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Journal of Neural Transmission (Vienna,... Dec 2021The emergence of new artistic activities or shifts in artistic style in patients with frontotemporal dementia (FTD) syndromes is well documented at or after disease... (Review)
Review
The emergence of new artistic activities or shifts in artistic style in patients with frontotemporal dementia (FTD) syndromes is well documented at or after disease onset. However, a closer look in the literature reveals emerging artistic creativity also before FTD onset, although the significance and underlying pathology of such creative endeavors remain elusive. Here, we systematically review relevant studies and report an additional FTD case to elaborate on artistic activities that developed years before disease manifestation by paying particular attention to the sequence of events in individual patients' biography and clinical history. We further discuss the FTD patient's creative activities in the context of their life events, other initial or "premorbid" dementia symptoms or risk factors described in the literature such as mental illness and mild behavioral impairment (MBI), as well as changes in neuronal systems (i.e., neuroimaging and neuropathology). In addition to our FTD patient, we identified five published cases with an FTD syndrome, including three with FTD, one with primary progressive aphasia (PPA), and one with the behavioral variant of PPA (bvPPA). Premorbid novel creativity emerged across different domains (visual, musical, writing), with the FTD diagnosis ensuing artistic productivity by a median of 8 years. Data on late-life and pre-dementia life events were available in four cases. The late creative phase in our case was accompanied by personality changes, accentuation of personality traits, and cessation of painting activities occurred with the onset of memory complaints. Thus, premorbid personality changes in FTD patients can be associated with de novo creative activity. Stressful life events may also contribute to the burgeoning of creativity. Moreover, primary neocortical areas that are largely spared by pathology at early FTD stages may facilitate the engagement in artistic activities, offering a window of opportunity for art therapy and other therapeutic interventions during the MBI stage or even earlier.
Topics: Creativity; Frontotemporal Dementia; Humans; Neuroimaging; Syndrome
PubMed: 34618237
DOI: 10.1007/s00702-021-02426-9 -
Current Pain and Headache Reports Jan 2020Although visual and somatosensory disturbances are the most common migraine aura (MA) symptoms, patients can also experience other symptoms during their MA. The aim of...
PURPOSE OF THE REVIEW
Although visual and somatosensory disturbances are the most common migraine aura (MA) symptoms, patients can also experience other symptoms during their MA. The aim of this review is to provide an overview of studies that report symptoms of dysphasia and other higher cortical dysfunctions (HCDs) during MA, as well as to determine the frequency of HCDs.
RECENT FINDINGS
Five studies met the inclusion criteria, corresponding to 697 patients overall. The most frequently reported HCDs were those of the language group (range 10-53%). The occurrence of visual HCDs was noted in 12-40 patients, somatosensory HCDs in 12-20%, and memory disturbances in 10-22% of the patients during MAs. MA is associated with a wide range of neurological symptoms, including symptoms of HCD. A better strategy for investigation of the HCD symptoms is needed to correctly stratify patients thus allowing meaningful studies of aura pathophysiology.
Topics: Aphasia; Apraxias; Cerebral Cortex; Humans; Memory Disorders; Migraine with Aura; Somatosensory Disorders
PubMed: 31981018
DOI: 10.1007/s11916-020-0836-3 -
Disability and Rehabilitation Nov 2023This study synthesizes participant and outcome data from peer-reviewed Intensive Comprehensive Aphasia Programme (ICAP) studies. (Review)
Review
PURPOSE
This study synthesizes participant and outcome data from peer-reviewed Intensive Comprehensive Aphasia Programme (ICAP) studies.
METHODS
A systematic review was conducted following PRISMA guidelines. Study eligibility criteria were specified in relation to population, intervention, comparison, outcome, and design considerations. Data were extracted according to six research questions. Narrative synthesis was used.
RESULTS
Twenty-one studies were included covering 13 ICAPs ( = 485, aged 18-86 years, between 11 and 335 months post-stroke). Twenty-seven participant selection criteria were identified. Fifty-six outcome measures spanning the WHO-ICF were used, with the majority assessing the body function domain. Only eight studies employed an experimental design with data appropriate for analysis and synthesis. Risk of bias was noted across this sub-group. Participants improved in word-finding, communication, activity/participation, and communication-related quality of life, and maintained their gains; however, except for word finding, evidence of effect came from isolated studies. Factors influencing outcomes were rarely considered. Some drop-outs, missed sessions, and fatigue were noted. Some studies reported IPD alongside group analyses.
