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García-Pérez P, Rodríguez-Martínez MC, Gallardo-Tur A, Blanco-Reina E, de la Cruz-Cosme C, Lara JP. Early Occupational Therapy Intervention post-stroke (EOTIPS): A randomized controlled trial. PLoS One 2024; 19:e0308800. [PMID: 39159190 PMCID: PMC11332918 DOI: 10.1371/journal.pone.0308800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 07/29/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND Occupational therapy (OT) is an effective evidence-based intervention that positively influences stroke patients'independence recovery, leading to new opportunities for better quality of life outcomes. OBJECTIVES To explore the effectiveness of an early OT intervention program (EOTIPS) in the process of hospital to home discharge after stroke in Spain. MATERIAL AND METHODS We conducted a prospective, randomized controlled clinical trial that included 60 adults who suffered a stroke and were discharged home. Participants assigned to the experimental group (n = 30) were included in EOTIPS and compared with a control group (n = 30). Evaluations assessed quality of life (Stroke and Aphasia Quality of Life Scale [SAQOL-39]), functional independence (Modified Rankin Scale [mRS], Barthel Index [BI] and Stroke Impact Scale-16 [SIS-16]), perceptual-cognitive skills (Montreal Cognitive Assessment [MoCA]), upper limb function (Fugl Meyer Assessment [FMA]), mobility (Berg Balance Scale [BBS] and Timed Up & Go [TUG]), communication skills (Communicative Activity Log [CAL]) and mood disorders (Beck Depression Inventory-II [BDI-II] and Hamilton Anxiety Scale [HAM-A]); they were completed within two weeks post-stroke and after three months follow-up. Statistical analysis included intent-to-treat analysis, considering all participants (dropouts as failures), and efficacy analysis, considering only end-of-treatment participants. RESULTS Participants in the intervention group showed a significant better evolution in the main outcome measure of quality of life (SAQOL-39 p = .029), as well as for independence (mRSp = .004), perceptual-cognitive skills (MoCA p = .012)and symptoms of depression (BDI-II p = .011) compared to the control group. CONCLUSIONS EOTIPS was effective in improving quality of life, as well as enhancing perceptual-cognitive skills, independence and reducing levels of depression for patients who suffered a stroke in a Spanish cohort and could be considered as an applicable non-pharmacologic therapeutic tool that can lead to patients' positive outcomes after stroke. This study was registered on ClinicalTrials.gov with the identifier NCT04835363.
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Affiliation(s)
- Patricia García-Pérez
- Physiology Department, Faculty of Medicine, University of Malaga, Malaga, Spain
- Occupational Therapy Department, Hospital Civil, Malaga, Spain
- Department of Physiotherapy, Faculty of Health Sciences, University of Malaga, Malaga, Spain
- Brain Health Unit, Centro de Investigaciones Médico-Sanitarias (CIMES), Malaga, Spain
| | - María Carmen Rodríguez-Martínez
- Department of Physiotherapy, Faculty of Health Sciences, University of Malaga, Malaga, Spain
- Biomedical Research Institute of Malaga-Nanomedicine Platform (IBIMA-BIONAND Platform), Malaga, Spain
| | | | - Encarnación Blanco-Reina
- Brain Health Unit, Centro de Investigaciones Médico-Sanitarias (CIMES), Malaga, Spain
- Biomedical Research Institute of Malaga-Nanomedicine Platform (IBIMA-BIONAND Platform), Malaga, Spain
- Pharmacology and Therapeutics Department, Faculty of Medicine, University of Malaga, Malaga, Spain
| | - Carlos de la Cruz-Cosme
- Biomedical Research Institute of Malaga-Nanomedicine Platform (IBIMA-BIONAND Platform), Malaga, Spain
- Neurology Department, Virgen de la Victoria University Hospital, Malaga, Spain
- Medicine and Dermatology Departments, Faculty of Medicine, University of Malaga, Malaga, Spain
| | - José Pablo Lara
- Physiology Department, Faculty of Medicine, University of Malaga, Malaga, Spain
- Brain Health Unit, Centro de Investigaciones Médico-Sanitarias (CIMES), Malaga, Spain
- Biomedical Research Institute of Malaga-Nanomedicine Platform (IBIMA-BIONAND Platform), Malaga, Spain
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Pierce JE, Hill AJ, Wong D, Pitt R, Rose ML. Adapting a group-based, multimodal aphasia treatment for telehealth - co-design of M-MAT Tele. Disabil Rehabil Assist Technol 2024:1-8. [PMID: 38967320 DOI: 10.1080/17483107.2024.2366423] [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: 12/06/2023] [Accepted: 06/01/2024] [Indexed: 07/06/2024]
Abstract
Multi-Modality Aphasia Treatment (M-MAT) is an effective group intervention for post-stroke aphasia. M-MAT employs interactive card games and the modalities of gesture, drawing, reading, and writing to improve spoken language. However, there are challenges to implementation of group interventions such as M-MAT, particularly for those who cannot travel or live in rural areas. To maximise access to this effective treatment, we aimed to adapt M-MAT to telehealth format (M-MAT Tele). The Human-Centred Design Framework was utilized to guide the adaptation approach. We identified the intended context of use (outpatient/community rehabilitation) and the stakeholders (clinicians, people with aphasia, health service funders). People with aphasia and practising speech pathologists were invited to co-design M-MAT Tele in a series of iterative workshops, to ensure the end product was user-friendly and clinically feasible. The use of co-design allowed us to understand the hardware, software and other constraints and preferences of end users. In particular, clinicians (n = 3) required software compatible with a range of telehealth platforms and people with aphasia (n = 3) valued solutions with minimal technical demands and costs for participants. Co-design within the Human-Centred Design Framework led to a telehealth solution compatible with all major telehealth platforms, with minimal hardware or software requirements. Pilot testing is underway to confirm acceptability of M-MAT Tele to clinicians and people with aphasia, aiming to provide an effective, accessible tool for aphasia therapy in telehealth settings.
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Affiliation(s)
- John E Pierce
- Aphasia CRE, La Trobe University, Melbourne, Australia
| | - Annie J Hill
- Aphasia CRE, La Trobe University, Melbourne, Australia
| | - Dana Wong
- Aphasia CRE, La Trobe University, Melbourne, Australia
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Spigarelli M, Lalancette A, Massé-Alarie H, Wilson MA. Repetitive Transcranial Magnetic Stimulation for Action Naming in Aphasia Rehabilitation: A Systematic Review and Meta-Analysis. Brain Sci 2024; 14:665. [PMID: 39061405 PMCID: PMC11275163 DOI: 10.3390/brainsci14070665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Revised: 06/21/2024] [Accepted: 06/27/2024] [Indexed: 07/28/2024] Open
Abstract
Anomia, characterized by difficulty in word retrieval, particularly action verbs, poses a significant challenge in post-stroke aphasia. Repetitive transcranial magnetic stimulation (rTMS) has gained attention for language processing investigations and interventions. This systematic review explores the potential of rTMS as a modality to address action-verb deficits in post-stroke aphasia. We searched MEDLINE via PubMed, CINAHL via Ebsco and Web of Science in February 2024 for English articles (1996-2024). Eligible studies involved post-stroke aphasia action naming rehabilitation with rTMS. In some of these studies, rTMS was combined with speech-language therapy. In total, 10 studies were included in this systematic review. These articles highlight the potential of rTMS in improving verb retrieval deficits. While significant improvements may not be evident, notable progress both before and after intervention is observed in this review. However, it also underscores the need for further research to enhance language recovery for individuals with post-stroke aphasia.
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Affiliation(s)
- Manon Spigarelli
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale—CIRRIS, 525 Bd Wilfrid-Hamel, Québec, QC G1M 2S8, Canada; (A.L.); (H.M.-A.); (M.A.W.)
| | - Audrey Lalancette
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale—CIRRIS, 525 Bd Wilfrid-Hamel, Québec, QC G1M 2S8, Canada; (A.L.); (H.M.-A.); (M.A.W.)
| | - Hugo Massé-Alarie
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale—CIRRIS, 525 Bd Wilfrid-Hamel, Québec, QC G1M 2S8, Canada; (A.L.); (H.M.-A.); (M.A.W.)
- École des Sciences de la Réadaptation, Faculté de Médecine, Université Laval, 1050 Av. de la Médecine, Québec, QC G1V 0A6, Canada
| | - Maximiliano A. Wilson
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale—CIRRIS, 525 Bd Wilfrid-Hamel, Québec, QC G1M 2S8, Canada; (A.L.); (H.M.-A.); (M.A.W.)
- École des Sciences de la Réadaptation, Faculté de Médecine, Université Laval, 1050 Av. de la Médecine, Québec, QC G1V 0A6, Canada
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Bueno‐Guerra N, Provencio M, Tarifa‐Rodríguez A, Navarro A, Sempere‐Iborra C, Jordi P, de Celis‐Ruiz E, Alonso de Leciñana M, Martín‐Alonso M, Rigual R, Ruiz‐Ares G, Rodríguez‐Pardo J, Virués‐Ortega J, Fuentes B. Impact of post-stroke aphasia on functional communication, quality of life, perception of health and depression: A case-control study. Eur J Neurol 2024; 31:e16184. [PMID: 38095330 PMCID: PMC11235649 DOI: 10.1111/ene.16184] [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: 09/05/2023] [Revised: 11/06/2023] [Accepted: 11/23/2023] [Indexed: 03/14/2024]
Abstract
BACKGROUND AND PURPOSE Post-stroke aphasia is associated with a reduced quality of life (QoL) and higher risk of depression. Few studies have addressed the effect of coping with aphasia. Our aim is to evaluate the impact of post-stroke aphasia on self-reported QoL and symptoms of depression. METHODS This was a cross-sectional prospective case-control study. Cases involved patients with post-stroke aphasia included in the DULCINEA trial (NCT04289493). Healthy controls were recruited using snowball sampling. All subjects completed the following questionnaires: General Health Questionnaire (GHQ-12), Stroke Aphasia Quality of Life Scale (SAQOL-39), Communicative Activity Log (CAL) and Stroke Aphasic Depression Questionnaire (SADQ-10). RESULTS Twenty-three patients (eight women; mean age 62.9 years) and 73 controls (42 women; mean age 53.7 years) were included. Cases scored lower than controls in perception of health (GHQ-12: median 3 [IQR 1; 6] vs. 0 [IQR 0; 2]) and perception of QoL (SAQOL-39: median 3.6 [IQR 3.3; 40] vs. 4.6 [IQR 4.2; 4.8]). Functional communication (CAL: median 135 [IQR 122; 148] vs. 94 [IQR 74; 103]) and SAQOL-39 communication subscale (median 2.7 [IQR 2.1; 3.2] vs. 4.8 [IQR 4.6; 5.0]) were also significantly lower in the case group. Notably, cases reported fewer depressive symptoms than controls (SADQ-10: median 11 [IQR 9; 15] vs. 13 [IQR 11; 16]; p = 0.016). A mediational analysis revealed that the relationship between post-stroke aphasia and depression was not mediated by functional communication. CONCLUSIONS Although communication difficulties impact the QoL of patients with post-stroke aphasia, such patients report fewer depressive symptoms on the SADQ-10 scale than healthy people, with no differences in scores related to social participation.
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Affiliation(s)
| | - Marta Provencio
- Faculty of PsychologyComillas Pontifical UniversityMadridSpain
| | | | - Ana Navarro
- Faculty of PsychologyComillas Pontifical UniversityMadridSpain
| | | | - Pablo Jordi
- La Paz University Hospital‐Autonomous University of MadridMadridSpain
| | - Elena de Celis‐Ruiz
- Department of Neurology and Stroke UnitHospital La Paz Institute for Health Research‐IdiPAZ (La Paz University Hospital‐Universidad Autónoma de Madrid)MadridSpain
| | - María Alonso de Leciñana
- Department of Neurology and Stroke UnitHospital La Paz Institute for Health Research‐IdiPAZ (La Paz University Hospital‐Universidad Autónoma de Madrid)MadridSpain
| | - Marta Martín‐Alonso
- Speech Therapy Unit, Department of RehabilitationHospital La Paz Institute for Health Research‐IdiPAZ (La Paz University Hospital‐Universidad Autónoma de Madrid)MadridSpain
| | - Ricardo Rigual
- Department of Neurology and Stroke UnitHospital La Paz Institute for Health Research‐IdiPAZ (La Paz University Hospital‐Universidad Autónoma de Madrid)MadridSpain
| | - Gerardo Ruiz‐Ares
- Department of Neurology and Stroke UnitHospital La Paz Institute for Health Research‐IdiPAZ (La Paz University Hospital‐Universidad Autónoma de Madrid)MadridSpain
| | - Jorge Rodríguez‐Pardo
- Department of Neurology and Stroke UnitHospital La Paz Institute for Health Research‐IdiPAZ (La Paz University Hospital‐Universidad Autónoma de Madrid)MadridSpain
| | | | - Blanca Fuentes
- Department of Neurology and Stroke UnitHospital La Paz Institute for Health Research‐IdiPAZ (La Paz University Hospital‐Universidad Autónoma de Madrid)MadridSpain
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Fuentes B, Jordi-Perea P, Sempere-Iborra C, Tarifa-Rodríguez A, de Celis-Ruiz E, Martín Alonso M, Ruiz-Ares G, Rigual R, Rodríguez-Pardo J, Alonso-López E, Alonso de Leciñana M, Virués-Ortega J, Borobia AM, Jiménez-González M, Martínez-Balaguer M, Blanco P, Bueno N. Dubbing language-therapy CINEma-based in aphasia post-stroke (DULCINEA): A feasibility randomized crossover controlled trial. Digit Health 2024; 10:20552076241288311. [PMID: 39421311 PMCID: PMC11483829 DOI: 10.1177/20552076241288311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 09/10/2024] [Indexed: 10/19/2024] Open
Abstract
Background Helping people recover from aphasia is among the top 10 research priorities relating to life after stroke. Objective We aimed to evaluate the feasibility of dubbing techniques (using newly developed software) for post-stroke aphasia therapy and explore its potential efficacy. Methods Randomised, crossover, interventional, feasibility trial that included patients with chronic post-stroke non-fluent aphasia. The intervention consisted of an individualised programme (16 sessions; 8 weeks) based on dubbing words and sentences progressively adapted to the severity of the aphasia. Patients were allocated to groups that underwent therapy within the first 3 months, or between 3 and 6 months from inclusion, each group serving as the control during the non-therapy periods. Outcomes were the pre-post differences in the Communicative Activity Log, the Boston Diagnostic Aphasia Examination, the General Health Questionnaire-12, the Stroke Aphasia Quality of Life Scale, and the Western Aphasia Battery Revised, administered by psychologists blinded to the patients' allocation. Results Recruitment was limited due to COVID-19 and prematurely stopped because of funding coming to an end. A total of 23 patients were randomised, 20 of whom completed the study (1 withdrew consent, and 2 dropped out). The adherence rate to the allocated group was 95.3%. No statistically significant differences were found in any of the outcomes; however, 17 (85%) patients reported subjective improvements in communication skills. Conclusions This trial shows the feasibility of dubbing therapy (using dedicated software) for patients with post-stroke non-fluent aphasia. Although it lacks statistical power, certain effects on language and communication cannot be ignored.
