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PubMedDate not supplied

Broca's aphasia, verbs and the mental lexicon.

Verb production is notoriously difficult for individuals with Broca's aphasia, both at the word and at the sentence level. An intriguing question is at which level in the speech production these problems arise. The aim of the present study is to identify the functional locus of the impairment that results in verb production deficits in Broca's aphasia. Levelt's (1989) model is used as a theoretical framework for this study. Two experiments have been conducted, one on verb movement and one on verbs with alternating transitivity. The results suggest that the functional impairment in Broca's aphasia should be located in Levelt's "grammatical encoder."

Aphasia, Broca↗
PubMed2004

[The situation of caregiver counselling in patients with frontotemporal lobar dementia in old psychiatry].

Caregiver counselling is an indispensable feature of current concepts for dementia treatment. Self-support groups and psychoeducative programms for caregivers of patients with Alzheimer's disease may reduce the burden of nursing and psychological strain. Specific caregiver needs from patients with frontotemporal lobar dementia (FTLD [frontotemporal dementia, semantic dementia, progressive aphasia, corticobasal degeneration]) are only partially taken into account. We conducted a German wide epidemiologic study which revealed that specific counselling for supporting relatives and caregivers of patients with FTLD is only fragmentary in hospital services for old age psychiatry. In most cases, they are referred to the local Alzheimer's disease Associations (89 %). Besides that, the existence of large hospital care units has significant negative repercussions on psychosocial supply for caregivers of patients with FTLD. To establish decentralized support units by these hospitals would lead to a significant improvement of medical and social care in this field.

Aged↗
PubMed1975

[Disruption and recovery of grammatical speech in patients with acoustic-mnestic aphasia].

The clinical picture of acustico-mnestical aphasia, besides defects of understanding, naming and reiteration is characterized by disorders of a grammatical shaping of statements as well. Such disorders as yet have not been specially studied. The conducted study explored disorders and rehabilitation of speech grammar in 10 patients with acustico-mnestical aphasia with the aid of a neuro-linguistical analysis of spontaneous speech in patients and some special tests. The study made it possible to eliminate general types of agrammatism in different forms of aphasia and disorders, specific of acustico-mnestical aphasia. The suggested methods appeared to be adequate for a rehabilitation of speech grammar in this group of patients. Besides rehabilitative training may be used as a supplementary method for studying the character and structure of agrammatism in acustico-mnestical aphasia. The achieved results may be used for the diagnostics and rehabilitation of speech in this form of aphasia.

Adult↗
PubMed1977

Cranial computed tomography in aphasia. Correlation of anatomical lesions with functional deficits.

A variety of aphasic patients were studied to determine the relationship betweeen lesion size, as demonstrated by cranial computed tomography (CCT), and the type of aphasia, as classified by the Boston Diagnostic Aphasia Examination (BDAE). CCT demonstrated a variety of lesions. Those in nonfluent Broca's aphasics and fluent Wernicke's aphasics were separable into pre-Rolandic and post-Rolandic areas, respectively. Conduction, global, and anomic aphasics had different lesion sites. Correlation of lesion location by CCT with aphasia type supports Geschwind's concepts of aphasia.

Adult↗
PubMed2005

Aphasia and auditory extinction: Preliminary evidence of binding.

