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CoDAS 2021the objective of this paper is to verify the effect of speech therapy intervention program in patients with non-fluent aphasia due to stroke in language tasks related to...
PURPOSE
the objective of this paper is to verify the effect of speech therapy intervention program in patients with non-fluent aphasia due to stroke in language tasks related to verbal fluency in semantic and phonological categories.
METHODS
Patients with aphasia due to stroke were selected to take part in this study. Two groups were formed: diagnosed patients with Broca/transcortical motor aphasia (GA), and a control group (healthy individuals). GA took a fluency verbal task (FAS, other complementary categories: phonological /p/ /l/ and semantic: "fruits" and "names"). These patients were all engaged in a language intervention program developed by the authors of this study. GA received speech therapy sessions (ten sessions lasting for an hour once a week), following a specific language program. After the sessions, the patients were re-evaluated.
RESULTS
GA had statistical significant improvement in the verbal fluency task after the speech therapy program (p-value < 0,001).
CONCLUSION
The speech language therapy program we proposed was efficient enough to show improvement in the results for GA in the verbal fluency task.
Topics: Aphasia; Humans; Language; Speech; Speech Therapy; Stroke
PubMed: 33503209
DOI: 10.1590/2317-1782/20202019124 -
Journal of Korean Medical Science Jan 2010To determine the relations between post-stroke aphasia severity and aphasia type and lesion location, a retrospective review was undertaken using the medical records of...
To determine the relations between post-stroke aphasia severity and aphasia type and lesion location, a retrospective review was undertaken using the medical records of 97 Korean patients, treated within 90 days of onset, for aphasia caused by unilateral left hemispheric stroke. Types of aphasia were classified according to the validated Korean version of the Western Aphasia Battery (K-WAB), and severities of aphasia were quantified using WAB Aphasia Quotients (AQ). Lesion locations were classified as cortical or subcortical, and were determined by magnetic resonance imaging. Two-step cluster analysis was performed using AQ values to classify aphasia severity by aphasia type and lesion location. Cluster analysis resulted in four severity clusters: 1) mild; anomic type, 2) moderate; Wernicke's, transcortical motor, transcortical sensory, conduction, and mixed transcortical types, 3) moderately severe; Broca's aphasia, and 4) severe; global aphasia, and also in three lesion location clusters: 1) mild; subcortical 2) moderate; cortical lesions involving Broca's and/or Wernicke's areas, and 3) severe; insular and cortical lesions not in Broca's or Wernicke's areas. These results revealed that within 3 months of stroke, global aphasia was the more severely affected type and cortical lesions were more likely to affect language function than subcortical lesions.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anomia; Aphasia; Aphasia, Broca; Aphasia, Wernicke; Cluster Analysis; Disability Evaluation; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Republic of Korea; Retrospective Studies; Severity of Illness Index; Stroke; Time Factors
PubMed: 20052357
DOI: 10.3346/jkms.2010.25.1.123 -
Arquivos de Neuro-psiquiatria Sep 2012There is evidence that the explicit lexical-semantic processing deficits which characterize aphasia may be observed in the absence of implicit semantic impairment. The... (Review)
Review
There is evidence that the explicit lexical-semantic processing deficits which characterize aphasia may be observed in the absence of implicit semantic impairment. The aim of this article was to critically review the international literature on lexical-semantic processing in aphasia, as tested through the semantic priming paradigm. Specifically, this review focused on aphasia and lexical-semantic processing, the methodological strengths and weaknesses of the semantic paradigms used, and recent evidence from neuroimaging studies on lexical-semantic processing. Furthermore, evidence on dissociations between implicit and explicit lexical-semantic processing reported in the literature will be discussed and interpreted by referring to functional neuroimaging evidence from healthy populations. There is evidence that semantic priming effects can be found both in fluent and in non-fluent aphasias, and that these effects are related to an extensive network which includes the temporal lobe, the pre-frontal cortex, the left frontal gyrus, the left temporal gyrus and the cingulated cortex.
