-
Journal of Speech, Language, and... Oct 2016This study evaluates how proposition density can differentiate between persons with aphasia (PWA) and individuals in a control group, as well as among subtypes of...
PURPOSE
This study evaluates how proposition density can differentiate between persons with aphasia (PWA) and individuals in a control group, as well as among subtypes of aphasia, on the basis of procedural discourse and personal narratives collected from large samples of participants.
METHOD
Participants were 195 PWA and 168 individuals in a control group from the AphasiaBank database. PWA represented 6 aphasia types on the basis of the Western Aphasia Battery-Revised (Kertesz, 2006). Narrative samples were stroke stories for PWA and illness or injury stories for individuals in the control group. Procedural samples were from the peanut-butter-and-jelly-sandwich task. Language samples were transcribed using Codes for the Human Analysis of Transcripts (MacWhinney, 2000) and analyzed using Computerized Language Analysis (MacWhinney, 2000), which automatically computes proposition density (PD) using rules developed for automatic PD measurement by the Computerized Propositional Idea Density Rater program (Brown, Snodgrass, & Covington, 2007; Covington, 2007).
RESULTS
Participants in the control group scored significantly higher than PWA on both tasks. PD scores were significantly different among the aphasia types for both tasks. Pairwise comparisons for both discourse tasks revealed that PD scores for the Broca's group were significantly lower than those for all groups except Transcortical Motor. No significant quadratic or linear association between PD and severity was found.
CONCLUSION
Proposition density is differentially sensitive to aphasia type and most clearly differentiates individuals with Broca's aphasia from the other groups.
Topics: Aged; Aphasia; Diagnosis, Computer-Assisted; Female; Humans; Language Tests; Male; Middle Aged; Multivariate Analysis; Narration; Pattern Recognition, Automated; Speech
PubMed: 27657850
DOI: 10.1044/2016_JSLHR-L-15-0401 -
Alternative Therapies in Health and... Sep 2023It is estimated that 25% of the patients in Pakistan experience stroke resulting in problems with language. Among many of the conditions, problem with verbal expressive... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
It is estimated that 25% of the patients in Pakistan experience stroke resulting in problems with language. Among many of the conditions, problem with verbal expressive production (Broca's Aphasia) is one of the main problem faced by people having stoke. Many traditional therapies are incorporated to treat symptoms of Aphasia including fluent and non- fluent Aphasia.
OBJECTIVES
The primary objective of the current study was to determine the effectiveness of Verbal Expressive Skill Management Program in Urdu (VESMP-U) with convention speech therapy, Melodic Intonation therapy (MIT) in enhancing the verbal expressive skills in patients with severe Broca's Aphasia. Another objective of this study was to compare the efficacy of Verbal Expressive Skill Management Program in Urdu (VESMP-U) with traditional therapy, as well as the quality of life of patients with severe Broca's Aphasia.
METHODS
A randomized control trial (NCT03699605, clinicaltrials.gov) was conducted from November 2018 - June 2019 in Pakistan railway Hospital (PRH). Patients having a three-month history of severe Broca's Aphasia, aged between 40-60 years, bilingual (Urdu and English language) and having the ability to use a smart phone were included in the study. Patients with cognitive impairments were excluded. Total of 77 patients were evaluated for eligibility criteria according to the G Power software for sample size. Out of 77, 54 individuals fulfilled the inclusion criteria. The participants were divided into 2 groups (27 each) through sealed envelope method. Patients of both groups were assessed pre and post intervention using the Boston Diagnostic Aphasia Examination (BADE) battery (Primary outcome measure). Experimental group n = 25 received VESMP-U therapy and control group n = 25 (2 drop out in each group) received MIT for 16 weeks i.e. 4 days per week having 64 sessions altogether. Each intervention session lasted up to 30-45 minutes for both groups.
RESULTS
Within and between group analysis after intervention showed that the VESMP-U group had significantly improved BDAE scores (P = .001; 95% CI) than the MIT group for all variables (articulatory intelligibility, phrase length, grammatical form, prosody/intonation, spontaneous speech, word finding, repetition, and auditory comprehension). The BDAE scores of participants in experimental group having VESMP-U therapy pre- and post-intervention were statistically significant (P = .001; 95% CI), which indicates that participant's communication skills were enhanced by use of VESMP-U.
CONCLUSION
Android based application VESMP-U has been found to be effective in improving expression and quality of life of patients with severe Broca's aphasia.
Topics: Adult; Humans; Middle Aged; Aphasia, Broca; Asian People; Pakistan; Quality of Life; Stroke
PubMed: 37295011
DOI: No ID Found -
Annals of Indian Academy of Neurology 2018Aphasia is a neurogenic communication disorder with significant deficits in various domains of language and communication. One such type of aphasia, which impacts the...
