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Mulroy E, Core LB, Chokesuwattanaskul A, Johnson JC, Fletcher PD, Marshall CR, Volkmer A, Rohrer JD, Hardy CJ, Rossor MN, Warren JD. Binary reversals: a diagnostic sign in primary progressive aphasia. J Neurol Neurosurg Psychiatry 2024; 95:477-480. [PMID: 38071563 DOI: 10.1136/jnnp-2023-331662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/08/2023] [Indexed: 02/22/2024]
Abstract
BACKGROUND Binary reversals (exemplified by 'yes'/'no' confusions) have been described in patients with primary progressive aphasia (PPA) but their diagnostic value and phenotypic correlates have not been defined. METHODS We conducted a retrospective cohort study analysing demographic, clinical, neuropsychological, linguistic and behavioural data from patients representing all major PPA syndromes (non-fluent/agrammatic variant, nfvPPA; logopenic variant, lvPPA; semantic variant, svPPA) and behavioural variant frontotemporal dementia (bvFTD). The prevalence of binary reversals and behavioural abnormalities, illness duration, parkinsonian features and neuropsychological test scores were compared between neurodegenerative syndromes, and the diagnostic predictive value of binary reversals was assessed using logistic regression. RESULTS Data were obtained for 83 patients (21 nfvPPA, 13 lvPPA, 22 svPPA, 27 bvFTD). Binary reversals occurred in all patients with nfvPPA, but significantly less frequently and later in lvPPA (54%), svPPA (9%) and bvFTD (44%). Patients with bvFTD with binary reversals had significantly more severe language (but not general executive or behavioural) deficits than those without reversals. Controlling for potentially confounding variables, binary reversals strongly predicted a diagnosis of nfvPPA over other syndromes. CONCLUSIONS Binary reversals are a sensitive (though not specific) neurolinguistic feature of nfvPPA, and should suggest this diagnosis if present as a prominent early symptom.
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Affiliation(s)
- Eoin Mulroy
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Lucy B Core
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Anthipa Chokesuwattanaskul
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
- Division of Neurology, Department of Internal Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- Cognitive Clinical and Computational Neuroscience Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Jeremy Cs Johnson
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Phillip D Fletcher
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Charles R Marshall
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
- Preventive Neurology Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Anna Volkmer
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Chris Jd Hardy
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Martin N Rossor
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Jason D Warren
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
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Kidwai J, Brumberg J, Gatts J. Aphasia and high-tech communication support: a survey of SLPs in USA and India. Disabil Rehabil Assist Technol 2024; 19:566-575. [PMID: 35972860 DOI: 10.1080/17483107.2022.2109072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE This survey was conducted to investigate American and Indian clinician's preference and usage of high-tech communication supports (HTCS) for aphasia rehabilitation to identify factors in each country that support the use of HTCS for improving post-aphasia communicative outcomes. In this study, HTCS include speech-generating augmentative and alternative communication (AAC) devices with varying methods of access. METHOD The survey exploring clinically practicing speech-language pathologists' (SLPs) training, assessment and aphasia rehabilitation practices using HTCS, was electronically distributed in both countries. The raw responses from the US SLPs (n = 56) and Indian SLPs (n = 43) were collected, segregated and then converted into percentages for all 41 survey questions. RESULTS The responses from SLPs indicated higher (70%) and lower use (58%) of HTCS for aphasia in a developed country (USA) and developing country (India), respectively. In the US, identifiable factors for successful use of HTCS for aphasia rehabilitation were familiarity in procuring and programming the device, caregiver training and effectiveness in reducing the time of communicating through the device. In India, factors leading to successful inclusion of HTCS were AAC coursework and clinical training for clinicians and availability of HTCS at affordable prices for clients. CONCLUSION There is a considerable difference in the educational and clinical practice of AAC as SLPs in the US tend to have more clinical AAC experience with a stronger network for device dissemination in comparison to SLPs in India leading to higher usage of high-tech AAC for aphasia rehabilitation in a developed country.Implications for RehabilitationFor the SLPs,Improve exposure to programming AAC devices in developed countries and increase coursework, clinical training and exposure to programming AAC devices in developing countries.Enhance awareness about integrating high-tech AAC devices in intervention programs.Improve efficiency by minimizing the time in message creation on high-tech AAC device in developed countries. For the bioengineers,Develop AAC application interfaces in regional languages for easier usage in developing countries.
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Affiliation(s)
- Juhi Kidwai
- Department of Communicative Sciences & Disorders, New York University, New York, NY, USA
| | - Jonathan Brumberg
- Department of Speech-Language-Hearing: Sciences and Disorders, University of Kansas, Lawrence, KS, USA
| | - Julie Gatts
- Department of Speech-Language-Hearing: Sciences and Disorders, University of Kansas, Lawrence, KS, USA
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Cai H, Dong J, Mei L, Feng G, Li L, Wang G, Yan H. Functional and structural abnormalities of the speech disorders: a multimodal activation likelihood estimation meta-analysis. Cereb Cortex 2024; 34:bhae075. [PMID: 38466117 DOI: 10.1093/cercor/bhae075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 03/12/2024] Open
Abstract
Speech disorders are associated with different degrees of functional and structural abnormalities. However, the abnormalities associated with specific disorders, and the common abnormalities shown by all disorders, remain unclear. Herein, a meta-analysis was conducted to integrate the results of 70 studies that compared 1843 speech disorder patients (dysarthria, dysphonia, stuttering, and aphasia) to 1950 healthy controls in terms of brain activity, functional connectivity, gray matter, and white matter fractional anisotropy. The analysis revealed that compared to controls, the dysarthria group showed higher activity in the left superior temporal gyrus and lower activity in the left postcentral gyrus. The dysphonia group had higher activity in the right precentral and postcentral gyrus. The stuttering group had higher activity in the right inferior frontal gyrus and lower activity in the left inferior frontal gyrus. The aphasia group showed lower activity in the bilateral anterior cingulate gyrus and left superior frontal gyrus. Across the four disorders, there were concurrent lower activity, gray matter, and fractional anisotropy in motor and auditory cortices, and stronger connectivity between the default mode network and frontoparietal network. These findings enhance our understanding of the neural basis of speech disorders, potentially aiding clinical diagnosis and intervention.
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Affiliation(s)
- Hao Cai
- Key Laboratory for Artificial Intelligence and Cognitive Neuroscience of Language, Xi'an International Studies University, Xi'an 710128, China
| | - Jie Dong
- Key Laboratory for Artificial Intelligence and Cognitive Neuroscience of Language, Xi'an International Studies University, Xi'an 710128, China
| | - Leilei Mei
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents (South China Normal University); School of Psychology; Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou 510631, China
| | - Genyi Feng
- Imaging Department, Xi'an GEM Flower Changqing Hospital, Xi'an 710201, China
| | - Lili Li
- Speech Language Therapy Department, Shaanxi Provincial Rehabilitation Hospital, Xi'an 710065, China
| | - Gang Wang
- Imaging Department, Xi'an GEM Flower Changqing Hospital, Xi'an 710201, China
| | - Hao Yan
- Key Laboratory for Artificial Intelligence and Cognitive Neuroscience of Language, Xi'an International Studies University, Xi'an 710128, China
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Taomoto D, Sato S, Kanemoto H, Suzuki M, Hirakawa N, Takasaki A, Akimoto M, Satake Y, Koizumi F, Yoshiyama K, Takahashi R, Shigenobu K, Hashimoto M, Miyagawa T, Boeve B, Knopman D, Mori E, Ikeda M. Utility of the Japanese version of the Clinical Dementia Rating® plus National Alzheimer's Coordinating Centre Behaviour and Language Domains for sporadic cases of frontotemporal dementia in Japan. Psychogeriatrics 2024; 24:281-294. [PMID: 38152057 DOI: 10.1111/psyg.13072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND We aimed to validate the Clinical Dementia Rating (CDR®) dementia staging instrument plus the National Alzheimer's Coordinating Centre Behaviour and Language Domains (CDR® plus NACC FTLD) for use in clinical settings in Japan and in the Japanese language. METHODS This prospective observational study enrolled 29 patients with frontotemporal dementia (FTD) and 21 patients with Alzheimer's disease (AD) dementia from the Departments of Psychiatry at Osaka University Hospital and Asakayama General Hospital and the Brain Function Centre at Nippon Life Hospital. CDR® plus NACC FTLD, CDR®, Mini-Mental State Examination (MMSE), Western Aphasia Battery (WAB), Neuropsychiatric Inventory-plus (NPI-plus), Stereotypy Rating Inventory (SRI), and frontal behavioural symptom scores obtained from items of NPI-plus and SRI, were conducted to assess inter- and intra-rater reliability, validity, and responsiveness. We performed receiver operating characteristic (ROC) curve analysis to evaluate the discriminating power of the Behaviour/Comportment/Personality (BEHAV) and Language (LANG) domains of the CDR® plus NACC FTLD and the MEMORY domain of the CDR® in patients AD dementia and FTD. RESULTS The CDR® plus NACC FTLD showed good inter- and intra-rater reliabilities. In patients with FTD, the BEHAV domain of the CDR® plus NACC FTLD was significantly correlated with all clinical measures except for the SRI total score, while the LANG domain of the CDR® plus NACC FTLD was significantly correlated with the MMSE and the WAB-Aphasia quotient. In addition, the CDR® plus NACC FTLD sum of boxes significantly changed after 6 months and after 1 year. ROC curve analysis showed that the BEHAV and LANG domains of the CDR® plus NACC FTLD distinguished between patients with AD dementia and FTD better than the MEMORY domain of the CDR®. CONCLUSIONS This study validated the Japanese version of the CDR® plus NACC FTLD with good reliability, validity, and responsiveness.
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Affiliation(s)
- Daiki Taomoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Shunsuke Sato
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Psychiatry, Esaka Hospital, Suita, Japan
| | - Hideki Kanemoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Maki Suzuki
- Department of Behavioural Neurology and Neuropsychiatry, United Graduate School of Child Development, Osaka University, Osaka, Japan
| | - Natsuho Hirakawa
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Akihiro Takasaki
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Miu Akimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yuto Satake
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Fuyuki Koizumi
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kenji Yoshiyama
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Rei Takahashi
- Brain Function Centre, Nippon Life Hospital, Osaka, Japan
| | - Kazue Shigenobu
- Department of Behavioural Neurology and Neuropsychiatry, United Graduate School of Child Development, Osaka University, Osaka, Japan
- Department of Psychiatry, Asakayama General Hospital, Sakai, Japan
| | - Mamoru Hashimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Neuropsychiatry, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Toji Miyagawa
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Bradley Boeve
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - David Knopman
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Etsuro Mori
- Department of Behavioural Neurology and Neuropsychiatry, United Graduate School of Child Development, Osaka University, Osaka, Japan
- Brain Function Centre, Nippon Life Hospital, Osaka, Japan
| | - Manabu Ikeda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
- Brain Function Centre, Nippon Life Hospital, Osaka, Japan
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Kakinuma K, Osawa SI, Katsuse K, Hosokawa H, Ukishiro K, Jin K, Niizuma K, Tominaga T, Endo H, Nakasato N, Suzuki K. Assessment of language lateralization in epilepsy patients using the super-selective Wada test. Acta Neurochir (Wien) 2024; 166:77. [PMID: 38340149 PMCID: PMC10858922 DOI: 10.1007/s00701-024-05957-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/28/2023] [Indexed: 02/12/2024]
Abstract
BACKGROUND The classical Wada test (cWada), performed by injecting a short-acting anesthetic through the intracarotid route, helps determine language dominance. In the cWada, adverse effects are observed in 10-30% of trials, hindering accurate assessments. In this study, we assessed the effectiveness of the super-selective Wada test (ssWada), a more selective approach for anesthetic infusion into the middle cerebral artery (MCA). METHODS We retrospectively examined the data of 17 patients with epilepsy who underwent ssWada via anesthetic injection into one M1 segment of the MCA and at least one contralateral trial. RESULTS The ssWada identified 12 patients with left language dominance, 3 with right language dominance, and 2 with bilateral language distribution. Nine trials on the language dominant side resulted in global aphasia for patients with left- or right language dominance. Of the 13 trials conducted on the non-dominant language side, 12 revealed intact language function and one resulted in confusion. Among these, the outcomes of global aphasia or no language impairment were confirmed in the contralateral trials. Among the 22 trials of unilateral M1 injections in patients with unilateral language dominance, 21 (95.5%) showed either global aphasia or no language impairment, indicating language dominance. CONCLUSIONS The ssWada yields clear results, with a high rate of over 90% in determining the language dominant hemisphere with few side effects.
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Affiliation(s)
- Kazuo Kakinuma
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai, 980-8575, Japan.
| | - Shin-Ichiro Osawa
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
| | - Kazuto Katsuse
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai, 980-8575, Japan
- Department of Neurology, The University of Tokyo Graduate School of Medicine Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Hiroaki Hosokawa
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai, 980-8575, Japan
- Department of Rehabilitation, National Hospital Organization Sendai Nishitaga Hospital, Taihaku-ku, Sendai, Japan
| | - Kazushi Ukishiro
- Department of Epileptology, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
| | - Kazutaka Jin
- Department of Epileptology, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
| | - Kuniyasu Niizuma
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
- Department of Neurosurgical Engineering and Translational Neuroscience, Tohoku University Graduate School of Biomedical Engineering, Aoba-ku, Sendai, Japan
- Department of Neurosurgical Engineering and Translational Neuroscience, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
| | - Hidenori Endo
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
| | - Nobukazu Nakasato
- Department of Epileptology, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
| | - Kyoko Suzuki
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai, 980-8575, Japan
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Nakkawita SG, Hartzheim DU, Donovan NJ. Exploring high-technology augmentative and alternative communication interfaces: the effect of age and technology experience. Disabil Rehabil Assist Technol 2024; 19:313-324. [PMID: 35709165 DOI: 10.1080/17483107.2022.2087771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 06/04/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Many people with aphasia have inadequate language skills for functional communication thereby necessitating well-designed augmentative and alternative communication (AAC) interfaces. Using both a grid and a VSD interface with single word hotspots by neurologically healthy adults, across ages and with different technology experiences, this study examines the utility of these interfaces prior to investigating their use with people with aphasia in future studies. METHOD Participants include 18 young adults, 24 older adults with technology experience, and 20 older adults with limited technology experience. The older adult groups were matched for mean age and for sex. Participants described pictures with each interface, and performance was measured based on four dependent variables: (a) the total number of correct information units (CIUs), (b) the percentage of CIUs, (c) CIUs per minute, and (d) preferred interface. RESULTS There was a significant difference between older adults and the young adult group for the total number of CIUs (p < 0.001) and CIUs per minute (p < 0.001). Despite the changes in technology experience between the two older groups, there was no significant difference in performance. Additionally, there was no significant difference in performance across the two interfaces in any of the groups. CONCLUSION Findings suggest age does impact performance on AAC. However, the difference in technology experience in older adult groups did not affect performance. Furthermore, both interfaces used in the current study were equally beneficial when describing pictures by healthy adults. Implications for RehabilitationAugmentative and alternative communication (AAC) systems involve various interface designs. Consequently, the comparative utility of these interfaces must be examined across populations and communicative functions.Advancement in technology has given rise to numerous high-tech AAC interface designs. However, older adults with acquired language difficulties whose technology experience is limited may become reluctant to use high-tech AAC. Hence, the influence of technology experience on high-tech AAC performance should be investigated.Prior to examining interfaces with individuals with acquired language difficulties, the current study examined the use of a) grid display and b) visual scene display (VSD) with single word hotspots, by healthy adults of different ages and technology experiences.The study revealed that older adults with limited technology experience were equally competent in using high-tech AAC interfaces, as those with technology experience. Hence, an individual's technology experience should not be considered a deterrent to using high-tech AAC interfaces.Additionally, the study found no differences in performance between the two interfaces, making it essential to consider user's personal preference when adopting AAC interface designs.