CONCLUSIONS
ICAP selection criteria need justification and should contribute to the understanding of candidacy for this treatment model. Rationalisation of ICAP treatment content and outcome measurement is required, spanning all WHO-ICF domains. Employment of the core outcome set for aphasia would enable data synthesis and facilitate comparisons between the ICAP and other therapy models.
PubMed: 37916542
DOI: 10.1080/09638288.2023.2274877 -
International Journal of Language &... 2023Individuals with affective-prosodic deficits have difficulty understanding or expressing emotions and attitudes through prosody. Affective prosody disorders can occur in... (Review)
Review
BACKGROUND
Individuals with affective-prosodic deficits have difficulty understanding or expressing emotions and attitudes through prosody. Affective prosody disorders can occur in multiple neurological conditions, but the limited knowledge about the clinical groups prone to deficits complicates their identification in clinical settings. Additionally, the nature of the disturbance underlying affective prosody disorder observed in different neurological conditions remains poorly understood.
AIMS
To bridge these knowledge gaps and provide relevant information to speech-language pathologists for the management of affective prosody disorders, this study provides an overview of research findings on affective-prosodic deficits in adults with neurological conditions by answering two questions: (1) Which clinical groups present with acquired affective prosodic impairments following brain damage? (2) Which aspects of affective prosody comprehension and production are negatively affected in these neurological conditions?
METHODS & PROCEDURES
We conducted a scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. A literature search was undertaken in five electronic databases (MEDLINE, PsycINFO, EMBASE, CINAHL and Linguistics, and Language Behavior Abstracts) to identify primary studies reporting affective prosody disorders in adults with neurological impairments. We extracted data on clinical groups and characterised their deficits based on the assessment task used.
OUTCOMES & RESULTS
The review of 98 studies identified affective-prosodic deficits in 17 neurological conditions. The task paradigms typically used in affective prosody research (discrimination, recognition, cross-modal integration, production on request, imitation and spontaneous production) do not target the processes underlying affective prosody comprehension and production. Therefore, based on the current state of knowledge, it is not possible to establish the level of processing at which impairment occurs in clinical groups. Nevertheless, deficits in the comprehension of affective prosody are observed in 14 clinical groups (mainly recognition deficits) and deficits in the production of affective prosody (either on request or spontaneously) in 10 clinical groups. Neurological conditions and types of deficits that have not been investigated in many studies are highlighted.
CONCLUSIONS & IMPLICATIONS
The aim of this scoping review was to provide an overview on acquired affective prosody disorders and to identify gaps in knowledge that warrant further investigation. Deficits in the comprehension or production of affective prosody are common to numerous clinical groups with various neurological conditions. However, the underlying cause of affective prosody disorders across them is still unknown. Future studies should implement standardised assessment methods with specific tasks based on a cognitive model to identify the underlying deficits of affective prosody disorders.
WHAT THIS PAPER ADDS
What is already known on the subject What is already known on the subjectAffective prosody is used to share emotions and attitudes through speech and plays a fundamental role in communication and social interactions. Affective prosody disorders can occur in various neurological conditions, but the limited knowledge about the clinical groups prone to affective-prosodic deficits and about the characteristics of different phenotypes of affective prosody disorders complicates their identification in clinical settings. Distinct abilities underlying the comprehension and production of affective prosody can be selectively impaired by brain damage, but the nature of the disturbance underlying affective prosody disorders in different neurological conditions remains unclear. What this study adds Affective-prosodic deficits are reported in 17 neurological conditions, despite being recognised as a core feature of the clinical profile in only a few of them. The assessment tasks typically used in affective prosody research do not provide accurate information about the specific neurocognitive processes impaired in the comprehension or production of affective prosody. Future studies should implement assessment methods based on a cognitive approach to identify underlying deficits. The assessment of cognitive/executive dysfunctions, motor speech impairment and aphasia might be important for distinguishing primary affective prosodic dysfunctions from those secondarily impacting affective prosody. What are the potential clinical implications of this study? Raising awareness about the possible presence of affective-prosodic disorders in numerous clinical groups will facilitate their recognition by speech-language pathologists and, consequently, their management in clinical settings. A comprehensive assessment covering multiple affective-prosodic skills could highlight specific aspects of affective prosody that warrant clinical intervention.
Topics: Humans; Adult; Emotions; Speech Disorders; Aphasia; Linguistics; Language; Communication Disorders
PubMed: 37212522
DOI: 10.1111/1460-6984.12909 -
Clinical Neurology and Neurosurgery Sep 2021Chronic subdural hematoma (CSDH) is one of the most common neurosurgical cases, especially in elderly individuals. Secondary parkinsonism due to CSDH is a rare entity....
