-
Seminars in Speech and Language Feb 2017This article reviews existing research on the interactions between verbal short-term memory and language processing impairments in aphasia. Theoretical models of... (Review)
Review
This article reviews existing research on the interactions between verbal short-term memory and language processing impairments in aphasia. Theoretical models of short-term memory are reviewed, starting with a model assuming a separation between short-term memory and language, and progressing to models that view verbal short-term memory as a cognitive requirement of language processing. The review highlights a verbal short-term memory model derived from an interactive activation model of word retrieval. This model holds that verbal short-term memory encompasses the temporary activation of linguistic knowledge (e.g., semantic, lexical, and phonological features) during language production and comprehension tasks. Empirical evidence supporting this model, which views short-term memory in the context of the processes it subserves, is outlined. Studies that use a classic measure of verbal short-term memory (i.e., number of words/digits correctly recalled in immediate serial recall) as well as those that use more intricate measures (e.g., serial position effects in immediate serial recall) are discussed. Treatment research that uses verbal short-term memory tasks in an attempt to improve language processing is then summarized, with a particular focus on word retrieval. A discussion of the limitations of current research and possible future directions concludes the review.
Topics: Aphasia; Comprehension; Humans; Language; Linguistics; Memory, Short-Term; Psychological Theory; Serial Learning; Verbal Learning
PubMed: 28201834
DOI: 10.1055/s-0036-1597261 -
PloS One 2022Aphasia following cerebro-vascular accidents has been a primary source of insight for models of language in the brain. However, deviant language patterns in aphasia may...
BACKGROUND
Aphasia following cerebro-vascular accidents has been a primary source of insight for models of language in the brain. However, deviant language patterns in aphasia may reflect processing limitations and cognitive impairment more than language impairment per se.
AIMS
We sought to obtain new evidence from spontaneous speech in Broca's aphasia (BA) for the intactness of grammatical knowledge, operationalized as the preservation of the basic hierarchical structure of syntactic projections.
METHODS & PROCEDURES
Speech obtained with the AphasiaBank protocol from 20 people with BA, which were independently rated as also being agrammatic, was analyzed and compared to 20 matched non-brain-damaged controls. We quantified (i) marking of Aspect, Tense, and Modality (A-T-M), which are located at specific (high) layers of the syntactic hierarchy and ordered in relation to one another ([M…[T…[A…]]]); (ii) hierarchies of clausal units ([C…[C]]); (iii) discourse markers embedding clauses, located at the highest layer of the hierarchy; and (iv) attachment of adjuncts at different heights of a given hierarchical syntactic structure. Supplementary evidence was obtained from a typology of errors and from pauses subcategorized according to their hierarchical syntactic position.
OUTCOMES & RESULTS
Groups did not quantitatively differ on rates of either Aspect or Modality but underproduced T and embedded clauses. Evidence for compensatory effects was seen in both of the latter two cases. While all adjunct types were underproduced in BA, and pauses overproduced, both showed the same relative proportions within both groups. Errors were largely restricted to omissions, of a kind that would also be expected in condensed neurotypical speech.
CONCLUSIONS
Overall, these patterns support the hypothesis of intactness of grammatical knowledge in BA clinically rated as agrammatic, questioning it as a disease model of language impairment.
Topics: Humans; Aphasia; Language Development Disorders
PubMed: 36473005
DOI: 10.1371/journal.pone.0278676 -
Neuroepidemiology 2022A decrease in ischemic stroke (IS) incidence has been observed in high income countries during the last decades. Whether this has influenced the occurrence of aphasia in...
INTRODUCTION
A decrease in ischemic stroke (IS) incidence has been observed in high income countries during the last decades. Whether this has influenced the occurrence of aphasia in IS is uncertain. We therefore examined the incidence rate and potentially related determinants of aphasia in IS.
METHODS
We prospectively examined consecutive patients admitted to hospital with first-ever acute IS between March 1, 2017, and February 28, 2018, as part of the Lund Stroke Register (LSR) Study, comprising patients from the uptake area of Skåne University Hospital, Lund, Sweden. Patients were assessed with National Institutes of Health Stroke Scale (NIHSS) at stroke onset. Presence of aphasia was evaluated with NIHSS item 9 (language). We registered IS subtypes and risk factors. To investigate possible temporal changes in aphasia incidence, we made comparisons with corresponding LSR data from 2005 to 2006. Incidence rates were calculated and adjusted to the European Standard Population (ESP) and to the Swedish population.
