Science.gov

Sample records for agrammatic aphasia processing

  1. Binding in agrammatic aphasia: Processing to comprehension

    PubMed Central

    Janet Choy, Jungwon; Thompson, Cynthia K.

    2010-01-01

    Background Theories of comprehension deficits in Broca’s aphasia have largely been based on the pattern of deficit found with movement constructions. However, some studies have found comprehension deficits with binding constructions, which do not involve movement. Aims This study investigates online processing and offline comprehension of binding constructions, such as reflexive (e.g., himself) and pronoun (e.g., him) constructions in unimpaired and aphasic individuals in an attempt to evaluate theories of agrammatic comprehension. Methods & Procedures Participants were eight individuals with agrammatic Broca’s aphasia and eight age-matched unimpaired individuals. We used eyetracking to examine online processing of binding constructions while participants listened to stories. Offline comprehension was also tested. Outcomes & Results The eye movement data showed that individuals with Broca’s aphasia were able to automatically process the correct antecedent of reflexives and pronouns. In addition, their syntactic processing of binding was not delayed compared to normal controls. Nevertheless, offline comprehension of both pronouns and reflexives was significantly impaired compared to the control participants. This comprehension failure was reflected in the aphasic participants’ eye movements at sentence end, where fixations to the competitor increased. Conclusions These data suggest that comprehension difficulties with binding constructions seen in agrammatic aphasic patients are not due to a deficit in automatic syntactic processing or delayed processing. Rather, they point to a possible deficit in lexical integration. PMID:20535243

  2. Automatic processing of wh- and NP-movement in agrammatic aphasia: Evidence from eyetracking

    PubMed Central

    Dickey, Michael Walsh; Thompson, Cynthia K.

    2009-01-01

    Individuals with agrammatic Broca’s aphasia show deficits in comprehension of non-canonical wh-movement and NP-movement sentences. Previous work using eyetracking has found that agrammatic and unimpaired listeners show very similar patterns of automatic processing for wh-movement sentences. The current study attempts to replicate this finding for sentences with wh-movement (in object relatives in the current study) and to extend it to sentences with NP movement (passives). For wh-movement sentences, aphasic and control participants’ eye-movements differed most dramatically in late regions of the sentence and post-offset, with aphasic participants exhibiting lingering attention to a salient but grammatically impermissible competitor. The eye-movement differences between correct and incorrect trials for wh-movement sentences were similar, with incorrect trials also exhibiting competition from an impermissible interpretation late in the sentence. Furthermore, the two groups exhibited similar eye-movement patterns in response to passive NP-movement sentences, but showed little evidence of gap-filling for passives. The results suggest that aphasic and unimpaired individuals may generate similar representations during comprehension, but that aphasics are highly vulnerable to interference from alternative interpretations (Ferreira, 2003). PMID:20161014

  3. Implicit and Explicit Learning in Individuals with Agrammatic Aphasia

    PubMed Central

    Schuchard, Julia; Thompson, Cynthia K.

    2013-01-01

    Implicit learning is a process of acquiring knowledge that occurs without conscious awareness of learning, whereas explicit learning involves the use of overt strategies. To date, research related to implicit learning following stroke has been largely restricted to the motor domain and has rarely addressed implications for language. The present study investigated implicit and explicit learning of an auditory word sequence in 10 individuals with stroke-induced agrammatic aphasia and 18 healthy age-matched participants using an adaptation of the Serial Reaction Time task. Individuals with aphasia showed significant learning under implicit, but not explicit, conditions, whereas age-matched participants learned under both conditions. These results suggest significant implicit learning ability in agrammatic aphasia. Furthermore, results of an auditory sentence span task indicated working memory deficits in individuals with agrammatic aphasia, which are discussed in relation to explicit and implicit learning processes. PMID:23532578

  4. Implicit and explicit learning in individuals with agrammatic aphasia.

    PubMed

    Schuchard, Julia; Thompson, Cynthia K

    2014-06-01

    Implicit learning is a process of acquiring knowledge that occurs without conscious awareness of learning, whereas explicit learning involves the use of overt strategies. To date, research related to implicit learning following stroke has been largely restricted to the motor domain and has rarely addressed implications for language. The present study investigated implicit and explicit learning of an auditory word sequence in 10 individuals with stroke-induced agrammatic aphasia and 18 healthy age-matched participants using an adaptation of the Serial Reaction Time task. Individuals with aphasia showed significant learning under implicit, but not explicit, conditions, whereas age-matched participants learned under both conditions. These results suggest significant implicit learning ability in agrammatic aphasia. Furthermore, results of an auditory sentence span task indicated working memory deficits in individuals with agrammatic aphasia, which are discussed in relation to explicit and implicit learning processes.

  5. Tracking Passive Sentence Comprehension in Agrammatic Aphasia

    PubMed Central

    Meyer, Aaron M.; Mack, Jennifer E.; Thompson, Cynthia K.

    2011-01-01

    People with agrammatic aphasia often experience greater difficulty comprehending passive compared to active sentences. The Trace Deletion Hypothesis (TDH; Grodzinsky, 2000) proposes that aphasic individuals cannot generate accurate syntactic representations of passive sentences and, hence, use an agent-first processing strategy which leads to at-chance performance. We tested this claim using the eyetracking-while-listening paradigm in order to reveal online processing routines. Ten agrammatic aphasic participants and 10 age-matched controls listened to passive and active sentences and performed a sentence-picture matching task (i.e., selecting between two pictures with reversed thematic roles), while their eye movements were monitored. Control participants’ performance was at ceiling, whereas accuracy for the aphasic participants was above chance for active sentences and at chance for passive sentences. Further, for the control participants, the eye movement data showed an initial agent-first processing bias, followed by fixation on the correct picture in the vicinity of the verb in both active and passive sentences. However, the aphasic participants showed no evidence of agent-first processing, counter the predictions of the TDH. In addition, in active sentences, they reliably fixated the correct picture only at sentence offset, reflecting slowed processing. During passive sentence processing, fixations were at chance throughout the sentence, but different patterns were noted for correct and incorrect trials. These results are consistent with the proposal that agrammatic sentence comprehension failure involves lexical processing and/or lexical integration deficits. PMID:22043134

  6. On-line processing of tense and temporality in agrammatic aphasia.

    PubMed

    Faroqi-Shah, Yasmeen; Dickey, Michael Walsh

    2009-02-01

    Agrammatic aphasic individuals exhibit marked production deficits for tense morphology. This paper presents three experiments examining whether a group of English-speaking agrammatic individuals (n=10) exhibit parallel deficits in their comprehension of tense. Results from two comprehension experiments (on-line grammaticality judgment studies) suggest that these individuals are impaired for tense comprehension, and furthermore that their deficit is more pronounced for morphosemantic rather than morphosyntactic aspects of tense processing. Results from a third experiment (an elicited production study) indicate that these individuals exhibit parallel production and comprehension impairments for tense. Across the three experiments, the consistent pattern was that of a significant difficulty in associating verb forms with a pre-specified temporal context when compared to all other processes. Implications for current models of agrammatic tense and morphological deficits are discussed.

  7. The forgotten grammatical category: Adjective use in agrammatic aphasia

    PubMed Central

    Meltzer-Asscher, Aya; Thompson, Cynthia K.

    2014-01-01

    Background In contrast to nouns and verbs, the use of adjectives in agrammatic aphasia has not been systematically studied. However, because of the linguistic and psycholinguistic attributes of adjectives, some of which overlap with nouns and some with verbs, analysis of adjective production is important for testing theories of word class production deficits in agrammatism. Aims The objective of the current study was to compare adjective use in agrammatic and healthy individuals, focusing on three factors: overall adjective production rate, production of predicative and attributive adjectives, and production of adjectives with complex argument structure. Method & Procedures Narratives elicited from 14 agrammatic and 14 control participants were coded for open class grammatical category production (i.e., nouns, verbs, adjectives), with each adjective also coded for its syntactic environment (attributive/predicative) and argument structure. Outcomes & Results Overall, agrammatic speakers used adjectives in proportions similar to that of cognitively healthy speakers. However, they exhibited a greater proportion of predicative adjectives and a lesser proportion of attributive adjectives, compared to controls. Additionally, agrammatic participants produced adjectives with less complex argument structure than controls. Conclusions The overall normal-like frequency of adjectives produced by agrammatic speakers suggests that agrammatism does not involve an inherent difficulty with adjectives as a word class or with predication, or that it entails a deficit in processing low imageability words. However, agrammatic individuals’ reduced production of attributive adjectives and adjectives with complements extends previous findings of an adjunction deficit and of impairment in complex argument structure processing, respectively, to the adjectival domain. The results suggest that these deficits are not tied to a specific grammatical category. PMID:24882945

  8. On-Line Processing of Tense and Temporality in Agrammatic Aphasia

    ERIC Educational Resources Information Center

    Faroqi-Shah, Yasmeen; Dickey, Michael Walsh

    2009-01-01

    Agrammatic aphasic individuals exhibit marked production deficits for tense morphology. This paper presents three experiments examining whether a group of English-speaking agrammatic individuals (n = 10) exhibit parallel deficits in their comprehension of tense. Results from two comprehension experiments (on-line grammaticality judgment studies)…