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Affiliation(s)
- Surani G Nakkawita
- Department of Communication Sciences & Disorders, Louisiana State University, Baton Rouge, Louisiana, United States
| | | | - Neila J Donovan
- Department of Communication Sciences & Disorders, Louisiana State University, Baton Rouge, Louisiana, United States
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Rheinländer A, Weih M. [Henry Head (1861-1940) and his importance for neurology]. Nervenarzt 2024; 95:162-168. [PMID: 37823921 PMCID: PMC10850193 DOI: 10.1007/s00115-023-01556-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 10/13/2023]
Abstract
Nowadays, Henry Head is best known for his Head zones. The concept was understood very differently by Head in comparison to what current medical books falsely describe them to be. In reality, there is no direct relationship between one particular skin zone and one single organ. It is certain that the drawings considered depictions of the Head zones in today's medical textbooks were actually not created by Head. From a neurological point of view, Head is important for two reasons: his self-experiment in 1909 to damage one of his own peripheral nerves followed by regeneration was heroic. It has helped generations of neurologists to have a better understanding of the pathophysiology of peripheral nerve damage and thus make a better assessment of the prognosis of such injuries. Head's second contribution pertains to the radicular organization at the level of the spinal cord. The pathophysiology of herpes zoster radiculitis enabled him to develop the concept of the dermatomes on the basis of preliminary work around 1900. Henry Head's contribution was the systematic compilation of the existing publications of the time and amendment of his own cases. As he was the most important neurologist at that time, at least in the English speaking world, and was well connected with people in the German neurology community, it was probably easy for him to make his dermatome maps well known. In retrospect, Head was less successful in neuropsychology with holistic concepts for higher cognitive functions which were in vogue during his lifetime. His late work on aphasia is now considered refuted. Head's criticism of the strict localization was well in syncronization with the zeitgeist of the early twentieth century. Establishing the fact that Broca's aphasia and Wernicke's aphasia are not easily diagnostically distinguishable from each other was more an achievement of subsequent generations of neurologists and neuropsychologists as well as technical advances.
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Affiliation(s)
| | - Markus Weih
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Deutschland.
- MVZ Medic Center Nürnberg, Schweinauer Hauptstraße 43, 90441, Nürnberg, Deutschland.
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Barbieri E, Lukic S, Rogalski E, Weintraub S, Mesulam MM, Thompson CK. Neural mechanisms of sentence production: a volumetric study of primary progressive aphasia. Cereb Cortex 2024; 34:bhad470. [PMID: 38100360 PMCID: PMC10793577 DOI: 10.1093/cercor/bhad470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 12/17/2023] Open
Abstract
Studies on the neural bases of sentence production have yielded mixed results, partly due to differences in tasks and participant types. In this study, 101 individuals with primary progressive aphasia (PPA) were evaluated using a test that required spoken production following an auditory prime (Northwestern Assessment of Verbs and Sentences-Sentence Production Priming Test, NAVS-SPPT), and one that required building a sentence by ordering word cards (Northwestern Anagram Test, NAT). Voxel-Based Morphometry revealed that gray matter (GM) volume in left inferior/middle frontal gyri (L IFG/MFG) was associated with sentence production accuracy on both tasks, more so for complex sentences, whereas, GM volume in left posterior temporal regions was exclusively associated with NAVS-SPPT performance and predicted by performance on a Digit Span Forward (DSF) task. Verb retrieval deficits partly mediated the relationship between L IFG/MFG and performance on the NAVS-SPPT. These findings underscore the importance of L IFG/MFG for sentence production and suggest that this relationship is partly accounted for by verb retrieval deficits, but not phonological loop integrity. In contrast, it is possible that the posterior temporal cortex is associated with auditory short-term memory ability, to the extent that DSF performance is a valid measure of this in aphasia.
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Affiliation(s)
- Elena Barbieri
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Department of Neurology, Northwestern University, 300 E Superior Street, Chicago, IL 60611, United States
| | - Sladjana Lukic
- Department of Communication Sciences and Disorders, Adelphi University, 158 Cambridge Avenue, Garden City, NY 11530, United States
| | - Emily Rogalski
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Department of Neurology, Northwestern University, 300 E Superior Street, Chicago, IL 60611, United States
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Department of Neurology, Northwestern University, 300 E Superior Street, Chicago, IL 60611, United States
- Department of Psychiatry and Behavioral Sciences, Northwestern University, 676 N Saint Clair Street, Chicago, IL 60611, United States
| | - Marek-Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Department of Neurology, Northwestern University, 300 E Superior Street, Chicago, IL 60611, United States
- Department of Neurology, Northwestern University, 300 E Superior Street, Chicago, IL 60611, United States
| | - Cynthia K Thompson
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Department of Neurology, Northwestern University, 300 E Superior Street, Chicago, IL 60611, United States
- Department of Neurology, Northwestern University, 300 E Superior Street, Chicago, IL 60611, United States
- Department of Communication Sciences and Disorders, Northwestern University, 2240 Campus Drive, Evanston, IL 60208, United States
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Schwen Blackett D, Borod JC, Speer SR, Pan X, Harnish SM. The effects of emotional stimuli on Word retrieval in people with aphasia. Neuropsychologia 2024; 192:108734. [PMID: 37952713 PMCID: PMC10833091 DOI: 10.1016/j.neuropsychologia.2023.108734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 10/07/2023] [Accepted: 11/08/2023] [Indexed: 11/14/2023]
Abstract
PURPOSE Prior studies have shown that people with aphasia (PWA) have demonstrated superior language performance for emotional compared to nonemotional stimuli on a range of tasks, including auditory comprehension, verbal pragmatics, repetition, reading, and writing. However, studies on word retrieval, specifically, have suggested a possible interference effect of emotion on naming. The purpose of this study was to examine the effect of the emotional valence of stimuli on word retrieval in a series of naming tasks in PWA. METHOD Thirteen PWA and 13 neurotypical controls participated in four single-word naming tasks, including 1) object picture naming, 2) action picture naming, 3) category-member generation, and 4) verb generation. Each task included three valence sets of positively-, negatively-, and neutrally-rated pictures or words, which were obtained from the standardized International Affective Picture System (Lang et al., 2008) and the Affective Norms for Emotional Words (Bradley and Lang, 1999) databases. Accuracy and reaction time (RT) were measured and compared across groups, tasks, and valence sets. RESULTS Emotional stimuli, especially negative stimuli, resulted in worse naming performance, as measured by accuracy and RT, compared to nonemotional stimuli in PWA and neurotypical controls. This effect was relatively robust across the four naming tasks. In most cases, negative stimuli resulted in lower accuracy and slower RT than positive stimuli. CONCLUSIONS These findings suggest that stimulus valence may interfere with word retrieval for PWA and neurotypical adults and that this effect is robust across different types of naming tasks that vary by word class (nouns versus verbs) and stimulus type (pictures versus words). Negative stimuli resulted in worse naming performance than positive stimuli. These results suggest that emotionality of stimuli is an important variable to consider in word retrieval research.
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Affiliation(s)
- Deena Schwen Blackett
- Department of Speech and Hearing Science, College of Arts & Sciences, The Ohio State University, 110 Pressey Hall, 1070 Carmack Road, Columbus, OH, 43210, USA.
| | - Joan C Borod
- Department of Psychology, Queens College of the City University of New York, 65-30 Kissena Blvd, Flushing, NY, 11367, USA.
| | - Shari R Speer
- Department of Linguistics, College of Arts & Sciences, The Ohio State University, Oxley Hall, 1712 Neil Ave, Columbus, OH, 43210, USA.
| | - Xueliang Pan
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University, 310-H Lincoln Tower, 1800 Cannon Drive, Columbus, OH, 43210, USA.
| | - Stacy M Harnish
- Department of Speech and Hearing Science, College of Arts & Sciences, The Ohio State University, 110 Pressey Hall, 1070 Carmack Road, Columbus, OH, 43210, USA.
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10
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Močilnik V, Rutar Gorišek V, Sajovic J, Pretnar Oblak J, Drevenšek G, Rogelj P. Integrating EEG and Machine Learning to Analyze Brain Changes during the Rehabilitation of Broca's Aphasia. Sensors (Basel) 2024; 24:329. [PMID: 38257423 PMCID: PMC10818958 DOI: 10.3390/s24020329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/27/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024]
Abstract
The fusion of electroencephalography (EEG) with machine learning is transforming rehabilitation. Our study introduces a neural network model proficient in distinguishing pre- and post-rehabilitation states in patients with Broca's aphasia, based on brain connectivity metrics derived from EEG recordings during verbal and spatial working memory tasks. The Granger causality (GC), phase-locking value (PLV), weighted phase-lag index (wPLI), mutual information (MI), and complex Pearson correlation coefficient (CPCC) across the delta, theta, and low- and high-gamma bands were used (excluding GC, which spanned the entire frequency spectrum). Across eight participants, employing leave-one-out validation for each, we evaluated the intersubject prediction accuracy across all connectivity methods and frequency bands. GC, MI theta, and PLV low-gamma emerged as the top performers, achieving 89.4%, 85.8%, and 82.7% accuracy in classifying verbal working memory task data. Intriguingly, measures designed to eliminate volume conduction exhibited the poorest performance in predicting rehabilitation-induced brain changes. This observation, coupled with variations in model performance across frequency bands, implies that different connectivity measures capture distinct brain processes involved in rehabilitation. The results of this paper contribute to current knowledge by presenting a clear strategy of utilizing limited data to achieve valid and meaningful results of machine learning on post-stroke rehabilitation EEG data, and they show that the differences in classification accuracy likely reflect distinct brain processes underlying rehabilitation after stroke.
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Affiliation(s)
- Vanesa Močilnik
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia (J.P.O.); (G.D.)
| | | | - Jakob Sajovic
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia (J.P.O.); (G.D.)
- University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia;
| | - Janja Pretnar Oblak
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia (J.P.O.); (G.D.)
- University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia;
| | - Gorazd Drevenšek
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia (J.P.O.); (G.D.)
- Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, 6000 Koper, Slovenia;
| | - Peter Rogelj
- Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, 6000 Koper, Slovenia;
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11
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Power E, Attard MC, Lanyon LE, Togher L. Efficacy of online communication partner training package for student healthcare professionals. Int J Lang Commun Disord 2024; 59:304-326. [PMID: 37661291 PMCID: PMC10952497 DOI: 10.1111/1460-6984.12947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 07/30/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND People with aphasia are vulnerable recipients of healthcare. The nature of the communicative environment and the communication disability can adversely impact access to timely and quality healthcare. Student healthcare professionals are often underprepared to interact successfully with people with aphasia and may benefit from communication partner training (CPT). AIMS To investigate the potential effectiveness and acceptability of a brief, two-part introductory Supported Conversation for Adults with Aphasia (SCA™)-based CPT package, delivered to a sample of students across a diverse range of healthcare disciplines. METHODS & PROCEDURES A pre-post-within group experimental design was used to investigate the potential effectiveness and acceptability of an online CPT package (50 minute module + 1 hour workshop) for healthcare students. The Aphasia Attitudes, Strategies and Knowledge (AASK) survey measured participants' knowledge of aphasia, facilitative communication strategies and attitudes towards people with aphasia. Data were collected pre-training, following the training module and following the workshop, and 6 weeks post-training. Statistical analysis was conducted on the AASK data. In addition, participant feedback (ratings and open text responses) was collected after the workshop. Ratings were analysed descriptively, and thematic content analysis was used for open text responses. OUTCOMES & RESULTS 236 participants completed the pre-training AASK and 106 completed the AASK at subsequent time points. Statistically significant gains were demonstrated from pre- to post-module completion. Between the end of the module and the end of the workshop, some gains were maintained and others showed further statistically significantly improvements. While all gains were not maintained at the 6-week follow-up, statistically significantly improvements from pre-training scores remained evident. Student feedback was predominantly positive, with suggested improvements for training content and length. CONCLUSIONS & IMPLICATIONS The results provide preliminary evidence that a brief, online CPT package can support student healthcare professionals' knowledge and attitudes towards aphasia and communicating with people with aphasia. Online training was acceptable to students and feasible as an embedded or optional component of curriculum. Ongoing training (e.g., in the form of refresher sessions) and inclusion of a skills-based component are recommended to maximize communication skill development. WHAT THIS PAPER ADDS What is already known on the subject Student healthcare professionals recognize the need to develop knowledge and skills to successfully support people with communication disability, such as aphasia, to participate effectively in their healthcare. Evidence in favour of online communication partner training for student healthcare professionals is currently limited. What this study adds to the existing knowledge This study demonstrates that a brief introductory online communication partner training program can be efficacious for improving knowledge and attitudes regarding communicating with people who have aphasia. What are the potential or actual clinical implications of this work? Students will likely need further ongoing refresher training with inclusion of practical components to develop and maintain the knowledge and skills required to be proficient communication partners with people with aphasia.
