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Expert Review of Neurotherapeutics Feb 2021: Aphasia is a debilitating language disorder and even mild forms of aphasia can negatively affect functional outcomes, mood, quality of life, social participation, and... (Randomized Controlled Trial)
Randomized Controlled Trial
: Aphasia is a debilitating language disorder and even mild forms of aphasia can negatively affect functional outcomes, mood, quality of life, social participation, and the ability to return to work. Language deficits after post-stroke aphasia are heterogeneous. : The first part of this manuscript reviews the traditional syndrome-based classification approach as well as recent advances in aphasia classification that incorporate automatic speech recognition for aphasia classification. The second part of this manuscript reviews the behavioral approaches to aphasia treatment and recent advances such as noninvasive brain stimulation techniques and pharmacotherapy options to augment the effectiveness of behavioral therapy. : Aphasia diagnosis has largely evolved beyond the traditional approach of classifying patients into specific syndromes and instead focuses on individualized patient profiles. In the future, there is a great need for more large scale randomized, double-blind, placebo-controlled clinical trials of behavioral treatments, noninvasive brain stimulation, and medications to boost aphasia recovery.
Topics: Aphasia; Double-Blind Method; Humans; Language Therapy; Quality of Life; Speech Therapy; Stroke Rehabilitation
PubMed: 33231117
DOI: 10.1080/14737175.2020.1855976 -
Archives de Pediatrie : Organe Officiel... Jun 1996Developmental dysphasia is characterized by severe, specific and unexplained developmental language impairment. Phonologic and syntactic disorders of expressive language... (Review)
Review
Developmental dysphasia is characterized by severe, specific and unexplained developmental language impairment. Phonologic and syntactic disorders of expressive language and perceptual deficit are almost always present. Moreover, certain specific linguistic symptoms are particular to each dysphasic child, explaining the efforts to classify different forms of dysphasia. The most important point is to separate receptive dysphasia from the expressive on the one hand, and severe forms from the mild which are closed to "simple language delay", on the other. The evolution of oral language is variable, but often long and difficult, with persistent linguistic deficit. Reading and writing acquisition is usually difficult, although very important for the socio-professional outcome and language improvement. The etiology remains unknown and is probably multifactorial. One pathogenic hypothesis is based on the absence of the usual hemisphere specialisation related to various prenatal or postnatal events. A genetic basis seems likely for certain dysphasic children. Development of knowledge about this condition and improvement of both speech therapy and teaching are essential for the outcome of these otherwise intelligent and normal children.
Topics: Aphasia; Child; Child, Preschool; Humans; Infant; Male
PubMed: 8881306
DOI: 10.1016/0929-693x(96)83232-5 -
La Tunisie Medicale May 2005Developmental dysphasia is a specific, primary and lasting oral language disorder (expressive or comprehensive) is the absence of any sensorineural damage oral organ... (Review)
Review
Developmental dysphasia is a specific, primary and lasting oral language disorder (expressive or comprehensive) is the absence of any sensorineural damage oral organ dystunction or psychiatric and psychologic disorders. Pathogensis is still unknown. Diagnosis is based on exprssive and comprehensive language investigation. Therapy should be early and multidisciplinary.
Topics: Aphasia; Child; Child, Preschool; Developmental Disabilities; Humans
PubMed: 16044895
DOI: No ID Found -
Drugs & Aging 2005Aphasia, the loss or impairment of language caused by brain damage, is one of the most devastating cognitive impairments of stroke. Aphasia is present in 21-38% of acute... (Review)
Review
Aphasia, the loss or impairment of language caused by brain damage, is one of the most devastating cognitive impairments of stroke. Aphasia is present in 21-38% of acute stroke patients and is associated with high short- and long-term morbidity, mortality and expenditure. Recovery from aphasia is possible even in severe cases. While speech-language therapy remains the mainstay treatment of aphasia, the effectiveness of conventional therapies has not been conclusively proved. This has motivated attempts to integrate knowledge from several domains in an effort to plan more rational therapies and to introduce other therapeutic strategies, including the use of intensive language therapy and pharmacological agents. Several placebo-controlled trials suggest that piracetam is effective in recovery from aphasia when started soon after the stroke, but its efficacy vanishes in patients with chronic aphasia. Drugs acting on catecholamine systems (bromocriptine, dexamfetamine) have shown varying degrees of efficacy in case series, open-label studies and placebo-controlled trials. Bromocriptine is useful in acute and chronic aphasias, but its beneficial action appears restricted to nonfluent aphasias with reduced initiation of spontaneous verbal messages. Dexamfetamine improves language function in subacute aphasia and the beneficial effect is maintained in the long term, but its use is restricted to highly selected samples. Pharmacological agents operating on the cholinergic system (e.g. donepezil) have shown promise. Data from single-case studies, case series and an open-label study suggest that donepezil may have beneficial effects on chronic poststroke aphasia. Preliminary evidence suggests that donepezil is well tolerated and its efficacy is maintained in the long term. Randomised controlled trials of donepezil and other cholinergic agents in poststroke aphasia are warranted.
