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Journal of the History of the... 2022Of all the nineteenth-century physicians whose names still resonate today, Armand Trousseau is perhaps the one most familiar, for his description of carpal spasm as a...
Of all the nineteenth-century physicians whose names still resonate today, Armand Trousseau is perhaps the one most familiar, for his description of carpal spasm as a sign of hypocalcemia (Trousseau's sign) and his description of the hypercoagulable state associated with cancer (Trousseau's syndrome). In the last three years of his life, Trousseau turned his attention to aphasia, which he included in his 1864 and 1865 lectures given at Hôtel-Dieu Hospital in Paris and which he discussed in an address to the Imperial Academy of Medicine in 1865. Trousseau preceded Wernicke in describing aphasia as a symptom complex, in which he included Broca's aphemia, receptive aphasia, the inability to read with and without the inability to write (alexia with and without agraphia), the inability to name common objects (amnesic aphasia or anomia) and to recognize numbers (acalculia), and the inability to draw. Trousseau concluded that such a varied symptomatology could not arise from a single area, and he proposed that lesions of the posterior inferior frontal convolution identified by Broca, of the insula and corpus striatum and of the temporal and parietal lobes, could give rise to aphasia. The role of the posterior temporal lobe in receptive aphasia was confirmed by Wernicke in 1874, and the role of the inferior parietal lobule in agraphia and alexia was confirmed by Dejerine in 1891. Trousseau thought that aphasia resulted from the loss of the memory for words and for the synergistic actions of the movements of articulations learned in early childhood. Trousseau added inattention, lack of comprehension, and cognitive decline to amnesia as contributing factors to the verbal and nonverbal expression of thought. Trousseau constructed a comprehensive theory of aphasia that unified its semiology, localization, and pathophysiology. This construct had the virtue of being predictive and falsifiable by the clinico-pathological method. Through insight born of observation, Trousseau identified the issues that dominated aphasiology into the twenty-first century.
Topics: Agraphia; Aphasia; Aphasia, Broca; Aphasia, Wernicke; Child, Preschool; Dyslexia; Humans; Male; Physicians
PubMed: 34115961
DOI: 10.1080/0964704X.2021.1898909 -
The Canadian Journal of Neurological... Nov 2022
Topics: Humans; Stroke; Corpus Callosum; Agraphia
PubMed: 34503587
DOI: 10.1017/cjn.2021.211 -
Neurocritical Care Jun 2024Gerstmann syndrome, characterized by a tetrad of symptoms, which are agraphia, acalculia, left-right disorientation, and finger agnosia, presents challenges in both...
Gerstmann syndrome, characterized by a tetrad of symptoms, which are agraphia, acalculia, left-right disorientation, and finger agnosia, presents challenges in both understanding its pathophysiology and establishing effective treatment modalities. Neuroanatomical studies have highlighted the involvement of the dominant parietal lobe, particularly the inferior parietal lobule, in the development of Gerstmann syndrome. Although current treatment options are largely supportive, recent research suggests a potential role for deep brain stimulation (DBS) in managing this condition. DBS, known for its efficacy in various neurological disorders, has been hypothesized to modulate neuronal pathways associated with Gerstmann syndrome. However, clinical evidence supporting DBS in Gerstmann syndrome remains scarce, posing challenges in patient selection and ethical considerations. Future research should prioritize investigating the efficacy and safety of DBS in Gerstmann syndrome to improve patient outcomes and quality of life.
PubMed: 38914905
DOI: 10.1007/s12028-024-02013-2 -
Neurology May 2022Most primary progressive aphasia (PPA) literature is based on English language users. Linguistic features that vary from English, such as logographic writing systems,...
BACKGROUND AND OBJECTIVES
Most primary progressive aphasia (PPA) literature is based on English language users. Linguistic features that vary from English, such as logographic writing systems, are underinvestigated. The current study characterized the dysgraphia phenotypes of patients with PPA who write in Chinese and investigated their diagnostic utility in classifying PPA variants.
METHODS
This study recruited 40 participants with PPA and 20 cognitively normal participants from San Francisco, Hong Kong, and Taiwan. We measured dictation accuracy using the Chinese Language Assessment for PPA (CLAP) 60-character orthographic dictation test and examined the occurrence of various writing errors across the study groups. We also performed voxel-based morphometry analysis to identify the gray matter regions correlated with dictation accuracy and prevalence of writing errors.