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Affiliation(s)
- Emma Power
- University of Technology SydneySydneyNSWAustralia
- Centre of Research Excellence in Aphasia Recovery and RehabilitationLa Trobe UniversityMelbourneVICAustralia
| | - Michelle C. Attard
- Centre of Research Excellence in Aphasia Recovery and RehabilitationLa Trobe UniversityMelbourneVICAustralia
- La Trobe UniversityMelbourneVICAustralia
- The University of SydneySydneyNSWAustralia
| | - Lucette E. Lanyon
- Centre of Research Excellence in Aphasia Recovery and RehabilitationLa Trobe UniversityMelbourneVICAustralia
- La Trobe UniversityMelbourneVICAustralia
| | - Leanne Togher
- Centre of Research Excellence in Aphasia Recovery and RehabilitationLa Trobe UniversityMelbourneVICAustralia
- The University of SydneySydneyNSWAustralia
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12
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Robinson CG, Coleman T, Buciuc M, Singh NA, Pham NTT, Machulda MM, Graff-Radford J, Whitwell JL, Josephs KA. Behavioral and Neuropsychiatric Differences Across Two Atypical Alzheimer's Disease Variants: Logopenic Progressive Aphasia and Posterior Cortical Atrophy. J Alzheimers Dis 2024; 97:895-908. [PMID: 38143349 PMCID: PMC10842893 DOI: 10.3233/jad-230652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
BACKGROUND Posterior cortical atrophy (PCA) and logopenic progressive aphasia (LPA) are two common atypical Alzheimer's disease (AD) variants. Little is known about behavioral and neuropsychiatric symptoms or activities of daily living (ADLs) in PCA and LPA, and whether they differ across syndromes. OBJECTIVE To characterize the behavioral and neuropsychiatric profiles and ADLs of PCA and LPA and compare presence/absence and severity of symptoms between syndromes. METHODS Seventy-eight atypical AD patients, 46 with PCA and 32 with LPA, completed the Neuropsychiatric Inventory Questionnaire (NPI-Q) and Cambridge Behavioral Inventory-Revised (CBI-R) at baseline and longitudinally over-time. Mann-Whitney U and Fisher's Exact Tests assessed for differences in symptoms between the two syndromes with significance set at p≤0.01. To eliminate demographic differences as confounders the groups were matched, and differences reanalyzed. RESULTS PCA were younger at onset (p = 0.006), at time of baseline assessment (p = 0.02) and had longer disease duration (p = 0.01). Neuropsychiatric symptoms were common in PCA and LPA, although more common and severe in PCA. At baseline, PCA had a higher NPI-Q total score (p = 0.01) and depression subscore (p = 0.01) than LPA. Baseline total CBI-R scores were also higher in PCA than LPA (p = 0.001) with PCA having worse scores in all 10 CBI-R categories. Longitudinally, there was no difference between groups on the NPI-Q. However, on the CBI-R, PCA had faster rates of worsening on self-grooming (p = 0.01) and self-dressing (p = 0.01) compared to LPA. CONCLUSIONS Behavioral and neuropsychiatric symptoms are common in PCA and LPA although these symptoms are more common and severe in PCA.
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Affiliation(s)
| | - Tia Coleman
- Department of Neurology, Mayo Clinic, Rochester, MN
| | - Marina Buciuc
- Department of Neurology, Medical University of South Carolina, Charleston, SC
| | | | | | - Mary M. Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
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13
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Levin Y, Bachem R, Brafman D, Ben-Ezra M. The association between dissociative symptoms and schizophrenia-related negative symptoms: A transdiagnostic approach. J Psychiatr Res 2024; 169:81-83. [PMID: 38006822 DOI: 10.1016/j.jpsychires.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 09/08/2023] [Accepted: 11/15/2023] [Indexed: 11/27/2023]
Abstract
Negative symptoms of schizophrenia remain clinically and theoretically understudied and represent an unmet psychiatric need. Negative symptoms are assumed to be related to other psychiatric disorders, but their association with dissociative symptoms is yet to be explored, particularly in light of depression and anxiety symptoms. We examined the five domains of negative symptoms (anhedonia, asociality, avolition, blunted affect and alogia) in an Israeli national sample of 1930 participants of whom 645 (33.4%) were with increased risk for dissociative disorder. The results show that anhedonia, blunted affect and alogia significantly associated with risk for dissociative disorder, above and beyond depression and anxiety. When assessing for negative symptoms it may be worth screening for dissociation and vice versa and thus make a more accurate clinical picture of the interplay between them.
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Affiliation(s)
- Yafit Levin
- Ariel University, School of Education, Ariel, Israel; Ariel University, School of Social Work, Ariel, Israel.
| | - Rahel Bachem
- University of Zurich, Depatment of Psychology, Division of Psychopathology and Clinical Intervention, Zurich, Switzerland
| | - Dorit Brafman
- Ariel University, School of Social Work, Ariel, Israel
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14
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Ogbeide-Latario OE, Kempfle J, Hamzei-Sichani F, Remenschneider AK. Aphasia as Presenting Symptom of Left Temporal Pneumocephalus After a Restrained Sneeze. Otol Neurotol 2024; 45:e66-e67. [PMID: 37641231 DOI: 10.1097/mao.0000000000004009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
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15
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Su W, Li H, Dang H, Han K, Liu J, Liu T, Liu Y, Tang Z, Lu H, Zhang H. Predictors of Cognitive Functions After Stroke Assessed Using the Wechsler Adult Intelligence Scale: A Retrospective Study. J Alzheimers Dis 2024; 98:109-117. [PMID: 38363609 DOI: 10.3233/jad-230840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Background The mechanism(s) of cognitive impairment remains complex, making it difficult to confirm the factors influencing poststroke cognitive impairment (PSCI). Objective This study quantitatively investigated the degree of influence and interactions of clinical indicators of PSCI. Methods Information from 270 patients with PSCI and their Wechsler Adult Intelligence Scale (WAIS-RC) scores, totaling 18 indicators, were retrospectively collected. Correlations between the indicators and WAIS scores were calculated. Multiple linear regression model(MLR), genetic algorithm modified Back-Propagation neural network(GA-BP), logistic regression model (LR), XGBoost model (XGB), and structural equation model were used to analyze the degree of influence of factors on the WAIS and their mediating effects. Results Seven indicators were significantly correlated with the WAIS scores: education, lesion side, aphasia, frontal lobe, temporal lobe, diffuse lesions, and disease course. The MLR showed significant effect of education, lesion side, aphasia, diffuse lesions, and frontal lobe on the WAIS. The GA-BP included five factors: education, aphasia, frontal lobe, temporal lobe, and diffuse lesions. LR predicted that the lesion side contributed more to mild cognitive impairment, while education, lesion side, aphasia, and course of the disease contributed more to severe cognitive impairment. XGB showed that education, side of the lesion, aphasia, and diffuse lesions contributed the most to PSCI. Aphasia plays a significant mediating role in patients with severe PSCI. Conclusions Education, lesion side, aphasia, frontal lobe, and diffuse lesions significantly affected PSCI. Aphasia is a mediating variable between clinical information and the WAIS in patients with severe PSCI.
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Affiliation(s)
- Wenlong Su
- China Rehabilitation Research Center, School of Rehabilitation, Capital Medical University, Beijing, China
- School of Health and Life Science, University of Health and Rehabilitation Sciences, Qingdao, China
| | - Hui Li
- Cheeloo College of Medicine, Shandong University, Jinan, China
- School of Health and Life Science, University of Health and Rehabilitation Sciences, Qingdao, China
- China Rehabilitation Research Center, Beijing Bo'ai Hospital, Beijing, China
| | - Hui Dang
- Cheeloo College of Medicine, Shandong University, Jinan, China
- School of Health and Life Science, University of Health and Rehabilitation Sciences, Qingdao, China
- China Rehabilitation Research Center, Beijing Bo'ai Hospital, Beijing, China
| | - Kaiyue Han
- China Rehabilitation Research Center, School of Rehabilitation, Capital Medical University, Beijing, China
- China Rehabilitation Research Center, Beijing Bo'ai Hospital, Beijing, China
| | - Jiajie Liu
- China Rehabilitation Research Center, School of Rehabilitation, Capital Medical University, Beijing, China
- China Rehabilitation Research Center, Beijing Bo'ai Hospital, Beijing, China
| | - Tianhao Liu
- China Rehabilitation Research Center, School of Rehabilitation, Capital Medical University, Beijing, China
- China Rehabilitation Research Center, Beijing Bo'ai Hospital, Beijing, China
| | - Ying Liu
- China Rehabilitation Research Center, School of Rehabilitation, Capital Medical University, Beijing, China
- China Rehabilitation Research Center, Beijing Bo'ai Hospital, Beijing, China
| | - Zhiqing Tang
- China Rehabilitation Research Center, School of Rehabilitation, Capital Medical University, Beijing, China
- China Rehabilitation Research Center, Beijing Bo'ai Hospital, Beijing, China
| | - Haitao Lu
- China Rehabilitation Research Center, School of Rehabilitation, Capital Medical University, Beijing, China
- China Rehabilitation Research Center, Beijing Bo'ai Hospital, Beijing, China
| | - Hao Zhang
- China Rehabilitation Research Center, School of Rehabilitation, Capital Medical University, Beijing, China
- School of Health and Life Science, University of Health and Rehabilitation Sciences, Qingdao, China
- China Rehabilitation Research Center, Beijing Bo'ai Hospital, Beijing, China
- Cheeloo College of Medicine, Shandong University, Jinan, China
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16
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Vostrý M, Pešatová I, Lanková B, Fleischmann O, Jelínková J, Štolová I, Beranová R, Mundoková N. Combination therapy for patients with a developmental dysphasia: selected approaches based on special education, rehabilitation and psychology in a systematic case study. Neuro Endocrinol Lett 2023; 44:517-527. [PMID: 38131175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 11/14/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE The paper deals with the possibilities of the development and the support of individuals with developmental dysphasia with regard to the legislative framework of the Czech Republic in the field of education and presents the results of a systematic case study of a child patient diagnosed with developmental dysphasia (according to ICD-10; F80.1 and F80.2). CASE REPORT The study aimed to determine the effect of combined therapy using long-term special educational, rehabilitation and psychological intervention, speech therapy and music therapy on the development of the patient's communication skills. The proband was selected by random, stratified sampling based on pre-determined relevant characteristics (age 6 years i.e., before entering primary school, diagnosed with developmental dysphasia). A 6-year-old child patient participated in the research with the consent of the legal representative. The therapy was focused on special educational care, speech therapy, music therapy and psychological intervention (including psychotherapy). During the hospitalization and post-hospitalization care, there was also the presence of a physiotherapist and an occupational therapist. CONCLUSION The results of the research point out the need for regular and close multidisciplinary cooperation of an occupational therapist, a physiotherapist, a special educator, a speech therapist, a music therapist and a psychologist when working with patients diagnosed with developmental dysphasia. These professions focus specifically on specific areas of support with a focus on cognitive, phatic and motor functions with the support of social adaptability.
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Affiliation(s)
- Michal Vostrý
- Department of Special and Social Education, Faculty of Education, Jan Evangelista Purkyne University in Usti nad Labem, Czech Republic
- Research Centre, Faculty of Health Studies, Jan Evangelista Purkyne University in Usti nad Labem, Czech Republic
| | - Ilona Pešatová
- Department of Special and Social Education, Faculty of Education, Jan Evangelista Purkyne University in Usti nad Labem, Czech Republic
| | - Barbora Lanková
- Department of Pre-Primary and Primary Education, Faculty of Education, Jan Evangelista Purkyne University in Usti nad Labem, Czech Republic
| | - Otakar Fleischmann
- Research Centre, Faculty of Health Studies, Jan Evangelista Purkyne University in Usti nad Labem, Czech Republic
- Department of Medical Rescue and Radiology Faculty of Health Studies, Department of Psychology, Faculty of Education, Jan Evangelista Purkyne University in Usti nad Labem, Czech Republic
| | - Jaroslava Jelínková
- Department of Languages, Faculty of Education, Jan Evangelista Purkyne University in Usti nad Labem, Czech Republic
| | - Ivana Štolová
- Research Centre, Faculty of Health Studies, Jan Evangelista Purkyne University in Usti nad Labem, Czech Republic
| | - Radka Beranová
- Research Centre, Faculty of Health Studies, Jan Evangelista Purkyne University in Usti nad Labem, Czech Republic
| | - Nikola Mundoková
- Department of Pre-Primary and Primary Education, Faculty of Education, Jan Evangelista Purkyne University in Usti nad Labem, Czech Republic
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Baker C, Love T. Modulating Complex Sentence Processing in Aphasia Through Attention and Semantic Networks. J Speech Lang Hear Res 2023; 66:5011-5035. [PMID: 37934886 PMCID: PMC11001378 DOI: 10.1044/2023_jslhr-23-00298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/05/2023] [Accepted: 09/07/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE Lexical processing impairments such as delayed and reduced activation of lexical-semantic information have been linked to syntactic processing disruptions and sentence comprehension deficits in individuals with aphasia (IWAs). Lexical-level deficits can also preclude successful lexical encoding during sentence processing and amplify the processing costs of similarity-based interference during syntactic retrieval. We investigate whether two manipulations to engage attention and pre-activate semantic features of a target (to-be-retrieved) noun will (a) boost lexical activation during initial lexical encoding and (b) facilitate syntactic dependency linking through improved resolution of interference in IWAs and neurologically unimpaired age-matched controls (AMCs). METHOD Eye-tracking-while-listening with a visual world paradigm was used to investigate whether semantic and attentional manipulations modulated initial lexical processing and downstream syntactic retrieval of the direct-object noun in object-relative sentences. RESULTS In the attention and semantic manipulations, the AMC group showed no changes in initial lexical access levels; however, gaze patterns revealed clear facilitations in dependency linking and interference resolution. In the IWA group, the attentional cue increased and maintained activation of N1 with modest facilitations in dependency linking. In the semantic condition, IWA results showed a greater degree of facilitation during dependency linking. CONCLUSIONS The results suggest that attention and semantic activation are parameters that may be manipulated to strengthen encoding of lexical representations to facilitate retrieval (i.e., dependency linking) and mitigate similarity-based interference. In IWAs, these manipulations may help to reduce lexical processing deficits that can preclude successful encoding.
