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Riccardi N, Nelakuditi S, den Ouden DB, Rorden C, Fridriksson J, Desai RH. Discourse- and lesion-based aphasia quotient estimation using machine learning. Neuroimage Clin 2024; 42:103602. [PMID: 38593534 PMCID: PMC11016805 DOI: 10.1016/j.nicl.2024.103602] [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: 06/28/2023] [Revised: 04/01/2024] [Accepted: 04/01/2024] [Indexed: 04/11/2024]
Abstract
Discourse is a fundamentally important aspect of communication, and discourse production provides a wealth of information about linguistic ability. Aphasia commonly affects, in multiple ways, the ability to produce discourse. Comprehensive aphasia assessments such as the Western Aphasia Battery-Revised (WAB-R) are time- and resource-intensive. We examined whether discourse measures can be used to estimate WAB-R Aphasia Quotient (AQ), and whether this can serve as an ecologically valid, less resource-intensive measure. We used features extracted from discourse tasks using three AphasiaBank prompts involving expositional (picture description), story narrative, and procedural discourse. These features were used to train a machine learning model to predict the WAB-R AQ. We also compared and supplemented the model with lesion location information from structural neuroimaging. We found that discourse-based models could estimate AQ well, and that they outperformed models based on lesion features. Addition of lesion features to the discourse features did not improve the performance of the discourse model substantially. Inspection of the most informative discourse features revealed that different prompt types taxed different aspects of language. These findings suggest that discourse can be used to estimate aphasia severity, and provide insight into the linguistic content elicited by different types of discourse prompts.
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Affiliation(s)
- Nicholas Riccardi
- Department of Communication Sciences and Disorders, University of South Carolina, United States.
| | | | - Dirk B den Ouden
- Department of Communication Sciences and Disorders, University of South Carolina, United States
| | - Chris Rorden
- Department of Psychology, University of South Carolina, United States
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, United States
| | - Rutvik H Desai
- Department of Psychology, University of South Carolina, United States
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Deng BM, Gao J, Liang LS, Zhao JX, Lin F, Yin MY, Zheng HQ, Hu XQ. Discourse Task Type-Specific Linguistic Characteristics in Anomic Aphasia and Healthy Controls: Evidence From Mandarin-Chinese AphasiaBank. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:937-951. [PMID: 38266215 DOI: 10.1044/2023_ajslp-23-00078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
PURPOSE This study was designed to examine the hypothesis that discourse task types influence language performance in Mandarin Chinese-speaking people and to reveal the discourse task-specific linguistic properties of persons with anomic aphasia compared to neurotypical controls. METHOD Language samples from persons with aphasia (n = 31) and age- and education-matched controls (n = 31) across four discourse tasks (sequential-picture description, single-picture description, story narrative, and procedural discourse) were collected from Mandarin AphasiaBank. Task-specific distributions of parts of speech were analyzed using mosaic plots. The main effects of tasks in each group and the between-group differences within each task for several typical linguistic variables were evaluated, including the mean length of utterance, tokens, moving-average type-token ratio, words per minute, propositional density, noun-verb ratio, noun percentage, and verb percentage. RESULTS The results revealed an impact of discourse tasks on most language variables in both groups. In the healthy controls, story narratives yielded the highest total words and lowest verb percentage. In the aphasia group, procedural discourse elicited the fewest total words and densest expressions, whereas their single-picture descriptions had the highest noun-verb ratio. For all tasks, the aphasia group performed worse than the control group in the mean length of utterance, tokens, moving-average type-token ratio, and words per minute. For noun-verb ratio, noun percentage, and verb percentage, only one task (i.e., single-picture description) showed significant between-group differences. CONCLUSION The selection of discourse tasks should be addressed in assessments and interventions for Mandarin Chinese-speaking individuals with aphasia to obtain more accurate and feasible outcomes.