RESULTS
All PPA groups produced significantly less accurate writing responses than the control group and no significant differences in dictation accuracy were noted among the PPA variants. With a cut score of 36 out of 60 in the CLAP orthographic dictation task, the test achieved sensitivity and specificity of 90% and 95% in identifying Chinese participants with PPA vs controls. In addition to a character frequency effect, dictation accuracy was affected by homophone density and the number of strokes in semantic variant PPA and logopenic variant PPA groups. Dictation accuracy was correlated with volumetric changes over left ventral temporal cortices, regions known to be critical for orthographic long-term memory. Individuals with semantic variant PPA frequently presented with phonologically plausible errors at lexical level, patients with logopenic variant PPA showed higher preponderance towards visual and stroke errors, and patients with nonfluent/agrammatic variant PPA commonly exhibited compound word and radical errors. The prevalence of phonologically plausible, visual, and compound word errors was negatively correlated with cortical volume over the bilateral temporal regions, left temporo-occipital area, and bilateral orbitofrontal gyri, respectively.
DISCUSSION
The findings demonstrate the potential role of the orthographic dictation task as a screening tool and PPA classification indicator in Chinese language users. Each PPA variant had specific Chinese dysgraphia phenotypes that vary from those previously reported in English-speaking patients with PPA, highlighting the importance of language diversity in PPA.
Topics: Agraphia; Aphasia, Primary Progressive; China; Humans; Language; Phenotype; Primary Progressive Nonfluent Aphasia
PubMed: 35410909
DOI: 10.1212/WNL.0000000000200350 -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2023The review is devoted to one of the current problems of pediatric neurology - reading and writing disorders in children as part of a partial developmental disorder. With...
The review is devoted to one of the current problems of pediatric neurology - reading and writing disorders in children as part of a partial developmental disorder. With the development of neuroscience, the paradigm of «brain damage» in the understanding of a number of pathological conditions was replaced by the concept of «evolutionary neurology». The dominance of the ontogenetic approach caused the appearance of a new section in ICD-11 - «Neurodevelopmental disorders». Twenty-one genes associated with the acquisition of reading and writing skills have been identified. Modern studies demonstrate the connection of neuropsychological prerequisites for reading and writing, and clinical phenotypes of dyslexia with changes in specific loci. It is assumed that there are different molecular genetic bases for dyslexia and dysgraphia depending on ethnicity, orthographic features of language, including logographic features. Pleiotropy of genes is a cause of comorbidity of reading and writing disorders with attention deficit and hyperactivity disorder, specific speech articulation disorders, and dyscalculia. A key function of many of the identified genes is their involvement in the processes of neurogenesis. Their dysfunctions cause atypical neuronal migration, ectopic formation, inadequate axonal growth, and dendrite branching at the early stage of brain development. Morphological changes can distort the correct distribution and/or integration of linguistic stimuli in critical brain areas, leading to abnormalities in phonology, semantics, spelling, and general reading comprehension. The knowledge gained can form the basis for the development of risk models for dysgraphia and dyslexia formation and be used as a diagnostic and/or screening tool, which is important for evidence-based correction, optimization of academic performance, and mitigation of psychosocial consequences.
Topics: Humans; Agraphia; Dyslexia; Genetic Background; Brain; Language
PubMed: 37315241
DOI: 10.17116/jnevro202312305148 -
Journal of the History of the... 2022This article is an outline of the transition in "brain maps" used to illustrate locations of cortical "centers" associated with movements, sensations, and language...
This article is an outline of the transition in "brain maps" used to illustrate locations of cortical "centers" associated with movements, sensations, and language beginning with images from Gall and Spurzheim in the nineteenth century through those of functional magnetic resonance imaging in the twenty-first century. During the intervening years, new approaches required new brain maps to illustrate them, and brain maps helped to objectify and naturalize mental processes. One approach, electrical stimulation of the cerebral cortex-exemplified by Fritsch and Hitzig in 1870, Ferrier in 1873, and Penfield by 1937-required brain maps showing functional centers with expanded and overlapping boundaries. In another approach, brain maps that linked cortical centers to account for the complex syndromes of aphasia, apraxia, alexia, and agraphia were initially constructed by Baginsky in 1871, Wernicke in 1874, and Lichtheim in 1885, then later by Lissauer in 1890, Dejerine in 1892, and Liepmann in 1920, and eventually by Geschwind in 1965 and others through the late twentieth century. Over that intervening time, brain maps changed from illustrations of on the cerebral cortex where movements and sensations were elicited to illustrations of (centers) associated with recognizable functions to illustrations of connections between those areas that account for complex symptoms occurring in clinical patients. By the end of this period, advancements in physics, mathematics, and cognitive science resulted in inventions that allowed brain maps of cortical locations derived from manipulations rather than from the usual electrical or ablative manipulations. "Mental" dependent variables became "cognitive" independent variables.
