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Behavioural Neurology 2013The paper reports findings derived from three experiments examining syntactic and morphosyntactic processing in individuals with agrammatic and logopenic variants of...
The paper reports findings derived from three experiments examining syntactic and morphosyntactic processing in individuals with agrammatic and logopenic variants of primary progressive aphasia (PPA-G and PPA-L, respectively) and stroke-induced agrammatic and anomic aphasia (StrAg and StrAn, respectively). We examined comprehension and production of canonical and noncanonical sentence structures and production of tensed and nontensed verb forms using constrained tasks in experiments 1 and 2, using the Northwestern Assessment of Verbs and Sentences (NAVS [57]) and the Northwestern Assessment of Verb Inflection (NAVI, Thompson and Lee, experimental version) test batteries, respectively. Experiment 3 examined free narrative samples, focusing on syntactic and morphosyntactic measures, i.e. production of grammatical sentences, noun to verb ratio, open-class to closed-class word production ratio, and the production of correctly inflected verbs. Results indicate that the two agrammatic groups (i.e., PPA-G and StrAg) pattern alike on syntactic and morphosyntactic measures, showing more impaired noncanonical compared to canonical sentence comprehension and production and greater difficulties producing tensed compared to nontensed verb forms. Their spontaneous speech also contained significantly fewer grammatical sentences and correctly inflected verbs, and they produced a greater proportion of nouns compared to verbs, than healthy speakers. In contrast, PPA-L and StrAn individuals did not display these deficits, and performed significantly better than the agrammatic groups on these measures. The findings suggest that agrammatism, whether induced by degenerative disease or stroke, is associated with characteristic deficits in syntactic and morphosyntactic processing. We therefore recommend that linguistically sophisticated tests and narrative analysis procedures be used to systematically evaluate the linguistic ability of individuals with PPA, contributing to our understanding of the language impairments of different PPA variants.
Topics: Aged; Anomia; Aphasia, Broca; Aphasia, Primary Progressive; Case-Control Studies; Comprehension; Female; Humans; Male; Middle Aged; Neuropsychological Tests; Semantics; Speech Production Measurement; Stroke
PubMed: 22713394
DOI: 10.3233/BEN-2012-110220 -
CoDAS 2021Aphasia is a common and debilitating manifestation of stroke. Transcranial electrical stimulation uses low-intensity electric currents to induce changes in neuronal...
PURPOSE
Aphasia is a common and debilitating manifestation of stroke. Transcranial electrical stimulation uses low-intensity electric currents to induce changes in neuronal activity. Recent evidence suggests that noninvasive techniques can be a valuable rehabilitation tool for patients with aphasia. However, it is difficult to recruit patients with aphasia for trials, and the reasons for this are not well understood. This study aimed to elucidate the main difficulties involved in patient's recruitment and inclusion in a randomized clinical study of neuromodulation in aphasia.
METHODS
We evaluated the reasons for the exclusion of patients in a pilot, randomized, double-blinded clinical trial in which patients diagnosed with motor aphasia after stroke were recruited from March to November 2018. A descriptive statistical analysis was performed.
RESULTS
Only 12.9% (4) of patients with ischemic stroke were included in the clinical trial. A total of 87.1% (27) of the 31 recruited patients were excluded for various reasons including: sensory aphasia (32.2%), dysarthria (25.8%), spontaneous clinical recovery (16.1%), previous stroke (6.4%), and death or mutism (3.2%).
CONCLUSION
The presence of other types of aphasia, dysarthria, spontaneous recovery, deaths, and mutism were barriers to recruiting patients evidenced in this neuromodulation study.
Topics: Aphasia, Broca; Humans; Pilot Projects; Randomized Controlled Trials as Topic; Stroke; Stroke Rehabilitation; Transcranial Direct Current Stimulation
PubMed: 34231751
DOI: 10.1590/2317-1782/20202020019 -
Brain and Language May 1992The production and comprehension of pantomimed movements by asphasic subjects were studied with respect to their relationship to the aphasic deficit on one hand and...
