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PubMedDate not supplied

Long-term effects of acquired aphasias in childhood.

This paper presents the results of study into the long-term effects of acquired childhood aphasia (ACA). Two groups of children, a longitudinal group followed up for at least 2 years (12 children), and a cross-sectional group seen at least 2 years post-onset (12 children) were examined for the severity and pattern of residual language deficits (total 24 children). The results are presented. Overall, these show that more children in group 2 had moderate or severe language deficits at 2 years post-onset than in group 1, in which most children achieved language scores within the normal range by this stage of recovery. These findings are discussed in respect of the educational needs and continuing development of children with acquired aphasias, and the service they require.

Adolescent↗
PubMed2001

Aphasia in multiple sclerosis.

Aphasia has rarely been reported in multiple sclerosis (MS). In this article a case with MS presenting as purely global aphasia during an exacerbation of MS is reported with clinical and MRI (magnetic resonance imaging) findings. MRI demonstrated giant plaques mimicking a cerebral tumour with surroundings characterised by oedematous transformations in the left frontal and parietal lobes.

Adult↗
PubMed2005

[A case of corticobasal degeneration that progressed from primary progressive aphasia].

A 65-year-old woman began to experience slowly progressive speech disturbance from 2001. She was admitted to our hospital for examination on May 2003. She had dysprosody, paragraphia, and mild disturbance in comprehension of spoken language. Repetition was preserved. No clear paraphasia was found. Calculation was disturbed, but there were no other neurological abnormalities including apraxia and agnosia. Brain MRI showed atrophy of the left frontal and parietal lobes. 99mTc-ECD SPECT showed decreased blood flow in the left frontal lobe and parietal lobe, especially in the Broca area and supplemental motor cortex. Primary progressive aphasia was diagnosed, because aphasia lasted for 2 years without other neurological deficits, and her daily activity was well preserved. During follow up, facial apraxia appeared from December 2003, and limb apraxia appeared from May 2004, followed by rigidity predominantly in the right upper limb and dementia. She was diagnosed as having corticobasal degeneration (CBD). The second SPECT on December 2004 showed progression of the decrease in cerebral flow at the same area showed by the first SPECT. SPECT is useful examination to predict the progress of the disease because the decrease of blood flow was recognized before the progression to CBD.

Aged↗
PubMed2006

Conduction aphasia as a function of the dominant posterior perisylvian cortex. Report of two cases.

Assessment of eloquent functions during brain mapping usually relies on testing reading, speech, and comprehension to uncover transient deficits during electrical stimulation. These tests stem from findings predicted by the Geschwind-Wernicke hypothesis of receptive and expressive cortices connected by white matter tracts. Later work, however, has emphasized cortical mechanisms of language function. The authors report two cases that demonstrate that conduction aphasia is cortically mediated and can be inadequately assessed if not specifically evaluated during brain mapping. To determine the distribution of language on the dominant cortex, electrical cortical stimulation was performed in two cases by using implanted subdural electrodes during brain mapping before epilepsy surgery. A transient isolated deficit in repetition of language was reported during stimulation of the posterior portion of the dominant superior temporal gyrus in one patient and during stimulation of the supramarginal gyrus in the other patient. These cases demonstrate a localization of language repetition to the posterior perisylvian cortex. Brain mapping of this region should include assessment of verbal repetition to avoid potential deficits resembling conduction aphasia.

Adult↗
PubMed2002

Reorganization of cortical language areas in patients with aphasia: a functional MRI study.

The purpose of this study is to delineate the pattern of reorganization of cortical language areas using functional magnetic resonance imaging (fMRI) after rehabilitation therapy in patients with aphasia. Six right-handed aphasic patients were investigated. Causes of aphasia were intracerebral hemorrhages of the left basal ganglia in 3 patients, cerebral infarction of the left MCA in 2, and surgical resection of the frontotemporal lobes to control intractable epilepsy in 1. An auditory sentence completion task was used to activate brain language areas during the fMRI. Three patients with left frontal lesions showed activation in the right inferior frontal lobes while performing language tasks, whereas the other 3, whose lesions located at subcortical areas, showed activation in the bilateral frontal and temporal lobes. Our results demonstrated the differences in interhemispheric reorganization of the language network depending on the location of the lesion in aphasic patients. While the patients with subcortical lesion showed tendency of bilateral frontal activation, those with cortical lesion showed activation of the right frontal lobe.

Adult↗
PubMed2001

Restitution of alpha-topography by piracetam in post-stroke aphasia.

OBJECTIVE: Electroencephalographic and clinical effects of piracetam in post-stroke aphasia were evaluated in a prospective, randomized, double-blind, placebo-controlled trial. METHODS: In 24 patients with mild to moderate aphasia after ischemic stroke, quantitative topographic EEG at rest was studied before and after a 6-week treatment period. RESULTS: In the active treatment group, a significant shift in the alpha-rhythm from frontal to occipital regions was observed which may be due to a restitution of corticothalamic circuits involved in the generation of alpha-activity. CONCLUSION: Neuropsychological scores improved significantly and markedly in various domains of speech during piracetam treatment, whereas improvements were less marked and restricted to a few categories in the placebo group.