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Affiliation(s)
- Blanca Fuentes
- Department of Neurology and Stroke Centre, La Paz University Hospital, Department of Medicine, Universidad Autónoma de Madrid, Neurosciences Area, IdiPAZ Institute for Health Research, Madrid, Spain
| | - Pablo Jordi-Perea
- Neurosciences Area, IdiPAZ Institute for Health Research, Madrid, Spain
| | | | | | - Elena de Celis-Ruiz
- Department of Neurology and Stroke Centre, La Paz University Hospital, Department of Medicine, Universidad Autónoma de Madrid, Neurosciences Area, IdiPAZ Institute for Health Research, Madrid, Spain
| | - Marta Martín Alonso
- Speech and Language Unit. Department of Rehabilitation, La Paz University Hospital, Madrid, Spain
| | - Gerardo Ruiz-Ares
- Department of Neurology and Stroke Centre, La Paz University Hospital, Department of Medicine, Universidad Autónoma de Madrid, Neurosciences Area, IdiPAZ Institute for Health Research, Madrid, Spain
| | - Ricardo Rigual
- Department of Neurology and Stroke Centre, La Paz University Hospital, Department of Medicine, Universidad Autónoma de Madrid, Neurosciences Area, IdiPAZ Institute for Health Research, Madrid, Spain
| | - Jorge Rodríguez-Pardo
- Department of Neurology and Stroke Centre, La Paz University Hospital, Department of Medicine, Universidad Autónoma de Madrid, Neurosciences Area, IdiPAZ Institute for Health Research, Madrid, Spain
| | - Elisa Alonso-López
- Department of Neurology and Stroke Centre, La Paz University Hospital, Department of Medicine, Universidad Autónoma de Madrid, Neurosciences Area, IdiPAZ Institute for Health Research, Madrid, Spain
| | - María Alonso de Leciñana
- Department of Neurology and Stroke Centre, La Paz University Hospital, Department of Medicine, Universidad Autónoma de Madrid, Neurosciences Area, IdiPAZ Institute for Health Research, Madrid, Spain
| | | | - Alberto M Borobia
- Clinical Trials Unit. Department of Clinical Pharmacology, La Paz University Hospital, IdiPAZ Institute for Health Research, Madrid, Spain
| | - María Jiménez-González
- Clinical Trials Unit. Department of Clinical Pharmacology, La Paz University Hospital, IdiPAZ Institute for Health Research, Madrid, Spain
| | - María Martínez-Balaguer
- Clinical Trials Unit. Department of Clinical Pharmacology, La Paz University Hospital, IdiPAZ Institute for Health Research, Madrid, Spain
| | | | - Nereida Bueno
- Department of Psychology, Universidad Pontificia Comillas, Madrid, Spain
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Harrison M, Palmer R, Cooper C. Identifying the Active Ingredients of a Computerized Speech and Language Therapy Intervention for Poststroke Aphasia: Multiple Methods Investigation Alongside a Randomized Controlled Trial. JMIR Rehabil Assist Technol 2023; 10:e47542. [PMID: 38051577 PMCID: PMC10731555 DOI: 10.2196/47542] [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: 03/23/2023] [Revised: 08/09/2023] [Accepted: 10/12/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Aphasia is a communication disorder affecting more than one-third of stroke survivors. Computerized Speech and Language Therapy (CSLT) is a complex intervention requiring computer software, speech and language therapists, volunteers, or therapy assistants, as well as self-managed practice from the person with aphasia. CSLT was found to improve word finding, a common symptom of aphasia, in a multicenter randomized controlled trial (Clinical and Cost Effectiveness of Computer Treatment for Aphasia Post Stroke [Big CACTUS]). OBJECTIVE This study provides a detailed description of the CSLT intervention delivered in the Big CACTUS trial and identified the active ingredients of the intervention directly associated with improved word finding for people with aphasia. METHODS We conducted a multiple methods study within the context of a randomized controlled trial. In study 1, qualitative interviews explored key informants' understanding of the CSLT intervention, how the components interacted, and how they could be measured. Qualitative data were transcribed verbatim and analyzed thematically. Qualitative findings informed the process measures collected as part of a process evaluation of the CSLT intervention delivered in the Big CACTUS trial. In study 2, quantitative analyses explored the relationship between intervention process measures (length of computer therapy access; therapists' knowledge of CSLT; degree of rationale for CSLT tailoring; and time spent using the software to practice cued confrontation naming, noncued naming, and using words in functional sentences) and change in word-finding ability over a 6-month intervention period. RESULTS Qualitative interviews were conducted with 7 CSLT approach experts. Thematic analysis identified four overarching components of the CSLT approach: (1) the StepByStep software (version 5; Steps Consulting Ltd), (2) therapy setup: tailoring and personalizing, (3) regular independent practice, and (4) support and monitoring. Quantitative analyses included process and outcome data from 83 participants randomized to the intervention arm of the Big CACTUS trial. The process measures found to be directly associated with improved word-finding ability were therapists providing a thorough rationale for tailoring the computerized therapy exercises and the amount of time the person with aphasia spent using the computer software to practice using words in functional sentences. CONCLUSIONS The qualitative exploration of the CSLT approach provided a detailed description of the components, theories, and mechanisms underpinning the intervention and facilitated the identification of process measures to be collected in the Big CACTUS trial. Quantitative analysis furthered our understanding of which components of the intervention are associated with clinical improvement. To optimize the benefits of using the CSLT approach for word finding, therapists are advised to pay particular attention to the active ingredients of the intervention: tailoring the therapy exercises based on the individual's specific language difficulties and encouraging people with aphasia to practice the exercises focused on saying words in functional sentences. TRIAL REGISTRATION ISRCTN Registry ISRCTN68798818; https://www.isrctn.com/ISRCTN68798818.
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Affiliation(s)
- Madeleine Harrison
- Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Rebecca Palmer
- Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Cindy Cooper
- Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, United Kingdom
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Bechtold L, Cosper SH, Malyshevskaya A, Montefinese M, Morucci P, Niccolai V, Repetto C, Zappa A, Shtyrov Y. Brain Signatures of Embodied Semantics and Language: A Consensus Paper. J Cogn 2023; 6:61. [PMID: 37841669 PMCID: PMC10573703 DOI: 10.5334/joc.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 07/29/2022] [Indexed: 10/17/2023] Open
Abstract
According to embodied theories (including embodied, embedded, extended, enacted, situated, and grounded approaches to cognition), language representation is intrinsically linked to our interactions with the world around us, which is reflected in specific brain signatures during language processing and learning. Moving on from the original rivalry of embodied vs. amodal theories, this consensus paper addresses a series of carefully selected questions that aim at determining when and how rather than whether motor and perceptual processes are involved in language processes. We cover a wide range of research areas, from the neurophysiological signatures of embodied semantics, e.g., event-related potentials and fields as well as neural oscillations, to semantic processing and semantic priming effects on concrete and abstract words, to first and second language learning and, finally, the use of virtual reality for examining embodied semantics. Our common aim is to better understand the role of motor and perceptual processes in language representation as indexed by language comprehension and learning. We come to the consensus that, based on seminal research conducted in the field, future directions now call for enhancing the external validity of findings by acknowledging the multimodality, multidimensionality, flexibility and idiosyncrasy of embodied and situated language and semantic processes.
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Affiliation(s)
- Laura Bechtold
- Institute for Experimental Psychology, Department for Biological Psychology, Heinrich-Heine University Düsseldorf, Germany
| | - Samuel H. Cosper
- Institute of Cognitive Science, University of Osnabrück, Germany
| | - Anastasia Malyshevskaya
- Centre for Cognition and Decision making, Institute for Cognitive Neuroscience, HSE University, Russian Federation
- Potsdam Embodied Cognition Group, Cognitive Sciences, University of Potsdam, Germany
| | | | | | - Valentina Niccolai
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany
| | - Claudia Repetto
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Ana Zappa
- Laboratoire parole et langage, Aix-Marseille Université, Aix-en-Provence, France
| | - Yury Shtyrov
- Centre for Cognition and Decision making, Institute for Cognitive Neuroscience, HSE University, Russian Federation
- Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University, Denmark
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López-Barroso D, Paredes-Pacheco J, Torres-Prioris MJ, Dávila G, Berthier ML. Brain structural and functional correlates of the heterogenous progression of mixed transcortical aphasia. Brain Struct Funct 2023:10.1007/s00429-023-02655-6. [PMID: 37256346 DOI: 10.1007/s00429-023-02655-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 05/13/2023] [Indexed: 06/01/2023]
Abstract
Mixed transcortical aphasia (MTCA) is characterized by non-fluent speech and comprehension deficits coexisting with preserved repetition. MTCA may evolve to less severe variants of aphasias or even to full language recovery. Mechanistically, MCTA has traditionally been attributed to a disconnection between the spared left perisylvian language network (PSLN) responsible for preserved verbal repetition, and damaged left extrasylvian networks, which are responsible for language production and comprehension impairments. However, despite significant advances in in vivo neuroimaging, the structural and functional status of the PSLN network in MTCA and its evolution has not been investigated. Thus, the aim of the present study is to examine the status of the PSLN, both in terms of its functional activity and structural integrity, in four cases who developed acute post-stroke MTCA and progressed to different types of aphasia. For it, we conducted a neuroimaging-behavioral study performed in the chronic stage of four patients. The behavioral profile of MTCA persisted in one patient, whereas the other three patients progressed to less severe types of aphasias. Neuroimaging findings suggest that preserved verbal repetition in MTCA does not always depend on the optimal status of the PSLN and its dorsal connections. Instead, the right hemisphere or the left ventral pathway may also play a role in supporting verbal repetition. The variability in the clinical evolution of MTCA may be explained by the varying degree of PSLN alteration and individual premorbid neuroanatomical language substrates. This study offers a fresh perspective of MTCA through the lens of modern neuroscience and unveils novel insights into the neural underpinnings of repetition.
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Affiliation(s)
- Diana López-Barroso
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias (CIMES), University of Malaga, Malaga, Spain
- Research Laboratory on the Neuroscience of Language, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
- Instituto de Investigación Biomédica de Málaga - IBIMA, Malaga, Spain
- Department of Psychobiology and Methodology of Behavioural Sciences, Faculty of Psychology, University of Malaga, Malaga, Spain
| | - José Paredes-Pacheco
- Radiology and Psychiatry Department, Faculty of Medicine, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Molecular Imaging Unit, Centro de Investigaciones Médico-Sanitarias (CIMES), General Foundation of the University of Malaga, Malaga, Spain
| | - María José Torres-Prioris
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias (CIMES), University of Malaga, Malaga, Spain
- Research Laboratory on the Neuroscience of Language, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
- Instituto de Investigación Biomédica de Málaga - IBIMA, Malaga, Spain
- Department of Psychobiology and Methodology of Behavioural Sciences, Faculty of Psychology, University of Malaga, Malaga, Spain
| | - Guadalupe Dávila
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias (CIMES), University of Malaga, Malaga, Spain
- Research Laboratory on the Neuroscience of Language, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
- Instituto de Investigación Biomédica de Málaga - IBIMA, Malaga, Spain
- Department of Psychobiology and Methodology of Behavioural Sciences, Faculty of Psychology, University of Malaga, Malaga, Spain
| | - Marcelo L Berthier
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias (CIMES), University of Malaga, Malaga, Spain.
- Research Laboratory on the Neuroscience of Language, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain.
- Instituto de Investigación Biomédica de Málaga - IBIMA, Malaga, Spain.
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Cui Y, Ma N, Liu X, Lian Y, Li Y, Xu G, Zhang J, Li Z. Progress in the clinical application of constraint-induced therapy following stroke since 2014. Front Neurol 2023; 14:1170420. [PMID: 37273704 PMCID: PMC10235632 DOI: 10.3389/fneur.2023.1170420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/02/2023] [Indexed: 06/06/2023] Open
Abstract
Stroke is a group of cerebrovascular diseases with high prevalence and mortality rate. Stroke can induce many impairments, including motor and cognitive dysfunction, aphasia/dysarthria, dysphagia, and mood disorders, which may reduce the quality of life among the patients. Constraint-induced therapy has been proven to be an effective treatment method for stroke rehabilitation. It has been widely used in the recovery of limb motor dysfunction, aphasia, and other impairment like unilateral neglect after stroke. In recent years, constraint-induced therapy can also combine with telehealth and home rehabilitation. In addition, constraint-induced therapy produces significant neuroplastic changes in the central nervous system. Functional magnetic resonance imaging, diffusion tensor imaging, and other imaging/electrophysiology methods have been used to clarify the mechanism and neuroplasticity. However, constraint-induced therapy has some limitations. It can only be used under certain conditions, and the treatment time and effectiveness are controversial. Further research is needed to clarify the mechanism and effectiveness of CI therapy.