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Affiliation(s)
- Bao-Mei Deng
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jing Gao
- School of Rehabilitation Medicine, Nanjing Medical University, Jiangsu, China
- Sir Run Run Hospital, Nanjing Medical University, Jiangsu, China
| | - Li-Si Liang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jia-Xin Zhao
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Feng Lin
- School of Rehabilitation Medicine, Nanjing Medical University, Jiangsu, China
| | - Ming-Yu Yin
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Hai-Qing Zheng
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xi-Quan Hu
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
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Deng BM, Liang LS, Zhao JX, Zheng HQ, Hu XQ. Correct Information Unit Analysis in Different Discourse Tasks Among Persons With Anomic Aphasia Based on Mandarin AphasiaBank. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:800-813. [PMID: 38099824 DOI: 10.1044/2023_ajslp-23-00217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
PURPOSE This study aimed to explore how well persons with anomic aphasia communicate information during discourse regarding quantity, quality, and efficiency compared to neurotypical controls, to investigate the influence of discourse tasks on informativeness and efficiency and to examine impact factors like aphasia severity and cognitive ability. METHOD Language samples of four discourse tasks from 31 persons with anomic aphasia and 31 neurotypical controls were collected from Mandarin AphasiaBank. Correct information unit (CIU) analysis measures including the total number of CIUs, percentage of CIUs, CIUs per minute, and words per minute were calculated. Group differences and the effects of discourse tasks on informativeness and efficiency were investigated. Correlations of CIU analysis measures with aphasia severity and cognitive ability were examined. RESULTS Persons with anomic aphasia showed lower efficiency in conveying information than controls. They underperformed controls on all CIU analysis measures when executing story narrative tasks. Discourse tasks influenced the informativeness and efficiency of both groups. Neurotypical controls delivered the greatest quantity of information most efficiently when narrating stories. Persons with anomic aphasia exhibited reduced quantity of information during procedural discourse and displayed superior information quality in sequential-picture descriptions. Discourse information may be impacted by aphasia severity and cognitive ability, with varying effects depending on the task. CONCLUSIONS Persons with anomic aphasia are inefficient in communicating discourse messages and perform poorly on all measures in story narratives. When measuring discourse information, the effects of discourse tasks and factors like aphasia severity and cognitive ability should be considered.
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Affiliation(s)
- Bao-Mei Deng
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Li-Si Liang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jia-Xin Zhao
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hai-Qing Zheng
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xi-Quan Hu
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Olujić Tomazin M, Kuvač Kraljević J, Alves RA. Reactivity of the triple task on writing processes and product in adults with dyslexia. Front Psychol 2023; 14:1112274. [PMID: 37876839 PMCID: PMC10591105 DOI: 10.3389/fpsyg.2023.1112274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 09/21/2023] [Indexed: 10/26/2023] Open
Abstract
Introduction The triple task (TT) is a method for assessing the dynamics of writing processes. It involves three tasks in one: writing a text, responding to a sound, and reporting the process. Previous research has mostly shown that the TT does not affect the writing process or the product. However, individuals with dyslexia often show difficulties in tasks that require organization, automation, integration of multiple processes, inhibition, and shifting/cognitive flexibility. The aim of this study was therefore to investigate whether TT affects the writing process and written product differently in adults with dyslexia compared to a control group of adults with typical reading skills. Methods Two groups of adult native Croatian speakers were included in this study: 20 adults with developmental dyslexia and 20 adults with typical reading skills; evenly distributed by: age (18-38 years), gender (13 males, 7 females per group), educational level, and nonverbal cognitive abilities. All participants wrote one text with a TT and another without. The writing of the text was tracked with a keystroke logging program - Inputlog. The two texts were compared at process and product level. Results and discussion The results showed that measures of writing processes and text quality in the groups of adults with dyslexia and adults with typical reading skills were unlikely to be differentially affected by TT. However, in the condition without TT, the total number of characters per minute was higher, more keys were typed per minute and more words were deleted. As expected, adults with dyslexia produced shorter texts of lower quality and with more errors; they also produced fewer characters per minute, used fewer keystrokes and typed fewer. Conclusion The study suggests that TT is unlikely to have a different impact on the writing process or written product in adults with dyslexia compared to adults with typical reading skills.
