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At least 289 records · Page 16Linked to original sources

Progressive addition lenses for deaf lip readers and signers.

Deaf patients depend on intermediate vision for interpersonal communication. Deaf presbyopes are at a particular disadvantage since they are usually corrected for near and far vision with bifocals without consideration of their intermediate vision. Progressive addition lenses were used in this study to provide an intermediate correction for a group of deaf presbyopes. The patients' communication ability was tested through Varilux II lenses and habitual bifocals on a series of standardized lip reading and sign language tests. The patients showed better visual communication skills with the progressive adds, a preference for the progressive adds, and the impression of better vision through the progressive addition lens as opposed to their habitual bifocals.

Aged↗

Organization of language areas in bilingual patients: a cortical stimulation study.

OBJECT: In an attempt to gain a better understanding of how multiple languages are represented in the human brain, the authors studied bilingual patients who underwent surgery for brain tumors, during which the authors mapped cortical language sites by using electrostimulation. METHODS: Reading, counting, and word retrieval tasks were studied in 12 right-handed bilingual patients with no language deficit. All bilingual patients were native to France. One patient spoke four languages. The patients constituted a nonhomogeneous group in terms of language proficiency or age of acquisition. Languages were evaluated and classified into three major groups, depending on proficiency and date of acquisition. Strict conditions of language site validation were applied, separating typical anomia sites from speech arrest or other language sites (such as hesitation sites). A total of 30 speech arrest sites, 16 anomia sites, and three sites of language difficulties (not typically classified as speech arrest) were found throughout the 26 language studies performed. Strict overlapping of language areas (for all language tasks) was found in five patients, whereas the remaining seven had at least one area that was language-specific and sometimes task-specific. Specific areas for a particular language were found for word retrieval tasks (anomia) in eight sites (50%) but also in six (20%) of the reading or counting sites (speech arrest), either in frontal (three patients) or in temporoparietal (four patients) regions. Among the four early bilingual patients tested (languages acquired before the age of 7 years), three had language-specific cortical areas. Interestingly, six patients in this series who had a discrepancy between two languages did not have more cortical areas devoted to the less proficient language (with acknowledgment of the limit in cortical exposure available for testing by the craniotomy). CONCLUSIONS: In this series, the authors found that bilingual patients could have common but also different cortical areas for both languages in temporoparietal areas and in frontal areas. In some cases, the authors found that language tasks such as counting, reading, or word retrieval in different languages can be sustained by language- and task-specific cortical areas. In bilingual patients, cortical mapping should ideally be performed using different language tasks in all languages in which the patient is fluent.

Adult↗

A longitudinal study of infant vocalizations during mother-infant games.

This study explored the development of verbal behaviours of infants during two mother-infant games. Twenty-five infants were videotaped as they played peek-a-boo and ball with their mothers at 0;6, 0;9, 1;0, 1;3, 1;6, and 2;0. The frequencies of eight categories of vocal/verbal behaviours were analysed as they evolved over time in both games. Despite differences in the structure and level of difficulty of peek-a-boo and ball, the development of these behaviours proved to be similar in the two games. One category, PRIMITIVE VOCALIZATIONS, which did not change in frequency over time, was seen to have a pragmatic rather than a linguistic function. Another category, PRELEXICAL COMMENT, demonstrated an early capacity for conveying topic and comment together in the form of speech sounds combined with an attention-getting gesture well before the emergence of multiple-word utterances. The vocal behaviours produced during games were compared with the results of language tests administered during the experimental sessions. Strong correlations were found between the results of these two measures of language. The predictive nature of vocal behaviours during games is discussed.

Child Development↗

[Configuration frequency analysis: Kieser's test against Victor's type and syndrome].

Tests against types and anti-types as performed in Victor's Configural Frequency Analysis (CFA) have shown to be non-conservative. The conservative test by Kieser is introduced. It is applied to data describing a sample that performs below average in language tests. For data including small expected cell frequencies the Harms-Ihm adjustment is recommended. It leads to valid chi-squared testing even if expectancies are small. The problem of identifying more than two types or syndromes in exploratory CFA is discussed.

Analysis of Variance↗

Speech disturbances (cluttering) in mildly impaired males with the Martin-Bell/fragile X syndrome.

