Diagnosis and treatment of aphasia. Part II.
Explore the source record for details and available documents.
Aphasia↗
Biomedical subjects
M L Albert
Publications and source records attributed to M L Albert.
Diagnosis and treatment of aphasia. Part I.
Explore the source record for details and available documents.
Aphasia↗
Alpha-melanocyte-stimulating hormonelike immunoreactivity is increased in cerebrospinal fluid of patients with Parkinson's disease.
We measured alpha-melanocyte-stimulating hormonelike immunoreactivity in cerebrospinal fluid of 12 healthy control subjects and nine patients with Parkinson's disease, four of whom had never been treated. Mean cerebrospinal fluid alpha-melanocyte-stimulating hormonelike immunoreactivity concentration was two-fold greater in parkinsonian patients (44.1 +/- 9.3 [SD] pg/mL) as compared with control subjects (21.8 +/- 10.0 pg/mL). No significant correlation was found between cerebrospinal fluid alpha-melanocyte-stimulating hormonelike immunoreactivity concentrations and patient age, disease severity, or duration of disease. These results suggest a functional relation between dopaminergic and melanotropinergic systems in the human brain.
Aged↗
Pharmacotherapy for aphasia.
Selected features of aphasia may reflect disruption of specific neurotransmitter systems. Pharmacotherapy focused on these aphasic symptoms may improve language performance following stroke. We attempted to restore speech fluency in a patient with long-standing transcortical motor aphasia by treating his symptoms of hesitancy and impaired initiation of speech with bromocriptine. During therapy his language performance improved substantially, due to reduced latency of response, decreased paraphasias, and increased naming ability. After cessation of drug therapy his language returned to baseline.
Aphasia↗
Treatment of aphasic perseveration (TAP) program. A new approach to aphasia therapy.
We have devised a new approach to the therapy of aphasia. Rather than focus on rehabilitation of linguistic errors, we treat perseveration, which may be an integral component of the aphasic symptoms. In this report we provide key elements of our Treatment of Aphasic Perseveration (TAP) technique, and the successful use of this method with three aphasic patients.
Aphasia↗
Naming errors in healthy aging and dementia of the Alzheimer type.
Naming errors were analyzed for healthy younger and older adults and patients with a diagnosis of senile dementia of the Alzheimer type (SDAT). Three types of errors were identified, varying in relatedness to the target word: near synonyms; semantically related naming errors; and unrelated naming errors. Older adults made relatively more related errors than did younger adults. SDAT patients were distinguished by the number of unrelated responses given. In addition, SDAT patients who scored within the normal range were identified by the high number of response attempts relative to the number of initial errors. We suggest that error patterns on naming tasks may potentially serve as clinical markers to distinguish healthy older persons with mild naming disorders from patients with SDAT.
Adult↗
Perseveration in behavioral neurology.
We tested a new taxonomy of perseverative behavior consisting of three categories: (1) repetition of a previous response to a subsequent stimulus (recurrent), (2) inappropriate maintenance of a category of activity (stuck-in-set), and (3) abnormal prolongation of a current activity (continuous). Three groups of neurologically impaired subjects (with aphasia, right hemisphere damage, and Parkinson's disease) were administered tests to elicit each category of perseveration. Patients with aphasia produced significantly more recurrent perseveration than did patients with right hemisphere damage or healthy controls. Stuck-in-set perseveration was associated with dopamine system dysfunction, and continuous perseveration with right hemisphere damage. We propose a theory of perseveration dependent on anatomic, neuropsychological, and pharmacologic factors related to cerebral dominance. According to this theory, disruption of specific anatomic and pharmacologic systems produces different forms of perseveration which, in turn, underlie particular neurobehavioral disorders.
Aged↗
Confabulation in aphasia.
We describe a brain-damaged patient who produced two distinctive forms of confabulation, typical and atypical (aphasic), both of which were associated with perseveration, poor self-monitoring, and denial of deficit. We propose that the typical confabulations are triggered by gaps in memory for the period surrounding the onset of his illness, while the aphasic (fantastic) confabulations are triggered by gaps in semantic representation. These observations suggest that confabulations may comprise a portion of the language deficit in patients with other varieties of fluent aphasia.
Aged↗
Perseveration in aphasia.
We developed a battery of tests to evaluate the relationship of perseveration to aphasia, and tested 44 subjects (18 with aphasia, 13 with right hemispheric lesions, 13 normal controls). Several major findings emerged: left hemispheric, posteriorly located, aphasia producing lesions also produced abundant perseverations, both verbal and non-verbal, which were primarily recurrent in type; right hemispheric lesions produced few perseverations, and these were primarily of the continuous type; more than half of the verbal recurrent perseverations of aphasia on a naming task were semantic in nature. We conclude that recurrent perseveration has a special, perhaps integral, link to language disorders of aphasia, particularly fluent aphasia associated with posterior lesions.
Anomia↗
CSF cyclic nucleotides and somatostatin in Parkinson's disease.
Concentrations of cyclic adenosine 3',5' monophosphate (cAMP) were significantly lower in parkinsonian patients than in controls, but concentrations of guanosine 3',5' monophosphate (cGMP) were not altered. Both cAMP and cGMP levels were lower in patients with more severe symptoms on the left side of the body. Somatostatin-like immunoreactivity (SLI) was similar in parkinsonian patients and controls. Both cAMP and SLI were significantly related to acetylcholinesterase activity.
