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Parkinsonism & Related Disorders Jun 2019Sensory trick is a specific maneuver that temporarily improves dystonia that is usually observed in 44%-89% of patients with cranial-cervical dystonia and in 20% of... (Comparative Study)
Comparative Study
INTRODUCTION
Sensory trick is a specific maneuver that temporarily improves dystonia that is usually observed in 44%-89% of patients with cranial-cervical dystonia and in 20% of patients with upper limb dystonia. This study aimed to assess the prevalence of sensory trick in a cohort of 37 patients with idiopathic adult-onset upper limb dystonia and to determine whether sensory trick can be a useful tool to distinguish dystonic and non-dystonic tremor.
METHODS
Thirty-seven right-handed patients with idiopathic upper limb dystonia and disturbed handwriting and 19 patients with non-dystonic action tremor in the upper limb causing writing disturbances participated into the study. Patients were asked to write a standard sentence twice, before and after applying a standardized sensory trick (gently grabbing right wrist with his left hand). Readability of the two sentences was assessed by three observers blinded to diagnosis.
RESULTS
Five/37 patients (13%) self-discovered ST over disease history, while performing the standardized trick maneuver improved handwriting in 14/37 patients (38%). Interobserver agreement on the effectiveness of sensory trick among the three observers yielded a kappa value of 0.86 (p < 0.0001). The standardized trick was effective in 8/19 patients with dystonic tremor (42%) and in 0/19 patients with non-dystonic tremor (p = 0.003).
CONCLUSION
The results of applying a standardized non-spontaneous trick demonstrated that, in upper limb dystonia, ST may be more frequent than usually observed. Effective sensory trick, when present, may be a hallmark of idiopathic dystonia. The lack of effective sensory trick may help to identify non dystonic upper limb tremor.
Topics: Aged; Agraphia; Cohort Studies; Dystonic Disorders; Essential Tremor; Female; Handwriting; Humans; Male; Middle Aged; Psychomotor Performance; Torticollis; Tremor; Upper Extremity
PubMed: 30655163
DOI: 10.1016/j.parkreldis.2019.01.006 -
Neuropsychological Rehabilitation May 2019Reading and writing impairments are common in individuals with post-stroke aphasia. Treatment typically aims to improve the function of one of these modalities by...
Reading and writing impairments are common in individuals with post-stroke aphasia. Treatment typically aims to improve the function of one of these modalities by strengthening aspects of either lexical or sublexical processing. In the present study, eight adults with acquired alexia and agraphia were administered a comprehensive treatment targeting specific lexical and sublexical processes underlying reading and/or writing. Two participants were trained in reading and six were trained in writing. Throughout treatment, reading and writing accuracy were monitored for trained items, as well as untrained but orthographically and semantically related items. Linear mixed effects models indicated that the most substantial gains were made on trained items in the trained modality; generalisation to trained items in the untrained modality and untrained but related items in both modalities was also observed. Participants improved significantly on a subset of treatment steps intended to address lexical access and representations, sublexical conversion mechanisms, and the graphemic and/or phonological buffer processes in both modalities. These results demonstrate the efficacy of a novel, comprehensive treatment protocol and suggest that targeting multiple reading and writing processes in conjunction may facilitate widespread generalisation.
Topics: Aged; Aged, 80 and over; Agraphia; Aphasia; Dyslexia, Acquired; Female; Generalization, Psychological; Humans; Language Therapy; Male; Middle Aged; Outcome and Process Assessment, Health Care; Stroke; Stroke Rehabilitation; Treatment Outcome
PubMed: 28421858
DOI: 10.1080/09602011.2017.1311271 -
Journal of Neurosurgery. Case Lessons Mar 2023Apraxia of speech is a disorder of speech-motor planning in which articulation is effortful and error-prone despite normal strength of the articulators. Phonological...
BACKGROUND
Apraxia of speech is a disorder of speech-motor planning in which articulation is effortful and error-prone despite normal strength of the articulators. Phonological alexia and agraphia are disorders of reading and writing disproportionately affecting unfamiliar words. These disorders are almost always accompanied by aphasia.
OBSERVATIONS
A 36-year-old woman underwent resection of a grade IV astrocytoma based in the left middle precentral gyrus, including a cortical site associated with speech arrest during electrocortical stimulation mapping. Following surgery, she exhibited moderate apraxia of speech and difficulty with reading and spelling, both of which improved but persisted 6 months after surgery. A battery of speech and language assessments was administered, revealing preserved comprehension, naming, cognition, and orofacial praxis, with largely isolated deficits in speech-motor planning and the spelling and reading of nonwords.
LESSONS
This case describes a specific constellation of speech-motor and written language symptoms-apraxia of speech, phonological agraphia, and phonological alexia in the absence of aphasia-which the authors theorize may be attributable to disruption of a single process of "motor-phonological sequencing." The middle precentral gyrus may play an important role in the planning of motorically complex phonological sequences for production, independent of output modality.