BACKGROUND
Aphasia is a neurogenic communication disorder with significant deficits in various domains of language and communication. One such type of aphasia, which impacts the quality of life significantly is Broca's aphasia, where the individual is aware of the communication difficulty.
OBJECTIVE
To compare the Quality of Communication Life (QoCL) between individuals with Broca's aphasia and normal individuals.
METHODS
The first phase of the study translated and validated QCL scale in Tamil. The second phase involved administration of the Tamil QCL scale on 12 individuals with Broca's aphasia and 12 age matched normal adults. The marked responses were analysed on a visual analogue scale independently.
STATISTICAL ANALYSIS
Three domains of QoCL were compared between the two groups using Mann-Whitney U-test.
RESULTS
The QoCL scores across three domains were observed to be lower in individuals with Broca's aphasia, when compared to normal adults. Individuals with Broca's aphasia expressed greater challenges in socialization/activities domain of QoCL than confidence/self-concept and roles and responsibilities domains.
CONCLUSIONS
Information obtained on self-reported QCL scale in familiar or native language will facilitate in planning client-oriented management of aphasia.
PubMed: 30532358
DOI: 10.4103/aian.AIAN_489_17 -
Revista de NeurologiaWe present a review the issue of agrammatism in order to examine its symptoms, the regularity with which they are observed, and the proposals suggested within the... (Review)
Review
INTRODUCTION
We present a review the issue of agrammatism in order to examine its symptoms, the regularity with which they are observed, and the proposals suggested within the framework of Cognitive Neuropsychology to account for them.
DEVELOPMENT
First, we focus on the debate regarding the status of agrammatism as an aphasic category with both theoretical and clinical validity, presenting two confronted views. On the one hand, the view that argues against the category of agrammatism due the variable performance of agrammatic patients in linguistic tasks. On the other hand, we present the view of those authors who defend, despite the variability, the notion of agrammatism as an aphasic syndrome. In the second section of the paper, we discussed the different symptoms that, on the basis of the available evidence, have been associated to agrammatism and the proposed explanations. We start by discussing the symptoms that agrammatic patients present in language production; in particular, we highlight the following: a) problems related to grammatical morphemes; b) a reduced sentence length; c) a noun-verb dissociation, with a better performance with nouns; d) difficulties in sentence construction, and finally, e) alteration in word order. Then, we discuss the symptoms that agrammatic patients have shown in language comprehension.
CONCLUSION
In general, on the basis of the different agrammatic symptoms we have discussed, we favour the view of agrammatism as multicomponential syndrome rather than unitary one, with deficits in both morpholexical and syntactic language components.
Topics: Aphasia, Broca; Humans; Linguistics
PubMed: 15795874
DOI: No ID Found -
Brain and Language Oct 1989Four hypotheses that attempt to account for the comprehension deficit in agrammatism are put to an empirical test. The interest in them is in that they all view the... (Review)
Review
Four hypotheses that attempt to account for the comprehension deficit in agrammatism are put to an empirical test. The interest in them is in that they all view the deficit as highly selective. The first, proposed by D. Caplan and C. Futter (1986, Brain and Language, 27, 117-134), argues that agrammatic patients cannot carry out normal syntactic analysis beyond the category label of each incoming lexical item and are reduced to the use of a cognitive strategy that commends assignment of thematic roles to noun phrases merely by their linear position in the string. A second, less radical hypothesis (Y. Grodzinsky, 1986a, Brain and Language, 27, 135-159), accounts for the deficit differently, by deleting a particular kind of syntactic object (trace) from the otherwise normal representation, and augmenting the resulting, underspecified representation by a strategy, whose use is quite restricted. A third account that is tested contends that agrammatic aphasics fail to comprehend perceptually complex constructions, where the metric for complexity is determined by results obtained from comprehension tests of normal listeners. The fourth account (M. F. Schwartz, M. C. Linebarger, E. M. Saffran, and D. S. Pate, 1987, Language and Cognitive Processes, 2, 85-113) argues that the thematic transparency of a construction (whether or not thematic roles are assigned directly to positions) is the best predictor of the manner by which agrammatics can handle it. An empirical test is thus constructed, both to extend the evidential basis concerning the comprehension skills of these patients and to distinguish between the accounts. Four types of relative clauses are presented to the patients, where embedding type (center vs. right) is one variable, and location of gap (subject vs. object position) is the other. The patients are tested in a sentence-picture matching paradigm. The finding, that is rather robust, is that gap location is the best predictor of agrammatic performance: the patients perform well above chance on both types of subject gap relatives, and at chance levels on object gaps. It is then shown that the Trace-Deletion Hypothesis (Grodzinsky, 1986a) is the only one among the accounts considered that is compatible with these data.