Topics: Anomia; Aphasia; Aphasia, Broca; Aphasia, Wernicke; Cognition; Comprehension; Evidence-Based Medicine; Evoked Potentials; Humans; Magnetic Resonance Imaging; Memory; Pattern Recognition, Visual; Reaction Time; Semantics
PubMed: 22990731
DOI: 10.1590/s0004-282x2012000900014 -
Brain and Language Nov 2012The importance of the left inferior pre-frontal cortex (LIPC) for speech production was first popularized by Paul Broca, providing a cornerstone of behavioral neurology...
The importance of the left inferior pre-frontal cortex (LIPC) for speech production was first popularized by Paul Broca, providing a cornerstone of behavioral neurology and laying the foundation for future research examining brain-behavior relationships. Although Broca's findings were rigorously challenged, comprehensive contradictory evidence was not published until 130years later. This evidence suggested that damage to left anterior insula was actually the best predictor of motor speech impairment. Using high-resolution structural magnetic resonance imaging (MRI) in patients with chronic stroke, we reveal that LIPC involvement more accurately predicts acquired motor speech impairment than insula damage. Perfusion-weighted MRI provides complementary evidence, highlighting how damage to left inferior pre-frontal gyrus often includes insula involvement, and vice versa. Our findings suggest that Broca's initial conclusions associating acquired motor speech impairment with LIPC damage remain valid nearly 150years after his initial report on this issue.
Topics: Aphasia, Broca; Cerebrovascular Circulation; Frontal Lobe; Humans; Magnetic Resonance Imaging; Stroke
PubMed: 23058844
DOI: 10.1016/j.bandl.2012.08.007 -
Cortex; a Journal Devoted To the Study... Feb 2018The neural basis of speech processing is still a matter of great debate. Phonotactic knowledge-knowledge of the allowable sound combinations in a language-remains...
The neural basis of speech processing is still a matter of great debate. Phonotactic knowledge-knowledge of the allowable sound combinations in a language-remains particularly understudied. The purpose of this study was to investigate the brain regions crucial to phonotactic knowledge in left-hemisphere stroke survivors. Results were compared to areas in which gray matter anatomy related to phonotactic knowledge in healthy controls. 44 patients with chronic left-hemisphere stroke, and 32 controls performed an English-likeness rating task on 60 auditory non-words of varying phonotactic regularities. They were asked to rate on a 1-5 scale, how close each non-word sounded to English. Patients' performance was compared to that of healthy controls, using mixed effects modeling. Multivariate lesion-symptom mapping and voxel-based morphometry were used to find the brain regions important for phonotactic processing in patients and controls respectively. The results showed that compared to controls, stroke survivors were less sensitive to phonotactic regularity differences. Lesion-symptom mapping demonstrated that a loss of sensitivity to phonotactic regularities was associated with lesions in left angular gyrus and posterior middle temporal gyrus. Voxel-based morphometry also revealed a positive correlation between gray matter density in left angular gyrus and sensitivity to phonotactic regularities in controls. We suggest that the angular gyrus is used to compare the incoming speech stream to internal predictions based on the frequency of sound sequences in the language derived from stored lexical representations in the posterior middle temporal gyrus.
Topics: Aged; Anomia; Aphasia; Aphasia, Broca; Aphasia, Conduction; Aphasia, Wernicke; Brain; Brain Mapping; Case-Control Studies; Female; Humans; Language; Linear Models; Male; Middle Aged; Parietal Lobe; Phonetics; Speech Perception; Stroke; Support Vector Machine; Temporal Lobe
PubMed: 29351881
DOI: 10.1016/j.cortex.2017.12.010 -
Cureus Oct 2021Expressive aphasia (non-fluent aphasia) is characterized by the inability to produce words or sentences. The most common cause of expressive aphasia is stroke, usually...