The production and comprehension of pantomimed movements by asphasic subjects were studied with respect to their relationship to the aphasic deficit on one hand and apraxia on the other. At issue was whether impaired use of pantomime is a manifestation of reduced symbolic capacity or purely a manifestation of an apraxic impairment of purposeful movement or both. Tests of pantomime included a Pantomime Recognition Test, a nonverbal Transitive Pantomime Production Test, and an Intransitive Pantomime Production Test (to oral command). Imitation of Nonmeaningful Movements served as a measure of apraxia, uncontaminated by symbolic or linguistic factors. Imitation of Meaningful Movements taken from the pantomime tasks was also tested. Independent measures of auditory comprehension, picture naming, and reading comprehension were used as indices of language impairment. Intellectual function was measured by the Performance scale of the WAIS. Thirty aphasic subjects were examined. Twenty healthy age-matched normals served to establish scoring standards for the pantomime tests. Multiple regression analysis revealed significant, independent contributions from both auditory comprehension and imitation of Nonmeaningful Movements to all of the tests of pantomime production and pantomime recognition. All measures of pantomime production and pantomime recognition were strongly intercorrelated. While the three language measures were strongly correlated with each other, auditory comprehension was the only one of them that was significantly and consistently related to the pantomime tests. None was related to the imitation of nonmeaningful movement. The results are taken as indicating (1) that pantomime production and imitation share common factors with both praxis and auditory comprehension; (2) apraxia entails impairment of both production and interpretation of purposeful movements. Possible theoretical accounts for these results are offered.
Topics: Aged; Aged, 80 and over; Aphasia; Aphasia, Broca; Aphasia, Wernicke; Apraxias; Female; Humans; Kinesthesis; Male; Middle Aged; Neurologic Examination; Neuropsychological Tests; Nonverbal Communication; Psychomotor Performance; Symbolism
PubMed: 1377075
DOI: 10.1016/0093-934x(92)90076-q -
Frontiers in Neurology 2022Motor aphasia, which can affect the communication ability of patients and even triggers severe psychological disorders, is one of the most common sequelae after stroke....
BACKGROUND
Motor aphasia, which can affect the communication ability of patients and even triggers severe psychological disorders, is one of the most common sequelae after stroke. Acupuncture (a typical complementary alternative therapy) is frequently combined with speech training (ST) to treat post-stroke motor aphasia (PSMA) and presents significant efficacy. However, the most effective acupuncture intervention is still unknown. This study aims to analyze the efficacy of several acupuncture approaches combined with ST for PSMA to identify the best intervention for clinical decision-making by using network meta-analysis (NMA).
METHODS
Eight major databases were searched from the time of their establishment to March 2022. Clinical efficacy rate (CER) was used as the primary outcome indicator. R software (version 4.13.0) and STATA software (version 16.0) were used to analyze the data.
RESULTS
A total of 29 randomized controlled trials (RCTs) and six treatment regimens were included in this study. In the pair-wise meta-analysis, we found that the efficacy of scalp-tongue acupuncture (STA) combined with ST [OR = 8.30; 95% Credible interval (CrI): 3.87, 17.33], tongue acupuncture (TA) combined with ST (OR = 3.95; 95% CrI: 2.27, 6.89), scalp-body acupuncture (SBA) combined with ST (OR = 3.75; 95% CrI: 2.26, 6.22), scalp acupuncture (SA) combined with ST (OR = 2.95; 95% CrI: 1.74, 5.0), and body acupuncture (BA) combined with ST (OR = 2.30; 95% CrI: 1.26, 4.19) were significantly superior to that of ST. In addition, the efficacy of STA + ST was significantly superior to that of SA +ST (OR = 2. 82; 95% CrI: 1.24, 6.38) and BA + ST (OR = 3.61; 95% CrI: 1.40, 9.29). According to the surface under the cumulative ranking curve (SUCRA), STA + ST (SUCRA = 97.9%) may be the best treatment regimen to improve the clinical outcome in patients with PSMA.
CONCLUSION
The NMA showed that STA combined with ST may be the best treatment to improve CER, compared with other combination treatments. However, since the overall quality and number of studies are limited, further RCTs with a large sample and multicenter are needed for further validation.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=316081, identifier CRD42022316081.
PubMed: 36619913
DOI: 10.3389/fneur.2022.992079 -
Journal of Rehabilitation Medicine Feb 2020To evaluate evidence from published systematic reviews of clinical trials to determine the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in stroke...
OBJECTIVE
To evaluate evidence from published systematic reviews of clinical trials to determine the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in stroke population.
METHODS
The Cochrane Library, MEDLINE, CINAHL, EMBASE, and PubMed were searched for systematic reviews up to 15 January 2019. Three authors independently screened the reviews and assessed the methodological quality, using Assessment of Multiple Systematic Reviews (AMSTAR) appraisal tool. Quality of evidence for outcomes evaluated within the reviews was appraised with Grade of Recommendation, Assessment, Development and Evaluation (GRADE) tool.