  9. On-Line Processing of Tense and Temporality in Agrammatic Aphasia

    ERIC Educational Resources Information Center

    Faroqi-Shah, Yasmeen; Dickey, Michael Walsh

    2009-01-01

    Agrammatic aphasic individuals exhibit marked production deficits for tense morphology. This paper presents three experiments examining whether a group of English-speaking agrammatic individuals (n = 10) exhibit parallel deficits in their comprehension of tense. Results from two comprehension experiments (on-line grammaticality judgment studies)…

  10. Lack of Frank Agrammatism in the Nonfluent Agrammatic Variant of Primary Progressive Aphasia

    PubMed Central

    Graham, Naida L.; Leonard, Carol; Tang-Wai, David F.; Black, Sandra; Chow, Tiffany W.; Scott, Chris J.M.; McNeely, Alicia A.; Masellis, Mario; Rochon, Elizabeth

    2016-01-01

    Background/Aims Frank agrammatism, defined as the omission and/or substitution of grammatical morphemes with associated grammatical errors, is variably reported in patients with nonfluent variant primary progressive aphasia (nfPPA). This study addressed whether frank agrammatism is typical in agrammatic nfPPA patients when this feature is not required for diagnosis. Method We assessed grammatical production in 9 patients who satisfied current diagnostic criteria. Although the focus was agrammatism, motor speech skills were also evaluated to determine whether dysfluency arose primarily from apraxia of speech (AOS), instead of, or in addition to, agrammatism. Volumetric MRI analyses provided impartial imaging-supported diagnosis. Results The majority of cases exhibited neither frank agrammatism nor AOS. Conclusion There are nfPPA patients with imaging-supported diagnosis and preserved motor speech skills who do not exhibit frank agrammatism, and this may persist beyond the earliest stages of the illness. Because absence of frank agrammatism is a subsidiary diagnostic feature in the logopenic variant of PPA, this result has implications for differentiation of the nonfluent and logopenic variants, and indicates that PPA patients with nonfluent speech in the absence of frank agrammatism or AOS do not necessarily have the logopenic variant. PMID:27790240

  11. Electrophysiological responses to argument structure violations in healthy adults and individuals with agrammatic aphasia

    PubMed Central

    Kielar, Aneta; Meltzer-Asscher, Aya; Thompson, Cynthia

    2012-01-01

    Sentence comprehension requires processing of argument structure information associated with verbs, i.e. the number and type of arguments that they select. Many individuals with agrammatic aphasia show impaired production of verbs with greater argument structure density. The extent to which these participants also show argument structure deficits during comprehension, however, is unclear. Some studies find normal access to verb arguments, whereas others report impaired ability. The present study investigated verb argument structure processing in agrammatic aphasia by examining event-related potentials associated with argument structure violations in healthy young and older adults as well as aphasic individuals. A semantic violation condition was included to investigate possible differences in sensitivity to semantic and argument structure information during sentence processing. Results for the healthy control participants showed a negativity followed by a positive shift (N400-P600) in the argument structure violation condition, as found in previous ERP studies (Friederici & Frisch, 2000; Frisch, Hahne, & Friederici, 2004). In contrast, individuals with agrammatic aphasia showed a P600, but no N400, response to argument structure mismatches. Additionally, compared to the control groups, the agrammatic participants showed an attenuated, but relatively preserved, N400 response to semantic violations. These data show that agrammatic individuals do not demonstrate normal real-time sensitivity to verb argument structure requirements during sentence processing. PMID:23022079

  12. Verb inflections in agrammatic aphasia: Encoding of tense features ⋆

    PubMed Central

    Faroqi-Shah, Yasmeen; Thompson, Cynthia K.

    2008-01-01

    Across most languages, verbs produced by agrammatic aphasic individuals are frequently marked by syntactically and semantically inappropriate inflectional affixes, such as Last night, I walking home. As per language production models, verb inflection errors in English agrammatism could arise from three potential sources: encoding the verbs’ morphology based on temporal information at the conceptual level, accessing syntactic well-formedness constraints of verbal morphology, and encoding morphophonological form. We investigate these aspects of encoding verb inflections in agrammatic aphasia. Using three sentence completion experiments, it was demonstrated that production of verb inflections was impaired whenever temporal reference was involved; while morphological complexity and syntactic constraints were less likely to be the source of verb inflection errors in agrammatism. These findings are discussed in relation to current language production models. PMID:18392120

  13. Time reference in agrammatic aphasia: A cross-linguistic study

    PubMed Central

    Bastiaanse, Roelien; Bamyaci, Elif; Hsu, Chien-Ju; Lee, Jiyeon; Duman, Tuba Yarbay; Thompson, Cynthia K.

    2015-01-01

    It has been shown across several languages that verb inflection is difficult for agrammatic aphasic speakers. In particular, Tense inflection is vulnerable. Several theoretical accounts for this have been posed, for example, a pure syntactic one suggesting that the Tense node is unavailable due to its position in the syntactic tree (Friedmann & Grodzinsky, 1997); one suggesting that the interpretable features of the Tense node are underspecified (Burchert, Swoboda-Moll, & De Bleser, 2005; Wenzlaff & Clahsen, 2004, 2005); and a morphosemantic one, arguing that the diacritic Tense features are affected in agrammatism (Faroqi–Shah & Dickey, 2009; Lee, Milman, & Thompson, 2008). However recent findings (Bastiaanse, 2008) and a reanalysis of some oral production studies (e.g. Lee et al., 2008; Nanousi, Masterson, Druks, & Atkinson, 2006) suggest that both Tense and Aspect are impaired and, most importantly, reference to the past is selectively impaired, both through simple verb forms (such as simple past in English) and through periphrastic verb forms (such as the present perfect, ‘has V-ed’, in English). It will be argued that reference to the past is discourse linked and reference to the present and future is not (Zagona, 2003, in press). In-line with Avrutin’s (2000) theory that suggests discourse linking is impaired in Broca’s aphasia, the PAst DIscourse LInking Hypothesis (PADILIH) has been formulated. Three predictions were tested: (1) patients with agrammatic aphasia are selectively impaired in use of grammatical morphology associated with reference to the past, whereas, inflected forms which refer to the present and future are relatively spared; (2) this impairment is language-independent; and (3) this impairment will occur in both production and comprehension. Agrammatic Chinese, English and Turkish speakers were tested with the Test for Assessing Reference of Time (TART; Bastiaanse, Jonkers, & Thompson, unpublished). Results showed that both the

  14. Dissociations Between Fluency And Agrammatism In Primary Progressive Aphasia.

    PubMed

    Thompson, Cynthia K; Cho, Soojin; Hsu, Chien-Ju; Wieneke, Christina; Rademaker, Alfred; Weitner, Bing Bing; Mesulam, M-Marsel; Weintraub, Sandra

    2012-01-01

    BACKGROUND: Classical aphasiology, based on the study of stroke sequelae, fuses speech fluency and grammatical ability. Nonfluent (Broca's) aphasia often is accompanied by agrammatism; whereas in the fluent aphasias grammatical deficits are not typical. The assumption that a similar relationship exists in primary progressive aphasia (PPA) has led to the dichotomization of this syndrome into fluent and nonfluent subtypes. AIMS: This study compared elements of fluency and grammatical production in the narrative speech of individuals with PPA to determine if they can be dissociated from one another. METHOD: Speech samples from 37 individuals with PPA, clinically assigned to agrammatic (N=11), logopenic (N=20) and semantic (N=6) subtypes, and 13 cognitively healthy control participants telling the "Cinderella Story" were analyzed for fluency (i.e., words per minute (WPM) and mean length of utterance in words (MLU-W)) and grammaticality (i.e., the proportion of grammatically correct sentences, open-to-closed-class word ratio, noun-to-verb ratio, and correct production of verb inflection, noun morphology, and verb argument structure.) Between group differences were analyzed for each variable. Correlational analyses examined the relation between WPM and each grammatical variable, and an off-line measure of sentence production. OUTCOMES AND RESULTS: Agrammatic and logopenic groups both had lower scores on the fluency measures and produced significantly fewer grammatical sentences than did semantic and control groups. However, only the agrammatic group evinced significantly impaired production of verb inflection and verb argument structure. In addition, some semantic participants showed abnormal open-to-closed and noun-to-verb ratios in narrative speech. When the sample was divided on the basis of fluency, all the agrammatic participants fell in the nonfluent category. The logopenic participants varied in fluency but those with low fluency showed variable performance on

  15. Dissociations Between Fluency And Agrammatism In Primary Progressive Aphasia

    PubMed Central

    Thompson, Cynthia K.; Cho, Soojin; Hsu, Chien-Ju; Wieneke, Christina; Rademaker, Alfred; Weitner, Bing Bing; Mesulam, M-Marsel; Weintraub, Sandra