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Affiliation(s)
- Marina Olujić Tomazin
- Faculty of Education and Rehabilitation Sciences, Department of Hearing Impairments, University of Zagreb, Zagreb, Croatia
| | - Jelena Kuvač Kraljević
- Faculty of Education and Rehabilitation Sciences, Department of Speech and Language Pathology, University of Zagreb, Zagreb, Croatia
| | - Rui A. Alves
- Faculty of Psychology and Educational Sciences, Psychology Department, University of Porto, Porto, Portugal
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Leaman MC, Edmonds LA. Analyzing Language in the Picnic Scene Picture and in Conversation: The Type of Discourse Sample We Choose Influences Findings in People With Aphasia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:1413-1430. [PMID: 37256694 PMCID: PMC10473387 DOI: 10.1044/2023_ajslp-22-00279] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 11/30/2022] [Accepted: 02/09/2023] [Indexed: 06/02/2023]
Abstract
PURPOSE People with aphasia express that improved conversational discourse is a primary rehabilitation goal. Discourse is usually assessed using monologue, such as a picture description task, but research shows that language in monologue varies from language in everyday conversation. Consequently, we investigated the relationship of language in unstructured conversation and in the picnic scene picture because it is a part of the most often used aphasia battery (Western Aphasia Battery-Revised) and thus is frequently used to inform therapy. Second, because previous research suggests people with severe aphasia may not demonstrate language production variability between types of monologue-level discourse, we evaluated the relationship of severity and the difference in scores between conversation and the picnic scene task. METHOD Thirty-four people with mild-to-severe aphasia described the picnic scene and provided a conversation sample. We measured language production and communicative success using seven measures with established psychometrics in conversation/monologue. We conducted correlations to answer the research questions. RESULTS Correlations were moderate and weaker for the measures in the two conditions. A strong negative relationship was demonstrated between aphasia severity and global coherence. All other relationships were moderate and weaker for the remaining measures when correlated with aphasia severity (also negative). CONCLUSIONS Results are consistent with other studies indicating that language varies in different types of discourse. We conclude that for accurate, meaningful assessment, discourse sampling needs to include the specific type of discourse the individual wishes to address in therapy, because discourse samples and their findings are not interchangeable.
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Minga J, Stockbridge MD, Durfee A, Johnson M. Clinical Guidelines for Eliciting Discourse Using the RHDBank Protocol. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:1949-1962. [PMID: 36044890 PMCID: PMC9907450 DOI: 10.1044/2022_ajslp-22-00097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/12/2022] [Accepted: 06/15/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Examining discourse after right hemisphere brain damage (RHD) can provide invaluable clinical data and insight into functional communication capabilities. Yet, clinicians preparing to enter the field may have limited experience eliciting and analyzing discourse for therapeutic purposes. The purpose of this work is to present a practical guide for the clinical use of the RHDBank protocol. METHOD Following a brief overview of the RHDBank protocol, elicitation guidelines and protocol administration considerations are offered. Measures that should be considered when analyzing RHDBank-elicited discourse are summarized. The RHDBank protocol is positioned as an accessible resource for discourse elicitation in the clinical setting, and examples for the clinical use of the protocol are provided. CONCLUSIONS Discourse production can be a key source of information regarding communication ability following RHD. The RHDBank provides a structured and scripted approach to the clinical elicitation of language and consideration of discourse production. Its immediate clinical utility will assist developing clinicians with the acquisition of a clinically relevant elicitation approach and more comprehensive view of the RHD communication impairments. Application of the protocol can aid in collective knowledge advancement that will promote a better understanding of RHD language production as a clinical entity with an array of possible characteristics.