Topics: Brain; Brain Mapping; Cerebral Cortex; History, 19th Century; Humans; Language; Sensation
PubMed: 35584551
DOI: 10.1080/0964704X.2022.2066409 -
Journal of Physical Therapy Science Feb 2023[Purpose] To assess the clinical applicability of a novel automated tractography tool named XTRACT during acute stroke rehabilitation. [Participants and Methods] Three...
[Purpose] To assess the clinical applicability of a novel automated tractography tool named XTRACT during acute stroke rehabilitation. [Participants and Methods] Three patients with left hemisphere stroke were sampled. Diffusion tensor images were acquired on the second week, and automated tractography was then applied. Tractography images and fractional anisotropy (FA) values in the corticospinal tract (CST) and arcuate fasciculus (AF) were assessed in relation to hemiparesis and aphasia. [Results] Patient 1 was nearly asymptomatic; FA in the left CST was 0.610 and that in the AF was 0.509. Patient 2 had severe hemiparesis and mild motor aphasia. Tractography images of the CST and AF were blurred; FA in the left CST was 0.295 and that in the AF was 0.304. Patient 3 showed no hemiparesis or aphasia at initial assessment. Tractography image of the CST was intact but that of the AF was less clear; FA in the left CST was 0.586 and that in the AF was 0.338. Considering the less clear images of the AF and lower FA value in Patients 2 and 3, further examinations for aphasia were performed, which revealed agraphia. [Conclusion] Visualization and quantification of neural fibers using automated tractography promoted planning acute care rehabilitative treatment in patients with stroke.
PubMed: 36744203
DOI: 10.1589/jpts.35.156 -
International Journal of Language &... Nov 2020Despite initial underreporting of language dysfunctions in corticobasal syndrome (CBS), aphasia is now recognized as a frequent feature of this disease. Aphasia in CBS...
BACKGROUND
Despite initial underreporting of language dysfunctions in corticobasal syndrome (CBS), aphasia is now recognized as a frequent feature of this disease. Aphasia in CBS seems clinically overlying to a non-fluent/agrammatic primary progressive aphasia (nfaPPA), which is also a clinical phenotype associated with corticobasal degeneration (CBD) pathology. However, the clinical features of aphasia in CBS still remain poorly delineated, resulting in misjudgements in the differential diagnosis from a PPA presentation of the disease.
AIMS
To investigate the language disorders of this syndrome, also through a systematic examination of recoding skills (reading, written spelling and repetition) and articulatory disturbances, which have been rarely examined in previous studies.
METHODS & PROCEDURES
We present a clinical and neuropsychological descriptive study of the language impairments in a case series of 12 aphasic patients with a clinical diagnosis of CBS. Language assessment was conducted by means of the Esame NeuroPsicologico dell'Afasia, a comprehensive Italian battery for language functions, the Token Test, and the Apraxia of Speech Rating Scale.
OUTCOMES & RESULTS
The language profile of the patients showed a severe expressive language disorder, characterized by non-fluent speech, apraxia of speech (AoS) with predominant stuttering-like dysfluencies, spatial/apraxic agraphia, lack of word-finding and defective sentence repetition. Severe limb apraxia, visual-spatial deficit and alien hand syndrome were also present. Neuroimaging showed bilateral left asymmetric atrophies and hypometabolism in the frontal premotor, parietal posterior and temporal areas.