Topics: Adult; Aged; Aphasia; Clinical Trials as Topic; Humans; Middle Aged; Stroke
PubMed: 15733022
DOI: 10.2165/00002512-200522020-00006 -
American Journal of Speech-language... May 2020Purpose The purpose of this article is to revisit the role of augmentative and alternative communication (AAC) in poststroke aphasia rehabilitation. The authors' intent... (Review)
Review
Purpose The purpose of this article is to revisit the role of augmentative and alternative communication (AAC) in poststroke aphasia rehabilitation. The authors' intent is to provide a viewpoint that expands the use of AAC in poststroke aphasia rehabilitation. Specifically, we seek to clarify the role of AAC in restorative and participation approaches to aphasia rehabilitation while also considering the role of AAC in a comprehensive treatment plan. The authors support their viewpoint with citations from both the historic and contemporary literature on aphasia rehabilitation. Conclusions A thought-provoking viewpoint on the role of AAC in poststroke aphasia rehabilitation is proposed. More specifically, the versatility of AAC strategies is reviewed, with an emphasis on how AAC can be used to empower people with aphasia to fully participate and engage in life activities with increased independence. Moreover, we argue that AAC can be viewed as a dual-purpose tool that can simultaneously serve to drive intersystemic reorganization resulting in some improved language performance-and perhaps restoration of language function-while offering a communication alternative during inevitable anomic events.
Topics: Aphasia; Communication; Communication Aids for Disabled; Humans; Language
PubMed: 32109137
DOI: 10.1044/2019_AJSLP-19-00041 -
American Journal of Ophthalmology Jan 1950
Topics: Aphasia; Humans; Retina
PubMed: 15400059
DOI: 10.1016/0002-9394(50)90695-7 -
Lancet (London, England) Nov 2013
Topics: Adult; Aphasia; Female; Humans; Hypothyroidism; Multilingualism
PubMed: 24209830
DOI: 10.1016/S0140-6736(13)61837-1 -
Endocrine Practice : Official Journal... 2007To describe a 24-year-old patient with immune-mediated primary adrenal insufficiency and type 1 diabetes mellitus (T1DM) receiving intensive diabetes management who was... (Review)
Review
Residual dysphasia after severe hypoglycemia in a patient with immune-mediated primary adrenal insufficiency and type 1 diabetes mellitus: case report and systematic review of the literature.
OBJECTIVE
To describe a 24-year-old patient with immune-mediated primary adrenal insufficiency and type 1 diabetes mellitus (T1DM) receiving intensive diabetes management who was comatose at presentation attributable to severe hypoglycemia and had residual dysphasia after recovery and to summarize the related literature.
METHODS
We present a case report and the findings on systematic review of the pertinent literature to identify the cumulative incidence of severe hypoglycemia with use of intensive insulin therapy in patients with primary adrenal insufficiency and T1DM and to determine the incidence of dysphasia after severe hypoglycemia.
RESULTS
After 5 days of mechanical ventilation, our patient was revived. He had severe dysphasia after recovery of consciousness. Magnetic resonance imaging of the brain revealed encephalomalacia in the left temporal, frontal, and parietal lobes. After 6 years of follow-up, he continues to have residual deficits of expressive dysphasia and difficult-to-control seizures but no other neurologic disorders. Systematic review of the literature revealed that studies from the 1950s reported mortality due to hypoglycemia in such a cohort, but no recent studies have described the cumulative incidence of severe hypoglycemia in a cohort of patients with primary adrenal insufficiency and T1DM. To the best of our knowledge, we report the first findings on magnetic resonance imaging of the head in such a patient.
CONCLUSION
Fortunately, residual dysphasia is an infrequent outcome after severe hypoglycemia.
Topics: Addison Disease; Adult; Aphasia; Diabetes Mellitus, Type 1; Diabetic Coma; Humans; Hypoglycemia; Magnetic Resonance Imaging; Male; Severity of Illness Index
PubMed: 17669715
DOI: 10.4158/EP.13.4.384 -
The Practitioner Nov 1957
Topics: Aphasia; Humans
PubMed: 13484686
DOI: No ID Found -
Cognitive Neuropsychology May 2008We report B.R.B., a bilingual Turkish-English speaker with deep dysphasia. B.R.B. shows the typical pattern of semantic errors in repetition with effects of lexicality...
We report B.R.B., a bilingual Turkish-English speaker with deep dysphasia. B.R.B. shows the typical pattern of semantic errors in repetition with effects of lexicality and imageability on performance in both languages. The question we asked is whether language type (Turkish or English) or language status--that is, first acquired (L1) or second acquired (L2)--has a greater impact on performance. Results showed that repetition in L1 (Turkish) was better than that in L2 (English). We also observed effects of language status on oral reading, writing to dictation, and naming (spoken and written) with greater impairment to repetition than other tasks in both languages. An additional finding was that spoken-word translation in both directions was worse than written-word translation, and word class had an effect on translation from L1 to L2. We argue that interactive activation models of deep dysphasia could explain deep dysphasia in bilingual speakers and interactions between task and language, if the weighted connections that support language processing in L2 are assumed to be weaker, thus causing rapid phonological decay to have more impact on task performance in L2. Implications of the results for models of bilingual language processing are also considered.
Topics: Aged; Aphasia; Cerebral Infarction; Comprehension; Emigrants and Immigrants; England; Humans; Imagination; Male; Mental Recall; Multilingualism; Neuropsychological Tests; Occipital Lobe; Parietal Lobe; Phonetics; Reading; Semantics; Speech Perception; Tomography, X-Ray Computed; Turkey; Verbal Behavior; Vocabulary; Writing
PubMed: 18587703
DOI: 10.1080/02643290802057311