Adult↗
PubMed1998

Expressive aphasia in glioblastoma multiforme patients: an application of content methodology.

Approximately one-third of patients with glioblastoma multiforme experience aphasia (Kraemer & Bullard, 1994). This loss of language abilities can be a major source of frustration for patients. Their quality of life is affected by the inability to interact with others. In this paper, an examination of the phenomenon of expressive aphasia will be conducted through the application of the content methodology process. Content methodology is a process for developing nursing knowledge, which strives to bridge the gap between theory, research and practice (Dawson & Wells, 1992). This process will guide in the development of substantive content for practice. An assessment tool and intervention plan will be presented.

Aphasia, Broca↗
PubMed1976

[Amnesiac aphasia. Study of 25 cases].

Twenty-five patients with "amnesic aphasia" were studied. The language difficulty is not related either to intellectual deficit, generalised memory disturbance or visual impairment but is a specific verbal memory defect. Amnesic aphasia also involves lack of perception of linguistic units which is caused by impairment of comprehension and erasure of the acoustico-mnesic traces of words. The responsible lesions are in the left temporal region. The authors maintain that, from the physio-pathological point of view, these lesions do not destroy the cortex and sub-cortex, as in focal necrosis, but cause cortical dysfunction selectively affecting the mnesic traces of words.

Adolescent↗
PubMed1999

Spared comprehension of emotional prosody in a patient with global aphasia.

BACKGROUND: Several studies have demonstrated that patients with right hemisphere damage, when compared with left-hemisphere damaged controls, are impaired at comprehending emotional prosody. Critics of these studies, however, note that selection may have been biased because left-hemisphere-damaged subjects had good verbal comprehension. OBJECTIVE: To learn whether a subject with a large left hemisphere stroke and global aphasia could comprehend emotional prosody in spoken material. METHOD: The authors formally tested speech and language with the Western Aphasia Battery and comprehension of emotional prosody and emotional facial expression with the Florida Affect Battery. RESULTS: The patient could not perform verbally mediated tests but demonstrated spared ability to match emotional prosody to emotional facial expressions under a variety of conditions. CONCLUSIONS: These observations further support the idea that verbal and emotional communication systems are independent and mediated by different hemispheres.

Adult↗
PubMed1999

Primary progressive aphasia : a case report.

Primary progressive aphasia is due to focal left perisylvian degeneration and manifests with progressive decline in language function for two or more years. There is preservation of cognitive functions and activities of daily living continue to be normal. We report a case of progressive aphasia in a 65 year old lady.

Aged↗
PubMed2000

[Aphasia research and speech localization in the brain].

Aphasia research has become an acknowledged branch of modern cognitive neuropsychology research whose aim is to explore more fully the structures of knowledge and of cerebral processes which might both be affected in patients with aphasia. Up to the second half of this century, a model based on a specific cerebral localisation of language processes had emerged based on brain localisation research by Broca and Wernicke (among others). New modern neuroimaging techniques, however, such as computed tomography and magnetic resonance imaging (MRI), but also functional imaging modalities such as positron emission tomography or functional MRI, have modified these concepts. It emerges that in comprehension as well as in production of language, not only a few well defined centres are responsible for the activity, but there is a synchronised activity in large neuronal networks connecting various regions located both in the cortex and in the deep subcortical structures; today, this activity can be demonstrated best in a non-invasive and reproducible way with functional MRI.

Aphasia↗
PubMed2000

Frontotemporal decreases in rCBF correlate with degree of dysnomia in primary progressive aphasia.

UNLABELLED: Primary progressive aphasia (PPA) is an uncommon degenerative dementia characterized by gradual impairment of language function with initial sparing of the memory domain. Using semiquantitative 99mTc-hexamethyl propyleneamine oxime (HMPAO) brain SPECT as a measure of regional cerebral blood flow (rCBF), we investigated the relationship between reduced 99mTc-HMPAO uptake and the severity of dysnomia in PPA. METHODS: Seven right-handed patients with PPA had their dysnomia assessed by the Boston Naming Test (BNT), a subtest of the Boston Diagnostic Aphasia Examination. Neuroimaging studies, including 99mTc-HMPAO brain SPECT, CT, and MRI, were performed. Correlational analysis between reduced rCBF and BNT was performed. RESULTS: Brain SPECT showed a reduction in 99mTc-HMPAO uptake involving the frontal and temporal lobes in all 7 patients. CT and MRI showed mild to moderate cerebral atrophy in 4 patients. Low scores on the BNT correlated with low frontotemporal 99mTc-HMPAO (Spearman r = 0.97, P = 0.004) in the 5 patients with left-hemisphere involvement. CONCLUSION: Decreased rCBF to the frontotemporal region characterized the cerebral abnormalities associated with PPA. The finding of focal rCBF abnormalities in the right hemisphere of 2 right-handed women corroborates that PPA symptoms may arise from a "non-left-dominant"-hemisphere degenerative process. Our results support the usefulness of rCBF SPECT imaging as a diagnostic aid in PPA.