The language characteristics of fra(X) males (n = 10) with an IQ greater than or equal to 70 were evaluated. Language testing demonstrated relatively stronger receptive vocabulary skills compared to weak auditory memory and processing skills. A characteristic speech and language disturbance, cluttering, was present in 9 of the 10 study patients. Their speech was characterized by a fast and fluctuating rate of speech, and repetitions of sounds, words or phrases. Other aspects of cluttering including attentional problems, hyperactivity, motor delays and reading difficulties are commonly seen in the fra(X) syndrome. Cluttering may be helpful in identifying the fra(X) syndrome in a male who is not retarded.

Child↗

Role of acetyl-L-carnitine in the treatment of cognitive deficit in chronic alcoholism.

Preliminary data are reported from a multicentred double-blind placebo-controlled study concerned with the effects of acetyl-L-carnitine (LAC) on some cognitive deficits of at least one month-abstinent alcoholics. Fifty-five patients, showing impaired performance in at least two out of six mnemonic, praxic and verbal tasks, were randomly assigned to either LAC 2 g/day or a placebo group. They were tested by means of a neuropsychological battery exploring the areas of memory, constructional praxia, deductive-logical functions and language. Testing time was on baseline (T0), after 45 (T45) and 90 (T90) days. On the Rey's 15 word memory test (long-term), the Wechsler memory scale (logical memory), and the Similarities WAIS subtest, the T90 difference between LAC and the placebo was significant in favour of the former treatment. On the copying drawing test (simple copy), the placebo group did not show any T0-T90 variation, while significant improvement in the LAC group was greater than in the placebo group. As LAC has proved to ameliorate the performance or to accelerate the recovery on tests representative of all cognitive areas explored, it is conceivable that the drug acts diffusely, either at the cholinergic transmission or at the neuronal metabolism level. It is concluded that acetyl-L-carnitine can be a useful and safe therapeutic agent in the subtle cognitive disturbances of chronic alcoholics.

Acetylcarnitine↗

Patterns of language dominance in focal left and right hemisphere epilepsies: relation to MRI findings, EEG, sex, and age at onset of epilepsy.

The present study evaluates results of language testing during intracarotid amobarbital procedures in 167 patients with either left (LHE, n = 81) or right hemisphere epilepsies (RHE, n = 86). In both groups there was a high rate of deviance from complete left hemisphere dominance of 24 and 31%, respectively. Whilst complete right hemisphere or incomplete left hemisphere language dominance were the prominent atypical patterns in LHE, RHE was associated with either bilateral dominance or incomplete left dominance. In LHE, atypical language dominance was frequently associated with an extratemporal localization of lesions or epileptic foci. The age at onset of epilepsy and the degree of right hemisphere language dominance correlated significantly in LHE but not in RHE. Finally, atypical dominance in LHE but not in RHE was associated with poorer language and nonlanguage functions, the latter being negatively correlated with the degree of right hemisphere language dominance. Conclusions are: (1) The data contradict the assumption of equipotentiality and favor the supposition of a predetermined left hemisphere superiority in language processing. (2) Atypical language dominance in LHE can largely be explained in terms of a plasticity dependent language shift as a consequence of early left hemisphere epilepsies and lesions. (3) Atypical dominance patterns in RHE appear to reflect the prevalence of genetically determined variants and the possibility of a language transfer from the right to the left hemisphere.

Age of Onset↗

[A study of functional plasticity of the brain in childhood. I. Critical period dislodging lateralization of language in the brain].

To investigate the functional plasticity of the brain in childhood, the intelligence and language tests, brain CT and dichotic listening test were performed on 34 patients with hemiplegia. All 13 patients with left hemiplegia, 8 to 37 years old, showed a right ear dominance suggesting the lateralization of language in the left hemisphere. Among 21 patients with right hemiplegia, 7 to 22 years old, 16 patients who had suffered from the left hemispheric damage before 6 years and 1 month of age, showed the left ear dominance suggesting the lateralization of language in right hemisphere except 2 patients. On the contrary, 3 patients with right hemiplegia who had suffered from the left hemispheric damage after 6 years and 6 months of age showed a right ear dominance. It was concluded that the critical period for the dislodging of language lateralization in the brain from the damaged left hemisphere to the intact right hemisphere is the first half of 6 years after birth. Five patients out of 8 patients with right hemiplegia showed significantly lower scores in performance than in verbal WISC IQ. The compensation of language function rather than performance function was considered to be characteristic for the left-hemispheric damage in childhood.

Adolescent↗

Dichotic ear preference in aphasia.

