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Brain : a Journal of Neurology Nov 2022Focal anterior temporal lobe degeneration often preferentially affects the left or right hemisphere. While patients with left-predominant anterior temporal lobe atrophy...
Focal anterior temporal lobe degeneration often preferentially affects the left or right hemisphere. While patients with left-predominant anterior temporal lobe atrophy show severe anomia and verbal semantic deficits and meet criteria for semantic variant primary progressive aphasia and semantic dementia, patients with early right anterior temporal lobe atrophy are more difficult to diagnose as their symptoms are less well understood. Focal right anterior temporal lobe atrophy is associated with prominent emotional and behavioural changes, and patients often meet, or go on to meet, criteria for behavioural variant frontotemporal dementia. Uncertainty around early symptoms and absence of an overarching clinico-anatomical framework continue to hinder proper diagnosis and care of patients with right anterior temporal lobe disease. Here, we examine a large, well-characterized, longitudinal cohort of patients with right anterior temporal lobe-predominant degeneration and propose new criteria and nosology. We identified individuals from our database with a clinical diagnosis of behavioural variant frontotemporal dementia or semantic variant primary progressive aphasia and a structural MRI (n = 478). On the basis of neuroimaging criteria, we defined three patient groups: right anterior temporal lobe-predominant atrophy with relative sparing of the frontal lobes (n = 46), frontal-predominant atrophy with relative sparing of the right anterior temporal lobe (n = 79) and left-predominant anterior temporal lobe-predominant atrophy with relative sparing of the frontal lobes (n = 75). We compared the clinical, neuropsychological, genetic and pathological profiles of these groups. In the right anterior temporal lobe-predominant group, the earliest symptoms were loss of empathy (27%), person-specific semantic impairment (23%) and complex compulsions and rigid thought process (18%). On testing, this group exhibited greater impairments in Emotional Theory of Mind, recognition of famous people (from names and faces) and facial affect naming (despite preserved face perception) than the frontal- and left-predominant anterior temporal lobe-predominant groups. The clinical symptoms in the first 3 years of the disease alone were highly sensitive (81%) and specific (84%) differentiating right anterior temporal lobe-predominant from frontal-predominant groups. Frontotemporal lobar degeneration-transactive response DNA binding protein (84%) was the most common pathology of the right anterior temporal lobe-predominant group. Right anterior temporal lobe-predominant degeneration is characterized by early loss of empathy and person-specific knowledge, deficits that are caused by progressive decline in semantic memory for concepts of socioemotional relevance. Guided by our results, we outline new diagnostic criteria and propose the name, 'semantic behavioural variant frontotemporal dementia', which highlights the underlying cognitive mechanism and the predominant symptomatology. These diagnostic criteria will facilitate early identification and care of patients with early, focal right anterior temporal lobe degeneration as well as in vivo prediction of frontotemporal lobar degeneration-transactive response DNA binding protein pathology.
Topics: Humans; Frontotemporal Dementia; Semantics; Frontotemporal Lobar Degeneration; Atrophy; Magnetic Resonance Imaging; Aphasia, Primary Progressive; DNA-Binding Proteins; Neuropsychological Tests
PubMed: 35731122
DOI: 10.1093/brain/awac217 -
Current Neurology and Neuroscience... Oct 2021Color provides important information about the identity of the objects we encounter. After early processing stages in the retinal cones, thalamus, and occipital cortex,... (Review)
Review
PURPOSE OF REVIEW
Color provides important information about the identity of the objects we encounter. After early processing stages in the retinal cones, thalamus, and occipital cortex, retinal signals reach the ventral temporal cortex for high-level color and object processing, which links color perception with top-down expectations and knowledge. In the language-dominant hemisphere, some of these regions communicate with the language systems; by assigning verbal labels to percepts, these circuits speed up stimulus categorization, and permit fast and accurate inter-individual communication. This paper provides a review of color processing deficits, from dysfunction of wavelength discrimination in the retinal photoreceptors to deficits of high-level processing in the ventral temporal cortex.