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Affiliation(s)
- Jamila Minga
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC
| | - Melissa D. Stockbridge
- Department of Neurology, Cerebrovascular Division, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Alexandra Durfee
- Department of Neurology, Cerebrovascular Division, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Melissa Johnson
- Department of Communication Sciences and Disorders, Nazareth College, Rochester, NY
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Stark BC, Cofoid C. Task-Specific Iconic Gesturing During Spoken Discourse in Aphasia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:30-47. [PMID: 34033493 PMCID: PMC9135014 DOI: 10.1044/2021_ajslp-20-00271] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/30/2020] [Accepted: 02/11/2021] [Indexed: 05/26/2023]
Abstract
PURPOSE In persons living with aphasia, we will explore the relationship between iconic gesture production during spontaneous speech and discourse task, spoken language, and demographic information. METHOD Employing the AphasiaBank database, we coded iconic gestures in 75 speakers with aphasia during two spoken discourse tasks: a procedural narrative, which involved participants telling the experimenter how to make a sandwich ("Sandwich"), and a picture sequence narrative, which had participants describe the picture sequence to the experimenter ("Window"). Forty-three produced a gesture during both tasks, and we further evaluate data from this subgroup as a more direct comparison between tasks. RESULTS More iconic gestures, at a higher rate, were produced during the procedural narrative. For both tasks, there was a relationship between iconic gesture rate, modeled as iconic gestures per word, and metrics of language dysfluency extracted from the discourse task as well as a metric of fluency extracted from a standardized battery. Iconic gesture production was correlated with aphasia duration, which was driven by performance during only a single task (Window), but not with other demographic metrics, such as aphasia severity or age. We also provide preliminary evidence for task differences shown through the lens of two types of iconic gestures. CONCLUSIONS While speech-language pathologists have utilized gesture in therapy for poststroke aphasia, due to its possible facilitatory role in spoken language, there has been considerably less work in understanding how gesture differs across naturalistic tasks and how we can best utilize this information to better assess gesture in aphasia and improve multimodal treatment for aphasia. Furthermore, our results contribute to gesture theory, particularly, about the role of gesture across naturalistic tasks and its relationship with spoken language. Supplemental Material https://doi.org/10.23641/asha.14614941.
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Affiliation(s)
- Brielle C. Stark
- Department of Speech, Language and Hearing Sciences, Indiana University Bloomington
| | - Caroline Cofoid
- Department of Speech, Language and Hearing Sciences, Indiana University Bloomington
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Yazu H, Kong APH, Yoshihata H, Okubo K. Adaptation and validation of the main concept analysis of spoken discourse by native Japanese adults. CLINICAL LINGUISTICS & PHONETICS 2022; 36:17-33. [PMID: 33988070 DOI: 10.1080/02699206.2021.1915385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 03/24/2021] [Accepted: 04/06/2021] [Indexed: 06/12/2023]
Abstract
Many people with aphasia demonstrate problems of oral production at the discourse level. The Main Concept Analysis (MCA) for oral discourse production is a published evidence-based battery for quantifying the degree of presence, accuracy, completeness, and efficiency of targeted main concepts in oral discourse. In Japan, such a standardized tool specialized for assessing spoken discourse is currently lacking. The purpose of this study was to adapt the Japanese version of MCA for oral discourse production (the Japanese-MCA) and examine its validity and reliability. Stage 1 of the study involved the establishment of linguistically-specific main concepts (MCs) of the Japanese-MCA. Ten speech-language-hearing therapists and 60 healthy participants who were native monolingual Japanese speakers were recruited to determine MCs. Stage 2 examined the criterion validity and reliability of the Japanese-MCA. Language samples of 20 participants with aphasia, as verified by Standard Language Test of Aphasia (SLTA), and 20 healthy older participants were used. Results of Stage 1 of the study yielded normative data with a set of target MCs that were geographically and linguistically specific for use in Japan. The results also revealed the comparability of the Japanese-MCA and previously reported versions of other languages. Stage 2 findings indicated not only a high correlation of criterion validity, but also good reliability of the test. With established norms and specific scoring criteria of the Japanese-MCA, it is believed that this new tool will become a useful addition to clinical management and research of aphasia in Japan.
