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PubMed1981

[Acquired aphasia in epileptic children--four cases with electrical infraclinic status epilepticus during sleep (author's transl)].

Four cases of acquired aphasia in epileptic children, associated with sub-continuous bitemporal paroxysmal activities (PA) during sleep, are described. Clinical improvement always followed the decrease or the unilateralization of PA. Persistence or aggravation of aphasia was observed when PA again became bitemporal and sub-continuous. Electroencephalographic characteristics of PA during sleep stages are described. Relationships of these cases with the 'sub-clinical electrical status epilepticus induced by sleep' and the physiopathology of aphasia are discussed.

Aphasia↗
PubMed2000

Postictal aphasia and paresis: a clinical and intracerebral EEG study.

BACKGROUND: We examined the lateralizing value of postictal language and motor deficits and studied their underlying mechanisms. PATIENTS AND METHODS: The total sample consisted of 35 patients (26 temporals, 8 frontals, 1 parietal) with a good postsurgical outcome (Engel's class I and II). Postictal examination was blindly reviewed on videotapes. In 15 cases (29 seizures), postictal language manifestations were analyzed in relation with the diffusion of the epileptic discharge recorded by intracerebral EEG. Language dominance was determined by the intracarotid amobarbital test. RESULTS: Postictal aphasia was observed only when (1) seizure originated in the dominant hemisphere and (2) ictal activity spread to language areas (Wernicke and/or Broca areas). When the epileptic focus was in the nondominant hemisphere, no postictal aphasia was observed even if there was secondary generalization of ictal activity affecting the language areas of the dominant hemisphere. Postictal motor deficits also had a strong lateralizing value even when seizures were secondarily generalized. CONCLUSION: Postictal aphasia in temporal epilepsies and postical motor deficits in temporal and extra temporal epilepsies provided excellent lateralizing information. Postictal deficits appear to be the result of inhibitory mechanisms induced by previous ictal activity of the structures related to these functions.

Adolescent↗
PubMed1997

Factor structure and age effects with an aphasia test battery in normal Taiwanese adults.

This study was designed to explore in a Taiwanese sample the factor structure of an aphasia test battery composed of parts of several standardized aphasia tests. A secondary goal was to assess effects of normal aging on the obtained factors. The sample was 120 healthy Taiwanese adults, ranging in age from 30 to 78 years. Principal-components analysis of the aphasia test battery revealed 5 factors: verbal comprehension, effortful writing, word production, automatized writing, and visuomotor coordination skills. Because the latter 2 factors have common psychological features, they can be combined and reinterpreted as a factor on the mechanics of writing. Further data analysis with factor scores shows that aging unfavorably influences verbal comprehension, effortful writing processing, and word production functions.

Adult↗
PubMed2002

Autonomic dysreflexia associated with transient aphasia.

STUDY DESIGN: Case report of autonomic dysreflexia presenting with transient aphasia in a subject with C4 tetraplegia. OBJECTIVES: To report a rare case of autonomic dysreflexia. SETTING: Rehabilitation Service, The Ohio State University, USA. CASE REPORT: A 21-year-old man with a C4 spinal cord injury (ASIA B) developed aphasia associated with autonomic dysreflexia. He was treated with an adrenergic blocking agent. CONCLUSION: Autonomic dysreflexia manifested by a transient aphasia and seizures is uncommon.

Adrenergic beta-Antagonists↗
PubMed2006

Influences of electromagnetic articulography sensors on speech produced by healthy adults and individuals with aphasia and apraxia.