Background: McNeil, Odell, and Tseng (1991), and Murray and colleagues (Murray, 2000; Murray, Holland, & Beeson, 1997a, 1997b) have suggested that variability of performance in patients with aphasia may be due to nonlinguistic cognitive variables, such as attention (i.e., resources, capacity, effort), which affect language comprehension and production. Given the research that has supported the relationship between aphasia and attention deficits, it is important to determine what effect this breakdown in attention may have on cognitive processes for individuals with aphasia.Aims: This study aims to determine if auditory extinction is present in individuals with aphasia, and if so, if this is due to a breakdown in binding. If extinction is found for individuals with aphasia, it would further support the notion that auditory attention difficulties are present among individuals with aphasia, since visual and auditory research has attributed extinction to a breakdown in attention (Baylis, Driver, & Rafal, 1993; Deouell, Bentin, & Soroker, 2000; Deouell & Soroker, 2000). If binding is found to be deficient, the fact that individuals with both left and right hemisphere lesions demonstrate this phenomenon would lead to a number of implications regarding the relationship of attention and aphasia.Methods & Procedures: Auditory extinction, in which one stimulus is not perceived during double simultaneous stimulation (DSS) presentation, was examined in six individuals with aphasia (aged 42-74 years) and six age-matched healthy adults. Two different experiments were conducted in which the auditory stimuli, consisting of male and female voices speaking the letters "T" or "O", were systematically varied to investigate whether binding of identification to location contributes to extinction.Outcomes & Results: Participants with aphasia made more omission errors (extinction) than the control group, and extinction was significantly greater for binding versus nonbinding conditions, suggesting that binding may play a role in extinction for individuals with aphasia.Conclusions: These data provide preliminary results that auditory extinction exists in individuals with aphasia and may be due to deficits in binding together identification and localisation information. Research on this phenomenon and how it influences language would be a worthwhile endeavour for future studies. Moreover, little is known about assessment of auditory attention in patients with aphasia. Further research in this area can lead to advancements in theoretical and functional assessment for individuals with aphasia who have auditory attention and/or binding deficits and require speech-language pathology intervention.

Journal Article↗
PubMed2006

Temporal processing and context dependency of phoneme discrimination in patients with aphasia.

Standard diagnostic procedures for assessing temporal-processing abilities of adult patients with aphasia have so far not been developed. In our study, temporal-order measurements were conducted using two different experimental procedures to identify a suitable measure for clinical studies. Additionally, phoneme-discrimination abilities were tested on the word, as well as on the sentence level, as a relationship between temporal processing and phoneme-discrimination abilities is assumed. Patients with aphasia displayed significantly higher temporal-order thresholds than control subjects. The detection of an association between temporal processing and speech processing, however, depended on the stimuli and the phoneme-discrimination tasks used. Our results also suggest top-down feedback on phonemic processing.

Adult↗
PubMed1985

[Recovery in aphasia (Part 2): Size and site of lesion].

The digitizer program was used to determine the size of the lesions by tracing them onto standardized matrices which were divided into 3000 point and corresponded to CT slices. Moreover, on the basis of the results of accumulated lesions on 127 cases with various types of aphasia, the highly involved sites were determined as Broca's area, Wernicke's area and conduction area, and the sizes of the lesions in each area were also determined. The correlation between these sizes of the lesions and recovery rates based on the 2 SLTA scores (initial and 3 months later) was studied. The results obtained were as follows: 1) The correlation coefficient between the size of total area and the initial SLTA score was -0.46, significant at p less than 0.01. The negative correlation means that the larger the lesion, the more severe the aphasia. This tendency was seen in all language aspects except "calculation" (i.e. hearing, speaking, reading, writing). A similar, highly significant negative correlation was obtained between the lesion sizes of Broca's area, Wernicke's area, conduction area and initial SLTA scores, but among the various types of aphasics, only the Broca aphasics have a highly significant negative correlation between lesion size and initial SLTA score. 2) The negative correlation between the size of total area and the recovery rate was observed. This tendency was seen especially in the expressive disorders, namely "speaking" and "writing". These findings indicate that the larger the lesions, the less overall recovery will occur in total language deficit and in speaking and writing disorders.(ABSTRACT TRUNCATED AT 250 WORDS)

Aphasia↗
PubMedDate not supplied

[Evaluation of language therapy in aphasia after stroke].

In 27 patients with aphasia and hemiparesis following strokes speech was tested before and after completion of sanatorium treatment. After three weeks of speech re-education aphasia improved in various degrees in 19 patients. The best results of logopedic treatment were obtained in patients with medium-grade or slight aphasia subjected to rehabilitation treatment during the first three months after stroke. Effective motor rehabilitation conducted parallelly with re-education exercises in early period after stroke has a favourable effect on advance in therapy and later resocialization of patients.

