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Greenslade KJ, Bogart E, Gyory J, Jaskolka S, Ramage AE. Story Grammar Analyses Capture Discourse Improvement in the First 2 Years Following a Severe Traumatic Brain Injury. Am J Speech Lang Pathol 2024; 33:1004-1020. [PMID: 38354104 PMCID: PMC11001193 DOI: 10.1044/2023_ajslp-23-00269] [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: 07/21/2023] [Revised: 11/03/2023] [Accepted: 12/19/2023] [Indexed: 02/16/2024]
Abstract
PURPOSE Narration within a story grammar framework requires speakers to organize characters and events logically. Despite abundant research characterizing narrative deficits following a traumatic brain injury (TBI), the evolution of narrative story grammar over the first 2 years post-TBI has rarely been explored. This study analyzed story grammar in complex narratives of adults with and without severe TBI to (a) examine between-group differences and (b) investigate longitudinal changes over the first 2 years post-TBI. METHOD Story grammar analyses of Cinderella narratives from 57 participants with TBI and 57 participants with no brain injury yielded measures of productivity (total number of episodes, total number of story grammar elements), elaboration (total number of elaborated-complete episodes, mean number of episodic elements per episode), and completeness (total number of incomplete episodes). Mann-Whitney U tests compared measures across groups; generalized estimating equation (GEE) models identified predictors of change, including recovery time (3, 6, 9, 12, and 24 months post-TBI) and demographic/injury-related characteristics. RESULTS Between-group differences were statistically significant for all productivity and elaboration measures at 3, 6, and 9 months post-TBI; one productivity measure and one elaboration measure at 12 months; and none of the measures at 24 months. GEE models showed significant improvements in all productivity and elaboration measures over the first 24 months post-TBI, with educational attainment and duration of posttraumatic amnesia affecting recovery. Incomplete episodes only showed between-group differences at 12 months and did not capture recovery. CONCLUSION Productivity and elaboration are key story grammar variables that (a) differentiate complex narration in individuals with and without severe TBI and (b) capture narrative improvements over the first 2 years post-TBI. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25148999.
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Affiliation(s)
- Kathryn J. Greenslade
- Department of Communication Sciences and Disorders, University of New Hampshire, Durham
| | - Elise Bogart
- Discipline of Speech Pathology, Sydney School of Health Sciences, The University of Sydney, New South Wales, Australia
| | - Joanna Gyory
- Health Management and Policy, University of New Hampshire, Durham
| | - Serena Jaskolka
- Department of Communication Sciences and Disorders, University of New Hampshire, Durham
| | - Amy E. Ramage
- Department of Communication Sciences and Disorders, University of New Hampshire, Durham
- Interdisciplinary Program in Neuroscience and Behavior, University of New Hampshire, Durham
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Vlasova RM, Panikratova YR, Pechenkova EV. Systematic Review and Meta-analysis of Language Symptoms due to Cerebellar Injury. Cerebellum 2023; 22:1274-1286. [PMID: 36205825 DOI: 10.1007/s12311-022-01482-5] [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] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
To date, cerebellar contribution to language is well established via clinical and neuroimaging studies. However, the particular functional role of the cerebellum in language remains to be clarified. In this study, we present the first systematic review of the diverse language symptoms in spoken language after cerebellar lesion that were reported in case studies for the last 30 years (18 clinical cases from 13 papers), and meta-analysis using cluster analysis with bootstrap and symptom co-occurrence analysis. Seven clusters of patients with similar language symptoms after cerebellar lesions were found. Co-occurrence analysis revealed pairs of symptoms that tend to be comorbid. Our results imply that the "linguistic cerebellum" has a multiform contribution to language function. The most possible mechanism of such contribution is the cerebellar reciprocal connectivity with supratentorial brain regions, where the cerebellar level of the language network has a general modulation function and the supratentorial level is more functionally specified. Based on cerebellar connectivity with supratentorial components of the language network, the "linguistic cerebellum" might be further functionally segregated.
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Affiliation(s)
- Roza M Vlasova
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA.
| | - Yana R Panikratova
- Laboratory of Neuroimaging and Multimodal Analysis, Mental Health Research Center, Moscow, Russia
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Maltman N, Willer R, Sterling A. An Exploratory Study of Pragmatic Language Use Across Contexts With the Pragmatic Rating Scale-School Age Among Autistic Boys and Boys With Fragile X Syndrome Plus Autism. J Speech Lang Hear Res 2023; 66:4547-4557. [PMID: 37844621 PMCID: PMC10721239 DOI: 10.1044/2023_jslhr-23-00024] [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: 01/11/2023] [Revised: 07/21/2023] [Accepted: 08/24/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE Autistic boys and boys with co-occurring fragile X syndrome and autism spectrum disorder (FXS + ASD) demonstrate similar pragmatic language difficulties. The Pragmatic Rating Scale-School Age (PRS-SA) captures ecologically valid metrics of pragmatic language impairments in these populations. It is traditionally scored based on the Autism Diagnostic Observation Schedule (ADOS), which may limit the use of the PRS-SA more broadly in research and clinical contexts. METHOD This study evaluated the feasibility of the PRS-SA based on a shorter, semistructured conversational context compared to the ADOS in school-age autistic boys (n = 16) and boys with FXS + ASD (n = 16), matched on ASD traits. Differences across ADOS and conversational contexts and associations with ASD-related social difficulties were evaluated. RESULTS Findings revealed differences in PRS-SA scores between ADOS and conversational contexts, but only for the FXS + ASD group. Limited associations were observed between PRS-SA scores and ASD traits. CONCLUSIONS Results from this study indicate the feasibility of using the PRS-SA in a shorter conversational context than the ADOS to assess pragmatic language among autistic boys. For boys with FXS + ASD, contextual differences warrant careful consideration in future work.
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Affiliation(s)
| | - Rebecca Willer
- Department of Communication Sciences and Disorders, University of Wisconsin–Madison
| | - Audra Sterling
- Waisman Center, University of Wisconsin–Madison
- Department of Communication Sciences and Disorders, University of Wisconsin–Madison
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Sakallah A, King K. B - 19 The Role of Neuropsychology in Characterizing an Unidentified Neurodegenerative Disorder: an Adolescent Case Study. Arch Clin Neuropsychol 2023; 38:1383. [PMID: 37807398 DOI: 10.1093/arclin/acad067.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVE 13-year, 9-month-old biracial female with no prior medical history presented with a new onset neurodegenerative disorder following a bullying incident. This case highlights the role of neuropsychology in the characterization of neurodegenerative disorders in a pediatric population. METHOD Patient presented with 4-week history of progressive ataxia, nystagmus, and poor memory. Concern for anoxic brain injury from the bullying led to an MRI showing T2 hyperintensity in the bilateral cerebellar peduncles, pons, and midbrain with a "hot cross bun" sign. A deletion in the EPRS gene was found, known to cause hypomyelinating leukodystrophy 15; however, this mutation was not thought to explain her condition. She was diagnosed with a neurodegenerative disorder, type unknown, and severe expressive language disorder. RESULTS Educational evaluation (age 8) showed low average to average cognitive functioning. Current testing showed intact effort with impaired cognitive functioning and bilateral speeded fine motor dexterity. Expressive and receptive language skills were below average to impaired; speech was slowed and dysarthric. Verbal memory was impaired, but visual memory and executive functioning testing were intact. Parent ratings indicated below average to impaired adaptive functioning. Patient received therapy for the bullying trauma and exhibited no trauma symptoms at this evaluation. CONCLUSIONS Despite the unclear diagnosis, this patient experienced a significant decline in motor and speech/expressive language skills due to an unidentified neurodegenerative disorder. Neuropsychological evaluation also confirmed impacts on intelligence and receptive language and ruled out trauma and psychiatric contributions. This case highlights the role of neuropsychology in multidisciplinary work-up of an unidentified neurodegenerative condition.
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Zhao Y, Cox CR, Lambon Ralph MA, Halai AD. Using in vivo functional and structural connectivity to predict chronic stroke aphasia deficits. Brain 2023; 146:1950-1962. [PMID: 36346107 PMCID: PMC10151190 DOI: 10.1093/brain/awac388] [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: 12/21/2022] [Revised: 09/11/2022] [Accepted: 09/20/2022] [Indexed: 11/10/2022] Open
Abstract
Focal brain damage caused by stroke can result in aphasia and advances in cognitive neuroscience suggest that impairment may be associated with network-level disorder rather than just circumscribed cortical damage. Several studies have shown meaningful relationships between brain-behaviour using lesions; however, only a handful of studies have incorporated in vivo structural and functional connectivity. Patients with chronic post-stroke aphasia were assessed with structural (n = 68) and functional (n = 39) MRI to assess whether predicting performance can be improved with multiple modalities and if additional variance can be explained compared to lesion models alone. These neural measurements were used to construct models to predict four key language-cognitive factors: (i) phonology; (ii) semantics; (iii) executive function; and (iv) fluency. Our results showed that each factor (except executive ability) could be significantly related to each neural measurement alone; however, structural and functional connectivity models did not explain additional variance above the lesion models. We did find evidence that the structural and functional predictors may be linked to the core lesion sites. First, the predictive functional connectivity features were found to be located within functional resting-state networks identified in healthy controls, suggesting that the result might reflect functionally specific reorganization (damage to a node within a network can result in disruption to the entire network). Second, predictive structural connectivity features were located within core lesion sites, suggesting that multimodal information may be redundant in prediction modelling. In addition, we observed that the optimum sparsity within the regularized regression models differed for each behavioural component and across different imaging features, suggesting that future studies should consider optimizing hyperparameters related to sparsity per target. Together, the results indicate that the observed network-level disruption was predicted by the lesion alone and does not significantly improve model performance in predicting the profile of language impairment.
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Affiliation(s)
- Ying Zhao
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Christopher R Cox
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | | | - Ajay D Halai
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
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Biddau F, Brisotto C, Innocenti T, Ranaldi S, Meneghello F, D'Imperio D, Nordio S. Speech and Language Therapy for Acquired Central Dysgraphia in Neurological Patients: A Systematic Review to Describe and Identify Trainings for Clinical Practice. Am J Speech Lang Pathol 2023; 32:762-785. [PMID: 36857041 DOI: 10.1044/2022_ajslp-22-00042] [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: 06/18/2023]
Abstract
PURPOSE Acquired central dysgraphia is a heterogeneous neurological disorder that usually co-occurs with other language disorders. Written language training is relevant to improve everyday skills and as a compensatory strategy to support limited oral communication. A systematic evaluation of existing writing treatments is thus needed. METHOD We performed a systematic review of speech and language therapies for acquired dysgraphia in studies of neurological diseases (PROSPERO: CRD42018084221), following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist with a search on several databases for articles written in English and published until August 31, 2021. Only methodological well-designed studies were included. Further assessment of methodological quality was conducted by means of a modified version of the Downs and Black checklist. RESULTS Eleven studies of 43 patients in total were included. For each study, we collected data on type of population, type of impairment, experimental design, type of treatment, and measured outcomes. The studies had a medium level of assessed methodological quality. An informative description of treatments and linkages to deficits is reported. CONCLUSIONS Although there is a need for further experimental evidence, most treatments showed good applicability and improvement of written skills in patients with dysgraphia. Lexical treatments appear to be more frequently adopted and more flexible in improving dysgraphia and communication, especially when a multimodal approach is used. Finally, the reported description of treatment modalities for dysgraphia in relation to patients' deficits may be important for providing tailored therapies in clinical management.
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Affiliation(s)
| | | | - Tiziano Innocenti
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, the Netherlands
- GIMBE Foundation, Bologna, Italy
| | - Sara Ranaldi
- UOIAF (Unità Operativa Infanzia Adolescenza Famiglia), Ulss 3 Serenissima, Venice, Italy
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Stockert A, Hormig-Rauber S, Wawrzyniak M, Klingbeil J, Schneider HR, Pirlich M, Schob S, Hoffmann KT, Saur D. Involvement of Thalamocortical Networks in Patients With Poststroke Thalamic Aphasia. Neurology 2023; 100:e485-e496. [PMID: 36302664 PMCID: PMC9931083 DOI: 10.1212/wnl.0000000000201488] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 09/14/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Theories assume that thalamic stroke may cause aphasia because of dysfunction in connected cortical networks. This takes into account that brain functions are organized in distributed networks, and in turn, localized damage may result in a network disorder such as thalamic aphasia. With this study, we investigate whether the integration of the thalamus into specific thalamocortical networks underlies symptoms after thalamic stroke. We hypothesize that thalamic lesions in patients with language impairments are functionally connected to cortical networks for language and cognition. METHODS We combined nonparametric lesion mapping methods in a retrospective cohort of patients with acute or subacute first-ever thalamic stroke. A relationship between lesion location and language impairments was assessed using nonparametric voxel-based lesion-symptom mapping. This method reveals regions more frequently damaged in patients with compared with those without a symptom of interest. To test whether these symptoms are linked to a common thalamocortical network, we additionally performed lesion-network-symptom mapping. This method uses normative connectome data from resting-state fMRI of healthy participants (n = 65) for functional connectivity analyses, with lesion sites serving as seeds. Resulting lesion-dependent network connectivity of patients with language impairments was compared with those with motor and sensory deficits as baseline. RESULTS A total of 101 patients (mean [SD] age 64.1 [14.6] years, 57 left, 42 right, and 2 bilateral lesions) were included in the study. Voxel-based lesion-symptom mapping showed an association of language impairments with damage to left mediodorsal thalamic nucleus lesions. Lesion-network-symptom mapping revealed that language compared with sensory deficits were associated with higher normative lesion-dependent network connectivity to left frontotemporal language networks and bilateral prefrontal, insulo-opercular, midline cingular, and parietal domain-general networks. Lesions related to motor and sensory deficits showed higher lesion-dependent network connectivity within the sensorimotor network spanning prefrontal, precentral, and postcentral cortices. DISCUSSION Thalamic aphasia relates to lesions in the left mediodorsal thalamic nucleus and to functionally connected left cortical language and bilateral cortical networks for cognitive control. This suggests that dysfunction in thalamocortical networks contributes to thalamic aphasia. We propose that inefficient integration between otherwise undamaged domain-general and language networks may cause thalamic aphasia.