RESULTS
Among 308 included IS patients, 30% presented with aphasia (n = 91; 95% CI: 25-35), a proportion of aphasia in IS that was similar to 2005-2006. The incidence rate of aphasia was 31 per 100,000 person-years adjusted to the ESP (95% CI: 25-38 per 100,000 person-years) corresponding to a significant decrease of 30% between 2005-2006 and 2017-2018. The decrease was significantly more pronounced in men. The initial severity of aphasia remained unchanged, with the majority of patients having severe to global aphasia. No significant differences between vascular stroke risk factors were noted among stroke patients with or without aphasia.
CONCLUSION
Even though the overall IS incidence rate has decreased during the first decades of the 21st century, the proportion of IS patients with aphasia at stroke onset remains stable at 30%. Aphasia continues to be an important symptom that needs to be considered in stroke care and rehabilitation.
Topics: Aphasia; Humans; Incidence; Ischemic Stroke; Male; Risk Factors; Stroke
PubMed: 35320798
DOI: 10.1159/000524206 -
American Journal of Speech-language... Jan 2022Person-centered approaches promote consistent use of supportive technology and feelings of empowerment for people with disabilities. Feature personalization is an aspect...
BACKGROUND
Person-centered approaches promote consistent use of supportive technology and feelings of empowerment for people with disabilities. Feature personalization is an aspect of person-centered approaches that can affect the benefit people with aphasia (PWA) derive from using text-to-speech (TTS) technology as a reading support.
AIMS
This study's primary purpose was to compare the comprehension and processing time of PWA when performing TTS-supported reading with preferred settings for voice, speech output rate, highlighting type, and highlighting color versus unsupported reading. A secondary aim was to examine initial support and feature preference selections, preference changes following TTS exposure, and anticipated functional reading activities for utilizing TTS technology.
METHOD AND PROCEDURE
Twenty PWA read passages either via written text or text combined with TTS output using personally selected supports and features. Participants answered comprehension questions, reevaluated their preference selections, and provided feedback both about feature selections and possible future TTS technology uses.
OUTCOMES AND RESULTS
Comprehension accuracy did not vary significantly between reading conditions; however, processing time was significantly less in the TTS-supported condition, thus suggesting TTS support promoted greater reading speed without compromising comprehension. Most participants preferred the TTS condition and several anticipated benefits when reading lengthy and difficult materials. Alterations to initial settings were relatively rare.
CONCLUSIONS
Personalizing TTS systems is relevant to person-centered interventions. Reading with desired TTS system supports and features promotes improved reading efficiency by PWA compared with reading without TTS support. Attending to client preferences is important when customizing and implementing TTS technology as a reading support.
Topics: Aphasia; Comprehension; Humans; Reading; Speech; Technology
PubMed: 34941376
DOI: 10.1044/2021_AJSLP-21-00182 -
American Journal of Speech-language... Sep 2021Purpose Aphasia intervention research aims to improve communication and quality of life outcomes for people with aphasia. However, few studies have evaluated the... (Review)
Review
Purpose Aphasia intervention research aims to improve communication and quality of life outcomes for people with aphasia. However, few studies have evaluated the translation and implementation of evidence-based aphasia interventions to clinical practice. Treatment dosage may be difficult to translate to clinical settings, and a mismatch between dosage in research and clinical practice threatens to attenuate intervention effectiveness. The purpose of this study is to quantify a potential research-practice dosage gap in outpatient aphasia rehabilitation. Method This study utilized a two-part approach. First, we estimated clinical treatment dosage in an episode of care (i.e., treatment provided from outpatient assessment to discharge) via utilization in a regional provider in the United States. Second, we undertook a scoping review of aphasia interventions published from 2009 to 2019 to estimate the typical dosage used in the current aphasia literature. Results Outpatient clinical episodes of care included a median of 10 treatment sessions and a mean of 14.8 sessions (interquartile range: 5-20 sessions). Sessions occurred 1-2 times a week over 4-14 weeks. The median total hours of treatment was 7.5 hr (interquartile range: 3.75-15 hr). In contrast, published interventions administered a greater treatment dosage, consisting of a median of 20 hr of treatment (interquartile range: 12-30 hr) over the course of 15 sessions (interquartile range: 10-24 sessions) approximately 3 times per week. Conclusions Results demonstrate a meaningful research-practice dosage gap, particularly in total treatment hours and weekly treatment intensity. This gap highlights the potential for attenuation of effectiveness from research to outpatient settings. Future translational research should consider clinical dosage constraints and take steps to facilitate intervention implementation, particularly with regard to dosage. Conversely, health care advocacy and continued development of alternative delivery methods are necessary for the successful implementation of treatments with dosage that is incompatible with current clinical contexts. Pragmatic, implementation-focused trials are recommended to evaluate and optimize treatment effectiveness in outpatient clinical settings. Supplemental Material https://doi.org/10.23641/asha.15161568.