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Affiliation(s)
- Carolyn Baker
- SDSU/UCSD Joint Doctoral Program in Language & Communicative Disorders, San Diego, CA
| | - Tracy Love
- SDSU/UCSD Joint Doctoral Program in Language & Communicative Disorders, San Diego, CA
- School of Speech, Language, and Hearing Sciences, San Diego State University, CA
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18
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Deniz A, Alikılıç D, Öztürk M, Karaca Ö, Güneş AS, Kara B. Myoclonic status epilepticus in non-progressive encephalopathies within the GRIN2A-associated epilepsy- aphasia spectrum. Seizure 2023; 113:13-15. [PMID: 37918319 DOI: 10.1016/j.seizure.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 11/04/2023] Open
Affiliation(s)
- Adnan Deniz
- Department of Pediatric Neurology, Faculty of Medicine, Kocaeli University, Turkiye.
| | - Defne Alikılıç
- Department of Pediatric Neurology, Faculty of Medicine, Kocaeli University, Turkiye
| | - Merve Öztürk
- Department of Pediatric Neurology, Faculty of Medicine, Kocaeli University, Turkiye
| | - Ömer Karaca
- Department of Pediatric Neurology, Faculty of Medicine, Kocaeli University, Turkiye
| | - Ayfer Sakarya Güneş
- Department of Pediatric Neurology, Faculty of Medicine, Kocaeli University, Turkiye
| | - Bülent Kara
- Department of Pediatric Neurology, Faculty of Medicine, Kocaeli University, Turkiye
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19
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Wende T, Hoffmann A, Scherlach C, Kasper J, Sander C, Arlt F, Dietel E, Stockert A, Meixensberger J, Prasse G. Preserved White Matter Integrity and Recovery After Brain Tumor Surgery: A Prospective Pilot Study on the Frontal Aslant Tract. Brain Connect 2023; 13:589-597. [PMID: 37646398 DOI: 10.1089/brain.2023.0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Abstract
Introduction: Damage to white matter tracts can cause severe neurological deficits, which are often hardly predictable before brain tumor surgery. To explore the possibility of assessing white matter integrity and its preservation, we chose the frontal aslant tract (FAT) due to its involvement in multiple neurological functions such as speech and movement initiation. Methods: Right-handed patients with left hemispheric intracerebral tumors underwent FAT tractography within 7 days before and 3 days after surgery. Neurological performance score and aphasia score were assessed within 7 days before and after surgery, as well as at follow-up 3 months postoperatively. Results: Fifteen patients were prospectively analyzed. After multivariate analysis and receiver operating characteristic analysis, we found that preoperative fractional anisotropy (FA) of the left FAT indicated the preoperative aphasia score (cutoff 0.40, p = 0.015). Aphasia scores 3 months postoperatively were predicted by both postoperative FA of the left FAT (cutoff 0.35, p = 0.005) and postoperatively preserved FA of the left FAT (cutoff 95.8%, p = 0.017). Postoperatively preserved right FAT FA inversely predicted postoperative aphasia score (cutoff 95.1%, p = 0.016). Discussion: Assessment of white matter integrity preservation is possible and correlates with outcome after brain tumor surgery. It may be useful for patient counseling and assessment of rehabilitation potential, as well as to investigate relevant brain networks in the future. Clinical Trial Registration: The trial was prospectively registered at ClinicalTrials.gov (NCT04302857).
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Affiliation(s)
- Tim Wende
- Department of Neurosurgery, University Hospital Leipzig, Leipzig, Germany
| | - Anastasia Hoffmann
- Institute of Neuroradiology, University Hospital Leipzig, Leipzig, Germany
| | - Cordula Scherlach
- Institute of Neuroradiology, University Hospital Leipzig, Leipzig, Germany
| | - Johannes Kasper
- Institute of Neuroradiology, University Hospital Leipzig, Leipzig, Germany
| | - Caroline Sander
- Department of Neurosurgery, University Hospital Leipzig, Leipzig, Germany
| | - Felix Arlt
- Department of Neurosurgery, University Hospital Leipzig, Leipzig, Germany
| | - Eric Dietel
- Department of Neurosurgery, University Hospital Leipzig, Leipzig, Germany
| | - Anika Stockert
- Department of Neurology, University Hospital Leipzig, Leipzig, Germany
| | | | - Gordian Prasse
- Institute of Neuroradiology, University Hospital Leipzig, Leipzig, Germany
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Milte R, Jemere D, Lay K, Hutchinson C, Thomas J, Murray J, Ratcliffe J. A scoping review of the use of visual tools and adapted easy-read approaches in Quality-of-Life instruments for adults. Qual Life Res 2023; 32:3291-3308. [PMID: 37344727 PMCID: PMC10624740 DOI: 10.1007/s11136-023-03450-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 06/23/2023]
Abstract
PURPOSE Self-Reporting using traditional text-based Quality-of-Life (QoL) instruments can be difficult for people living with sensory impairments, communication challenges or changes to their cognitive capacity. Adapted communication techniques, such as Easy-Read techniques, or use of pictures could remove barriers to participation for a wide range of people. This review aimed to identify published studies reporting adapted communication approaches for measuring QoL, the methodology used in their development and validation among adult populations. METHODS A scoping review of the literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews checklist was undertaken. RESULTS The initial search strategy identified 13,275 articles for screening, with 264 articles identified for full text review. Of these 243 articles were excluded resulting in 21 studies for inclusion. The majority focused on the development of an instrument (12 studies) or a combination of development with some aspect of validation or psychometric testing (7 studies). Nineteen different instruments were identified by the review, thirteen were developed from previously developed generic or condition-specific quality of life instruments, predominantly aphasia (7 studies) and disability (4 studies). Most modified instruments included adaptations to both the original questions, as well as the response categories. CONCLUSIONS Studies identified in this scoping review demonstrate that several methods have been successfully applied e.g. with people living with aphasia post-stroke and people living with a disability, which potentially could be adapted for application with more diverse populations. A cohesive and interdisciplinary approach to the development and validation of communication accessible versions of QOL instruments, is needed to support widespread application, thereby reducing reliance on proxy assessors and promoting self-assessment of QOL across multiple consumer groups and sectors.
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Affiliation(s)
- Rachel Milte
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
| | - Digisie Jemere
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Kiri Lay
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Claire Hutchinson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Jolene Thomas
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Joanne Murray
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Julie Ratcliffe
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
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García AM, de Leon J, Tee BL, Blasi DE, Gorno-Tempini ML. Speech and language markers of neurodegeneration: a call for global equity. Brain 2023; 146:4870-4879. [PMID: 37497623 PMCID: PMC10690018 DOI: 10.1093/brain/awad253] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/29/2023] [Accepted: 07/15/2023] [Indexed: 07/28/2023] Open
Abstract
In the field of neurodegeneration, speech and language assessments are useful for diagnosing aphasic syndromes and for characterizing other disorders. As a complement to classic tests, scalable and low-cost digital tools can capture relevant anomalies automatically, potentially supporting the quest for globally equitable markers of brain health. However, this promise remains unfulfilled due to limited linguistic diversity in scientific works and clinical instruments. Here we argue for cross-linguistic research as a core strategy to counter this problem. First, we survey the contributions of linguistic assessments in the study of primary progressive aphasia and the three most prevalent neurodegenerative disorders worldwide-Alzheimer's disease, Parkinson's disease, and behavioural variant frontotemporal dementia. Second, we address two forms of linguistic unfairness in the literature: the neglect of most of the world's 7000 languages and the preponderance of English-speaking cohorts. Third, we review studies showing that linguistic dysfunctions in a given disorder may vary depending on the patient's language and that English speakers offer a suboptimal benchmark for other language groups. Finally, we highlight different approaches, tools and initiatives for cross-linguistic research, identifying core challenges for their deployment. Overall, we seek to inspire timely actions to counter a looming source of inequity in behavioural neurology.
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Affiliation(s)
- Adolfo M García
- Global Brain Health Institute, University of California, San Francisco, CA 94143, USA
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires B1644BID, Argentina
- Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago 9160000, Chile
- Latin American Brain Health (BrainLat) Institute, Universidad Adolfo Ibáñez, Avenida Diagonal Las Torres 2640 (7941169), Santiago, Peñalolén, Región Metropolitana, Chile
| | - Jessica de Leon
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94143, USA
| | - Boon Lead Tee
- Global Brain Health Institute, University of California, San Francisco, CA 94143, USA
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94143, USA
| | - Damián E Blasi
- Data Science Initiative, Harvard University, Cambridge, MA 02138, USA
- Department of Human Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA
- Department of Linguistic and Cultural Evolution, Max Planck Institute for the Science of Human History, Jena 07745, Germany
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94143, USA
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Li F, Huang YY, Zhang S, Wang W. Different phenotypes of moyamoya disease in a Chinese familial case involving heterozygous c.14429G>a variant in RNF213. Br J Neurosurg 2023; 37:1882-1885. [PMID: 35642380 DOI: 10.1080/02688697.2021.1916433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 04/09/2021] [Indexed: 11/02/2022]
Abstract
PURPOSE Moyamoya disease (MMD) is an uncommon chronic and occlusive cerebrovascular disorder involving the development of abnormal collateral vessels. This report aimed to describe a Chinese familial case with a rare variant in the RNF213 gene. METHODS The present report presents a rare familial case of MMD involving a heterozygous c.14429G>A variant in RNF213 and exhibiting different phenotypes. RESULTS A 3-year-old Chinese boy and his 10-year-old sister diagnosed severe bilateral MMD, while their mother was diagnosed asymptomatic bilateral MMD, based on the imaging results of magnetic resonance angiography (MRA). The boy mainly showed numbness at left hand accompanied by dysphasia and dyskinesia, while his sister had complex symptoms including dysphasia, dyskinesia at both hands and fatigue of limbs. Muscle force was ranked as left (upper limb/lower limb: 4/3) and right (upper limb/lower limb: 3/4). Genetic testing indicated a heterozygous c.14429G>A variant in RNF213 in 3 patients. The 3 patients shared the same amino acid substitution of p.Arg4810Lys caused by c.14429G>A. The father of two children also underwent genetic testing for RNF213 and MRI examination but found normal in all indices. CONCLUSIONS Genetic testing for RNF213 is suggested for MMD screening towards family members, and c.14576G>A variant is identified as an important pathogenic mutation with family heritability.
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Affiliation(s)
- Feng Li
- Outpatient Department of Pediatrics, The First Hospital of Jilin University, Changchun, P.R. China
| | - Yuan-Yuan Huang
- Outpatient Department of Pediatrics, The First Hospital of Jilin University, Changchun, P.R. China
| | - Sai Zhang
- Outpatient Department of Pediatrics, The First Hospital of Jilin University, Changchun, P.R. China
| | - Wei Wang
- Outpatient Department of Pediatrics, The First Hospital of Jilin University, Changchun, P.R. China
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Off CA, Kim E, Devanga SR, Sather T. Proceedings of the 2022 International Aphasia Rehabilitation Conference: The Engaged Community. J Commun Disord 2023; 106:106383. [PMID: 37857125 DOI: 10.1016/j.jcomdis.2023.106383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Affiliation(s)
- Catherine A Off
- School of Speech, Language, Hearing,& Occupational Sciences, College of Health, University of Montana, Missoula, MT, United States of America.
| | - Esther Kim
- Department of Communication Sciences and Disorders, Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Suma R Devanga
- Department of Communication Disorders and Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Tom Sather
- Department of Communication Sciences and Disorders, University of Wisconsin, Eau Claire, Eau Claire, Wisconsin, United States of America
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Sullivan R, Hemsley B, Harding K, Skinner I. 'Patient unable to express why he was on the floor, he has aphasia.' A content thematic analysis of medical records and incident reports on the falls of hospital patients with communication disability following stroke. Int J Lang Commun Disord 2023; 58:2033-2048. [PMID: 37355936 DOI: 10.1111/1460-6984.12916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 05/30/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND People with communication disability following stroke are at risk of falls during inpatient rehabilitation. However, they are often excluded from hospital falls research, and little is known about the circumstances or outcomes of their falls to inform risk management strategies. AIMS To examine hospital medical records and incident reports relating to falls of patients with communication disability following stroke for content codes, categories and themes relating to communication. METHODS & PROCEDURES This medical record chart review examined data on 72 patients and 265 falls. A content thematic analysis was used to identify how patient communication is characterized in relation to falls, and their prevention and management strategies. OUTCOMES & RESULTS The data reflected that staff viewed patients having difficulty following simple instructions as contributing to falls. Gaining the attention of staff and communicating basic needs were also considered to be contributing factors for falls. Patients were often described as experiencing a fall when taking a risk or attempting to address an unmet basic need. Furthermore, written notes for patients with more severe communication disability reflected that the patient's communication impairments prevented staff from establishing the circumstances of some falls and complicated the assessment for injury following a fall. CONCLUSIONS & IMPLICATIONS The medical records and incident reports of patients with communication disability following stroke reveal that hospital staff recognize the impact of communication disability as potential risk factors for falls for this group. It was difficult for staff to report the circumstances of the fall for patients with severe communication disability. Despite the recognition of communication as a potential contributing factor, few medical record entries documented strategies related to communication interventions to improve patients' ability to understand instructions, gain attention or communicate basic needs. WHAT THIS PAPER ADDS What is already known on the subject People with stroke are at a high risk of falls during their hospital admission. However, little is known about the circumstances of their falls and the influence of communication disability on these falls. What this paper adds to existing knowledge Patients with communication disability have unique factors that contribute to their falls in the hospital. Patients were described as experiencing a fall when taking a risk or attempting to address an unmet need, and these falls were often related to a patient's difficulties communicating their basic needs, gaining attention from staff, and following simple instructions. What are the potential or actual clinical implications of this work? Communication disability as a risk factor for a fall, and fall prevention strategies tailored to the communication disability, were typically identified and documented by physiotherapists, occupational therapists and nursing staff. The inclusion of speech pathologists in fall risk assessment, management, and prevention strategies may provide crucial information regarding the patient's communication disability that may enhance their fall prevention plan.