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Affiliation(s)
- Hitomi Yazu
- Department of Rehabilitation, Nippon Medical School Hospital, Tokyo, Japan
- Graduate School of Languages and Linguistics, Sophia University, Tokyo, Japan
| | - Anthony Pak-Hin Kong
- School of Communication Sciences and Disorders, University of Central Florida, Orlando, Florida, USA
| | - Hiroyo Yoshihata
- Graduate School of Languages and Linguistics, Sophia University, Tokyo, Japan
| | - Kimihiro Okubo
- Department of Oto-Rhino-Laryngology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
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Abstract
This chapter is written for the qualified neurologist or related professional working with persons who have had a stroke or other sudden brain injury. It is critical that the presence of aphasia is detected, no matter how mild the presentation, and to support that assertion, this chapter highlights the plight of persons with latent aphasia. At the individual level, the impact of aphasia is devastating, with overwhelming evidence that aphasia negatively impacts psychosocial outcomes. At the global level, sensitive detection and accurate diagnosis of aphasia are critical for accurate characterization and quantification of the global burden of aphasia. The word "LANGUAGE" is leveraged as an acronym to create a useful and memorable checklist to guide navigation of aphasia screening and assessment: it begins with the definition of language (L), followed by the definition and diagnostic criteria for aphasia (A). Then language abilities and characteristics to be considered in assessment are presented: naming (N); grammar and syntax (G); unintelligible words, jargon, and paraphasias (U); auditory comprehension and repetition (A); graphemic abilities-reading and writing (G); and everyday communication and discourse (E). Recommendations for improving procedural adherence are provided, and a list of potential brief assessment measures are introduced.
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Affiliation(s)
- Jessica D Richardson
- Department of Speech and Hearing Sciences, University of New Mexico, Albuquerque, NM, United States.
| | - Sarah Grace Dalton
- Department of Speech Pathology and Audiology, Marquette University, Milwaukee, WI, United States
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Day M, Dey RK, Baucum M, Paek EJ, Park H, Khojandi A. Predicting Severity in People with Aphasia: A Natural Language Processing and Machine Learning Approach. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:2299-2302. [PMID: 34891746 DOI: 10.1109/embc46164.2021.9630694] [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
Speech language pathologists need an accurate assessment of the severity of people with aphasia (PWA) to design and provide the best course of therapy. Currently, severity is evaluated manually by an increasingly scarce pool of experienced and well-trained clinicians, taking considerable time resources. By analyzing the transcripts from three discourse elicitation methods, this study combines natural language processing (NLP) and machine learning (ML) to predict the severity of PWA, both by score and severity level. By engineering language features from PWA tasks, an unstructured k-means clustering presents distinct aphasia types, showing validity of the selected features. We develop regression models to predict severity scores along with a classification of severity by level (Mild, Moderate, Severe, and Very Severe) to assist clinicians to easily plan and monitor the course of treatment. Our best ML regression model uses a deep neural network and results in a mean absolute error (MAE) of 0.0671 and root mean squared error (RMSE) of 0.0922. Our best classification model uses a random forest and result in an overall accuracy of 73%, with the highest accuracy of 87.5% for mild severity. Our results suggest that using NLP and ML provides an accurate and cost-effective approach to evaluate the severity levels in PWA to consequently help clinicians determine rehabilitation procedures.
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Fromm D, Greenhouse J, Pudil M, Shi Y, MacWhinney B. Enhancing the Classification of Aphasia: A Statistical Analysis Using Connected Speech. APHASIOLOGY 2021; 36:1492-1519. [PMID: 36457942 PMCID: PMC9708051 DOI: 10.1080/02687038.2021.1975636] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 08/30/2021] [Indexed: 05/31/2023]
Abstract
BACKGROUND Large shared databases and automated language analyses allow for the application of new data analysis techniques that can shed new light on the connected speech of people with aphasia (PWA). AIMS To identify coherent clusters of PWA based on language output using unsupervised statistical algorithms and to identify features that are most strongly associated with those clusters. METHODS & PROCEDURES Clustering and classification methods were applied to language production data from 168 PWA. Language samples were from a standard discourse protocol tapping four genres: free speech personal narratives, picture descriptions, Cinderella storytelling, procedural discourse. OUTCOMES & RESULTS Seven distinct clusters of PWA were identified by the K-means algorithm. Using the random forests algorithm, a classification tree was proposed and validated, showing 91% agreement with the cluster assignments. This representative tree used only two variables to divide the data into distinct groups: total words from free speech tasks and total closed class words from the Cinderella storytelling task. CONCLUSION Connected speech data can be used to distinguish PWA into coherent groups, providing insight into traditional aphasia classifications, factors that may guide discourse research and clinical work.