Acetylcholinesterase↗
Serotonin and 5-hydroxyindoleacetic acid in CSF. Difference in Parkinson's disease and dementia of the Alzheimer's type.
Serotonin (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA) levels were measured in the sixth, 13th, and 20th milliliters of CSF in patients with dementia of the Alzheimer's type (DAT) and Parkinson's disease (PD), and in an aliquot of CSF in controls. In patients with PD there was a positive correlation between 5-HT and 5-HIAA levels in the 20th milliliter of CSF, while in patients with DAT there was a negative correlation of these levels in this CSF fraction. In patients with the senile form of DAT the 5-HIAA levels in the 20th milliliter of CSF were higher than in patients with PD. These results indicate differential involvement of the serotoninergic system in DAT and PD, and may lead to the development of a chemical marker for DAT.
Aged↗
Historical note: Jules Séglas on language in dementia.
In his book Des troubles du language chez les aliénés (1892) Séglas applied the model of language processing of his teacher, Charcot, to analyze the language disorders of various groups of mentally ill, including patients considered to suffer from dementia. Among the language phenomena he described from dementia are logorrhea, neologisms, embolalia, near-mutism, angophrasia, automatic speech, alexia, and agraphia. Séglas must be credited for his early descriptions of how language behaviors cluster in various psychiatric and dementing diseases.
Dementia↗
On comprehension across the adult lifespan.
To test whether healthy elderly subjects develop language comprehension strategies to compensate for decreases in pure-tone audition, we tested 128 healthy subjects aged 30-79 on two tasks: (1) Comprehension materials from the Boston Diagnostic Aphasia Examination (Goodglass and Kaplan, 1972) presented over babble noise with and without the speaker's face visible; and (2) the Kalikow et al. (1977) Speech Perception in Noise test, which assesses the effect of semantic predictability on sentence-final word intelligibility. Whereas, as predicted, overall performance decreased with advancing age, it appeared, unexpectedly, that older and younger adults were equally affected by the absence of visual input and the absence of semantic predictability.
Adult↗
Empty speech in Alzheimer's disease and fluent aphasia.
Fourteen measures of empty speech during a picture description task were examined in four subject groups--patients with Alzheimer's dementia, Wernicke's aphasias, anomic aphasias, and normal controls--to discover if these groups could be distinguished on the basis of their discourse. Patients with Alzheimer's dementia were distinguished from patients with Wernicke's aphasia by producing more empty phrases and conjunctions, whereas patients with Wernicke's aphasia produced more neologisms, and verbal and literal paraphasias. The demented patients shared many empty speech characteristics with patients with anomic aphasia. Naming deficits, as measured by confrontation naming tasks, did not correlate with empty discourse production. Our findings may be useful clinically for distinguishing these different patient groups.
Adult↗
Catecholamine metabolites and cyclic nucleotides in cerebrospinal fluid in dementia of Alzheimer type.
Three, 4-dihydroxyphenylacetic acid (DOPAC); 3-methoxy, 4-hydroxyphenylacetic acid (HVA); 3-methoxy; 4-hydroxyphenylglycol (MHPG); adenosine 3', 5'-cyclic monophosphate (cyclic AMP); and guanosine 3', 5'-cyclic monophosphate (cyclic GMP) were measured in cerebrospinal fluid (CSF) of patients with dementia of Alzheimer type (DAT) and controls. DOPAC levels were lower and HVA levels were higher in DAT patients than in controls. In the most rostral fractions of CSF from DAT patients there was a negative correlation between DOPAC and cyclic AMP levels. In addition, patients with onset of DAT symptoms before the age of 65 had lower DOPAC levels, a higher HVA/DOPAC ratio, and higher cyclic nucleotide levels than patients with late onset of DAT. By combining DOPAC and cyclic AMP levels, we could clearly distinguish these two groups.
3,4-Dihydroxyphenylacetic Acid↗
Education provides no protection against Alzheimer's disease.
It has been suggested that educational achievement confers protection against dementia. We examined educational level and age of onset in 28 patients with Alzheimer's disease, and assessed the progression of dementia over a mean period of 28 months using both a measure of neurobehavioral status and an index of functional impairment. No protective effect of education was found in either early- or late-onset dementia.
Alzheimer Disease↗
Henry Hécaen, MD neurologist-neuropsychologist 1912-1983.
Explore the source record for details and available documents.
France↗
Parkinson's disease. The possible relationship of laterality to dementia and neurochemical findings.
We examined the relationship of disease laterality to neuropsychological and neurochemical features in patients with idiopathic Parkinson's disease (PD). We tested patients with PD, patients with Alzheimer's type of senile dementia, and a control group neuropsychologically, and we determined their CSF levels of homovanillic acid, 3,4-dihydroxyphenylacetic acid, 3-methoxy-4-hydroxyphenylglycol, 5-hydroxyindolacetic acid, serotonin, and acetylcholinesterase. The patients with PD were divided into two groups depending on the side of the body with greater disease involvement. Both parkinsonian groups, those more affected on the left (group L) and those more affected on the right (group R), were otherwise similar in all other clinical and historical features. Group L patients showed greater neuropsychological impairments than group R patients. Group L also had significantly higher CSF levels of homovanillic acid and acetylcholinesterase than group R. These findings of neuropsychological and neurochemical differences between groups L and R suggest functional or anatomic asymmetries of dopaminergic systems in the CNS.
Acetylcholinesterase↗