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10
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Peebles IS, Phillips TO, Hamilton RH. Toward more diverse, inclusive, and equitable neuromodulation. Brain Stimul 2023; 16:737-741. [PMID: 37088453 DOI: 10.1016/j.brs.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/28/2023] [Accepted: 04/18/2023] [Indexed: 04/25/2023] Open
Abstract
Racial and ethnic disparities exist for many nervous system disorders that are intervention targets for neuromodulation investigators. Yet, to date, there has been both a lack of racial and ethnic diversity and a lack of emphasis on diversity in neuromodulation research. In this paper, we suggest three potential reasons for the lack of racial and ethnic diversity in neuromodulation research: 1) the lack of diversity in the neuromodulation workforce, 2) incompatibility between the technologies employed and phenotypic traits (e.g., hair texture) commonly present in minoritized populations, and 3) minoritized populations' reluctance to participate in clinical trials. We argue that increasing diversity in the neuromodulation workforce, in conjunction with mutual collaboration between current neuromodulation researchers and underrepresented communities in neuromodulation, can aid in removing barriers to diversity, equity, and inclusion in neuromodulation research. This is important, because greater diversity, equity, and inclusion in neuromodulation research brings with it the development of novel, yet safe and effective, treatment approaches for brain disorders and enhances the rigor and generalizability of discoveries in the field.
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Affiliation(s)
- Ian S Peebles
- University Center for Human Values, Princeton University, Princeton, NJ, 08544, United States.
| | - Taylor O Phillips
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, 19104, United States
| | - Roy H Hamilton
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, 19104, United States
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11
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Bayram M, Palluel-Germain R, Lebon F, Durand E, Harquel S, Perrone-Bertolotti M. Motor imagery training to improve language processing: What are the arguments? Front Hum Neurosci 2023; 17:982849. [PMID: 36816506 PMCID: PMC9929469 DOI: 10.3389/fnhum.2023.982849] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 01/09/2023] [Indexed: 02/04/2023] Open
Abstract
Studies showed that motor expertise was found to induce improvement in language processing. Grounded and situated approaches attributed this effect to an underlying automatic simulation of the motor experience elicited by action words, similar to motor imagery (MI), and suggest shared representations of action conceptualization. Interestingly, recent results also suggest that the mental simulation of action by MI training induces motor-system modifications and improves motor performance. Consequently, we hypothesize that, since MI training can induce motor-system modifications, it could be used to reinforce the functional connections between motor and language system, and could thus lead to improved language performance. Here, we explore these potential interactions by reviewing recent fundamental and clinical literature in the action-language and MI domains. We suggested that exploiting the link between action language and MI could open new avenues for complementary language improvement programs. We summarize the current literature to evaluate the rationale behind this novel training and to explore the mechanisms underlying MI and its impact on language performance.
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Affiliation(s)
- Mariam Bayram
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000 Grenoble, France
| | | | - Florent Lebon
- Laboratoire INSERM U1093 Cognition, Action, et Plasticité Sensorimotrice, Université de Bourgogne, Faculté des Sciences du Sport (UFR STAPS), Dijon, France,Institut Universitaire de France (IUF), Paris, France
| | - Edith Durand
- Département d’Orthophonie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Sylvain Harquel
- Defitech Chair of Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
| | - Marcela Perrone-Bertolotti
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000 Grenoble, France,Institut Universitaire de France (IUF), Paris, France,*Correspondence: Marcela Perrone-Bertolotti,
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Low TA, Lindland K, Kirton A, Carlson HL, Harris AD, Goodyear BG, Monchi O, Hill MD, Dukelow SP. Repetitive transcranial magnetic stimulation (rTMS) combined with multi-modality aphasia therapy for chronic post-stroke non-fluent aphasia: A pilot randomized sham-controlled trial. BRAIN AND LANGUAGE 2023; 236:105216. [PMID: 36525719 DOI: 10.1016/j.bandl.2022.105216] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 10/22/2022] [Accepted: 12/03/2022] [Indexed: 06/17/2023]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) shows promise in improving speech production in post-stroke aphasia. Limited evidence suggests pairing rTMS with speech therapy may result in greater improvements. Twenty stroke survivors (>6 months post-stroke) were randomized to receive either sham rTMS plus multi-modality aphasia therapy (M-MAT) or rTMS plus M-MAT. For the first time, we demonstrate that rTMS combined with M-MAT is feasible, with zero adverse events and minimal attrition. Both groups improved significantly over time on all speech and language outcomes. However, improvements did not differ between rTMS or sham. We found that rTMS and sham groups differed in lesion location, which may explain speech and language outcomes as well as unique patterns of BOLD signal change within each group. We offer practical considerations for future studies and conclude that while combination therapy of rTMS plus M-MAT in chronic post-stroke aphasia is safe and feasible, personalized intervention may be necessary.
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Affiliation(s)
- Trevor A Low
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kevin Lindland
- Department of Allied Health, Alberta Health Services, Calgary, Alberta, Canada
| | - Adam Kirton
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Pediatrics, Cummings School of Medicine, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Helen L Carlson
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Pediatrics, Cummings School of Medicine, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Ashley D Harris
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Bradley G Goodyear
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Oury Monchi
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Michael D Hill
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sean P Dukelow
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Division of Physical Medicine and Rehabilitation, University of Calgary, Calgary, Alberta, Canada.
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13
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Wallace SE, Patterson J, Purdy M, Knollman-Porter K, Coppens P. Auditory Comprehension Interventions for People With Aphasia: A Scoping Review. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2404-2420. [PMID: 36252946 DOI: 10.1044/2022_ajslp-21-00297] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE This scoping review examined studies reporting restorative treatments designed to improve auditory comprehension in people with aphasia. METHOD We searched eight databases using keywords aphasia, auditory comprehension, treatment, intervention, and rehabilitation, for studies published between 1970 and 2020. Searches returned 170 records, and after applying exclusionary criteria, 28 articles remained. For each article, two authors independently extracted data on study design parameters, participant characteristics, treatment protocol, and treatment outcomes, including generalization. RESULTS Studies were categorized by treatment focus: direct auditory (n = 7), mixed auditory (n = 13), or indirect (n = 8). Study designs were group (n = 12), single-subject experimental design (n = 11), or case study (n = 5). Fifteen studies had a control condition and/or a control group. Thirteen studies included two to 10 participants. Aphasia severity and auditory comprehension severity were infrequently reported, and most participants were greater than 1-year poststroke. Treatment targets and tasks varied. Sessions ranged from 8 to 240 min, once or more per week, for eight to 60 total sessions over 2-20 weeks. Impairment-based outcome measures were typically used. Improvement and generalization were regularly reported; however, authors frequently did not report statistical significance. CONCLUSIONS A variety of treatments have addressed auditory comprehension deficits in people with aphasia, with many reporting improvements in auditory comprehension for some people. However, the variability in treatment tasks and delivery and outcome measurements preclude confidently offering specific clinical recommendations for implementing auditory comprehension treatments. Gaps identified by the current study may guide the development and exploration of transparent, repeatable, patient-centered treatments. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21291345.
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Affiliation(s)
- Sarah E Wallace
- Department of Communication Science and Disorders, University of Pittsburgh, PA
| | - Janet Patterson
- Research Service, VA Northern California Health Care System, Martinez
| | - Mary Purdy
- Department of Communication Disorders, Southern Connecticut State University, New Haven
| | | | - Patrick Coppens
- Department of Communication Sciences and Disorders, State University of New York College at Plattsburgh
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14
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Ulanov M, Shtyrov Y. Oscillatory beta/alpha band modulations: A potential biomarker of functional language and motor recovery in chronic stroke? Front Hum Neurosci 2022; 16:940845. [PMID: 36226263 PMCID: PMC9549964 DOI: 10.3389/fnhum.2022.940845] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
Stroke remains one of the leading causes of various disabilities, including debilitating motor and language impairments. Though various treatments exist, post-stroke impairments frequently become chronic, dramatically reducing daily life quality, and requiring specific rehabilitation. A critical goal of chronic stroke rehabilitation is to induce, usually through behavioral training, experience-dependent plasticity processes in order to promote functional recovery. However, the efficiency of such interventions is typically modest, and very little is known regarding the neural dynamics underpinning recovery processes and possible biomarkers of their efficiency. Some studies have emphasized specific alterations of excitatory–inhibitory balance within distributed neural networks as an important recovery correlate. Neural processes sensitive to these alterations, such as task-dependent oscillatory activity in beta as well as alpha bands, may be candidate biomarkers of chronic stroke functional recovery. In this review, we discuss the results of studies on motor and language recovery with a focus on oscillatory processes centered around the beta band and their modulations during functional recovery in chronic stroke. The discussion is based on a framework where task-dependent modulations of beta and alpha oscillatory activity, generated by the deep cortical excitatory–inhibitory microcircuits, serve as a neural mechanism of domain-general top-down control processes. We discuss the findings, their limitations, and possible directions for future research.
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Affiliation(s)
- Maxim Ulanov
- Centre for Cognition and Decision Making, Institute for Cognitive Neuroscience, HSE University, Moscow, Russia
- *Correspondence: Maxim Ulanov,
| | - Yury Shtyrov
- Center of Functionally Integrative Neuroscience (CFIN), Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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15
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Gravier ML, Hula WD, Johnson JP, Autenreith A, Dickey MW. Is there a Relationship Between Cortisol and Treatment Response in Chronic Aphasia? TOPICS IN LANGUAGE DISORDERS 2022; 42:193-211. [PMID: 36406142 PMCID: PMC9670258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Michelle L Gravier
- Department of Speech, Language, and Hearing Sciences, California State East Bay, Hayward, CA, USA
| | - William D Hula
- Geriatric Research, Education, and Clinical Center and Audiology and Speech Pathology Service, VA Pittsburgh Healthcare System, Pittsburgh PA, USA
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh PA, USA
| | - Jeffrey P Johnson
- Geriatric Research, Education, and Clinical Center and Audiology and Speech Pathology Service, VA Pittsburgh Healthcare System, Pittsburgh PA, USA
| | - Alyssa Autenreith
- Geriatric Research, Education, and Clinical Center and Audiology and Speech Pathology Service, VA Pittsburgh Healthcare System, Pittsburgh PA, USA
| | - Michael Walsh Dickey
- Geriatric Research, Education, and Clinical Center and Audiology and Speech Pathology Service, VA Pittsburgh Healthcare System, Pittsburgh PA, USA
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh PA, USA
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16
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van Minkelen P, Krahmer E, Vogt P. Exploring How People with Expressive Aphasia Interact with and Perceive a Social Robot. Int J Soc Robot 2022; 14:1821-1840. [PMID: 36032661 PMCID: PMC9395781 DOI: 10.1007/s12369-022-00908-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2022] [Indexed: 11/25/2022]
Abstract
People with aphasia need high-intensive language training to significantly improve their language skills, however practical barriers arise. Socially assistive robots have been proposed as a possibility to provide additional language training. However, it is yet unknown how people with aphasia perceive interacting with a social robot, and which factors influence this interaction. The aim of this study was to gain insight in how people with mild to moderate chronic expressive aphasia perceived interacting with the social robot NAO, and to explore what needs and requisites emerged. A total of 11 participants took part in a single online semi-structured interaction, which was analysed using observational analysis, thematic analysis, and post-interaction questionnaire. The findings show that participants overall felt positive towards using the social robot NAO. Moreover, they perceived NAO as enjoyable, useful, and to a lesser extent easy to use. This exploratory study provides a tentative direction for the intention of people with mild to moderate chronic expressive aphasia to use social robots. Design implications and directions for future research are proposed.
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Affiliation(s)
- Peggy van Minkelen
- Department of Communication Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Emiel Krahmer
- Department of Communication and Cognition, Tilburg University, Tilburg, The Netherlands
| | - Paul Vogt
- School of Communication, Media and IT, Hanze University of Applied Sciences, Groningen, The Netherlands
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17
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Bonnet C, Bayram M, El Bouzaïdi Tiali S, Lebon F, Harquel S, Palluel-Germain R, Perrone-Bertolotti M. Kinesthetic motor-imagery training improves performance on lexical-semantic access. PLoS One 2022; 17:e0270352. [PMID: 35749512 PMCID: PMC9232155 DOI: 10.1371/journal.pone.0270352] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 06/08/2022] [Indexed: 11/30/2022] Open
Abstract
The objective of this study was to evaluate the effect of Motor Imagery (MI) training on language comprehension. In line with literature suggesting an intimate relationship between the language and the motor system, we proposed that a MI-training could improve language comprehension by facilitating lexico-semantic access. In two experiments, participants were assigned to a kinesthetic motor-imagery training (KMI) group, in which they had to imagine making upper-limb movements, or to a static visual imagery training (SVI) group, in which they had to mentally visualize pictures of landscapes. Differential impacts of both training protocols on two different language comprehension tasks (i.e., semantic categorization and sentence-picture matching task) were investigated. Experiment 1 showed that KMI training can induce better performance (shorter reaction times) than SVI training for the two language comprehension tasks, thus suggesting that a KMI-based motor activation can facilitate lexico-semantic access after only one training session. Experiment 2 aimed at replicating these results using a pre/post-training language assessment and a longer training period (four training sessions spread over four days). Although the improvement magnitude between pre- and post-training sessions was greater in the KMI group than in the SVI one on the semantic categorization task, the sentence-picture matching task tended to provide an opposite pattern of results. Overall, this series of experiments highlights for the first time that motor imagery can contribute to the improvement of lexical-semantic processing and could open new avenues on rehabilitation methods for language deficits.