CONCLUSIONS & IMPLICATIONS
These findings suggest that aphasia in CBS might present as a 'mixed PPA', instead of an nfaPPA as previously stated, showing a combination of features of the nfa and logopenic variants of the PPA, associated with AoS, stuttering and agraphia, which might be additional important cognitive markers for the clinical diagnosis of CBS and discriminating features of an nfaPPA presentation of a CBD. These results might also suggest specific intervention areas in the rehabilitation of patients with CBS. What this paper adds What is already known on the subject Language disorders in CBS patients usually present clinically overlying to an nfaPPA, which is also a clinical phenotype associated with CBD pathology, according to recent diagnostic criteria. However, the clinical features of aphasia in CBS still remain poorly delineated, and this raises difficulties and misjudgements for clinicians in the differential diagnosis from a PPA presentation of the disease. What this paper adds to existing knowledge This study shows that the language profile of our CBS patients was characterized by severe expressive language disorders, with non-fluent speech, apraxia of speech (AoS) with predominant stuttering-like dysfluencies, spatial/apraxic agraphia, lack of word-finding, and defective sentence repetition. These findings suggest that aphasia in CBS might present as a 'mixed PPA', rather than an nfaPPA as previously stated, showing a combination of features of the nfa and logopenic variants of the PPA associated with AoS, stuttering and agraphia. What are the potential or actual clinical implications of this work? These results suggest that AoS, stuttering and agraphia might be important additional cognitive markers for the clinical diagnosis of CBS, and discriminating features of an nfaPPA presentation of a CBD. The language disorders exhibited in the present study might also support speech and language therapists in targeting specific intervention areas in the rehabilitation of patients with CBS.
Topics: Aged; Aged, 80 and over; Agraphia; Aphasia; Apraxias; Basal Ganglia Diseases; Female; Humans; Language; Language Tests; Male; Middle Aged; Neurodegenerative Diseases; Neuropsychological Tests; Verbal Behavior
PubMed: 32725870
DOI: 10.1111/1460-6984.12559 -
Sensors (Basel, Switzerland) May 2023Handwriting learning disabilities, such as dysgraphia, have a serious negative impact on children's academic results, daily life and overall well-being. Early detection...
Handwriting learning disabilities, such as dysgraphia, have a serious negative impact on children's academic results, daily life and overall well-being. Early detection of dysgraphia facilitates an early start of targeted intervention. Several studies have investigated dysgraphia detection using machine learning algorithms with a digital tablet. However, these studies deployed classical machine learning algorithms with manual feature extraction and selection as well as binary classification: either dysgraphia or no dysgraphia. In this work, we investigated the fine grading of handwriting capabilities by predicting the SEMS score (between 0 and 12) with deep learning. Our approach provided a root-mean-square error of less than 1 with automatic instead of manual feature extraction and selection. Furthermore, the SensoGrip smart pen SensoGrip was used, i.e., a pen equipped with sensors to capture handwriting dynamics, instead of a tablet, enabling writing evaluation in more realistic scenarios.
Topics: Child; Humans; Deep Learning; Handwriting; Agraphia; Algorithms; Machine Learning
PubMed: 37299942
DOI: 10.3390/s23115215 -
Journal of Learning Disabilities 2022This article presents the application of the interactive dynamic literacy (IDL) model (Kim, 2020b) toward understanding difficulties in learning to read and write....
This article presents the application of the interactive dynamic literacy (IDL) model (Kim, 2020b) toward understanding difficulties in learning to read and write. According to the IDL model, reading and writing are part of communicative acts that draw on largely shared processes and skills as well as unique processes and skills. As such, reading and writing are dissociable but interdependent systems that have hierarchical, interactive, and dynamic relations. These key tenets of the IDL model are applied to the disruption of reading and writing development to explain co-occurrence of reading-writing difficulties using a single framework. The following hypotheses are presented: (a) co-occurrence between word reading and spelling and handwriting difficulties; (b) co-occurrence of dyslexia with written composition difficulties; (c) co-occurrence between reading comprehension and written composition difficulties; (d) co-occurrence of language difficulties with reading difficulties and writing difficulties; (e) co-occurrence of reading, writing, and language difficulties with weak domain-general skills or executive functions such as working memory and attentional control (including attention-deficit/ hyperactivity disorder [ADHD]); and (f) multiple pathways for reading and writing difficulties. Implications are discussed.
Topics: Agraphia; Dyslexia; Humans; Literacy; Reading; Writing
PubMed: 35001719
DOI: 10.1177/00222194211060868