PURPOSE: This study examined whether the intraoral transducers used in electromagnetic articulography (EMA) interfere with speech and whether there is an added risk of interference when EMA systems are used to study individuals with aphasia and apraxia. METHOD: Ten adult talkers (5 individuals with aphasia/apraxia, 5 controls) produced 12 American English vowels in /hVd/ words, the fricative-vowel (FV) words (/si/, /su/, /ei/, /eu/), and the sentence She had your dark suit in greasy wash water all year, in EMA sensors-on and sensors-off conditions. Segmental durations, vowel formant frequencies, and fricative spectral moments were measured to address possible acoustic effects of sensor placement. A perceptual experiment examined whether FV words produced in the sensors-on condition were less identifiable than those produced in the sensors-off condition. RESULTS: EMA sensors caused no consistent acoustic effects across all talkers, although significant within-subject effects were noted for a small subset of the talkers. The perceptual results revealed some instances of sensor-related intelligibility loss for FV words produced by individuals with aphasia and apraxia. CONCLUSIONS: The findings support previous suggestions that acoustic screening procedures be used to protect articulatory experiments from those individuals who may show consistent effects of having devices placed on intraoral structures. The findings further suggest that studies of fricatives produced by individuals with aphasia and apraxia may require additional safeguards to ensure that results are not adversely affected by intraoral sensor interference.

Adult↗
PubMed1977

Patterns of dysfunction in schizophrenic patients on an aphasia test battery.

Twenty-seven schizophrenic patients free of any known neurologic deficit were tested with an aphasia test battery. The objective of the research was to derive a profile of schizophrenic language performance to permit its comparison with the profiles characteristic of aphasia, apraxia of speech, generalized intellectual impairment, and confused language. Results indicate that schizophrenic patients exhibit a profile of language performance distinctive from those found in aphasia, apraxia of speech, confusion, or generalized intellectual impairment and demonstrate that the disruption of language in schizophrenia is not aphasic in nature.

Adult↗
PubMed1982

Gesture recognition in patients with aphasia.

This study focuses on the controversial issue of the integrity of gestural communication abilities in subjects with aphasia. To define the ability of subjects to interpret symbolic gestures, an Amer-Ind Recognition Test (ART) was developed which required no verbal response from the examiner or the subject. The relationships between impairment of Amer-Ind signal recognition and (a) severity of aphasia, (b) listening and talking abilities and (c) the type of response picture used were investigated. Whether subjects more often chose related foils than unrelated foils in a forced-choice format was also examined. Two training tests and the ART are described. Results from administration to 15 aphasic subjects indicated that: (a) all subjects performed equally well, regardless of their aphasia severity classification; (b) action picture recognition was related to listening ability; (c) action pictures were easier to identify than object pictures; and (d) on error responses, subjects overwhelmingly chose related over unrelated foils. The possibility that gestural abilities were relatively well preserved among the subjects tested, in the presence of a wide range of listening and talking deficits, is also discussed.

Adult↗
PubMed1986

Subcortical crossed aphasia: a case report.

A 74-year-old, right-handed woman suffered acute aphasia and left hemiplegia secondary to a cerebral infarction in the right cerebral hemisphere. The lesion was located deep in the parietal lobe and extended to the posterior limb of the internal capsule and the head of the caudate nucleus. The patient's aphasia was characterized by severe impairment in auditory and visual comprehension and auditory retention span, as well as by anomia, agraphia, and dyscalculia. She showed rapid recovery from her aphasia, with residual deficits in writing, naming, calculation, and memory.

Aged↗
PubMed1989

Outcome of intensive language treatment in aphasia.

Sixty-eight aphasic inpatients received intensive language treatment (9 hr per week over a period of 6-8 weeks). Outcome was assessed by means of the Aachen Aphasia Test (AAT), a standardized test battery for the German language. For patients with duration of aphasia up to 12 months, amount of improvement was corrected by the expected rate of spontaneous recovery as determined by a previous multicenter follow-up study. About two thirds of the patients showed significant improvement in AAT performance according to psychometric single case analysis procedures. A similar rate of improvement was found for individuals with chronic aphasia beyond the stage of spontaneous recovery.

Adolescent↗
PubMed1990

Subcortical lesions and aphasia.

