebrovasdis.2011.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2010] [Revised: 05/04/2011] [Accepted: 07/10/2011] [Indexed: 10/17/2022] Open
Abstract
To elucidate the precise recovery process and prognosis of language functions in aphasic patients with left putaminal hemorrhage, we investigated 48 aphasic patients classified into 4 groups according to the location and extent of hematoma. The hematoma extended to the corona radiata in all patients, extracapsular in type I (12 cases), to the anterior limb in type II (10 cases), to the posterior limb in type III (12 cases), and to both limbs in type IV (14 cases). The Standard Language Test for Aphasia was performed at 1 month, 3 months, and 6 months after the attack. The type II, III, and IV patients were divided into 2 groups, with and without ventricular rupture of the hemorrhage. At 3 and 6 months after the attack, the type I, II, and III patients showed significant improvement (P < .05) in all language modalities compared with the type IV patients. Most improvement in language modalities occurred in the first 3 months. The evaluation of patients with ventricular rupture after 6 months revealed poor recovery (P < .05) in oral commands, visual commands, confrontation naming, sentence repetition, narratives, verbal fluency, and writing in type II and III patients. In type IV patients, this evaluation showed poor recovery (P < .05) only in oral and written naming (kanji words). No significant difference in prognostic outcome was observed between the surgical treatment group and the nonsurgical treatment group. The classification of hemorrhage may be useful in predicting the outcome of aphasia with putaminal hemorrhage and in guiding clinicians in providing effective instructions to patients and their relatives.
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Affiliation(s)
- Keiji Komiya
- Department of Rehabilitation, Kofu Jonan Hospital, Kofu City, Yamanashi, Japan.
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Lambon Ralph MA, Snell C, Fillingham JK, Conroy P, Sage K. Predicting the outcome of anomia therapy for people with aphasia post CVA: Both language and cognitive status are key predictors. Neuropsychol Rehabil 2010; 20:289-305. [DOI: 10.1080/09602010903237875] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Yaryura-Tobias JA, Neziroglu F. Basal ganglia hemorrhagic ablation associated with temporary suppression of obsessive-compulsive symptoms. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2003; 25:40-2. [PMID: 12975678 DOI: 10.1590/s1516-44462003000100008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Currently, basal ganglia (BG) are considered regulators of motor and emotional activity. It's operationality encompass Obsessive Compulsive Disorder (OCD). The case of a patient suffering with severe OCD is described of note, his symptoms disappeared following a hemorrhage of the left BG. However, once the hemorrhage was reabsorbed his symptoms returned. It is possible that lesions affecting cerebral OCD association circuits may influence the evolution of obsessive-compulsive symptoms.
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