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Affiliation(s)
- Camille Bonnet
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, Grenoble, France
- Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Mariam Bayram
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, Grenoble, France
| | | | - Florent Lebon
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, Dijon, France
| | - Sylvain Harquel
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, Grenoble, France
- Defitech Chair of Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology Lausanne (EPFL), Campus Biotech, Geneva, Switzerland
| | | | - Marcela Perrone-Bertolotti
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, Grenoble, France
- Institut Universitaire de France, Paris, France
- * E-mail:
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18
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Röders D, Klepp A, Schnitzler A, Biermann-Ruben K, Niccolai V. Induced and Evoked Brain Activation Related to the Processing of Onomatopoetic Verbs. Brain Sci 2022; 12:brainsci12040481. [PMID: 35448012 PMCID: PMC9029984 DOI: 10.3390/brainsci12040481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/16/2022] [Accepted: 03/31/2022] [Indexed: 02/01/2023] Open
Abstract
Grounded cognition theory postulates that cognitive processes related to motor or sensory content are processed by brain networks involved in motor execution and perception, respectively. Processing words with auditory features was shown to activate the auditory cortex. Our study aimed at determining whether onomatopoetic verbs (e.g., “tröpfeln”—to dripple), whose articulation reproduces the sound of respective actions, engage the auditory cortex more than non-onomatopoetic verbs. Alpha and beta brain frequencies as well as evoked-related fields (ERFs) were targeted as potential neurophysiological correlates of this linguistic auditory quality. Twenty participants were measured with magnetoencephalography (MEG) while semantically processing visually presented onomatopoetic and non-onomatopoetic German verbs. While a descriptively stronger left temporal alpha desynchronization for onomatopoetic verbs did not reach statistical significance, a larger ERF for onomatopoetic verbs emerged at about 240 ms in the centro-parietal area. Findings suggest increased cortical activation related to onomatopoeias in linguistically relevant areas.
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Affiliation(s)
- Dorian Röders
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, 40225 Duesseldorf, Germany; (A.K.); (A.S.); (K.B.-R.); (V.N.)
- Neural Basis of Learning Lab, Institute for Cognitive Neuroscience, Faculty of Psychology, Ruhr University, 44801 Bochum, Germany
- Correspondence:
| | - Anne Klepp
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, 40225 Duesseldorf, Germany; (A.K.); (A.S.); (K.B.-R.); (V.N.)
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, 40225 Duesseldorf, Germany; (A.K.); (A.S.); (K.B.-R.); (V.N.)
| | - Katja Biermann-Ruben
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, 40225 Duesseldorf, Germany; (A.K.); (A.S.); (K.B.-R.); (V.N.)
| | - Valentina Niccolai
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, 40225 Duesseldorf, Germany; (A.K.); (A.S.); (K.B.-R.); (V.N.)
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Brock KL, Koul R, Corwin M, Schlosser RW. Attitudes Toward and Perceived Communicative Competence of Individuals with Aphasia Using Speech-Generating Devices. Augment Altern Commun 2022; 38:15-28. [PMID: 35296192 DOI: 10.1080/07434618.2022.2028009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The purpose of this study was to investigate the effects of interface display and respondent group on listener attitudes toward and perceived communicative competence of persons with aphasia. The Attitudes Toward Nonspeaking Persons scale and the Communicative Competence Scale was used to measure listener attitudes and communicative competence, respectively. A 2 × 3 mixed factorial design was used. Interface display videos served as the within-subjects variable (i.e., grid and scene displays), and the respondent group served as the between-subjects variable. A total of 113 respondents (i.e., undergraduate lower-division students, undergraduate upper-division students, and family caregivers of individuals with aphasia) watched an individual with aphasia using a grid display in one video and a scene display in another video. The respondents completed the two scales. Significant main effects (p < .05) were found for interface display and respondent group. The use of scene displays had a more favorable impact on competence ratings than the use of grid displays. Family caregiver ratings were significantly (p < .05) more favorable than ratings from other groups. The Communicative Competence Scale was found to be a reliable measure of perceived communicative competence. Scene displays have the potential to enhance the perceived communicative competence of this population.
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Affiliation(s)
- Kris L Brock
- Department of Communication Sciences and Disorders, Idaho State University Health Sciences, Meridian, ID, USA
| | - Rajinder Koul
- Department of Speech, Language, and Hearing Sciences, University of Texas, Austin, TX, USA.,Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
| | - Melinda Corwin
- Department of Speech, Language, and Hearing Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Ralf W Schlosser
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa.,Department of Communication Sciences and Disorders, Northeastern University, Boston, MA, USA.,Center for Communication Enhancement, Boston Children's Hospital, Waltham, MA, USA
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20
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What is Functional Communication? A Theoretical Framework for Real-World Communication Applied to Aphasia Rehabilitation. Neuropsychol Rev 2022; 32:937-973. [PMID: 35076868 PMCID: PMC9630202 DOI: 10.1007/s11065-021-09531-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Aphasia is an impairment of language caused by acquired brain damage such as stroke or traumatic brain injury, that affects a person’s ability to communicate effectively. The aim of rehabilitation in aphasia is to improve everyday communication, improving an individual’s ability to function in their day-to-day life. For that reason, a thorough understanding of naturalistic communication and its underlying mechanisms is imperative. The field of aphasiology currently lacks an agreed, comprehensive, theoretically founded definition of communication. Instead, multiple disparate interpretations of functional communication are used. We argue that this makes it nearly impossible to validly and reliably assess a person’s communicative performance, to target this behaviour through therapy, and to measure improvements post-therapy. In this article we propose a structured, theoretical approach to defining the concept of functional communication. We argue for a view of communication as “situated language use”, borrowed from empirical psycholinguistic studies with non-brain damaged adults. This framework defines language use as: (1) interactive, (2) multimodal, and (3) contextual. Existing research on each component of the framework from non-brain damaged adults and people with aphasia is reviewed. The consequences of adopting this approach to assessment and therapy for aphasia rehabilitation are discussed. The aim of this article is to encourage a more systematic, comprehensive approach to the study and treatment of situated language use in aphasia.
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21
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García-Pérez P, Rodríguez-Martínez MDC, Lara JP, de la Cruz-Cosme C. Early Occupational Therapy Intervention in the Hospital Discharge after Stroke. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412877. [PMID: 34948486 PMCID: PMC8700854 DOI: 10.3390/ijerph182412877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/23/2021] [Accepted: 12/03/2021] [Indexed: 11/25/2022]
Abstract
Stroke is the leading cause of acquired disability in adults which is a cerebrovascular disease of great impact in health and social terms, not only due to its prevalence and incidence but also because of its significant consequences in terms of patient dependence and its consequent impact on the patient and family lives. The general objective of this study is to determine whether an early occupational therapy intervention at hospital discharge after suffering a stroke has a positive effect on the functional independence of the patient three months after discharge—the patient’s level of independence being the main focus of this research. Data will be collected on readmissions to hospitals, mortality, returns to work and returns to driving, as well as an economic health analysis. This is a prospective, randomized, controlled clinical trial. The sample size will be made up of 60 patients who suffered a stroke and were discharged from the neurology unit of a second-level hospital in west Malaga (Spain), who were then referred to the rehabilitation service by the joint decision of the neurology and rehabilitation department. The patients and caregivers assigned to the experimental group were included in an early occupational therapy intervention program and compared with a control group that receives usual care.
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Affiliation(s)
- Patricia García-Pérez
- Faculty of Medicine, University of Málaga, 29010 Málaga, Spain;
- Occupational Therapy Department, Hospital Marítimo, Servicio Andaluz de Salud (SAS), 29620 Málaga, Spain
| | | | - José Pablo Lara
- Faculty of Medicine, University of Málaga, 29010 Málaga, Spain;
- Brain Health Unit, CIMES, 29010 Málaga, Spain
- Malaga Biomedical Research Institute (IBIMA), 29010 Málaga, Spain;
- Correspondence: (M.C.R.-M.); (J.P.L.)
| | - Carlos de la Cruz-Cosme
- Malaga Biomedical Research Institute (IBIMA), 29010 Málaga, Spain;
- Neurology Department, Virgen de la Victoria University Hospital, 29010 Málaga, Spain
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Basilakos A, Hula WD, Johnson LP, Kiran S, Walker GM, Fridriksson J. Defining the Neurobiological Mechanisms of Action in Aphasia Therapies: Applying the RTSS Framework to Research and Practice in Aphasia. Arch Phys Med Rehabil 2021; 103:581-589. [PMID: 34748759 DOI: 10.1016/j.apmr.2021.10.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 08/25/2021] [Accepted: 10/04/2021] [Indexed: 11/15/2022]
Abstract
The Rehabilitation Treatment Specification System (RTSS; Van Stan et al., 2019) was developed as a systematic way to describe rehabilitation treatments for the purpose of both research and practice. The RTSS groups treatments by type and describes them by three elements - the treatment (i) ingredients and (ii) the mechanisms of action that yield changes in the (iii) target behavior. Adopting the RTSS has the potential to improve consistency in research, allowing for better cross-study comparisons to strengthen the body of research supporting various treatments. As it is still early in its development, the RTSS has not yet been widely implemented across different rehabilitation disciplines. In particular, aphasia recovery is one area of rehabilitation that could benefit from a unifying framework. Accordingly, this paper is part of a series where we illustrate how the RTSS can be applied to aphasia treatment and research. This paper more specifically focuses on examining the neurobiological mechanisms of action associated with experimental aphasia therapies - including brain stimulation and pharmacological intervention - as well as more traditional behavioral therapy. Key elements of the RTSS are described, and four example studies are used to illustrate how the RTSS can be implemented. The benefits of a unifying framework for the future of aphasia treatment research and practice are discussed.
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Affiliation(s)
- Alexandra Basilakos
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC
| | - William D Hula
- Geriatric Research, Education, and Clinical Center and Audiology and Speech Pathology Service, VA Pittsburgh Healthcare System, Pittsburgh, PA; Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh PA
| | - Lorelei Phillip Johnson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC.
| | - Swathi Kiran
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA
| | - Grant M Walker
- Department of Cognitive Sciences, University of California, Irvine, CA
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC
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23
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Doppelbauer L, Mohr B, Dreyer FR, Stahl B, Büscher V, Pulvermüller F. Long-Term Stability of Short-Term Intensive Language-Action Therapy in Chronic Aphasia: A 1-2 year Follow-Up Study. Neurorehabil Neural Repair 2021; 35:861-870. [PMID: 34232091 DOI: 10.1177/15459683211029235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. Intensive aphasia therapy can improve language functions in chronic aphasia over a short therapy interval of 2-4 weeks. For one intensive method, intensive language-action therapy, beneficial effects are well documented by a range of randomized controlled trials. However, it is unclear to date whether therapy-related improvements are maintained over years. Objective. The current study aimed at investigating long-term stability of ILAT treatment effects over circa 1-2 years (8-30 months). Methods. 38 patients with chronic aphasia participated in ILAT and were re-assessed at a follow-up assessment 8-30 months after treatment, which had been delivered 6-12.5 hours per week for 2-4 weeks. Results. A standardized clinical aphasia battery, the Aachen Aphasia Test, revealed significant improvements with ILAT that were maintained for up to 2.5 years. Improvements were relatively better preserved in comparatively young patients (<60 years). Measures of communicative efficacy confirmed improvements during intensive therapy but showed inconsistent long-term stability effects. Conclusions. The present data indicate that gains resulting from intensive speech-language therapy with ILAT are maintained up to 2.5 years after the end of treatment. We discuss this novel finding in light of a possible move from sparse to intensive therapy regimes in clinical practice.
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Affiliation(s)
- Lea Doppelbauer
- Brain Language Laboratory, 9166Freie Universität Berlin, Berlin, Germany
- Einstein Center for Neurosciences, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt Universität zu Berlin, Berlin, Germany
| | - Bettina Mohr
- Department of Psychiatry, Charité Universitätsmedizin, Berlin, Germany
- ZeNIS - Centre for Neuropsychology and Intensive Language Therapy, Berlin, Germany
| | - Felix R Dreyer
- Brain Language Laboratory, 9166Freie Universität Berlin, Berlin, Germany
- Cluster of Excellence 'Matters of Activity', Humboldt Universität zu Berlin, Berlin, Germany
| | - Benjamin Stahl
- Department of Neurology, Charité Universitätsmedizin, Berlin, Germany
- Department of Neurology, 60634Universitätsmedizin Greifswald, Greifswald, Germany
- Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Psychologische Hochschule Berlin, Berlin, Germany
| | - Verena Büscher
- Brain Language Laboratory, 9166Freie Universität Berlin, Berlin, Germany
| | - Friedemann Pulvermüller
- Brain Language Laboratory, 9166Freie Universität Berlin, Berlin, Germany
- Einstein Center for Neurosciences, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt Universität zu Berlin, Berlin, Germany
- Cluster of Excellence 'Matters of Activity', Humboldt Universität zu Berlin, Berlin, Germany
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24
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Haro-Martínez A, Pérez-Araujo CM, Sanchez-Caro JM, Fuentes B, Díez-Tejedor E. Melodic Intonation Therapy for Post-stroke Non-fluent Aphasia: Systematic Review and Meta-Analysis. Front Neurol 2021; 12:700115. [PMID: 34421802 PMCID: PMC8371046 DOI: 10.3389/fneur.2021.700115] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 07/05/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Melodic intonation therapy (MIT) is one of the most studied speech and language therapy (SLT) approaches for patients with non-fluent aphasia, although the methodological quality of the studies has been rated as low in previous reviews. The aim of this study is to update current evidence on the possible efficacy of MIT for the treatment of non-fluent post-stroke aphasia. Methods: A systematic review and meta-analysis. We selected randomized clinical trials (RCT) that included adult patients over 18 years of age with non-fluent post-stroke aphasia, whose intervention was MIT vs. no therapy or other therapy. We excluded non-RCT studies, mixed populations including patients with aphasia of non-stroke etiology, studies with no availability of post-stroke aphasia-specific data, and incomplete studies. Three sections of communicative ability were analyzed as outcomes: functional communication, expressive language (naming and repetition), and comprehension. Results: We identified a total of four eligible RCTs involving 94 patients. Despite the heterogeneity in the psychometric tests employed among the trials, a significant effect of MIT on functional communication (evaluated by the Communication Activity Log) was found (SMD 1.47; 95% CI 0.39–2.56). In addition, a positive effect of MIT on expressive language (repetition) was found (SMD 0.45; 95% CI 0.01–0.90). No significant effects on comprehension measurements were found, despite a lack of significant statistical heterogeneity. Conclusion: This systematic review and meta-analysis shows a significant effect of MIT on improving functional communication and on repetition tasks. Future larger RCT specifically addressing those outcomes should provide the definite evidence on the efficacy of MIT on post-stroke aphasia recovery. Systematic Review Registration:PROSPERO-URL https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020144604.
