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Goral M, Norvik MI, Antfolk J, Agrotou I, Lehtonen M. Cross-language generalization of language treatment in multilingual people with post-stroke aphasia: A meta-analysis. BRAIN AND LANGUAGE 2023; 246:105326. [PMID: 37994828 DOI: 10.1016/j.bandl.2023.105326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 09/09/2023] [Accepted: 09/26/2023] [Indexed: 11/24/2023]
Abstract
Studies on the efficacy of language treatment for multilingual people with post-stroke aphasia and its generalization to untreated languages have produced mixed results. We conducted a systematic review and a meta-analysis to examine within- and cross-language treatment effects and the variables that affect them. We searched PubMed, PsycINFO, CINAHL, and Google Scholar (February 2020; January 2023), identifying 40 studies reporting on 1573 effect sizes from 85 individuals. We synthesized effect sizes for treatment outcomes using a multi-level model to correct for multiple observations from the same individuals. The results showed significant treatment effects, with robust within-language treatment effects and weaker cross-language treatment effects. Age of language acquisition of the treatment language predicted within-language and cross-language effects. Our results suggest that treating multilingual people with aphasia in one language may generalize to their other languages, especially following treatment in an early-acquired language and a later-learned language that became the language of immersion.
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Affiliation(s)
- Mira Goral
- Lehman College, The City University of New York, Bronx, NY, USA; The Graduate Center, The City University of New York, New York, NY, USA; MultiLing Center for Multilingualism in Society Across the Lifespan, Department of Linguistics and Scandinavian Studies, University of Oslo, Oslo, Norway.
| | - Monica I Norvik
- MultiLing Center for Multilingualism in Society Across the Lifespan, Department of Linguistics and Scandinavian Studies, University of Oslo, Oslo, Norway; Department of Acquired Brain Injury, Statped, Oslo, Norway
| | - Jan Antfolk
- Department of Psychology, Abo Akademi University, Turku, Finland
| | - Ioulia Agrotou
- The Graduate Center, The City University of New York, New York, NY, USA
| | - Minna Lehtonen
- MultiLing Center for Multilingualism in Society Across the Lifespan, Department of Linguistics and Scandinavian Studies, University of Oslo, Oslo, Norway; Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland; Turku Brain and Mind Center, University of Turku, Turku, Finland
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Mellahn K, Larkman C, Lakhani A, Siyambalapitiya S, Rose ML. The nature of inpatient rehabilitation for people with aphasia from culturally and linguistically diverse backgrounds: a scoping review. Top Stroke Rehabil 2023; 30:146-156. [PMID: 34854368 DOI: 10.1080/10749357.2021.2008599] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Due to language and cultural barriers, people with aphasia from culturally and linguistically diverse (CALD) backgrounds are at risk of disadvantage in their access to comprehensive care. They are at higher risk of poorer inpatient outcomes in addition to challenges in receiving appropriate aphasia assessment and intervention. OBJECTIVES This study aims to examine the extent and nature of what is known about the inpatient phase of aphasia rehabilitation for CALD stroke survivors and identify potential research gaps in the literature for investigation. METHODS A scoping review with systematic search was conducted in September 2020 following the PRISMA Scoping Review checklist. Five electronic databases were searched using a combination of terms pertaining to "aphasia," "inpatient care" and "CALD." Key variables were extracted from studies that met the inclusion criteria for analysis. RESULTS Eighteen studies were yielded. Data regarding the inpatient phase of care indicate that CALD people with aphasia do not always receive comprehensive assessment or intervention in all their languages that may impact their discharge destination and access to community services. Speech-language pathologists (SLPs) report numerous barriers to service provision for this population. No studies investigated the degree and nature of differences in outcomes between CALD and non-CALD stroke survivors with aphasia. CONCLUSIONS CALD stroke survivors with aphasia inconsistently access SLP services in hospital. Assessment is unlikely to be conducted in patient primary languages and therapy is usually provided in the language of SLPs. Further research is required to determine whether this impacts functional outcomes and health services.