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Affiliation(s)
- Anika Stockert
- From the Language and Aphasia Laboratory (A.S., S.H.-R., M.W., J.K., H.R.S., M.P., D.S.), Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany; Department of Neuroradiology (S.S.), Clinic and Policlinic of Radiology, University Hospital Halle, Halle (Saale), Germany; and Department of Neuroradiology (K.-T.H.), University of Leipzig Medical Center, Leipzig, Germany.
| | - Sophia Hormig-Rauber
- From the Language and Aphasia Laboratory (A.S., S.H.-R., M.W., J.K., H.R.S., M.P., D.S.), Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany; Department of Neuroradiology (S.S.), Clinic and Policlinic of Radiology, University Hospital Halle, Halle (Saale), Germany; and Department of Neuroradiology (K.-T.H.), University of Leipzig Medical Center, Leipzig, Germany
| | - Max Wawrzyniak
- From the Language and Aphasia Laboratory (A.S., S.H.-R., M.W., J.K., H.R.S., M.P., D.S.), Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany; Department of Neuroradiology (S.S.), Clinic and Policlinic of Radiology, University Hospital Halle, Halle (Saale), Germany; and Department of Neuroradiology (K.-T.H.), University of Leipzig Medical Center, Leipzig, Germany
| | - Julian Klingbeil
- From the Language and Aphasia Laboratory (A.S., S.H.-R., M.W., J.K., H.R.S., M.P., D.S.), Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany; Department of Neuroradiology (S.S.), Clinic and Policlinic of Radiology, University Hospital Halle, Halle (Saale), Germany; and Department of Neuroradiology (K.-T.H.), University of Leipzig Medical Center, Leipzig, Germany
| | - Hans Ralf Schneider
- From the Language and Aphasia Laboratory (A.S., S.H.-R., M.W., J.K., H.R.S., M.P., D.S.), Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany; Department of Neuroradiology (S.S.), Clinic and Policlinic of Radiology, University Hospital Halle, Halle (Saale), Germany; and Department of Neuroradiology (K.-T.H.), University of Leipzig Medical Center, Leipzig, Germany
| | - Mandy Pirlich
- From the Language and Aphasia Laboratory (A.S., S.H.-R., M.W., J.K., H.R.S., M.P., D.S.), Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany; Department of Neuroradiology (S.S.), Clinic and Policlinic of Radiology, University Hospital Halle, Halle (Saale), Germany; and Department of Neuroradiology (K.-T.H.), University of Leipzig Medical Center, Leipzig, Germany
| | - Stefan Schob
- From the Language and Aphasia Laboratory (A.S., S.H.-R., M.W., J.K., H.R.S., M.P., D.S.), Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany; Department of Neuroradiology (S.S.), Clinic and Policlinic of Radiology, University Hospital Halle, Halle (Saale), Germany; and Department of Neuroradiology (K.-T.H.), University of Leipzig Medical Center, Leipzig, Germany
| | - Karl-Titus Hoffmann
- From the Language and Aphasia Laboratory (A.S., S.H.-R., M.W., J.K., H.R.S., M.P., D.S.), Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany; Department of Neuroradiology (S.S.), Clinic and Policlinic of Radiology, University Hospital Halle, Halle (Saale), Germany; and Department of Neuroradiology (K.-T.H.), University of Leipzig Medical Center, Leipzig, Germany
| | - Dorothee Saur
- From the Language and Aphasia Laboratory (A.S., S.H.-R., M.W., J.K., H.R.S., M.P., D.S.), Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany; Department of Neuroradiology (S.S.), Clinic and Policlinic of Radiology, University Hospital Halle, Halle (Saale), Germany; and Department of Neuroradiology (K.-T.H.), University of Leipzig Medical Center, Leipzig, Germany
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Zyryanov A, Stupina E, Gordeyeva E, Buivolova O, Novozhilova E, Akinina Y, Bronov O, Gronskaya N, Gunenko G, Iskra E, Ivanova E, Kalinovskiy A, Kliuev E, Kopachev D, Kremneva E, Kryuchkova O, Medyanik I, Pedyash N, Pozdniakova V, Pronin I, Rainich K, Reutov A, Samoukina A, Shlyakhova A, Sitnikov A, Soloukhina O, Yashin K, Zelenkova V, Zuev A, Ivanova MV, Dragoy O. 'Moderate global aphasia': A generalized decline of language processing caused by glioma surgery but not stroke. Brain Lang 2022; 224:105057. [PMID: 34883333 PMCID: PMC8743859 DOI: 10.1016/j.bandl.2021.105057] [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: 05/01/2021] [Revised: 10/15/2021] [Accepted: 11/24/2021] [Indexed: 06/13/2023]
Abstract
Unlike stroke, neurosurgical removal of left-hemisphere gliomas acts upon a reorganized language network and involves brain areas rarely damaged by stroke. We addressed whether this causes the profiles of neurosurgery- and stroke-induced language impairments to be distinct. K-means clustering of language assessment data (neurosurgery cohort: N = 88, stroke cohort: N = 95) identified similar profiles in both cohorts. But critically, a cluster of individuals with specific phonological deficits was only evident in the stroke but not in the neurosurgery cohort. Thus, phonological deficits are less clearly distinguished from other language deficits after glioma surgery compared to stroke. Furthermore, the correlations between language production and comprehension scores at different linguistic levels were more extensive in the neurosurgery than in the stroke cohort. Our findings suggest that neurosurgery-induced language impairments do not correspond to those caused by stroke, but rather manifest as a 'moderate global aphasia' - a generalized decline of language processing abilities.
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Affiliation(s)
- Andrey Zyryanov
- Center for Language and Brain, HSE University, 3 Krivokolenny Pereulok, Moscow 101000, Russia.
| | - Ekaterina Stupina
- Center for Language and Brain, HSE University, 3 Krivokolenny Pereulok, Moscow 101000, Russia
| | - Elizaveta Gordeyeva
- Center for Language and Brain, HSE University, 3 Krivokolenny Pereulok, Moscow 101000, Russia
| | - Olga Buivolova
- Center for Language and Brain, HSE University, 3 Krivokolenny Pereulok, Moscow 101000, Russia; Federal Center for Brain and Neurotechnologies, 1 Building 10 Ostrovityanova Ulitsa, Moscow 117997, Russia
| | - Evdokiia Novozhilova
- Center for Language and Brain, HSE University, 3 Krivokolenny Pereulok, Moscow 101000, Russia
| | - Yulia Akinina
- Center for Language and Brain, HSE University, 3 Krivokolenny Pereulok, Moscow 101000, Russia
| | - Oleg Bronov
- Department of Radiology, National Medical and Surgical Center Named after N.I. Pirogov, 70 Nizhnyaya Pervomayskaya Ulitsa, Moscow 105203, Russia
| | - Natalia Gronskaya
- Center for Language and Brain, HSE University, 25/12 Bolshaya Pecherskaya Ulitsa, Nizhny Novgorod 603155, Russia
| | - Galina Gunenko
- Department of Neurooncology, Federal Center of Neurosurgery Novosibirsk, 132/1 Nemirovicha-Danchenko Ulitsa, Novosibirsk 630048, Russia
| | - Ekaterina Iskra
- Center for Language and Brain, HSE University, 3 Krivokolenny Pereulok, Moscow 101000, Russia; Center for Speech Pathology and Neurorehabilitation, 20/1 Nikoloyamskaya Ulitsa, Moscow 109240, Russia
| | - Elena Ivanova
- Federal Center for Brain and Neurotechnologies, 1 Building 10 Ostrovityanova Ulitsa, Moscow 117997, Russia; Pirogov Russian National Research Medical University, 1 Ostrovityanova Ulitsa, Moscow 117198, Russia
| | - Anton Kalinovskiy
- Department of Neurooncology, Federal Center of Neurosurgery Novosibirsk, 132/1 Nemirovicha-Danchenko Ulitsa, Novosibirsk 630048, Russia
| | - Evgenii Kliuev
- Department of Radiology, Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod 603005, Russia
| | - Dmitry Kopachev
- Research Center of Neurology, 80 Volokolamskoye Shosse, Moscow 125367, Russia
| | - Elena Kremneva
- Research Center of Neurology, 80 Volokolamskoye Shosse, Moscow 125367, Russia
| | - Oksana Kryuchkova
- Department of Radiology, Central Clinical Hospital with Outpatient Health Center of the Business Administration for the President of the Russian Federation, 15 Marshala Timoshenko Ulitsa, Moscow 121359, Russia
| | - Igor Medyanik
- Department of Neurosurgery, Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod 603005, Russia
| | - Nikita Pedyash
- Department of Neurosurgery, National Medical and Surgical Center named after N.I. Pirogov, 70 Nizhnyaya Pervomayskaya Ulitsa, Moscow 105203, Russia
| | - Viktoria Pozdniakova
- Center for Language and Brain, HSE University, 3 Krivokolenny Pereulok, Moscow 101000, Russia
| | - Igor Pronin
- Department of Neuroradiology, National Medical Research Center for Neurosurgery named after N. N. Burdenko, 16 4-ya Tverskaya-Yamskaya Ulitsa, Moscow 125047, Russia
| | - Kristina Rainich
- Center for Language and Brain, HSE University, 3 Krivokolenny Pereulok, Moscow 101000, Russia
| | - Andrey Reutov
- Department of Neurosurgery, Central Clinical Hospital with Outpatient Health Center of the Business Administration for the President of the Russian Federation, 15 Marshala Timoshenko Ulitsa, Moscow 121359, Russia
| | - Anastasia Samoukina
- Center for Language and Brain, HSE University, 3 Krivokolenny Pereulok, Moscow 101000, Russia
| | - Anastasia Shlyakhova
- Center for Language and Brain, HSE University, 3 Krivokolenny Pereulok, Moscow 101000, Russia
| | - Andrey Sitnikov
- Department of Neurosurgery, Federal Centre of Treatment and Rehabilitation of the Ministry of Healthcare of the Russian Federation, 3 Ivan'kovskoye Shosse, Moscow 125367, Russia
| | - Olga Soloukhina
- Center for Language and Brain, HSE University, 3 Krivokolenny Pereulok, Moscow 101000, Russia
| | - Konstantin Yashin
- Department of Neurosurgery, Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod 603005, Russia
| | - Valeriya Zelenkova
- Center for Language and Brain, HSE University, 3 Krivokolenny Pereulok, Moscow 101000, Russia
| | - Andrey Zuev
- Department of Neurosurgery, National Medical and Surgical Center named after N.I. Pirogov, 70 Nizhnyaya Pervomayskaya Ulitsa, Moscow 105203, Russia
| | - Maria V Ivanova
- Aphasia Recovery Lab, Department of Psychology, University of California, Berkley, 210 Barker Hall, CA 94720, USA
| | - Olga Dragoy
- Center for Language and Brain, HSE University, 3 Krivokolenny Pereulok, Moscow 101000, Russia; Institute of Linguistics, Russian Academy of Sciences, 1 bld. 1 Bolshoy Kislovsky lane, Moscow 125009, Russia
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Gipson TT, Ramsay G, Ellison EE, Bene ER, Long HL, Oller DK. Early Vocal Development in Tuberous Sclerosis Complex. Pediatr Neurol 2021; 125:48-52. [PMID: 34628143 DOI: 10.1101/2021.01.06.21249364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 12/22/2020] [Revised: 08/24/2021] [Accepted: 08/29/2021] [Indexed: 05/27/2023]
Abstract
BACKGROUND Our goal was to assess for the first time early vocalizations as precursors to speech in audio-video recordings of infants with tuberous sclerosis complex (TSC). METHODS We randomly selected 40 infants with TSC from the TSC Autism Center of Excellence Research Network dataset. Using human observers, we analyzed 74 audio-video recordings within a flexible software-based coding environment. During the recordings, infants were engaged in developmental testing. We determined syllables per minute (volubility), the number of consonant-vowel combinations, such as 'ba' (canonical babbling), and the canonical babbling ratio (canonical syllables/total syllables) and compared the data with two groups of typically developing (TD) infants. One comparison group's data had come from a laboratory setting, while the other's had come from all-day Language Environment Analysis recordings at home. RESULTS Compared with TD infants in laboratory and all-day Language Environment Analysis recordings, entry into the canonical babbling stage was delayed in the majority of infants with TSC, and the canonical babbling ratio was low (TD mean = 0.346, SE = 0.19; TSC mean = 0.117, SE = 0.023). Volubility level in infants with TSC was less than half that of TD infants (TD mean = 9.82, SE = 5.78; TSC mean = 3.99, SE = 2.16). CONCLUSIONS Entry into the canonical stage and other precursors of speech development were delayed in infants with TSC and may signal poor language and developmental outcomes. Future studies are planned to assess prediction of language and developmental outcomes using these measures in a larger sample and in more precisely comparable recording circumstances.
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Affiliation(s)
- Tanjala T Gipson
- University of Tennessee Health Sciences Center, Boling Center for Disabilities, Le Bonheur Children's Hospital, Memphis, Tennessee.
| | - Gordon Ramsay
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia; Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Ellen E Ellison
- University of Tennessee Health Sciences Center, Boling Center for Disabilities, Le Bonheur Children's Hospital, Memphis, Tennessee
| | - Edina R Bene
- School of Communication Sciences and Disorders, University of Memphis, Memphis, Tennessee
| | - Helen L Long
- School of Communication Sciences and Disorders, University of Memphis, Memphis, Tennessee
| | - D Kimbrough Oller
- University of Memphis, School of Communication Sciences and Disorders, Institute for Intelligent Systems, Memphis, Tennessee; Konrad Lorenz Institute for Evolution and Cognition Research, Klosterneuburg, Austria
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10
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Williams E, McAuliffe M, Theys C. Language changes in Alzheimer's disease: A systematic review of verb processing. Brain Lang 2021; 223:105041. [PMID: 34688957 DOI: 10.1016/j.bandl.2021.105041] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 08/10/2020] [Revised: 09/30/2021] [Accepted: 10/09/2021] [Indexed: 06/13/2023]
Abstract
Alzheimer's disease (AD) results in language impairments and higher-level communication problems. Research into the language of people with AD (pwAD) has mainly focused on nouns; however, improved understanding of verb processing by pwAD could improve diagnostic assessments and communicative interventions. This systematic review synthesizes findings of AD's effects on verbs from single-word, sentence, and discourse tasks. Review of 57 studies revealed that pwAD were less accurate than controls on single-word tasks and less accurate with verbs than nouns on these tasks. They had difficulty comprehending sentences featuring multiple verbs or verbs with reversible thematic roles. Discourse production by pwAD was marked by vagueness, including declines in total output and propositional content and a preference for generic verbs and simple syntax. Few studies examining sentence production or discourse comprehension were found. Future research should address relationships between long-term memory and language preservation as well as verb use in discourse.
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Affiliation(s)
- Eric Williams
- School of Psychology, Speech, and Hearing, University of Canterbury, Christchurch, New Zealand.
| | - Megan McAuliffe
- School of Psychology, Speech, and Hearing, University of Canterbury, Christchurch, New Zealand; New Zealand Institute of Language, Brain and Behaviour, University of Canterbury, Christchurch, New Zealand.
| | - Catherine Theys
- School of Psychology, Speech, and Hearing, University of Canterbury, Christchurch, New Zealand; New Zealand Institute of Language, Brain and Behaviour, University of Canterbury, Christchurch, New Zealand.
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11
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Andrade CLO, Alves CDAD, Ramos HE. Congenital Hypothyroidism and the Deleterious Effects on Auditory Function and Language Skills: A Narrative Review. Front Endocrinol (Lausanne) 2021; 12:671784. [PMID: 34447350 PMCID: PMC8382885 DOI: 10.3389/fendo.2021.671784] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 07/01/2021] [Indexed: 12/03/2022] Open
Abstract
Congenital hypothyroidism (CH) is an endocrine disease commonly found in newborns and is related to the absence or reduction of thyroid hormones (THs), which are essential for development since intrauterine life. Children with CH can develop hearing problems as THs are crucial for the auditory pathway's development and maturation. Sensory deprivations, especially in hearing disorders at early ages of development, can impair language skills, literacy, and behavioral, cognitive, social, and psychosocial development. In this review we describe clinical and molecular aspects linking CH and hearing loss.