Adult↗
PubMed2006

A randomized, double-blind trial of bromocriptine efficacy in nonfluent aphasia after stroke.

The authors assessed the efficacy of bromocriptine in nonfluent aphasia after stroke in a 16-week, randomized, double-blind, placebo-controlled clinical trial conducted from June 2002 to April 2004. In all 38 patients after 4 months of treatment, improvement in both the bromocriptine and placebo treatment groups was observed (p < 0.001). The analysis of repeated-measures analysis of variance revealed bromocriptine did not improve nonfluent aphasia.

Adult↗
PubMed1997

Promoting recovery in chronic aphasia with an interactive technology.

OBJECTIVE: To assess chronic aphasic patients' responses to resumption of therapy using an innovative, computer-based treatment system. DESIGN: Patients were assessed pretreatment and posttreatment using standardized assessment tools. Pretreatment and posttreatment performance score means were computed and compared, with statistical significance of the differences established using a one-tailed, matched t test. SETTING: The work was conducted at (1) a Veterans Affairs medical center participating in treatment research and (2) a regional aphasia center delivering therapy services for reimbursement. PATIENTS: Chronic aphasic patients (n = 23) from 6 months to more than 15 years postonset were enrolled in the study. They included a wide range of types and severities of aphasia, and all had received traditional speech-language therapy services earlier. INTERVENTIONS: All patients were treated in 1-hour clinical sessions by speech-language pathologists using the designated computer-based treatment system. All but one of the patients had access to the computer-based treatment system at home for practice between clinical therapy sessions. MAIN OUTCOME MEASURES: The outcome measures used were (1) the Porch Index of Communicative Ability (PICA), (2) the Boston Naming Test (BNT), (3) the Western Aphasia Battery (WAB), and (4) the Boston Diagnostic Aphasia Examination (BDAE). RESULTS: The majority of patients improved significantly in multiple modalities as assessed by these instruments. CONCLUSIONS: Specific measures of language function can be broadly, positively, and significantly influenced by computer-based language therapy in chronic aphasia.

Adult↗
PubMed1985

Spared musical abilities in a conductor with global aphasia and ideomotor apraxia.

A conductor suddenly developed global aphasia and severe ideomotor apraxia as a result of an infarct in the territory of the left middle cerebral artery. Although aphasia and apraxia remained unchanged during the following six years, his musical capacities were largely spared and he was still able to conduct. This case provides some evidence in favour of right hemisphere dominance for music.

Aged↗
PubMed1987

[Allergic reaction in therapy with naftidrofuryl (Dusodril). A case report].

There are many drugs marketed for the purpose of altering vascular blood flow in various regions, especially of the central nervous system and in peripheral arterial insufficiency. More than 50 different methods are described for the treatment of sudden deafness. Considerations of the therapy of sudden deafness are influenced by the fact that the cause of the disease is unknown. The dysfunction of the hair-cells of the organ of CORTI is thought to be caused by a deficit of oxygen due to disorders of micro-circulation in the inner ear. The infusion of vaso-active drugs in the early state of disease can lead to a remarkable improvement of hearing whereas the prospect of improvement without treatment remains uncertain. Nevertheless it may be difficult to distinguish the beneficial effects of vasodilator agents from spontaneous improvement. Naftidrofuryl oxalate (dusodril) has been in use for many years and proved its therapeutic value in many studies. It is regarded as non-toxic and is used extensively in Europe. Side effects are only reported rarely, and include decrease of cerebral blood flow, abdominal distension, diarrhoea, oesophageal ulceration, epileptic seizures, aphasia, disturbances of consciousness, hypotension, hypertensive crisis, vertigo and dizziness, depression of cardiac conduction, thrombophlebitis, and allergy. This case report of allergic reaction in a young female patient demonstrates that the intravenous application of this drug may lead to severe complications.