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Affiliation(s)
- Kathleen Mellahn
- School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Bundoora, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Australia
| | - Chelsea Larkman
- School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Bundoora, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Australia
| | - Ali Lakhani
- School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Bundoora, Australia
| | | | - Miranda L Rose
- School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Bundoora, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Australia
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Arheix-Parras S, Glize B, Guehl D, Python G. Electrophysiological Changes in Patients with Post-stroke Aphasia: A Systematic Review. Brain Topogr 2023; 36:135-171. [PMID: 36749552 DOI: 10.1007/s10548-023-00941-4] [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: 07/16/2022] [Accepted: 01/19/2023] [Indexed: 02/08/2023]
Abstract
Background Magnetoencephalography (MEG) and electroencephalography (EEG) record two main types of data: continuous measurements at rest or during sleep, and event-related potentials/evoked magnetic fields (ERPs/EMFs) that involve specific and repetitive tasks. In this systematic review, we summarized longitudinal studies on recovery from post-stroke aphasia that used continuous or event-related temporal imaging (EEG or MEG). Methods We searched PubMed and Scopus for English articles published from 1950 to May 31, 2022. Results 34 studies were included in this review: 11 were non-interventional studies and 23 were clinical trials that used specific rehabilitation methods, neuromodulation, or drugs. The results of the non-interventional studies suggested that poor language recovery was associated with slow-wave activity persisting over time. The results of some clinical trials indicated that behavioral improvements were correlated with significant modulation of the N400 component. Discussion Compared with continuous EEG, ERP/EMF may more reliably identify biomarkers of therapy-induced effects. Electrophysiology should be used more often to explore language processes that are impaired after a stroke, as it may highlight treatment challenges for patients with post-stroke aphasia.
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Affiliation(s)
- Sophie Arheix-Parras
- ACTIVE team, Bordeaux Population Health, INSERM UMR 1219, university of Bordeaux, 33000, Bordeaux, France. .,Institut Universitaire des Sciences de la Réadaptation, University of Bordeaux, 33000, Bordeaux, France. .,Department of physical medicine and rehabilitation, CHU de Bordeaux, 33000, Bordeaux, France.
| | - Bertrand Glize
- ACTIVE team, Bordeaux Population Health, INSERM UMR 1219, university of Bordeaux, 33000, Bordeaux, France.,Institut Universitaire des Sciences de la Réadaptation, University of Bordeaux, 33000, Bordeaux, France.,Department of physical medicine and rehabilitation, CHU de Bordeaux, 33000, Bordeaux, France
| | - Dominique Guehl
- Pole des neurosciences cliniques, CHU de Bordeaux, 33000, Bordeaux, France.,IMN CNRS UMR 5293, CNRS, University of Bordeaux, 33000, Bordeaux, France
| | - Grégoire Python
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.,Department of Clinical Neurosciences, Lausanne University Hospital (CHUV), Lausanne, Switzerland
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Alterations to dual stream connectivity predicts response to aphasia therapy following stroke. Cortex 2020; 125:30-43. [DOI: 10.1016/j.cortex.2019.12.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 10/03/2019] [Accepted: 12/10/2019] [Indexed: 01/06/2023]
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Kuzmina E, Goral M, Norvik M, Weekes BS. What Influences Language Impairment in Bilingual Aphasia? A Meta-Analytic Review. Front Psychol 2019; 10:445. [PMID: 31024369 PMCID: PMC6460996 DOI: 10.3389/fpsyg.2019.00445] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 02/13/2019] [Indexed: 12/04/2022] Open
Abstract
Patterns of language impairment in multilingual speakers with post-stroke aphasia are diverse: in some cases the language deficits are parallel, that is, all languages are impaired relatively equally, whereas in other cases deficits are differential, that is, one language is more impaired than the other(s). This diversity stems from the intricate structure of the multilingual language system, which is shaped by a complex interplay of influencing factors, such as age of language acquisition, frequency of language use, premorbid proficiency, and linguistic similarity between one's languages. Previous theoretical reviews and empirical studies shed some light on these factors, however no clear answers have been provided. The goals of this review were to provide a timely update on the increasing number of reported cases in the last decade and to offer a systematic analysis of the potentially influencing variables. One hundred and thirty cases from 65 studies were included in the present systematic review and effect sizes from 119 cases were used in the meta-analysis. Our analysis revealed better performance in L1 compared to L2 in the whole sample of bilingual speakers with post-stroke aphasia. However, the magnitude of this difference was influenced by whether L2 was learned early in childhood or later: those who learned L2 before 7 years of age showed comparable performance in both of their languages contrary to the bilinguals who learned L2 after 7 years of age and showed better performance in L1 compared to L2. These robust findings were moderated mildly by premorbid proficiency and frequency of use. Finally, linguistic similarity did not appear to influence the magnitude of the difference in performance between L1 and L2. Our findings from the early bilingual subgroup were in line with the previous reviews which included mostly balanced early bilinguals performing comparably in both languages. Our findings from the late bilingual subgroup stressed the primacy of L1 and the importance of age of L2 learning. In addition, the evidence from the present review provides support for theories emphasizing the role of premorbid proficiency and language use in language impairment patterns in bilingual aphasia.