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Affiliation(s)
| | | | - Helton Estrela Ramos
- Post-Graduate Program in Medicine and Health, Medical School of Medicine, Federal University of Bahia, Salvador, Brazil
- Postgraduate Program in Interactive Processes of Organs and Systems, Health & Science Institute, Federal University of Bahia, Salvador, Brazil
- Bioregulation Department, Health and Science Institute, Federal University of Bahia, Salvador, Brazil
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12
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Salem AC, MacFarlane H, Adams JR, Lawley GO, Dolata JK, Bedrick S, Fombonne E. Evaluating atypical language in autism using automated language measures. Sci Rep 2021; 11:10968. [PMID: 34040042 PMCID: PMC8155086 DOI: 10.1038/s41598-021-90304-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/06/2021] [Indexed: 11/09/2022] Open
Abstract
Measurement of language atypicalities in Autism Spectrum Disorder (ASD) is cumbersome and costly. Better language outcome measures are needed. Using language transcripts, we generated Automated Language Measures (ALMs) and tested their validity. 169 participants (96 ASD, 28 TD, 45 ADHD) ages 7 to 17 were evaluated with the Autism Diagnostic Observation Schedule. Transcripts of one task were analyzed to generate seven ALMs: mean length of utterance in morphemes, number of different word roots (NDWR), um proportion, content maze proportion, unintelligible proportion, c-units per minute, and repetition proportion. With the exception of repetition proportion (p [Formula: see text]), nonparametric ANOVAs showed significant group differences (p[Formula: see text]). The TD and ADHD groups did not differ from each other in post-hoc analyses. With the exception of NDWR, the ASD group showed significantly (p[Formula: see text]) lower scores than both comparison groups. The ALMs were correlated with standardized clinical and language evaluations of ASD. In age- and IQ-adjusted logistic regression analyses, four ALMs significantly predicted ASD status with satisfactory accuracy (67.9-75.5%). When ALMs were combined together, accuracy improved to 82.4%. These ALMs offer a promising approach for generating novel outcome measures.
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Affiliation(s)
- Alexandra C Salem
- Department of Psychiatry, Oregon Health and Science University, Portland, 97239, USA.
| | - Heather MacFarlane
- Department of Psychiatry, Oregon Health and Science University, Portland, 97239, USA
| | - Joel R Adams
- Computer Science and Electrical Engineering, Oregon Health and Science University, Portland, 97239, USA
| | - Grace O Lawley
- Computer Science and Electrical Engineering, Oregon Health and Science University, Portland, 97239, USA
| | - Jill K Dolata
- Department of Pediatrics, Oregon Health and Science University, Portland, 97239, USA
| | - Steven Bedrick
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, 97239, USA
| | - Eric Fombonne
- Department of Psychiatry, Oregon Health and Science University, Portland, 97239, USA
- Department of Pediatrics, Oregon Health and Science University, Portland, 97239, USA
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13
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Wang H, Du Y, Mao Z, Che Y, Li H, Ding L, Jin H. Use of the Griffiths mental development scale-Chinese in the assessment of children with autism spectrum disorder and global developmental delay/intellectual disability. Medicine (Baltimore) 2021; 100:e25407. [PMID: 33787650 PMCID: PMC8021334 DOI: 10.1097/md.0000000000025407] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 03/12/2021] [Indexed: 01/04/2023] Open
Abstract
The Griffiths Mental Development Scale-Chinese (GDS-C) is used in China to assess the development of children from birth to 8 years of age. Language disorders are a common symptom of autism spectrum disorder (ASD) and global developmental delay (GDD)/intellectual disability (ID). There is a need to identify distinct clinical characteristics in children suspected of having these 2 disorders, mainly presenting as language disorders. Here, we aimed to use the GDS-C to evaluate children presenting with language problems to identify characteristics that distinguish ASD and GDD/ID. Children with language problems were recruited between August 2018 and December 2019. A total of 150 children aged 25 to 95.2 months were enrolled (50 in the ASD group, 50 in the GDD/ID group, and 50 in the typical group). Each group was subdivided by age as follows: 24-36 months, >36-60 months, and >60-96 months. Developmental characteristics assessed using the GDS-C were analyzed and compared. Both, children with ASD and GDD/ID presented with a lower developmental level than typical children in all six subscales of the GDS-C. No significant differences were observed in the six subscale scores between the ASD and GDD/ID groups, except for the practical reasoning subscale score in the >36 to 60 months subgroups, which was significantly lower in the GDD/ID group than in the ASD group. The developmental imbalance of subscales within the ASD and GDD/ID groups identified troughs in the personal-social, language, and practical reasoning areas in children with ASD and in the language and practical reasoning areas in children with GDD/ID relative to typical children. The GDS-C is a useful, comprehensive tool for the assessment of the developmental state of children with ASD and GDD/ID. Characteristics of practical reasoning subscale help diagnose autism in >36 to 60 months old children.
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14
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Webster CS, Grieve ROS. Transient involuntary fixation on a second language following exposure to general anaesthetics. Br J Anaesth 2021; 126:e164-e167. [PMID: 33641935 DOI: 10.1016/j.bja.2021.01.024] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 01/25/2021] [Accepted: 01/25/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Craig S Webster
- Department of Anaesthesiology, and Centre for Medical and Health Sciences Education, University of Auckland, Auckland, New Zealand.
| | - Robert O S Grieve
- Department of Cardiothoracic Anaesthesia, Auckland City Hospital, Auckland, New Zealand
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15
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Tibbs MD, Huynh-Le MP, Karunamuni R, Reyes A, Macari AC, Tringale KR, Salans M, Yip A, Liu E, Simon A, McDonald CR, Hattangadi-Gluth JA. Microstructural Injury to Left-Sided Perisylvian White Matter Predicts Language Decline After Brain Radiation Therapy. Int J Radiat Oncol Biol Phys 2020; 108:1218-1228. [PMID: 32712255 PMCID: PMC7680351 DOI: 10.1016/j.ijrobp.2020.07.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 07/14/2020] [Accepted: 07/21/2020] [Indexed: 01/16/2023]
Abstract
PURPOSE Our purpose was to investigate the association between imaging biomarkers of radiation-induced white matter (WM) injury within perisylvian regions and longitudinal language decline in patients with brain tumors. METHODS AND MATERIALS Patients with primary brain tumors (n = 44) on a prospective trial underwent brain magnetic resonance imaging, diffusion-weighted imaging, and language assessments of naming (Boston Naming Test [BNT]) and fluency (Delis-Kaplan Executive Function System Category Fluency [DKEFS-CF]) at baseline and 3, 6, and 12 months after fractionated radiation therapy (RT). Reliable change indices of language function (0-6 months), accounting for practice effects (RCI-PE), evaluated decline. Bilateral perisylvian WM regions (superficial WM subadjacent to Broca's area and the superior temporal gyrus [STG], inferior longitudinal fasciculus [ILF], inferior fronto-occipital fasciculus [IFOF], and arcuate fasciculus) were autosegmented. We quantified volume and diffusion measures of WM microstructure: fractional anisotropy (FA; lower values indicate disruption) and mean diffusivity (MD; higher values indicate injury). Linear mixed-effects models assessed mean dose as predictor of imaging biomarker change and imaging biomarkers as longitudinal predictors of language scores. RESULTS DKEFS-CF scores declined at 6 months post-RT (RCI-PE, -0.483; P = .01), whereas BNT scores improved (RCI-PE, 0.262; P = .04). Higher mean dose to left and right regions was predictive of decreased volume (left-STG, P = .02; right-ILF and IFOF, P = .03), decreased FA (left-WM tracts, all P < .01; right-STG and IFOF, P < .02), and increased MD of left-WM tracts (all P < .03). Volume loss within left-Broca's area (P = .01), left-ILF (P = .01), left-IFOF (P = .01), and left-arcuate fasciculus (P = .04) was associated with lower BNT scores. Lower FA correlated with poorer DKEFS-CF and BNT scores within left-ILF (P = .02, not significant), left-IFOF (P = .02, .04), and left-arcuate fasciculus (P = .01, .01), respectively. Poorer DKEFS-CF scores correlated with increased MD values within the left-arcuate fasciculus (P = .03). Right-sided biomarkers did not correlate with language scores. CONCLUSIONS Patients with primary brain tumors experience language fluency decline post-RT. Poorer fluency and naming function may be explained by microstructural injury to left-sided perisylvian WM, representing potential dose-avoidance targets for language preservation.
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Affiliation(s)
- Michelle D Tibbs
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Minh-Phuong Huynh-Le
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Roshan Karunamuni
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California; Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California
| | - Anny Reyes
- Department of Psychiatry, University of California San Diego, La Jolla, California
| | | | - Kathryn R Tringale
- Department of Radiation Oncology, Memorial Sloan Kettering, New York, New York
| | - Mia Salans
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Anthony Yip
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Eulanca Liu
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Aaron Simon
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Carrie R McDonald
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California; Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California; Department of Psychiatry, University of California San Diego, La Jolla, California
| | - Jona A Hattangadi-Gluth
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California; Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California.
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16
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Sahraoui S, Daoudi S, Lefebvre L. [Rehabilitation of language processing disorders in bilingual patients with Alzheimer disease]. Geriatr Psychol Neuropsychiatr Vieil 2020; 18:459-463. [PMID: 33289489 DOI: 10.1684/pnv.2020.0895] [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] [Indexed: 06/12/2023]
Abstract
We studied the levels of language production processing of bilingual subjects with Alzheimer's disease (AD). The results focus on the deficit of levels of language production processing of bilingual patients with AD at the semantic level of the first language in two aspects, which are the procedure based on the lexical implications of the terms and the continuity. While the grammatical level seems rather affected in the second language (L2) and relatively spared in the first language (L1). Consequently, the cognitive-language stimulation protocol for bilingual patients with AD is developed to offer cognitive training adapted to this deficit. The present study aims at assessing the effectiveness of PSCLAB in the rehabilitation of disturbed levels of language production processing in bilingual patients with AD from early to medium stage, by analyzing the discourse of 30 bilingual patients before and after the administration of the protocol. The results of this study suggest a cognitive language training. The PSCLAB seems effective in the rehabilitation of disturbed levels of language production processing in these patients, although controlled studies with larger samples may be necessary in order to conclude to a therapeutic efficacy of this protocol.
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Affiliation(s)
- Sara Sahraoui
- Service de psychologie cognitive et neuropsychologie, Université de Mons, Mons, Belgique ; Université Mouloud Mammeri, Tizi Ouzou, Algérie
| | - Smail Daoudi
- Service de neurologie, Centre hospitalier universitaire Balloua, Université Mouloud Mammeri, Tizi-Ouzou, Algérie
| | - Laurent Lefebvre
- Service de psychologie cognitive et neuropsychologie, Institut de recherche en sciences et technologies de la santé, Mons, Belgique
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17
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Zakariás L, Rózsa S, Lukács Á. [The Comprehensive Aphasia Test in Hungarian]. Ideggyogy Sz 2020; 73:405-416. [PMID: 33264534 DOI: 10.18071/isz.73.0405] [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] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND PURPOSE In this paper we present the Comprehensive Aphasia Test-Hungarian (CAT-H; Zakariás and Lukács, in preparation), an assessment tool newly adapted to Hungarian, currently under standardisation. The test is suitable for the assessment of an acquired language disorder, post-stroke aphasia. The aims of this paper are to present 1) the main characteristics of the test, its areas of application, and the process of the Hungarian adaptation and standardisation, 2) the first results from a sample of Hungarian people with aphasia and healthy controls. METHODS Ninety-nine people with aphasia, mostly with unilateral, left hemisphere stroke, and 19 neurologically intact control participants were administered the CAT-H. In addition, we developed a questionnaire assessing demographic and clinical information. The CAT-H consists of two parts, a Cognitive Screening Test and a Language Test. RESULTS People with aphasia performed significantly worse than the control group in all language and almost all cognitive subtests of the CAT-H. Consistent with our expectations, the control group performed close to ceiling in all subtests, whereas people with aphasia exhibited great individual variability both in the language and the cognitive subtests. In addition, we found that age, time post-onset, and type of stroke were associated with cognitive and linguistic abilities measured by the CAT-H. CONCLUSION Our results and our experiences clearly show that the CAT-H provides a comprehensive profile of a person's impaired and intact language abilities and can be used to monitor language recovery as well as to screen for basic cognitive deficits in aphasia. We hope that the CAT-H will be a unique resource for rehabilitation professionals and aphasia researchers in aphasia assessment and diagnostics in Hungary.
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Affiliation(s)
- Lilla Zakariás
- Eötvös Loránd Tudományegyetem, Bárczi Gusztáv Gyógypedagógiai Kar, Gyógypedagógiai Módszertani és Rehabilitációs Intézet, Budapest
- Országos Orvosi Rehabilitációs Intézet, Budapest
- MTA-BME Lendület Nyelvelsajátítás Kutatócsoport, Budapest
| | - Sándor Rózsa
- Washington University, School of Medicine, Department of Psychiatry, St. Louis, USA
| | - Ágnes Lukács
- MTA-BME Lendület Nyelvelsajátítás Kutatócsoport, Budapest
- Budapesti Mûszaki és Gazdaságtudományi Egyetem, Kognitív Tudományi Tanszék, Budapest
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18
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Key AP, Venker CE, Sandbank MP. Psychophysiological and Eye-Tracking Markers of Speech and Language Processing in Neurodevelopmental Disorders: New Options for Difficult-to-Test Populations. Am J Intellect Dev Disabil 2020; 125:465-474. [PMID: 33211813 PMCID: PMC8011582 DOI: 10.1352/1944-7558-125.6.465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 08/19/2019] [Accepted: 07/01/2020] [Indexed: 06/02/2023]
Abstract
It can be challenging to accurately assess speech and language processing in preverbal or minimally verbal individuals with neurodevelopmental disabilities (NDD) using standardized behavioral tools. Event-related potential and eye tracking methods offer novel means to objectively document receptive language processing without requiring purposeful behavioral responses. Working around many of the cognitive, motor, or social difficulties in NDDs, these tools allow for minimally invasive, passive assessment of language processing and generate continuous scores that may have utility as biomarkers of individual differences and indicators of treatment effectiveness. Researchers should consider including physiological measures in assessment batteries to allow for more precise capture of language processing in individuals for whom it may not behaviorally apparent.
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19
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Petti U, Baker S, Korhonen A. A systematic literature review of automatic Alzheimer's disease detection from speech and language. J Am Med Inform Assoc 2020; 27:1784-1797. [PMID: 32929494 PMCID: PMC7671617 DOI: 10.1093/jamia/ocaa174] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 05/14/2020] [Accepted: 07/14/2020] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE In recent years numerous studies have achieved promising results in Alzheimer's Disease (AD) detection using automatic language processing. We systematically review these articles to understand the effectiveness of this approach, identify any issues and report the main findings that can guide further research. MATERIALS AND METHODS We searched PubMed, Ovid, and Web of Science for articles published in English between 2013 and 2019. We performed a systematic literature review to answer 5 key questions: (1) What were the characteristics of participant groups? (2) What language data were collected? (3) What features of speech and language were the most informative? (4) What methods were used to classify between groups? (5) What classification performance was achieved? RESULTS AND DISCUSSION We identified 33 eligible studies and 5 main findings: participants' demographic variables (especially age ) were often unbalanced between AD and control group; spontaneous speech data were collected most often; informative language features were related to word retrieval and semantic, syntactic, and acoustic impairment; neural nets, support vector machines, and decision trees performed well in AD detection, and support vector machines and decision trees performed well in decline detection; and average classification accuracy was 89% in AD and 82% in mild cognitive impairment detection versus healthy control groups. CONCLUSION The systematic literature review supported the argument that language and speech could successfully be used to detect dementia automatically. Future studies should aim for larger and more balanced datasets, combine data collection methods and the type of information analyzed, focus on the early stages of the disease, and report performance using standardized metrics.