    2011-01-01

    Background Classical aphasiology, based on the study of stroke sequelae, fuses speech fluency and grammatical ability. Nonfluent (Broca's) aphasia often is accompanied by agrammatism; whereas in the fluent aphasias grammatical deficits are not typical. The assumption that a similar relationship exists in primary progressive aphasia (PPA) has led to the dichotomization of this syndrome into fluent and nonfluent subtypes. Aims This study compared elements of fluency and grammatical production in the narrative speech of individuals with PPA to determine if they can be dissociated from one another. Method Speech samples from 37 individuals with PPA, clinically assigned to agrammatic (N=11), logopenic (N=20) and semantic (N=6) subtypes, and 13 cognitively healthy control participants telling the “Cinderella Story” were analyzed for fluency (i.e., words per minute (WPM) and mean length of utterance in words (MLU-W)) and grammaticality (i.e., the proportion of grammatically correct sentences, open-to-closed-class word ratio, noun-to-verb ratio, and correct production of verb inflection, noun morphology, and verb argument structure.) Between group differences were analyzed for each variable. Correlational analyses examined the relation between WPM and each grammatical variable, and an off-line measure of sentence production. Outcomes And Results Agrammatic and logopenic groups both had lower scores on the fluency measures and produced significantly fewer grammatical sentences than did semantic and control groups. However, only the agrammatic group evinced significantly impaired production of verb inflection and verb argument structure. In addition, some semantic participants showed abnormal open-to-closed and noun-to-verb ratios in narrative speech. When the sample was divided on the basis of fluency, all the agrammatic participants fell in the nonfluent category. The logopenic participants varied in fluency but those with low fluency showed variable performance on

  16. Conversation Therapy for Agrammatism: Exploring the Therapeutic Process of Engagement and Learning by a Person with Aphasia

    ERIC Educational Resources Information Center

    Beckley, Firle; Best, Wendy; Johnson, Fiona; Edwards, Susan; Maxim, Jane; Beeke, Suzanne

    2013-01-01

    Background & Aims: A recent systematic review of conversation training for communication partners of people with aphasia has shown that it is effective, and improves participation in conversation for people with chronic aphasia. Other research suggests that people with aphasia are better able to learn communication strategies in an environment…

  17. Conversation Therapy for Agrammatism: Exploring the Therapeutic Process of Engagement and Learning by a Person with Aphasia

    ERIC Educational Resources Information Center

    Beckley, Firle; Best, Wendy; Johnson, Fiona; Edwards, Susan; Maxim, Jane; Beeke, Suzanne

    2013-01-01

    Background & Aims: A recent systematic review of conversation training for communication partners of people with aphasia has shown that it is effective, and improves participation in conversation for people with chronic aphasia. Other research suggests that people with aphasia are better able to learn communication strategies in an environment…

  18. Sequential learning in individuals with agrammatic aphasia: evidence from artificial grammar learning.

    PubMed

    Schuchard, Julia; Thompson, Cynthia K

    2017-01-01

    We examined sequential learning in individuals with agrammatic aphasia (n = 12) and healthy age-matched participants (n = 12) using an artificial grammar. Artificial grammar acquisition, 24-hour retention, and the potential benefits of additional training were examined by administering an artificial grammar judgment test (1) immediately following auditory exposure-based training, (2) one day after training, and (3) after a second training session on the second day. An untrained control group (n = 12 healthy age-matched participants) completed the tests on the same time schedule. The trained healthy and aphasic groups showed greater sensitivity to the detection of grammatical items than the control group. No significant correlations between sequential learning and language abilities were observed among the aphasic participants. The results suggest that individuals with agrammatic aphasia show sequential learning, but the underlying processes involved in this learning may be different than for healthy adults.

  19. Grammatical Planning Units during Real-Time Sentence Production in Speakers with Agrammatic Aphasia and Healthy Speakers

    ERIC Educational Resources Information Center

    Lee, Jiyeon; Yoshida, Masaya; Thompson, Cynthia K.

    2015-01-01

    Purpose: Grammatical encoding (GE) is impaired in agrammatic aphasia; however, the nature of such deficits remains unclear. We examined grammatical planning units during real-time sentence production in speakers with agrammatic aphasia and control speakers, testing two competing models of GE. We queried whether speakers with agrammatic aphasia…

  20. Grammatical Planning Units during Real-Time Sentence Production in Speakers with Agrammatic Aphasia and Healthy Speakers

    ERIC Educational Resources Information Center

    Lee, Jiyeon; Yoshida, Masaya; Thompson, Cynthia K.

    2015-01-01

    Purpose: Grammatical encoding (GE) is impaired in agrammatic aphasia; however, the nature of such deficits remains unclear. We examined grammatical planning units during real-time sentence production in speakers with agrammatic aphasia and control speakers, testing two competing models of GE. We queried whether speakers with agrammatic aphasia…

  1. Psych verb production and comprehension in agrammatic Broca's aphasia.

    PubMed

    Thompson, Cynthia K; Lee, Miseon

    2009-07-01

    This study examined the factors that affect agrammatic sentence production by testing eight agrammatic aphasic participants' comprehension and production of active and passive sentences using two types of English psych verbs, those with an Experiencer-marked subject (Subject-Experiencer (SubExp)) and those with an Experiencer-marked object (Object-Experiencer (ObjExp)). The Argument Structure Complexity Hypothesis (ASCH, [J. Neuroling. 16 (2003) 151]) posits that the verb (and sentence) production difficulties observed in agrammatic aphasia can be attributed, at least in part, to the argument structure properties of verbs, with verbs that are marked for more complex argument structure (in terms of the number and type of arguments) presenting greater difficulty than those with less complex argument structure entries. Based on previous linguistic analyses of psych verbs, ObjExp psych verbs are more complex than SubjExp verbs. Therefore, we predicted that the former would present greater production (but not comprehension) difficulty than the latter. Results showed above chance comprehension of all sentence types, with the exception of SubjExp passive constructions, in which the subject position is occupied by a non-Experiencer argument. In active sentence production, ObjExp verbs were more impaired than SubjExp verbs. However, the opposite pattern was noted for passive sentence production. While all participants had difficulty producing passive sentences of both types, they showed better performance on ObjExp verbs, as compared to SubjExp verbs, in which the Experiencer is in the subject position. Further, agrammatic aphasic speakers showed a preference for producing actives for SubjExp verbs and passives for ObjExp verbs, indicating that the thematic role requirements of selected verbs (e.g., Experiencer, Theme) influence production patterns, as they do in normal speakers. These data, as well as the error patterns seen in our patients, support the ASCH and suggest

  2. Effects of verb meaning on lexical integration in agrammatic aphasia: Evidence from eyetracking

    PubMed Central

    Mack, Jennifer E.; Ji, Woohyuk; Thompson, Cynthia K.

    2013-01-01

    Relatively little is known about the time course of access to the lexical representations of verbs in agrammatic aphasia and its effects on the prediction and integration of the verb’s arguments. The present study used visual-world eyetracking to test whether verb meaning can be used by agrammatic aphasic individuals to predict and facilitate the integration of a subsequent noun argument. Nine adults with agrammatic aphasia and ten age-matched controls participated in the study. In Experiment 1, participants viewed arrays of four objects (e.g., jar, plate, stick, pencil) while listening to sentences containing either a restrictive verb that was semantically compatible only with the target object or an unrestrictive verb compatible with all four objects (e.g., Susan will open/break the jar). For both participant groups, the restrictive condition elicited more fixations to the target object immediately after the verb. Experiment 2 differed from Experiment 1 in that the auditory sentences presented were incomplete (e.g., Susan will open/break the…). For controls, restrictive verbs elicited more target fixations immediately after the verb; however, the effects of verb type were noted downstream from the verb for the aphasic listeners. The results suggest that individuals with agrammatic aphasia have preserved ability to use verb information to facilitate integration of overt arguments, but prediction of upcoming arguments is impaired. Impaired lexical-semantic prediction processes may be caused by damage to the left inferior frontal gyrus, which has been argued to support higher-level lexical processes. PMID:24092952

  3. Training verb argument structure production in agrammatic aphasia: Behavioral and neural recovery patterns

    PubMed Central

    Thompson, Cynthia K.; Riley, Ellyn A.; den Ouden, Dirk-Bart; Meltzer-Asscher, Aya; Lukic, Sladjana

    2013-01-01

    Introduction Neuroimaging and lesion studies indicate a left hemisphere network for verb and verb argument structure processing, involving both frontal and temporoparietal brain regions. Although their verb comprehension is generally unimpaired, it is well known that individuals with agrammatic aphasia often present with verb production deficits, characterized by an argument structure complexity hierarchy, indicating faulty access to argument structure representations for production and integration into syntactic contexts. Recovery of verb processing in agrammatism, however, has received little attention and no studies have examined the neural mechanisms associated with improved verb and argument structure processing. In the present study we trained agrammatic individuals on verbs with complex argument structure in sentence contexts and examined generalization to verbs with less complex argument structure. The neural substrates of improved verb production were examined using functional magnetic resonance imaging (fMRI). Methods Eight individuals with chronic agrammatic aphasia participated in the study (four experimental and four control participants). Production of three-argument verbs in active sentences was trained using a sentence generation task emphasizing the verb’s argument structure and the thematic roles of sentential noun phrases. Before and after training, production of trained and untrained verbs was tested in naming and sentence production and fMRI scans were obtained, using an action naming task. Results Significant pre- to post-training improvement in trained and untrained (one- and two-argument) verbs was found for treated, but not control, participants, with between-group differences found for verb naming, production of verbs in sentences, and production of argument structure. fMRI activation derived from post-treatment compared to pre-treatment scans revealed upregulation in cortical regions implicated for verb and argument structure processing

  4. The non-fluent/agrammatic variant of primary progressive aphasia.

    PubMed

    Grossman, Murray

    2012-06-01

    The non-fluent/agrammatic variant of primary progressive aphasia (naPPA) is a young-onset neurodegenerative disorder characterised by poor grammatical comprehension and expression and a disorder of speech sound production. In an era of disease-modifying treatments, the identification of naPPA might be an important step in establishing a specific cause of neurodegenerative disease. However, difficulties in defining the characteristic language deficits and heterogeneity in the anatomical distribution of disease in naPPA have led to controversy. Findings from imaging studies have linked an impairment of this uniquely human language capacity with disruption of large-scale neural networks centred in left inferior frontal and anterior superior temporal regions. Accordingly, the pathological burden of disease in naPPA is anatomically focused in these regions. Most cases of naPPA are associated with the spectrum of pathological changes found in frontotemporal lobar degeneration involving the microtubule-associated protein tau. Knowledge of these unique clinical-pathological associations should advance care for patients with this important class of neurodegenerative diseases while supplementing our knowledge of human cognitive neuroscience.

