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NeuroImage. Clinical 2022Progressive apraxia of speech (AOS) is a motor speech disorder affecting the ability to produce phonetically or prosodically normal speech. Progressive AOS can present...
Progressive apraxia of speech (AOS) is a motor speech disorder affecting the ability to produce phonetically or prosodically normal speech. Progressive AOS can present in isolation or co-occur with agrammatic aphasia and is associated with degeneration of the supplementary motor area. We aimed to assess breakdowns in structural connectivity from the supplementary motor area in patients with any combination of progressive AOS and/or agrammatic aphasia to determine which supplementary motor area tracts are specifically related to these clinical symptoms. Eighty-four patients with progressive AOS or progressive agrammatic aphasia were recruited by the Neurodegenerative Research Group and underwent neurological, speech/language, and neuropsychological testing, as well as 3 T diffusion magnetic resonance imaging. Of the 84 patients, 36 had apraxia of speech in isolation (primary progressive apraxia of speech, PPAOS), 40 had apraxia of speech and agrammatic aphasia (AOS-PAA), and eight had agrammatic aphasia in isolation (progressive agrammatic aphasia, PAA). Tractography was performed to identify 5 distinct tracts connecting to the supplementary motor area. Fractional anisotropy and mean diffusivity were assessed at 10 positions along the length of the tracts to construct tract profiles, and median profiles were calculated for each tract. In a case-control comparison, decreased fractional anisotropy and increased mean diffusivity were observed along the supplementary motor area commissural fibers in all three groups compared to controls. PPAOS also had abnormal diffusion in tracts from the supplementary motor area to the putamen, prefrontal cortex, Broca's area (frontal aslant tract) and motor cortex, with greatest abnormalities observed closest to the supplementary motor area. The AOS-PAA group showed abnormalities in the same set of tracts, but with greater involvement of the supplementary motor area to prefrontal tract compared to PPAOS. PAA showed abnormalities in the left prefrontal and frontal aslant tracts compared to both other groups, with PAA showing greatest abnormalities furthest from the supplementary motor area. Severity of AOS correlated with tract metrics in the supplementary motor area commissural and motor cortex tracts. Severity of aphasia correlated with the frontal aslant and prefrontal tracts. These findings provide insight into how AOS and agrammatism are differentially related to disrupted diffusivity, with progressive AOS associated with abnormalities close to the supplementary motor area, and the frontal aslant and prefrontal tracts being particularly associated with agrammatic aphasia.
Topics: Aphasia; Aphasia, Primary Progressive; Apraxias; Humans; Motor Cortex; Neuropsychological Tests; Speech
PubMed: 35395498
DOI: 10.1016/j.nicl.2022.102999 -
Journal of Physical Therapy Science Jun 2016[Purpose] This study explored health science students' perceptions of motor aphasia and sensory aphasia caused by stroke to provide basic material for the improvement of...
[Purpose] This study explored health science students' perceptions of motor aphasia and sensory aphasia caused by stroke to provide basic material for the improvement of rehabilitation practitioners' perceptions of aphasia. [Subjects and Methods] The subjects of this study were 642 freshmen and sophomores majoring in health science. Perceptions of aphasia were surveyed on a semantic differential scale using the Anchoring Vignette Method and the difference in perception of the two types of aphasia was analyzed using multi-dimensional scaling. [Results] The analysis revealed that motor aphasia and sensory aphasia have mutually corresponding images. Motor aphasia had high levels of 'quiet', 'passive' 'dumb', 'unstable' and 'gloomy' images, while sensory aphasia had high levels of 'noisy', 'unstable', 'cheerful', 'sensitive', 'fluctuating in emotions', 'active', 'dumb' and 'gloomy' images. [Conclusion] A systematic education is required to be implemented in the future to improve health science students' negative perceptions of the aftereffects of stroke such as aphasia.
PubMed: 27390413
DOI: 10.1589/jpts.28.1772 -
ArXiv Feb 2023Aphasia is a speech-language impairment commonly caused by damage to the left hemisphere. Due to the complexity of speech-language processing, the neural mechanisms that...