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Affiliation(s)
- Ana Haro-Martínez
- Doctoral Programme, Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Juan M Sanchez-Caro
- Department of Medicine, Department of Neurology and Stroke Center, Hospital Universitario La Paz, Universidad Autónoma de Madrid, IdiPAZ Health Research Institute, Madrid, Spain
| | - Blanca Fuentes
- Department of Medicine, Department of Neurology and Stroke Center, Hospital Universitario La Paz, Universidad Autónoma de Madrid, IdiPAZ Health Research Institute, Madrid, Spain
| | - Exuperio Díez-Tejedor
- Department of Medicine, Department of Neurology and Stroke Center, Hospital Universitario La Paz, Universidad Autónoma de Madrid, IdiPAZ Health Research Institute, Madrid, Spain
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25
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Cichon N, Wlodarczyk L, Saluk-Bijak J, Bijak M, Redlicka J, Gorniak L, Miller E. Novel Advances to Post-Stroke Aphasia Pharmacology and Rehabilitation. J Clin Med 2021; 10:jcm10173778. [PMID: 34501229 PMCID: PMC8432240 DOI: 10.3390/jcm10173778] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/07/2021] [Accepted: 07/29/2021] [Indexed: 12/23/2022] Open
Abstract
Aphasia is one of the most common clinical features of functional impairment after a stroke. Approximately 21–40% of stroke patients sustain permanent aphasia, which progressively worsens one’s quality of life and rehabilitation outcomes. Post-stroke aphasia treatment strategies include speech language therapies, cognitive neurorehabilitation, telerehabilitation, computer-based management, experimental pharmacotherapy, and physical medicine. This review focuses on current evidence of the effectiveness of impairment-based aphasia therapies and communication-based therapies (as well as the timing and optimal treatment intensities for these interventions). Moreover, we present specific interventions, such as constraint-induced aphasia therapy (CIAT) and melodic intonation therapy (MIT). Accumulated data suggest that using transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) is safe and can be used to modulate cortical excitability. Therefore, we review clinical studies that present TMS and tDCS as (possible) promising therapies in speech and language recovery, stimulating neuroplasticity. Several drugs have been used in aphasia pharmacotherapy, but evidence from clinical studies suggest that only nootropic agents, donepezil and memantine, may improve the prognosis of aphasia. This article is an overview on the current state of knowledge related to post-stroke aphasia pharmacology, rehabilitation, and future trends.
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Affiliation(s)
- Natalia Cichon
- Biohazard Prevention Centre, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska, 141/143, 90-236 Lodz, Poland; (M.B.); (L.G.)
- Correspondence:
| | - Lidia Wlodarczyk
- Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland;
| | - Joanna Saluk-Bijak
- Department of General Biochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska, 141/143, 90-236 Lodz, Poland;
| | - Michal Bijak
- Biohazard Prevention Centre, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska, 141/143, 90-236 Lodz, Poland; (M.B.); (L.G.)
| | - Justyna Redlicka
- Department of Neurological Rehabilitation, Medical University of Lodz, Milionowa, 14, 93-113 Lodz, Poland; (J.R.); (E.M.)
| | - Leslaw Gorniak
- Biohazard Prevention Centre, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska, 141/143, 90-236 Lodz, Poland; (M.B.); (L.G.)
| | - Elzbieta Miller
- Department of Neurological Rehabilitation, Medical University of Lodz, Milionowa, 14, 93-113 Lodz, Poland; (J.R.); (E.M.)
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Increased links between language and motor areas: A proof-of-concept study on resting-state functional connectivity following Personalized Observation, Execution and Mental imagery therapy in chronic aphasia. Brain Cogn 2021; 148:105659. [PMID: 33485051 DOI: 10.1016/j.bandc.2020.105659] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 11/02/2020] [Accepted: 11/25/2020] [Indexed: 11/24/2022]
Abstract
A tight coupling of language and motor processes has been established, which is consistent with embodied cognition theory. However, very few therapies have been designed to exploit the synergy between motor and language processes to help rehabilitate people with aphasia (PWA). Moreover, the underlying mechanisms supporting the efficacy of such approaches remain unknown. Previous work in our laboratory has demonstrated that personalized observation, execution, and mental imagery therapy (POEM)-a new therapy using three sensorimotor strategies to trigger action verb naming-leads to significant improvements in verb retrieval in PWA. Moreover, these improvements were supported by significant activations in language and sensorimotor processing areas, which further reinforce the role of both processes in language recovery (Durand et al., 2018). The present study investigates resting state functional connectivity (rsFC) changes following POEM in a pre-/post-POEM therapy design. A whole brain network functional connectivity approach was used to assess and describe changes in rsFC in a group of four PWA, who were matched and compared with four healthy controls (HC). Results showed increased rsFC in PWA within and between visuo-motor and language areas (right cuneal cortex-left supracalcarin (SCC) cortex/right precentral gyrus (PreCG)-left lingual gyrus (LG)) and between areas involved in action processing (right anterior parahippocampal gyrus (aPaHC)-left superior parietal lobule (SPL). In comparison to HC, the PWA group showed increased rsFC between the right inferior frontal gyrus (IFG) and left thalamus, which are areas involved in lexico-semantic processing. This proof-of-concept study suggests that the sensorimotor and language strategies used in POEM may induce modifications in large-scale networks, probably derived from the integration of visual and sensorimotor systems to sustain action naming, which is consistent with the embodied cognition theory.
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27
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Bislick L. A Phonomotor Approach to Apraxia of Speech Treatment. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:2109-2130. [PMID: 32997520 DOI: 10.1044/2020_ajslp-19-00116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose This study continued Phase I investigation of a modified Phonomotor Treatment (PMT) Program on motor planning in two individuals with apraxia of speech (AOS) and aphasia and, with support from prior work, refined Phase I methodology for treatment intensity and duration, a measure of communicative participation, and the use of effect size benchmarks specific to AOS. Method A single-case experimental design with multiple baselines across behaviors and participants was used to examine acquisition, generalization, and maintenance of treatment effects 8-10 weeks posttreatment. Treatment was distributed 3 days a week, and duration of treatment was specific to each participant (criterion based). Experimental stimuli consisted of target sounds or clusters embedded nonwords and real words, specific to each participants' deficit. Results Findings show improved repetition accuracy for targets in trained nonwords, generalization to targets in untrained nonwords and real words, and maintenance of treatment effects at 10 weeks posttreatment for one participant and more variable outcomes for the other participant. Conclusions Results indicate that a modified version of PMT can promote generalization and maintenance of treatment gains for trained speech targets via a multimodal approach emphasizing repeated exposure and practice. While these results are promising, the frequent co-occurrence of AOS and aphasia warrants a treatment that addresses both motor planning and linguistic deficits. Thus, the application of traditional PMT with participant-specific modifications for AOS embedded into the treatment program may be a more effective approach. Future work will continue to examine and maximize improvements in motor planning, while also treating anomia in aphasia.
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Affiliation(s)
- Lauren Bislick
- School of Communication Sciences and Disorders, University of Central Florida, Orlando
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28
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Schevenels K, Price CJ, Zink I, De Smedt B, Vandermosten M. A Review on Treatment-Related Brain Changes in Aphasia. NEUROBIOLOGY OF LANGUAGE (CAMBRIDGE, MASS.) 2020; 1:402-433. [PMID: 37215585 PMCID: PMC10158631 DOI: 10.1162/nol_a_00019] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 06/29/2020] [Indexed: 05/24/2023]
Abstract
Numerous studies have investigated brain changes associated with interventions targeting a range of language problems in patients with aphasia. We strive to integrate the results of these studies to examine (1) whether the focus of the intervention (i.e., phonology, semantics, orthography, syntax, or rhythmic-melodic) determines in which brain regions changes occur; and (2a) whether the most consistent changes occur within the language network or outside, and (2b) whether these are related to individual differences in language outcomes. The results of 32 studies with 204 unique patients were considered. Concerning (1), the location of treatment-related changes does not clearly depend on the type of language processing targeted. However, there is some support that rhythmic-melodic training has more impact on the right hemisphere than linguistic training. Concerning (2), we observed that language recovery is not only associated with changes in traditional language-related structures in the left hemisphere and homolog regions in the right hemisphere, but also with more medial and subcortical changes (e.g., precuneus and basal ganglia). Although it is difficult to draw strong conclusions, because there is a lack of systematic large-scale studies on this topic, this review highlights the need for an integrated approach to investigate how language interventions impact on the brain. Future studies need to focus on larger samples preserving subject-specific information (e.g., lesion effects) to cope with the inherent heterogeneity of stroke-induced aphasia. In addition, recovery-related changes in whole-brain connectivity patterns need more investigation to provide a comprehensive neural account of treatment-related brain plasticity and language recovery.
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Affiliation(s)
- Klara Schevenels
- Experimental Oto-Rhino-Laryngology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Cathy J. Price
- Welcome Centre for Human Neuroimaging, Institute of Neurology, University College London, UK
| | - Inge Zink
- Experimental Oto-Rhino-Laryngology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Bert De Smedt
- Parenting and Special Education Research Unit, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Maaike Vandermosten
- Experimental Oto-Rhino-Laryngology, Department of Neurosciences, KU Leuven, Leuven, Belgium
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29
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Grechuta K, Rubio Ballester B, Espín Munné R, Usabiaga Bernal T, Molina Hervás B, Mohr B, Pulvermüller F, San Segundo RM, Verschure PFMJ. Multisensory cueing facilitates naming in aphasia. J Neuroeng Rehabil 2020; 17:122. [PMID: 32907594 PMCID: PMC7487671 DOI: 10.1186/s12984-020-00751-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 08/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Impaired naming is a ubiquitous symptom in all types of aphasia, which often adversely impacts independence, quality of life, and recovery of affected individuals. Previous research has demonstrated that naming can be facilitated by phonological and semantic cueing strategies that are largely incorporated into the treatment of anomic disturbances. Beneficial effects of cueing, whereby naming becomes faster and more accurate, are often attributed to the priming mechanisms occurring within the distributed language network. OBJECTIVE We proposed and explored two novel cueing techniques: (1) Silent Visuomotor Cues (SVC), which provided articulatory information of target words presented in the form of silent videos, and (2) Semantic Auditory Cues (SAC), which consisted of acoustic information semantically relevant to target words (ringing for "telephone"). Grounded in neurophysiological evidence, we hypothesized that both SVC and SAC might aid communicative effectiveness possibly by triggering activity in perceptual and semantic language regions, respectively. METHODS Ten participants with chronic non-fluent aphasia were recruited for a longitudinal clinical intervention. Participants were split into dyads (i.e., five pairs of two participants) and required to engage in a turn-based peer-to-peer language game using the Rehabilitation Gaming System for aphasia (RGSa). The objective of the RGSa sessions was to practice communicative acts, such as making a request. We administered SVCs and SACs in a pseudorandomized manner at the moment when the active player selected the object to be requested from the interlocutor. For the analysis, we compared the times from selection to the reception of the desired object between cued and non-cued trials. RESULTS Naming accuracy, as measured by a standard clinical scale, significantly improved for all stimuli at each evaluation point, including the follow-up. Moreover, the results yielded beneficial effects of both SVC and SAC cues on word naming, especially at the early intervention sessions when the exposure to the target lexicon was infrequent. CONCLUSIONS This study supports the efficacy of the proposed cueing strategies which could be integrated into the clinic or mobile technology to aid naming even at the chronic stages of aphasia. These findings are consistent with sensorimotor accounts of language processing, suggesting a coupling between language, motor, and semantic brain regions. TRIAL REGISTRATION NCT02928822 . Registered 30 May 2016.