Aged↗
PubMed2000

[A case of non-convulsive status epilepticus worsened Wernicke's aphasia reversely].

A 62-year-old right-handed woman had presented progressive speech impediment over 4 months. She was alert without any convulsions or involuntary movements. Neurological examination showed Wernicke's aphasia, constructional apraxia. Her magnetic resonance imaging (MRI) showed an old cerebral infarction in the left parieto-occipital area, in addition to ischemic changes in the bilateral deep white matter. Electroencephalography (EEG) revealed periodic lateralized epileptiform discharges (PLEDs) predominant in the posterior left hemisphere. The PLEDs as well as the cortical symptoms improved after an administration of anti-convulsive agents, thus establishing the diagnosis of non-convulsive status epilepticus (NSE). It should be emphasized that NSE manifesting as Wernicke's aphasia should be distinguished from dementia syndrome because it is a treatable disorder.

Anticonvulsants↗
PubMed1998

Crossed aphasia leading to pure word deafness.

We report a case of crossed aphasia following a vascular insult of the right hemisphere in a middle aged dextral man with subsequent evolution to pure word deafness. Development of pure word deafness during recovery from crossed Wernickes aphasia is an extremely rare clinical entity. Probably this is the first Indian report of this entity.

Aphasia↗
PubMedDate not supplied

[Progressive primary aphasia associated with corticobasal degeneration].

INTRODUCTION: Progressive primary aphasia generally progresses to global cognitive deterioration of Alzheimer type, although occasionally it remains unchanged. The neuropathological findings are varied: Alzheimer, spongiform etc. The case we describe followed a very unusual course. Initially there was a clinical picture of progressive primary aphasia with which that of corticobasal degeneration was later associated. CASE REPORT: The patient, who had no relevant previous clinical history apart from chronic obstructive pulmonary disease presented with gradually deteriorating oral expression, with no loss of memory and maintenance of autonomy in everyday activities. This condition was later associated with slowing of voluntary movements, hypertonia of the right limbs, difficulty in manipulation with the right hand and myoclonic jerks. Neuro imaging on cranial CT showed global cerebral atrophy, most marked on the right and cerebral SPECT showed reduced fronto temporal uptake. No other significant alterations were found in the investigations done. On neuropsychological examination there was alteration of language in the form of mutism and reduction in denomination, repetition, fluency and comprehension (except for simple orders). However, copies of drawings were done correctly with absence of apraxia of ideas or ideomotor initiation. Handwriting was also normal. CONCLUSION: . The unusual aspect of our case was the simultaneous presentation of an aphasic disorder and corticobasal degeneration.

Aged↗
PubMed1975

A basic aphasia examination: description with discussion of first results.

A new basic aphasia test (Grunntest for Afasi) constructed for use with a Norwegian patient population is briefly described. This test follows the principles established by Goodglass and Kaplan in the Boston Diagnostic Aphasia Examination. Results with the first 43 patients examined are presented. Three alternative methods for utilizing the basic results in classifying types of aphasic disorder are considered. The classical method, as formalized by Goodglass and Kaplan, which emphasizes an evaluation of patients' speech characteristics was found to employ dimensions with the lowest intercorrelations. While this method provided the better dimensions, the description of disorder in terms of classical syndromes defined by impairment along these dimensions could not classify a majority of the patients. However, the dimensions on which such classification is based (Fluency, Comprehension, Naming, Repetition) form a useable descriptive system.

Aphasia↗
PubMedDate not supplied

Patterns of cerebral atrophy in primary progressive aphasia.

The authors illustrate the spectrum of clinical and imaging patterns in primary progressive aphasia (PPA), a syndrome of slowly progressive speech and language impairment occurring with neurodegenerative disease. Although PPA presents with relatively isolated impairment in language, many patients progress to global cognitive or behavioral dysfunction. The syndrome may be associated with frontotemporal dementia (FTD)- or Alzheimer disease (AD)-type changes. Authors describe the clinical presentation in three cases of PPA and analyze the pattern of cerebral atrophy in each case with voxel-based morphometry. Two patients presented with nonfluent progressive aphasia. Subtle differences in the clinical features were suggestive of FTD in one case and AD in the other. Neuroimaging revealed a predominance of frontal atrophy in the first case and temporo-parietal atrophy in the second. The third case presented with the syndrome of semantic dementia and showed the typical behavioral problems associated with FTD and a pattern of left-greater-than-right temporal atrophy. Different clinical syndromes in PPA are associated with different patterns of atrophy. In the future, combined analysis of imaging and clinical characteristics may allow more accurate etiologic diagnosis.

Aged↗