  5. THE NON-FLUENT/AGRAMMATIC VARIANT OF PRIMARY PROGRESSIVE APHASIA

    PubMed Central

    Grossman, Murray

    2012-01-01

    In an era of disease-modifying treatments, the non-fluent/agrammatic variant of primary progressive aphasia (naPPA) may help screen for a specific cause of neurodegenerative disease. However, there are controversies surrounding the identification of naPPA. This review describes the characteristic features associated with this discrete, young-onset neurodegenerative condition. Patients with naPPA have a distinct limitation in language emphasizingtheir poor grammatical comprehension and expression, as well as a disorder of speech sound production. Imaging studies associate an impairment of this uniquely human language capacity with disruption of a large-scale neural network centered in left inferior frontal and anterior-superior temporal regions. This corresponds to thepathologic burden of disease anatomically focused in left inferior frontal and anterior-superior temporal regions. A review of the histopathology underlying naPPA relates this condition to frontotemporal lobar degeneration spectrum pathology involving the microtubule-associated protein tau in a majority of cases. While much work remains to be done, these observations point to unique clinical-pathological correlations that can advance care for an important class of diseases while supplementing our knowledge of human cognitive neuroscience. PMID:22608668

  6. Grammatical Planning Units During Real-Time Sentence Production in Speakers With Agrammatic Aphasia and Healthy Speakers

    PubMed Central

    Yoshida, Masaya; Thompson, Cynthia K.

    2015-01-01

    Purpose Grammatical encoding (GE) is impaired in agrammatic aphasia; however, the nature of such deficits remains unclear. We examined grammatical planning units during real-time sentence production in speakers with agrammatic aphasia and control speakers, testing two competing models of GE. We queried whether speakers with agrammatic aphasia produce sentences word by word without advanced planning or whether hierarchical syntactic structure (i.e., verb argument structure; VAS) is encoded as part of the advanced planning unit. Method Experiment 1 examined production of sentences with a predefined structure (i.e., “The A and the B are above the C”) using eye tracking. Experiment 2 tested production of transitive and unaccusative sentences without a predefined sentence structure in a verb-priming study. Results In Experiment 1, both speakers with agrammatic aphasia and young and age-matched control speakers used word-by-word strategies, selecting the first lemma (noun A) only prior to speech onset. However, in Experiment 2, unlike controls, speakers with agrammatic aphasia preplanned transitive and unaccusative sentences, encoding VAS before speech onset. Conclusions Speakers with agrammatic aphasia show incremental, word-by-word production for structurally simple sentences, requiring retrieval of multiple noun lemmas. However, when sentences involve functional (thematic to grammatical) structure building, advanced planning strategies (i.e., VAS encoding) are used. This early use of hierarchical syntactic information may provide a scaffold for impaired GE in agrammatism. PMID:25908309

  7. Grammatical Planning Units During Real-Time Sentence Production in Speakers With Agrammatic Aphasia and Healthy Speakers.

    PubMed

    Lee, Jiyeon; Yoshida, Masaya; Thompson, Cynthia K

    2015-08-01

    Grammatical encoding (GE) is impaired in agrammatic aphasia; however, the nature of such deficits remains unclear. We examined grammatical planning units during real-time sentence production in speakers with agrammatic aphasia and control speakers, testing two competing models of GE. We queried whether speakers with agrammatic aphasia produce sentences word by word without advanced planning or whether hierarchical syntactic structure (i.e., verb argument structure; VAS) is encoded as part of the advanced planning unit. Experiment 1 examined production of sentences with a predefined structure (i.e., "The A and the B are above the C") using eye tracking. Experiment 2 tested production of transitive and unaccusative sentences without a predefined sentence structure in a verb-priming study. In Experiment 1, both speakers with agrammatic aphasia and young and age-matched control speakers used word-by-word strategies, selecting the first lemma (noun A) only prior to speech onset. However, in Experiment 2, unlike controls, speakers with agrammatic aphasia preplanned transitive and unaccusative sentences, encoding VAS before speech onset. Speakers with agrammatic aphasia show incremental, word-by-word production for structurally simple sentences, requiring retrieval of multiple noun lemmas. However, when sentences involve functional (thematic to grammatical) structure building, advanced planning strategies (i.e., VAS encoding) are used. This early use of hierarchical syntactic information may provide a scaffold for impaired GE in agrammatism.

  8. Semantic Interference during Object Naming in Agrammatic and Logopenic Primary Progressive Aphasia (PPA)

    ERIC Educational Resources Information Center

    Thompson, Cynthia K.; Cho, Soojin; Price, Charis; Wieneke, Christina; Bonakdarpour, Borna; Rogalski, Emily; Weintraub, Sandra; Mesulam, M-Marsel

    2012-01-01

    This study examined the time course of object naming in 21 individuals with primary progressive aphasia (PPA) (8 agrammatic (PPA-G); 13 logopenic (PPA-L)) and healthy age-matched speakers (n=17) using a semantic interference paradigm with related and unrelated interfering stimuli presented at stimulus onset asynchronies (SOAs) of -1000, -500, -100…

  9. Patterns of Comprehension Performance in Agrammatic Broca's Aphasia: A Test of the Trace Deletion Hypothesis

    ERIC Educational Resources Information Center

    Caramazza, A.; Capasso, R.; Capitani, E.; Miceli, G.

    2005-01-01

    We tested the core prediction of the Trace Deletion Hypothesis (TDH) of agrammatic Broca's aphasia, which contends that such patients' comprehension performance is normal for active reversible sentences but at chance level for passive reversible sentences. We analyzed the comprehension performance of 38 Italian Broca's aphasics with verified…

  10. Semantic Interference during Object Naming in Agrammatic and Logopenic Primary Progressive Aphasia (PPA)

    ERIC Educational Resources Information Center

    Thompson, Cynthia K.; Cho, Soojin; Price, Charis; Wieneke, Christina; Bonakdarpour, Borna; Rogalski, Emily; Weintraub, Sandra; Mesulam, M-Marsel

    2012-01-01

    This study examined the time course of object naming in 21 individuals with primary progressive aphasia (PPA) (8 agrammatic (PPA-G); 13 logopenic (PPA-L)) and healthy age-matched speakers (n=17) using a semantic interference paradigm with related and unrelated interfering stimuli presented at stimulus onset asynchronies (SOAs) of -1000, -500, -100…

  11. Training and Generalized Production of wh- and NP-Movement Structures in Agrammatic Aphasia.

    ERIC Educational Resources Information Center

    Thompson, Cynthia K.; And Others

    1997-01-01

    Production of complex sentences was studied in two men with agrammatic aphasia. The influence of training question production (wh)-movement structures on untrained wh-movement structures and on noun phrases (NP)-movement structures was investigated. Results indicate that movement to an argument position, as in NP-movement, is distinct from a…

  12. Patterns of Comprehension Performance in Agrammatic Broca's Aphasia: A Test of the Trace Deletion Hypothesis

    ERIC Educational Resources Information Center

    Caramazza, A.; Capasso, R.; Capitani, E.; Miceli, G.

    2005-01-01

    We tested the core prediction of the Trace Deletion Hypothesis (TDH) of agrammatic Broca's aphasia, which contends that such patients' comprehension performance is normal for active reversible sentences but at chance level for passive reversible sentences. We analyzed the comprehension performance of 38 Italian Broca's aphasics with verified…

  13. Verbs: some properties and their consequences for agrammatic Broca's aphasia

    PubMed Central

    Bastiaanse, Roelien; Rispens, Judith; Ruigendijk, Esther; Rabadaán, Oneésimo Juncos; Thompson, Cynthia K.