Topics: Aphasia; Aphasia, Broca; Humans; Neuropsychological Tests; Semantics; Speech Perception
PubMed: 2478254
DOI: 10.1016/0093-934x(89)90031-x -
Frontiers in Human Neuroscience 2013Assessment of brain-damaged subjects presenting with dissociated repetition deficits after selective injury to either the left dorsal or ventral auditory pathways can...
Dissociated repetition deficits in aphasia can reflect flexible interactions between left dorsal and ventral streams and gender-dimorphic architecture of the right dorsal stream.
Assessment of brain-damaged subjects presenting with dissociated repetition deficits after selective injury to either the left dorsal or ventral auditory pathways can provide further insight on their respective roles in verbal repetition. We evaluated repetition performance and its neural correlates using multimodal imaging (anatomical MRI, DTI, fMRI, and(18)FDG-PET) in a female patient with transcortical motor aphasia (TCMA) and in a male patient with conduction aphasia (CA) who had small contiguous but non-overlapping left perisylvian infarctions. Repetition in the TCMA patient was fully preserved except for a mild impairment in nonwords and digits, whereas the CA patient had impaired repetition of nonwords, digits and word triplet lists. Sentence repetition was impaired, but he repeated novel sentences significantly better than clichés. The TCMA patient had tissue damage and reduced metabolism in the left sensorimotor cortex and insula. DTI showed damage to the left temporo-frontal and parieto-frontal segments of the arcuate fasciculus (AF) and part of the left ventral stream together with well-developed right dorsal and ventral streams, as has been reported in more than one-third of females. The CA patient had tissue damage and reduced metabolic activity in the left temporoparietal cortex with additional metabolic decrements in the left frontal lobe. DTI showed damage to the left temporo-parietal and temporo-frontal segments of the AF, but the ventral stream was spared. The direct segment of the AF in the right hemisphere was also absent with only vestigial remains of the other dorsal subcomponents present, as is often found in males. fMRI during word and nonword repetition revealed bilateral perisylvian activation in the TCMA patient suggesting recruitment of spared segments of the left dorsal stream and right dorsal stream with propagation of signals to temporal lobe structures suggesting a compensatory reallocation of resources via the ventral streams. The CA patient showed a greater activation of these cortical areas than the TCMA patient, but these changes did not result in normal performance. Repetition of word triplet lists activated bilateral perisylvian cortices in both patients, but activation in the CA patient with very poor performance was restricted to small frontal and posterior temporal foci bilaterally. These findings suggest that dissociated repetition deficits in our cases are probably reliant on flexible interactions between left dorsal stream (spared segments, short tracts remains) and left ventral stream and on gender-dimorphic architecture of the right dorsal stream.
PubMed: 24391569
DOI: 10.3389/fnhum.2013.00873 -
Current Neurology and Neuroscience... Nov 2010Primary progressive aphasia (PPA), typically resulting from a neurodegenerative disease such as frontotemporal lobar degeneration or Alzheimer's disease, is... (Review)
Review
Primary progressive aphasia (PPA), typically resulting from a neurodegenerative disease such as frontotemporal lobar degeneration or Alzheimer's disease, is characterized by a progressive loss of specific language functions with relative sparing of other cognitive domains. Three variants of PPA are now recognized: semantic variant, logopenic variant, and nonfluent/agrammatic variant. We discuss recent work characterizing the neurolinguistic, neuropsychological, imaging and pathologic profiles associated with these variants. Improved reliability of diagnoses will be increasingly important as trials for etiology-specific treatments become available. We also discuss the implications of these syndromes for theories of language function.
Topics: Aphasia, Broca; Aphasia, Primary Progressive; Cerebral Cortex; Humans; Semantics; Speech
PubMed: 20809401
DOI: 10.1007/s11910-010-0140-4 -
Annals of the New York Academy of... Jul 2009For more than 100 years, clinicians have noted that patients with nonfluent aphasia are capable of singing words that they cannot speak. Thus, the use of melody and... (Review)
Review
For more than 100 years, clinicians have noted that patients with nonfluent aphasia are capable of singing words that they cannot speak. Thus, the use of melody and rhythm has long been recommended for improving aphasic patients' fluency, but it was not until 1973 that a music-based treatment [Melodic Intonation Therapy (MIT)] was developed. Our ongoing investigation of MIT's efficacy has provided valuable insight into this therapy's effect on language recovery. Here we share those observations, our additions to the protocol that aim to enhance MIT's benefit, and the rationale that supports them.