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Affiliation(s)
- Rebecca Sullivan
- University of Technology Sydney, Ultimo, NSW, Australia
- Eastern Health, Box Hill, VIC, Australia
| | | | - Katherine Harding
- Eastern Health, Box Hill, VIC, Australia
- La Trobe University, Bundoora, VIC, Australia
| | - Ian Skinner
- School of Allied Health Exercise and Sports Sciences, Charles Sturt University, Port Macquarie, NSW, Australia
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25
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Vasilopoulou ME, Triarhou LC. Neurobiological and pathophysiological concepts of Christfried Jakob (1866-1956) on language and aphasia: An English translation of two communications [1910,1932] and a modern perspective. J Chem Neuroanat 2023; 133:102341. [PMID: 37717828 DOI: 10.1016/j.jchemneu.2023.102341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 09/19/2023]
Abstract
The aim of the present article is to preserve, in English translation, two historical communications on aphasia and the pathophysiology of language by the neurobiologist Christfried Jakob (1866-1956) of Buenos Aires, and to place them in a modern perspective. The morphofunctional basis of human language and its pathology occupied Jakob's mind over three decades. His synthetic conclusions were based on the neuropathological examination of dozens of aphasic cases from the Hospital de Las Mercedes and the National Women's Psychiatric Hospital between 1906 and 1936. Special mention is made of the role of the cerebellum, the thalamus, and their connections with the cerebral cortex, and the language network. Current research and imaging studies support and elaborate that which Jacob presented so many years ago; many of his analyses and ideas are informative and remain relevant today.
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Affiliation(s)
- Maria E Vasilopoulou
- Graduate Program in Neuroscience and Education, University of Macedonia School of Social Sciences, Humanities and Arts, Thessalonica 54636, Greece
| | - Lazaros C Triarhou
- Graduate Program in Neuroscience and Education, University of Macedonia School of Social Sciences, Humanities and Arts, Thessalonica 54636, Greece; Department of Psychology, Division of Brain, Behavior and Cognition, Aristotelian University Faculty of Philosophy, Thessalonica 54124, Greece.
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Nichol L, Pitt R, Wallace SJ, Rodriguez AD, Hill AJ. "There are endless areas that they can use it for": speech-language pathologist perspectives of technology support for aphasia self-management. Disabil Rehabil Assist Technol 2023; 18:1473-1488. [PMID: 35166636 DOI: 10.1080/17483107.2022.2037758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 01/28/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Aphasia is a debilitating acquired language disorder that often persists as a chronic condition. However, long-term support options are scarce, necessitating the consideration of alternative approaches. Chronic condition self-management approaches, which aim to build self-efficacy and empower people to take responsibility for the day-to-day management of their health condition, may benefit people with aphasia (PwA). Technology is widely used in chronic condition self-management and investigation is required to determine whether it could play a role in aphasia self-management. OBJECTIVE This study aimed to explore speech-language pathologist (SLP) perspectives on the potential use of technology to support aphasia self-management. METHODS A qualitative study was conducted with 15 SLPs using semi-structured interviews. Qualitative content analysis was applied to verbatim transcripts to identify codes, categories, and sub-themes which were developed into themes. RESULTS Three themes were identified: (1) technology supports holistic aphasia self-management by providing additional avenues for service delivery, overall communication, and learning opportunities thus enhancing independence and life participation; (2) SLP and communication partner (CP) assistance can support PwA to use technology for aphasia self-management; (3) considerations and potential barriers to PwA use of technology for aphasia self-management. CONCLUSIONS Technology can support aphasia self-management by expanding service delivery options, allowing for increased frequency and intensity of therapy practise, and facilitating communication and participation. Personal, professional, and organizational barriers should be addressed in the development of technology-enabled aphasia self-management approaches. SLPs and CPs can offer PwA assistance with technology but may themselves need additional support. Solutions for identified barriers should be considered, such as providing training in the use of technology and implementing aphasia-friendly modifications.IMPLICATIONS FOR REHABILITATIONSelf-management approaches are being explored in the area of aphasia management as a means of offering a holistic, sustainable intervention option that meets the long-term needs of people with aphasia.A range of technology-based resources are currently used in chronic condition self-management and in aphasia therapy, and there are many possibilities for the use of technology in aphasia self-management approaches.Speech-language pathologists identified that technology could facilitate aphasia self-management by expanding service delivery options (e.g., real-time and asynchronous telepractice), enabling increased frequency and intensity of therapy through providing a means of independent practise, offering options for augmentative alternative communication, and enhancing life participation by supporting social communication and daily tasks.,Speech-language pathologists are interested in using technology for aphasia self-management; however, barriers related to organizational policies, individual experience and confidence using technology, and technology itself must be addressed.
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Affiliation(s)
- Leana Nichol
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Rachelle Pitt
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
- West Moreton Health, Ipswich, Australia
| | - Sarah J Wallace
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
| | - Amy D Rodriguez
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center, Decatur, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Annie J Hill
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
- Surgical, Treatment and Rehabilitation Service (STARS), Metro North Hospital and Health Service, Brisbane, Australia
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Rook J, Llufriu S, de Kok D, Rofes A. Language impairments in people with autoimmune neurological diseases: A scoping review. J Commun Disord 2023; 106:106368. [PMID: 37717472 DOI: 10.1016/j.jcomdis.2023.106368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/02/2023] [Accepted: 08/16/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION Autoimmune neurological diseases (ANDs) are a specific type of autoimmune disease that affect cells within the central and peripheral nervous system. ANDs trigger various physical/neuropsychiatric symptoms. However, language impairments in people with ANDs are not well characterized. Here we aimed to determine the kinds of language impairment that most commonly emerge in 10 ANDs, the characteristics of the patients (demographic, neurological damage), and the assessment methods used. METHODS We followed the PRISMA Extension for Scoping Reviews (PRISMA-ScR). PubMed and Google Scholar were searched. We used a list of search terms containing 10 types of ANDs (e.g., multiple sclerosis, acute disseminated encephalomyelitis) in combination with the terms aphasia, dysphasia, fluency, language, listening, morphology, phonology, pragmatics, reading, semantics, speaking, syntax, writing. The reference lists and citations of the relevant papers were also investigated. The type of AND, patient characteristics, neurological damage and examination technique, language tests administered, and main findings were noted for each study meeting the inclusion criteria. RESULTS We found 171 studies meeting our inclusion criteria. These comprised group studies and case studies. Language impairments differed largely among types of ANDs. Neurological findings were mentioned in most of the papers, but specific language tests were rarely used. CONCLUSIONS Language symptoms in people with ANDs are commonly reported. These are often not full descriptions or only focus on specific time points in the course of the disease. Future research needs to assess specific language functions in people with ANDs and relate their language impairments to brain damage at different stages of disease evolution.
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Affiliation(s)
- Janine Rook
- Center for Language and Cognition, University of Groningen, Groningen, The Netherlands; Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands
| | - Sara Llufriu
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Dörte de Kok
- Center for Language and Cognition, University of Groningen, Groningen, The Netherlands
| | - Adrià Rofes
- Center for Language and Cognition, University of Groningen, Groningen, The Netherlands.
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Saito N, Kuroha Y, Hasegawa A, Tada M, Kakita A, Watanabe K, Takahashi T. [Case of hereditary Y69H (p.Y89H) transthyretin variant leptomeningeal amyloidosis presenting with drop attacks and recurrent transient language disorder]. Rinsho Shinkeigaku 2023; 63:650-655. [PMID: 37779024 DOI: 10.5692/clinicalneurol.cn-001852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
We report a 73-year-old woman who started developing recurrent transient aphasia at the age of 66 years. During the attacks, she was aware she could not understand what was being said and both her spoken and written speech were meaningless. The attacks usually lasted for a few days, following which she could explain what had happened. Anti-epileptics did not improve her symptoms. She also noticed tremor of her right hand and gait disturbance at the age of 71 years. The recurrent transient aphasia was followed by drop attacks. At the time of her admission to our hospital, she showed paraplegia, phonological paraphasia, and difficulty in understanding complex sentences. Her language disturbance resembled a logopenic variant of primary progressive aphasia. However, the symptoms fluctuated for a few days and subsequently improved. Electroencephalography showed no abnormalities. Gadolinium-enhanced brain and spinal MRI showed diffuse leptomeningeal enhancement over the surface of the spinal cord, brain stem, and cerebrum on T1-weighed imaging. Surgical biopsy of a varicose vein in the subarachnoid space at the level of the Th11 spinal cord was performed. Pathological evaluation of the biopsied specimens revealed TTR-immunolabeled amyloid deposits in the subarachnoid vessel walls and on the arachnoid membrane. Gene analysis revealed c.265T>C, p.Y89H (Y69H) TTR mutation, which is known as one of the causative mutations of familial leptomeningeal amyloidosis. Leptomeningeal forms of transthyretin amyloidosis might present transient focal neurological episodes.
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Affiliation(s)
- Natsumi Saito
- Department of Neurology, NHO Nishiniigata Chuo Hospital
| | - Yasuko Kuroha
- Department of Neurology, NHO Nishiniigata Chuo Hospital
| | | | - Mari Tada
- Department of Pathology, Brain Research Institute, Niigata University
| | - Akiyoshi Kakita
- Department of Pathology, Brain Research Institute, Niigata University
| | - Kei Watanabe
- Department of Orthopedic Surgery, Niigata University School of Medicine
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Kallhoff L, Mauszycki S, Rose B, Wambaugh J. The Impact of Telehealth on the Efficacy of Sound Production Treatment. Am J Speech Lang Pathol 2023; 32:2461-2479. [PMID: 37541301 DOI: 10.1044/2023_ajslp-22-00301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/06/2023]
Abstract
PURPOSE This investigation was designed to systematically examine the acquisition, maintenance, and response generalization effects of Sound Production Treatment (SPT) delivered via telehealth in comparison to existing in-person outcomes for SPT. METHOD A multiple-baseline design across behaviors and participants was used with two individuals with chronic apraxia of speech (AOS) and aphasia. Accuracy of target speech sounds in treated and untreated words within phrases served as the dependent variable. RESULTS Both participants demonstrated positive gains for treatment and generalization items. Participant 1 demonstrated gains for both sets of treatment items with the application of treatment, but production accuracy at 2 and 6 weeks posttreatment was inconsistent. Participant 2 demonstrated large gains for both sets of treatment items with good maintenance at 2 and 6 weeks posttreatment. Effect sizes for both participants were similar to the traditional (in-person) SPT effect size benchmarks. CONCLUSIONS The positive outcomes from this study indicate that individuals with AOS can benefit from SPT delivered via telehealth. These findings warrant further research examining the effects of SPT through telehealth and should include individuals with AOS with varying severity. This investigation serves as the first telehealth study to systematically examine treatment outcomes for SPT.
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Affiliation(s)
- Lydia Kallhoff
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City
| | - Shannon Mauszycki
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City
| | - Brooke Rose
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City
| | - Julie Wambaugh
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City
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Weterings RPC, Kessels RPC, de Leeuw FE, Piai V. Cognitive impairment after a stroke in young adults: A systematic review and meta-analysis. Int J Stroke 2023; 18:888-897. [PMID: 36765436 PMCID: PMC10507997 DOI: 10.1177/17474930231159267] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/29/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Information about cognitive functioning is vital in the management of stroke, but the literature is mostly based on data from individuals older than 50 years of age who make up the majority of the stroke population. As cognitive functioning is subject to change due to aging, it is unclear whether such cognitive impairment patterns from the general stroke literature apply to the growing population of younger people with a stroke. AIM The aim of the study was to conduct a systematic review and meta-analysis of the proportion and severity of cognitive impairment in young-stroke patients. SUMMARY OF REVIEW MEDLINE, Embase, PsycINFO, and Web of Science were systematically searched up to 11 October 2022. Studies were included if they reported on a population of young-stroke patients, evaluated cognitive functioning as an outcome measure, and reported original data. We estimated the pooled prevalence rates for cognitive impairment and for aphasia. In addition, we calculated the pooled estimates for the severity of impairment per cognitive domain in the chronic phase (defined as >6 months post-stroke). Six hundred thirty-five articles were identified, of which 29 were eligible for inclusion. The pooled prevalence of cognitive impairment was 44% (k = 10; 95% confidence interval (CI): 34-54%) and of aphasia 22% (k = 13; 95% CI: 12-39%). Young-stroke patients in the chronic phase performed worse than stroke-free healthy age-appropriate controls across all cognitive domains examined, with Hedges' g effect sizes ranging from -0.49 to -1.64. CONCLUSION Around half of all young-stroke patients present with cognitive impairment and around a quarter with aphasia. Our data suggest that patterns of impairment in young-stroke patients follow those in the general stroke literature.
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Affiliation(s)
- Rosemarije PC Weterings
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Roy PC Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Medical Psychology, Radboud University Medical Center and Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
- Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
| | - Frank-Erik de Leeuw
- Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Vitória Piai
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Medical Psychology, Radboud University Medical Center and Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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Bihovsky A, Ben-Shachar M, Meir N. Language abilities, not cognitive control, predict language mixing behavior in bilingual speakers with aphasia. J Commun Disord 2023; 105:106367. [PMID: 37579674 DOI: 10.1016/j.jcomdis.2023.106367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 07/14/2023] [Accepted: 07/14/2023] [Indexed: 08/16/2023]
Abstract
PURPOSE Language Mixing (LM) occurs among neurotypical bilinguals as well as among bilingual persons with aphasia (BiPWAs). The current study aimed to investigate whether LM in BiPWAs stems from a linguistic impairment, an impairment in cognitive control, or both. METHOD Twenty Russian-Hebrew-speaking BiPWAs were split into two groups based on aphasia severity (Severe/Moderate vs. Mild). Frequencies and patterns of LM in narrative production by BiPWAs in L1-Russian and in L2-Hebrew were analyzed. To investigate the underlying mechanisms of LM, all participants completed linguistic background questionnaires, the Bilingual Aphasia Test (BAT) in both languages, and a battery of 10 cognitive tests. RESULTS The results indicated an effect of aphasia severity and an effect of language. Higher LM frequency was observed in BiPWAs with severe/moderate aphasia symptoms as compared to BiPWAs with mild symptoms. In both groups, higher LM frequency was observed in L2-Hebrew narratives, the weaker post-stroke language for most participants in the sample. The results also showed qualitative LM differences in L1-Russsian and L2-Hebrew contexts. In L1-Russian narratives, BiPWAs mainly switched to L2-Hebrew nouns, while in L2-Hebrew narratives, they mainly inserted L1-Russian discourse markers and function words. CONCLUSIONS Linguistic factors such as pre- and post-stroke self-rated language proficiency and level of language impairment due to aphasia were found to predict LM frequency in L1-Russian and in L2-Hebrew. Cognitive abilities did not predict LM frequency. Based on our findings, we suggest that LM behavior in BiPWAs might be primarily related to language skills in L1 and L2, rather than to cognitive control impairments.