RESULTS
Twelve reviews (nā=ā9,117 participants) evaluated the effectiveness of rTMS on motor and non-motor (aphasia, depression, dysphagia and cognition) functions. The rTMS protocols applied and outcomes measured were diverse amongst the selected reviews. The findings suggest beneficial effect of rTMS with: "moderate quality" evidence for dysphagia and hemineglect, "low to moderate quality" evidence for motor function (upper limb function, daily activities), and "low quality" evidence for aphasia and post-stroke depression.
CONCLUSION
Despite widespread use of rTMS, high-quality evidence for its routine use for the treatment of stroke survivors is lacking. Further studies are required to establish differential roles of various protocols and long-term effects of rTMS in the stroke population.
Topics: Humans; Stroke; Stroke Rehabilitation; Transcranial Magnetic Stimulation
PubMed: 31922207
DOI: 10.2340/16501977-2637 -
CoDAS Mar 2019To explore the relationship between the two components of spontaneous speech in the Brief Aphasia Evaluation (BAE) and the rest of the scale represented by its three...
PURPOSE
To explore the relationship between the two components of spontaneous speech in the Brief Aphasia Evaluation (BAE) and the rest of the scale represented by its three main factors: The Expression, Comprehension, and Complementary factors.
METHODS
BAE has proven validity and reliability. The evaluation of spontaneous speech in this scale comprises two components: Performance Rank (score: 0-3) and Type of Disorder (Fluency [F], Content [C], or Mixed [FC]) when rank < 3. Sixty-seven patients with left brain damage and 30 demographically matched healthy participants (HP) were studied. It was analyzed the correlation between Performance Rank and the three BAE factors and, recoding 3 as 0 and < 3 as 1, the sensitivity/specificity of this component for each factor. The effect of Type of Disorder on the three factors was analyzed.
RESULTS
1) Performance Rank: Correlations of 0.84 (Expression), 0.81 (Comprehension), and 0.76 (Complementary) were observed, with a sensitivity and specificity ā„ 78% for any factor; 2) Type of Disorder: The performance significantly decreased from FC to C and from C to F in Expression (FC < C < F), from FC to C and from FC to F also in Comprehension and Complementary, from patients with any type of disorder to HP.
CONCLUSION
Performance Rank was a relevant indicator of aphasia by its consistency with valid and comprehensive dimensions of acute language impairments. A degree difference between F and C was observed, being F a milder disorder; i.e., fluency problems were less severe than retrieval or anomia ones.
Topics: Acute Disease; Aphasia, Broca; Aphasia, Wernicke; Case-Control Studies; Educational Status; Female; Humans; Male; Middle Aged; Neuropsychological Tests; Risk Factors; Sensitivity and Specificity; Severity of Illness Index
PubMed: 30843923
DOI: 10.1590/2317-1782/20192018048 -
Neuropsychologia Sep 2017Patients with non-fluent aphasias display impairments of expressive and receptive grammar. This has been attributed to deficits in processing configurational and...
Patients with non-fluent aphasias display impairments of expressive and receptive grammar. This has been attributed to deficits in processing configurational and hierarchical sequencing relationships. This hypothesis had not been formally tested. It was also controversial whether impairments are specific to language, or reflect domain general deficits in processing structured auditory sequences. Here we used an artificial grammar learning paradigm to compare the abilities of controls to participants with agrammatic aphasia of two different aetiologies: stroke and frontotemporal dementia. Ten patients with non-fluent variant primary progressive aphasia (nfvPPA), 12 with non-fluent aphasia due to stroke, and 11 controls implicitly learned a novel mixed-complexity artificial grammar designed to assess processing of increasingly complex sequencing relationships. We compared response profiles for otherwise identical sequences of speech tokens (nonsense words) and tone sweeps. In all three groups the ability to detect grammatical violations varied with sequence complexity, with performance improving over time and being better for adjacent than non-adjacent relationships. Patients performed less well than controls overall, and this was related more strongly to aphasia severity than to aetiology. All groups improved with practice and performed well at a control task of detecting oddball nonwords. Crucially, group differences did not interact with sequence complexity, demonstrating that aphasic patients were not disproportionately impaired on complex structures. Hierarchical cluster analysis revealed that response patterns were very similar across all three groups, but very different between the nonsense word and tone tasks, despite identical artificial grammar structures. Overall, we demonstrate that agrammatic aphasics of two different aetiologies are not disproportionately impaired on complex sequencing relationships, and that the learning of phonological and non-linguistic sequences occurs independently. The similarity of profiles of discriminatory abilities and rule learning across groups suggests that insights from previous studies of implicit sequence learning in vascular aphasia are likely to prove applicable in nfvPPA.