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Affiliation(s)
- Ekaterina Kuzmina
- Faculty of Humanities, Center for Multilingualism in Society Across the Lifespan, University of Oslo, Oslo, Norway
| | - Mira Goral
- Faculty of Humanities, Center for Multilingualism in Society Across the Lifespan, University of Oslo, Oslo, Norway
- The Graduate Center and Lehman College, City University of New York, New York, NY, United States
| | - Monica Norvik
- Faculty of Humanities, Center for Multilingualism in Society Across the Lifespan, University of Oslo, Oslo, Norway
- Department of Speech and Language Disorders, Statped, Oslo, Norway
- Department of Language and Literature, Norwegian University of Science and Technology, Trondheim, Norway
| | - Brendan S. Weekes
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, VIC, Australia
- Laboratory for Communication Science, Faculty of Education, The University of Hong Kong, Pokfulam, Hong Kong
- State Key Laboratory for Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong
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Monaco E, Jost LB, Gygax PM, Annoni JM. Embodied Semantics in a Second Language: Critical Review and Clinical Implications. Front Hum Neurosci 2019; 13:110. [PMID: 30983983 PMCID: PMC6449436 DOI: 10.3389/fnhum.2019.00110] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 03/12/2019] [Indexed: 12/20/2022] Open
Abstract
The role of the sensorimotor system in second language (L2) semantic processing as well as its clinical implications for bilingual patients has hitherto been neglected. We offer an overview of the issues at stake in this under-investigated field, presenting the theoretical and clinical relevance of studying L2 embodiment and reviewing the few studies on this topic. We highlight that (a) the sensorimotor network is involved in L2 processing, and that (b) in most studies, L2 is differently embodied than L1, reflected in a lower degree or in a different pattern of L2 embodiment. Importantly, we outline critical issues to be addressed in order to guide future research. We also delineate the subsequent steps needed to confirm or dismiss the value of language therapeutic approaches based on embodiment theories as a complement of speech and language therapies in adult bilinguals.