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Affiliation(s)
- Alina Bihovsky
- The Department of English Literature and Linguistics, Bar-Ilan University, Israel; The Sheba Rehabilitation Hospital, Israel.
| | - Michal Ben-Shachar
- The Department of English Literature and Linguistics, Bar-Ilan University, Israel; The Department of English Literature and Linguistics, The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| | - Natalia Meir
- The Department of English Literature and Linguistics, Bar-Ilan University, Israel; The Department of English Literature and Linguistics, The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
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Douglas NF, Archer B, Azios JH, Strong KA, Simmons-Mackie N, Worrall L. A scoping review of friendship intervention for older adults: lessons for designing intervention for people with aphasia. Disabil Rehabil 2023; 45:3012-3031. [PMID: 36170126 DOI: 10.1080/09638288.2022.2117866] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 08/18/2022] [Accepted: 08/21/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Map the landscape of friendship interventions/programs for older adults to guide intervention/program development inclusive of the unique needs of older people with aphasia (PWA). METHODS A search query of multiple databases was completed for articles published before 4 January 2021. Studies included all the following: (1) participants aged 55 years or older; (2) addressed an intervention/program designed to prevent social isolation and/or friendship loss; (3) used an outcome variable related to social isolation and/or friendship; and (4) published in a peer-reviewed journal. Title and abstract screening were conducted using Covidence software, which tracked disagreements across the study team. All studies included in the full-text review were identified as relevant by a minimum of two study authors, and a consensus was reached on all full-text reviews. Data were extracted according to (1) theoretical frameworks used; (2) interventionist and discipline; (3) participant characteristics; (4) intervention/program replicability; (5) format of intervention/program; (6) measures used in the intervention/programs; (7) and, reported effects of intervention/programs on individuals. RESULTS A total of 40 articles with 42 intervention/programs were included and represented 4584 intervention/program participants ranging in age from 40 to 104 years. Intervention/programs involved a wide range of theoretical frameworks (e.g., theories of loneliness, feminist theory, positive psychology). Disciplines such as psychology and exercise science informed intervention/programs. Interventionists included many types of individuals like therapists, volunteers and home health aides. Intervention/programs often lacked adequate description for replication and included individual and group formats, most commonly delievered in the participants homes. Outcomes usually included self-report measures of loneliness, social networks, or well-being, and intervention/programming was primarily educational, activity-based, or networking-based in nature. CONCLUSIONS The intervention/programs reviewed yield important lessons to support innovation in developing friendship intervention/programs for older PWA as most yielded positive results and were acceptable to participants.IMPLICATIONS FOR REHABILITATIONPeople with aphasia want their friendships addressed as part of their rehabilitation; however, the research literature has little guidance in this area.Studies reviewed of friendship intervention/programs for older adults yielded helpful lessons for consideration in developing this type of intervention/programming for people with aphasia.Interprofessional teams made up of rehabilitation professionals should address friendship for people with aphasia in both research and clinical practice.
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Affiliation(s)
- Natalie F Douglas
- Department of Communication Sciences and Disorders, Central Michigan University, Mount Pleasant, MI, USA
| | - Brent Archer
- Department of Communication Sciences & Disorders, Bowling Green State University, Bowling Green, OH, USA
| | - Jamie H Azios
- Department of Speech & Hearing Sciences, Lamar University, Beaumont, TX, USA
| | - Katie A Strong
- Department of Communication Sciences and Disorders, Central Michigan University, Mount Pleasant, MI, USA
| | - Nina Simmons-Mackie
- Department of Health & Human Sciences, Southeastern Louisiana University, Hammond, LA, USA
| | - Linda Worrall
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Nikkels A, Berns P, Neijenhuis K. Communication partner training for SLT students: Changes in communication skills, knowledge and confidence. J Commun Disord 2023; 105:106366. [PMID: 37541131 DOI: 10.1016/j.jcomdis.2023.106366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 08/06/2023]
Abstract
This paper describes the changes in communication skills, knowledge and confidence in Speech Language Therapy (SLT) students in conversations with People With Aphasia (PWA) after Training Con-tAct, a Dutch Communication Partner Training. METHODS On a voluntary basis, nine SLT students (2nd yr) completed Training Con-tAct, in which People With Aphasia (PWA) were involved as co-workers. A mixed method design with pre- and post-measures was used to analyze the students' communication skills, knowledge and confidence. A quantitative video analysis was used to measure changes in students' communication skills. Besides, a self-report questionnaire was used to measure the changes in students' knowledge and confidence regarding their communication with PWA. To evaluate the perspectives of the students on Training Con-tAct, additionally a focus group interview was held. RESULTS Regarding students' communication skills the outcomes revealed a significantly higher score on the 'supporting' competence in students who took part in Training Con-tAct. The mean scores for the 'acknowledging' and 'checking information' competences did not improve significantly. The outcomes of the questionnaire showed students gained more knowledge and confidence regarding communication with PWA. The focus group interview provided insights into: motivation for participating in Communication Partner Training, content and structure of the training, feedback in CPT, and learning experiences. CONCLUSION The present study suggests that SLT students may benefit from Training Con-tAct as the training leads to better skills, more knowledge about aphasia and more confidence in communicating with PWA. Training Con-tAct could be a valuable addition to the curricula of all healthcare disciplines, and eventually support interprofessional collaboration, resulting in improved access to health care, which is important for communication vulnerable people. Further research with a larger sample size and a control group is required.
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Affiliation(s)
- Alissa Nikkels
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Postbus 25035, Rotterdam, the Netherlands.
| | - Philine Berns
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Postbus 25035, Rotterdam, the Netherlands
| | - Karin Neijenhuis
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Postbus 25035, Rotterdam, the Netherlands
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Sarmukadam K, Behroozmand R. Neural oscillations reveal disrupted functional connectivity associated with impaired speech auditory feedback control in post-stroke aphasia. Cortex 2023; 166:258-274. [PMID: 37437320 PMCID: PMC10527672 DOI: 10.1016/j.cortex.2023.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/11/2023] [Accepted: 05/24/2023] [Indexed: 07/14/2023]
Abstract
The oscillatory brain activities reflect neuro-computational processes that are critical for speech production and sensorimotor control. In the present study, we used neural oscillations in left-hemisphere stroke survivors with aphasia as a model to investigate network-level functional connectivity deficits associated with disrupted speech auditory feedback control. Electroencephalography signals were recorded from 40 post-stroke aphasia and 39 neurologically intact control participants while they performed speech vowel production and listening tasks under pitch-shifted altered auditory feedback (AAF) conditions. Using weighted phase-lag index, we calculated broadband (1-70 Hz) functional neural connectivity between electrode pairs covering the frontal, pre- and post-central, and parietal regions. Results revealed reduced fronto-central delta and theta band and centro-parietal low-beta band connectivity in left-hemisphere electrodes associated with diminished speech AAF compensation responses in post-stroke aphasia compared with controls. Lesion-mapping analysis demonstrated that stroke-induced damage to multi-modal brain networks within the inferior frontal gyrus, Rolandic operculum, inferior parietal lobule, angular gyrus, and supramarginal gyrus predicted the reduced functional neural connectivity within the delta and low-beta bands during both tasks in aphasia. These results provide evidence that disrupted neural connectivity due to left-hemisphere brain damage can result in network-wide dysfunctions associated with impaired sensorimotor integration mechanisms for speech auditory feedback control.
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Affiliation(s)
- Kimaya Sarmukadam
- Speech Neuroscience Lab, Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.
| | - Roozbeh Behroozmand
- Speech Neuroscience Lab, Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.
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Souter NE, Reddy A, Walker J, Marino Dávolos J, Jefferies E. How do valence and meaning interact? The contribution of semantic control. J Neuropsychol 2023; 17:521-539. [PMID: 37010272 DOI: 10.1111/jnp.12312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 03/06/2023] [Indexed: 04/04/2023]
Abstract
The hub-and-spoke model of semantic cognition proposes that conceptual representations in a heteromodal 'hub' interact with and emerge from modality-specific features or 'spokes', including valence (whether a concept is positive or negative), along with visual and auditory features. As a result, valence congruency might facilitate our ability to link words conceptually. Semantic relatedness may similarly affect explicit judgements about valence. Moreover, conflict between meaning and valence may recruit semantic control processes. Here we tested these predictions using two-alternative forced-choice tasks, in which participants matched a probe word to one of two possible target words, based on either global meaning or valence. Experiment 1 examined timed responses in healthy young adults, while Experiment 2 examined decision accuracy in semantic aphasia patients with impaired controlled semantic retrieval following left hemisphere stroke. Across both experiments, semantically related targets facilitated valence matching, while related distractors impaired performance. Valence congruency was also found to facilitate semantic decision-making. People with semantic aphasia showed impaired valence matching and had particular difficulty when semantically related distractors were presented, suggesting that the selective retrieval of valence information relies on semantic control processes. Taken together, the results are consistent with the hypothesis that automatic access to the global meaning of written words affects the processing of valence, and that the valence of words is also retrieved even when this feature is task-irrelevant, affecting the efficiency of global semantic judgements.
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Affiliation(s)
| | - Ariyana Reddy
- Department of Psychology, University of York, York, UK
- Faculty of Health Sciences, University of Hull, Hull, UK
| | - Jake Walker
- Department of Psychology, University of York, York, UK
- School of Psychology and Computer Science, University of Central Lancashire, Preston, UK
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Ortiz K, Tognin J, Medeiros JSFD, McNeil MR. Translation and Adaptation of the English Story Retell Procedure to Portuguese: A Preliminary Study. Folia Phoniatr Logop 2023; 76:172-182. [PMID: 37557086 DOI: 10.1159/000533471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 07/27/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION The comprehension and production of connected language are essential for effective communication. However, few assessment and intervention programs requiring connected language have been made available in Brazilian Portuguese. One connected language sampling procedure, the Story Retell Procedure (SRP), has been widely studied in English and primarily for people with aphasia. The SRP employs 12 stories, whose individual plots are quite different and still equivalent in terms of verbal productivity measures. The first objective of this study was to present the translation and adaptation of the SRP stories into Portuguese and to determine whether the translations are similar to English stories. The second objective was to analyze a small group of healthy adults' responses to this assessment, thus observing whether the retellings of the SRP story forms in Portuguese would be similar to each other in the number of words, information units (IUs), and propositions - as demonstrated in English. METHODS This preliminary study translated and adapted into Portuguese, the 12 original English SRP stories. Only small cultural adaptations were made, preserving the essential content of the stories. The stories were then presented to 14 healthy adults, and the participants' retellings from each story were compared to the other stories regarding the number of words, IUs, and propositions. RESULTS Few differences were found in the retellings considering the variables analyzed. Particularly, the retells of Gasolina (Gas), Biblioteca (Library), Empréstimo (Loan), Sanduíche (Sandwich), Futebol (Baseball), and Multas (Ticket) were not significantly different in the three aspects investigated in this study (percentages of words, IUs, and propositions). CONCLUSION The SRP stories adapted to Portuguese, despite having a quite close number of words, IUs, and propositions to those in the original stories, did not result in retellings with similar number of words, IUs, or propositions across stories. Nonetheless, the parameters analyzed were not significantly different among the majority of the stories, and some were nearly identical. This study identified the SRP stories that can be equivalently used in assessment, reassessment, and possibly in the rehabilitation of patients with communication disorders. Likewise, differences must be considered when the stories are used with pathological populations.
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Affiliation(s)
- Karin Ortiz
- Department of Speech, Language and Hearing Sciences, Escola Paulista de Medicina. Universidade Federal de São Paulo, São Paulo, Brazil
| | - Juliana Tognin
- Department of Speech, Language and Hearing Sciences, Escola Paulista de Medicina. Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Malcom R McNeil
- Department of Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Planche V, Mansencal B, Manjon JV, Tourdias T, Catheline G, Coupé P. Anatomical MRI staging of frontotemporal dementia variants. Alzheimers Dement 2023; 19:3283-3294. [PMID: 36749884 DOI: 10.1002/alz.12975] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 12/27/2022] [Accepted: 01/04/2023] [Indexed: 02/09/2023]
Abstract
INTRODUCTION The three clinical variants of frontotemporal dementia (behavioral variant [bvFTD], semantic dementia, and progressive non-fluent aphasia [PNFA]) are likely to develop over decades, from the preclinical stage to death. METHODS To describe the long-term chronological anatomical progression of FTD variants, we built lifespan brain charts of normal aging and FTD variants by combining 8022 quality-controlled MRIs from multiple large-scale data-bases, including 107 bvFTD, 44 semantic dementia, and 38 PNFA. RESULTS We report in this manuscript the anatomical MRI staging schemes of the three FTD variants by describing the sequential divergence of volumetric trajectories between normal aging and FTD variants. Subcortical atrophy precedes focal cortical atrophy in specific behavioral and/or language networks, with a "radiological" prodromal phase lasting 8-10 years (time elapsed between the first structural alteration and canonical cortical atrophy). DISCUSSION Amygdalar and striatal atrophy can be candidate biomarkers for future preclinical/prodromal FTD variants definitions. HIGHLIGHTS We describe the chronological MRI staging of the most affected structures in the three frontotemporal dementia (FTD) syndromic variants. In behavioral variant of FTD (bvFTD): bilateral amygdalar, striatal, and insular atrophy precedes fronto-temporal atrophy. In semantic dementia: bilateral amygdalar atrophy precedes left temporal and hippocampal atrophy. In progressive non-fluent aphasia (PNFA): left striatal, insular, and thalamic atrophy precedes opercular atrophy.