RECENT FINDINGS
Neuroimaging evidence defined the existence and localization of color-preferring domains in the ventral occipito-temporal cortex. Evidence from the performance of a brain-damaged patient with color anomia but preserved color categorization demonstrated the independence of color categorization from color naming in the adult brain. Evidence from patients with brain damage suggests that high-level color processing may be divided into at least three functional domains: perceptual color experience, color naming, and color knowledge.
Topics: Anomia; Color Perception; Color Vision; Humans; Magnetic Resonance Imaging; Occipital Lobe
PubMed: 34606018
DOI: 10.1007/s11910-021-01137-8 -
Gaceta Sanitaria 2020During the economic crisis, developed countries have experienced financial fraud, with effects on the physical and mental health of the people affected, and on social... (Review)
Review
During the economic crisis, developed countries have experienced financial fraud, with effects on the physical and mental health of the people affected, and on social domains. Based on the theoretical framework in literature reviews and in quantitative studies, this paper aims to obtain evidence on the effects of financial fraud on health and on the family and social environments of those affected. An intentional sample of 32 people affected by abusive and multi-currency mortgages, preferred and swap stock in Madrid was approached. In-depth interviews were conducted, and the resulting data was analysed using content analysis. Fraud-affected individuals had conditions of age, sex, educational level and occupations that possibly allowed them to accumulate economic resources throughout the course of their lives and, predictably in many cases, to take out fraudulent financial products, based on trust in the financial institutions. Financial fraud has led to the emergence of various processes of anomia and adverse health effects. The consequences on health were physical ailments (symptoms and diseases in various systems and parts of the body) and mental disorders (anxiety, depression, suicidal ideation), all affecting lifestyles, behaviour and personal and social relationships, both in affected individuals and their families. The increase in the use of medical drugs and health services serves as a final corollary to the imbalances on the affected people's health. Individuals and the Spanish society demand public health policy measures to mitigate the effects on health and the recovery of their confidence in the banking and political system.
Topics: Adult; Banking, Personal; Bankruptcy; Drug Utilization; Economic Recession; Family; Female; Fraud; Health Policy; Health Status; Humans; Income; Interviews as Topic; Life Style; Male; Mental Disorders; Middle Aged; Patient Acceptance of Health Care; Qualitative Research; Social Interaction; Socioeconomic Factors; Spain
PubMed: 31964535
DOI: 10.1016/j.gaceta.2019.11.006 -
Medical Sciences (Basel, Switzerland) Nov 2023Frontotemporal dementia (FTD) is a neurodegenerative disorder characterized by progressive impairments in behavior, executive function, and language, primarily affecting... (Review)
Review
Frontotemporal dementia (FTD) is a neurodegenerative disorder characterized by progressive impairments in behavior, executive function, and language, primarily affecting individuals under the age of 65. This disorder is associated with expressive and receptive anomia, word comprehension deficits, and behavioral symptoms such as apathy, loss of empathy, and disinhibition, all of which closely correlate with functional impairment in daily activities. Despite substantial efforts, research on occupational therapy (OT) interventions has yet to demonstrate clear benefits in managing the disease. The aim of this study is to investigate OT interventions and assess their efficacy, with a specific focus on individuals suffering from FTD. We systematically conducted searches on two databases, namely Medline and Science Direct, spanning a ten-year period from 2003 to 2023, in accordance with the PRISMA guidelines. Eleven studies met the inclusion criteria. OT interventions targeted both patients and caregivers and yielded significant positive improvements in their lives. A key focus of these interventions was to teach acceptable alternatives to the behaviors exhibited by FTD patients, as these behaviors are strongly influenced by the disease itself. OT contributes positively to enhancing the quality of life of FTD patients and alleviating the caregiving burden experienced by those providing long-term care to these patients.
Topics: Humans; Frontotemporal Dementia; Occupational Therapy; Quality of Life; Pick Disease of the Brain; Caregivers
PubMed: 37987326
DOI: 10.3390/medsci11040071 -
Journal of Speech, Language, and... Oct 2022The impact of stimulus-level psycholinguistic variables and person-level semantic and phonological processing skills on treatment outcomes in individuals with aphasia...
PURPOSE
The impact of stimulus-level psycholinguistic variables and person-level semantic and phonological processing skills on treatment outcomes in individuals with aphasia requires further examination to inform clinical decision making in treatment prescription and stimuli selection. This study investigated the influence of stimulus-level psycholinguistic properties and person-level semantic and phonological processing skills on word production accuracy and treatment response.