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Affiliation(s)
- Klaudia Grechuta
- Institute for Bioengineering of Catalonia (IBEC), Av. d'Eduard Maristany 16, 08019, Barcelona, Spain
| | - Belén Rubio Ballester
- Institute for Bioengineering of Catalonia (IBEC), Av. d'Eduard Maristany 16, 08019, Barcelona, Spain
| | - Rosa Espín Munné
- Servei de Medicina Física i Rehabilitació de l'Hospital Univ. de Tarragona, 43-005, Tarragona, Spain
| | - Teresa Usabiaga Bernal
- Servei de Medicina Física i Rehabilitació de l'Hospital Univ. de Tarragona, 43-005, Tarragona, Spain
| | - Begoña Molina Hervás
- Servei de Medicina Física i Rehabilitació de l'Hospital Univ. de Tarragona, 43-005, Tarragona, Spain
| | - Bettina Mohr
- Charite Universitätsmedizin Berlin, 10-117, Berlin, Germany
| | - Friedemann Pulvermüller
- Freie University Berlin, Brain Language Laboratory, DPH, WE4, 14-195, Berlin, Germany
- Humboldt Universität, BSMB, 10-099, Berlin, Germany
- Einstein Center for Neurosciences, 10-117, Berlin, Germany
| | - Rosa Maria San Segundo
- Servei de Medicina Física i Rehabilitació de l'Hospital Univ. de Tarragona, 43-005, Tarragona, Spain
| | - Paul F M J Verschure
- Institute for Bioengineering of Catalonia (IBEC), Av. d'Eduard Maristany 16, 08019, Barcelona, Spain.
- Institució Catalana de Recerca i Estudis Avançats, 08-010, Barcelona, Spain.
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Singh P, Pauranik N, Pauranik A. Culturally Appropriate Stimuli for Cognitive Neuropsychology-Based Treatment "Intensive Language Action Therapy (ILAT)". Ann Indian Acad Neurol 2020; 23:S135-S142. [PMID: 33343138 PMCID: PMC7731687 DOI: 10.4103/aian.aian_670_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/02/2020] [Accepted: 08/02/2020] [Indexed: 11/04/2022] Open
Abstract
CONTEXT A standardized set of picture stimuli for neuro-language disorder has been long overdue. AIMS To develop a standardized set of 303 pictures for use in experiments of Intensive Language Action Therapy (ILAT). METHODS AND MATERIAL Several sources with standardized picture stimuli having culturally unbiased features were studied. Among those studies two prime sources (1) Snodgrass & Vanderwart (1980), 127 (89+37) items and (2) Neininger & Pulvermuller (2002), 147 (89+56) items were used extensively. Out of 303 stimuli, 89 items were common to both principle sources. An Indian study by George & Mathuranath (2007) has also been taken as an additional source. Line drawing stimuli were standardized on four variables of central relevance to memory and cognitive processing: name agreement, image agreement, familiarity, and visual complexity. STATISTICAL ANALYSIS USED All measures related to 303 concepts i.e. % correct, H statistics, familiarity, image agreement and visual complexity were analysed descriptively. RESULTS Low mean and positive skew on H statistics and visual complexity show that many concepts had a high name agreement (13 concepts have H values of .0, and 55 have H values of 0.68 or below, where 0.68 represents consensus among all but few of the subjects on a picture's name) and were visually simple line drawings. The intercorrelations among the four measures were low, suggesting that they are indices of different attributes of the pictures. CONCLUSIONS Usage of appropriate items/stimuli has immense potential to influence aphasia therapy outcome. This set of pictures and its normative variable has enhanced the ILAT outcome. It could be generalised for other aphasia therapy too to understand its efficacy.
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Affiliation(s)
- Pinki Singh
- Ex- Speech Language Pathologist, Department of ENT, AIIMS Bhopal, M.P, India,Address for correspondence: Dr. Pinki Singh, F-4 Doctors Colony, NSCB Medical College, Jabalpur, M.P, India. E-mail:
| | - Nipun Pauranik
- Consultant Neurologist, Apollo Hospital Vijaynagar, Indore, M.P, India
| | - Apoorva Pauranik
- Director: Pauranik Academy of Medical Education, Ex-Professor, Department of Medicine/Neurology, M.G.M. Medical College & M.Y.H. Hospital, Indore, M.P., India
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31
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Berthier ML, Edelkraut L, Mohr B, Pulvermüller F, Starkstein SE, Green-Heredia C, Dávila G. Intensive aphasia therapy improves low mood in fluent post-stroke aphasia: Evidence from a case-controlled study. Neuropsychol Rehabil 2020; 32:148-163. [PMID: 32867571 DOI: 10.1080/09602011.2020.1809463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Introduction: Depressive symptoms are a major drawback of aphasia, negatively impacting on functional outcomes. In a previous study, Intensive Language-Action Therapy (ILAT) was effective in improving depression and low mood in persons with chronic non-fluent aphasia. We present a proof-of-concept case-control study that evaluates language and mood outcomes amongst persons with fluent post-stroke aphasia.Participants: Thirteen Spanish speaking persons with fluent aphasia due to chronic stroke lesions in the left hemisphere participated in the study.Intervention: Five participants (intervention group) received ILAT for 3 h/day during two consecutive weeks, for an overall of 30 h, and 8 participants (control group) entered a waiting-list no-treatment arm.Results: The main finding was that participants receiving active treatment showed significant improvements on depression and aphasia severity scores, whereas no significant changes were found in the control group.Conclusions: The implementation of ILAT was efficient in improving clinical language deficits in people with fluent aphasia and contributes to improvement in mood after therapy.Trial registration: EUDRACT (2008-008481-12).
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Affiliation(s)
- Marcelo L Berthier
- Unit of Cognitive Neurology and Aphasia, Centro de Investigaciones Médico-Sanitarias (CIMES), University of Malaga, Málaga, Spain.,Research Laboratory on the Neuroscience of Language, Faculty of Psychology and Speech and Language Therapy, University of Malaga, Málaga, Spain.,Instituto de Investigación Biomédica de Málaga - IBIMA, Málaga, Spain
| | - Lisa Edelkraut
- Unit of Cognitive Neurology and Aphasia, Centro de Investigaciones Médico-Sanitarias (CIMES), University of Malaga, Málaga, Spain.,Research Laboratory on the Neuroscience of Language, Faculty of Psychology and Speech and Language Therapy, University of Malaga, Málaga, Spain.,Instituto de Investigación Biomédica de Málaga - IBIMA, Málaga, Spain.,Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology and Speech and Language Therapy, University of Málaga, Málaga, Spain
| | - Bettina Mohr
- Department of Psychiatry, Charité Universitätsmedizin, Berlin, Germany.,Zentrum für Neuropsychologie und Intensive Sprachtherapie, ZENIS, Berlin, Germany
| | - Friedemann Pulvermüller
- Brain Language Laboratory, Department of Philosophy and Humanities, WE4, Freie Universität Berlin, Berlin, Germany.,Berlin School of Mind and Brain, Humboldt Universität zu Berlin, Berlin, Germany
| | - Sergio E Starkstein
- Division of Psychiatry, School of Medicine, The University of Western Australia, Perth, Australia
| | | | - Guadalupe Dávila
- Unit of Cognitive Neurology and Aphasia, Centro de Investigaciones Médico-Sanitarias (CIMES), University of Malaga, Málaga, Spain.,Research Laboratory on the Neuroscience of Language, Faculty of Psychology and Speech and Language Therapy, University of Malaga, Málaga, Spain.,Instituto de Investigación Biomédica de Málaga - IBIMA, Málaga, Spain.,Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology and Speech and Language Therapy, University of Málaga, Málaga, Spain
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Keator LM, Basilakos A, Rorden C, Elm J, Bonilha L, Fridriksson J. Clinical Implementation of Transcranial Direct Current Stimulation in Aphasia: A Survey of Speech-Language Pathologists. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:1376-1388. [PMID: 32437243 PMCID: PMC7893518 DOI: 10.1044/2020_ajslp-19-00037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 10/23/2019] [Accepted: 01/26/2020] [Indexed: 06/11/2023]
Abstract
Purpose The objectives of this study are to (a) identify speech-language pathologists' (SLPs') familiarity with transcranial direct current stimulation (tDCS), (b) quantify what SLPs consider necessary tDCS-related improvement in aphasia severity (i.e., tDCS enhancement; desired improvement above and beyond traditional behavioral therapy) to implement this adjuvant therapy for the clinical management of aphasia, and (c) identify concerns that could potentially hinder the clinical adoption of tDCS. Method A brief (14-question) survey was disseminated via e-mail and social media outlets targeting SLPs working with individuals with aphasia. Results Two hundred twenty-one individuals responded, and 155 valid surveys were analyzed. Seventy-one percent of participants reported familiarity with tDCS prior to taking the survey. Clinicians reported a desired mean enhancement of 22.9% additional points on the Western Aphasia Battery-Revised Aphasia Quotient. Importantly, 94.2% of SLPs reported concerns regarding the implementation of tDCS in clinical settings (i.e., safety, cost, administrative approval, reimbursement and training). Conclusions This is the first study to identify SLPs' perspectives regarding the clinical adoption of tDCS. Results suggest the majority of queried SLPs were familiar with tDCS prior to taking the survey. Although SLPs report a desired improvement of approximately 23% additional points on the Western Aphasia Battery-Revised Aphasia Quotient to consider adopting tDCS into practice, many SLPs reported concerns regarding clinical adoption. Responses from the current survey offer important preliminary evidence to begin bridging the research-to-practice gap as it relates to the clinical implementation of tDCS. Relatedly, these results will inform future clinical trials.
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Affiliation(s)
- Lynsey M. Keator
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia
| | - Alexandra Basilakos
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia
| | - Christopher Rorden
- McCausland Center For Brain Imaging, University of South Carolina, Columbia
- Department of Psychology, University of South Carolina, Columbia
| | - Jordan Elm
- Department of Public Health Sciences, Medical University of South Carolina, Charleston
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, Charleston
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia
- McCausland Center For Brain Imaging, University of South Carolina, Columbia
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Dávila G, Moyano MP, Edelkraut L, Moreno-Campos L, Berthier ML, Torres-Prioris MJ, López-Barroso D. Pharmacotherapy of Traumatic Childhood Aphasia: Beneficial Effects of Donepezil Alone and Combined With Intensive Naming Therapy. Front Pharmacol 2020; 11:1144. [PMID: 32848757 PMCID: PMC7411310 DOI: 10.3389/fphar.2020.01144] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 07/13/2020] [Indexed: 12/14/2022] Open
Abstract
At present, language therapy is the only available treatment for childhood aphasia (CA). Studying new interventions to augment and hasten the benefits provided by language therapy in children is strongly needed. CA frequently emerges as a consequence of traumatic brain injury and, as in the case of adults, it may be associated with dysfunctional activity of neurotransmitter systems. The use of cognitive-enhancing drugs, alone or combined with aphasia therapy, promotes improvement of language deficits in aphasic adults. In this study we report the case of a 9-year-old right-handed girl, subject P, who had chronic anomic aphasia associated with traumatic lesions in the left temporal-parietal cortex. We performed a single-subject, open-label study encompassing administration of the cholinergic agent donepezil (DP) alone during 12 weeks, followed by a combination of DP and intensive naming therapy (INT) for 2 weeks and thereafter by a continued treatment of DP alone during 12 weeks, a 4-week washout period, and another 2 weeks of INT. Four comprehensive language and neuropsychological evaluations were performed at different timepoints along the study, and multiple naming evaluations were performed after each INT in order to assess performance in treated and untreated words. Structural magnetic resonance imaging (MRI) was performed at baseline. MRI revealed two focal lesions in the left hemisphere, one large involving the posterior inferior and middle temporal gyri and another comprising the angular gyrus. Overall, baseline evaluation disclosed marked impairment in naming with mild-to-moderate compromise of spontaneous speech, repetition, and auditory comprehension. Executive and attention functions were also affected, but memory, visuoconstructive, and visuoperceptive functions were preserved. Treatment with DP alone significantly improved spontaneous speech, auditory comprehension, repetition, and picture naming, in addition to processing speed, selective, and sustained attention. Combined DP-INT further improved naming. After washout of both interventions, most of these beneficial changes remained. Importantly, DP produced no side effects and subject P attained the necessary level of language competence to return to regular schooling. In conclusion, the use of DP alone and in combination with INT improved language function and related cognitive posttraumatic deficits in a child with acquired aphasia. Further studies in larger samples are warranted.
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Affiliation(s)
- Guadalupe Dávila
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Malaga, Spain.,Instituto de Investigación Biomédica de Málaga - IBIMA, Málaga, Spain.,Department of Psychobiology and Methodology of Behavioural Sciences, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain.,Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - María Pilar Moyano
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Malaga, Spain
| | - Lisa Edelkraut
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Malaga, Spain.,Instituto de Investigación Biomédica de Málaga - IBIMA, Málaga, Spain.,Department of Psychobiology and Methodology of Behavioural Sciences, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain.,Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - Lorena Moreno-Campos
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Malaga, Spain
| | - Marcelo L Berthier
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Malaga, Spain.,Instituto de Investigación Biomédica de Málaga - IBIMA, Málaga, Spain.,Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - María José Torres-Prioris
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Malaga, Spain.,Instituto de Investigación Biomédica de Málaga - IBIMA, Málaga, Spain.,Department of Psychobiology and Methodology of Behavioural Sciences, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain.,Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - Diana López-Barroso
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Malaga, Spain.,Instituto de Investigación Biomédica de Málaga - IBIMA, Málaga, Spain.,Department of Psychobiology and Methodology of Behavioural Sciences, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain.,Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
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Brogan E, Ciccone N, Godecke E. An exploration of aphasia therapy dosage in the first six months of stroke recovery. Neuropsychol Rehabil 2020; 31:1254-1288. [PMID: 32538277 DOI: 10.1080/09602011.2020.1776135] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Aphasia research uses the length of time within rehabilitation sessions as the main measure of dosage. Few papers detail therapeutic ingredients or outline the number of times these were delivered over the treatment period. The present observational study identified therapeutic ingredients in the Very Early Rehabiltiation in SpEech (VERSE) trial and explored the dosage provided using a model of cumulative intervention intensity (CII). Therapists video recorded one therapy session per week and 53 (12%) randomly selected therapy videos were analysed. The videos were coded for number of error productions, self-corrections and type and frequency of therapist cueing. The Western Aphasia Battery Revised-Aphasia Quotient (WABR-AQ) was used for measuring patient outcome with total verbal utterances (p < 0.001) and cues used with success (p < 0.001) being independent positive predictors of WABR-AQ score at six months post stroke and hypothesized as key therapeutic ingredients. The CII was calculated by counting identified therapeutic ingredients and multiplying this by the number of sessions completed. Collectively, the key ingredients occurred on average 504 times per session and over 10,000 times per participant during the treatment period. This paper reports a novel approach for identifying key treatment ingredients and detailing the dosage delivered within an early aphasia rehabilitation trial.