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Affiliation(s)
- Ulla Petti
- Department of Theoretical and Applied Linguistics, University of Cambridge, Language Technology Lab, Cambridge, UK
| | - Simon Baker
- Department of Theoretical and Applied Linguistics, University of Cambridge, Language Technology Lab, Cambridge, UK
| | - Anna Korhonen
- Department of Theoretical and Applied Linguistics, University of Cambridge, Language Technology Lab, Cambridge, UK
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20
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Eismann EA, Theuerling J, Cassedy A, Curry PA, Colliers T, Makoroff KL. Early developmental, behavioral, and quality of life outcomes following abusive head trauma in infants. Child Abuse Negl 2020; 108:104643. [PMID: 32739598 DOI: 10.1016/j.chiabu.2020.104643] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 04/06/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Developmental delays following pediatric abusive head trauma are common. OBJECTIVE To assess early developmental, behavioral, and quality of life outcomes following infant abusive head trauma and evaluate injury severity and early therapeutic intervention as potential predictors. PARTICIPANTS AND SETTING Infants under 12 months old who were admitted to a large pediatric hospital with abusive head trauma between October 2010 and October 2017 and followed at a multidisciplinary post-injury clinic were included. METHODS Injury severity groups were classified based on days in the Pediatric Intensive Care Unit. Participation in early intervention services and/or physical or occupational therapy by the first clinic visit was documented. Development was assessed using the Mullen Scales of Early Learning, which 47 patients completed at approximately 6 month intervals up to 3 years of age (an average of 19 months post-injury). Behavior and quality of life were assessed around age 2 using the Child Behavior Checklist (n = 24) and PedsQL™ (n = 27), respectively. RESULTS Overall cognitive development, fine motor function, and expressive language significantly declined with age up to 3 years (p < 0.05). The changes in these developmental scales with age differed significantly between injury severity groups (p < 0.05). Internalizing behaviors were also greater in patients with moderate than mild injuries (t = 2.37, p = 0.037). Quality of life was comparable to healthy populations. Early therapeutic intervention was not significantly associated with developmental, behavioral, or quality of life outcomes (p > 0.05). CONCLUSIONS Long-term comprehensive follow-up is recommended for children following abusive head trauma, as developmental delays and behavioral problems may present at later ages.
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Affiliation(s)
- Emily A Eismann
- Mayerson Center for Safe and Healthy Children, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - Jack Theuerling
- Mayerson Center for Safe and Healthy Children, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - Amy Cassedy
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - Patricia A Curry
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - Tracy Colliers
- Mayerson Center for Safe and Healthy Children, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - Kathi L Makoroff
- Mayerson Center for Safe and Healthy Children, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH, 45267, USA.
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21
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Wagner D, Eslinger PJ, Sterling NW, Du G, Lee EY, Styner M, Lewis MM, Huang X. Lexical-semantic search related to side of onset and putamen volume in Parkinson's disease. Brain Lang 2020; 209:104841. [PMID: 32818719 PMCID: PMC8189666 DOI: 10.1016/j.bandl.2020.104841] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 05/29/2019] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 06/11/2023]
Abstract
Parkinson's disease (PD) is characterized by dopaminergic cell loss and reduced striatal volume. Prior studies have demonstrated striatal involvement in access to lexical-semantic knowledge and damage to this structure may be evident in the lexical properties of responses. Semantic fluency task responses from early stage, non-demented PD participants with right (PD-R) or left (PD-L) lateralizing symptoms were compared to matched controls on lexical properties (word frequency, age of acquisition) and correlated with striatal volumes segmented from T1-weighted brain MR images. PD-R participants produced semantic fluency responses of a lower age of acquisition than PD-L and control participants (p < 0.05). PD-R age of acquisition responses correlated positively with putamen volume (p < 0.05), while age of acquisition of responses correlated negatively with caudate volume in controls (p < 0.05). Findings provide evidence for a role of the striatum in lexical-semantic access and qualitative changes in lexical access in select PD patients.
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Affiliation(s)
- Daymond Wagner
- Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, United States.
| | - Paul J Eslinger
- Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, United States; Departments of Neural and Behavioral Sciences, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, United States; Departments of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, United States.
| | - Nicholas W Sterling
- Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, United States.
| | - Guangwei Du
- Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, United States.
| | - Eun-Young Lee
- Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, United States.
| | - Martin Styner
- Departments of Psychiatry, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599, United States; Departments of Computer Science, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599, United States.
| | - Mechelle M Lewis
- Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, United States; Departments of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, United States.
| | - Xuemei Huang
- Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, United States; Departments of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, United States; Departments of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, United States; Departments of Kinesiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, United States.
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22
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Korlimarla A, Spiridigliozzi GA, Crisp K, Herbert M, Chen S, Malinzak M, Stefanescu M, Austin SL, Cope H, Zimmerman K, Jones H, Provenzale JM, Kishnani PS. Novel approaches to quantify CNS involvement in children with Pompe disease. Neurology 2020; 95:e718-e732. [PMID: 32518148 PMCID: PMC7455359 DOI: 10.1212/wnl.0000000000009979] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 01/26/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To characterize the extent of CNS involvement in children with Pompe disease using brain MRI and developmental assessments. METHODS The study included 14 children (ages 6-18 years) with infantile Pompe disease (IPD) (n = 12) or late-onset Pompe disease (LOPD) (n = 2) receiving enzyme replacement therapy. White matter (WM) hyperintense foci seen in the brain MRIs were systematically quantified using the Fazekas scale (FS) grading system with a novel approach: the individual FS scores from 10 anatomical areas were summed to yield a total FS score (range absent [0] to severe [30]) for each child. The FS scores were compared to developmental assessments of cognition and language obtained during the same time period. RESULTS Mild to severe WM hyperintense foci were seen in 10/12 children with IPD (median age 10.6 years) with total FS scores ranging from 2 to 23. Periventricular, subcortical, and deep WM were involved. WM hyperintense foci were seen throughout the path of the corticospinal tracts in the brain in children with IPD. Two children with IPD had no WM hyperintense foci. Children with IPD had relative weaknesses in processing speed, fluid reasoning, visual perception, and receptive vocabulary. The 2 children with LOPD had no WM hyperintense foci, and high scores on most developmental assessments. CONCLUSION This study systematically characterized WM hyperintense foci in children with IPD, which could serve as a benchmark for longitudinal follow-up of WM abnormalities in patients with Pompe disease and other known neurodegenerative disorders or leukodystrophies in children.
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Affiliation(s)
- Aditi Korlimarla
- From the Division of Medical Genetics, Department of Pediatrics (A.K., M.S., S.L.A., H.C., P.S.K.), Department of Psychiatry and Behavioral Sciences (G.A.S.), Department of Surgery (K.C., H.J.), and Department of Neuroradiology (S.C., M.M., J.M.P.), Duke University Medical Center, Durham, NC; Department of Pediatric Neurology (M.H.), University of Kentucky Medical Center, Lexington; and Duke Clinical Research Institute (K.Z.), Durham, NC
| | - Gail A Spiridigliozzi
- From the Division of Medical Genetics, Department of Pediatrics (A.K., M.S., S.L.A., H.C., P.S.K.), Department of Psychiatry and Behavioral Sciences (G.A.S.), Department of Surgery (K.C., H.J.), and Department of Neuroradiology (S.C., M.M., J.M.P.), Duke University Medical Center, Durham, NC; Department of Pediatric Neurology (M.H.), University of Kentucky Medical Center, Lexington; and Duke Clinical Research Institute (K.Z.), Durham, NC
| | - Kelly Crisp
- From the Division of Medical Genetics, Department of Pediatrics (A.K., M.S., S.L.A., H.C., P.S.K.), Department of Psychiatry and Behavioral Sciences (G.A.S.), Department of Surgery (K.C., H.J.), and Department of Neuroradiology (S.C., M.M., J.M.P.), Duke University Medical Center, Durham, NC; Department of Pediatric Neurology (M.H.), University of Kentucky Medical Center, Lexington; and Duke Clinical Research Institute (K.Z.), Durham, NC
| | - Mrudu Herbert
- From the Division of Medical Genetics, Department of Pediatrics (A.K., M.S., S.L.A., H.C., P.S.K.), Department of Psychiatry and Behavioral Sciences (G.A.S.), Department of Surgery (K.C., H.J.), and Department of Neuroradiology (S.C., M.M., J.M.P.), Duke University Medical Center, Durham, NC; Department of Pediatric Neurology (M.H.), University of Kentucky Medical Center, Lexington; and Duke Clinical Research Institute (K.Z.), Durham, NC
| | - Steven Chen
- From the Division of Medical Genetics, Department of Pediatrics (A.K., M.S., S.L.A., H.C., P.S.K.), Department of Psychiatry and Behavioral Sciences (G.A.S.), Department of Surgery (K.C., H.J.), and Department of Neuroradiology (S.C., M.M., J.M.P.), Duke University Medical Center, Durham, NC; Department of Pediatric Neurology (M.H.), University of Kentucky Medical Center, Lexington; and Duke Clinical Research Institute (K.Z.), Durham, NC
| | - Michael Malinzak
- From the Division of Medical Genetics, Department of Pediatrics (A.K., M.S., S.L.A., H.C., P.S.K.), Department of Psychiatry and Behavioral Sciences (G.A.S.), Department of Surgery (K.C., H.J.), and Department of Neuroradiology (S.C., M.M., J.M.P.), Duke University Medical Center, Durham, NC; Department of Pediatric Neurology (M.H.), University of Kentucky Medical Center, Lexington; and Duke Clinical Research Institute (K.Z.), Durham, NC
| | - Mihaela Stefanescu
- From the Division of Medical Genetics, Department of Pediatrics (A.K., M.S., S.L.A., H.C., P.S.K.), Department of Psychiatry and Behavioral Sciences (G.A.S.), Department of Surgery (K.C., H.J.), and Department of Neuroradiology (S.C., M.M., J.M.P.), Duke University Medical Center, Durham, NC; Department of Pediatric Neurology (M.H.), University of Kentucky Medical Center, Lexington; and Duke Clinical Research Institute (K.Z.), Durham, NC
| | - Stephanie L Austin
- From the Division of Medical Genetics, Department of Pediatrics (A.K., M.S., S.L.A., H.C., P.S.K.), Department of Psychiatry and Behavioral Sciences (G.A.S.), Department of Surgery (K.C., H.J.), and Department of Neuroradiology (S.C., M.M., J.M.P.), Duke University Medical Center, Durham, NC; Department of Pediatric Neurology (M.H.), University of Kentucky Medical Center, Lexington; and Duke Clinical Research Institute (K.Z.), Durham, NC
| | - Heidi Cope
- From the Division of Medical Genetics, Department of Pediatrics (A.K., M.S., S.L.A., H.C., P.S.K.), Department of Psychiatry and Behavioral Sciences (G.A.S.), Department of Surgery (K.C., H.J.), and Department of Neuroradiology (S.C., M.M., J.M.P.), Duke University Medical Center, Durham, NC; Department of Pediatric Neurology (M.H.), University of Kentucky Medical Center, Lexington; and Duke Clinical Research Institute (K.Z.), Durham, NC
| | - Kanecia Zimmerman
- From the Division of Medical Genetics, Department of Pediatrics (A.K., M.S., S.L.A., H.C., P.S.K.), Department of Psychiatry and Behavioral Sciences (G.A.S.), Department of Surgery (K.C., H.J.), and Department of Neuroradiology (S.C., M.M., J.M.P.), Duke University Medical Center, Durham, NC; Department of Pediatric Neurology (M.H.), University of Kentucky Medical Center, Lexington; and Duke Clinical Research Institute (K.Z.), Durham, NC
| | - Harrison Jones
- From the Division of Medical Genetics, Department of Pediatrics (A.K., M.S., S.L.A., H.C., P.S.K.), Department of Psychiatry and Behavioral Sciences (G.A.S.), Department of Surgery (K.C., H.J.), and Department of Neuroradiology (S.C., M.M., J.M.P.), Duke University Medical Center, Durham, NC; Department of Pediatric Neurology (M.H.), University of Kentucky Medical Center, Lexington; and Duke Clinical Research Institute (K.Z.), Durham, NC
| | - James M Provenzale
- From the Division of Medical Genetics, Department of Pediatrics (A.K., M.S., S.L.A., H.C., P.S.K.), Department of Psychiatry and Behavioral Sciences (G.A.S.), Department of Surgery (K.C., H.J.), and Department of Neuroradiology (S.C., M.M., J.M.P.), Duke University Medical Center, Durham, NC; Department of Pediatric Neurology (M.H.), University of Kentucky Medical Center, Lexington; and Duke Clinical Research Institute (K.Z.), Durham, NC
| | - Priya S Kishnani
- From the Division of Medical Genetics, Department of Pediatrics (A.K., M.S., S.L.A., H.C., P.S.K.), Department of Psychiatry and Behavioral Sciences (G.A.S.), Department of Surgery (K.C., H.J.), and Department of Neuroradiology (S.C., M.M., J.M.P.), Duke University Medical Center, Durham, NC; Department of Pediatric Neurology (M.H.), University of Kentucky Medical Center, Lexington; and Duke Clinical Research Institute (K.Z.), Durham, NC.
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Marcotte K, Sanchez E, Arbour C, Brambati SM, Bedetti C, Martineau S, Descoteaux M, Gosselin N. Long-term discourse outcomes and their relationship to white matter damage in moderate to severe adulthood traumatic brain injury. Brain Lang 2020; 204:104769. [PMID: 32078946 DOI: 10.1016/j.bandl.2020.104769] [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] [Received: 11/22/2018] [Revised: 12/08/2019] [Accepted: 01/30/2020] [Indexed: 06/10/2023]
Affiliation(s)
- Karine Marcotte
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (Hôpital du Sacré-Coeur de Montréal), Montréal, Québec, Canada; École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Montréal, Quebec, Canada.
| | - Erlan Sanchez
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (Hôpital du Sacré-Coeur de Montréal), Montréal, Québec, Canada; Département de neurosciences, Université de Montréal, Montréal, Québec, Canada
| | - Caroline Arbour
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (Hôpital du Sacré-Coeur de Montréal), Montréal, Québec, Canada; Faculté des sciences infirmières, Université de Montréal, Montréal, Québec, Canada
| | - Simona Maria Brambati
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada; Département de psychologie, Faculté des arts et Sciences, Université de Montréal, Montréal, Québec, Canada
| | - Christophe Bedetti
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Sarah Martineau
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (Hôpital du Sacré-Coeur de Montréal), Montréal, Québec, Canada; École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Montréal, Quebec, Canada
| | - Maxime Descoteaux
- Département d'informatique, Université de Sherbrooke, Québec, Canada
| | - Nadia Gosselin
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (Hôpital du Sacré-Coeur de Montréal), Montréal, Québec, Canada; Département de psychologie, Faculté des arts et Sciences, Université de Montréal, Montréal, Québec, Canada
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24
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Pluck G, Barajas BM, Hernandez-Rodriguez JL, Martínez MA. Language ability and adult homelessness. Int J Lang Commun Disord 2020; 55:332-344. [PMID: 31925870 DOI: 10.1111/1460-6984.12521] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 06/15/2019] [Revised: 11/21/2019] [Accepted: 12/16/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND People experiencing homelessness are at increased risk of neurological disorder due to multiple factors such as substance abuse, infection, and higher rates of serious mental illness and traumatic brain injury. This could affect cognitive and language skills. Indeed, past research has suggested that certain language-related skills tend to be lower in people experiencing homelessness. However, that research has compared homeless samples with age-matched normative samples and not with samples of people from similar socio-economic backgrounds. Therefore, it is unclear whether homelessness is even a relevant factor, or if adults who are homeless tend to have appropriate linguistic skills relative to their social and educational background. AIMS To compare the language skills of a group of adults with histories of homelessness with an education-matched control group. It was hypothesized that participants with histories of homelessness would have worse language performance than their matched controls. METHODS & PROCEDURES A quasi-experimental design was employed involving 17 adults with histories of homelessness, mainly rough sleeping, in the city of Quito in Ecuador, and a sample of 16 adults who had never been homeless. All were assessed with measures of head injury, substance dependence, affective disorder and language skills. A paired-sample analysis was performed on homeless and control participants matched for educational background, used as an index of socio-economic background. OUTCOMES & RESULTS The mean years of formal education was low in both the homeless sample (mean = 5.82 years) and the control sample (mean = 6.75 years). There were no differences between the groups for any demographic or clinical factors, nor for a measure of expected or 'premorbid' ability based on single-word reading, nor for current non-verbal cognitive functioning. In contrast, the homeless group scored significantly worse than the control group on measures of auditory comprehension and oral expression. CONCLUSIONS & IMPLICATIONS Adults with histories of homelessness may have worse language skills than would be expected based on their educational backgrounds and non-verbal cognitive abilities. It is possible that some of this lower language ability is pathological, in the form of either a developmental language disorder or an acquired impairment. As such, some adults who are homeless may benefit from therapy directed at clinical language disorders.