Topics: Aphasia; Communication; Delivery of Health Care; Humans; Quality of Life
PubMed: 34411485
DOI: 10.1044/2021_AJSLP-20-00257 -
Neurologia Sep 2022In the context of neurological disorders, language assessment is traditionally based on the use of the standard language of the community in which the assessment is... (Review)
Review
INTRODUCTION
In the context of neurological disorders, language assessment is traditionally based on the use of the standard language of the community in which the assessment is performed. Dialectal variables constitute a "forgotten" topic. This review aims to provide resources and working guidelines to overcome this limitation.
DEVELOPMENT
The study was conducted as follows: 1) review of basic concepts of dialectology (language, dialect, isogloss line, idiolect, register, "standard variant," bilingualism); 2) characterisation of Spanish and Catalan dialectologies and search for online resources for the development of neurological assessment tools; 3) ad hoc search on the PubMed database (keywords: "dialect," "aphasia," and "multilingual").
CONCLUSIONS
We provide online resources to promote adequate development of assessment tools in Spanish and Catalan, accounting for dialectal considerations. We propose a set of working guidelines for the introduction of dialectal variables in language tests to ensure their ultimate objective: to evaluate the real use of the language, and not cultural knowledge of the standard language.
Topics: Aphasia; Humans; Language; Multilingualism; Neurology
PubMed: 34509402
DOI: 10.1016/j.nrleng.2019.07.007 -
Neurologia Sep 2022In the context of neurological disorders, language assessment is traditionally based on the use of the standard language of the community in which the assessment is... (Review)
Review
INTRODUCTION
In the context of neurological disorders, language assessment is traditionally based on the use of the standard language of the community in which the assessment is performed. Dialectal variables constitute a 'forgotten' topic. This review aims to provide resources and working guidelines to overcome this limitation.
DEVELOPMENT
The study was conducted as follows: 1) review of basic concepts of dialectology (language, dialect, isogloss line, idiolect, register, 'standard variant', bilingualism); 2) characterisation of Spanish and Catalan dialectologies and search for online resources for the development of neurological assessment tools; 3) ad hoc search on the PubMed database (keywords 'dialect', 'aphasia' and 'multilingual').
CONCLUSIONS
We provide online resources to promote adequate development of assessment tools in Spanish and Catalan, accounting for Dialectal considerations. We propose a set of working guidelines for the introduction of Dialectal variables in language tests to ensure their ultimate objective: to evaluate the real use of the language, and not cultural knowledge of the standard language.
Topics: Humans; Language; Aphasia; Neurology
PubMed: 31780323
DOI: 10.1016/j.nrl.2019.07.002 -
Journal of Traditional Chinese Medicine... Sep 2012Acupuncture has often been used for aphasia rehabilitation in China. The purpose of this paper was to: 1) provide a historic overview of acupuncture for aphasia due to... (Review)
Review
OBJECTIVE
Acupuncture has often been used for aphasia rehabilitation in China. The purpose of this paper was to: 1) provide a historic overview of acupuncture for aphasia due to stroke; 2) summarize the commonly used acupuncture approaches; and 3) objectively comment on the effectiveness of acupuncture for the rehabilitation of this type of disorder.