Aphasia is a speech-language impairment commonly caused by damage to the left hemisphere. Due to the complexity of speech-language processing, the neural mechanisms that underpin various symptoms between different types of aphasia are still not fully understood. We used the network-based statistic method to identify distinct subnetwork(s) of connections differentiating the resting-state functional networks of the anomic and Broca groups. We identified one such subnetwork that mainly involved the brain regions in the premotor, primary motor, primary auditory, and primary sensory cortices in both hemispheres. The majority of connections in the subnetwork were weaker in the Broca group than the anomic group. The network properties of the subnetwork were examined through complex network measures, which indicated that the regions in the superior temporal gyrus and auditory cortex bilaterally exhibit intensive interaction, and primary motor, premotor and primary sensory cortices in the left hemisphere play an important role in information flow and overall communication efficiency. These findings underlied articulatory difficulties and reduced repetition performance in Broca aphasia, which are rarely observed in anomic aphasia. This research provides novel findings into the resting-state brain network differences between groups of individuals with anomic and Broca aphasia. We identified a subnetwork of, rather than isolated, connections that statistically differentiate the resting-state brain networks of the two groups, in comparison with standard lesion symptom mapping results that yield isolated connections.
PubMed: 36798458
DOI: No ID Found -
European Neurology 2009After Gall, Bouillaud and Auburtin had localized the function of language to the frontal lobes in the early 19th century, Paul Broca's famous patient, M. Leborgne (known...
After Gall, Bouillaud and Auburtin had localized the function of language to the frontal lobes in the early 19th century, Paul Broca's famous patient, M. Leborgne (known as 'Tan'), was described to the Anthropological Society of Paris and his case was published in the Bulletin de la Société Anatomique, in 1861. Broca relied on the uncut brain for his clinicopathological inferences. A few months later, his second case, M. Lelong, yielded similar pathological details and confirmed Broca's localization of language. The subsequent controversies with Dax and Pierre Marie are summarized. More recent imaging of the brains of Lelong and Leborgne has partly vindicated Broca's controversial conclusions. Most papers on Broca's work contain only brief, derivative references to his 1861 paper; the actual contents, translated into English, are reproduced here.
Topics: Aphasia, Broca; Eponyms; France; Frontal Lobe; History, 19th Century; Humans; Language; Neurology
PubMed: 19129706
DOI: 10.1159/000189272 -
Cureus Nov 2021Broca's aphasia results due to lesions involving the anterior perisylvian speech area. Patients have intact comprehension and writing but have labored, nonfluent speech...
Broca's aphasia results due to lesions involving the anterior perisylvian speech area. Patients have intact comprehension and writing but have labored, nonfluent speech with decreased linguistic output. We hereby present a case of a 47-year-old female who was operated on for left ventricular trigonal meningioma by a modified middle temporal gyrus approach and developed motor aphasia as a complication. She had intact comprehension and writing but had decreased linguistic, labored output. It could not be labeled as subcortical aphasia as she had no repetition. Eventually, her aphasia improved completely. Our case is the first of its kind and hence we propose that the posterior middle temporal gyrus area has speech output function, the lesion of which could cause motor aphasia.
PubMed: 34912635
DOI: 10.7759/cureus.19495 -
Trials Jun 2022Motor aphasia after stroke is a common and intractable complication of stroke. Acupuncture and language training may be an alternative and effective approach. However,...
BACKGROUND
Motor aphasia after stroke is a common and intractable complication of stroke. Acupuncture and language training may be an alternative and effective approach. However, the efficacy of acupuncture and language training for motor aphasia after stroke has not been confirmed. The main objectives of this trial are to evaluate the effectiveness and safety of acupuncture and low-intensity, low-dose language training in treating ischemic motor aphasia after stroke from 15 to 90 days.
METHODS
This is a multicenter randomized sham-controlled clinical trial. We will allocate 252 subjects aged between 45 and 75 years diagnosed with motor aphasia after stroke with an onset time ranging from 15 to 90 days into two groups randomly in a 1:1 ratio. Patients in the experimental group will be treated with "Xing-Nao Kai-Qiao" acupuncture therapy plus language training, and those in the control group will be treated with sham-acupoint (1 cun next to the acupoints) acupuncture therapy plus language training. All the patients will be given acupuncture and language training for 6 weeks, with a follow-up evaluation 6 weeks after the end of the treatment and 6 months after the onset time. The patients will mainly be evaluated using the Western Aphasia Battery and Chinese Functional Communication Profile, and the incidence of treatment-related adverse events at the 2nd, 4th, and 6th weeks of treatment will be recorded. The baseline characteristics of the patients will be summarized by group, the chi-squared test will be used to compare categorical variables, and repeated measures of analysis of variance or a linear mixed model will be applied to analyze the changes measured at different time points.
DISCUSSION
The present study is designed to investigate the effectiveness and safety of traditional acupuncture therapy and language training in ischemic motor aphasia after stroke and explore the correlation between the treatment time and clinical effect of acupuncture. We hope our results will help doctors understand and utilize acupuncture combined with language training.
