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de Lima Ramos R, Bahia MM, Flamand-Roze C, Chun RYS. Brazilian Portuguese Adaptation and Validation of the Language Screening Test for Poststroke Patients. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:2296-2315. [PMID: 37410632 DOI: 10.1044/2023_jslhr-22-00611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
BACKGROUND There is a lack of standardized assessment tools for poststroke aphasia in Brazil, particularly bedside screenings for early identification of patients with suspected language disorders. The Language Screening Test (LAST) is a valid and reliable method for screening hospitalized patients following a stroke. This tool was first developed in French and then translated and validated in other languages. PURPOSE This study aimed to translate, culturally adapt, and validate the LAST into Brazilian Portuguese. METHOD Following a systematic, multistep approach to translation and cultural adaptation of language instruments, this study developed the two parallel versions of the Brazilian Portuguese LAST (pLAST) Versions A and B. The final versions were applied to 70 healthy and 30 poststroke adults across age and educational levels. Subtests of the Boston Diagnostic Aphasia Examination (BDAE) were used to assess the external validity of the pLAST. RESULTS Findings showed that the two versions (A and B) of the pLAST were equivalent (intraclass correlation coefficient = .91; p < .001). No floor or ceiling effects were observed, and internal validity was excellent (Cronbach's α = .85). Moreover, its external validity against the BDAE was moderate to strong. Test sensitivity and specificity were 0.88 and 1, respectively, and accuracy was 0.96. CONCLUSION The Brazilian Portuguese version of the LAST is a valid, simple, easy, and rapid test to screen poststroke aphasia in hospital settings. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23548911.
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Affiliation(s)
- Renata de Lima Ramos
- Department of Human Development and Rehabilitation, University of Campinas, SP, Brazil
| | - Mariana M Bahia
- Department of Communication Sciences and Disorders, Syracuse University, NY
| | - Constance Flamand-Roze
- Department of Neurology, Centre Hospitalier Sud-Francilien, Paris Sud University, Corbeil-Essonnes, France
| | - Regina Yu Shon Chun
- Department of Human Development and Rehabilitation, University of Campinas, SP, Brazil
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Wang Y, Guo S, Wang N, Liu J, Chen F, Zhai Y, Wang Y, Jiao Y, Zhao W, Fan C, Xue Y, Gao G, Ji P, Wang L. The clinical and neurocognitive functional changes with awake brain mapping for gliomas invading eloquent areas: Institutional experience and the utility of The Montreal Cognitive Assessment. Front Oncol 2023; 13:1086118. [PMID: 36910631 PMCID: PMC9992726 DOI: 10.3389/fonc.2023.1086118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 02/09/2023] [Indexed: 02/24/2023] Open
Abstract
Objective Awake craniotomy with intraoperative brain functional mapping effectively reduces the potential risk of neurological deficits in patients with glioma invading the eloquent areas. However, glioma patients frequently present with impaired neurocognitive function. The present study aimed to investigate the neurocognitive and functional outcomes of glioma patients after awake brain mapping and assess the experience of a tertiary neurosurgical center in China over eight years. Methods This retrospective study included 80 patients who underwent awake brain mapping for gliomas invading the eloquent cortex between January 2013 and December 2021. Clinical and surgical factors, such as the extent of resection (EOR), perioperative Karnofsky Performance Score (KPS), progression-free survival (PFS), and overall survival (OS), were evaluated. We also used the Montreal Cognitive Assessment (MoCA) to assess the neurocognitive status changes. Results The most frequently observed location of glioma was the frontal lobe (33/80, 41.25%), whereas the tumor primarily invaded the language-related cortex (36/80, 45%). Most patients had supratotal resection (11/80, 13.75%) and total resection (45/80, 56.25%). The median PFS was 43.2 months, and the median OS was 48.9 months in our cohort. The transient (less than seven days) neurological deficit rate was 17.5%, whereas the rate of persistent deficit (lasting for three months) was 15%. At three months of follow-up, most patients (72/80, 90%) had KPS scores > 80. Meanwhile, compared to the preoperative baseline tests, the changes in MoCA scores presented significant improvements at discharge and three months follow-up tests. Conclusion Awake brain mapping is a feasible and safe method for treating glioma invading the eloquent cortex, with the benefit of minimizing neurological deficits, increasing EOR, and extending survival time. The results of MoCA test indicated that brain mapping plays a critical role in preserving neurocognitive function during tumor resection.