BACKGROUND
Chronic subdural hematoma (CSDH) is one of the most common neurosurgical cases, especially in elderly individuals. Secondary parkinsonism due to CSDH is a rare entity. The mechanism of parkinsonism symptoms in chronic subdural hematoma has been suggested to include direct mechanical compression of the basal ganglia due to hematoma or indirectly through brain structure changes due to space lesions and vascular disorders. Surgery on the subdural hematoma provides a favorable outcome for parkinsonism symptoms.
OBJECTIVES
To systematically review the literature on CSDH-induced parkinsonism.
SEARCH METHODS
This is a systematic review on case reports. Literature search was performed using the predefined keywords on PubMed, ProQuest, and Google Scholar. We also provided our own case report and compared it with published studies.
RESULT
Sixteen cases from 13 case reports/series were identified, predominantly consisting of male patients with the mean age of 66.5 ± 9.73 years. The most common symptoms were rigidity, gait disturbance, and bradykinesia, observed in 12 (75%) cases each. The second and third most common symptoms were tremor (11; 68.75%) and facial masking (8; 50%), respectively. Other reported symptoms were dysphasia (3; 18.75%), dysarthria (3; 18.75%), and urinary incontinence (2; 12. 5%). Time gap between the symptom onset and CSDH diagnosis and unilateral location seemed to influence the outcome.
CONCLUSION
Only 16 CSDH-induced parkinsonism were identified since the 1960s. This condition is thought to occur due to basal ganglia compression. Surgery on the subdural hematoma provides a favorable outcome for parkinsonism symptoms. Timely CSDH diagnosis might yield better outcome. However, further research on CSDH-induced parkinsonism is needed, especially in the mechanisms and treatment outcomes.
Topics: Aged; Basal Ganglia; Female; Hematoma, Subdural, Chronic; Humans; Male; Middle Aged; Parkinsonian Disorders
PubMed: 34314946
DOI: 10.1016/j.clineuro.2021.106826 -
Medicine Jan 2024Although the effectiveness of noninvasive brain stimulation (NIBS) technology in assisting rehabilitation is widely recognized, its therapeutic efficacy in patients with... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Although the effectiveness of noninvasive brain stimulation (NIBS) technology in assisting rehabilitation is widely recognized, its therapeutic efficacy in patients with poststroke aphasia (PSA) requires further validation. Here, we aimed to explore the efficacy and safety of the NIBS technique combined with speech training in PSA by traditional Meta-analysis and to compare the intervention effects of the 2 NIBS techniques by Network meta-analysis.
METHODS
Randomized controlled trials of the NIBS technique combined with speech training for treating PSA in 9 databases, including Web of Science, PubMed, and CNKI, and 2 clinical trial registries were searched by computer. Literature screening was performed using EndNote X9 software, and data analysis and presentation of results were performed using RevMan 5.4.1 and Stata 17.0 software.
RESULTS
Screening yielded 17 studies with 1013 patients with PSA. Meta-analysis showed that aphasia quotient scores were higher in the intervention group than in the control group [standardized mean difference (SMD) = 1.06, 95% confidence interval (CI) (0.63, 1.49), Z = 4.80, P < .00001]; Western aphasia battery scores on all 4 subscales were higher than those of the control group, the spontaneous language score is [SMD = 0.62, 95% CI (0.46, 0.78), Z = 7.52, P < .00001], the listening comprehension score is [SMD = 0.46, 95% CI (0.30, 0.62), Z = 5.62, P < .00001], the repetition score is [SMD = 1.14, 95% CI (0.59, 1.70), Z = 4.04, P < .0001], the naming score is [SMD = 1.06, 95% CI (0.79, 1.32), Z = 7.85, P < .00001]; The effective rate of the intervention group was higher than that of the control group [odd ratio = 4.19, 95% CI (2.39, 7.37), Z = 4.99, P < .00001]. The results of the Network meta-analysis showed that the best probability ranking of the 2 NIBS techniques combined with speech training in improving aphasia quotient scores was repetitive transcranial magnetic stimulation group (92.2%) > transcranial direct current stimulation group (55.7%). Regarding safety, it was not found that the NIBS technique combined with speech training to treat PSA increases the risk of adverse reactions.