Administration, Oral↗
PubMed1984

18F positron emission computed tomography in closed head injury.

Locus and extent of cerebral dysfunction in five closed head injured patients as inferred from positron emission tomography (PET) and computed tomography (CT) scan studies were compared with locus and extent inferences made in the same five patients using three additional independent sources of data. These data included: (1) clinical neurologic examination findings, (2) an extensive battery of neuropsychologic tests (including WAIS, Wechsler Memory, Halstead Reitan procedures), and (3) a comprehensive speech and language assessment battery (including the Boston Diagnostic Aphasia Examination (BDAE) and the Token Test). Neurologic, psychologic, and speech examinations were conducted within one week of the PET and CT studies. Three patients were studied at three months, one patient at six months, and one patient at two years after head injury. Follow-up CT scans were done 14 months later on four of five patients. This study supported the following major conclusions: the PET findings closely correspond with the site and extent of cerebral dysfunction inferences derived from the neurologic and behaviorial examinations but the CT findings did not; the follow-up CT scans, however, showed structural abnormalities (ie, encephalomalacia and atrophy) that were consistent with the PET, neurologic examination, and behavioral assessment findings; the study strongly supports the validity and predictive utility of neurobehavioral data which are directly pertinent to rehabilitation planning/programming in patients with closed head injury.

Brain↗
PubMed1986

Aphasics' sensitivity to contextual appropriateness conditions for pragmatic indicators.

Twenty normal and twenty aphasic subjects were tested for their understanding of implicit meanings of the French adverbs même (even), aussi (also), and surtout (mainly). Their sensitivity to the contextual appropriateness conditions of such items was analyzed in a multiple-choice paradigm requiring them to select from three figures the one which was best described by a sentence like "Show me the figure that is même (aussi, surtout) red." A global quantitative comparison indicates that aphasics' performance was inferior to that of the normal controls. Yet, the analysis of individual responses allowed the identification of three different subgroups of aphasics: the first produced responses identical to the normals' responses; the second seemed to ignore the adverb and systematically selected the figure with the highest amount of the asserted color; and the third produced responses identical to the normals' responses for surtout but had difficulties with même or aussi. As concerns the relationship between aphasics' performance and their scores on literal language comprehension tests, the data favor the dissociation between literal and pragmatic factors in comprehension. Finally, no clear relationship was observed between aphasia type and aphasics' performance, although three points are noted in the discussion: (1) all the conduction aphasics performed like normals, (2) among the Broca's aphasics, the one with the clearest agrammatic verbal output produced responses similar to those of the normals, and (3) there was no anomic patient in the second subgroup.

Adult↗
PubMed1989

Dysprosody in Broca's aphasia: a case study.

A detailed acoustic analysis of timing, intensity, and fundamental frequency (F0) at different levels of linguistic structure was conducted on the speech output of a Broca's aphasic who was a native speaker of Thai. Timing was measured with respect to syllables, phrases, and sentences in connected speech. Intensity variation at the sentence level was measured in connected speech. F0 variation associated with the five Thai tones was measured in both isolated words and connected speech. Results indicated that timing was differentially impaired depending upon complexity of articulatory gesture and size of the linguistic structure. Timing, as well as intensity, was aberrant at the sentence level. In contrast, F0 contours of the five tones were spared at all levels of linguistic structure. Findings are interpreted to support the view that dysprosody in Broca's aphasia is more applicable to speech timing than to F0.

Aphasia↗
PubMed1996

Neurobiology of learning disabilities.

Learning disabilities are the product of neurological damage which occurs during fetal development. The malformations produced are unique to each individual and do not resemble acquired neurological damage. Consequently, models of developmental disorders must be developed independently and cannot be based on acquired adult aphasia or dyslexia literature. Neurological conditions of adults with developmental disorders are difficult to interpret since aberrations that occur early during fetal development can have a cascading effect, disrupting neural organization in other brain regions. An appreciation of basic concepts of brain development suggests treatment interventions that will modify neurophysiological functioning.

Aphasia↗