    2011-01-01

    It has repeatedly been shown that agrammatic Broca's aphasics have serious problems with the retrieval of verbs on action naming tests (Miceli, Silveri, Villa & Caramazza, 1984; Kohn, Lorch & Pearson, 1989; Basso, Razzano, Faglioni & Zanobio, 1990; Jonkers, 1998; Kim & Thompson, 2000). Less attention has been paid to the production of verbs at the sentence level (but see Miceli, Mazzuchi, Menn & Goodglass, 1983; Thompson, Shapiro, Li & Schendel, 1995; Thompson, Lange, Schneider & Shapiro, 1997; Bastiaanse & Van Zonneveld, 1998; Bastiaanse, Rispens & Van Zonneveld, 2000; Friedmann, 2000), although it has been mentioned that in agrammatic spontaneous speech verbs are lacking (Saffran, Berndt & Schwartz, 1989; Thompson et al., 1995, but see Bastiaanse & Jonkers, 1998). In this paper, three cross-linguistic studies are discussed to show that these problems with verbs have consequences for other grammatical morphemes and structures that have been mentioned to be impaired in agrammatic speech and that these consequences are different per language, depending on linguistic characteristics. The first study focuses on finiteness and compares the production of finite verbs in matrix and embedded clauses in Dutch and English, showing that a linguistic rule in Dutch (Verb Second), which does not exist in English, can explain the different performance of Dutch and English agrammatic Broca's aphasics. The second study focuses on determiners and (finite) verbs in German and shows that poor determiner production is directly related to poor verb production. The last study demonstrates that the ability to construct negative sentences is dependent on the language specific relation between verb movement and negation: Dutch and Norwegian agrammatics perform equally well on affirmative and negative sentences, whereas English and Spanish agrammatics are more impaired on negative sentences. Overall, these studies show that the problems agrammatics encounter with verbs and their properties

  14. Grammatical Encoding and Learning in Agrammatic Aphasia: Evidence from Structural Priming.

    PubMed

    Cho-Reyes, Soojin; Mack, Jennifer E; Thompson, Cynthia K

    2016-12-01

    The present study addressed open questions about the nature of sentence production deficits in agrammatic aphasia. In two structural priming experiments, 13 aphasic and 13 age-matched control speakers repeated visually- and auditorily-presented prime sentences, and then used visually-presented word arrays to produce dative sentences. Experiment 1 examined whether agrammatic speakers form structural and thematic representations during sentence production, whereas Experiment 2 tested the lasting effects of structural priming in lags of two and four sentences. Results of Experiment 1 showed that, like unimpaired speakers, the aphasic speakers evinced intact structural priming effects, suggesting that they are able to generate such representations. Unimpaired speakers also evinced reliable thematic priming effects, whereas agrammatic speakers did so in some experimental conditions, suggesting that access to thematic representations may be intact. Results of Experiment 2 showed structural priming effects of comparable magnitude for aphasic and unimpaired speakers. In addition, both groups showed lasting structural priming effects in both lag conditions, consistent with implicit learning accounts. In both experiments, aphasic speakers with more severe language impairments exhibited larger priming effects, consistent with the "inverse preference" prediction of implicit learning accounts. The findings indicate that agrammatic speakers are sensitive to structural priming across levels of representation and that such effects are lasting, suggesting that structural priming may be beneficial for the treatment of sentence production deficits in agrammatism.

  15. Production of non-canonical sentences in agrammatic aphasia: limits in representation or rule application?

    PubMed

    Burchert, Frank; Meissner, Nadine; De Bleser, Ria

    2008-02-01

    The study reported here compares two linguistically informed hypotheses on agrammatic sentence production, the TPH [Friedmann, N., & Grodzinsky, Y. (1997). Tense and agreement in agrammatic production: Pruning the syntactic tree. Brain and Language, 56, 397-425.] and the DOP [Bastiaanse, R., & van Zonneveld, R. (2005). Sentence production with verbs of alternating transitivity in agrammatic Broca's aphasia. Journal of Neurolinguistics, 18, 59-66]. To explain impaired production of non-canonical sentences in agrammatism, the TPH basically relies on deleted or pruned clause structure positions in the left periphery, whereas the DOP appeals to limitations in the application of movement rules. Certain non-canonical sentences such as object-questions and object-relative clauses require the availability of nodes in the left periphery as well as movement to these nodes. In languages with relatively fixed word order such as English, the relevant test cases generally involve a coincidence of left periphery and movement, such that the predictions of the TPH and the DOP are identical although for different reasons. In languages with relatively free word order such as German, on the other hand, it is possible to devise specific tests of the different predictions due to the availability of scrambling. Scrambled object sentences, for example, do not involve the left periphery but do require application of movement in a domain below the left periphery. A study was conducted with German agrammatic subjects which elicited canonical sentences without object movement and non-canonical scrambled sentences with object movement. The results show that agrammatic speakers have a particular problem with the production of scrambled sentences. Further evidence reported in the study from spontaneous speech, elicitation of object relatives, questions and passives and with different agrammatic subjects confirms that non-canonical sentences are generally harder to produce for agrammatics. These

  16. Extended turn construction and test question sequences in the conversations of three speakers with agrammatic aphasia

    PubMed Central

    Beckley, Firle; Best, Wendy; Johnson, Fiona; Edwards, Susan; Maxim, Jane

    2013-01-01

    The application of Conversation Analysis (CA) to the investigation of agrammatic aphasia reveals that utterances produced by speakers with agrammatism engaged in everyday conversation differ significantly from utterances produced in response to decontextualised assessment and therapy tasks. Early studies have demonstrated that speakers with agrammatism construct turns from sequences of nouns, adjectives, discourse markers and conjunctions, packaged by a distinct pattern of prosody. This article presents examples of turn construction methods deployed by three people with agrammatism as they take an extended turn, in order to recount a past event, initiate a discussion or have a disagreement. This is followed by examples of sequences occurring in the talk of two of these speakers that result in different, and more limited, turn construction opportunities, namely “test” questions asked in order to initiate a new topic of talk, despite the conversation partner knowing the answer. The contrast between extended turns and test question sequences illustrates the effect of interactional context on aphasic turn construction practices, and the potential of less than optimal sequences to mask turn construction skills. It is suggested that the interactional motivation for test question sequences in these data are to invite people with aphasia to contribute to conversation, rather than to practise saying words in an attempt to improve language skills. The idea that test question sequences may have their origins in early attempts to deal with acute aphasia, and the potential for conversation partnerships to become “stuck” in such interactional patterns after they may have outlived their usefulness, are discussed with a view to clinical implications. PMID:23848370

  17. Phonological facilitation of object naming in agrammatic and logopenic primary progressive aphasia (PPA)

    PubMed Central

    Mack, Jennifer E.; Cho-Reyes, Soojin; Kloet, James D.; Weintraub, Sandra; Mesulam, M-Marsel; Thompson, Cynthia K.

    2013-01-01

    Phonological processing deficits are characteristic of both the agrammatic and logopenic subtypes of primary progressive aphasia (PPA-G and PPA-L). However, it is an open question which substages of phonological processing (i.e., phonological word form retrieval, phonological encoding) are impaired in these subtypes of PPA, as well as how phonological processing deficits contribute to anomia. In the present study, participants with PPA-G (n=7), PPA-L (n=7), and unimpaired controls (n=17) named objects as interfering written words (phonologically related/unrelated) were presented at different stimulus onset asynchronies (SOAs) of 0, +100, +300, and +500 ms. Phonological facilitation (PF) effects (faster naming times with phonologically related interfering words) were found for the controls and PPA-L group only at SOA=0 and +100 ms. However, the PPA-G group exhibited protracted PF effects (PF at SOA=0, +100, and +300 ms). These results may reflect deficits in phonological encoding in PPA-G, but not in PPA-L, supporting the neuropsychological reality of this substage of phonological processing and the distinction between these two PPA subtypes. PMID:24070176

  18. Semantic interference during object naming in agrammatic and logopenic primary progressive aphasia (PPA).

    PubMed

    Thompson, Cynthia K; Cho, Soojin; Price, Charis; Wieneke, Christina; Bonakdarpour, Borna; Rogalski, Emily; Weintraub, Sandra; Mesulam, M-Marsel

    2012-03-01

    This study examined the time course of object naming in 21 individuals with primary progressive aphasia (PPA) (8 agrammatic (PPA-G); 13 logopenic (PPA-L)) and healthy age-matched speakers (n=17) using a semantic interference paradigm with related and unrelated interfering stimuli presented at stimulus onset asynchronies (SOAs) of -1000, -500, -100 and 0 ms. Results showed semantic interference (SI) (i.e. significantly slower RTs in related compared to unrelated conditions) for all groups at -500, -100 and 0 ms, indicating timely spreading activation to semantic competitors. However, both PPA groups showed a greater magnitude of SI than normal across SOAs. The PPA-L group and six PPA-G participants also evinced SI at -1000 ms, suggesting an abnormal time course of semantic interference resolution, and concomitant left hemisphere cortical atrophy in brain regions associated with semantic processing. These subtle semantic mapping impairments in non-semantic variants of PPA may contribute to the anomia of these patients. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. Semantic Interference during Object Naming in Agrammatic and Logopenic Primary Progressive Aphasia (PPA)

    PubMed Central

    Thompson, Cynthia K.; Cho, Soojin; Price, Charis; Wieneke, Christina; Bonakdarpour, Borna; Rogalski, Emily; Weintraub, Sandra; Mesulam, M-Marsel

    2011-01-01

    This study examined the time course of object naming in 21 individuals with primary progressive aphasia (PPA) (8 agrammatic (PPA-G); 13 logopenic (PPA-G)) and healthy age-matched speakers (n=17) using a semantic interference paradigm with related and unrelated interfering stimuli presented at stimulus onset asynchronies (SOAs) of −1000, −500, −100 and 0 ms. Results showed semantic interference (SI) (i.e. significantly slower RTs in related compared to unrelated conditions) for all groups at −500, −100 and 0 ms, indicating timely spreading activation to semantic competitors. However, both PPA groups showed a greater magnitude of SI than normal across SOAs. The PPA-L group and six PPA-G participants also evinced SI at −1000 ms, suggesting an abnormal time course of semantic interference resolution, and concomitant left hemisphere cortical atrophy in brain regions associated with semantic processing. These subtle semantic mapping impairments in non-semantic variants of PPA may contribute to the anomia of these patients. PMID:22244508

  20. Phonological facilitation effects on naming latencies and viewing times during noun and verb naming in agrammatic and anomic aphasia.