PubMed: 37014023
DOI: 10.3171/CASE22504 -
International Journal of Language &... Nov 2022Written communication has become an increasingly important part of everyday life in social, educational and professional spheres. The substantial increase in writing via...
BACKGROUND
Written communication has become an increasingly important part of everyday life in social, educational and professional spheres. The substantial increase in writing via the internet and mobile technologies provides both an opportunity for social engagement and distinct challenges for people with aphasia. Within the current literature there has been limited research into the lived experiences of people with aphasia of their writing difficulties and how these affect their ability to communicate.
AIMS
This qualitative study aimed to explore the experiences of people with aphasia of living with language-related writing difficulties and the impact of these on their lives.
METHODS & PROCEDURES
Eight people with post-stroke aphasia and writing difficulties took part in semi-structured interviews. The interviews were analysed using inductive reflexive thematic analysis.
OUTCOMES & RESULTS
Two themes were found in the data. The first theme was a gradual and effortful improvement to writing: Participants described how writing had improved since their stroke due to strategies and support, but they still found writing to be difficult and frustrating and described many barriers to writing. The second theme was the importance of writing for fulfilling adult social roles: Participants found writing to be important for communicating with family, friends and organizations, but their participation in society and self-esteem and confidence were impacted by writing difficulties; reduced social roles meant reduced need for writing, but participants were still motivated to work towards writing goals.
CONCLUSIONS & IMPLICATIONS
The findings demonstrate the emerging importance of writing skills for people with aphasia with respect to communication, well-being, participation and inclusion in society, and carrying out social roles. They provide an insight into the process of improvement, including the difficulties, facilitators and barriers. Implications for speech and language therapy assessment and management are discussed.
WHAT THIS PAPER ADDS
What is already known on the subject People with aphasia have difficulties with writing that can affect their ability to communicate. A small body of qualitative research has provided insights into individuals' experiences of literacy difficulties. More research is needed to understand the writing experiences of people with aphasia to help design appropriate assessments and interventions. What this paper adds to existing knowledge Participants experienced gradual and effortful improvement since their stroke. They felt negative about aspects of their writing, including speed, accuracy and range of vocabulary. Writing was facilitated through assistive technologies, spelling practice and support from others; barriers included technology, lack of time, stroke-related symptoms and others' lack of awareness about aphasia. Participants considered writing skills to be important, particularly for communication, carrying out adult social roles and participating in society, and were therefore still working towards goals related to everyday writing activities. What are the potential or actual clinical implications of this work? This study suggests that speech and language therapy assessment should include interviewing participants about their activities, strengths, difficulties, facilitators and barriers in writing, and informal assessment of a range of functional writing tasks. Intervention should be tailored to the individual's needs. This should include meaningful activities that relate to functional everyday writing and, where appropriate, self-management, compensatory technologies and group approaches, while making use of existing strategies identified by the individual.
Topics: Adult; Humans; Aphasia; Speech Therapy; Agraphia; Stroke Rehabilitation; Stroke; Writing
PubMed: 35929726
DOI: 10.1111/1460-6984.12762 -
Neurodegenerative Disease Management Oct 2015
Review
Topics: Agraphia; Biomarkers; Disease Progression; Handwriting; Humans; Parkinson Disease
PubMed: 26517047
DOI: 10.2217/nmt.15.29 -
PloS One 2020Handwriting is a complex skill to acquire and it requires years of training to be mastered. Children presenting dysgraphia exhibit difficulties automatizing their...
Handwriting is a complex skill to acquire and it requires years of training to be mastered. Children presenting dysgraphia exhibit difficulties automatizing their handwriting. This can bring anxiety and can negatively impact education. 280 children were recruited in schools and specialized clinics to perform the Concise Evaluation Scale for Children's Handwriting (BHK) on digital tablets. Within this dataset, we identified children with dysgraphia. Twelve digital features describing handwriting through different aspects (static, kinematic, pressure and tilt) were extracted and used to create linear models to investigate handwriting acquisition throughout education. K-means clustering was performed to define a new classification of dysgraphia. Linear models show that three features only (two kinematic and one static) showed a significant association to predict change of handwriting quality in control children. Most kinematic and statics features interacted with age. Results suggest that children with dysgraphia do not simply differ from ones without dysgraphia by quantitative differences on the BHK scale but present a different development in terms of static, kinematic, pressure and tilt features. The K-means clustering yielded 3 clusters (Ci). Children in C1 presented mild dysgraphia usually not detected in schools whereas children in C2 and C3 exhibited severe dysgraphia. Notably, C2 contained individuals displaying abnormalities in term of kinematics and pressure whilst C3 regrouped children showing mainly tilt problems. The current results open new opportunities for automatic detection of children with dysgraphia in classroom. We also believe that the training of pressure and tilt may open new therapeutic opportunities through serious games.
Topics: Agraphia; Biomechanical Phenomena; Child; Female; Handwriting; Humans; Male; Motor Skills
PubMed: 32915793
DOI: 10.1371/journal.pone.0237575 -
Brain and Language Jan 2017We used fMRI to examine the neural substrates of sublexical phoneme-grapheme conversion during spelling in a group of healthy young adults. Participants performed a...