TRIAL REGISTRATION
ChiCTR ChiCTR1900026740 . Registered on 20 October 2019.
Topics: Acupuncture Points; Acupuncture Therapy; Aged; Aphasia, Broca; Combined Modality Therapy; Humans; Language Therapy; Middle Aged; Multicenter Studies as Topic; Randomized Controlled Trials as Topic; Stroke; Treatment Outcome
PubMed: 35773693
DOI: 10.1186/s13063-022-06280-2 -
Seminars in Neurology Nov 2014Given the increasing rates of stroke and our aging population, it is critical that we continue to foster innovation in stroke rehabilitation. Although there is evidence... (Review)
Review
Given the increasing rates of stroke and our aging population, it is critical that we continue to foster innovation in stroke rehabilitation. Although there is evidence supporting cognitive rehabilitation in stroke, the set of cognitive domains effectively addressed to date represents only a small subset of the problems experienced by stroke survivors. Further, a gap remains between investigational treatments and our evolving theories of brain function. These limitations present opportunities for improving the functional impact of stroke rehabilitation. The authors use a case example to encourage the reader to consider the evidence base for cognitive rehabilitation in stroke, focusing on four domains critical to daily life function: (1) speech and language, (2) functional memory, (3) executive function and skilled learned purposive movements, and (4) spatial-motor systems. Ultimately, they attempt to draw neuroscience and practice closer together by using translational reasoning to suggest possible new avenues for treating these disorders.
Topics: Aged, 80 and over; Aphasia, Broca; Cognition Disorders; Female; Humans; Stroke; Stroke Rehabilitation
PubMed: 25520021
DOI: 10.1055/s-0034-1396003 -
Restorative Neurology and Neuroscience 2010This review of our research with rTMS to treat aphasia contains four parts: Part 1 reviews functional brain imaging studies related to recovery of language in aphasia... (Review)
Review
This review of our research with rTMS to treat aphasia contains four parts: Part 1 reviews functional brain imaging studies related to recovery of language in aphasia with emphasis on nonfluent aphasia. Part 2 presents the rationale for using rTMS to treat nonfluent aphasia patients (based on results from functional imaging studies). Part 2 also reviews our current rTMS treatment protocol used with nonfluent aphasia patients, and our functional imaging results from overt naming fMRI scans, obtained pre- and post- a series of rTMS treatments. Part 3 presents results from a pilot study where rTMS treatments were followed immediately by constraint-induced language therapy (CILT). Part 4 reviews our diffusion tensor imaging (DTI) study that examined white matter connections between the horizontal, midportion of the arcuate fasciculus (hAF) to different parts within Broca's area (pars triangularis, PTr; pars opercularis, POp), and the ventral premotor cortex (vPMC) in the RH and in the LH. Part 4 also addresses some of the possible mechanisms involved with improved naming and speech, following rTMS with nonfluent aphasia patients.
Topics: Animals; Aphasia; Aphasia, Broca; Diffusion Magnetic Resonance Imaging; Functional Laterality; Humans; Language; Language Therapy; Magnetic Resonance Imaging; Nerve Net; Neuropsychological Tests; Transcranial Magnetic Stimulation; Treatment Outcome
PubMed: 20714075
DOI: 10.3233/RNN-2010-0559 -
Ciencia & Saude Coletiva Aug 2022This text is the result of an ethnographic research conducted in the neurological rehabilitation service at the Center for Mental and Neurological Health Care in Mexico...
This text is the result of an ethnographic research conducted in the neurological rehabilitation service at the Center for Mental and Neurological Health Care in Mexico City. This work focuses its problematic on elucidating how the body language of people with motor aphasia is reconstructed and what senses they generate. The analysis of the collected information led us to identify that language rehabilitation reconstructs a body grammar and uses the ability to narrate in order to restore language and communication. In this sense, we follow Goffman's notion of strip of activity, Csordas' embodiment and Bakhtin's polyphony, in order to understand the discursive construction of language that is introjected into the body and reproduced during clinical interaction. The employed methodology was an ethnography of the clinical context using narratives as a suitable tool to describe the meaning constructed between therapists and people affected with motor aphasia.
Topics: Anthropology, Cultural; Aphasia, Broca; Hospitals; Humans; Linguistics; Mexico
PubMed: 35894344
DOI: 10.1590/1413-81232022278.04242022 -
BMJ Case Reports Dec 2014
Topics: Aged, 80 and over; Aphasia, Broca; Broca Area; Cerebral Arterial Diseases; Female; Humans; Language; Middle Cerebral Artery
PubMed: 25527689
DOI: 10.1136/bcr-2014-208214