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PubMed1998

Transcortical sensory aphasia following left frontal infarction.

Two right-handed patients who exhibited language disability after left frontal infarction are described. The patients spoke fluently and exhibited excellent repetition ability from the onset of infarction without exhibiting any oral apraxia, but had deficits in auditory comprehension, naming, reading and writing. In both patients, brain magnetic resonance imaging (MRI) revealed infarction in the left inferior frontal gyrus, the middle frontal gyrus and the anterior part of the lower precentral gyrus. Single photon emission computed tomography (SPECT) revealed decreased blood flow in the same regions as those shown to be infarcted by MRI. The MRI and SPECT findings and the symptoms of these patients suggest that left frontal lesions that encompass Broca's area produce fluent aphasia if the posterior part of the left precentral gyrus or motor cortex remains intact and that lesions anterior to Broca's area and the middle frontal gyrus produce a deficit in auditory comprehension of single words as well as sentences.

Aphasia, Wernicke↗
PubMed2001

Motor neurone disease, dementia and aphasia: coincidence, co-occurrence or continuum?

Cognitive, and particularly aphasic, symptoms associated with motor neurone disease (MND) are still frequently described as rare and "recently discovered". This review demonstrates that the association between MND and dementia was described and recognised as an entity as early as 1929, and its close relationship to Pick's disease was postulated in 1932. Changes in language production and comprehension were also observed by early authors, although they were rarely described as aphasia. The striking similarity to the contemporary descriptions is, however, sometimes obscured by diverging terminology. The syndromes of MND/dementia and MND/aphasia are well established but represent a comparatively small subgroup of MND. In addition, subtle cognitive alterations have also been reported in non-demented MND patients; most studies have found evidence of frontal-executive dysfunction, similar in pattern, but much milder than in patients with frank MND/dementia. These findings are strengthened further by post-mortem studies demonstrating pathological changes in the frontal lobes, and functional neuroimaging studies, showing reduced frontal activation. The issue of whether memory, visuospatial skills and language are affected in non-demented subjects remains, however, controversial. Further studies are required to establish whether MND/dementia and MND/aphasia form separate disease entities or can be viewed as extreme forms of a cognitive deficit characteristic of MND in general.

Aphasia↗
PubMed2006

Antonio Berti and the early history of aphasia in Italy.

Whilst the debate about cerebral localisation of articulate speech was raging in France in the 1860s and in particular with reference to the observations of Paul Broca, there were also some Italians who attempted to make a contribution on the subject. Among those was the physician Antonio Berti, who in 1865 furnished some interesting observations on the association of aphasia with the frontal lobe. In this paper we intend to revive this forgotten episode that represents one of the early Italian observations on the issue of cortical localisation of speech.

Aphasia↗
PubMed2000

Primary progressive aphasia: a patient with stress assignment impairment in reading aloud.

Surface dyslexia is a pattern of reading impairment which has been seldom described in Italian native speakers. We report the case of a female Italian patient, RM, suffering from primary progressive aphasia (PPA) of the fluent type, who presented stress assignment errors in reading aloud. In Italian these errors are considered to be strongly suggestive of surface dyslexia. We studied RM's reading performance in light of existing cognitive models on reading. Since the first assessment, she presented multi-level impairment involving pre-semantic, lexical-semantic and post-semantic stages. Her stress assignment errors have been interpreted as a generalisation of the most frequent tendency in Italian language: namely to assign stress to the penultimate syllable. In agreement with previous studies, our case suggests that surface dyslexia in PPA is not a monolithic entity but, on the contrary, that it may arise from impairment at various stages of the reading process.

Aged↗
PubMed2006

Evaluating single-subject treatment research: lessons learned from the aphasia literature.

The mandate for evidence-based practice has prompted careful consideration of the weight of the scientific evidence regarding the therapeutic value of various clinical treatments. In the field of aphasia, a large number of single-subject research studies have been conducted, providing clinical outcome data that are potentially useful for clinicians and researchers; however, it has been difficult to discern the relative potency of these treatments in a standardized manner. In this paper we describe an approach to quantify treatment outcomes for single-subject research studies using effect sizes. These values provide a means to compare treatment outcomes within and between individuals, as well as to compare the relative strength of various treatments. Effect sizes also can be aggregated in order to conduct meta-analyses of specific treatment approaches. Consideration is given to optimizing research designs and providing adequate data so that the value of treatment research is maximized.