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Affiliation(s)
- Graham Pluck
- Institute of Neurosciences, Universidad San Francisco de Quito, Cumbayá, Ecuador
| | - Brittany M Barajas
- College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, USA
| | | | - María A Martínez
- Institute of Neurosciences, Universidad San Francisco de Quito, Cumbayá, Ecuador
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25
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Finestack LH, Rohwer B, Hilliard L, Abbeduto L. Using Computerized Language Analysis to Evaluate Grammatical Skills. Lang Speech Hear Serv Sch 2020; 51:184-204. [PMID: 32255745 PMCID: PMC7225022 DOI: 10.1044/2019_lshss-19-00032] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 08/16/2019] [Accepted: 12/03/2019] [Indexed: 11/09/2022] Open
Abstract
Purpose Conducting in-depth grammatical analyses based on language samples can be time consuming. Developmental Sentence Scoring (DSS) and the Index of Productive Syntax (IPSyn) analyses provide detailed information regarding the grammatical profiles of children and can be conducted using free computer-based software. Here, we provide a tutorial to support clinicians' use of computer-based analyses to aid diagnosis and develop and monitor treatment goals. Method We analyzed language samples of a 5-year-old with developmental language disorder and an adolescent with Down syndrome using computer-based software, Computerized Language Analysis. We focused on DSS and IPSyn analyses. The tutorial includes step-by-step procedures for conducting the analyses. We also illustrate how the analyses may be used to assist in diagnosis, develop treatment goals focused on grammatical targets, and monitor progress on these treatment goals. Conclusion Clinicians should consider using Computerized Language Analysis's IPSyn and DSS analyses to support grammatical language assessments used to aid diagnosis, develop treatment goals, and monitor progress on these treatment goals. Supplemental Material https://doi.org/10.23641/asha.12021141.
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Affiliation(s)
- Lizbeth H. Finestack
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Minneapolis
| | - Bobbi Rohwer
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Minneapolis
| | - Lisa Hilliard
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Minneapolis
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26
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Bedore LM, Peña ED, Fiestas C, Lugo-Neris MJ. Language and Literacy Together: Supporting Grammatical Development in Dual Language Learners With Risk for Language and Learning Difficulties. Lang Speech Hear Serv Sch 2020; 51:282-297. [PMID: 32255748 PMCID: PMC7225020 DOI: 10.1044/2020_lshss-19-00055] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 11/21/2019] [Accepted: 01/06/2020] [Indexed: 11/09/2022] Open
Abstract
Purpose Early Interventions in Reading (Vaughn et al., 2006), the only literacy intervention with demonstrated effectiveness for U.S. dual language learners, was enhanced to support the development of oral language (vocabulary, grammar, and narrative) and literacy, which we refer to as "Language and Literacy Together." The primary focus of this study is to understand the extent to which grammatical skills of bilinguals with risk for language and/or reading difficulties improve in the Language and Literacy Together intervention. Method Fifteen first-grade dual language learners with risk for language and/or reading difficulties participated in an enhanced version of Early Interventions in Reading in Spanish. Children completed pre- and postintervention evaluations in Spanish and English, including grammatical testing from the Bilingual English Spanish Oral Screener (Peña et al., 2008) and narrative evaluation Test of Narrative Language story prompts (Gillam & Pearson, 2004; Gillam et al., n.d.). Data from six comparison participants with typical language skills who completed pre- and posttesting demonstrate the stability of the measures. Results The intervention group made gains in English and Spanish as evidenced by significant increases in their cloze and sentence repetition accuracy on the Bilingual English Spanish Oral Screener Morphosyntax subtest. They increased productivity on their narratives in Spanish and English as indexed by mean length of utterance in words but did not make gains in their overall grammaticality. Conclusions Structured intervention that includes an emphasis on grammatical elements in the context of a broader intervention can lead to change in the production of morphosyntax evident in both elicited constructions and narrative productivity as measured by mean length of utterance in words. Additional work is needed to determine if and how cross-linguistic transfer might be achieved for these learners.
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Affiliation(s)
- Lisa M. Bedore
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA
| | | | - Christine Fiestas
- Department of Communication Sciences and Disorders, Texas A&M University, Kingsville
| | - Mirza J. Lugo-Neris
- Department of Communication Sciences and Disorders, The University of Texas at Austin
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27
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Quinn ED, Kaiser AP, Ledford JR. Teaching Preschoolers With Down Syndrome Using Augmentative and Alternative Communication Modeling During Small Group Dialogic Reading. Am J Speech Lang Pathol 2020; 29:80-100. [PMID: 31697898 PMCID: PMC8645247 DOI: 10.1044/2019_ajslp-19-0017] [Citation(s) in RCA: 4] [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: 01/26/2019] [Revised: 05/02/2019] [Accepted: 08/01/2019] [Indexed: 05/10/2023]
Abstract
Purpose This study evaluated the effect of aided augmentative and alternative communication modeling (AAC-MOD) on the communication skills of children with Down syndrome (DS) during small group dialogic reading. Method Four children with DS between 3;1 and 5;3 (years;months; M = 4;5) and 5 typically developing peers between 3;5 and 5;9 (M = 4;3) participated. Effects were examined using a multiple probe across behaviors design with 4 children with DS. To simulate typical dialogic reading routines in inclusive classrooms, a strategy called Read, Ask, Answer, Prompt (Binger, Kent-Walsh, Ewing, & Taylor, 2010) was applied during the baseline and intervention sessions. Results A functional relation was demonstrated between (a) AAC-MOD and percentage of correctly identified symbols for 3 participants, (b) AAC-MOD and rate of symbolic communication for 2 participants, and (c) AAC-MOD and number of different words for 2 participants. Increases in number of multiple word combinations occurred for 2 participants. All 4 children maintained their percentage of correctly identified symbols. Increases in rate of symbolic communication did not generalize to thematic play contexts, a distal measure of response generalization. Conclusion AAC-MOD is an effective strategy for teaching target vocabulary and increasing rate of symbolic communication in young children with DS. Supplemental Material https://doi.org/10.23641/asha.10093538.
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Affiliation(s)
- Emily D. Quinn
- Department of Pediatrics, Oregon Health & Science University, Portland
| | - Ann P. Kaiser
- Department of Special Education, Vanderbilt University, Nashville, TN
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28
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Lawton M, Haddock G, Conroy P, Serrant L, Sage K. People with aphasia's perspectives of the therapeutic alliance during speech-language intervention: A Q methodological approach. Int J Speech Lang Pathol 2020; 22:59-69. [PMID: 30987440 DOI: 10.1080/17549507.2019.1585949] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 02/07/2018] [Revised: 10/17/2018] [Accepted: 12/10/2018] [Indexed: 06/09/2023]
Abstract
Purpose: To identify which elements of the therapeutic alliance are important to people with aphasia (PWA) attending speech-language pathology post-stroke.Method: A Q methodology design was adopted to explore which elements of the therapeutic alliance were valued by PWA. Statements (n = 453) relevant to the research question were extrapolated from the literature and qualitative interviews. A representative sample of statements (n = 38) was identified from the expansive data set. PWA (n = 23) sorted statements hierarchically according to whether they thought the statement was important or unimportant. Completed Q sorts were analysed using a by-person factor analysis.Result: Analysis yielded a five-factor solution, representing five distinct viewpoints: (1) acknowledge me, help me to understand; (2) respect me, listen to me; (3) challenge me, direct me; (4) understand me, laugh with me; and (5) hear me, encourage me.Conclusion: The findings highlight the need for clinicians to adopt a flexible and idiosyncratic approach to therapeutic alliance construction in order to meet the relational needs of a heterogeneous population. This is the first study to use Q methodology with PWA, demonstrating that Q methodology is an effective and viable method for investigating subjectivity in this population.
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Affiliation(s)
- Michelle Lawton
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK
| | - Gillian Haddock
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK
| | - Paul Conroy
- Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, UK
| | - Laura Serrant
- Faculty of Health and Wellbeing, Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK
| | - Karen Sage
- Faculty of Health and Wellbeing, Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK
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Lundin NB, Hochheiser J, Minor KS, Hetrick WP, Lysaker PH. Piecing together fragments: Linguistic cohesion mediates the relationship between executive function and metacognition in schizophrenia. Schizophr Res 2020; 215:54-60. [PMID: 31784337 PMCID: PMC8106973 DOI: 10.1016/j.schres.2019.11.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 04/07/2019] [Revised: 08/24/2019] [Accepted: 11/19/2019] [Indexed: 12/28/2022]
Abstract
Speech disturbances are prevalent in psychosis. These may arise in part from executive function impairment, as research suggests that inhibition and monitoring are associated with production of cohesive discourse. However, it is not yet understood how linguistic and executive function impairments in psychosis interact with disrupted metacognition, or deficits in the ability to integrate information to form a complex sense of oneself and others and use that synthesis to respond to psychosocial challenges. Whereas discourse studies have historically employed manual hand-coding techniques, automated computational tools can characterize deep semantic structures that may be closely linked with metacognition. In the present study, we examined whether higher executive functioning promotes metacognition by way of altering linguistic cohesion. Ninety-four individuals with schizophrenia-spectrum disorders provided illness narratives and completed an executive function task battery (Delis-Kaplan Executive Function System). We assessed the narratives for linguistic cohesion (Coh-Metrix 3.0) and metacognitive capacity (Metacognition Assessment Scale - Abbreviated). Selected linguistic indices measured the frequency of connections between causal and intentional content (deep cohesion), word and theme overlap (referential cohesion), and unique word usage (lexical diversity). In path analyses using bootstrapped confidence intervals, we found that deep cohesion and lexical diversity independently mediated the relationship between executive functioning and metacognitive capacity. Findings suggest that executive control abilities support integration of mental experiences by way of increasing causal, goal-driven speech and word expression in individuals with schizophrenia. Metacognitive-based therapeutic interventions for psychosis may promote insight and recovery in part by scaffolding use of language that links ideas together.
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Affiliation(s)
- Nancy B Lundin
- Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, 1101 E. 10th Street, Bloomington, IN 47405, United States.
| | - Jesse Hochheiser
- Department of Psychiatry, Richard L. Roudebush VA Medical Center, 1481 W. 10th Street, Indianapolis, IN 46202, United States
| | - Kyle S Minor
- Department of Psychology, Indiana University Purdue University Indianapolis, 402 N. Blackford Street, Indianapolis, IN 46202, United States.
| | - William P Hetrick
- Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, 1101 E. 10th Street, Bloomington, IN 47405, United States.
| | - Paul H Lysaker
- Department of Psychiatry, Richard L. Roudebush VA Medical Center, 1481 W. 10th Street, Indianapolis, IN 46202, United States; Indiana University School of Medicine, department of Psychiatry Indianapolis IN.
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Kaestner E, Balachandra AR, Bahrami N, Reyes A, Lalani SJ, Macari AC, Voets NL, Drane DL, Paul BM, Bonilha L, McDonald CR. The white matter connectome as an individualized biomarker of language impairment in temporal lobe epilepsy. Neuroimage Clin 2019; 25:102125. [PMID: 31927128 PMCID: PMC6953962 DOI: 10.1016/j.nicl.2019.102125] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 12/10/2019] [Accepted: 12/13/2019] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The distributed white matter network underlying language leads to difficulties in extracting clinically meaningful summaries of neural alterations leading to language impairment. Here we determine the predictive ability of the structural connectome (SC), compared with global measures of white matter tract microstructure and clinical data, to discriminate language impaired patients with temporal lobe epilepsy (TLE) from TLE patients without language impairment. METHODS T1- and diffusion-MRI, clinical variables (CVs), and neuropsychological measures of naming and verbal fluency were available for 82 TLE patients. Prediction of language impairment was performed using a robust tree-based classifier (XGBoost) for three models: (1) a CV-model which included demographic and epilepsy-related clinical features, (2) an atlas-based tract-model, including four frontotemporal white matter association tracts implicated in language (i.e., the bilateral arcuate fasciculus, inferior frontal occipital fasciculus, inferior longitudinal fasciculus, and uncinate fasciculus), and (3) a SC-model based on diffusion MRI. For the association tracts, mean fractional anisotropy was calculated as a measure of white matter microstructure for each tract using a diffusion tensor atlas (i.e., AtlasTrack). The SC-model used measurement of cortical-cortical connections arising from a temporal lobe subnetwork derived using probabilistic tractography. Dimensionality reduction of the SC was performed with principal components analysis (PCA). Each model was trained on 49 patients from one epilepsy center and tested on 33 patients from a different center (i.e., an independent dataset). Randomization was performed to test the stability of the results. RESULTS The SC-model yielded a greater area under the curve (AUC; .73) and accuracy (79%) compared to both the tract-model (AUC: .54, p < .001; accuracy: 70%, p < .001) and the CV-model (AUC: .59, p < .001; accuracy: 64%, p < .001). Within the SC-model, lateral temporal connections had the highest importance to model performance, including connections similar to language association tracts such as links between the superior temporal gyrus to pars opercularis. However, in addition to these connections many additional connections that were widely distributed, bilateral and interhemispheric in nature were identified as contributing to SC-model performance. CONCLUSION The SC revealed a white matter network contributing to language impairment that was widely distributed, bilateral, and lateral temporal in nature. The distributed network underlying language may be why the SC-model has an advantage in identifying sub-components of the complex fiber networks most relevant for aspects of language performance.