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Affiliation(s)
- Davida Fromm
- Department of Psychology, Carnegie Mellon University
| | - Joel Greenhouse
- Department of Statistics & Data Science, Carnegie Mellon University
| | - Mitchell Pudil
- Department of Statistics & Data Science, Carnegie Mellon University
| | - Yichun Shi
- Department of Statistics & Data Science, Carnegie Mellon University
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Dalton SGH, Cavanagh JF, Richardson JD. Spectral Resting-State EEG (rsEEG) in Chronic Aphasia Is Reliable, Sensitive, and Correlates With Functional Behavior. Front Hum Neurosci 2021; 15:624660. [PMID: 33815079 PMCID: PMC8010195 DOI: 10.3389/fnhum.2021.624660] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 02/22/2021] [Indexed: 11/13/2022] Open
Abstract
We investigated spectral resting-state EEG in persons with chronic stroke-induced aphasia to determine its reliability, sensitivity, and relationship to functional behaviors. Resting-state EEG has not yet been characterized in this population and was selected given the demonstrated potential of resting-state investigations using other neuroimaging techniques to guide clinical decision-making. Controls and persons with chronic stroke-induced aphasia completed two EEG recording sessions, separated by approximately 1 month, as well as behavioral assessments of language, sensorimotor, and cognitive domains. Power in the classic frequency bands (delta, theta, alpha, and beta) was examined via spectral analysis of resting-state EEG data. Results suggest that power in the theta, alpha, and beta bands is reliable for use as a repeated measure. Significantly greater theta and lower beta power was observed in persons with aphasia (PWAs) than controls. Finally, in PWAs theta power negatively correlated with performance on a discourse informativeness measure, while alpha and beta power positively correlated with performance on the same measure. This indicates that spectral rsEEG slowing observed in PWAs in the chronic stage is pathological and suggests a possible avenue for directly altering brain activation to improve behavioral function. Taken together, these results suggest that spectral resting-state EEG holds promise for sensitive measurement of functioning and change in persons with chronic aphasia. Future studies investigating the utility of these measures as biomarkers of frank or latent aphasic deficits and treatment response in chronic stroke-induced aphasia are warranted.
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Affiliation(s)
- Sarah G. H. Dalton
- Department of Speech Pathology and Audiology, Marquette University, Milwaukee, WI, United States
| | - James F. Cavanagh
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Jessica D. Richardson
- Department of Speech and Hearing Sciences, University of New Mexico, Albuquerque, NM, United States
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Main Concept, Sequencing, and Story Grammar Analyses of Cinderella Narratives in a Large Sample of Persons with Aphasia. Brain Sci 2021; 11:brainsci11010110. [PMID: 33467602 PMCID: PMC7830981 DOI: 10.3390/brainsci11010110] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/08/2021] [Accepted: 01/10/2021] [Indexed: 01/27/2023] Open
Abstract
Recently, a multilevel analytic approach called Main Concept, Sequencing, and Story Grammar (MSSG) was presented along with preliminary normative information. MSSG analyses leverage the strong psychometrics and rich procedural knowledge of both main concept analysis and story grammar component coding, complementing it with easy-to-obtain sequencing information for a rich understanding of discourse informativeness and macrostructure. This study is the next critical step for demonstrating the clinical usefulness of MSSG’s six variables (main concept composite, sequencing, main concept+sequencing, essential story grammar components, total episodic components, and episodic complexity) for persons with aphasia (PWAs). We present descriptive statistical information for MSSG variables for a large sample of PWAs and compare their performance to a large sample of persons not brain injured (PNBIs). We observed significant differences between PWAs and PNBIs for all MSSG variables. These differences occurred at the omnibus group level and for each aphasia subtype, even for PWAs with very mild impairment that is not detected with standardized aphasia assessment. Differences between PWAs and PNBIs were also practically significant, with medium to large effect sizes observed for nearly all aphasia subtypes and MSSG variables. This work deepens our understanding of discourse informativeness and macrostructure in PWAs and further develops an efficient tool for research and clinical use. Future research should investigate ways to expand MSSG analyses and to improve sensitivity and specificity.