CONCLUSION
The NIBS technique combined with speech training can effectively improve the recovery of language function in PSA patients with minimal adverse effects, and the clinic can give priority to r TMS combined with speech training in treating PSA.
Topics: Humans; Aphasia; Brain; Speech; Stroke; Stroke Rehabilitation; Transcranial Direct Current Stimulation; Transcranial Magnetic Stimulation; Network Meta-Analysis
PubMed: 38215135
DOI: 10.1097/MD.0000000000036880 -
International Journal of Language &... Mar 2023Factors influencing the implementation of communication partner training (CPT) with familiar partners of people with aphasia (PWA) have previously been documented using...
BACKGROUND
Factors influencing the implementation of communication partner training (CPT) with familiar partners of people with aphasia (PWA) have previously been documented using disparate approaches. To date there has been no synthesis of these factors using a common theoretical framework. Investigating CPT implementation factors using a common theoretical framework may further our understanding of universal barriers and guide future development of tailored, theoretically informed implementation strategies.
AIMS
(1) To determine the perceived and/or observed barriers and facilitators to implementing CPT with familiar partners of adults with aphasia; (2) to map extracted barriers and facilitators to a common theoretical framework; (3) to synthesize extracted barriers and facilitators; and (4) to identify potential implementation strategies to address the most frequently identified barriers and facilitators.
METHODS & PROCEDURES
A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four electronic databases (MEDLINE, EMBASE, CINAHL, Web of Science) were systematically searched in April 2021. Empirical qualitative and/or quantitative research studies reporting barriers/facilitators to speech-language therapists (SLTs) implementing CPT with familiar partners of adults with aphasia were included. The search was limited to English or French articles with no date limit applied. Methodological quality of included studies was assessed using the Mixed-Methods Appraisal Tool (MMAT). A framework and content analysis was then conducted to extract and synthesize the implementation factors in alignment with the Theoretical Domains Framework (TDF), followed by a theoretically informed mapping exercise to identify potential implementation strategies.
RESULTS & MAIN CONTRIBUTION
The database searches yielded 2115 studies. Following screening, 17 studies were included in the review. Overall, the included studies had good methodological quality. Extracted implementation factors were classified as barriers, facilitators or mixed (i.e., both) and aligned with 13 of the 14 TDF domains, plus two additional domains: 'carer perspectives on the CPT intervention' and 'patient/carer characteristics'. Synthesized data revealed eight key theoretical domains: Environmental context and resources; Social influences; Beliefs about consequences; Skills; Memory, attention and decision-making; Knowledge; Beliefs about capabilities; and Reinforcement. Within each domain, the research team identified common categories and developed illustrative examples of theoretically informed implementation strategies.
CONCLUSIONS & IMPLICATIONS
This systematic review and theory-informed synthesis of previously reported CPT implementation factors enabled the identification of key barriers to SLTs delivering this best practice. This led to proposed implementation strategies that should be validated, refined and evaluated in future research involving stakeholders who have contextual understanding of implementing CPT.
WHAT THIS PAPER ADDS
What is already known on the subject CPT of familiar partners of PWA is an effective intervention that is inconsistently used in clinical settings. Factors influencing CPT implementation have previously been identified, but using disparate approaches and frameworks. A synthesis of these factors articulated around a common framework is currently not available. What this paper adds to existing knowledge This paper provides a theory-informed synthesis of previously reported barriers and facilitators to SLTs implementing CPT with familiar partners of PWA. It highlights key factors influencing the uptake of this best practice and includes suggestion of implementation strategies to address them. What are the potential or actual clinical implications of this work? The key influencing factors and proposed implementation strategies reported in this paper may support stakeholders in the future design of tailored and theoretically informed implementation strategies aiming to improve the delivery of familiar CPT in their setting.
Topics: Adult; Humans; Allied Health Personnel; Aphasia; Communication
PubMed: 36417196
DOI: 10.1111/1460-6984.12805 -
Dementia & Neuropsychologia 2021Language is commonly impacted in corticobasal syndrome (CBS). However, the profile and type of language assessment in CBS are poorly studied.
UNLABELLED
Language is commonly impacted in corticobasal syndrome (CBS). However, the profile and type of language assessment in CBS are poorly studied.
OBJECTIVE
To identify language impairments in CBS.
METHODS
A search was performed in the Medline/PubMed database, according to the PRISMA criteria, using the keywords "corticobasal syndrome" OR "corticobasal degeneration" AND "language". Articles on CBS covering language assessment that were written in English were included, with no constraints on the publication date.