    PubMed

    Lee, Jiyeon; Thompson, Cynthia K

    Phonological priming has been shown to facilitate naming in individuals with aphasia as well as healthy speakers, resulting in faster naming latencies. However, the mechanisms of phonological facilitation (PF) in aphasia remain unclear. Within discrete vs. interactive models of lexical access, this study examined whether PF occurs via the sub-lexical or lexical route during noun and verb naming in agrammatic and anomic aphasia. Thirteen participants with agrammatic aphasia and 10 participants with anomic aphasia and their young and age-matched controls (n=20/each) were tested. Experiment 1 examined noun and verb naming deficit patterns in an off-line confrontation naming task. Experiment 2 examined PF effects on naming both word categories using eyetracking priming paradigm. Results of Experiment 1 showed greater naming difficulty for verbs than for nouns in the agrammatic group, with no difference between the two word categories in the anomic group. For both participant groups, errors were dominated by semantic paraphasias, indicating impaired lexical selection. In the phonological priming task (Experiment 2), young and age-matched control groups showed PF in both noun and verb naming. Interestingly, the agrammatic group showed PF when naming verbs, but not nouns, whereas the anomic group showed PF for nouns only. Consistent with lexically mediated PF in interactive models of lexical access, selective PF for different word categories in our agrammatic and anomic groups suggest that phonological primes facilitate lexical selection via feedback activation, resulting in greater PF for more difficult (i.e., verbs in agrammatic and possibly nouns in anomic group) lexical items.

  1. Phonological facilitation effects on naming latencies and viewing times during noun and verb naming in agrammatic and anomic aphasia

    PubMed Central

    Lee, Jiyeon; Thompson, Cynthia K.

    2015-01-01

    Background Phonological priming has been shown to facilitate naming in individuals with aphasia as well as healthy speakers, resulting in faster naming latencies. However, the mechanisms of phonological facilitation (PF) in aphasia remain unclear. Aims Within discrete vs. interactive models of lexical access, this study examined whether PF occurs via the sub-lexical or lexical route during noun and verb naming in agrammatic and anomic aphasia. Methods and Procedures Thirteen participants with agrammatic aphasia and 10 participants with anomic aphasia and their young and age-matched controls (n=20/each) were tested. Experiment 1 examined noun and verb naming deficit patterns in an off-line confrontation naming task. Experiment 2 examined PF effects on naming both word categories using eyetracking priming paradigm. Results Results of Experiment 1 showed greater naming difficulty for verbs than for nouns in the agrammatic group, with no difference between the two word categories in the anomic group. For both participant groups, errors were dominated by semantic paraphasias, indicating impaired lexical selection. In the phonological priming task (Experiment 2), young and age-matched control groups showed PF in both noun and verb naming. Interestingly, the agrammatic group showed PF when naming verbs, but not nouns, whereas the anomic group showed PF for nouns only. Conclusions Consistent with lexically mediated PF in interactive models of lexical access, selective PF for different word categories in our agrammatic and anomic groups suggest that phonological primes facilitate lexical selection via feedback activation, resulting in greater PF for more difficult (i.e., verbs in agrammatic and possibly nouns in anomic group) lexical items. PMID:26412922

  2. The New Classification of Primary Progressive Aphasia into Semantic, Logopenic, or Nonfluent/Agrammatic Variants

    PubMed Central

    Bonner, Michael F.; Ash, Sharon

    2010-01-01

    Primary progressive aphasia (PPA), typically resulting from a neurodegenerative disease such as frontotemporal lobar degeneration or Alzheimer’s disease, is characterized by a progressive loss of specific language functions with relative sparing of other cognitive domains. Three variants of PPA are now recognized: semantic variant, logopenic variant, and nonfluent/agrammatic variant. We discuss recent work characterizing the neurolinguistic, neuropsychological, imaging and pathologic profiles associated with these variants. Improved reliability of diagnoses will be increasingly important as trials for etiology-specific treatments become available. We also discuss the implications of these syndromes for theories of language function. PMID:20809401

  3. Apraxia of Speech and Phonological Errors in the Diagnosis of Nonfluent/Agrammatic and Logopenic Variants of Primary Progressive Aphasia

    ERIC Educational Resources Information Center

    Croot, Karen; Ballard, Kirrie; Leyton, Cristian E.; Hodges, John R.

    2012-01-01

    Purpose: The International Consensus Criteria for the diagnosis of primary progressive aphasia (PPA; Gorno-Tempini et al., 2011) propose apraxia of speech (AOS) as 1 of 2 core features of nonfluent/agrammatic PPA and propose phonological errors or absence of motor speech disorder as features of logopenic PPA. We investigated the sensitivity and…

  4. Apraxia of Speech and Phonological Errors in the Diagnosis of Nonfluent/Agrammatic and Logopenic Variants of Primary Progressive Aphasia

    ERIC Educational Resources Information Center

    Croot, Karen; Ballard, Kirrie; Leyton, Cristian E.; Hodges, John R.

    2012-01-01

    Purpose: The International Consensus Criteria for the diagnosis of primary progressive aphasia (PPA; Gorno-Tempini et al., 2011) propose apraxia of speech (AOS) as 1 of 2 core features of nonfluent/agrammatic PPA and propose phonological errors or absence of motor speech disorder as features of logopenic PPA. We investigated the sensitivity and…

  5. Conversation focused aphasia therapy: investigating the adoption of strategies by people with agrammatism

    PubMed Central

    Beeke, Suzanne; Beckley, Firle; Johnson, Fiona; Heilemann, Claudia; Edwards, Susan; Maxim, Jane; Best, Wendy

    2015-01-01

    Background: A recent review of interaction (or conversation)-focused therapy highlighted the potential of programmes targeting the person with aphasia (PWA) directly. However, it noted the key limitations of current work in this field to be a reliance on single case analyses and qualitative evidence of change, a situation that is not unusual when a complex behavioural intervention is in the early stages of development and evaluation. Aims: This article aims to evaluate an intervention that targeted a PWA and their conversation partner (CP), a dyad, as equals in a novel conversation therapy for agrammatic aphasia, using both quantitative and qualitative evidence of change. The intervention aimed to increase the insight of a dyad into facilitator and barrier conversation behaviours, to increase the understanding of the effect of agrammatism on communication, and to support each speaker to choose three strategies to work on in therapy to increase mutual understanding and enhance conversation. Methods & Procedures: Quantitative and qualitative methods are used to analyse multiple pre-therapy and follow up assessments of conversation for two dyads. Outcomes & Results: Results show that one person with severe and chronic agrammatic aphasia was able to select and practise strategies that led to qualitative and quantitative changes in his post-therapy conversations. The other PWA showed a numerical increase in one of his three strategies post therapy, but no significant quantitative change. Although both CPs significantly reduced barrier behaviours in their post-therapy conversations, neither showed a significant increase in the strategies they chose to work on. For one CP, there was qualitative evidence of the use of different turn types. Conclusions: Individually tailored input from a speech and language therapist can assist some people with chronic agrammatism to develop conversational strategies that enhance communication. Outcomes are influenced by the severity and

  6. A Computational Evaluation of Sentence Processing Deficits in Aphasia

    ERIC Educational Resources Information Center

    Patil, Umesh; Hanne, Sandra; Burchert, Frank; De Bleser, Ria; Vasishth, Shravan

    2016-01-01

    Individuals with agrammatic Broca's aphasia experience difficulty when processing reversible non-canonical sentences. Different accounts have been proposed to explain this phenomenon. The Trace Deletion account (Grodzinsky, 1995, 2000, 2006) attributes this deficit to an impairment in syntactic representations, whereas others (e.g., Caplan,…

  7. A Computational Evaluation of Sentence Processing Deficits in Aphasia

    ERIC Educational Resources Information Center

    Patil, Umesh; Hanne, Sandra; Burchert, Frank; De Bleser, Ria; Vasishth, Shravan

    2016-01-01

    Individuals with agrammatic Broca's aphasia experience difficulty when processing reversible non-canonical sentences. Different accounts have been proposed to explain this phenomenon. The Trace Deletion account (Grodzinsky, 1995, 2000, 2006) attributes this deficit to an impairment in syntactic representations, whereas others (e.g., Caplan,…

  8. Pronominal Resolution and Gap Filling in Agrammatic Aphasia: Evidence from Eye Movements

    ERIC Educational Resources Information Center

    Thompson, Cynthia K.; Choy, Jungwon Janet

    2009-01-01

    This paper reports the results of three studies examining comprehension and real-time processing of pronominal (Experiment 1) and Wh-movement (Experiments 2 and 3) structures in agrammatic and unimpaired speakers using eyetracking. We asked the following questions: (a) Is off-line comprehension of these constructions impaired in agrammatic…

  9. In vivo signatures of nonfluent/agrammatic primary progressive aphasia caused by FTLD pathology

    PubMed Central

    Caso, Francesca; Mandelli, Maria Luisa; Henry, Maya; Gesierich, Benno; Bettcher, Brianne M.; Ogar, Jennifer; Filippi, Massimo; Comi, Giancarlo; Magnani, Giuseppe; Sidhu, Manu; Trojanowski, John Q.; Huang, Eric J.; Grinberg, Lea T.; Miller, Bruce L.; Dronkers, Nina; Seeley, William W.