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Affiliation(s)
- Elisa Monaco
- Laboratory for Cognitive and Neurological Sciences, Neurology Unit, Medicine Section, Department of Neuroscience and Movement Science, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Lea B. Jost
- Laboratory for Cognitive and Neurological Sciences, Neurology Unit, Medicine Section, Department of Neuroscience and Movement Science, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Pascal M. Gygax
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Jean-Marie Annoni
- Laboratory for Cognitive and Neurological Sciences, Neurology Unit, Medicine Section, Department of Neuroscience and Movement Science, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
- Neurology Unit, Fribourg Cantonal Hospital, Fribourg, Switzerland
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van Zyl M, Pillay B, Kritzinger A, Lekganyane M, Graham M. Significance of speech production errors on cross-linguistic processing in Sepedi-English individuals with bilingual aphasia: a case series analysis. Top Stroke Rehabil 2019; 26:294-306. [PMID: 30913996 DOI: 10.1080/10749357.2019.1593612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Bilingual aphasia forms a significant part of speech-language pathologists' (SLP) caseload, globally, and specifically in South Africa. Few tools supporting clinical decision-making are available due to limited understanding of typical and disordered cross-linguistic processing (how the languages interact). Speech errors may provide insight about "hidden" bilingual mechanisms. OBJECTIVES To determine what speech errors can impart about cross-linguistic processing, as well as, associated language and impairment variables in Sepedi-English individuals with aphasia. METHOD The case series included six participants, purposively selected from three rehabilitation sites in South Africa. Detailed language and clinical profiles were obtained. Participants performed a confrontation naming task in their most dominant (MDL) and less dominant language (LDL). Responses were audio recorded, transcribed, and analyzed for overall accuracy and error type in MDL and LDL; verified by a Sepedi-speaking linguist and a qualified SLP. RESULTS (1) No statistically significant differences in MDL-LDL naming accuracy were found, supporting recent literature of simultaneous inter-activation of both languages and shared word retrieval mechanisms. All types of speech errors occurred, and semantic errors were produced most frequently and consistently in each participant's MDL and LDL. (2) Language proficiency, language recovery patterns, and aphasia type (Broca's and Anomic) and severity (mild and/or moderate) appeared to be more strongly linked to cross-linguistic processing than Sepedi-English linguistic differences and age of acquisition of both languages. CONCLUSIONS Participants with bilingual aphasia may use typical cross-linguistic and word retrieval mechanisms, concurring with current theories of bilingualism. Findings are preliminary, warranting investigations of other language tasks, modalities, pairs, and related variables.
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Affiliation(s)
- Mianda van Zyl
- a Department of Speech-Language Pathology and Audiology , University of Pretoria , Pretoria , South Africa
| | - Bhavani Pillay
- a Department of Speech-Language Pathology and Audiology , University of Pretoria , Pretoria , South Africa
| | - Alta Kritzinger
- a Department of Speech-Language Pathology and Audiology , University of Pretoria , Pretoria , South Africa
| | - Matemane Lekganyane
- c Department of African Languages , University of Pretoria , Pretoria , South Africa
| | - Marien Graham
- b Department of Science, Mathematics and Technology Education , University of Pretoria , Pretoria , South Africa
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Khachatryan E, Wittevrongel B, De Keyser K, De Letter M, Hulle MMV. Event Related Potential Study of Language Interaction in Bilingual Aphasia Patients. Front Hum Neurosci 2018; 12:81. [PMID: 29556182 PMCID: PMC5844919 DOI: 10.3389/fnhum.2018.00081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 02/15/2018] [Indexed: 11/13/2022] Open
Abstract
Half of the global population can be considered bilingual. Nevertheless when faced with patients with aphasia, clinicians and therapists usually ignore the patient's second language (L2) albeit its interference in first language (L1) processing has been shown. The excellent temporal resolution by which each individual linguistic component can be gaged during word-processing, promoted the event-related potential (ERP) technique for studying language processing in healthy bilinguals and monolingual aphasia patients. However, this technique has not yet been applied in the context of bilingual aphasia. In the current study, we report on L2 interference in L1 processing using the ERP technique in bilingual aphasia. We tested four bilingual- and one trilingual patients with aphasia, as well as several young and older (age-matched with patients) healthy subjects as controls. We recorded ERPs when subjects were engaged in a semantic association judgment task on 122 related and 122 unrelated Dutch word-pairs (prime and target words). In 61 related and 61 unrelated word-pairs, an inter-lingual homograph was used as prime. In these word-pairs, when the target was unrelated to the prime in Dutch (L1), it was associated to the English (L2) meaning of the homograph. Results showed a significant effect of homograph use as a prime on early and/or late ERPs in response to word-pairs related in Dutch or English. Each patient presented a unique pattern of L2 interference in L1 processing as reflected by his/her ERP image. These interferences depended on the patient's pre- and post-morbid L2 proficiency. When the proficiency was high, the L2 interference in L1 processing was higher. Furthermore, the mechanism of interference in patients that were pre-morbidly highly proficient in L2 additionally depended on the frequency of pre-morbid L2 exposure. In summary, we showed that the mechanism behind L2 interference in L1 processing in bilingual patients with aphasia depends on a complex interaction between pre- and post-morbid L2 proficiency, pre- and post-morbid L2 exposure, impairment and the presented stimulus (inter-lingual homographs). Our ERP study complements the usually adopted behavioral approach by providing new insights into language interactions on the level of individual linguistic components in bilingual patients with aphasia.