Expressive aphasia (non-fluent aphasia) is characterized by the inability to produce words or sentences. The most common cause of expressive aphasia is stroke, usually due to thrombus or emboli in the middle cerebellar artery or internal carotid artery affecting Broca's area. We present an important, reversible, and previously undescribed cause of a purely expressive aphasia secondary to steroid use. A case of a steroid-induced expressive aphasia has not yet been described in the medical literature. Recognition of this presentation is critical to appropriate therapy and excess morbidity, particularly as steroid (dexamethasone) utilization has increased since the COVID-19 pandemic.
PubMed: 34804716
DOI: 10.7759/cureus.18863 -
Neuropsychologia Jan 2021This study examined grammatical production impairments in primary progressive aphasia (PPA), as measured by structured tests and narrative samples. We aimed to quantify...
PURPOSE
This study examined grammatical production impairments in primary progressive aphasia (PPA), as measured by structured tests and narrative samples. We aimed to quantify the strength of the relationship between grammatical measures across tasks, and identify factors that condition it. Three grammatical domains were investigated: overall sentence production, verb morphology, and verb-argument structure.
METHODS
77 participants with PPA (34 PPA-G, 16 PPA-L, 15 PPA-S and 12 other) completed a battery of grammatical tests and a narrative language sample was obtained. Accuracy scores were computed for the language tests and the narrative samples were analyzed for both accuracy of selected narrative variables as well as grammatical diversity across the three grammatical domains. Principal components analysis (PCA) and multiple regression were used to examine cross-task relationships for all measures.
RESULTS
As expected on the basis of classification criteria, accuracy scores were lower for the PPA-G group as compared to the PPA-L and PPA-S participants for overall sentence production and verb morphology, but not argument structure. Grammatical accuracy in narratives strongly predicted overall language test performance in PPA-G, whereas grammatical diversity in narratives did so in PPA-L, and no significant correspondence between narrative and language test performance was found for PPA-S. For individuals with severe grammatical impairments only, error distribution for both morphology and argument structure was strongly associated in structured tasks and narratives.
CONCLUSIONS
Grammatical production in narrative language predicts accuracy elicited with structured language tests in PPA. However, unique narrative production patterns distinguish PPA by subtype: accuracy for PPA-G, and grammatical diversity for PPA-L. The impairment in PPA-G is likely to reflect a core impairment in grammar whereas that of PPA-L may be closely tied to the word retrieval and verbal working memory deficits that characterize this variant. This underscores the theoretical distinction between PPA-L and PPA-G, as well as the importance of including grammatical diversity measures in analyses of language production, especially for patients who do not display frank agrammatism. Further, the results suggest that measures of domain-specific language deficits (i.e., verb morphology vs. argument structure) are robust across tasks only in individuals with severe grammatical impairments.
Topics: Aphasia, Broca; Aphasia, Primary Progressive; Humans; Language; Language Tests; Narration
PubMed: 33285187
DOI: 10.1016/j.neuropsychologia.2020.107713 -
Brain and Language Nov 1989Numerous theories discuss the neuropsychological functions of the frontal lobes, most based on some concept of supramodality, and an extensive literature presents the...
Numerous theories discuss the neuropsychological functions of the frontal lobes, most based on some concept of supramodality, and an extensive literature presents the phenomenology and semiology of language and communication deficits after focal brain lesions involving the frontal lobes. Despite this, few attempts have been made to link the clinical phenomenology to a theory. This paper presents (1) a general theory of frontal functions; (2) a brief summary of experimental and anatomical literatures in support of defined frontal functional systems; (3) clinical observations that delineate these functional systems for the specific modalities of language and communication; (4) a review of the available literature supporting the idea of specific modal and supramodal language and communication capacities; (5) hypotheses about the distributed anatomy of these functional systems; and (6) implications for traditional clinical notions of aphasia, particularly in relation to a general theory of frontal lobe functions.
Topics: Aphasia; Aphasia, Broca; Brain Damage, Chronic; Brain Mapping; Dominance, Cerebral; Frontal Lobe; Humans; Motor Cortex
PubMed: 2479448
DOI: 10.1016/0093-934x(89)90118-1 -
Frontiers in Neurology 2023Apraxia of speech (AOS) is a motor speech disorder impairing the coordination of complex articulatory movements needed to produce speech. AOS typically co-occurs with a...