Topics: Aphasia, Broca; Brain; Humans; Music Therapy; Neuronal Plasticity
PubMed: 19673819
DOI: 10.1111/j.1749-6632.2009.04859.x -
BMC Neurology Jun 2020Cerebral venous sinus thrombosis (CVST), a rare cause of cerebral infarction, is often unrecognized at initial presentation. We report the case of a patient with...
BACKGROUND
Cerebral venous sinus thrombosis (CVST), a rare cause of cerebral infarction, is often unrecognized at initial presentation. We report the case of a patient with bilateral corpus callosum and corona radiata infarction due to cerebral venous sinus thrombosis presenting as headache and acute reversible aphasia.
CASE PRESENTATION
A 30-year-old female patient presented with headache, vomiting, and motor aphasia. She was 20 days post-partum and had a lower than normal food intake following a normal vaginal delivery. Brain magnetic resonance images revealed a bilateral corpus callosum and corona radiata infarction. MR venography (MRV) and digital subtraction angiography (DSA) images showed a signal void in the anterior aspect of the superior sagittal sinus and inferior sagittal sinus, ophthalmic vein expansion, and the reversed direction of venous flow. In addition, images showed non-visualization of the left transverse sinus. The left slender sigmoid sinus and small internal jugular vein were also noted. The diagnosis of cerebral venous thrombosis was considered based on the above findings. The patient was managed with anticoagulation therapy, and recovered substantially after treatment.
CONCLUSIONS
Bilateral corpus callosum and corona radiata infarction is very rare. However, for patients who clinically show cranial hypertension and neurological deficits during the puerperium period, the possibility of CVST should be considered. Furthermore, DSA plays an important role in the diagnosis of CVST, and should be routinely checked. Early diagnosis is crucial for the patient suffering from CVST.
Topics: Adult; Aphasia; Brain; Cerebral Infarction; Corpus Callosum; Female; Headache; Humans; Postpartum Period; Sinus Thrombosis, Intracranial
PubMed: 32560642
DOI: 10.1186/s12883-020-01829-7 -
Brain : a Journal of Neurology Nov 2013Non-fluent aphasia implies a relatively straightforward neurological condition characterized by limited speech output. However, it is an umbrella term for different...
Non-fluent aphasia implies a relatively straightforward neurological condition characterized by limited speech output. However, it is an umbrella term for different underlying impairments affecting speech production. Several studies have sought the critical lesion location that gives rise to non-fluent aphasia. The results have been mixed but typically implicate anterior cortical regions such as Broca's area, the left anterior insula, and deep white matter regions. To provide a clearer picture of cortical damage in non-fluent aphasia, the current study examined brain damage that negatively influences speech fluency in patients with aphasia. It controlled for some basic speech and language comprehension factors in order to better isolate the contribution of different mechanisms to fluency, or its lack. Cortical damage was related to overall speech fluency, as estimated by clinical judgements using the Western Aphasia Battery speech fluency scale, diadochokinetic rate, rudimentary auditory language comprehension, and executive functioning (scores on a matrix reasoning test) in 64 patients with chronic left hemisphere stroke. A region of interest analysis that included brain regions typically implicated in speech and language processing revealed that non-fluency in aphasia is primarily predicted by damage to the anterior segment of the left arcuate fasciculus. An improved prediction model also included the left uncinate fasciculus, a white matter tract connecting the middle and anterior temporal lobe with frontal lobe regions, including the pars triangularis. Models that controlled for diadochokinetic rate, picture-word recognition, or executive functioning also revealed a strong relationship between anterior segment involvement and speech fluency. Whole brain analyses corroborated the findings from the region of interest analyses. An additional exploratory analysis revealed that involvement of the uncinate fasciculus adjudicated between Broca's and global aphasia, the two most common kinds of non-fluent aphasia. In summary, the current results suggest that the anterior segment of the left arcuate fasciculus, a white matter tract that lies deep to posterior portions of Broca's area and the sensory-motor cortex, is a robust predictor of impaired speech fluency in aphasic patients, even when motor speech, lexical processing, and executive functioning are included as co-factors. Simply put, damage to those regions results in non-fluent aphasic speech; when they are undamaged, fluent aphasias result.
Topics: Aged; Aphasia, Broca; Cerebral Cortex; Cerebrum; Cohort Studies; Female; Humans; Language Tests; Magnetic Resonance Imaging; Male; Middle Aged; Neural Pathways; Neuropsychological Tests; Predictive Value of Tests
PubMed: 24131592
DOI: 10.1093/brain/awt267