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Affiliation(s)
- Emily Brogan
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.,Speech Pathology, Sir Charles Gairdner Hospital, Perth, Australia
| | - Natalie Ciccone
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Erin Godecke
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.,Speech Pathology, Sir Charles Gairdner Hospital, Perth, Australia
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35
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Pierce JE, O'Halloran R, Menahemi-Falkov M, Togher L, Rose ML. Comparing higher and lower weekly treatment intensity for chronic aphasia: A systematic review and meta-analysis. Neuropsychol Rehabil 2020; 31:1289-1313. [PMID: 32496963 DOI: 10.1080/09602011.2020.1768127] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Optimizing intensity for aphasia treatment is a high priority research issue for people with aphasia, their families and clinicians, and could result in healthcare cost savings. An important aspect of intensity is the frequency of intervention, or how regularly treatment should be provided each week. While principles of neuroplasticity endorse massed practice, cognitive psychology has established superiority of distributed practice within normal learning. Neither concept has been conclusively tested in aphasia. There have been many literature reviews of intensity in aphasia intervention, but most have not investigated treatment intensity whilst also ensuring that therapy dose and treatment type are identical between study groups. Some have also combined studies across acute, subacute and chronic aphasia. We searched systematically for studies directly comparing higher and lower weekly treatment frequency in chronic aphasia. Eight studies were retrieved and rated for methodological quality. Meta-analysis was completed for group and single case experimental designs. Results showed that there are few studies investigating treatment frequency in chronic aphasia and their quality is low-moderate. Meta-analyses were inconclusive due to limited data, but there was no indication of either schedule being superior. Further research directly comparing treatment schedules is needed.
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Affiliation(s)
- John E Pierce
- School of Allied Health, La Trobe University, Melbourne, Australia.,Speech Pathology, Cabrini Health, Melbourne, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Australia
| | - Robyn O'Halloran
- School of Allied Health, La Trobe University, Melbourne, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Australia
| | - Maya Menahemi-Falkov
- School of Allied Health, La Trobe University, Melbourne, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Australia
| | - Leanne Togher
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Australia.,Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Miranda L Rose
- School of Allied Health, La Trobe University, Melbourne, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Australia
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36
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Dietz A, Wallace SE, Weissling K. Revisiting the Role of Augmentative and Alternative Communication in Aphasia Rehabilitation. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:909-913. [PMID: 32109137 PMCID: PMC7842873 DOI: 10.1044/2019_ajslp-19-00041] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/11/2019] [Accepted: 11/14/2019] [Indexed: 06/10/2023]
Abstract
Purpose The purpose of this article is to revisit the role of augmentative and alternative communication (AAC) in poststroke aphasia rehabilitation. The authors' intent is to provide a viewpoint that expands the use of AAC in poststroke aphasia rehabilitation. Specifically, we seek to clarify the role of AAC in restorative and participation approaches to aphasia rehabilitation while also considering the role of AAC in a comprehensive treatment plan. The authors support their viewpoint with citations from both the historic and contemporary literature on aphasia rehabilitation. Conclusions A thought-provoking viewpoint on the role of AAC in poststroke aphasia rehabilitation is proposed. More specifically, the versatility of AAC strategies is reviewed, with an emphasis on how AAC can be used to empower people with aphasia to fully participate and engage in life activities with increased independence. Moreover, we argue that AAC can be viewed as a dual-purpose tool that can simultaneously serve to drive intersystemic reorganization resulting in some improved language performance-and perhaps restoration of language function-while offering a communication alternative during inevitable anomic events.
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Affiliation(s)
- Aimee Dietz
- Department of Communication Sciences & Disorders, University of Cincinnati, OH
| | - Sarah E. Wallace
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA
| | - Kristy Weissling
- Department of Special Education and Communication Disorders, University of Nebraska–Lincoln
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37
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Berthier ML, Dávila G, Torres-Prioris MJ, Moreno-Torres I, Clarimón J, Dols-Icardo O, Postigo MJ, Fernández V, Edelkraut L, Moreno-Campos L, Molina-Sánchez D, de Zaldivar PS, López-Barroso D. Developmental Dynamic Dysphasia: Are Bilateral Brain Abnormalities a Signature of Inefficient Neural Plasticity? Front Hum Neurosci 2020; 14:73. [PMID: 32265672 DOI: 10.3389/fnhum.2020.00073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 02/19/2020] [Indexed: 12/30/2022] Open
Abstract
The acquisition and evolution of speech production, discourse and communication can be negatively impacted by brain malformations. We describe, for the first time, a case of developmental dynamic dysphasia (DDD) in a right-handed adolescent boy (subject D) with cortical malformations involving language-eloquent regions (inferior frontal gyrus) in both the left and the right hemispheres. Language evaluation revealed a markedly reduced verbal output affecting phonemic and semantic fluency, phrase and sentence generation and verbal communication in everyday life. Auditory comprehension, repetition, naming, reading and spelling were relatively preserved, but executive function was impaired. Multimodal neuroimaging showed a malformed cerebral cortex with atypical configuration and placement of white matter tracts bilaterally and abnormal callosal fibers. Dichotic listening showed right hemisphere dominance for language, and functional magnetic resonance imaging (fMRI) additionally revealed dissociated hemispheric language representation with right frontal activation for phonology and bilateral dominance for semantic processing. Moreover, subject D also had congenital mirror movements (CMM), defined as involuntary movements of one side of the body that mirror intentional movements of the other side. Transcranial magnetic stimulation and fMRI during voluntary unimanual (left and right) hand movements showed bilateral motor cortex recruitment and tractography revealed a lack of decussation of bilateral corticospinal tracts. Genetic testing aimed to detect mutations that disrupt the development of commissural tracts correlating with CMM (e.g., Germline DCC mutations) was negative. Overall, our findings suggest that DDD in subject D resulted from the underdevelopment of the left inferior frontal gyrus with limited capacity for plastic reorganization by its homologous counterpart in the right hemisphere. Corpus callosum anomalies probably contributed to hinder interhemispheric connectivity necessary to compensate language and communication deficits after left frontal involvement.
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Affiliation(s)
- Marcelo L Berthier
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain
| | - Guadalupe Dávila
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain.,Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology, University of Malaga, Málaga, Spain
| | - María José Torres-Prioris
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain.,Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology, University of Malaga, Málaga, Spain
| | | | - Jordi Clarimón
- Department of Neurology and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Center for Networked Biomedical Research into Neurodegenerative Diseases, Madrid, Spain
| | - Oriol Dols-Icardo
- Department of Neurology and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Center for Networked Biomedical Research into Neurodegenerative Diseases, Madrid, Spain
| | - María J Postigo
- Neurophysiology Unit, Regional University Hospital Carlos Haya, Málaga, Spain
| | - Victoria Fernández
- Neurophysiology Unit, Regional University Hospital Carlos Haya, Málaga, Spain
| | - Lisa Edelkraut
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain.,Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology, University of Malaga, Málaga, Spain
| | - Lorena Moreno-Campos
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain
| | - Diana Molina-Sánchez
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain
| | - Paloma Solo de Zaldivar
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain
| | - Diana López-Barroso
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain.,Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology, University of Malaga, Málaga, Spain
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38
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Middleton EL, Schuchard J, Rawson KA. A Review of the Application of Distributed Practice Principles to Naming Treatment in Aphasia. TOPICS IN LANGUAGE DISORDERS 2020; 40:36-53. [PMID: 32831450 PMCID: PMC7437680 DOI: 10.1097/tld.0000000000000202] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
It is uncontroversial in psychological research that different schedules of practice, which govern the distribution of practice over time, can promote radically different outcomes in terms of gains in performance and the durability of learning. In contrast, in speech-language treatment research, there is a critical need for well-controlled studies examining the impact of the distribution of treatment on efficacy (for reviews, see Cherney, 2012; Warren, Fey, & Yoder, 2007). In this paper, we enumerate key findings from psychological research on learning and memory regarding how different schedules of practice differentially confer durable learning. We review existing studies of aphasia treatment with a focus on naming impairment that have examined how the distribution of practice affects treatment efficacy. We close by discussing potential productive lines of research to elaborate the clinical applicability of distributed practice principles to language treatment.
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Best W, Ping Sze W, Edmundson A, Nickels L. What counts as evidence? Swimming against the tide: Valuing both clinically informed experimentally controlled case series and randomized controlled trials in intervention research. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/17489539.2019.1597444] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Wendy Best
- Language and Cognition, Division of Psychology and Language Sciences, University College London, London, UK
| | - Wei Ping Sze
- Language and Cognition, Division of Psychology and Language Sciences, University College London, London, UK
| | - Anne Edmundson
- Language and Cognition, Division of Psychology and Language Sciences, University College London, London, UK
| | - Lyndsey Nickels
- Australian Research Council Centre of Excellence in Cognition and Its Disorders, Macquarie University, Sydney, Australia
- Department of Cognitive Science, Macquarie University, Sydney, Australia
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40
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Torres-Prioris MJ, López-Barroso D, Paredes-Pacheco J, Roé-Vellvé N, Dawid-Milner MS, Berthier ML. Language as a Threat: Multimodal Evaluation and Interventions for Overwhelming Linguistic Anxiety in Severe Aphasia. Front Psychol 2019; 10:678. [PMID: 31133908 PMCID: PMC6517493 DOI: 10.3389/fpsyg.2019.00678] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 03/11/2019] [Indexed: 12/30/2022] Open
Abstract
Linguistic anxiety (LA) is an abnormal stress response induced by situations that require the use of verbal behavior, and it is accentuated during language testing in persons with aphasia (PWA). The presence of LA in PWA may jeopardize the interpretation of cognitive evaluations, leading to biased conclusions about the severity of the language alteration and the effectiveness of the treatments. In the present study, we report the case of a woman (Mrs. A) with severe chronic mixed transcortical aphasia due to left frontal and parietal hemorrhages that partially spared the perisylvian area. Mrs. A was treated with the dopamine agonist Rotigotine alone and combined with Intensive Language-Action Therapy (ILAT). Complementary evaluations included autonomic reactivity during the performance of different language tasks, resting state functional magnetic resonance imaging (rs-fMRI) and [18F]-fluorodeoxyglucose positron emission tomography (18F-FDG-PET). We found that formal language testing in a clinical setting triggered a dramatic increase of automatic echolalia, perseverations and frustration, making the task completion difficult. The treatment improved aphasia, but gains were more robust when evaluation was performed by Mrs. A's husband at home than by clinicians. Autonomic evaluation under Rotigotine revealed higher reactivity during tasks tapping an impaired function in comparison with a task evaluating a preserved function (verbal repetition). Baseline 18F-FDG-PET analysis showed decreased metabolic activity in left limbic-paralimbic areas, whereas rs-fMRI revealed compensatory activity in the right hemisphere. We also analyzed the different factors (e.g., premorbid personality traits, task difficulty) that may have contributed to LA in Mrs. A during language testing. Our findings emphasize the usefulness of implicating adequately trained laypersons in the evaluation and treatment of PWA showing LA. Further studies using multidimensional evaluations are needed to disentangle the interplay between anxiety and abnormal language as well as the neural mechanisms underpinning LA in PWA.
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Affiliation(s)
- María José Torres-Prioris
- Cognitive Neurology and Aphasia Unit (UNCA), Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga - IBIMA, University of Málaga, Málaga, Spain.,Area of Psychobiology, Faculty of Psychology, University of Málaga, Málaga, Spain
| | - Diana López-Barroso
- Cognitive Neurology and Aphasia Unit (UNCA), Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga - IBIMA, University of Málaga, Málaga, Spain.,Area of Psychobiology, Faculty of Psychology, University of Málaga, Málaga, Spain
| | - José Paredes-Pacheco
- Molecular Imaging Unit, Centro de Investigaciones Médico-Sanitarias, General Foundation of the University of Malaga, Málaga, Spain.,Molecular Imaging and Medical Physics Group, Department of Psychiatry, Radiology and Public Health, University of Compostela, Santiago de Compostela, Spain
| | - Núria Roé-Vellvé
- Molecular Imaging Unit, Centro de Investigaciones Médico-Sanitarias, General Foundation of the University of Malaga, Málaga, Spain.,Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain
| | - Marc S Dawid-Milner
- Neurophysiology of Autonomic Nervous System Laboratory, Centro de Investigaciones Médico-Sanitarias, University of Málaga, Málaga, Spain
| | - Marcelo L Berthier
- Cognitive Neurology and Aphasia Unit (UNCA), Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga - IBIMA, University of Málaga, Málaga, Spain
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41
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Augmented Dyadic Therapy Boosts Recovery of Language Function in Patients With Nonfluent Aphasia. Stroke 2019; 50:1270-1274. [DOI: 10.1161/strokeaha.118.023729] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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42
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Wortman-Jutt S, Edwards D. Poststroke Aphasia Rehabilitation: Why All Talk and No Action? Neurorehabil Neural Repair 2019; 33:235-244. [PMID: 30900528 DOI: 10.1177/1545968319834901] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
There is ample agreement in the scientific literature, across diverse areas of study, that suggests that language and movement are interrelated. In particular, it is widely held that the upper limb and hand play a key role in language use. Aphasia, a common, disabling language disorder frequently associated with stroke, requires new restorative methods. A combinatorial hand-arm-language paradigm that capitalizes on shared neural networks may therefore prove beneficial for aphasia recovery in stroke patients and requires further exploration.