A dichotic listening test, composed at 30 CVC-word pairs, was administered to 20 adults with aphasia and 20 normal adults. The subjects with aphasia were selected for inclusion in one of four experimental groups which differed according to intitial severity of aphasia and time post onset. All experimental subjects were given a diagnostic language test within the first four weeks following aphasia onset and again at the time of dichotic testing. Difference scores provided a quantitative estimate of language improvement. Data analysis revealed a strong left-ear preference (-0.363) for the experimental subjects which differed significantly from a right-ear preference (+0.290) obtained from the normal control subjects. Further, initial severity of aphasia was found to be a significant variable, capable of influencing the magnitude of ear preference. Multiple regression and partial correlational methods revealed significant, positive relationships between the magnitude of ear preference and initial severity of aphasia and between the former and the magnitude of language improvement. Time post aphasia onset was not shown to be a significant variable. The theoretical and potential clinical relevance of the results are discussed.

Adult↗

Speech patterns in Kabuki make-up syndrome: a case report.

The case of a girl aged 3 years and 8 months with Kabuki make-up syndrome is reported. At presentation, she had normal cognitive functioning, and she also had a history of otitis media, a submucous cleft palate, and some hypotonia. Language testing showed normal receptive skills and good expressive vocabulary but poor morphosyntactic abilities. Speech analysis showed that she was capable of producing most of the sounds of her native language but demonstrated high variability in production of the sounds. In addition, she inconsistently simplified words by application of several phonologic processes. Possible explanations for the communication problems demonstrated are discussed.

Abnormalities, Multiple↗

Cognitive correlates of interictal discharges.

Interictal discharges can occur silently without apparent simultaneous clinical manifestations. Nevertheless, formal testing during electroencephalographic (EEG) recording may demonstrate transitory cognitive impairment (TCI). The probability of demonstrating TCI is related to the nature of the test employed and the type of epileptiform discharge. Difficult tasks are more useful to detect TCI, and working memory and language tests may be particularly sensitive. Generalized 3-Hz spike-wave bursts lasting at least 3 s are most likely to produce demonstrable TCI, but they can also be found during briefer and even focal discharges. The latter exhibit some specificity: left-sided focal spiking more frequently produces errors in verbal tasks, whereas right-sided discharges are more often accompanied by impairment in handling nonverbal material. TCI may adversely affect the patient's psychosocial functioning in daily life, as has been shown by some studies pointing out an impairment of educational skill in epileptic children and of driving performance in motorists. Our study on benign childhood epilepsy with Rolandic spikes also detected TCI in the majority of the patients. Nevertheless, it is not possible to claim that everyone with subclinical EEG discharges has TCI that adversely affects their psychosocial functioning. It may be possible to treat TCI by antiepileptic drugs.

Anticonvulsants↗

Use of the Clark-Madison Test of Oral Language with the hearing-impaired: a content validity and comparative study.

This study examined the content validity of the Clark-Madison Test of Oral Language (CMTOL) as a measure of nonwritten expressive language with hearing-impaired children. Twenty severely hearing-impaired children were administered the CMTOL using total communication. All test administrations were considered valid. The content of the test was generally found to be valid. The content validity of selected items is discussed. A comparison of the performance of the hearing-impaired to a group of normal-hearing respondents revealed a different profile of strengths and weaknesses than did intragroup analysis.

Child↗

"Transcortical" features of aphasia following left thalamic hemorrhage.

In a series of 14 thalamic hemorrhage documented by Computerized Axial Tomography (CT) scans, aphasia was present in seven out of eight patients with left lesions while it was absent in the six patients with right lesions. In three cases where detailed language testing was performed, aphasia was characterized by reduction of spontaneous speech with semantic paraphasias, preserved repetition and partially defective auditory verbal comprehension. The language disturbance was persistent in two patients, while it recovered spontaneously within four weeks in one patient. The clinical picture in these patients is similar to the classical "transcortical" aphasias, which are usually due to damage of the marginal language areas. It is suggested that the left thalamus contributes to the semantic level of verbal behavior, which is possibly subserved by these areas.

Aged↗

The neuropsychological profile of alcohol-related dementia suggests cortical and subcortical pathology.