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Minga J, Johnson M, Blake ML, Fromm D, MacWhinney B. Making Sense of Right Hemisphere Discourse Using RHDBank. TOPICS IN LANGUAGE DISORDERS 2021; 41:99-122. [PMID: 34584326 PMCID: PMC8475789 DOI: 10.1097/tld.0000000000000244] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
PURPOSE Right hemisphere brain damage (RHD) commonly causes pragmatic language disorders that are apparent in discourse production. Specific characteristics and approaches to assessment, diagnosis, and treatment of these disorders are not well-defined. RHDBank, a shared database of multimedia interactions for the study of communication using discourse, was created to address these gaps. The database, materials, and related analysis programs are free resources to clinicians, researchers, educators, and students. METHOD A standard discourse protocol was developed to elicit multiple types of discourse: free speech, conversation, picture description, storytelling, procedural discourse, and question-asking. Testing included measures of cognition, unilateral neglect, and communicative participation. Language samples were video-recorded and transcribed in CHAT format. Currently, the database includes 24 adults with RHD and 24 controls. RESULTS Illustrative analyses show how RHDBank can facilitate research using micro- and macrolinguistic discourse analysis techniques both within this population and across populations. Educational resources, such as the Grand Rounds tutorial, were developed using case studies from the database. CONCLUSIONS RHDBank is a shared database of resources that can facilitate educational and research efforts to address the gaps in knowledge about RHD communication and improve the clinical management of individuals with RHD.
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Affiliation(s)
- Jamila Minga
- Communication Disorders Program, Department of Allied Professions, North Carolina Central University, Durham (Dr Minga); Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, North Carolina (Dr Minga); Department of Communication Sciences and Disorders, Nazareth College, Rochester, New York (Dr Johnson); Department of Communication Sciences and Disorders, University of Houston, Houston, Texas (Dr Blake); and Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania (Drs Fromm and MacWhinney)
| | - Melissa Johnson
- Communication Disorders Program, Department of Allied Professions, North Carolina Central University, Durham (Dr Minga); Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, North Carolina (Dr Minga); Department of Communication Sciences and Disorders, Nazareth College, Rochester, New York (Dr Johnson); Department of Communication Sciences and Disorders, University of Houston, Houston, Texas (Dr Blake); and Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania (Drs Fromm and MacWhinney)
| | - Margaret Lehman Blake
- Communication Disorders Program, Department of Allied Professions, North Carolina Central University, Durham (Dr Minga); Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, North Carolina (Dr Minga); Department of Communication Sciences and Disorders, Nazareth College, Rochester, New York (Dr Johnson); Department of Communication Sciences and Disorders, University of Houston, Houston, Texas (Dr Blake); and Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania (Drs Fromm and MacWhinney)
| | - Davida Fromm
- Communication Disorders Program, Department of Allied Professions, North Carolina Central University, Durham (Dr Minga); Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, North Carolina (Dr Minga); Department of Communication Sciences and Disorders, Nazareth College, Rochester, New York (Dr Johnson); Department of Communication Sciences and Disorders, University of Houston, Houston, Texas (Dr Blake); and Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania (Drs Fromm and MacWhinney)
| | - Brian MacWhinney
- Communication Disorders Program, Department of Allied Professions, North Carolina Central University, Durham (Dr Minga); Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, North Carolina (Dr Minga); Department of Communication Sciences and Disorders, Nazareth College, Rochester, New York (Dr Johnson); Department of Communication Sciences and Disorders, University of Houston, Houston, Texas (Dr Blake); and Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania (Drs Fromm and MacWhinney)
