-
International Journal of Language &... Mar 2022Intervention studies aimed to improve the written production of single words by persons with aphasia have yielded promising results and there is growing interest in...
BACKGROUND
Intervention studies aimed to improve the written production of single words by persons with aphasia have yielded promising results and there is growing interest in interventions targeting text writing. The development of technical writing aids offers opportunities for persons with aphasia, and studies have shown that using them can have a positive impact on written output.
AIMS
The aim was to investigate what impact training to use a computerised spell checker had on text writing in persons with aphasia.
METHODS & PROCEDURES
The study had a multiple-baseline single-case experimental design replicated across six male Swedish participants with mild-to-moderate post-stroke aphasia. The participants received training twice a week during 8 weeks, learning how to use the spell checker. At baseline and before every session, the participants wrote two texts which were logged in a keystroke-logging tool. Dependent variables were continuously measured in the texts, and the participants performed tests of language function and answered questionnaires on reading and writing habits and health-related quality of life before and after the intervention. The participants were also interviewed about how they had experienced the training. The results were evaluated on individual and group level.
RESULTS
The study showed that systematic individual training involving a spell checker was experienced as positive by the participants and that they all described their writing ability in more positive terms after the intervention. Evaluation showed statistically significant improvements on group level for the dependent variables of spelling accuracy, rated syntax, writing speed and proportion of unedited text during text writing when using the spell checker. The intervention also had a generalising effect on writing speed and editing during text writing without the spell checker and on spelling accuracy in a dictation test. The participants who had the greatest spelling problems were the ones who showed the most progress, but participants with only minor writing difficulties at baseline also improved.
CONCLUSIONS & IMPLICATIONS
The study shows that a digital spelling aid constitutes effective support for people with aphasia and may also affect levels other than spelling. The training had a generalising positive effect on text writing and spelling in a test. Although writing difficulties is a persisting symptom in aphasia, it can be supported and improved through use of digital spelling aids. Hence, treatment of writing ability should always be included in the rehabilitation of people with aphasia.
WHAT THIS PAPER ADDS
What is already known on this subject Use of a technical writing aid can have a positive impact on the written output of persons with aphasia. Using a digital spell checker may improve spelling as well as other levels of writing, but it has not been investigated using a keystroke-logging tool in combination with language-test scores and results from questionnaires. What this paper adds to existing knowledge Through analyses on both individual and group level, this study shows that a digital spelling aid constitutes effective support for people with aphasia and also affects levels other than spelling. The training had a generalising positive effect on text writing and spelling in a test. What are the potential or actual clinical implications of this work? Digital spelling support, which is a relatively simple and inexpensive technology, can support and improve text writing in persons with post-stroke aphasia.
Topics: Humans; Male; Agraphia; Aphasia; Language; Quality of Life; Writing
PubMed: 35092331
DOI: 10.1111/1460-6984.12696 -
Brain Structure & Function Dec 2022Most of us can use our "mind's eye" to mentally visualize things that are not in our direct line of sight, an ability known as visual mental imagery. Extensive left...
Most of us can use our "mind's eye" to mentally visualize things that are not in our direct line of sight, an ability known as visual mental imagery. Extensive left temporal damage can impair patients' visual mental imagery experience, but the critical locus of lesion is unknown. Our recent meta-analysis of 27 fMRI studies of visual mental imagery highlighted a well-delimited region in the left lateral midfusiform gyrus, which was consistently activated during visual mental imagery, and which we called the Fusiform Imagery Node (FIN). Here, we describe the connectional anatomy of FIN in neurotypical participants and in RDS, a right-handed patient with an extensive occipito-temporal stroke in the left hemisphere. The stroke provoked right homonymous hemianopia, alexia without agraphia, and color anomia. Despite these deficits, RDS had normal subjective experience of visual mental imagery and reasonably preserved behavioral performance on tests of visual mental imagery of object shape, object color, letters, faces, and spatial relationships. We found that the FIN was spared by the lesion. We then assessed the connectional anatomy of the FIN in the MNI space and in the patient's native space, by visualizing the fibers of the inferior longitudinal fasciculus (ILF) and of the arcuate fasciculus (AF) passing through the FIN. In both spaces, the ILF connected the FIN with the anterior temporal lobe, and the AF linked it with frontal regions. Our evidence is consistent with the hypothesis that the FIN is a node of a brain network dedicated to voluntary visual mental imagery. The FIN could act as a bridge between visual information and semantic knowledge processed in the anterior temporal lobe and in the language circuits.