    2014-01-01

    Objective: To identify early cognitive and neuroimaging features of sporadic nonfluent/agrammatic variant of primary progressive aphasia (nfvPPA) caused by frontotemporal lobar degeneration (FTLD) subtypes. Methods: We prospectively collected clinical, neuroimaging, and neuropathologic data in 11 patients with sporadic nfvPPA with FTLD-tau (nfvPPA-tau, n = 9) or FTLD–transactive response DNA binding protein pathology of 43 kD type A (nfvPPA-TDP, n = 2). We analyzed patterns of cognitive and gray matter (GM) and white matter (WM) atrophy at presentation in the whole group and in each pathologic subtype separately. We also considered longitudinal clinical data. Results: At first evaluation, regardless of pathologic FTLD subtype, apraxia of speech (AOS) was the most common cognitive feature and atrophy involved the left posterior frontal lobe. Each pathologic subtype showed few distinctive features. At presentation, patients with nfvPPA-tau presented with mild to moderate AOS, mixed dysarthria with prominent hypokinetic features, clear agrammatism, and atrophy in the GM of the left posterior frontal regions and in left frontal WM. While speech and language deficits were prominent early, within 3 years of symptom onset, all patients with nfvPPA-tau developed significant extrapyramidal motor signs. At presentation, patients with nfvPPA-TDP had severe AOS, dysarthria with spastic features, mild agrammatism, and atrophy in left posterior frontal GM only. Selective mutism occurred early, when general neurologic examination only showed mild decrease in finger dexterity in the right hand. Conclusions: Clinical features in sporadic nfvPPA caused by FTLD subtypes relate to neurodegeneration of GM and WM in frontal motor speech and language networks. We propose that early WM atrophy in nfvPPA is suggestive of FTLD-tau pathology while early selective GM loss might be indicative of FTLD-TDP. PMID:24353332

  10. Implicit and Explicit Learning in Individuals with Agrammatic Aphasia

    ERIC Educational Resources Information Center

    Schuchard, Julia; Thompson, Cynthia K.

    2014-01-01

    Implicit learning is a process of acquiring knowledge that occurs without conscious awareness of learning, whereas explicit learning involves the use of overt strategies. To date, research related to implicit learning following stroke has been largely restricted to the motor domain and has rarely addressed implications for language. The present…

  11. Implicit and Explicit Learning in Individuals with Agrammatic Aphasia

    ERIC Educational Resources Information Center

    Schuchard, Julia; Thompson, Cynthia K.

    2014-01-01

    Implicit learning is a process of acquiring knowledge that occurs without conscious awareness of learning, whereas explicit learning involves the use of overt strategies. To date, research related to implicit learning following stroke has been largely restricted to the motor domain and has rarely addressed implications for language. The present…

  12. Grammatical comprehension deficits in non-fluent/agrammatic primary progressive aphasia.

    PubMed

    Charles, Dorothy; Olm, Christopher; Powers, John; Ash, Sharon; Irwin, David J; McMillan, Corey T; Rascovsky, Katya; Grossman, Murray

    2014-03-01

    Grammatical comprehension difficulty is an essential supporting feature of the non-fluent/agrammatic variant of primary progressive aphasia (naPPA), but well-controlled clinical measures of grammatical comprehension are unavailable. To develop a measure of grammatical comprehension and examine this comparatively in PPA variants and behavioural-variant frontotemporal degeneration (bvFTD) and to assess the neuroanatomic basis for these deficits with volumetric grey matter atrophy and whole-brain fractional anisotropy (FA) in white matter tracts. Case-control study. Academic medical centre. 39 patients with variants of PPA (naPPA=12, lvPPA=15 and svPPA=12), 27 bvFTD patients without aphasia and 12 healthy controls. Grammatical comprehension accuracy. Patients with naPPA had selective difficulty understanding cleft sentence structures, while all PPA variants and patients with bvFTD were impaired with sentences containing a centre-embedded subordinate clause. Patients with bvFTD were also impaired understanding sentences involving short-term memory. Linear regressions related grammatical comprehension difficulty in naPPA to left anterior-superior temporal atrophy and reduced FA in corpus callosum and inferior frontal-occipital fasciculus. Difficulty with centre-embedded sentences in other PPA variants was related to other brain regions. These findings emphasise a distinct grammatical comprehension deficit in naPPA and associate this with interruption of a frontal-temporal neural network.

  13. Grammatical comprehension deficits in non-fluent/agrammatic primary progressive aphasia

    PubMed Central

    Charles, Dorothy; Olm, Christopher; Powers, John; Ash, Sharon; Irwin, David J; McMillan, Corey T; Rascovsky, Katya; Grossman, Murray

    2014-01-01

    Importance Grammatical comprehension difficulty is an essential supporting feature of the non-fluent/agrammatic variant of primary progressive aphasia (naPPA), but well-controlled clinical measures of grammatical comprehension are unavailable. Objective To develop a measure of grammatical comprehension and examine this comparatively in PPA variants and behavioural-variant frontotemporal degeneration (bvFTD) and to assess the neuroanatomic basis for these deficits with volumetric grey matter atrophy and whole-brain fractional anisotropy (FA) in white matter tracts. Design Case–control study. Setting Academic medical centre. Participants 39 patients with variants of PPA (naPPA=12, lvPPA=15 and svPPA=12), 27 bvFTD patients without aphasia and 12 healthy controls. Main outcome measure Grammatical comprehension accuracy. Results Patients with naPPA had selective difficulty understanding cleft sentence structures, while all PPA variants and patients with bvFTD were impaired with sentences containing a centre-embedded subordinate clause. Patients with bvFTD were also impaired understanding sentences involving short-term memory. Linear regressions related grammatical comprehension difficulty in naPPA to left anterior-superior temporal atrophy and reduced FA in corpus callosum and inferior frontal-occipital fasciculus. Difficulty with centre-embedded sentences in other PPA variants was related to other brain regions. Conclusions and relevance These findings emphasise a distinct grammatical comprehension deficit in naPPA and associate this with interruption of a frontal-temporal neural network. PMID:24039027

  14. What Goes Wrong during Passive Sentence Production in Agrammatic Aphasia: An Eyetracking Study

    PubMed Central

    Cho, Soojin; Thompson, Cynthia K.

    2010-01-01

    Background Production of passive sentences is often impaired in agrammatic aphasia and has been attributed both to an underlying structural impairment (e.g., Schwartz, Saffran, Fink, Myers, & Martin, 1994) and to a morphological deficit (e.g., Caplan & Hanna, 1998; Faroqi-Shah & Thompson, 2003). However, the nature of the deficit in passive sentence production is not clear due to methodological issues present in previous studies. Aims This study examined active and passive sentence production in nine agrammatic aphasic speakers under conditions of structural priming using eyetracking to test whether structural impairments occur independently of morphological impairments and whether the underlying nature of error types is reflected in on-line measures, i.e., eye movements and speech onset latencies. Methods & Procedures Nine participants viewed and listened to a prime sentence in either active or passive voice, and then repeated it aloud. Next, a target picture appeared on the computer monitor and participants were instructed to describe it using the primed sentence structure. Outcomes & Results Participants made substantial errors in sentence structure, i.e., passives with role reversals (RRs) and actives-for-passives, but few errors in passive morphology. Longer gaze durations to the first-produced noun for passives with RRs as compared to correct passives were found before and during speech. For actives-for-passives, however, this pattern was found during speech, but not before speech. Conclusions The deficit in passive sentence production does not solely arise from a morphological deficit, rather it stems, at least in part, from a structural level impairment. The underlying nature of passives with RRs is qualitatively different from that of actives-for-passives, which cannot be clearly differentiated with off-line testing methodology. PMID:21188294

  15. [Non-pharmacological therapies for language deficits in the agrammatic and logopenic variants of primary progressive aphasia: a literature review].

    PubMed

    Routhier, Sonia; Gravel-Laflamme, Karine; Macoir, Joël

    2013-03-01

    Primary progressive aphasia is a neurodegenerative condition characterised by a progressive and isolated disorder of expressive language, associated with atrophy of the left posterior frontoinsular region (nonfluent/agrammatic variant) or with atrophy of the left temporoparietal junction area (logopenic variant). This literature review reports studies about language therapies for these two variants of primary progressive aphasia. More precisely, the review presents the behavioral interventions and the augmentative/alternative communication tools reported in the literature to improve language performances or to compensate for language difficulties. Most of these studies reported that interventions are efficient. However, inconsistent results are found regarding maintenance of improvement and generalization to untreated language abilities. Other studies are still required to establish the clinical relevance of interventions for language and communication disorders in primary progressive aphasia. In these studies, the use of more ecological interventions focusing on the specific needs of people living with this disease should be specifically addressed.

