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Contrast Media & Molecular Imaging 2022A total of 35 patients with aphasia after cerebral infarct were included. Among them, 15 conjunctures were sensory (Wernicke's) aphasia and 20 cases were motor (Broca)...
A total of 35 patients with aphasia after cerebral infarct were included. Among them, 15 conjunctures were sensory (Wernicke's) aphasia and 20 cases were motor (Broca) aphasia. Perfusion Weighted Imaging (PWI) and Magnetic Resonance Spectroscopy (MRS) were performed on the attached hard area to measure the local cerebral blood flow (rCBF) and sectional cerebral blood compass (rCBV), mean conveyance tense (MTT), point delay (TTP), and -acetylaspartate (NAA), choline (Cho), creatine (Cr)), and lactic acidic (lactate, Lac) and generally a relative analysis. . Among the patients with contaminative aphasia, rCBF was way diminished in the contralateral mirror extent. MTT and TTP were significantly longer than the contralateral mirror range, NAA and Cho were sullenness than the contralateral side, and the Lac peak appeared. The distinction was statistically taken ( < 0.05). Compared with the contralateral mirror circumference, motor aphasia was significantly reduced in rCBF and rCBV, and MTT and TTP were way prolonged. NAA and Cho were reduced compared with the contralateral side, and the Lac peak appeared. The dispute was statistically momentous ( < 0.05). . After cerebral infarction, the language cosine extent of patients with aphasia bestows a rank of hypoperfusion and light metabolism, suggesting that it may be the pathogeny of aphasia.
Topics: Aphasia; Choline; Creatine; Humans; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy
PubMed: 35360264
DOI: 10.1155/2022/5885860 -
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 -
NeuroImage Aug 2013The goal of this paper is to discuss experimental design options available for establishing the effects of treatment in studies that aim to examine the neural mechanisms... (Review)
Review
The goal of this paper is to discuss experimental design options available for establishing the effects of treatment in studies that aim to examine the neural mechanisms associated with treatment-induced language recovery in aphasia, using functional magnetic resonance imaging (fMRI). We present both group and single-subject experimental or case-series design options for doing this and address advantages and disadvantages of each. We also discuss general components of and requirements for treatment research studies, including operational definitions of variables, criteria for defining behavioral change and treatment efficacy, and reliability of measurement. Important considerations that are unique to neuroimaging-based treatment research are addressed, pertaining to the relation between the selected treatment approach and anticipated changes in language processes/functions and how such changes are hypothesized to map onto the brain.
Topics: Aphasia; Brain Mapping; Humans; Practice Guidelines as Topic; Research Design; Treatment Outcome
PubMed: 23063559
DOI: 10.1016/j.neuroimage.2012.10.011 -
Journal of Neurology, Neurosurgery, and... Aug 2013Transcranial direct current stimulation (tDCS), a non-invasive neuromodulation technique inducing prolonged brain excitability changes and promoting cerebral plasticity,... (Meta-Analysis)
Meta-Analysis Review
Transcranial direct current stimulation (tDCS), a non-invasive neuromodulation technique inducing prolonged brain excitability changes and promoting cerebral plasticity, is a promising option for neurorehabilitation. Here, we review progress in research on tDCS and language functions and on the potential role of tDCS in the treatment of post-stroke aphasia. Currently available data suggest that tDCS over language-related brain areas can modulate linguistic abilities in healthy individuals and can improve language performance in patients with aphasia. Whether the results obtained in experimental conditions are functionally important for the quality of life of patients and their caregivers remains unclear. Despite the fact that important variables are yet to be determined, tDCS combined with rehabilitation techniques seems a promising therapeutic option for aphasia.
Topics: Adult; Aged; Aphasia; Brain; Electric Stimulation Therapy; Female; Frontal Lobe; Humans; Language; Male; Middle Aged; Quality of Life; Temporal Lobe; Young Adult
PubMed: 23138766
DOI: 10.1136/jnnp-2012-302825 -
International Journal of Language &... Sep 2017Few studies have investigated how people with aphasia (PWA) experience literacy skills. Taking the insider's perspective is a way to increase understanding of the...
BACKGROUND
Few studies have investigated how people with aphasia (PWA) experience literacy skills. Taking the insider's perspective is a way to increase understanding of the individual experiences of literacy among PWA, which may have clinical implications.
AIMS
To describe how literacy, i.e., reading and writing, is experienced in everyday life by PWA and to gain insight into the part played by literacy skills in their lives.
METHODS & PROCEDURES
A qualitative descriptive research approach was taken. In-depth interviews were conducted with 12 PWA (six women and six men) who had all lived with aphasia for at least 6 months post-stroke. The interviews were analysed using qualitative content analysis.
OUTCOMES & RESULTS
One overarching theme emerged from the data: literacy as an ongoing recovery process. Based on this overarching theme, two subthemes were identified: changes in conditions for literacy (experiences of reading and writing initially post-onset compared with experiences at the time of the interview); and facing expectations about literacy (participants' own and other people's expectations of them in terms of literacy).
CONCLUSIONS & IMPLICATIONS
The findings are important at a general level in that they indicate that PWA are able to articulate their individual experiences and thoughts about literacy, i.e., reading and writing. Specifically, PWA in this study experience literacy as playing an essential part in their lives and the findings imply that personal experiences are important in the design of reading and writing interventions in speech and language therapy.