Aphasia↗
PubMed2006

The contribution of neuroimaging to the study of language and aphasia.

New structural and functional imaging methods continue to be developed at a rapid pace. In the last 25 years, advanced imaging techniques have provided insights into how language is represented and processed in the brain and how it can be disrupted by damage to, or dysfunction of, various parts of the brain. Imaging studies have also yielded new information regarding how individuals recover language after stroke. We briefly review the strengths and weaknesses of the various radiological methods currently used to study language and aphasia.

Aphasia↗
PubMed1992

Bromocriptine treatment of nonfluent aphasia.

Two patients with nonfluent aphasia, secondary to stroke, of more than 18 months' duration, were started on bromocriptine to determine its effect on speech fluency. The first patient showed some improvement in fluency at 10 mg and marked improvement at 30 mg; he increased from a mean length of 3.19 words to 4.23 words per utterance. The second patient improved at 10 mg, got worse at 30 mg, and improved again at 10 mg; he increased again to 4.44 at 10 mg. Functionally, both of the patients, their families, and the hospital staff noticed marked improvement in producing multisyllable words and providing information in sentence form. Our results suggest that bromocriptine may be useful for improving fluency in some chronically nonfluent aphasic patients and that the optimum dose may vary from person to person.

Aged↗
PubMed1977

Automatisation of a localising technique in aphasia based upon averaged evoked potentials.

Averaged evoked potentials were utilised as a localising technique in aphasia. Based on a set of measurements extracted from various evoked potentials, subjects from four diagnostic categories were correctly classified in more than 70% of the cases. The measurements were derived from amplitudes and latencies of significant peaks which were selected by human judgement from plots of the recorded evoked potentials. An algorithm has been developed which simulates the manual procedure and reduces the processing time per patient by several magnitudes. The automated method yields results which are more consistent with expected results than those from the manual method. The percentage of correct classification is in both cases essentially the same.

Aphasia↗
PubMed1975

The use of representational prompts in aphasia therapy.

The uses of representational prompts, which have received little specific attention in the literature of aphasia therapy, are discussed in this paper. A representational prompt is one that represents the concept pinpointed in the naming or matching response the prompt is intended to help elicit. It may fall into either of two major categories: symbolic, as in the form of a written word or realistic, as in the form of an object or picture. A number of examples are described that were clinically utilized by the authors within the framework of operant behavior principles, and a tentative outline is presented suggestive of the variety of such prompts that can be adapted to the precise and varying needs of the patient.

Aphasia↗
PubMed1979

Effects of clinician behaviors on acceptability of patients' responses in aphasia treatment sessions.

Records of the content of 40 videotaped samples of aphasia treatment sessions were prepared. These records were analyzed to determine (a) whether certain clinician behaviors and task characteristics are related to the occurrence of patient error responses in speech and language treatment sessions for aphasic individuals, and (b) whether "errors generate errors"; that is, whether error responses tend to occur in clusters rather than being distributed uniformly throughout the treatment session. The results of these analyses indicated that a number of event categories were significantly related to the occurrence of unacceptable patient responses. These results suggest that certain clinician behaviors generate patient error responses and also that clinicians tend to response to patient errors in characteristic ways. An analysis of these results also confirmed that unacceptable patient responses tended to occur in clusters.

Aphasia↗
PubMed1983

Factors influencing naming performance in aphasia: a review of the literature.

The naming performance of aphasic patients may vary substantially, depending upon linguistic factors associated with the target words, characteristics of the referent (real or pictured), the manner in which the response is elicited, and the particular situation in which the naming response is produced. Furthermore, the specific influence of certain of these factors on naming performance appears to vary with type of aphasia. This article reviews and evaluates the literature pertaining to factors that influence adult aphasics' naming performances. Implications for future research are discussed.

Adult↗
PubMed1984

Pantomime in aphasia: effects of stimulus characteristics.

The effects of three types of stimuli (objects, line drawings, action pictures) on the comprehension and production of pantomimes in aphasic patients were assessed. A significantly higher number of correct pantomime responses was found for objects and action pictures than for line drawings. Significant positive correlations were found between aphasia subtest scores and pantomimic scores. The theoretical and clinical implications of these findings are discussed.

Aphasia↗
PubMed1985

A word-ordering test to differentiate between aphasia and schizophrenia.