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Affiliation(s)
- Elvira Khachatryan
- Laboratory for Neuro- and Psychophysiology, Department of Neuroscience, KU Leuven, Leuven, Belgium
| | - Benjamin Wittevrongel
- Laboratory for Neuro- and Psychophysiology, Department of Neuroscience, KU Leuven, Leuven, Belgium
| | - Kim De Keyser
- Department of Speech, Language and Hearing Sciences, Ghent University, Ghent, Belgium
| | - Miet De Letter
- Department of Speech, Language and Hearing Sciences, Ghent University, Ghent, Belgium
| | - Marc M. Van Hulle
- Laboratory for Neuro- and Psychophysiology, Department of Neuroscience, KU Leuven, Leuven, Belgium
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Radman N, Mouthon M, Di Pietro M, Gaytanidis C, Leemann B, Abutalebi J, Annoni JM. The Role of the Cognitive Control System in Recovery from Bilingual Aphasia: A Multiple Single-Case fMRI Study. Neural Plast 2016; 2016:8797086. [PMID: 27965899 PMCID: PMC5124691 DOI: 10.1155/2016/8797086] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 09/15/2016] [Accepted: 10/12/2016] [Indexed: 11/26/2022] Open
Abstract
Aphasia in bilingual patients is a therapeutic challenge since both languages can be impacted by the same lesion. Language control has been suggested to play an important role in the recovery of first (L1) and second (L2) language in bilingual aphasia following stroke. To test this hypothesis, we collected behavioral measures of language production (general aphasia evaluation and picture naming) in each language and language control (linguistic and nonlinguistic switching tasks), as well as fMRI during a naming task at one and four months following stroke in five bilingual patients suffering from poststroke aphasia. We further applied dynamic causal modelling (DCM) analyses to the connections between language and control brain areas. Three patients showed parallel recovery in language production, one patient improved in L1, and one improved in L2 only. Language-control functions improved in two patients. Consistent with the dynamic view of language recovery, DCM analyses showed a higher connectedness between language and control areas in the language with the better recovery. Moreover, similar degrees of connectedness between language and control areas were found in the patients who recovered in both languages. Our data suggest that engagement of the interconnected language-control network is crucial in the recovery of languages.
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Affiliation(s)
- Narges Radman
- Neurology Unit, Department of Medicine, Faculty of Sciences, University of Fribourg, Fribourg, Switzerland
| | - Michael Mouthon
- Neurology Unit, Department of Medicine, Faculty of Sciences, University of Fribourg, Fribourg, Switzerland
| | - Marie Di Pietro
- Neurorehabilitation Department, University Hospital, University of Geneva, Geneva, Switzerland
| | - Chrisovalandou Gaytanidis
- Neurorehabilitation Department, University Hospital, University of Geneva, Geneva, Switzerland
- Neuropsychology Unit, Fribourg Cantonal Hospital, Fribourg, Switzerland
| | - Beatrice Leemann
- Neurorehabilitation Department, University Hospital, University of Geneva, Geneva, Switzerland
| | - Jubin Abutalebi
- Center for Neurolinguistics and Psycholinguistics, San Raffaele University and Scientific Institute San Raffaele, Milan, Italy
| | - Jean-Marie Annoni
- Neurology Unit, Department of Medicine, Faculty of Sciences, University of Fribourg, Fribourg, Switzerland
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