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Affiliation(s)
- Yuan Wang
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Shaochun Guo
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Na Wang
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Jinghui Liu
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Fan Chen
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yulong Zhai
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yue Wang
- Department of Health Statistics, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yang Jiao
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Wenjian Zhao
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Chao Fan
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yanrong Xue
- National Time Service Center, Chinese Academy of Sciences, Xi'an, Shaanxi, China.,School of Optoelectronics, University of Chinese Academy of Sciences, Beijing, China
| | - GuoDong Gao
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Peigang Ji
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Liang Wang
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
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Grönberg A, Henriksson I, Lindgren A. Accuracy of NIH Stroke Scale for diagnosing aphasia. Acta Neurol Scand 2021; 143:375-382. [PMID: 33368189 PMCID: PMC7985870 DOI: 10.1111/ane.13388] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 11/10/2020] [Accepted: 11/26/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The National Institutes of Health Stroke Scale (NIHSS) has not been validated to diagnose aphasia in the stroke population. We therefore examined the diagnostic accuracy of NIHSS for detecting aphasia in acute ischemic stroke. METHODS Consecutive patients with acute first-ever ischemic stroke were included prospectively in Lund Stroke Register Study at Skåne University Hospital, Sweden. Exclusion criteria were: (a) non-native Swedish; (b) obtundation (c) dementia or psychiatric diagnosis. Patients were assessed with NIHSS item 9 (range 0-3, where 1-3 indicate aphasia) by a NIHSS certified research nurse in the acute phase after stroke onset (median 3 days). Within 24 h after this assessment, a speech therapist evaluated the patients' language function with the comprehensive language screening test (LAST, range 0-15 where 0-14 indicates aphasia). Data were analyzed using LAST as 'reference standard'. RESULTS We examined 221 patients. Among these, 23% (n = 50) had aphasia according to NIHSS (distribution of scores 0, 1, 2, 3 were n = 171, n = 29, n = 12, n = 9) compared to 26% (n = 58) with aphasia according to LAST (score ≤14; median = 11). Assuming LAST as reference standard, NIHSS gave 16 false negatives (NIHSS item 9 = 0) for aphasia (LAST scores range 8-14), and 8 false positives (NIHSS item 9 score = 1) for aphasia, yielding a sensitivity of 72% (0.59-0.83) and a specificity of 95% (0.91-0.98). CONCLUSIONS When using NIHSS for screening and diagnosing aphasia in adults with acute ischemic stroke, patients with severe aphasia can be detected, however, some mild aphasias might be misclassified. Given the 72% sensitivity, absence of aphasia on the NIHSS should not be used to guide stroke treatment.
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Affiliation(s)
- Angelina Grönberg
- Department of Clinical Sciences Lund Neurology Lund University Lund Sweden
- Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics Skåne University Hospital Lund Sweden
| | - Ingrid Henriksson
- Speech and Language Pathology Unit Institute of Neuroscience and Physiology Sahlgrenska AcademyUniversity of Gothenburg Gothenburg Sweden
| | - Arne Lindgren
- Department of Clinical Sciences Lund Neurology Lund University Lund Sweden
- Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics Skåne University Hospital Lund Sweden
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Paplikar A, Iyer GK, Varghese F, Alladi S, Pauranik A, Mekala S, Kaul S, Sharma M, Dhaliwal RS, Saroja AO, Dharamkar S, Dutt A, Divyaraj G, Ghosh A, Kandukuri R, Mathew R, Menon R, Narayanan J, Nehra A, Padma MV, Ramakrishnan S, Ravi SK, Shah U, Tripathi M, Sylaja PN, Varma RP. A Screening Tool to Detect Stroke Aphasia: Adaptation of Frenchay Aphasia Screening Test (FAST) to the Indian Context. Ann Indian Acad Neurol 2020; 23:S143-S148. [PMID: 33343139 PMCID: PMC7731676 DOI: 10.4103/aian.aian_499_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 05/23/2020] [Indexed: 12/01/2022] Open
Abstract
Background: Aphasia is a common consequence of stroke. To optimize recovery, it becomes critical as there are early identification and treatment of language deficits. The rising burden of stroke aphasia and lack of screening tools in the Indian context necessitates the need for a screening tool. Objective: We aimed to adapt and validate the Frenchay Aphasia Screening Test (FAST) to the Indian context in two widely spoken Indian languages, Telugu and Kannada, for the literate and illiterate population. Methods: A systematic process of adaptation and culturally appropriate modifications of the original FAST were done in 116 healthy controls and 115 patients. The validity of the adapted test was established. Results: The optimum cut-off values for detecting aphasia in our sample ranged from 25 to 25.5 (literate) and 13.5 to 15.5 (illiterate) with high sensitivity and specificity. There was also a significant correlation between aphasia scores for adapted FAST and the Western Aphasia Battery (WAB), establishing good convergent validity. Discussion: Results of the adaptation and validation of two Indian versions of FAST, suggest that it is an easy-to-use screening measure for detecting stroke-related language disabilities. The psychometric properties of the Indian version of FAST met the standardised requirements for adaptation and validation. Conclusions: The Indian version of FAST was found to be a reliable and valid bedside screening tool for aphasia in stroke patients. We aim that this study will facilitate the use of the test across other Indian languages and a large clinical population in the future.
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Affiliation(s)
- Avanthi Paplikar
- National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Gowri K Iyer
- Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.,Indian Institute of Public Health, Hyderabad, Telangana, India
| | - Feba Varghese
- National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Suvarna Alladi
- National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.,Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | | | - Shailaja Mekala
- Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Subhash Kaul
- Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.,Krishna Institute of Medical Sciences, Hyderabad, Telangana, India
| | | | - R S Dhaliwal
- Indian Council of Medical Research, New Delhi, India
| | | | | | - Aparna Dutt
- Duttanagar Mental Health Centre, Duttanagar, Kolkata,West Bengal, India
| | | | | | | | | | - Ramshekhar Menon
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | | | - Ashima Nehra
- All India Institute of Medical Sciences, Delhi, India
| | - M V Padma
- All India Institute of Medical Sciences, Delhi, India
| | | | - Sunil Kumar Ravi
- Shravana Institute of Speech and Hearing, Bellary, Karnataka, India
| | | | | | - P N Sylaja
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Ravi Prasad Varma
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
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Mahmoud SS, Kumar A, Tang Y, Li Y, Gu X, Fu J, Fang Q. An Efficient Deep Learning Based Method for Speech Assessment of Mandarin-Speaking Aphasic Patients. IEEE J Biomed Health Inform 2020; 24:3191-3202. [DOI: 10.1109/jbhi.2020.3011104] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Correction: A Chinese version of the Language Screening Test (CLAST) for early-stage stroke patients. PLoS One 2018; 13:e0201938. [PMID: 30071106 PMCID: PMC6072115 DOI: 10.1371/journal.pone.0201938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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