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Affiliation(s)
- Vincent Planche
- Univ. Bordeaux, CNRS, UMR 5293, Institut des Maladies Neurodégénératives, Bordeaux, France
- Centre Mémoire Ressources Recherches, Pôle de Neurosciences Cliniques, CHU de Bordeaux, Bordeaux, France
| | | | - José V Manjon
- Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA), Universitat Politècnica de València, Valencia, Spain
| | - Thomas Tourdias
- Inserm U1215 - Neurocentre Magendie, Bordeaux, France
- Service de Neuroimagerie diagnostique et thérapeutique, CHU de Bordeaux, Bordeaux, France
| | - Gwenaëlle Catheline
- Univ. Bordeaux, CNRS, UMR 5287, Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, Bordeaux, France
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Akkad H, Hope TMH, Howland C, Ondobaka S, Pappa K, Nardo D, Duncan J, Leff AP, Crinion J. Mapping spoken language and cognitive deficits in post-stroke aphasia. Neuroimage Clin 2023; 39:103452. [PMID: 37321143 PMCID: PMC10275719 DOI: 10.1016/j.nicl.2023.103452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/24/2023] [Accepted: 06/06/2023] [Indexed: 06/17/2023]
Abstract
Aphasia is an acquired disorder caused by damage, most commonly due to stroke, to brain regions involved in speech and language. While language impairment is the defining symptom of aphasia, the co-occurrence of non-language cognitive deficits and their importance in predicting rehabilitation and recovery outcomes is well documented. However, people with aphasia (PWA) are rarely tested on higher-order cognitive functions, making it difficult for studies to associate these functions with a consistent lesion correlate. Broca's area is a particular brain region of interest that has long been implicated in speech and language production. Contrary to classic models of speech and language, cumulative evidence shows that Broca's area and surrounding regions in the left inferior frontal cortex (LIFC) are involved in, but not specific to, speech production. In this study we aimed to explore the brain-behaviour relationships between tests of cognitive skill and language abilities in thirty-six adults with long-term speech production deficits caused by post-stroke aphasia. Our findings suggest that non-linguistic cognitive functions, namely executive functions and verbal working memory, explain more of the behavioural variance in PWA than classical language models imply. Additionally, lesions to the LIFC, including Broca's area, were associated with non-linguistic executive (dys)function, suggesting that lesions to this area are associated with non-language-specific higher-order cognitive deficits in aphasia. Whether executive (dys)function - and its neural correlate in Broca's area - contributes directly to PWA's language production deficits or simply co-occurs with it, adding to communication difficulties, remains unclear. These findings support contemporary models of speech production that place language processing within the context of domain-general perception, action and conceptual knowledge. An understanding of the covariance between language and non-language deficits and their underlying neural correlates will inform better targeted aphasia treatment and outcomes.
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Affiliation(s)
- Haya Akkad
- Institute of Cognitive Neuroscience, University College London, UK.
| | - Thomas M H Hope
- Institute of Cognitive Neuroscience, University College London, UK; Wellcome Centre for Human Neuroimaging, University College London, UK
| | | | - Sasha Ondobaka
- Institute of Cognitive Neuroscience, University College London, UK
| | | | - Davide Nardo
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK; Department of Education, University of Roma Tre, Italy
| | - John Duncan
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK; Department of Experimental Psychology, University of Oxford, UK
| | - Alexander P Leff
- Institute of Cognitive Neuroscience, University College London, UK; Wellcome Centre for Human Neuroimaging, University College London, UK; Institute of Neurology, University College London, UK
| | - Jenny Crinion
- Institute of Cognitive Neuroscience, University College London, UK; Wellcome Centre for Human Neuroimaging, University College London, UK
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Chen X, Affourtit J, Ryskin R, Regev TI, Norman-Haignere S, Jouravlev O, Malik-Moraleda S, Kean H, Varley R, Fedorenko E. The human language system, including its inferior frontal component in "Broca's area," does not support music perception. Cereb Cortex 2023; 33:7904-7929. [PMID: 37005063 PMCID: PMC10505454 DOI: 10.1093/cercor/bhad087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 04/04/2023] Open
Abstract
Language and music are two human-unique capacities whose relationship remains debated. Some have argued for overlap in processing mechanisms, especially for structure processing. Such claims often concern the inferior frontal component of the language system located within "Broca's area." However, others have failed to find overlap. Using a robust individual-subject fMRI approach, we examined the responses of language brain regions to music stimuli, and probed the musical abilities of individuals with severe aphasia. Across 4 experiments, we obtained a clear answer: music perception does not engage the language system, and judgments about music structure are possible even in the presence of severe damage to the language network. In particular, the language regions' responses to music are generally low, often below the fixation baseline, and never exceed responses elicited by nonmusic auditory conditions, like animal sounds. Furthermore, the language regions are not sensitive to music structure: they show low responses to both intact and structure-scrambled music, and to melodies with vs. without structural violations. Finally, in line with past patient investigations, individuals with aphasia, who cannot judge sentence grammaticality, perform well on melody well-formedness judgments. Thus, the mechanisms that process structure in language do not appear to process music, including music syntax.
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Affiliation(s)
- Xuanyi Chen
- Department of Cognitive Sciences, Rice University, TX 77005, United States
- Department of Brain and Cognitive Sciences, MIT, Cambridge, MA 02139, United States
- McGovern Institute for Brain Research, MIT, Cambridge, MA 02139, United States
| | - Josef Affourtit
- Department of Brain and Cognitive Sciences, MIT, Cambridge, MA 02139, United States
- McGovern Institute for Brain Research, MIT, Cambridge, MA 02139, United States
| | - Rachel Ryskin
- Department of Brain and Cognitive Sciences, MIT, Cambridge, MA 02139, United States
- McGovern Institute for Brain Research, MIT, Cambridge, MA 02139, United States
- Department of Cognitive & Information Sciences, University of California, Merced, Merced, CA 95343, United States
| | - Tamar I Regev
- Department of Brain and Cognitive Sciences, MIT, Cambridge, MA 02139, United States
- McGovern Institute for Brain Research, MIT, Cambridge, MA 02139, United States
| | - Samuel Norman-Haignere
- Department of Biostatistics & Computational Biology, University of Rochester Medical Center, Rochester, NY, United States
- Department of Neuroscience, University of Rochester Medical Center, Rochester, NY, United States
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, United States
- Department of Brain and Cognitive Sciences, University of Rochester, Rochester, NY, United States
| | - Olessia Jouravlev
- Department of Brain and Cognitive Sciences, MIT, Cambridge, MA 02139, United States
- McGovern Institute for Brain Research, MIT, Cambridge, MA 02139, United States
- Department of Cognitive Science, Carleton University, Ottawa, ON, Canada
| | - Saima Malik-Moraleda
- Department of Brain and Cognitive Sciences, MIT, Cambridge, MA 02139, United States
- McGovern Institute for Brain Research, MIT, Cambridge, MA 02139, United States
- The Program in Speech and Hearing Bioscience and Technology, Harvard University, Cambridge, MA 02138, United States
| | - Hope Kean
- Department of Brain and Cognitive Sciences, MIT, Cambridge, MA 02139, United States
- McGovern Institute for Brain Research, MIT, Cambridge, MA 02139, United States
| | - Rosemary Varley
- Psychology & Language Sciences, UCL, London, WCN1 1PF, United Kingdom
| | - Evelina Fedorenko
- Department of Brain and Cognitive Sciences, MIT, Cambridge, MA 02139, United States
- McGovern Institute for Brain Research, MIT, Cambridge, MA 02139, United States
- The Program in Speech and Hearing Bioscience and Technology, Harvard University, Cambridge, MA 02138, United States
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Xie X, Hu P, Tian Y, Qiu B, Wang K, Bai T. Abnormal resting-state function within language network and its improvement among post-stroke aphasia. Behav Brain Res 2023; 443:114344. [PMID: 36781021 DOI: 10.1016/j.bbr.2023.114344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/30/2023] [Accepted: 02/10/2023] [Indexed: 02/13/2023]
Abstract
Several studies with resting-state magnetic resonance imaging (rs-fMRI) have examined functional impairments and plasticity within language network in patients with post-stroke aphasia (PSA). However, there is still ubiquitous inconsistency across these studies, partly due to restricted to very small sample size and the absence of validation with follow-up data. In the current study, we aimed at providing relatively strong evidence to support functional impairments and its reorganization in PSA. Here, the amplitude of low frequency fluctuations (ALFF) and functional connectivity were used to assess functional alterations of PSA with moderate sample size at baseline (thirty-five PSA patients and thirty-five healthy controls). Functional abnormalities at baseline were observed whether improved among sixteen follow-up patients. Compared with controls, PSA at baseline presented decreased ALFF in the left inferior frontal gyrus (IFG) and decreased functional connectivity of the left IFG with the bilateral supplementary motor area (SMA) and right superior temporal gyrus (STG). The decreased ALFF in IFG, decreased IFG-SMA and IFG-STG connectivity were enhanced among follow-up patients and was synchronized with language-performance improvement. Our results revealed reduced intrinsic neural activity and inter-connections within language network in PSA, which would be normalized synchronously as the improvement of language performance.
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Affiliation(s)
- Xiaohui Xie
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Panpan Hu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yanghua Tian
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China; Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China; Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China
| | - Bensheng Qiu
- Center for Biomedical Engineering, University of Science and Technology of China, Hefei, China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China; Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China; The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.
| | - Tongjian Bai
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
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Li L, Zhou Y, Zou S, Wang Y. The Effects of High-Altitude Mountaineering on Cognitive Function in Mountaineers: A Meta-Analysis. Int J Environ Res Public Health 2023; 20:5101. [PMID: 36982007 PMCID: PMC10049572 DOI: 10.3390/ijerph20065101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/04/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Nowadays, with the convenience of international traveling and driven by many individuals' fond dreams of challenging high-altitude exercises, high-altitude mountaineering is becoming increasingly popular worldwide. Therefore, we performed a meta-analysis to determine the effects of high-altitude mountaineering on cognitive functions in mountaineers before and after climbing. METHODS After a thorough electronic literature search and selection, eight studies were included in this meta-analysis, and the conducted test cycles ranged from 8 to 140 days. Eight variables were included in this meta-analysis: the Trail-Making Test (TMB), Digit Span-Forward (DSF), Digit Span-Backward (DSB), Finger Tapping Test-Right (FTR) Finger Tapping Test-Left (FTL), Wechsler Memory Scale Visual (WMSV), the Aphasia Screening Test (Verbal Items) (AST-Ver), and the Aphasia Screening Test (Visual Motor Errors) (AST-Vis). The effect sizes (ES) and forest plots of these eight variables were generated. RESULTS Five variables (TMB, ES = 0.39; DSF, ES = 0.57; FTR, ES = 0.50; FTL, ES = 0.16; WMSV, ES = 0.63) out of eight were significantly improved after high-altitude mountaineering, whereas the ES values of DSB, AST-Ver, and AST-Vis did not show significant improvement after climbing. CONCLUSION Despite two limitations, namely, methodological issues inherent in the meta-analysis and the inability to explain high heterogeneity between studies, this study is the first meta-analysis that has attempted to specify and compare the cognitive functions of mountaineers before and after high-altitude mountaineering. Furthermore, as a short-term plateau exercise, high-altitude mountaineering has no significant negative impacts on the cognitive functions of climbers. Future research is needed for a long period of high-altitude mountaineering.
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Affiliation(s)
- Lun Li
- College of Physical Education, China University of Geosciences (Wuhan), Wuhan 430074, China; (L.L.)
| | - Yun Zhou
- College of Physical Education, China University of Geosciences (Wuhan), Wuhan 430074, China; (L.L.)
| | - Shisi Zou
- College of Physical Education, China University of Geosciences (Wuhan), Wuhan 430074, China; (L.L.)
| | - Yongtai Wang
- College of Health Sciences and Technology, Rochester Institute of Technology, Rochester, NY 14623, USA
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Casilio M, Fergadiotis G, Salem AC, Gale RC, McKinney-Bock K, Bedrick S. ParAlg: A Par aphasia Algorithm for Multinomial Classification of Picture Naming Errors. J Speech Lang Hear Res 2023; 66:966-986. [PMID: 36791263 PMCID: PMC10461785 DOI: 10.1044/2022_jslhr-22-00255] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/05/2022] [Accepted: 11/21/2022] [Indexed: 06/18/2023]
Abstract
PURPOSE A preliminary version of a paraphasia classification algorithm (henceforth called ParAlg) has previously been shown to be a viable method for coding picture naming errors. The purpose of this study is to present an updated version of ParAlg, which uses multinomial classification, and comprehensively evaluate its performance when using two different forms of transcribed input. METHOD A subset of 11,999 archival responses produced on the Philadelphia Naming Test were classified into six cardinal paraphasia types using ParAlg under two transcription configurations: (a) using phonemic transcriptions for responses exclusively (phonemic-only) and (b) using phonemic transcriptions for nonlexical responses and orthographic transcriptions for lexical responses (orthographic-lexical). Agreement was quantified by comparing ParAlg-generated paraphasia codes between configurations and relative to human-annotated codes using four metrics (positive predictive value, sensitivity, specificity, and F1 score). An item-level qualitative analysis of misclassifications under the best performing configuration was also completed to identify the source and nature of coding discrepancies. RESULTS Agreement between ParAlg-generated and human-annotated codes was high, although the orthographic-lexical configuration outperformed phonemic-only (weighted-average F1 scores of .78 and .87, respectively). A qualitative analysis of the orthographic-lexical configuration revealed a mix of human- and ParAlg-related misclassifications, the former of which were related primarily to phonological similarity judgments whereas the latter were due to semantic similarity assignment. CONCLUSIONS ParAlg is an accurate and efficient alternative to manual scoring of paraphasias, particularly when lexical responses are orthographically transcribed. With further development, it has the potential to be a useful software application for anomia assessment. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.22087763.
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Wunderlich A, Newesely G, Reheis J. Communicative participation with public authorities: Experiences of people with aphasia, people who stutter, and employees of public authorities. J Commun Disord 2023; 102:106314. [PMID: 36801532 DOI: 10.1016/j.jcomdis.2023.106314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Several studies have examined the communicative participation of people with communication disorders (PWCD). Hindering and facilitating factors were analyzed in different population groups considering various private and public communication contexts. However, knowledge about (a) the experiences of persons with different communication disorders, (b) communication with public authorities, and (c) the perspective of communication partners in this area remains limited. Therefore, this study aimed to explore the communicative participation of PWCD with public authorities. We analyzed communicative experiences (hindering and facilitating factors) and suggestions for improving communicative access described by persons with aphasia (PWA) and persons who stutter (PWS) as well as by employees of public authorities (EPA). METHODS In semi-structured interviews, PWA (n = 8), PWS (n = 9), and EPA (n = 11) reported specific communicative encounters with public authorities. The interviews were analyzed using qualitative content analysis, focusing on hindering/facilitating experiences and suggestions for improvement. RESULTS The personal experiences of the participants during authority encounters were represented by the interwoven themes of familiarity and awareness, attitudes and behavior, and support and autonomy. The perspectives of the three groups overlap in several areas; however, the results also indicate specific differences between PWA and PWS as well as between PWCD and EPA. CONCLUSION The results indicate a need to improve awareness/knowledge about communication disorders and communicative behavior in EPA. Moreover, PWCD should actively engage in encounters with authorities. In both groups, awareness must be raised about how each communication partner can contribute to successful communication, and avenues to achieve this goal must be demonstrated.