METHOD
This retrospective analysis included 35 individuals with chronic, poststroke aphasia, 30 of whom completed typicality-based semantic feature treatment. Mixed-effects logistic regression models were used to predict binary naming accuracy (a) at baseline and (b) over the course of treatment using stimulus-level psycholinguistic word properties and person-level semantic and phonological processing skills as predictors.
RESULTS
In baseline naming, words with less complex lexical-semantic and phonological properties showed greater predicted accuracy. There was also an interaction at baseline between stimulus-level lexical-semantic properties and person-level semantic processing skills in predicting baseline naming accuracy. With treatment, words that were more complex from a lexical-semantic standpoint (vs. less complex) and less complex from a phonological standpoint (vs. more complex) improved more. Individuals with greater baseline semantic and phonological processing skills showed a greater treatment response.
CONCLUSIONS
This study suggests that future clinical research and clinical work should consider semantic and phonological properties of words in selecting stimuli for semantically based treatment. Furthermore, future clinical research should continue to evaluate baseline individual semantic and phonological profiles as predictors of response to semantically based treatment.
SUPPLEMENTAL MATERIAL
https://doi.org/10.23641/asha.21256341.
Topics: Anomia; Aphasia; Humans; Linguistics; Retrospective Studies; Semantics
PubMed: 36201169
DOI: 10.1044/2022_JSLHR-21-00527 -
Frontiers in Rehabilitation Sciences 2023The current study employed interrupted time series (ITS) models to analyze all available (published and unpublished) Abstract Semantic Associative Network Training...
The current study employed interrupted time series (ITS) models to analyze all available (published and unpublished) Abstract Semantic Associative Network Training (AbSANT) data. AbSANT is a semantically focused anomia treatment that targets not only concrete but abstract words, unique among existing anomia treatments. However, evidence to date for the positive effects of AbSANT comes only from small-sample, single-subject design studies, limiting the strength of this evidence and the inferences that can be drawn from it. The statistical power and greater representativeness afforded by this larger aggregated sample enabled us to look for group-level efficacy evidence for AbSANT, examine specific questions about AbSANT's direct training and generalization effects, and identify potential predictors and mechanisms of AbSANT treatment response. We found that across 33 participants from four different data sources, AbSANT appears to be a robust word retrieval therapy protocol, with overall direct training and generalization effects that were more meaningful than exposure effects. Similar to previous smaller-sample study conclusions, we found that in this large sample, training abstract words results not only in larger direct training effects than training concrete words, but also larger generalization effects, suggesting that while AbSANT successfully improves both abstract and concrete word retrieval, it may be better suited for training abstract words. In general, direct training effects were more persistent after treatment ended than generalization effects and effects for concrete words were more persistent than for abstract words. Additionally, the effects of generalization appear to be distinct from the effects of simple exposure to words, and generalization effects are consistent with AbSANT's hypothesized mechanism of action: spreading activation from directly trained concepts to related concepts. Also consistent with this mechanism, we found that milder aphasia and both conceptual and lexical semantic processing ability predicted both direct training and generalization gains, and that executive function was predictive of generalization effects. These factors are thus important to consider when evaluating the appropriateness of AbSANT for individual clients.
PubMed: 37608806
DOI: 10.3389/fresc.2023.1017389 -
American Journal of Speech-language... Jan 2022Anomia, or difficulty with naming and word finding, is a pervasive deficit among individuals with aphasia. There is an extensive literature on the mechanisms underlying...
PURPOSE
Anomia, or difficulty with naming and word finding, is a pervasive deficit among individuals with aphasia. There is an extensive literature on the mechanisms underlying anomia and on approaches to treatment, but very little is known about the subjective experience of anomia during day-to-day life.
METHOD
As part of a larger testing battery, 53 adults with poststroke aphasia took part in a novel, structured interview that included an open-ended question about the general experience of anomia: "Do you ever know what you want to say, but you can't say it out loud? Please describe that feeling." Video-recorded interview responses were transcribed and analyzed using thematic analysis, an iterative, data-driven process that categorizes interview data into common themes.