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Greenslade KJ, Stuart JEB, Richardson JD, Dalton SG, Ramage AE. Macrostructural Analyses of Cinderella Narratives in a Large Nonclinical Sample. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:1923-1936. [PMID: 32924890 PMCID: PMC8740559 DOI: 10.1044/2020_ajslp-19-00151] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 03/15/2020] [Accepted: 05/20/2020] [Indexed: 06/11/2023]
Abstract
Purpose Macrostructural narrative analyses are important clinical measures, revealing age-related declines and disorder-related impairments in the accuracy, completeness, logical sequencing, and organization of content. The current study aims to provide preliminary data on typical aging and psychometric evidence supporting multilevel Main Concept, Sequencing, and Story Grammar (MSSG) analyses that capture these aspects of narratives. Method Transcripts of Cinderella narratives for 92 healthy control participants stratified across four age brackets from the online database AphasiaBank were coded by Richardson and Dalton (2016) for main concept (MC) analysis. In the current study, MSSG analyses were completed for (a) logical sequencing, independently and in combination with MC accuracy and completeness (MC + sequencing), and (b) story grammar organization (i.e., inclusion of episodic components and complexity of episodes). Interrater agreement (99%-100%) revealed highly reliable scoring. Results Descriptive statistics for the typically aging sample are presented for sequencing, MC + sequencing, total episodic components, and episodic complexity. Scores for participants over 60 years of age were lower (poorer) than scores for those 20-59 years of age, supporting the construct validity of score use for identifying age-related declines in performance. Conclusions This study's novel MSSG analyses of narrative production efficiently assess the logical sequencing and story grammar organization of content in healthy controls. Preliminary reliability and validity evidence support the use of all scores to measure age-related changes in narrative macrostructure. Data from this typically aging sample provide a foundation for future research and clinical assessment aimed at quantifying narrative deficits in adults with communication disorders. Supplemental Material https://doi.org/10.23641/asha.12683495.
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Affiliation(s)
- Kathryn J. Greenslade
- Department of Communication Sciences & Disorders, University of New Hampshire, Durham
| | - Jade E. B. Stuart
- Department of Communication Sciences & Disorders, University of New Hampshire, Durham
| | | | - Sarah Grace Dalton
- Department of Speech Pathology and Audiology, Marquette University, Milwaukee, WI
| | - Amy E. Ramage
- Department of Communication Sciences & Disorders, University of New Hampshire, Durham
- Interdisciplinary Program in Neuroscience and Behavior, University of New Hampshire, Durham
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Dalton SGH, Hubbard HI, Richardson JD. Moving Toward Non-transcription based Discourse Analysis in Stable and Progressive Aphasia. Semin Speech Lang 2020; 41:32-44. [PMID: 31869847 PMCID: PMC11363584 DOI: 10.1055/s-0039-3400990] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Measurement of communication ability at the discourse level holds promise for predicting how well persons with stable (e.g., stroke-induced), or progressive aphasia navigate everyday communicative interactions. However, barriers to the clinical utilization of discourse measures have persisted. Recent advancements in the standardization of elicitation protocols and the existence of large databases for development of normative references have begun to address some of these barriers. Still, time remains a consistently reported barrier by clinicians. Non-transcription based discourse measurement would reduce the time required for discourse analysis, making clinical utilization a reality. The purpose of this article is to present evidence regarding discourse measures (main concept analysis, core lexicon, and derived efficiency scores) that are well suited to non-transcription based analysis. Combined with previous research, our results suggest that these measures are sensitive to changes following stroke or neurodegenerative disease. Given the evidence, further research specifically assessing the reliability of these measures in clinical implementation is warranted.
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Affiliation(s)
| | - H Isabel Hubbard
- Department of Communication Sciences and Disorders, University of Kentucky, Lexington, Kentucky
| | - Jessica D Richardson
- Department of Speech and Hearing Sciences, University of New Mexico, Albuquerque, New Mexico
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