Recent evidence suggests that subcortical lesions can give rise to aphasic symptoms. Two subcortical structures thought to participate in the pathogenesis of aphasia are the basal ganglia and the thalamus. This paper reports on 3 patients with lesions of the thalamus and 10 patients with lesions of the basal ganglia, most of whom had persistent aphasias. The role of subcortical structures in aphasia and the importance of subcortical structures in neural models of language are discussed.

Adult↗
PubMed1990

Aphasic and non-brain-damaged adults' descriptions of aphasia test pictures and gender-biased pictures.

Twelve aphasic and 12 non-brain-damaged adult males described the speech elicitation pictures from the Boston Diagnostic Aphasia Examination (BDAE), the Minnesota Test for Differential Diagnosis of Aphasia (MTDDA), the Western Aphasia Battery (WAB), and six pictures representing male-biased or female-biased daily-life situations. For each speech sample we calculated number of words, words per minute, number of correct information units, percentage of words that were correct information units, and percentage of correct information units that were nouns or adjectives (amount of enumeration or naming). The WAB picture elicited more enumeration than the BDAE or MTDDA pictures, and information was produced at a slower rate in response to the WAB picture than the other two pictures. These differences were statistically significant and appear to be clinically important. Gender bias had statistically significant effects on two measures. Male-biased pictures elicited significantly more words and significantly more correct information units than female-biased pictures. However, these differences were small and do not appear to be clinically important. Two of the five measures (words per minute and percentage of words that were correct information units) differentiated non-brain-damaged speakers from aphasic speakers. The magnitude of these differences suggests that these measures provide clinically important information about the problems aphasic adults may have when they produce narrative discourse.

Aged↗
PubMed1977

Validity of the Sklar Aphasia Scale.

A German version of the Sklar Aphasia Scale (SAS) was administered to groups of fluent aphasics, nonfluent aphasics, and three control groups (brain-damaged patients without aphasia, schizophrenics, and normal subjects). The SAS discriminated fluent and nonfluent aphasics from schizophrenic brain-damaged, and normal control subjects with a high level of confidence; 91.8% of the aphasic and 81.5% of the brain-damaged patients without aphasia were correctly classified. However, the SAS did not discriminate between fluent and nonfluent aphasics. A factor analysis, which also included the subtests of the Token Test and eight other variables, showed the SAS and the Token Test to load mainly on the same general factor, which represents the severity of language disorders or the impairment of those left-hemisphere functions that might be basic to language. Subtests II and IV of the SAS also had loadings on a memory factor, but none of the subtests had variance on the third factor which represented the sensory-motor or fluency/nonfluencey dimension.

Aphasia↗
PubMed1995

Presence, completeness, and accuracy of main concepts in the connected speech of non-brain-damaged adults and adults with aphasia.

A standard rule-based system was used to evaluate the presence, accuracy, and completeness of main concepts in the connected speech of 20 non-brain-damaged adults and 20 adults with aphasia. Main concepts form a skeletal outline of the most important information (or "gist") in a message. The interjudge and intrajudge reliability of the main concept scoring system and the test-retest stability of scores were acceptable. The non-brain-damaged group produced significantly more Accurate/complete main concepts, and significantly fewer Accurate/incomplete, Inaccurate, and Absent main concepts than the group with aphasia. However, when the performance of individual subjects was evaluated, what best discriminated the performance of subjects with aphasia from that of non-brain-damaged subjects was not the number of main concepts they failed to mention but the accuracy and completeness of the main concepts they did produce. Measures of main concept production may be a clinically useful complement to other measures of communicative informativeness and efficiency.

Aged↗
PubMed1996

Treatment efficacy: aphasia.

This article presents a brief overview of aphasia, followed by a summary of research studies and program evaluation data addressed to answering the question of the efficacy of treatment for aphasia. Selected studies are reviewed in terms of the quality of evidence they present. In addition, a number of questions that remain unanswered are also presented. Several tables, designed to provide clarifying information concerning several aspects of research design (number and types of patients studied, examples of well-designed small-group or single-subject studies, clinical techniques for which efficacy data are available), are included. The conclusion of this review is that, generally, treatment for aphasia is efficacious.