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Affiliation(s)
- Erik Kaestner
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Akshara R Balachandra
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Naeim Bahrami
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Anny Reyes
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Sanam J Lalani
- Department of Neurology, University of California - San Francisco, San Francisco, CA, USA
| | - Anna Christina Macari
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Natalie L Voets
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Daniel L Drane
- Departments of Neurology and Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Department of Neurology, University of Washington, Seattle, WA, USA
| | - Brianna M Paul
- Department of Neurology, University of California - San Francisco, San Francisco, CA, USA
| | - Leonardo Bonilha
- Medical University of South Carolina, Department of Neurology, USA
| | - Carrie R McDonald
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA.
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El-Wahsh S, Heard R, Bogaardt H. Development and validation of a speech pathology-specific questionnaire for persons with multiple sclerosis (SMS). Int J Speech Lang Pathol 2019; 21:553-563. [PMID: 30348018 DOI: 10.1080/17549507.2018.1499802] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 11/21/2017] [Revised: 05/07/2018] [Accepted: 07/08/2018] [Indexed: 06/08/2023]
Abstract
Purpose: The aim of this study was to develop and validate the Speech pathology-specific questionnaire for persons with Multiple Sclerosis (SMS).Method: Forty-one items were generated through a literature review. Items were submitted to a preliminary psychometric validation process consisting of principal component analysis, internal consistency, test-retest reliability, and floor and ceiling effects using data from 164 participants. Criterion validity was assessed by comparing the SMS with the 12-item Short Form Health Survey (SF-12). Participants were recruited internationally through online channels and questionnaires were completed online.Result: The SMS contains 16 items describing three components: speech and voice, language, and swallowing. Internal consistency (Cronbach's alpha) of the three components was satisfactory (α = 0.89-α = 0.91). Criterion validity was evaluated using Spearman's rank correlation coefficient (ρ). A statistically significant weak to moderate correlation between the SMS and the SF-12 was identified (ρ = -0.004-ρ = -0.359). No floor or ceiling effects were present. The SMS demonstrated strong test-retest reliability. All items had an intra-class correlation coefficient ≥0.70.Conclusion: The SMS is a psychometrically robust patient-reported outcome measure to assess speech-language pathology symptoms in persons with MS.
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Affiliation(s)
- Sarah El-Wahsh
- Department of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
| | - Robert Heard
- Department of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
| | - Hans Bogaardt
- Department of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
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Lundine JP, Barron HD. Microstructural and Fluency Characteristics of Narrative and Expository Discourse in Adolescents With Traumatic Brain Injury. Am J Speech Lang Pathol 2019; 28:1638-1648. [PMID: 31525074 DOI: 10.1044/2019_ajslp-19-0012] [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: 06/10/2023]
Abstract
Purpose The purpose of this exploratory study was to identify specific microstructural and fluency differences in expository and narrative summaries produced by students with a traumatic brain injury (TBI) compared to students with typical development (TD). Method Five adolescents with TBI and 5 matched peers with TD verbally summarized 1 narrative and 2 expository (compare-contrast, cause-effect) lectures, creating 30 summaries. Researchers transcribed summaries and used paired t tests to analyze between-group differences in microstructural measures (productivity, lexical diversity, syntactic complexity), mazing behaviors, and pausing patterns. Results Youth with TBI produced significantly fewer utterances than teens with TD in both expository contexts, whereas youth with TD produced a significantly greater mean length of C-unit than teens with TBI in the narrative summary only. Youth with TBI produced significantly fewer filled pauses per utterance than did youth with TD during the cause-effect summary only and significantly more pauses per utterance and within-clause pauses per utterance during the compare-contrast summary. Where findings were statistically significant, effect sizes were large. There were no statistically significant between-group differences in mazing or pausing behaviors during narrative summary production. Conclusions This study is the 1st to compare microstructural and fluency characteristics in teens with TBI and those without when producing verbal summaries of a narrative and 2 types of expository passages. Findings from this study reinforce the need to expand research focusing on expository discourse tasks and identify variables that may be prone to disruption following TBI. Future work is needed to confirm whether identified differences correspond to true discourse difficulties. Supplemental Material https://doi.org/10.23641/asha.9807812.
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Affiliation(s)
- Jennifer P Lundine
- Department of Speech & Hearing Science, The Ohio State University, Columbus
- Division of Clinical Therapies & Inpatient Rehabilitation Program, Nationwide Children's Hospital, Columbus, OH
| | - Heath D Barron
- Department of Speech & Hearing Science, The Ohio State University, Columbus
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Abstract
Purpose The purpose of this research is to determine whether individuals with a history of concussion retain enduring differences in narrative writing tasks, which necessitate rapid and complex integration of both cognitive and linguistic faculties. Method Participants aged 12-40 years old, who did or did not have a remote history of concussion, were recruited to take an online survey that included writing both a familiar and a novel narrative. They also were asked to complete multiple tasks targeting word-level and domain general cognitive skills, so that their performance could be interpreted across these dimensions. Results Participants with a concussion history were largely similar to participants with no history of brain injury across tasks that targeted a single skill in isolation. However, participants with prior concussions demonstrated difficulty in providing both key content and details when presented with a novel video and asked to provide a summary of what they had just seen. Number of lifetime concussions predicted the inclusion of key content when summarizing the video. Thus, differences in cognitive and linguistic skills required for written narrative language may continue to be present far after concussion, despite average normative levels of performance on tasks targeting these skills in isolation. Conclusions These findings suggest that individuals with a concussion history, particularly a history of multiple concussions, may continue to experience difficulties for a long period after injury and are likely to benefit from more complex and ecologically valid assessment prior to discharge. Individuals with a concussion history who return to full participation in work, school, and recreational activities may continue to benefit from assistance when asked to rapidly acquire and distill novel information, as is often required in academic and professional environments.
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Affiliation(s)
| | - Rochelle Newman
- Department of Hearing and Speech Sciences, University of Maryland, College Park
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Jarret T, Stockert A, Kotz SA, Tillmann B. Implicit learning of artificial grammatical structures after inferior frontal cortex lesions. PLoS One 2019; 14:e0222385. [PMID: 31539390 PMCID: PMC6754135 DOI: 10.1371/journal.pone.0222385] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 08/29/2019] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Previous research associated the left inferior frontal cortex with implicit structure learning. The present study tested patients with lesions encompassing the left inferior frontal gyrus (LIFG; including Brodmann areas 44 and 45) to further investigate this cognitive function, notably by using non-verbal material, implicit investigation methods, and by enhancing potential remaining function via dynamic attending. Patients and healthy matched controls were exposed to an artificial pitch grammar in an implicit learning paradigm to circumvent the potential influence of impaired language processing. METHODS Patients and healthy controls listened to pitch sequences generated within a finite-state grammar (exposure phase) and then performed a categorization task on new pitch sequences (test phase). Participants were not informed about the underlying grammar in either the exposure phase or the test phase. Furthermore, the pitch structures were presented in a highly regular temporal context as the beneficial impact of temporal regularity (e.g. meter) in learning and perception has been previously reported. Based on the Dynamic Attending Theory (DAT), we hypothesized that a temporally regular context helps developing temporal expectations that, in turn, facilitate event perception, and thus benefit artificial grammar learning. RESULTS Electroencephalography results suggest preserved artificial grammar learning of pitch structures in patients and healthy controls. For both groups, analyses of event-related potentials revealed a larger early negativity (100-200 msec post-stimulus onset) in response to ungrammatical than grammatical pitch sequence events. CONCLUSIONS These findings suggest that (i) the LIFG does not play an exclusive role in the implicit learning of artificial pitch grammars, and (ii) the use of non-verbal material and an implicit task reveals cognitive capacities that remain intact despite lesions to the LIFG. These results provide grounds for training and rehabilitation, that is, learning of non-verbal grammars that may impact the relearning of verbal grammars.
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Affiliation(s)
- Tatiana Jarret
- CNRS, UMR5292, INSERM, U1028, Lyon Neuroscience Research Center, Auditory Cognition and Psychoacoustics Team, Lyon, France
- University Lyon 1, Villeurbanne, France
| | - Anika Stockert
- Language and Aphasia Laboratory, Department of Neurology, University of Leipzig, Leipzig, Germany
| | - Sonja A. Kotz
- Dept. of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Faculty of Psychology and Neuroscience, Dept. of Neuropsychology, Maastricht University, Maastricht, The Netherlands
- Faculty of Psychology and Neuroscience, Dept. of Psychopharmacology, Maastricht University, Maastricht, The Netherlands
| | - Barbara Tillmann
- CNRS, UMR5292, INSERM, U1028, Lyon Neuroscience Research Center, Auditory Cognition and Psychoacoustics Team, Lyon, France
- University Lyon 1, Villeurbanne, France
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Abstract
OBJECTIVE The present study investigated the ability of the Multilingual Naming Test (MINT), a picture naming test recently added to the National Alzheimer's Coordinating Center's (NACC) Uniform Data Set neuropsychological test battery, to detect naming impairment (i.e., dysnomia) across stages of Alzheimer's disease (AD). METHOD Data from the initial administration of the MINT were obtained on NACC participants who were cognitively normal (N = 3,981) or diagnosed with mild cognitive impairment (N = 852) or dementia (N = 1,148) with presumed etiology of AD. Dementia severity was rated using the Clinical Dementia Rating (CDR) scale. RESULTS Cross-sectional multiple regression analyses revealed significant effects of diagnostic group, sex, education, age, and race on naming scores. Planned comparisons collapsing across age and education groups revealed significant group differences in naming scores across levels of dementia severity. ROC curve analyses showed good diagnostic accuracy of MINT scores for distinguishing cognitively normal controls from AD dementia, but not from MCI. Within the cognitively normal group, there was a robust interaction between age and education such that naming scores exhibited the most precipitous drop across age groups for the least educated participants. Additionally, education effects were stronger in African-Americans than in Whites (a race-by-education interaction), and race effects were stronger in older than in younger age groups (a race-by-age interaction). CONCLUSIONS The MINT successfully detects naming deficits at different levels of cognitive impairment in patients with MCI or AD dementia, but comparison to age, sex, race, and education-corrected norms to determine impairment is essential.
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Affiliation(s)
- Alena Stasenko
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, USA
| | - Diane M. Jacobs
- Department of Neurosciences, Shiley-Marcos Alzheimer’s Disease Research Center, University of California, 9444 Medical Center Dr #1-100, La Jolla, CA 92037, USA
| | - David P. Salmon
- Department of Neurosciences, Shiley-Marcos Alzheimer’s Disease Research Center, University of California, 9444 Medical Center Dr #1-100, La Jolla, CA 92037, USA
| | - Tamar H. Gollan
- Department of Psychiatry, University of California, 9500 Gilman Drive, La Jolla, San Diego, CA 92093, USA
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Hay I, Hynes KL, Burgess JR. Mild-to-Moderate Gestational Iodine Deficiency Processing Disorder. Nutrients 2019; 11:E1974. [PMID: 31443337 PMCID: PMC6770179 DOI: 10.3390/nu11091974] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 08/12/2019] [Accepted: 08/15/2019] [Indexed: 12/28/2022] Open
Abstract
This synopsis paper aims to identify if a common pattern of learning and social difficulties can be conceptualized across recent longitudinal studies investigating the influence of mild-to-moderate gestational iodine deficiency (GID) on offspring's optimal cognitive and psycho-social development. The main studies investigated are: The Southampton Women's Study (SWS)-United Kingdom; the Avon Longitudinal Study of Parents and Children (ALSPAC)-United Kingdom; the Gestational Iodine Cohort Longitudinal Study-Tasmania, Australia, and the Danish National Birth Cohort Case-Control Study-Denmark. In contrast to severe GID where there is a global negative impact on neurodevelopment, mild-to-moderate intrauterine iodine deficiency has subtler, but nonetheless important, permanent cognitive and psycho-social consequences on the offspring. This paper links the results from each study and maintains that mild-to-moderate GID is associated with a disorder that is characterized by speed of neural transmitting difficulties that are typically associated with working memory capacity difficulties and attention and response inhibition. The authors maintain that this disorder is better identified as Gestational Iodine Deficiency Processing Disorder (GIDPD), rather than, what to date has often been identified as 'suboptimal development'. The Autistic Spectrum Disorder (ASD), Attention Deficit, Hyperactivity Disorder (ADHD), language and literacy disorders (learning disabilities and dyslexia) are the main manifestations associated with GIDPD. GIDPD is identified on IQ measures, but selectively and mainly on verbal reasoning IQ subtests, with individuals with GIDPD still operating within the 'normal' full-scale IQ range. Greater consideration needs to be given by public health professionals, policy makers and educators about the important and preventable consequences of GID. Specifically, more emphasis should be placed on adequate iodine intake in women prior to pregnancy, as well as during pregnancy and when lactating. Secondly, researchers and others need to further extend, refine and clarify whether GIDPD, as a nosological (medical classification) entity, is a valid disorder and concept for consideration.
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Affiliation(s)
- Ian Hay
- Faculty of Education, University of Tasmania, Launceston 7250, Australia.
| | - Kristen L Hynes
- Menzies Institute for Medical Research, University of Tasmania, Hobart 7001, Australia
| | - John R Burgess
- Department of Endocrinology, Royal Hobart Hospital, Hobart 7001, Australia
- School of Medicine, University of Tasmania, Hobart 7000, Australia
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Kaestner E, Reyes A, Macari AC, Chang YH, Paul B, Hermann B, McDonald CR. Identifying the neural basis of a language-impaired phenotype of temporal lobe epilepsy. Epilepsia 2019; 60:1627-1638. [PMID: 31297795 PMCID: PMC6687533 DOI: 10.1111/epi.16283] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 03/25/2019] [Revised: 06/17/2019] [Accepted: 06/17/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To identify neuroimaging and clinical biomarkers associated with a language-impaired phenotype in refractory temporal lobe epilepsy (TLE). METHODS Eighty-five patients with TLE were characterized as language-impaired (TLE-LI) or non-language-impaired (TLE-NLI) based on comprehensive neuropsychological testing. Structural magnetic resonance imaging (MRI), diffusion tensor imaging, and functional MRI (fMRI) were obtained in patients and 47 healthy controls (HC). fMRI activations and cortical thickness were calculated within language regions of interest, and fractional anisotropy (FA) was calculated within deep white matter tracts associated with language. Analyses of variance were performed to test for differences among the groups in imaging measures. Receiver operator characteristic curves were used to determine how well different clinical versus imaging measures discriminated TLE-LI from TLE-NLI. RESULTS TLE-LI patients showed significantly less activation within left superior temporal cortex compared to HC and TLE-NLI, regardless of side of seizure onset. TLE-LI also showed decreased FA in the inferior longitudinal fasciculus and arcuate fasciculus compared to HC. Cortical thickness did not differ between groups in any region. A model that included language-related fMRI activations within the superior temporal gyrus, age at onset, and demographic variables was the most predictive of language impairment (area under the curve = 0.80). SIGNIFICANCE These findings demonstrate a unique imaging signature associated with a language-impaired phenotype in TLE, characterized by functional and microstructural alterations within the language network. Reduced left superior temporal activation combined with compromise to language association tracts underlies this phenotype, extending our previous work on cognitive phenotypes that could have implications for treatment-planning or cognitive progression in TLE.