The capacity of a word-ordering task to differentiate aphasic and schizophrenic patients was assessed. Cards containing words from 10 types of sentences were given to the patients. Each sentence was presented individually with the words in jumbled order and patients were asked to reorder them to produce a gramatically correct sentence. Process and reactive schizophrenics were differentiated from aphasic patients using the dual criteria of more than three incorrect sentences or an average of more than 90 sec per sentence as indicative of aphasia. These criteria were initially tested on a group of aphasics matched with the schizophrenics on age and education and cross-validated using a second more representative sample (unmatched) of aphasics. Both comparisons showed no errors of classification. Further analyses indicated no need for separate norms or classification criteria related to the sex, age, or educational level of the patients.

Adult↗
PubMed1985

Comprehension of neutral, melodically intoned, and affectively toned sentences by adults with aphasia.

The purpose of this study was to investigate whether there is a notable improvement in the auditory comprehension of adults with aphasia when sentences are melodically intoned or spoken with strong affect, as compared to when the same sentence materials are spoken in a neutral manner. The subjects for this study were six aphasic patients with left-brain damage and two control subjects: one patient with bilateral brain damage and one subject with no history of neurological insult. The subjects responded to a picture identification task where the same sentence stimuli were presented in three conditions: neutral, melodic intonation, and strong affect. There was no significant difference in the left-brain damaged patients' auditory comprehension scores in the three conditions. No improvement of performance was noted for the bilaterally brain-damaged patient, and the nonaphasic subject attained a perfect or near-perfect score in each condition. Results are discussed in terms of the need for future research.

Adult↗
PubMed1985

Psychometric review of nine aphasia tests.

Nine aphasia tests are reviewed using six psychometric criteria appropriate to standardized tests. The number of criteria met by individual tests ranged from one to five, with a median and mode of three. A seventh criterion was applied to six tests that used normative data. Two of the six reviewed tests met that criterion. The need for test manuals to contain a wide range of psychometric information is discussed and, in particular, the role of subject description in test standardization is emphasized.

Aphasia↗
PubMed1986

The effectiveness of simultaneous cues on naming disturbance in aphasia.

The effects of increased information redundancy on word retrieval in aphasic patients was investigated in this study. Protocols involved combining five types of cues commonly utilized in aphasia management into eight pairs, each of which could be presented simultaneously. The resulting cue combinations were presented to 16 anterior lesion aphasic subjects who manifested mild to severe word-finding difficulty. All of the combinations were effective in facilitating picture-naming performance, with the severe group demonstrating the most dramatic improvement when simultaneous prompts were utilized. A cueing hierarchy incorporating increased stimulus redundancy is supported.

Aged↗
PubMed1993

Treatment of Wernicke's aphasia with jargon: a case study.

This case study concerns an adult with Wernicke's aphasia characterized by neologistic jargon and a severe auditory comprehension deficit. No communicative or linguistic improvements had been observed after eight months poststroke. Up until this time, therapeutic intervention was aimed at managing the patient's rambling communicative style and improving auditory comprehension skills. A therapeutic regimen was introduced that focused on visual/written information and included a hierarchy of visual word and sentence comprehension tasks. All auditory/verbal stimulus presentation was eliminated. After two months on the program, improvement was noted in naming abilities and general ability to communicate in conversation, including a reduction of neologistic jargon and an increase in semantic jargon. No improvement was noted in auditory comprehension. The visual program may have facilitated the patient's general attentional set, thereby possibly contributing to her improvement in communicative style and sensitivity to conversational interactions with others.

Aged↗
PubMed1993

Evoked potential measures of auditory cortical function and auditory comprehension in aphasia.

This study investigated the relation between severity of auditory comprehension impairment in aphasia and the functional integrity of the posterior superior temporal region as evaluated by middle- and long-latency auditory evoked potentials and dipole source analysis. AEPs were studied in 20 stroke patients and in age-matched controls. AEPs and language data were collected 1 year or more post onset, and were compared to performance early after onset. Patients were differentiated in a group with severe and a group with moderate to recovered auditory comprehension impairment. Significant asymmetries of auditory evoked dipole source potentials were more frequent in the severely impaired group. However, a severe auditory comprehension deficit was not incompatible with normal AEPs. The results confirm the importance of the posterior superior temporal region for auditory language comprehension, but the correlation between AEP asymmetry and auditory comprehension seems due to the close spatial relation of AEP generating substrate and posterior language area rather than to partial overlap. Dipole source analysis of AEPs proved to be a valuable method for the assessment of interhemispheric asymmetries, enhancing the sensitivity of AEPs to unilateral damage of auditory cortex.

Aged↗