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Affiliation(s)
| | - Georg Newesely
- University of Applied Sciences Tyrol, Innsbruck, Austria
| | - Johanna Reheis
- University of Applied Sciences Tyrol, Innsbruck, Austria
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Abstract
BACKGROUND Stroke is a leading cause of long-term disability. Greater rehabilitation therapy after stroke is known to improve functional outcomes. This study examined therapy doses during the first year of stroke recovery and identified factors that predict rehabilitation therapy dose. METHODS Adults with new radiologically confirmed stroke were enrolled 2 to 10 days after stroke onset at 28 acute care hospitals across the United States. Following an initial assessment during acute hospitalization, the number of physical therapy, occupational therapy, and speech therapy sessions were determined at visits occurring 3, 6, and 12 months following stroke. Negative binomial regression examined whether clinical and demographic factors were associated with therapy counts. False discovery rate was used to correct for multiple comparisons. RESULTS Of 763 patients enrolled during acute stroke admission, 510 were available for follow-up. Therapy counts were low overall, with most therapy delivered within the first 3 months; 35.0% of patients received no physical therapy; 48.8%, no occupational therapy, and 61.7%, no speech therapy. Discharge destination was significantly related to cumulative therapy; the percentage of patients discharged to an inpatient rehabilitation facility varied across sites, from 0% to 71%. Most demographic factors did not predict therapy dose, although Hispanic patients received a lower cumulative amount of physical therapy and occupational therapy. Acutely, the severity of clinical factors (grip strength and National Institutes of Health Stroke Scale score, as well as National Institutes of Health Stroke Scale subscores for aphasia and neglect) predicted higher subsequent therapy doses. Measures of impairment and function (Fugl-Meyer, modified Rankin Scale, and Stroke Impact Scale Activities of Daily Living) assessed 3 months after stroke also predicted subsequent cumulative therapy doses. CONCLUSIONS Rehabilitative therapy doses during the first year poststroke are low in the United States. This is the first US-wide study to demonstrate that behavioral deficits predict therapy dose, with patients having more severe deficits receiving higher doses. Findings suggest directions for identifying groups at risk of receiving disproportionately low rehabilitation doses.
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Affiliation(s)
- Brittany M. Young
- Department of Neurology, University of California, Los Angeles; and California Rehabilitation Institute
| | - E. Alison Holman
- Sue and Bill Gross School of Nursing, University of California, Irvine
| | - Steven C. Cramer
- Department of Neurology, University of California, Los Angeles; and California Rehabilitation Institute
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Shrubsole K, Power E, Hallé MC. Communication partner training with familiar partners of people with aphasia: A systematic review and synthesis of barriers and facilitators to implementation. Int J Lang Commun Disord 2023; 58:601-628. [PMID: 36417196 DOI: 10.1111/1460-6984.12805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Factors influencing the implementation of communication partner training (CPT) with familiar partners of people with aphasia (PWA) have previously been documented using disparate approaches. To date there has been no synthesis of these factors using a common theoretical framework. Investigating CPT implementation factors using a common theoretical framework may further our understanding of universal barriers and guide future development of tailored, theoretically informed implementation strategies. AIMS (1) To determine the perceived and/or observed barriers and facilitators to implementing CPT with familiar partners of adults with aphasia; (2) to map extracted barriers and facilitators to a common theoretical framework; (3) to synthesize extracted barriers and facilitators; and (4) to identify potential implementation strategies to address the most frequently identified barriers and facilitators. METHODS & PROCEDURES A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four electronic databases (MEDLINE, EMBASE, CINAHL, Web of Science) were systematically searched in April 2021. Empirical qualitative and/or quantitative research studies reporting barriers/facilitators to speech-language therapists (SLTs) implementing CPT with familiar partners of adults with aphasia were included. The search was limited to English or French articles with no date limit applied. Methodological quality of included studies was assessed using the Mixed-Methods Appraisal Tool (MMAT). A framework and content analysis was then conducted to extract and synthesize the implementation factors in alignment with the Theoretical Domains Framework (TDF), followed by a theoretically informed mapping exercise to identify potential implementation strategies. RESULTS & MAIN CONTRIBUTION The database searches yielded 2115 studies. Following screening, 17 studies were included in the review. Overall, the included studies had good methodological quality. Extracted implementation factors were classified as barriers, facilitators or mixed (i.e., both) and aligned with 13 of the 14 TDF domains, plus two additional domains: 'carer perspectives on the CPT intervention' and 'patient/carer characteristics'. Synthesized data revealed eight key theoretical domains: Environmental context and resources; Social influences; Beliefs about consequences; Skills; Memory, attention and decision-making; Knowledge; Beliefs about capabilities; and Reinforcement. Within each domain, the research team identified common categories and developed illustrative examples of theoretically informed implementation strategies. CONCLUSIONS & IMPLICATIONS This systematic review and theory-informed synthesis of previously reported CPT implementation factors enabled the identification of key barriers to SLTs delivering this best practice. This led to proposed implementation strategies that should be validated, refined and evaluated in future research involving stakeholders who have contextual understanding of implementing CPT. WHAT THIS PAPER ADDS What is already known on the subject CPT of familiar partners of PWA is an effective intervention that is inconsistently used in clinical settings. Factors influencing CPT implementation have previously been identified, but using disparate approaches and frameworks. A synthesis of these factors articulated around a common framework is currently not available. What this paper adds to existing knowledge This paper provides a theory-informed synthesis of previously reported barriers and facilitators to SLTs implementing CPT with familiar partners of PWA. It highlights key factors influencing the uptake of this best practice and includes suggestion of implementation strategies to address them. What are the potential or actual clinical implications of this work? The key influencing factors and proposed implementation strategies reported in this paper may support stakeholders in the future design of tailored and theoretically informed implementation strategies aiming to improve the delivery of familiar CPT in their setting.
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Affiliation(s)
- Kirstine Shrubsole
- The Queensland Aphasia Research Centre, Brisbane, QLD, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
- Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia
- Centre for Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Victoria, Australia
| | - Emma Power
- Centre for Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Victoria, Australia
- Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Marie-Christine Hallé
- Speech and Language Pathology Department, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada
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Salem AC, Gale R, Casilio M, Fleegle M, Fergadiotis G, Bedrick S. Refining Semantic Similarity of Par aphasias Using a Contextual Language Model. J Speech Lang Hear Res 2023; 66:206-220. [PMID: 36492294 PMCID: PMC10023190 DOI: 10.1044/2022_jslhr-22-00277] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 08/19/2022] [Accepted: 09/15/2022] [Indexed: 05/24/2023]
Abstract
PURPOSE ParAlg (Paraphasia Algorithms) is a software that automatically categorizes a person with aphasia's naming error (paraphasia) in relation to its intended target on a picture-naming test. These classifications (based on lexicality as well as semantic, phonological, and morphological similarity to the target) are important for characterizing an individual's word-finding deficits or anomia. In this study, we applied a modern language model called BERT (Bidirectional Encoder Representations from Transformers) as a semantic classifier and evaluated its performance against ParAlg's original word2vec model. METHOD We used a set of 11,999 paraphasias produced during the Philadelphia Naming Test. We trained ParAlg with word2vec or BERT and compared their performance to humans. Finally, we evaluated BERT's performance in terms of word-sense selection and conducted an item-level discrepancy analysis to identify which aspects of semantic similarity are most challenging to classify. RESULTS Compared with word2vec, BERT qualitatively reduced word-sense issues and quantitatively reduced semantic classification errors by almost half. A large percentage of errors were attributable to semantic ambiguity. Of the possible semantic similarity subtypes, responses that were associated with or category coordinates of the intended target were most likely to be misclassified by both models and humans alike. CONCLUSIONS BERT outperforms word2vec as a semantic classifier, partially due to its superior handling of polysemy. This work is an important step for further establishing ParAlg as an accurate assessment tool.
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Affiliation(s)
| | - Robert Gale
- Oregon Health & Science University, Portland
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Baumard J. Is Shadowing Behavior Caused by Body Representation Disorders and Apraxia? J Alzheimers Dis 2023; 94:1331-1333. [PMID: 37545244 DOI: 10.3233/jad-230731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Shadowing is a person-following behavior, commonly observed in dementia (e.g., Alzheimer's disease). It may be caused by neuropsychological impairments associated with posterior brain lesions, as Kudo et al. described it in a patient with posterior cortical atrophy and no frontal signs. These authors have suggested that shadowing may arise from the combination of visuospatial impairments, aphasia, apraxia, and prosopagnosia. However, how these symptoms may contribute to shadowing remains unclear. It is suggested that the combination of visuospatial impairments, body representation disorders, and apraxia, may result in complete loss of spatial representations and hence, shadowing behavior.
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Tetzloff KA, Duffy JR, Clark HM, Pham NTT, Machulda MM, Botha H, Jack CR, Dickson DW, Lowe VJ, Josephs KA, Whitwell JL, Utianski RL. Amyloid and Tau PET Positivity in Progressive Agrammatic Aphasia and Apraxia of Speech. J Alzheimers Dis 2023; 96:1759-1765. [PMID: 38007664 PMCID: PMC10804396 DOI: 10.3233/jad-230912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
BACKGROUND The agrammatic variant of primary progressive aphasia (PAA), primary progressive apraxia of speech (PPAOS), or a combination of both (AOS-PAA) are neurodegenerative disorders characterized by speech-language impairments and together compose the AOS-PAA spectrum disorders. These patients typically have an underlying 4-repeat tauopathy, although they sometimes show evidence of amyloid-β and tau deposition on PET, suggesting Alzheimer's disease (AD). Given the growing number of pharmacologic treatment options for AD, it is important to better understand the incidence of AD pathology in these patients. OBJECTIVE This study aimed to evaluate the frequency of amyloid-β and tau positivity in AOS-PAA spectrum disorders. Sixty-five patients with AOS-PAA underwent a clinical speech-language battery and PiB PET and flortaucipir PET imaging. METHODS Global PiB PET standardized uptake value ratios (SUVRs) and flortaucipir PET SUVRs from the temporal meta region of interest were compared between patient groups. For 19 patients who had died and undergone autopsy, their PET and pathology findings were also compared. RESULTS The results showed that although roughly half of the patients are positive for at least one biomarker, their clinical symptoms and biomarker status were not related, suggesting that AD is not the primary cause of their neurodegeneration. All but one patient in the autopsy subset had a Braak stage of IV or less, despite four being positive on tau PET imaging. CONCLUSIONS Inclusion criteria for clinical trials should specify clinical presentation or adjust the evaluation of such treatments to be specific to disease diagnosis beyond the presence of certain imaging biomarkers.
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Singh NA, Graff-Radford J, Machulda MM, Thu NT, Schwarz CG, Reid RI, Lowe VJ, Petersen RC, Jack CR, Josephs KA, Whitwell JL. Diffusivity Changes in Posterior Cortical Atrophy and Logopenic Progressive Aphasia: A Longitudinal Diffusion Tensor Imaging Study. J Alzheimers Dis 2023; 94:709-725. [PMID: 37302032 PMCID: PMC10785680 DOI: 10.3233/jad-221217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Posterior cortical atrophy (PCA) and logopenic progressive aphasia (LPA) are associated with characteristic patterns of structural network degeneration. Little is known about longitudinal patterns of white matter tract degeneration in these phenotypes. OBJECTIVE To assess longitudinal patterns of white matter degeneration and identify phenotype specific cross-sectional and longitudinal diffusion tensor imaging (DTI) biomarkers in PCA and LPA. METHODS Twenty-five PCA, 22 LPA and 25 cognitively unimpaired (CU) individuals were recruited and underwent structural MRI that included a DTI sequence with a follow-up one year later. Cross-sectional and longitudinal mixed effects models were fit to assess the effects of diagnosis on baseline and annualized change in regional DTI metrics. Discriminatory power was investigated using the area under the receiver operating characteristic curves (AUROC). RESULTS PCA and LPA showed overlapping white matter degeneration profiles predominantly in the left occipital and temporal lobes, the posterior thalamic radiation and sagittal stratum at baseline, as well as the parietal lobe longitudinally. PCA showed degeneration in the occipital and parietal white matter, cross-sectionally and longitudinally, compared to CU, while LPA showed greater degeneration in the temporal and inferior parietal white matter and the inferior fronto-occipital fasciculus cross-sectionally, and in parietal white matter longitudinally compared to CU. Cross-sectionally, integrity of the inferior occipital white matter was best able to differentiate PCA from LPA, with an AUROC of 0.82. CONCLUSION These findings contribute to our understanding of white matter degeneration and support usage of DTI as a useful additional diagnostic biomarker for PCA and LPA.
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Affiliation(s)
| | | | - Mary M. Machulda
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Nha Trang Thu
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Robert I. Reid
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | - Val J. Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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Pregla D, Vasishth S, Lissón P, Stadie N, Burchert F. Can the resource reduction hypothesis explain sentence processing in aphasia? A visual world study in German. Brain Lang 2022; 235:105204. [PMID: 36435153 DOI: 10.1016/j.bandl.2022.105204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 10/21/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
Resource limitation has often been invoked as a key driver of sentence comprehension difficulty, in both theories of language-unimpaired and language-impaired populations. In the field of aphasia, one such influential theory is Caplan's resource reduction hypothesis (RRH). In this large investigation of online processing in aphasia in German, we evaluated three key predictions of the RRH in 21 individuals with aphasia and 22 control pparticipants. Measures of online processing were obtained by combining a sentence-picture matching task with the visual world paradigm. Four sentence types were used to investigate the generality of the findings, and two test phases were used to investigate RRH's predictions regarding variability in aphasia. The processing patterns were consistent with two of the three predictions of the RRH. Overall, our investigation shows that the RRH can account for important aspects of sentence processing in aphasia.
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