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Affiliation(s)
- Susan Wortman-Jutt
- 1 Burke Rehabilitation Hospital, White Plains, NY, USA
- 2 Burke Neurological Institute, White Plains, NY, USA
| | - Dylan Edwards
- 3 Moss Rehabilitation Research Institute, Elkins Park, PA, USA
- 4 Edith Cowan University, Joondalup, Western Australia, Australia
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43
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Mattioli F. The clinical management and rehabilitation of post stroke aphasia in Italy: evidences from the literature and clinical experience. Neurol Sci 2019; 40:1329-1334. [DOI: 10.1007/s10072-019-03844-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 03/13/2019] [Indexed: 01/09/2023]
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44
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Heikkinen PH, Pulvermüller F, Mäkelä JP, Ilmoniemi RJ, Lioumis P, Kujala T, Manninen RL, Ahvenainen A, Klippi A. Combining rTMS With Intensive Language-Action Therapy in Chronic Aphasia: A Randomized Controlled Trial. Front Neurosci 2019; 12:1036. [PMID: 30778280 PMCID: PMC6369187 DOI: 10.3389/fnins.2018.01036] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 12/20/2018] [Indexed: 11/13/2022] Open
Abstract
Neuromodulation technologies, such as transcranial magnetic stimulation (TMS), are promising tools for neurorehabilitation, aphasia therapy included, but not yet in common clinical use. Combined with behavioral techniques, in particular treatment-efficient Intensive Language-Action Therapy (ILAT, previously CIAT or CILT), TMS could substantially amplify the beneficial effect of such behavioral therapy alone (Thiel et al., 2013; Martin et al., 2014; Mendoza et al., 2016; Kapoor, 2017). In this randomized study of 17 subjects with post-stroke aphasia in the chronic stage, we studied the combined effect of ILAT and 1-Hz placebo-controlled navigated repetitive TMS (rTMS) to the right-hemispheric inferior frontal cortex—that is, to the anterior part of the non-dominant hemisphere's homolog Broca's area (pars triangularis). Patients were randomized to groups A and B. Patients in group A received a 2-week period of rTMS during naming training where they named pictures displayed on the screen once every 10 s, followed by 2 weeks of rTMS and naming combined with ILAT. Patients in group B received the same behavioral therapy but TMS was replaced by sham stimulation. The primary outcome measures for changes in language performance were the Western Aphasia Battery's aphasia quotient AQ; the secondary outcome measures were the Boston naming test (BNT) and the Action naming test (Action BNT, ANT). All subjects completed the study. At baseline, no statistically significant group differences were discovered for age, post-stroke time or diagnosis. ILAT was associated with significant improvement across groups, as documented by both primary and secondary outcome measures. No significant effect of rTMS could be documented. Our results agree with previous results proving ILAT's ability to improve language in patients with chronic aphasia. In contrast with earlier claims, however, a beneficial effect of rTMS in chronic post-stroke aphasia rehabilitation was not detected in this study. Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT03629665
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Affiliation(s)
- Paula H Heikkinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Friedemann Pulvermüller
- Brain Language Laboratory, Department of Philosophy and Humanities, WE4, Freie Universität Berlin, Berlin, Germany
| | - Jyrki P Mäkelä
- BioMag Laboratory, HUS Medical Imaging Center University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Risto J Ilmoniemi
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
| | - Pantelis Lioumis
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Teija Kujala
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Riitta-Leena Manninen
- BioMag Laboratory, HUS Medical Imaging Center University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Antti Ahvenainen
- BioMag Laboratory, HUS Medical Imaging Center University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anu Klippi
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Barnes S, Nickels L. Interaction-focussed therapy for aphasia: Effects on communication and quality of life. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 20:528-540. [PMID: 28682118 DOI: 10.1080/17549507.2017.1329851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 02/21/2017] [Accepted: 05/06/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE This study examined the effects of an interaction-focussed therapy for aphasia, which involved both people with aphasia and their familiar conversation partners. It was hypothesised the interaction-focussed therapy would lead to positive changes in targeted conversation behaviours, and improved quality of life for participants with aphasia. METHOD Three people with chronic aphasia and three of their familiar conversation partners completed an 8-week interaction-focussed therapy programme. A series of single case multiple-baseline ABA experiments were conducted. Outcome measures focussed on changes in targeted behaviours between pre- and post-therapy conversation samples, and changes in quality of life. RESULT All participant dyads improved their conversations. Familiar conversation partners demonstrated significant changes in targeted behaviours, while only one participant with aphasia achieved significant improvements. There was little evidence of a positive impact on quality of life for participants with aphasia. CONCLUSION Interaction-focussed therapy enhances everyday communication for people with aphasia and their conversation partners. However, the complex nature of learning in this intervention means that further, likely interdisciplinary work is required to better understand what mediates skill acquisition and therapeutic change and its psychosocial impact. This information is particularly important for optimising interaction-focussed therapy for people with aphasia.
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Affiliation(s)
- Scott Barnes
- a Department of Linguistics , Macquarie University , Sydney , Australia and
| | - Lyndsey Nickels
- b Centre for Cognition and its Disorders, Department of Cognitive Science , Macquarie University , Sydney , Australia
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The Neural and Behavioral Correlates of Anomia Recovery following Personalized Observation, Execution, and Mental Imagery Therapy: A Proof of Concept. Neural Plast 2018; 2018:5943759. [PMID: 30154837 PMCID: PMC6092994 DOI: 10.1155/2018/5943759] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 04/11/2018] [Accepted: 06/13/2018] [Indexed: 11/18/2022] Open
Abstract
The impact of sensorimotor strategies on aphasia recovery has rarely been explored. This paper reports on the efficacy of personalized observation, execution, and mental imagery (POEM) therapy, a new approach designed to integrate sensorimotor and language-based strategies to treat verb anomia, a frequent aphasia sign. Two participants with verb anomia were followed up in a pre-/posttherapy fMRI study. POEM was administered in a massed stimulation schedule, with personalized stimuli, resulting in significant improvement in both participants, with both trained and untrained items. Given that the latter finding is rarely reported in the literature, the evidence suggests that POEM favors the implementation of a word retrieval strategy that can be integrated and generalized. Changes in fMRI patterns following POEM reflect a reduction in the number of recruited areas supporting naming and the recruitment of brain areas that belong to the language and mirror neuron systems. The data provide evidence on the efficacy of POEM for verb anomia, while pointing to the added value of combined language and sensorimotor strategies for recovery from verb anomia, contributing to the consolidation of a word retrieval strategy that can be better generalized to untrained words. Future studies with a larger sample of participants are required to further explore this avenue.
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Knollman-Porter K, Dietz A, Dahlem K. Intensive Auditory Comprehension Treatment for Severe Aphasia: A Feasibility Study. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 27:936-949. [PMID: 29800054 DOI: 10.1044/2018_ajslp-17-0117] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 02/22/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Severe auditory comprehension impairments secondary to aphasia can adversely influence rehabilitative outcomes and quality of life. Studies examining intensive rehabilitative treatments for severe single-word auditory comprehension impairments are needed. OBJECTIVES Our purpose was to examine the feasibility and influence of a high-intensity word-picture verification treatment on high-frequency, word response accuracy. Research questions: (a) Can people with severe aphasia tolerate an intensive comprehension treatment? (b) Does an intensive intervention increase auditory comprehension response accuracy of spoken high-frequency words? METHOD This single-case ABA design study included 2 participants with chronic, severe auditory comprehension deficits secondary to stroke. A high-frequency, word-picture verification treatment was administered 2 hr/day, 5 days/week for 4 weeks and required participants to match the spoken word of the examiner to a picture representing an object. RESULTS Preliminary results suggest that some people with severe chronic aphasia can tolerate an intensive auditory comprehension treatment and demonstrate improvements in high-frequency, word-level response accuracy with large effect sizes suggesting generalization to untrained stimuli. CONCLUSIONS An intensive auditory comprehension treatment protocol can contribute to improvements in response accuracy for some people with severe aphasia. Larger sample size studies are needed to further examine the influence of intensity on improvements in auditory comprehension.
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Affiliation(s)
| | - Aimee Dietz
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
| | - Kelly Dahlem
- Department of Speech Pathology & Audiology, Miami University, FL
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Grechuta K, Bellaster BR, Munne RE, Bernal TU, Hervas BM, Segundo RS, Verschure PFMJ. The effects of silent visuomotor cueing on word retrieval in Broca's aphasies: A pilot study. IEEE Int Conf Rehabil Robot 2018; 2017:193-199. [PMID: 28813817 DOI: 10.1109/icorr.2017.8009245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
About a quarter of stroke patients worldwide suffer serious language disorders such as aphasias. Most common symptoms of Broca's aphasia are word naming disorders which highly impact verbal communication and the quality of life of aphasic patients. In order to recover disturbances in word retrieval, several cueing methods (i.e. phonemic and semantic) have been established to improve lexical access establishing effective language rehabilitation techniques. Based on recent evidence from action-perception theories, which postulate that neural circuits for speech perception and articulation are tightly coupled, in the present work, we propose and investigate an alternative type of cueing using silent articulation-related visual stimuli. We hypothesize that providing patients with primes in the form of silent videos showing lip motions representative of correct pronunciation of target words, will result in faster word retrieval than when no such cue is provided. To test our prediction, we realize a longitudinal clinical virtual reality-based trial with four post-stroke Broca's patients and compare the interaction times between the two conditions over the eight weeks of the therapy. Our results suggest that silent visuomotor cues indeed facilitate word retrieval and verbal execution, and might be beneficial in lexical relearning in chronic Broca's patients.
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Szaflarski JP, Griffis J, Vannest J, Allendorfer JB, Nenert R, Amara AW, Sung V, Walker HC, Martin AN, Mark VW, Zhou X. A feasibility study of combined intermittent theta burst stimulation and modified constraint-induced aphasia therapy in chronic post-stroke aphasia. Restor Neurol Neurosci 2018; 36:503-518. [DOI: 10.3233/rnn-180812] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Jerzy P. Szaflarski
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Joseph Griffis
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
- Currently at Washington University in St. Louis, St. Louis, MO, USA
| | - Jennifer Vannest
- Cincinnati Children’s Hospital Medical Center, Division of Neurology and Pediatric Neuroimaging Research Consortium, Cincinnati, OH, USA
| | - Jane B. Allendorfer
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rodolphe Nenert
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Amy W. Amara
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Victor Sung
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Harrison C. Walker
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Amber N. Martin
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Victor W. Mark
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Xiaohua Zhou
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, USA
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Vuksanović J, Milovanović T, Konstantinović L, Filipović SR. Effect of type of language therapy on expressive language skills in patients with post-stroke aphasia. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2018; 53:825-835. [PMID: 29749688 DOI: 10.1111/1460-6984.12390] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 04/08/2018] [Accepted: 04/11/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Constraint-induced (language) aphasia therapy (CIAT), based on constraint usage of the language channel only, massed practice and shaping through therapeutic language games, has been suggested as a more efficient therapy approach than traditional aphasia therapies. AIMS To examine the comparative efficacy of CIAT and a traditional therapy approach on expressive language ability, with the intensity of therapy controlled and matched, in the treatment of post-stroke aphasia. METHODS & PROCEDURES Two successive 4-week blocks of intense (1 h, 5 days a week) of aphasia therapy programmes were delivered in a randomized within-subject crossover design: one therapy block consisted of stimulation aphasia therapy (SAT, a common traditional therapy approach), another of CIAT. Twenty consecutive patients, up to 1 year after stroke, were randomly assigned either to have SAT followed by CIAT (S1C2 group) or to have CIAT followed by SAT (C1S2 group). Measurements of naming (Boston Naming Test) and spontaneous sentence production (Cookie Theft Picture description task) were carried at the baseline, following the first therapy block, following the second therapy block and 4 weeks following the last therapy block. OUTCOMES & RESULTS Both groups of patients significantly improved in all variables of expressive language skills; the improvement was maintained 1 month post-treatment. However, patients who started with CIAT and continued with SAT (C1S2 group) tended to have higher final improvement than the patients who started with SAT and continued with CIAT (S1C2 group). This was particularly pronounced for naming. Moreover, when CIAT was the first therapy (the C1S2 group) the improvement achieved in naming following CIAT significantly exceeded the improvements achieved following SAT, not only in the same group (when SAT was the second) but also in the S1C2 group (when SAT was the first). In addition, the improvement in naming following CIAT in the C1S2 group exceeded the one in the S1C2 group, too. Similarly, the improvement in the total number of sentences produced following each therapy was quite clear and significant in the C1S2 group (when CIAT was the first), while in the S1C2 group it was much more modest and not significant. CONCLUSIONS & IMPLICATIONS Results suggest that the maximization of quantity and frequency of language therapy have a significant impact on the improvement of expressive language ability. Moreover, if practised early in aphasia therapy, the constrained usage of the language modality, as practised in CIAT, confers an additional benefit to massed practice, particularly on naming ability.
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Affiliation(s)
- Jasmina Vuksanović
- University of Belgrade, Institute for Medical Research, Belgrade, Serbia
| | | | - Ljubica Konstantinović
- Klinika za Rehabilitaciju 'Dr Miroslav Zotović', Belgrade, Serbia
- University of Belgrade, Faculty of Medicine (Rehabilitation), Belgrade, Serbia
| | - Saša R Filipović
- University of Belgrade, Institute for Medical Research, Belgrade, Serbia
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