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Affiliation(s)
- Erik Kaestner
- Center for Multimodal Imaging and Genetics, University of California, San Diego
| | - Anny Reyes
- Center for Multimodal Imaging and Genetics, University of California, San Diego
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego
| | | | - Yu-Hsuan Chang
- Center for Multimodal Imaging and Genetics, University of California, San Diego
| | - Brianna Paul
- Department of Neurology, University of California – San Francisco, San Francisco
- UCSF Comprehensive Epilepsy Center, San Francisco
| | - Bruce Hermann
- Matthews Neuropsychology Section, University of Wisconsin
| | - Carrie R. McDonald
- Center for Multimodal Imaging and Genetics, University of California, San Diego
- UCSD Comprehensive Epilepsy Center, San Diego
- Department of Psychiatry, University of California, San Diego
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Wong B, Lucente DE, MacLean J, Padmanabhan J, Quimby M, Brandt KD, Putcha D, Sherman J, Frosch MP, McGinnis S, Dickerson BC. Diagnostic evaluation and monitoring of patients with posterior cortical atrophy. Neurodegener Dis Manag 2019; 9:217-239. [PMID: 31392920 PMCID: PMC6949516 DOI: 10.2217/nmt-2018-0052] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 12/23/2018] [Accepted: 05/03/2019] [Indexed: 12/21/2022] Open
Abstract
Posterior cortical atrophy (PCA) is a progressive neurocognitive syndrome, most commonly associated with the loss of complex visuospatial functions. Diagnosis is challenging, and international consensus classification and nomenclature for PCA subtypes have only recently been reached. Presently, no established treatments exist. Efforts to develop treatments are hampered by the lack of standardized methods to monitor illness progression. Although measures developed from work with Alzheimer's disease and other dementias provide a foundation for diagnosing and monitoring progression, PCA presents unique challenges for clinicians counseling patients and families on clinical status and prognosis, and experts designing clinical trials of interventions. Here, we review issues facing PCA clinical research and care, summarize our approach to diagnosis and monitoring of disease progression, and outline ideas for developing tools for these purposes.
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Affiliation(s)
- Bonnie Wong
- Posterior Cortical Atrophy Program, Frontotemporal Disorders Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Diane E Lucente
- Posterior Cortical Atrophy Program, Frontotemporal Disorders Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Centerfor Genomic Medicine, Massachusetts General Hospital & Harvard Medical School, Boston, MA 02114, USA
| | - Julie MacLean
- Department of Physical & Occupational Therapy, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Jaya Padmanabhan
- Posterior Cortical Atrophy Program, Frontotemporal Disorders Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Neurology, Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Megan Quimby
- Posterior Cortical Atrophy Program, Frontotemporal Disorders Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Neurology, Massachusetts General Hospital, Boston,MA 02114, USA
- Department of Speech & Language Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Katherine D Brandt
- Posterior Cortical Atrophy Program, Frontotemporal Disorders Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Neurology, Massachusetts General Hospital, Boston,MA 02114, USA
| | - Deepti Putcha
- Posterior Cortical Atrophy Program, Frontotemporal Disorders Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Janet Sherman
- Posterior Cortical Atrophy Program, Frontotemporal Disorders Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Matthew P Frosch
- Department of Pathology, Division of Neuropathology, Massachusetts General Hospital, Boston, MA 02114, USA
- Massachusetts Alzheimer’s Disease Research Center, Boston, MA 02129, USA
| | - Scott McGinnis
- Posterior Cortical Atrophy Program, Frontotemporal Disorders Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Neurology, Massachusetts General Hospital, Boston,MA 02114, USA
- Department of Neurology, Division of Cognitive & Behavioral Neurology, Brigham & Women's Hospital, Boston, MA 02115, USA
| | - Bradford C Dickerson
- Posterior Cortical Atrophy Program, Frontotemporal Disorders Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Neurology, Massachusetts General Hospital, Boston,MA 02114, USA
- Massachusetts Alzheimer’s Disease Research Center, Boston, MA 02129, USA
- Athinoula A Martinos Center for Biomedical Imaging, Charlestown, MA 02129, USA
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Parsons L, Cordier R, Munro N, Joosten A. The feasibility and appropriateness of a peer-to-peer, play-based intervention for improving pragmatic language in children with autism spectrum disorder. Int J Speech Lang Pathol 2019; 21:412-424. [PMID: 30175619 DOI: 10.1080/17549507.2018.1492630] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 09/17/2017] [Revised: 06/11/2018] [Accepted: 06/19/2018] [Indexed: 06/08/2023]
Abstract
Purpose: This study trialled a play-based, peer-to-peer intervention with children with autism spectrum disorder (ASD) to identify suitable instruments for measuring changes in pragmatic language following the intervention, and evaluate preliminary effectiveness. It also aimed to investigate the appropriateness of the intervention for participants. Method: Ten children with ASD, their typically developing peers, and parents participated. The Pragmatics Observational Measure (POM), Social Emotional Evaluation (SEE) and Profiling Elements of Prosody in Speech Communication (PEPS-C) measured the participant's social communication skills before, after, and 2-months following the intervention. Parent interviews were conducted two months after the intervention and responses were analysed using a thematic approach. Result: Children demonstrated gains in pragmatic language on the POM (χ2(3) = 11.160, p = 0.011) and related higher-level language on the SEE (χ2(2) = 6.686, p = 0.035). The PEPS-C did not produce any significant results. Parent interview responses indicated the intervention was appropriate for the children and families involved. Conclusion: The intervention warrants further investigation of effectiveness with a more robust research design. Consideration should be given to using observational measures of pragmatic language away from the clinic environment to evaluate generalisation, and future development of the intervention might consider variations in playmates and group size.
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Affiliation(s)
- Lauren Parsons
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University , Perth , Australia
| | - Reinie Cordier
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University , Perth , Australia
| | - Natalie Munro
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University , Perth , Australia
- Faculty of Health Sciences, The University of Sydney , Sydney , Australia , and
| | - Annette Joosten
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University , Perth , Australia
- School of Allied Health, Australian Catholic University , Brisbane , Australia
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Lupo M, Siciliano L, Olivito G, Masciullo M, Bozzali M, Molinari M, Cercignani M, Silveri MC, Leggio M. Non-linear spelling in writing after a pure cerebellar lesion. Neuropsychologia 2019; 132:107143. [PMID: 31302109 DOI: 10.1016/j.neuropsychologia.2019.107143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 03/18/2019] [Revised: 07/08/2019] [Accepted: 07/09/2019] [Indexed: 11/17/2022]
Abstract
The most common deficits in processing written language result from damage to the graphemic buffer system and refer to semantic and lexical problems or difficulties in phoneme-graphene conversion. However, a writing disorder that has not yet been studied in depth is the non-linear spelling phenomenon. Indeed, although some cases have been described, no report has exhaustively explained the cognitive mechanism and the anatomical substrates underlying this process. In the present study, we analyzed the modality of non-linear writing in a patient affected by a focal cerebellar lesion, who presented with an alteration of the normal trend to write the order of the letters. Based on this evidence, we analyzed the functional connectivity between the cerebellum and the brain network that subtends handwriting and demonstrated how the cerebellar lesion of the patient affected the connections between the cerebellum and cortical areas that support the anatomical system of writing. This is the first report of non-linear spelling in a patient with a lesion outside the fronto-parietal network, specifically with a focal cerebellar lesion. We propose that non-linear writing can be interpreted in view of the role of the cerebellum in timing and sequential processing. Thus, considering the current functional connectivity data, we hypothesize that the cerebellum might be relevant in the mechanism that allows the correct activation timing of letters within a string and placement of the letters in a specific sequential writing order.
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Affiliation(s)
- Michela Lupo
- Ataxia Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy.
| | - Libera Siciliano
- PhD Program in Behavioral Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Giusy Olivito
- Ataxia Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy; Neuroimaging Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy; Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Marco Bozzali
- Neuroimaging Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy; Clinical Imaging Science Center, Brighton and Sussex Medical School, Brighton, UK
| | - Marco Molinari
- Neurorehabilitation 1 and Spinal Center, Neuro-Robot Rehabilitation Lab, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Mara Cercignani
- Clinical Imaging Science Center, Brighton and Sussex Medical School, Brighton, UK
| | | | - Maria Leggio
- Ataxia Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy; Department of Psychology, Sapienza University of Rome, Rome, Italy
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Abstract
Preterm infants are at increased risk for adverse neurodevelopmental outcomes. The impact of maternal, NICU, and social environmental factors on early neurobehavior and language outcomes of preterm infants is recognized. There is a need for health care professionals to have a clear understanding of the importance of facilitating positive mother-infant relationships, and to address not only the infant's sensory and language environment, but also focus on adverse maternal mental health and social adversities to optimize infant outcomes.
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Affiliation(s)
- Elisabeth C McGowan
- Warren Alpert Medical School of Brown University, and Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI
| | - Betty R Vohr
- Warren Alpert Medical School of Brown University, and Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI
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Carlson HL, Sugden C, Brooks BL, Kirton A. Functional connectivity of language networks after perinatal stroke. Neuroimage Clin 2019; 23:101861. [PMID: 31141787 PMCID: PMC6536856 DOI: 10.1016/j.nicl.2019.101861] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 04/17/2019] [Accepted: 05/19/2019] [Indexed: 02/06/2023]
Abstract
Successful language acquisition during development is imperative for lifelong function. Complex language networks develop throughout childhood. Perinatal stroke may cause significant language disabilities but function can also be remarkably normal. Studying such very early brain injury populations may inform developmental plasticity models of language networks. We examined functional connectivity (FC) of language networks in children with arterial and venous perinatal stroke and typically developing controls (TDC) in a population-based, controlled, cohort study. Resting state functional MRI was performed at 3 T (TR/TE = 2000/30 ms, 150 volumes, 3.6mm3 voxels). Seed-based analyses used bilateral inferior frontal and superior temporal gyri. A subset of stroke participants completed clinical language testing. Sixty-six children participated (median age: 12.85±3.8y, range 6-19; arterial N = 17; venous N = 15; TDC N = 34]. Children with left hemisphere strokes had comparable FC in their right hemispheres compared to TDC. Inter- and intra-hemispheric connectivity strengths were similar between TDC and PVI but lower for AIS. Reduced FC was associated with poorer language comprehension. Language networks can be estimated using resting-state fMRI in children with perinatal stroke. Altered connectivity may occur in both hemispheres, is more pronounced with arterial lesions, and is associated with clinical function. Our results have implications for therapeutic language interventions after early stroke.
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Affiliation(s)
- Helen L Carlson
- Calgary Pediatric Stroke Program, Alberta Children's Hospital, Calgary, AB, Canada; Alberta Children's Hospital Research Institute (ACHRI), Calgary, AB, Canada; Department of Pediatrics, University of Calgary, Calgary, AB, Canada.
| | - Cole Sugden
- Calgary Pediatric Stroke Program, Alberta Children's Hospital, Calgary, AB, Canada
| | - Brian L Brooks
- Alberta Children's Hospital Research Institute (ACHRI), Calgary, AB, Canada; Department of Pediatrics, University of Calgary, Calgary, AB, Canada; Neuropsychology Service, Alberta Children's Hospital, Calgary, AB, Canada; Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Adam Kirton
- Calgary Pediatric Stroke Program, Alberta Children's Hospital, Calgary, AB, Canada; Alberta Children's Hospital Research Institute (ACHRI), Calgary, AB, Canada; Department of Pediatrics, University of Calgary, Calgary, AB, Canada; Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada; Department of Radiology, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
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Barnett C, Armes J, Smith C. Speech, language and swallowing impairments in functional neurological disorder: a scoping review. Int J Lang Commun Disord 2019; 54:309-320. [PMID: 30592118 DOI: 10.1111/1460-6984.12448] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 11/27/2018] [Accepted: 12/04/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Functional neurological disorder (FND) is common across healthcare settings. The Diagnostic and Statistical Manual of Mental Disorders states that speech and swallowing symptoms can be present in FND. Despite this, there is a dearth of guidelines for speech and language therapists (SLTs) for this client group. AIMS To address the following question in order to identify gaps for further research: What is known about speech, language and swallowing symptoms in patients with FND? METHODS & PROCEDURES A scoping review was conducted. Six healthcare databases were searched for relevant literature: CINAHL PLUS, MEDLINE, ProQuest Nursing and Allied Health Professionals, Science Citation Index, Scopus, and PsychINFO. The following symptoms were excluded from the review: dysphonia, globus pharyngeus, dysfluency, foreign accent syndrome and oesophageal dysphagia. MAIN CONTRIBUTION A total of 63 papers were included in the final review; they ranged in date from 1953 to 2018. Case studies were the most frequent research method (n = 23, 37%). 'Psychogenic' was the term used most frequently (n = 24, 38%), followed by 'functional' (n = 21, 33%). Speech symptoms were reported most frequently (n = 41, 65%), followed by language impairments (n = 35, 56%) and dysphagia (n = 13, 21%). Only 11 publications comment on the involvement of SLTs. Eight papers report direct speech and language therapy input; however, none studied the effectiveness of speech and language therapy. CONCLUSIONS & IMPLICATIONS Speech, language and swallowing symptoms do occur in patients with FND, yet it is a highly under-researched area. Further research is required to create a set of positive diagnostic criteria, gather accurate data on numbers of patients with FND and speech, language or swallowing symptoms, and to evaluate the effectiveness of direct speech and language therapy involvement.
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Affiliation(s)
- Caroline Barnett
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Jean Armes
- Birmingham Community Healthcare NHS Trust, Birmingham, UK
| | - Christina Smith
- Department of Language and Cognition, University College London, London, UK
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Pistono A, Jucla M, Bézy C, Lemesle B, Le Men J, Pariente J. Discourse macrolinguistic impairment as a marker of linguistic and extralinguistic functions decline in early Alzheimer's disease. Int J Lang Commun Disord 2019; 54:390-400. [PMID: 30444044 DOI: 10.1111/1460-6984.12444] [Citation(s) in RCA: 10] [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] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 10/26/2018] [Accepted: 10/29/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Alzheimer's disease is characterized by macrolinguistic changes. This decline is often analyzed with quantitative scales. AIMS To analyze discourse production in early Alzheimer's disease (AD) and to identify qualitative markers of macrolinguistic decline. METHODS & PROCEDURES We analyzed macrolinguistic features of a clinical narrative task along with patients' cognitive changes. To do so, 17 early AD participants and 17 healthy controls were recruited and given a full neuropsychological and language assessment. Narrative discourses produced during the language assessment were transcribed and macrolinguistic features were qualitatively analyzed (i.e., local and global coherence marks and discourse informativeness). Inter-group comparison was complemented by intra-group correlation. As some inter-group comparisons revealed the existence of subgroups of patients, permutation tests were used to investigate how these subgroups differed vis-à-vis cognitive measures. OUTCOMES & RESULTS Overall, the results indicate that AD participants presented declines in informativeness and global coherence, correlated with declines in memory and executive functions. Permutation tests showed that participants with AD producing referential errors or misinterpretations had a deeper lexical-executive decline and a lower Mini-Mental State Evaluation (MMSE). CONCLUSIONS & IMPLICATIONS This study shows that two clinically relevant, qualitative signs differ in discourse production between typical ageing and early AD, namely information units and modalizing discourse. It also shows that macrolinguistic assessment is a useful tool for revealing impaired communication and cognition in early AD. Although lexical processing decline probably contributes to patients' macrolinguistic impairment, implications of extralinguistic functioning should be further investigated.