The neuropathology associated with chronic alcohol abuse varies across studies, though research suggests generalized reductions in cortical and subcortical grey and white matter. Neuropsychological findings also differ within the literature. The inconsistent findings with respect to the neuropathology and neurobehavior of patients with histories of alcohol abuse may be due, at least in part, to differing nosology and the highly variable inclusion/exclusion criteria employed by researchers. Oslin et al. [Int J Geriatr Psychiatry 1998;13:203-212] have proposed and recently validated specific criteria for probable alcohol-related dementia (ARD). We were interested in comparing the neuropsychological profile of ARD patients with the neurocognitive profiles of typical cortical and subcortical dementia patients. Participants included 14 ARD patients, 15 patients diagnosed with Alzheimer's disease (AD), 13 patients diagnosed with subcortical vascular dementia (VaD), and 20 normal controls. Patient subgroups were similar with respect to age (mean = 79), education (mean = 12 years) and dementia severity (MMSE; mean = 22.1). The three dementia patient subgroups demonstrated significantly worse performance than the normal controls subgroup on all neuropsychological tests. The ARD subgroup exhibited very similar executive control deficits to VaD patients. However, the different neurocognitive profiles of the patient subgroups suggest that ARD patients may also, in fact, demonstrate some degree of amnesia given that they perform slightly worse than subcortical patients on delayed verbal free recall and recognition. Nonetheless, the ARD patients did not display as severe impairment as the AD patients on the memory tasks. No significant differences between the three patient groups were identified on language tests. In sum, we present preliminary evidence of a distinct neuropsychological profile for ARD patients that includes impairment on both executive control and memory tests. This pattern of performance suggests that long-term alcohol abuse, in comparison to AD and VaD, may be associated with both cortical and subcortical neuropathology.

Aged↗

Sentence processing in the cerebral cortex.

Human language is a unique faculty of the mind. It has been the ultimate mystery throughout the history of neuroscience. Despite many aphasia and functional imaging studies, the exact correlation between cortical language areas and subcomponents of the linguistic system has not been established. One notable drawback is that most functional imaging studies have tested language tasks at the word level, such as lexical decision and word generation tasks, thereby neglecting the syntactic aspects of the language faculty. As proposed by Chomsky, the critical knowledge of language involves universal grammar (UG), which governs the syntactic structure of sentences. In this article, we will review recent advances made by functional neuroimaging studies of language, focusing especially on sentence processing in the cerebral cortex. We also present the recent results of our functional magnetic resonance imaging (fMRI) study intended to identify cortical areas specifically involved in syntactic processing. A study of sentence processing that employs a newly developed technique, optical topography (OT), is also presented. Based on these findings, we propose a modular specialization of Broca's area, Wernicke's area, and the angular gyrus/supramarginal gyrus. The current direction of research in neuroscience is beginning to establish the existence of distinct modules responsible for our knowledge of language.

Brain Mapping↗

Thirty-six-month outcome of prenatal cocaine exposure for term or near-term infants: impact of early case management.

Gestational cocaine use is associated with serious pregnancy complications having fetal and neonatal implications. However, many cocaine-abusing women deliver uneventfully at term. The purpose of this study was to assess the neurodevelopmental outcome for term or near-term infants after prenatal cocaine exposure and to determine whether that outcome would be modified by early, intensive family case management. Cocaine-exposed infants identified after delivery at an urban hospital were alternately assigned to receive case management (n = 70) or routine follow-up (n = 48). A matched, non-drug-exposed group of infants was identified for comparison (n = 41). Infants aged up to 36 months were serially evaluated in a multidisciplinary clinic with cognitive, psychomotor, and language testing. Group comparisons were performed using one-way analysis of variance. There were no statistical differences in mean cognitive, psychomotor, or language quotients between cocaine-exposed and non-drug-exposed infant groups aged up to 36 months. At 6 months of age, case-managed cocaine-exposed infants had a significantly higher mean Bayley Mental Developmental Index score than those who were routinely managed. However, no differences were present at subsequent assessments. Among cocaine-exposed infants who remained with their mothers at 36 months, verbal scores were significantly higher for case-managed compared with routine-managed infants. The negative effects of urban, low socioeconomic status may overshadow the impact of prenatal cocaine exposure on early childhood outcome for those infants born without prenatal complications.

Adult↗

Successive activation of both cerebral hemispheres during cued word generation.

Most humans have a left hemispheric dominance for language. However, during diagnostic language testing there also is activation of the right hemisphere, which is probably related to attention. To investigate further the role of attention during language production we monitored cerebral blood flow velocities in the middle cerebral arteries by continuous bilateral transcranial Doppler ultrasonography (TCD) in nine right-handed subjects. During cued word generation, a successive activation of the right hemisphere in the preparatory phase, and of the left hemisphere during word searching was demonstrated. These findings indicate that attentional processes precede verbal activation and that the two procedures can be separated by comparative blood flow velocity measurement.

Acoustic Stimulation↗