Topics: Humans; Temporal Lobe; Brain Mapping; Nerve Net; Semantics; Magnetic Resonance Imaging; Stroke
PubMed: 35622159
DOI: 10.1007/s00429-022-02505-x -
Journal of Alzheimer's Disease : JAD 2022The established causative mutations in the APP, PSEN1, and PSEN2 can explain less than 1%,Alzheimer's disease (AD) patients. Of the identified variants, the PSEN2...
BACKGROUND
The established causative mutations in the APP, PSEN1, and PSEN2 can explain less than 1%,Alzheimer's disease (AD) patients. Of the identified variants, the PSEN2 mutations are even less common.
OBJECTIVE
With the genetic study from the dementia cohort of Peking Union Medical College Hospital (PUMCH), we aim to illustrate the PSEN2 mutation spectrum and novel functionally validated mutations in Chinese AD patients.
METHODS
702 AD participants, aged 30-85, were identified in PUMCH dementia cohort. They all received history inquiry, physical examination, biochemical test, cognitive evaluation, brain CT/MRI, and next-generation DNA sequencing. Functional analysis was achieved by transfection of the HEK293 cells with plasmids harboring the wild-type PSEN2 or candidate mutations.
RESULTS
Nine PSEN2 rare variants were found, including two reported (M239T, R62C) and seven novel variants (N141S, I368F, L396I, G117X, I146T, S147N, H220Y). The HEK293 cells transfected with the PSEN2 N141S, M239T, I368F plasmids showed higher Aβ42 and Aβ42/Aβ40 levels relative to the wild-type PSEN2. The PSEN2 L396I, G117X, S147N, H220Y, and R62C did not alter Aβ42, Aβ40 levels, or Aβ42/Aβ40 ratio. 1.9%,(13/702) subjects harbored rare PSEN2 variants. 0.4%,(3/702) subjects carried pathogenic/likely pathogenic PSEN2 mutations. The three subjects with the functionally validated PSEN2 mutations were all familial early-onset AD patients. The common symptoms included amnesia and mental symptom. Additionally, the M239T mutation carrier presented with dressing apraxia, visuospatial agraphia, dyscalculia and visual mislocalization.
CONCLUSION
The PSEN2 N141S, M239T, and I368F are functionally validated mutations.
Topics: Alzheimer Disease; Amyloid beta-Protein Precursor; HEK293 Cells; Humans; Mutation; Presenilin-2
PubMed: 35491795
DOI: 10.3233/JAD-220194 -
Clinical Child Psychology and Psychiatry Apr 2023Research on the relationship between sluggish cognitive tempo (SCT) and scores on neuropsychological tests (such as those measuring processing speed and reaction time)...
Research on the relationship between sluggish cognitive tempo (SCT) and scores on neuropsychological tests (such as those measuring processing speed and reaction time) is inconclusive, and the association between SCT and motor incoordination and dysgraphia has not been objectively investigated. Mothers of 413 elementary school children (6-12 years of age) rated their children on the Pediatric Behavior Scale (PBS), which yields psychological problem scores, including SCT. Children were administered an extensive battery of neuropsychological tests assessing processing and performance speed, working memory, immediate and delayed recall, sustained attention, response inhibition, cognitive flexibility, fine motor manipulative skill, verbal fluency and retrieval, set shifting, and interference control, as well as intelligence and reading and math achievement. Only three of the 19 correlations between SCT and neuropsychological scores were significant, and all involved graphomotor tests (two timed and one untimed). In regression analysis, the strongest independent predictor of SCT was the maternal PBS incoordination factor score, followed by ratings of autism, inattention, and depression. Neuropsychological test scores did not contribute significantly more to predicting SCT. Among the incoordination PBS factor items, clumsy and draws or writes poorly were significant SCT predictors. Our novel and unexpected findings showed that motor incoordination was a stronger correlate of SCT than other variables assessed in our study, including those previously linked with SCT. Future SCT research needs to include measures of incoordination and dysgraphia in order to replicate and expand upon the current findings. Our results suggest that SCT traits are not reliably measured by currently available neuropsychological tests.