Topics: Activities of Daily Living; Aged; Aphasia; Cost of Illness; Female; Humans; Interviews as Topic; Literacy; Male; Middle Aged; Qualitative Research; Quality of Life; Reading; Stroke; Writing
PubMed: 28039933
DOI: 10.1111/1460-6984.12302 -
Journal of Vascular Surgery Oct 2014
Topics: Aneurysm; Angiography; Aphasia; Bronchoscopy; Diagnosis, Differential; Endovascular Procedures; Female; Humans; Middle Aged; Subclavian Artery; Tomography, X-Ray Computed; Vascular Malformations
PubMed: 25260474
DOI: 10.1016/j.jvs.2013.08.043 -
Brain Stimulation 2023Aphasia affects approximately one-third of stroke patients and yet its rehabilitation outcomes are often unsatisfactory. More effective strategies are needed to promote... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Aphasia affects approximately one-third of stroke patients and yet its rehabilitation outcomes are often unsatisfactory. More effective strategies are needed to promote recovery.
OBJECTIVE
We aimed to examine the efficacy and safety of the theta-burst stimulation (TBS) on the language area in the superior frontal gyrus (SFG) localized by personalized functional imaging, in facilitating post-stroke aphasia recovery.
METHODS
This randomized sham-controlled trial uses a parallel design (intermittent TBS [iTBS] in ipsilesional hemisphere vs. continuous TBS [cTBS] in contralesional hemisphere vs. sham group). Participants had aphasia symptoms resulting from their first stroke in the left hemisphere at least one month prior. Participants received three-week speech-language therapy coupled with either active or sham stimulation applied to the left or right SFG. The primary outcome was the change in Western Aphasia Battery-Revised (WAB-R) aphasia quotient after the three-week treatment. The secondary outcome was WAB-R aphasia quotient improvement after one week of treatment.
RESULTS
Ninety-seven patients were screened between January 2021 and January 2022, 45 of whom were randomized and 44 received intervention (15 in each active group, 14 in sham). Both iTBS (estimated difference = 14.75, p < 0.001) and cTBS (estimated difference = 13.43, p < 0.001) groups showed significantly greater improvement than sham stimulation after the 3-week intervention and immediately after one week of treatment (p's < 0.001). The adverse events observed were similar across groups. A seizure was recorded three days after the termination of the treatment in the iTBS group.
CONCLUSION
The stimulation showed high efficacy and SFG is a promising stimulation target for post-stroke language recovery.
Topics: Humans; Transcranial Magnetic Stimulation; Aphasia; Stroke; Stroke Rehabilitation; Treatment Outcome; Prefrontal Cortex
PubMed: 37652135
DOI: 10.1016/j.brs.2023.08.023 -
Annals of the New York Academy of... Apr 2016Is thought possible without language? Individuals with global aphasia, who have almost no ability to understand or produce language, provide a powerful opportunity to... (Review)
Review
Is thought possible without language? Individuals with global aphasia, who have almost no ability to understand or produce language, provide a powerful opportunity to find out. Surprisingly, despite their near-total loss of language, these individuals are nonetheless able to add and subtract, solve logic problems, think about another person's thoughts, appreciate music, and successfully navigate their environments. Further, neuroimaging studies show that healthy adults strongly engage the brain's language areas when they understand a sentence, but not when they perform other nonlinguistic tasks such as arithmetic, storing information in working memory, inhibiting prepotent responses, or listening to music. Together, these two complementary lines of evidence provide a clear answer: many aspects of thought engage distinct brain regions from, and do not depend on, language.
Topics: Aphasia; Brain; Cognition; Functional Neuroimaging; Humans; Language; Thinking
PubMed: 27096882
DOI: 10.1111/nyas.13046 -
Folia Phoniatrica Et Logopaedica :... 2012
Comparative Study
Topics: Adult; Aphasia; Communication Disorders; Cross-Cultural Comparison; Humans; Language Therapy; Netherlands; Speech Therapy; Stroke
PubMed: 23108444
DOI: 10.1159/000342021 -
Neuropsychological Rehabilitation Apr 2018Impairments of short-term and working memory (STM, WM), both verbal and non-verbal, are ubiquitous in aphasia. Increasing interest in assessing STM and WM in aphasia... (Review)
Review
Impairments of short-term and working memory (STM, WM), both verbal and non-verbal, are ubiquitous in aphasia. Increasing interest in assessing STM and WM in aphasia research and clinical practice as well as a growing evidence base of STM/WM treatments for aphasia warrant an understanding of the range of standardised STM/WM measures that have been utilised in aphasia. To date, however, no previous systematic review has focused on aphasia. Accordingly, the goals of this systematic review were: (1) to identify standardised tests of STM and WM utilised in the aphasia literature, (2) to evaluate critically the psychometric strength of these tests, and (3) to appraise critically the quality of the investigations utilising these tests. Results revealed that a very limited number of standardised tests, in the verbal and non-verbal domains, had robust psychometric properties. Standardisation samples to elicit normative data were often small, and most measures exhibited poor validity and reliability properties. Studies using these tests inconsistently documented demographic and aphasia variables essential to interpreting STM/WM test outcomes. In light of these findings, recommendations are provided to foster, in the future, consistency across aphasia studies and confidence in STM/WM tests as assessment and treatment outcome measures.
Topics: Aphasia; Humans; Memory, Short-Term; Neuropsychological Tests; Psychometrics; Reproducibility of Results
PubMed: 27143500
DOI: 10.1080/09602011.2016.1174718