RESULTS
Five main themes emerged among the data from 37 participants who produced adequate responses for use in thematic analysis: strategies to cope with or compensate for anomia, comments on awareness of the level of breakdown (e.g., "I have an idea, but can't get the right words"), negative emotions, impact on relationships, and changes in frequency over time.
CONCLUSIONS
Participants showed strong awareness of anomia and its implications, demonstrating an ability to describe their language breakdown, identify relevant strategies to compensate and/or cope, and acknowledge the impact of anomia on their emotions and social interactions. This patient perspective may serve as a valuable supplement to information typically gained via objective language assessments. Clinicians and researchers may wish to consider incorporating similar subjective measures during assessment and treatment planning. Supplemental Material https://doi.org/10.23641/asha.15032643.
Topics: Adult; Anomia; Aphasia; Humans; Language; Language Therapy
PubMed: 34310203
DOI: 10.1044/2021_AJSLP-20-00265 -
Cognitive and Behavioral Neurology :... Jun 2020Semantic dementia (SD) is characterized by progressive semantic anomia extending to a multimodal loss of semantic knowledge. Although often considered an early-onset...
BACKGROUND
Semantic dementia (SD) is characterized by progressive semantic anomia extending to a multimodal loss of semantic knowledge. Although often considered an early-onset dementia, SD also occurs in later life, when it may be misdiagnosed as Alzheimer disease (AD).
OBJECTIVE
To evaluate late-onset SD in comparison to early-onset SD and to AD.
METHODS
We identified 74 individuals with SD and then compared those with late-onset SD (≥65 years of age) to those with early-onset SD (<65) on demographic and clinical features. We also compared a subgroup of 23 of the late-onset SD individuals with an equal number of individuals with clinically probable AD.
RESULTS
Twenty-six (35.1%) of the SD individuals were late onset, and 48 (64.9%) were early onset. There were no differences between the two groups on clinical measures, although greater asymmetry of temporal involvement trended to significance in the late-onset SD group. Compared to the 23 AD individuals, the subgroup of 23 late-onset SD individuals had worse performance on confrontational naming, irregular word reading, and face recognition; however, this subgroup displayed better verbal delayed recall and constructions. The late-onset SD individuals also experienced early personality changes at a time when most individuals with AD had not yet developed behavioral changes.
CONCLUSIONS
Approximately one-third of SD individuals may be late onset, and the differentiation of late-onset SD from AD can lead to better disease management, education, and prognosis. SD may be distinguished by screening for disproportionate changes in reading, face recognition, and personality.
Topics: Aged; Female; Frontotemporal Dementia; Humans; Male; Neuropsychological Tests; Retrospective Studies; Semantics
PubMed: 32496297
DOI: 10.1097/WNN.0000000000000229 -
Epilepsy & Behavior Reports 2024Around 40% of patients who undergo a left temporal lobe epilepsy (LTLE) surgery suffer from anomia (word-finding difficulties), a condition that negatively impacts...
Around 40% of patients who undergo a left temporal lobe epilepsy (LTLE) surgery suffer from anomia (word-finding difficulties), a condition that negatively impacts quality of life. Despite these observations, language rehabilitation is still understudied in LTLE. We assessed the effect of a four-week rehabilitation on four drug-resistant LTLE patients after their surgery. The anomia rehabilitation was based on cognitive descriptions of word finding deficits in LTLE. Its primary ingredients were psycholinguistic tasks and a psychoeducation approach to help patients cope with daily communication issues. We repeatedly assessed naming skills for trained and untrained words, before and during the therapy using an A-B design with follow-up and replication. Subjective anomia complaint and standardized language assessments were also collected. We demonstrated the effectiveness of the rehabilitation program for trained words despite the persistence of seizures. Furthermore, encouraging results were observed for untrained items. Variable changes in anomia complaint were observed. One patient who conducted the protocol as self-rehabilitation responded similarly to the others, despite the different manner of intervention. These results open promising avenues for helping epileptic patients suffering from anomia. For example, this post-operative program could easily be adapted to be conducted preoperatively.
PubMed: 38881885
DOI: 10.1016/j.ebr.2024.100681