Topics: Female; Humans; Child; Agraphia; Sluggish Cognitive Tempo; Attention Deficit Disorder with Hyperactivity; Cognition; Neuropsychological Tests
PubMed: 35751158
DOI: 10.1177/13591045221110730 -
Cortex; a Journal Devoted To the Study... Oct 2022When Gerstmann published the case report which later became known as the first case of Gerstmann syndrome, he did not claim the discovery of a new syndrome. It was only...
When Gerstmann published the case report which later became known as the first case of Gerstmann syndrome, he did not claim the discovery of a new syndrome. It was only a few years later, after reporting on another two similar cases, that he isolated the famous tetrad of symptoms (finger agnosia, right-left disorientation, agraphia and acalculia) as a meaningful cluster with both localising and functional value. In this article, we provide the translation of key-excerpts of the second of Gerstmann's reports (Gerstmann, 1927) and a synoptic description of the symptoms as reported in the three original cases, which were later identified as cases of Gerstmann syndrome. The descriptions appear highly consistent across cases. Among symptoms, finger agnosia stands out for its pervasiveness, which may explain why Gerstmann considered this as the core symptom and speculated it could subtend all symptoms. However, no common functional denominator emerges from the original descriptions.
Topics: Agnosia; Dyscalculia; Gerstmann Syndrome; Humans; Male; Translations
PubMed: 35998548
DOI: 10.1016/j.cortex.2022.07.002 -
The American Journal of Occupational... Sep 2023Handwriting legibility and speed assessments have a critical role in identifying and evaluating handwriting problems, which are common among children.
IMPORTANCE
Handwriting legibility and speed assessments have a critical role in identifying and evaluating handwriting problems, which are common among children.
OBJECTIVE
The objective was to evaluate the psychometric properties and clinical utility of handwriting assessments for children ages 3 to 16 yr.
DATA SOURCES
A systematic review was conducted in CINAHL, PubMed (MEDLINE), Scopus, and education databases, with no time limits. The search strategy included a combination of the following keywords: handwriting, write, children, assessment, and validity. The exclusion criteria were assessment tools that were electronic, that focused on cognitive components of handwriting, or that only evaluated alphabets other than Latin.
STUDY SELECTION AND DATA COLLECTION
The systematic review was carried out on the basis of the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The protocol was registered in the Prospective Register of Systematic Reviews (PROSPERO).
FINDINGS
The 14 included instruments had a total sample of 4,987 children. Internal consistency ranged from moderate (.73; Writing Readiness Inventory Tool in Context) to high (.98; Letter Writing). The interexaminer reliability values of the 11 direct assessment instruments ranged from .77 (Systematic Screening for Handwriting Difficulties) to 1.00 (Handwriting Speed Test).
CONCLUSIONS AND RELEVANCE
In this systematic review, existing tools were evaluated by clinical utility and the quality of psychometric properties. Direct assessments showed good psychometric properties. Indirect and self-assessment tools demonstrated poor psychometric properties. Further research on screening tools and tools in other languages is needed. What This Article Adds: Specific learning disorders (e.g., dysgraphia) negatively affect academic learning and, when prolonged in time, self-concept. However, handwriting legibility and speed assessments could be used to identify and evaluate these learning disorders if an early referral to occupational therapy is carried out.
Topics: Humans; Child; Psychometrics; Reproducibility of Results; Handwriting; Agraphia; Checklist
PubMed: 37877571
DOI: 10.5014/ajot.2023.050174 -
Cognitive Neuropsychology 2022The present study explores the extent to which properties of abstract graphemic representations are maintained at the post-graphemic level of graphic motor plans, where...
The present study explores the extent to which properties of abstract graphemic representations are maintained at the post-graphemic level of graphic motor plans, where the sequences of writing strokes for producing the letters in a word are represented. On the basis of results from a stroke patient (NGN) who has a deficit affecting the activation of graphic motor plans, we explore the post-graphemic representation of 1) consonant/vowel status of letters; 2) geminate (double) letters, such as the BB in RABBIT; and 3) digraphs, such as the SH in SHIP. Through analyses of NGN's letter substitution errors, we conclude that 1) consonant-vowel status is not represented at the level of graphic motor plans; 2) geminates have special representations at the motor-plan level, as at the graphemic level; and 3) digraphs are represented by two separate single-letter graphic motor plans, and not by unitary digraph motor plans.