INTRODUCTION
Apraxia of speech (AOS) is a motor speech disorder impairing the coordination of complex articulatory movements needed to produce speech. AOS typically co-occurs with a non-fluent aphasia, or language disorder, making it challenging to determine the specific brain structures that cause AOS. Cases of pure AOS without aphasia are rare but offer the best window into the neural correlates that support articulatory planning. The goal of the current study was to explore patterns of apraxic speech errors and their underlying neural correlates in a case of pure AOS.
METHODS
A 67-year-old right-handed man presented with severe AOS resulting from a fronto-insular lesion caused by an ischemic stroke. The participant's speech and language were evaluated at 1-, 3- and 12-months post-onset. High resolution structural MRI, including diffusion weighted imaging, was acquired at 12 months post-onset.
RESULTS
At the first assessment, the participant made minor errors on the Comprehensive Aphasia Test, demonstrating mild deficits in writing, auditory comprehension, and repetition. By the second assessment, he no longer had aphasia. On the Motor Speech Evaluation, the severity of his AOS was initially rated as 5 (out of 7) and improved to a score of 4 by the second visit, likely due to training by his SLP at the time to slow his speech. Structural MRI data showed a fronto-insular lesion encompassing the superior precentral gyrus of the insula and portions of the inferior and middle frontal gyri and precentral gyrus. Tractography derived from diffusion MRI showed partial damage to the frontal aslant tract and arcuate fasciculus along the white matter projections to the insula.
DISCUSSION
This pure case of severe AOS without aphasia affords a unique window into the behavioral and neural mechanisms of this motor speech disorder. The current findings support previous observations that AOS and aphasia are dissociable and confirm a role for the precentral gyrus of the insula and BA44, as well as underlying white matter in supporting the coordination of complex articulatory movements. Additionally, other regions including the precentral gyrus, Broca's area, and Area 55b are discussed regarding their potential role in successful speech production.
PubMed: 37576017
DOI: 10.3389/fneur.2023.1187399 -
BMC Neurology Mar 2021Global aphasia without hemiparesis (GAWH) is a rare stroke syndrome characterized by the dissociation of motor and language functions. Here, we present a case of GAWH...
BACKGROUND
Global aphasia without hemiparesis (GAWH) is a rare stroke syndrome characterized by the dissociation of motor and language functions. Here, we present a case of GAWH with the patient later regaining speech fluency.
CASE PRESENTATION
A 73-year-old man was admitted to our emergency department immediately after an episode of syncope. On arrival, we noted his global aphasia but without any focal neurologic signs. Computed tomography (CT) perfusion scans showed a large hypodense region over his left perisylvian area. Under the impression of acute ischaemic stroke, he received recombinant tissue plasminogen activator (rtPA) injection and was treated as an inpatient. The patient was later discharged with GAWH status and received regular speech rehabilitation. After 14 months of rehabilitation, the patient gradually recovered his language expression ability. The degree of aphasia was evaluated with the Concise Chinese Aphasia Test (CCAT), and we obtained brain single photon emission computed tomography (SPECT) scans to assess cerebral blood flow.
CONCLUSION
A patient with severe impairments of Broca's and Wernicke's areas was able to talk fluently despite being unintelligible. SPECT revealed relative high level of radioactivity uptake in the right frontal lobe, suggesting the deficits in speech fluency could have been compensated by the right hemisphere. Although this is a single case demonstration, the results may strengthen the role of the right hemisphere in GAWH patients and suggests additional study that examines the possible benefits of stimulating activity at right homologous regions for recovering language function after global aphasia.
Topics: Aged; Aphasia; Aphasia, Wernicke; Humans; Ischemic Stroke; Male; Tomography, Emission-Computed, Single-Photon
PubMed: 33706719
DOI: 10.1186/s12883-021-02131-w