We used fMRI to examine the neural substrates of sublexical phoneme-grapheme conversion during spelling in a group of healthy young adults. Participants performed a writing-to-dictation task involving irregular words (e.g., choir), plausible nonwords (e.g., kroid), and a control task of drawing familiar geometric shapes (e.g., squares). Written production of both irregular words and nonwords engaged a left-hemisphere perisylvian network associated with reading/spelling and phonological processing skills. Effects of lexicality, manifested by increased activation during nonword relative to irregular word spelling, were noted in anterior perisylvian regions (posterior inferior frontal gyrus/operculum/precentral gyrus/insula), and in left ventral occipito-temporal cortex. In addition to enhanced neural responses within domain-specific components of the language network, the increased cognitive demands associated with spelling nonwords engaged domain-general frontoparietal cortical networks involved in selective attention and executive control. These results elucidate the neural substrates of sublexical processing during written language production and complement lesion-deficit correlation studies of phonological agraphia.
Topics: Adult; Agraphia; Brain Mapping; Cerebral Cortex; Female; Functional Laterality; Humans; Language; Magnetic Resonance Imaging; Male; Middle Aged; Occipital Lobe; Reading; Temporal Lobe; Writing; Young Adult
PubMed: 27838547
DOI: 10.1016/j.bandl.2016.10.001 -
Cerebellum & Ataxias 2014Clinical case descriptions and experimental evidence dating back to the early part of the 19th century from time to time documented a range of nonmotor cognitive and... (Review)
Review
Clinical case descriptions and experimental evidence dating back to the early part of the 19th century from time to time documented a range of nonmotor cognitive and affective impairments following cerebellar pathology. However, a causal relationship between disruption of nonmotor cognitive and affective skills and cerebellar disease was dismissed for several decades and the classical view of the cerebellum as a mere coordinator of autonomic and somatic sensorimotor function prevailed for more than two centuries in behavioural neuroscience. The ignorance of early clinical evidence suggesting a much richer and complex role for the cerebellum than a pure sensorimotor one is remarkable given that in addition: 1) the cerebellum contains more neurons than the rest of the combined cerebral cortex and 2) no other structure has as many connections with other parts of the brain as the cerebellum. During the past decades, the long-standing view of the cerebellum as pure coordinator of sensorimotor function has been substantially modified. From the late 1970s onwards, major advances were made in elucidating the many functional neuroanatomical connections of the cerebellum with the supratentorial association cortices that subserve nonmotor language, cognition and affect. Combined with evidence derived from experimental functional neuroimaging studies in healthy subjects and neurophysiological and neuropsychological research in patients, the role of the cerebellum has been substantially extended to include that of a crucial modulator of cognitive and affective processes. In addition to its long-established role in coordinating motor aspects of speech production, clinical and experimental studies with patients suffering from etiologically different cerebellar disorders have identified involvement of the cerebellum in a variety of nonmotor language functions, including motor speech planning, language dynamics and verbal fluency, phonological and semantic word retrieval, expressive and receptive syntax processing, various aspects of reading and writing and aphasia-like phenomena. Despite considerable efforts currently devoted to further refine typology and anatomoclinical configurations of nonmotor linguistic dysfunctions linked to cerebellar pathology, the exact underlying pathophysiological mechanisms of cerebellar involvement remain to be elucidated.
PubMed: 26331036
DOI: 10.1186/2053-8871-1-12 -
Cureus Apr 2024Alexia without agraphia is a striking vascular syndrome of the acquired inability to read words just written down. This syndrome occurs after lesions in the splenium of...
Alexia without agraphia is a striking vascular syndrome of the acquired inability to read words just written down. This syndrome occurs after lesions in the splenium of the corpus callosum that disconnect the angular gyrus from the visual pathway. Most of the time, a lesion in the left occipital lobe is also present, and patients present with a visual field deficit. It is a classic neurological syndrome that is rarely seen. We present two cases of alexia without agraphia seen in our hospital the same week.
PubMed: 38752100
DOI: 10.7759/cureus.58309 -
Arquivos de Neuro-psiquiatria Feb 2019Maurice Ravel is one of the most important French musicians. In the last years of his life, Ravel was victim of a dementia of uncertain etiology that caused aphasia,...
Maurice Ravel is one of the most important French musicians. In the last years of his life, Ravel was victim of a dementia of uncertain etiology that caused aphasia, apraxia, agraphia and amusia. The artistic brain of the author of eternal musical compositions was progressively silenced due to his neurodegenerative disease. On the 90th anniversary of Boléro, this historical note revisits Ravel's case and discusses the relationship of his dementia to his artistic production. It illustrates the intimacy that can exist between art, music, creativity, and neurology.
Topics: Art; Dementia; France; History, 19th Century; History, 20th Century; Humans; Music; Neurology
PubMed: 30810599
DOI: 10.1590/0004-282X20180134