Topics: Humans; Stroke; Writing; Agraphia
PubMed: 36803202
DOI: 10.1080/02643294.2023.2178293 -
International Journal of Geriatric... Jan 2024We have previously demonstrated difficulties in written production in dementia with Lewy bodies (DLB) patients. We now aim to determine the neural correlates of writing...
OBJECTIVES
We have previously demonstrated difficulties in written production in dementia with Lewy bodies (DLB) patients. We now aim to determine the neural correlates of writing production in DLB, combining clinical data and structural MRI measures.
METHOD
Sixteen prodromal to mild DLB patients were selected to participate in the study. The GREMOTS test was used to assess writing production. Using three-dimensional T1 brain MRI images, correlations between the GREMOTS test and grey matter (GM) volume were performed using voxel-based morphometry (VBM; SPM12, XjView and Matlab R2021b softwares).
RESULTS
VBM analysis (p < 0.001, uncorrected) revealed a positive and significant correlation between both left anterior insula and left supramarginal gyrus GM volumes and DLB patients' ability to write logatoms using the phonological route. The handwriting deficit was negatively and significantly correlated to the supplementary motor area. The parkinsonism-like characteristics of agraphia were negatively and significantly correlated with both right anterior and right posterior cerebellum GM volumes. Our study also revealed a negative and significant correlation between grammatical spelling impairments and an area of the orbitofrontal gyrus, and a negative and significant correlation between supramarginal gyrus and general slowness in dictation tasks.
CONCLUSION
Writing disorders in early DLB patients appears to be GM decreases in several brain regions, such as the left anterior insula, the left supramaginal gyrus, as well as two areas of the right cerebellum.
Topics: Humans; Lewy Body Disease; Dementia; Brain; Gray Matter; Magnetic Resonance Imaging; Writing
PubMed: 38229210
DOI: 10.1002/gps.6056 -
BMC Neurology Nov 2021Neurological manifestations of coronavirus disease 2019 (COVID-19) are increasingly recognized and include encephalopathy, although direct infection of the brain by...
BACKGROUND
Neurological manifestations of coronavirus disease 2019 (COVID-19) are increasingly recognized and include encephalopathy, although direct infection of the brain by SARS-CoV-2 remains controversial. We herein report the clinical course and cytokine profiles of a patient with severe SARS-CoV-2-related encephalopathy presenting aphasia.
CASE PRESENTATION
An 81-year-old man developed acute consciousness disturbance and status epileptics several days after SARS-CoV-2 infection. Following treatment with remdesivir and dexamethasone, his consciousness and epileptic seizures improved; however, amnestic aphasia and agraphia remained. Two months after methylprednisolone pulse and intravenous immunoglobulin, his neurological deficits improved. We found increased levels of interleukin (IL)-6, IL-8, and monocyte chemoattractant protein-1 (MCP-1), but not IL-2 and IL-10 in the serum and cerebrospinal fluid (CSF), and the levels of serum IL-6 and MCP-1 were much higher than those in the CSF. The level of IL-8 in the CSF after immunotherapy was four times higher than that before immunotherapy.
CONCLUSION
The cytokine profile of our patient was similar to that seen in severe SARS-CoV-2-related encephalopathy. We demonstrated (i) that the characteristic aphasia can occur as a focal neurological deficit associated with SARS-CoV-2-related encephalopathy, and (ii) that IL8-mediated central nervous system inflammation follows systemic inflammation in SARS-CoV-2-related encephalopathy and can persist and worsen even after immunotherapy. Monitoring IL-8 in CSF, and long-term corticosteroids may be required for treating SARS-CoV-2-related encephalopathy.
Topics: Aged, 80 and over; Aphasia; Brain Diseases; COVID-19; Humans; Interleukin-8; Male; SARS-CoV-2
PubMed: 34727881
DOI: 10.1186/s12883-021-02459-3 -
Neurology India 2022
Topics: Humans; Alexia, Pure; Agraphia; Reading
PubMed: 36352656
DOI: 10.4103/0028-3886.359157