RESULTS
A total of 259 articles were found and 35 were analyzed, consisting of 531 participants. Twenty-eight studies showed heterogeneous language deficits and seven mentioned nonfluent primary progressive aphasia. The most used tests were the Western Aphasia Battery (8 studies) and the Boston Naming Test (8 studies).
CONCLUSION
It was not possible to identify a unique linguistic profile in CBS.
PubMed: 33907594
DOI: 10.1590/1980-57642021dn15-010002 -
Frontiers in Psychiatry 2023We aimed to determine the effects and tolerability of repetitive transcranial magnetic stimulation (rTMS) on apathy in patients with neurodegenerative conditions, mild...
Repetitive transcranial magnetic stimulation for apathy in patients with neurodegenerative conditions, cognitive impairment, stroke, and traumatic brain injury: a systematic review.
BACKGROUND
We aimed to determine the effects and tolerability of repetitive transcranial magnetic stimulation (rTMS) on apathy in patients with neurodegenerative conditions, mild cognitive impairment (MCI), stroke, and traumatic brain injury (TBI) via systematic review.
METHODS
We conducted a systematic search in major electronic health databases, including PubMed, Scopus, and PsycINFO, covering the period from inception to June 2023. Comparative clinical trials and cohort studies, and studies with before-after designs were considered for inclusion. We used the Cochrane Risk of Bias and the National Institutes of Health (NIH) tools to assess methodological quality.
RESULTS
Out of 258 records identified, 14 studies met our eligibility criteria (11 randomized controlled trials (RCT) and 3 studies utilized before-and-after designs) with a total of 418 patients (overall female-to-male ratio 1:1.17) included in the review. The overall methodological quality of the included studies was assessed to be fair to good. The stimulation parameters used varied considerably across the studies. The summary findings of our review indicate the following observations on the effects of rTMS on apathy: (1) the results of all included studies in Alzheimer's disease investigating the effects of rTMS on apathy have consistently shown a positive impact on apathy; (2) the majority of studies conducted in Parkinson's disease have not found statistically significant results; (3) a single study (RCT) on patients with primary progressive aphasia demonstrated significant beneficial effects of rTMS on apathy; (4) the trials conducted on individuals with MCI yielded varying conclusions; (5) one study (RCT) in chronic stroke suggested that rTMS might have the potential to improve apathy; (6) one study conducted on individuals with mild TBI did not find a significant favorable association on apathy; and (7) the use of different rTMS protocols on the populations described is generally safe.
CONCLUSION
The feasibility of utilizing rTMS as a treatment for apathy has been suggested in this review. Overall, limited evidence suggests that rTMS intervention may have the potential to modify apathy among patients with AD, PPA, MCI and chronic stroke, but less so in PD and mild TBI. These findings require confirmation by larger, well-designed clinical trials.
PubMed: 38034914
DOI: 10.3389/fpsyt.2023.1259481 -
The effect of sleep on novel word learning in healthy adults: A systematic review and meta-analysis.Psychonomic Bulletin & Review Dec 2021There is increasing evidence to indicate that sleep plays a role in language acquisition and consolidation; however, there has been substantial variability in... (Meta-Analysis)
Meta-Analysis Review
There is increasing evidence to indicate that sleep plays a role in language acquisition and consolidation; however, there has been substantial variability in methodological approaches used to examine this phenomenon. This systematic review and meta-analysis aimed to investigate the effect of sleep on novel word learning in adults, and explore whether these effects differed by retrieval domain (i.e., recall, recognition, and tests of lexical integration). Twenty-five unique studies met the inclusion criteria for the review, and 42 separate outcome measures were synthesized in the meta-analysis (k = 29 separate between-group comparisons, n = 1,396 participants). The results from the omnibus meta-analysis indicated that sleep was beneficial for novel word learning compared with wakefulness (g = 0.50). Effect sizes differed across the separate domain-specific meta-analyses, with moderate effects for recall (g = 0.57) and recognition memory (g = 0.52), and a small effect for tasks which measured lexical integration (g = 0.39). Overall, the results of this meta-analysis indicate that sleep generally benefits novel word acquisition and consolidation compared with wakefulness across differing retrieval domains. This systematic review highlights the potential for sleep to be used to improve second-language learning in healthy adults, and overall provides further insight into methods to facilitate language development.
Topics: Adult; Humans; Mental Recall; Recognition, Psychology; Sleep; Verbal Learning; Wakefulness
PubMed: 34549375
DOI: 10.3758/s13423-021-01980-3