Topics: Acoustic Stimulation; Aged; Aged, 80 and over; Aphasia, Broca; Brain Mapping; Female; Humans; Learning; Linguistics; Machine Learning; Magnetic Resonance Imaging; Male; Middle Aged; Neuropsychological Tests; Primary Progressive Nonfluent Aphasia; Semantics; Statistics as Topic; Stroke; Vocabulary
PubMed: 28843341
DOI: 10.1016/j.neuropsychologia.2017.08.022 -
Cureus Jul 2021The authors present a unique case of immune-mediated necrotizing myopathy in a 60-year-old female who presented with aphasia, tremor, and progressive muscular weakness....
The authors present a unique case of immune-mediated necrotizing myopathy in a 60-year-old female who presented with aphasia, tremor, and progressive muscular weakness. To the best of our knowledge, the presentation of aphasia and tremor has not been previously reported in immune-mediated necrotizing myopathy. This rare presentation may mimic a variety of other central nervous system and myopathic disorders. Delays in prompt diagnosis and treatment of immune-mediated necrotizing myopathy can be detrimental to the physical and mental well-being of the patient and additionally leads to inefficient use of healthcare resources. Therefore, it is beneficial for clinicians to be aware of this symptomatic presentation in order to include immune-mediated necrotizing myopathy as a key differential diagnosis. Awareness of aphasia and tremor as potential symptoms of immune-mediated necrotizing myopathy will improve the quality of patient care.
PubMed: 34367769
DOI: 10.7759/cureus.16159 -
Revista de Neurologia May 2018The Argentine neuropsychological school is born of the hand of the European school and is part of the beginning of the Experimental Psychology. In 1896 Horacio Pinero... (Review)
Review
The Argentine neuropsychological school is born of the hand of the European school and is part of the beginning of the Experimental Psychology. In 1896 Horacio Pinero creates the first Department of Psychology at the University of Buenos Aires and in 1898 the first laboratory of Experimental Psychology is annexed. Jose Ingeniero, psychiatrist, neurologist, politician and above all sociologist publishes in France his work about the musical aphasia, the first neuropsychological work with international significance. In the same redeems to Charcot instead of to Knoblauch like the first one to describe the amusias, it speaks of an intelligence instead of a musical language and proposes a new classification and a methodology of assessment with a neurological-psychiatric integrative perspective. This article gave rise to this book in French on the musical language and its hysterical alterations awarded by the Academy of Medicine of Paris.
Topics: Aphasia, Broca; Apraxias; Argentina; Auditory Perceptual Disorders; Dyslexia; History, 19th Century; History, 20th Century; Music; Neuropsychology; Psychophysiology; Sensation Disorders; Singing
PubMed: 29749596
DOI: No ID Found -
American Journal of Speech-language... Mar 2018The purpose of this study was to examine the relationship between picture naming performance and the ability to communicate the gist, or essential elements, of a story....
PURPOSE
The purpose of this study was to examine the relationship between picture naming performance and the ability to communicate the gist, or essential elements, of a story. We also sought to determine if this relationship varied according to Western Aphasia Battery-Revised (WAB-R; Kertesz, 2007) aphasia subtype.
METHOD
Demographic information, test scores, and transcripts of 258 individuals with aphasia completing 3 narrative tasks were retrieved from the AphasiaBank database. Narratives were subjected to a main concept analysis to determine gist production. A correlation analysis was used to investigate the relationship between naming scores and main concept production for the whole group of persons with aphasia and for WAB-R subtypes separately.
RESULTS
We found strong correlations between naming test scores and narrative gist production for the large sample of persons with aphasia. However, the strength of the correlations varied by WAB-R subtype.
CONCLUSIONS
Picture naming may accurately predict gist production for individuals with Broca's and Wernicke's aphasia, but not for other WAB-R subtypes. Given the current reprioritization of outcome measurement, picture naming may not be an appropriate surrogate measure for functional communication for all persons with aphasia.
SUPPLEMENTAL MATERIALS
https://doi.org/10.23641/asha.5851848.
Topics: Aged; Aged, 80 and over; Anomia; Aphasia, Broca; Aphasia, Conduction; Aphasia, Wernicke; Comprehension; Databases, Factual; Female; Humans; Language; Language Tests; Male; Middle Aged; Photic Stimulation; Severity of Illness Index
PubMed: 29497752
DOI: 10.1044/2017_AJSLP-16-0211