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Affiliation(s)
- Aurélie Pistono
- Octogone-Lordat Interdisciplinary Research Unit (EA 4156), University of Toulouse II-Jean Jaurès, Toulouse, France
- Toulouse NeuroImaging Center, Toulouse University, Inserm, UPS, France
| | - M Jucla
- Octogone-Lordat Interdisciplinary Research Unit (EA 4156), University of Toulouse II-Jean Jaurès, Toulouse, France
| | - C Bézy
- Neurology Department, Toulouse University Hospital, Toulouse, France
| | - B Lemesle
- Neurology Department, Toulouse University Hospital, Toulouse, France
| | - J Le Men
- Neurology Department, Toulouse University Hospital, Toulouse, France
| | - J Pariente
- Toulouse NeuroImaging Center, Toulouse University, Inserm, UPS, France
- Neurology Department, Toulouse University Hospital, Toulouse, France
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45
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Marceaux JC, Prosje MA, McClure LA, Kana B, Crowe M, Kissela B, Manly J, Howard G, Tam JW, Unverzagt FW, Wadley VG. Verbal fluency in a national sample: Telephone administration methods. Int J Geriatr Psychiatry 2019; 34:578-587. [PMID: 30588700 PMCID: PMC6420356 DOI: 10.1002/gps.5054] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 05/13/2018] [Accepted: 12/09/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Describe novel methods for ascertaining verbal fluency in a large national sample of adults, examine demographic factors influencing performance, and compare scores to studies using in-person assessment. METHODS/DESIGN Participants were from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a national, population-based, longitudinal study of stroke in adults aged 45 years and older. Letter and semantic fluency were gathered, using Letter "F" and Animal Naming, via a telephone-based assessment with computer-assisted scoring of digital recordings. RESULTS Initial letter and semantic fluency scores were obtained on 18 505 and 18 072 participants, respectively. For both fluency tests, scores were normally distributed. Younger age and more years of education were associated with better performances (p < 0.0001). The mean and standard deviation for matched subgroups, based on age, gender, and education, were quite comparable with scores reported out of samples using an in-person administration format. Telephone-based assessment also allowed for a level of quality control not available via in-person measurement. CONCLUSIONS Telephone-based assessment of verbal fluency and computer-assisted scoring programs designed for this study facilitated large-scale data acquisition, storage, and scoring of protocols. The resulting scores have similar characteristics to those obtained by traditional methods. These findings extend validation of cognitive assessment methods, using survey research staff and computer-assisted technology for test administration.
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Affiliation(s)
- Janice C Marceaux
- Department of Veterans Affairs, South Texas Veterans Health Care System, San Antonio, TX
| | | | - Leslie A McClure
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, PA
| | - Bhumika Kana
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Michael Crowe
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL
| | - Brett Kissela
- Department of Neurology, University of Cincinnati, Cincinnati, OH
| | - Jennifer Manly
- Department of Neurology, Columbia University, New York, NY
| | - George Howard
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL
| | - Joyce W Tam
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
| | | | - Virginia G Wadley
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
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46
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Abstract
Purpose Evidence exists that changes in language performance may be an early indicator of mild cognitive impairment (MCI), often a harbinger of dementing disease. The purpose of this study was the evaluation of language performance in individuals at risk for MCI by virtue of age and self-concern and its relation to performance on tests of memory, visuospatial function, and mental status. Method Eighty-three individuals 55 years or older were administered the Arizona Battery for Communication Disorders of Dementia ( Bayles & Tomoeda, 1993 ), a standardized battery with normative data from 86 healthy older adults (HOAs) and 86 individuals with Alzheimer's dementia, the most common dementing disease. A performance criterion of 1-1.5 SDs below the mean of HOAs defined MCI, as recommended in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. We hypothesized that (a) the majority of at-risk participants would score 1 SD or more below the mean of HOAs on 1 or more subtests and (b) language performance tests would present a greater challenge than memory, mental status, and visuospatial construction tests. Results Both hypotheses were confirmed. Sixty-two participants (74.6%) met the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria on at least 1 subtest. Moreover, language subtests were those most likely to elicit a performance 1 SD or more below the mean of HOAs. Conclusions Language performance deficits can appear early before impairment in episodic memory, visuospatial construction ability, or mental status in individuals at risk for MCI. Speech-language pathologists are uniquely qualified to identify subtle changes in language, and standardized language tests with normative data should be used when testing for MCI.
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Affiliation(s)
- Kim C McCullough
- Department of Communication Sciences and Disorders, Appalachian State University, Boone, NC
| | - Kathryn A Bayles
- Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson
| | - Erin D Bouldin
- Department of Health and Exercise Science, Appalachian State University, Boone, NC
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Lindsey A, Hurley E, Mozeiko J, Coelho C. Follow-Up on the Story Goodness Index for Characterizing Discourse Deficits Following Traumatic Brain Injury. Am J Speech Lang Pathol 2019; 28:330-340. [PMID: 30054625 DOI: 10.1044/2018_ajslp-17-0151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Purpose The Story Goodness Index (SGI) is a hybrid analysis of narrative discourse combining 2 macrostructural measures: story grammar and story completeness. Initially proposed by Lê and colleagues ( Lê, Coelho, Mozeiko, & Grafman, 2011 ), the SGI is intended to characterize the discourse performance of individuals with cognitive-communication disorders. In this study, the SGI was utilized to examine the discourse of 2 groups, one with closed head injuries and another with non-brain injured (NBI) peers. The intent of this study was to ascertain whether the SGI could differentiate the discourse performance of the 2 groups, as was previously reported for individuals with penetrating traumatic brain injury and an NBI comparison group ( Lê, Coelho, Mozeiko, Krueger, & Grafman, 2012 ). Because of the retrospective nature of this study, the wordless visual narrative used to elicit discourse was different from the narrative used by Lê and colleagues (2012) . Method A retrospective analysis of discourse was performed on 55 individuals with a history of closed head injury and 47 NBI socioeconomically matched peers. During the initial assessment, participants were engaged in a narrative retell task. Each participant was shown a wordless picture story and then asked to retell the story to the examiner. Story narratives were reanalyzed for story grammar (organization) and completeness (critical content). Results A significant group difference was noted for the story grammar measure, but not for story completeness. Although the SGI plots depicted the heterogeneity in discourse performance of the 2 groups, a chi-square test of independence revealed no significant association between group membership and SGI quadrant. Conclusions Findings from this study were inconsistent with those of Lê and colleagues. The studies did not use identical SGI protocols; specifically, different picture stimuli were used to elicit the story retells. Therefore, this study cannot be considered a replication. The story used by Lê and colleagues was judged to be more complex, requiring more inference for story interpretation. Future studies should interpret findings within the context of the story stimuli presented.
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Affiliation(s)
- André Lindsey
- Department of Speech, Language, and Hearing Sciences, University of Connecticut, Storrs
- Neurobiology of Language Training Program, University of Connecticut, Storrs
| | - Erin Hurley
- Cognitive Science Program, University of Connecticut, Storrs
| | - Jennifer Mozeiko
- Department of Speech, Language, and Hearing Sciences, University of Connecticut, Storrs
- Connecticut Institute for the Brain and Cognitive Sciences, University of Connecticut, Storrs
| | - Carl Coelho
- Department of Speech, Language, and Hearing Sciences, University of Connecticut, Storrs
- Cognitive Science Program, University of Connecticut, Storrs
- Connecticut Institute for the Brain and Cognitive Sciences, University of Connecticut, Storrs
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48
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Rolinski R, Austermuehle A, Wiggs E, Agrawal S, Sepeta L, Gaillard WD, Zaghloul K, Inati SK, Theodore WH. Functional MRI and direct cortical stimulation: Prediction of postoperative language decline. Epilepsia 2019; 60:560-570. [PMID: 30740700 PMCID: PMC6467056 DOI: 10.1111/epi.14666] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 11/05/2018] [Revised: 01/16/2019] [Accepted: 01/16/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the ability of functional MRI (fMRI) to predict postoperative language decline compared to direct cortical stimulation (DCS) in epilepsy surgery patients. METHODS In this prospective case series, 17 patients with drug-resistant epilepsy had intracranial monitoring and resection from 2012 to 2016 with 1-year follow-up. All patients completed preoperative language fMRI, mapping with DCS of subdural electrodes, pre- and postoperative neuropsychological testing for language function, and resection. Changes in language function before and after surgery were assessed. fMRI activation and DCS electrodes in the resection were evaluated as potential predictors of language decline. RESULTS Four of 17 patients (12 female; median [range] age, 43 [23-59] years) experienced postoperative language decline 1 year after surgery. Two of 4 patients had overlap of fMRI activation, language-positive electrodes in basal temporal regions (within 1 cm), and resection. Two had overlap between resection volume and fMRI activation, but not DCS. fMRI demonstrated 100% sensitivity and 46% specificity for outcome compared to DCS (50% and 85%, respectively). When fMRI and DCS language findings were concordant, the combined tests showed 100% sensitivity and 75% specificity for language outcome. Seizure-onset age, resection side, type, volume, or 1 year seizure outcome did not predict language decline. SIGNIFICANCE Language localization overlap of fMRI and direct cortical stimulation in the resection influences postoperative language performance. Our preliminary study suggests that fMRI may be more sensitive and less specific than direct cortical stimulation. Together they may predict outcome better than either test alone.
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Affiliation(s)
- Rachel Rolinski
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke, Bethesda, MD
| | - Alison Austermuehle
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke, Bethesda, MD
| | - Edythe Wiggs
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke, Bethesda, MD
| | - Shubhi Agrawal
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke, Bethesda, MD
- Berman Brain & Spine Institute, Baltimore, MD
| | - Leigh Sepeta
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke, Bethesda, MD
- Department of Neurology Children’s National Medical
Center, Washington, D.C
| | - William D Gaillard
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke, Bethesda, MD
- Department of Neurology Children’s National Medical
Center, Washington, D.C
| | - Kareem Zaghloul
- Surgical Neurology Branch, National Institute of
Neurological Disorders and Stroke, Bethesda, MD
| | - Sara K Inati
- Electroencephalography Section, National Institute of
Neurological Disorders and Stroke, Bethesda, MD
| | - William H Theodore
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke, Bethesda, MD
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49
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You X, Zachery AN, Fanto E, Norato G, Germeyan SC, Emery EJ, Sepeta LN, Berl MM, Black CL, Wiggs E, Zaghloul K, Inati SK, Gaillard WD, Theodore WH. fMRI prediction of naming change after adult temporal lobe epilepsy surgery: Activation matters. Epilepsia 2019; 60:527-538. [PMID: 30740666 PMCID: PMC6401285 DOI: 10.1111/epi.14656] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 10/04/2018] [Revised: 01/04/2019] [Accepted: 01/07/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE We aimed to predict language deficits after epilepsy surgery. In addition to evaluating surgical factors examined previously, we determined the impact of the extent of functional magnetic resonance imaging (fMRI) activation that was resected on naming ability. METHOD Thirty-five adults (mean age 37.5 ± 10.9 years, 13 male) with temporal lobe epilepsy completed a preoperative fMRI auditory description decision task, which reliably activates frontal and temporal language networks. Patients underwent temporal lobe resections (20 left resection). The Boston Naming Test (BNT) was used to determine language functioning before and after surgery. Language dominance was determined for Broca and Wernicke area (WA) by calculating a laterality index following statistical parametric mapping processing. We used an innovative method to generate anatomic resection masks automatically from pre- and postoperative MRI tissue map comparison. This mask provided the following: (a) resection volume; (b) overlap between resection and preoperative activation; and (c) overlap between resection and WA. We examined postoperative language change predictors using stepwise linear regression. Predictors included parameters described above as well as age at seizure onset (ASO), preoperative BNT score, and resection side and its relationship to language dominance. RESULTS Seven of 35 adults had significant naming decline (6 dominant-side resections). The final regression model predicted 38% of the naming score change variance (adjusted r2 = 0.28, P = 0.012). The percentage of top 10% fMRI activation resected (P = 0.017) was the most significant contributor. Other factors in the model included WA LI, ASO, volume of WA resected, and WA LI absolute value (extent of laterality). SIGNIFICANCE Resection of fMRI activation during a word-definition decision task is an important factor for postoperative change in naming ability, along with other previously reported predictors. Currently, many centers establish language dominance using fMRI. Our results suggest that the amount of the top 10% of language fMRI activation in the intended resection area provides additional predictive power and should be considered when planning surgical resection.
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Affiliation(s)
- Xiaozhen You
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke
- Children’s Research Institute, Children’s
National Hospital System
- Psychology, Georgetown University
| | - Ashley N. Zachery
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke
- Children’s Research Institute, Children’s
National Hospital System
| | - Eleanor Fanto
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke
- Children’s Research Institute, Children’s
National Hospital System
| | - Gina Norato
- Office of the Clinical Director, National Institute of
Neurological Disorders and Stroke
| | - Sierra C. Germeyan
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke
| | - Eric J. Emery
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke
- Children’s Research Institute, Children’s
National Hospital System
| | - Leigh N. Sepeta
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke
- Children’s Research Institute, Children’s
National Hospital System
| | - Madison M. Berl
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke
- Children’s Research Institute, Children’s
National Hospital System
| | - Chelsea L. Black
- Children’s Research Institute, Children’s
National Hospital System
| | - Edythe Wiggs
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke
| | - Kareem Zaghloul
- Surgical Neurology Branch, National Institute of
Neurological Disorders and Stroke
| | - Sara K. Inati
- Office of the Clinical Director, National Institute of
Neurological Disorders and Stroke
| | - William D. Gaillard
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke
- Children’s Research Institute, Children’s
National Hospital System
| | - William H. Theodore
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke
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50
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Wolff L, Benge J. Everyday Language Difficulties in Parkinson's Disease: Caregiver Description and Relationship With Cognition, Activities of Daily Living, and Motor Disability. Am J Speech Lang Pathol 2019; 28:165-173. [PMID: 31072160 DOI: 10.1044/2018_ajslp-18-0091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose Parkinson's disease (PD) impacts language in multiple ways, though important questions remain. The current article explores 2 main issues: what type of everyday language difficulties (ELDs) are noted by care partners and how do ELDs relate to cognition, daily activities, and motor disability in PD. Method Care partner reports of ELD were collected in 42 community-dwelling individuals with PD. Descriptive information of ELD was tallied, and the relationship of cognitive decline, activities of daily living (ADLs), and motor disability with ELD was evaluated. Results Forty-two percent of patients were described by care partners as having at least 1 consistent ELD, and the frequency of ELD increased in the presence of dementia, χ2(2) = 14.37, p = .0008. The most commonly described ELDs by caregivers were related to comprehension of instructions and deriving the point of conversations. ELD was correlated with worse cognition ( r s = -.524, p < .001), increased difficulty with daily activities ( r s = .634, p < .001), and increased motor dysfunction ( r s = .554, p < .001). Mild ADL decline (Functional Assessment Questionnaire score of 4); an area under the curve of .81 ( SE = .07) was highly specific to the presence of ELD (95.4%). Conclusions Care partners note a variety of ELDs in patients with PD, most commonly comprehension difficulties. These difficulties increase with overall cognitive decline but are described in 30%-40% of those without significant cognitive deficits. ADL difficulties correlate with functional, motoric, and cognitive status, with even mild functional declines predictive of the presence of ELD. Implications for research and practice in this population are discussed.
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Affiliation(s)
- Logan Wolff
- Department of Neurology, Baylor Scott & White Health, Temple, TX
| | - Jared Benge
- Department of Neurology, Baylor Scott & White Health, Temple, TX
- Plummer Movement Disorders Center, Baylor Scott & White Health, Temple, TX
- Department of Internal Medicine, Texas A&M College of Medicine, Temple
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