METHODS
The Elsevier database and a Chinese database (CNKI) were searched through December, 2010 with the key words "aphasia, acupuncture" in English and Chinese, respectively. Case reports, uncontrolled clinical observations and controlled clinical trials were all included if acupuncture was the sole treatment or the main component of complex intervention for the rehabilitation of aphasia caused by cerebrovascular disease.
RESULTS
More than 100 relevant articles were found. After analyzing these articles, we found that acupuncture for apoplectic aphasia most often included tongue, scalp, body and combination acupuncture. Tongue bleeding, deep insertion and strong stimulation were adopted by many practitioners. The ten most frequently used acupoints (or areas) were Lianquan (RN 23), Jinjin (EX-HN 12), Yuye (EX-HN 13), Tongli (HT 5), Fengchi (GB 20), Neiguan (PC 6), Baihui (DU 20), No. 1, 2 and 3 language sections, Sanyinjiao (SP 6) and Yamen (DU 15).
CONCLUSIONS
Controlled clinical studies and a systematic literature review demonstrate that acupuncture has therapeutic effects on aphasia after stroke.
Topics: Acupuncture Therapy; Animals; Aphasia; Humans; Stroke
PubMed: 23297549
DOI: 10.1016/s0254-6272(13)60031-x -
Current Neurology and Neuroscience... Nov 2009In this review, we discuss the basic mechanisms of neural regeneration and repair and attempt to correlate findings from animal models of stroke recovery with clinical... (Review)
Review
In this review, we discuss the basic mechanisms of neural regeneration and repair and attempt to correlate findings from animal models of stroke recovery with clinical trials for aphasia. Several randomized controlled clinical trials involving manipulation of different neurotransmitter systems, including noradrenergic, dopaminergic, cholinergic, and glutamatergic systems, have shown signals of efficacy. Biological approaches such as anti-Nogo and cell replacement therapy have shown efficacy in preclinical models but have yet to reach proof of concept in the clinic. Finally, noninvasive cortical stimulation techniques have been used in a few small trials and have shown promising results. It appears that the efficacy of all these platforms can be potentiated through coupling with concomitant behavioral intervention. Given this array of potential mechanisms that exist to augment and/or stimulate neural reorganization after stroke, we are optimistic that approaches to aphasia therapy will transition from compensatory models to models in which brain reorganization is the goal.
Topics: Acetylcholine; Animals; Aphasia; Catecholamines; Cell- and Tissue-Based Therapy; Disease Models, Animal; Extracellular Matrix; Humans; Recovery of Function; Stroke
PubMed: 19818231
DOI: 10.1007/s11910-009-0066-x -
Seizure Apr 2000Epilepsy, and its treatment, can affect the development and use of language in a number of different ways. The seizures may be a symptom of a lesion in areas of the... (Review)
Review
Epilepsy, and its treatment, can affect the development and use of language in a number of different ways. The seizures may be a symptom of a lesion in areas of the brain essential for language function, and the complications of both the seizures and of the drugs can interfere with learning. However, the purpose of this review is to consider the role of epileptic activity as demonstrated by electrical discharges in the electroencephalogram (EEG), whether these are accompanied by overt seizures or not, on cerebral function especially that of language. The Landau-Kleffner, the continuous spike-waves during sleep, and the benign epilepsy of childhood with Rolandic spikes syndromes are considered; as well as the evidence of epileptic discharges affecting language development. If there are doubts that a patient is suffering from epilepsy the diagnosis may be difficult; and anyone involved in the treatment of language disorders should keep this possibility in mind. Particularly during childhood an EEG, awake and asleep, should be an important part of the assessment of both developmental and acquired dysphasia. The control of overt fits may be relatively easy, but drugs are not so effective in controlling the epileptic activity in the EEG. The treatment of such discharges used to be discouraged, but the evidence is now strongly in favour of employing both medical and surgical treatment. The results in restoring language function are sometimes dramatic.
Topics: Adolescent; Aphasia; Child; Cognition Disorders; Electroencephalography; Epilepsy; Female; Humans; Landau-Kleffner Syndrome; Male; Neuropsychological Tests; Sleep
PubMed: 10775514
DOI: 10.1053/seiz.2000.0390