Aphasia↗
PubMed2001

Effects of bromocriptine in a patient with crossed nonfluent aphasia: a case report.

OBJECTIVE: Because studies have shown some positive effects of the dopaminergic agent bromocriptine for improving verbal production in patients with nonfluent aphasia, we examined its effect in a patient with an atypical form of crossed nonfluent aphasia from a right hemisphere lesion. DESIGN: Open-label single-subject experimental ABAB withdrawal design. PATIENT: A right-handed man who, after a right frontal stroke, developed nonfluent aphasia, emotional aprosodia, and limb apraxia. INTERVENTION: Escalating doses up to 20mg of bromocriptine in 2 separate phases. MAIN OUTCOME MEASURES: We measured verbal fluency (words/min in discourse, Thurstone letter fluency), expression of emotional prosody, and gesture production. RESULTS: The patient showed substantial improvement in both verbal fluency measures and no significant improvement in gesture or emotional prosody. Verbal fluency improvements continued in withdrawal phases. CONCLUSIONS: Our results are less likely caused by practice or spontaneous recovery because we observed little improvement in emotional prosody and gesture tasks. Verbal fluency improvements during treatment and withdrawal phases suggest that the effects of bromocriptine may be long-lasting in its influence on the neural networks subserving verbal initiation.

Aphasia↗
PubMed2001

Recovery from moderate aphasia in the first year poststroke: effect of type of therapy.

OBJECTIVES: (1) To determine whether 2 model-based remediation programs affect writing performance in unselected subjects with moderate aphasia and whether there is consequent improvement in everyday life, and (2) to interpret the potential changes observed by recourse to a theoretical model. DESIGN: Consecutive sample, multiple baseline, within subject crossover study. SETTING: Ambulatory care units. PARTICIPANTS: Eight subjects with moderate aphasia from 6 to 12 months postonset. INTERVENTION: A standardized test for reading and writing skills was given at the beginning and the end of each therapy program and 1 month after therapy stopped. MAIN OUTCOME MEASURES: Functional outcome measures were the Communicative Abilities in Daily Living (CADL) test and subtests from standardized aphasia assessment. RESULTS: After the 2 programs, there was improved writing performance, which was maintained after therapy stopped. Patterns of improvement corresponded to each of the 2 programs. Learning transfer was observed on the CADL test and functional writing, but gains on oral language were limited. Only 1 program was effective for 6 of the 8 patients. CONCLUSION: Specific rehabilitation programs aid recovery from aphasic symptoms from 6 to 12 months postonset. Individual response is linked to type of treatment. The interpretation is linked to a model-based description of aphasic symptoms and mechanisms of functional recovery.

Activities of Daily Living↗
PubMed2002

Attention deficits in aphasia: presence, nature, assessment, and treatment.

Recently, there has been growing interest in understanding how nonlinguistic cognitive problems such as impaired attention might negatively affect the linguistic abilities of adults with aphasia. This article begins with a summary of research focused on the relationship between attention and language impairments in aphasia and a discussion of why it might be important for clinicians to address the attention abilities of their aphasic patients. Also discussed are formal and informal measures for quantifying and qualifying attention problems, treatment strategies for directly or indirectly remediating attention problems in patients with aphasia, and empirical support for such treatment.

Aphasia↗
PubMed2004

Can drug therapies improve language functions of individuals with aphasia? A review of the evidence.

The neurochemistry of language and the neuropharmacology of aphasia are two domains of cognitive neuroscience still in their infancy. In this article we review what is known about these two domains, especially with regard to treating aphasia with drugs. Selected neurotransmitters can improve language function in certain patients with aphasia. We discuss which neurotransmitters work for which language functions in which patients, and why.

Acetylcholine↗