  16. A Systematic Review on methods of evaluate sentence production deficits in agrammatic aphasia patients: Validity and Reliability issues

    PubMed Central

    Mehri, Azar; Jalaie, Shohreh

    2014-01-01

    Background: The grammar assessment in aphasia has been done by few standard tests, but today these tests cannot precise evaluate the sentence production in agrammatic patients. In this study, we review structures and contents of tests or tasks designed to find more frequent methods for sentence production ability in aphasia patients. Materials and Methods: We searched the Cochrane library, Medline by PubMed, Science Direct, Scopus, and Google Scholar from 1980 to October 1, 2013 and evaluated all of exist tests or tasks included in the articles and systematic reviews. The sentence production has been studied in three methods. It contains the use of sentence production in spontaneous speech, tasks designed and both methods. The quality of studies was assessed using Critical Appraisal Skills Program. Results: The 160 articles were reviewed and 38 articles were studied according to inclusion and exclusion criteria. They were classified into three categories based on assessment methods of sentence production. In 39.5% studies, researchers have used tasks designed, 7.9% articles have applied spontaneous speech and 52.6% articles have used both methods for evaluation production. Inter-rater reliability was between 90% and 100% and intra-rater reliability was between 96% and 98% in studied. Conclusion: Agrammatic aphasia has syntax disorders, especially in sentence production. Most researchers and clinicians used both methods for evaluation production. PMID:25535505

  17. Losing track of time? Processing of time reference inflection in agrammatic and healthy speakers of German.

    PubMed

    Bos, Laura S; Hanne, Sandra; Wartenburger, Isabell; Bastiaanse, Roelien

    2014-12-01

    Individuals with agrammatic aphasia (IWAs) have problems with grammatical decoding of tense inflection. However, these difficulties depend on the time frame that the tense refers to. Verb morphology with reference to the past is more difficult than with reference to the non-past, because a link needs to be made to the past event in discourse, as captured in the PAst DIscourse LInking Hypothesis (PADILIH; Bastiaanse, R., Bamyaci, E., Hsu, C., Lee, J., Yarbay Duman, T., Thompson, C. K., 2011. Time reference in agrammatic aphasia: A cross-linguistic study. J. Neurolinguist. 24, 652-673). With respect to reference to the (non-discourse-linked) future, data so far indicate that IWAs experience less difficulties as compared to past time reference (Bastiaanse, R., Bamyaci, E., Hsu, C., Lee, J., Yarbay Duman, T., Thompson, C. K., 2011. Time reference in agrammatic aphasia: A cross-linguistic study. J. Neurolinguist. 24, 652-673), supporting the assumptions of the PADILIH. Previous online studies of time reference in aphasia used methods such as reaction times analysis (e.g., Faroqi-Shah, Y., Dickey, M. W., 2009. On-line processing of tense and temporality in agrammatic aphasia. Brain Lang. 108, 97-111). So far, no such study used eye-tracking, even though this technique can bring additional insights (Burchert, F., Hanne, S., Vasishth, S., 2013. Sentence comprehension disorders in aphasia: the concept of chance performance revisited. Aphasiology 27, 112-125, doi:10.1080/02687038.2012.730603). This study investigated (1) whether processing of future and past time reference inflection differs between non-brain-damaged individuals (NBDs) and IWAs, and (2) underlying mechanisms of time reference comprehension failure by IWAs. A visual-world experiment combining sentence-picture matching and eye-tracking was administered to 12 NBDs and 6 IWAs, all native speakers of German. Participants heard German sentences with periphrastic future ('will+V') or periphrastic past ('has

  18. Decreased striatal dopamine transporter uptake in the non-fluent/agrammatic variant of primary progressive aphasia.

    PubMed

    Gil-Navarro, S; Lomeña, F; Cot, A; Lladó, A; Montagut, N; Castellví, M; Bosch, B; Rami, L; Antonell, A; Balasa, M; Pavia, J; Iranzo, A; Molinuevo, J L; Sánchez-Valle, R

    2013-11-01

    Patients with the non-fluent/agrammatic variant of primary progressive aphasia (nfvPPA) may develop atypical parkinsonian syndromes. However, there is no current biomarker to assess which patients are at high risk of developing parkinsonism. 123I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl)-nortropane (123I-FP-CIT)-SPECT detects striatal dopamine dysfunction in vivo. The objective of the present study was to study whether non-fluent/agrammatic patients without parkinsonism at baseline present decreased striatal 123I-FP-CIT uptake. Visual and semi-quantitative assessments of the striatal 123I-FP-CIT uptake ratio were carried out in 15 patients with nfvPPA, eight patients with the logopenic variant of PPA (lvPPA) and 18 controls. To rule out progranulin mutations or underlying Alzheimer's disease (AD), serum progranulin levels and cerebrospinal fluid (CSF) biomarkers of AD (Aβ42 , total-tau, phosphorylated-tau181 ) were determined. A second 123I-FP-CIT-SPECT analysis in the biomarker-enriched groups was also carried out. Patients with nfvPPA presented reduced striatal 123I-FP-CIT binding, especially in the left hemisphere (P = 0.002), compared with controls. All lvPPA patients had normal striatal 123I-FP-CIT uptake. 123I-FP-CIT striatal binding in nfvPPA patients with normal progranulin and CSF biomarker levels (nfvPPA/bio-) was also significantly reduced (P < 0.05) compared with lvPPA patients with positive AD biomarkers. Sixty-four per cent (9/14) of nfvPPA patients and 80% of nfvPPA/bio- patients (8/10) showed a diminished individual left striatal 123I-FP-CIT uptake ratio. On follow-up, seven nfvPPA/bio- patients developed parkinsonism (median 1.9 years; range 1.2-2.9), six of them with baseline reduced 123I-FP-CIT uptake. Reduced striatal tracer uptake in nfvPPA patients prior to clinical parkinsonism can be detected by 123I-FP-CIT-SPECT, especially in those with nfvPPA/bio-, suggesting subclinical nigrostriatal degeneration. Decreased striatal 123I

  19. Training and generalized production of wh- and NP-movement structures in agrammatic aphasia.

    PubMed

    Thompson, C K; Shapiro, L P; Ballard, K J; Jacobs, B J; Schneider, S S; Tait, M E

    1997-04-01

    The present research examines production of "complex" sentences, which involve movement of noun phrases (NPs), in 2 agrammatic aphasic subjects. According to linguistic theory (Chomsky, 1991, 1993), such sentences are derived using one of two movement operations, either wh- or NP-movement, subsumed under the general rule "move alpha." In this experiment recovery of both wh- and NP-movement derived sentences was investigated using a treatment research paradigm. Subjects were sequentially trained to produce either wh-movement (i.e., who questions, object clefts) or NP-movement (i.e., passives, subject-raising structures) derived sentences. Throughout training, generalization to untrained sentences relying on both types of movement was tested. The influence of training on aspects of narrative discourse also was examined. Results showed generalization patterns constrained to type of movement. Training wh-movement structures resulted in generalized production of untrained wh-movement structures without influencing production of NP-movement structures. Similarly, training of NP-movement structures resulted in generalization only to other sentence types also relying on NP-movement. Aspects of sentence production in narrative contexts also was improved with treatment. These data indicate that movement to an argument (A) position as in NP-movement is distinct from movement to a non-argument (A-bar) position, required in wh-movement. The site where movement terminates in the s-structure of noncanonical sentences appears to influence sentence production. These findings show that linguistic properties of sentences influence sentence production breakdown and recovery in aphasia.

  20. Sentence Comprehension in Agrammatic Aphasia: History and Variability to Clinical Implications

    ERIC Educational Resources Information Center

    Johnson, Danielle; Cannizzaro, Michael S.

    2009-01-01

    Individuals with Broca's aphasia often present with deficits in their ability to comprehend non-canonical sentences. This has been contrastingly characterized as a systematic loss of specific grammatical abilities or as individual variability in the dynamics between processing load and resource availability. The present study investigated sentence…

  1. Phonological processing in primary progressive aphasia

    PubMed Central

    Henry, M.L.; Wilson, S.M.; Babiak, M.C.; Mandelli, M.L; Beeson, P.M.; Miller, Z.A.; Gorno-Tempini, M.L.

    2016-01-01

    Individuals with primary progressive aphasia (PPA) show selective breakdown in regions within the proposed dorsal (articulatory-phonological) and ventral (lexical-semantic) pathways involved in language processing. Phonological short-term memory impairment, which has been attributed to selective damage to dorsal pathway structures, is considered to be a distinctive feature of the logopenic variant of PPA. By contrast, phonological abilities are considered to be relatively spared in the semantic variant and are largely unexplored in the nonfluent/agrammatic variant. Comprehensive assessment of phonological ability in the three variants of PPA has not been undertaken. We investigated phonological processing skills in a group of participants with PPA as well as healthy controls, with the goal of identifying whether patterns of performance support the dorsal versus ventral functional-anatomical framework and to discern whether phonological ability differs amongst PPA subtypes. We also explored the neural bases of phonological performance using voxel-based morphometry (VBM). Phonological performance was impaired in patients with damage to dorsal pathway structures (nonfluent/agrammatic and logopenic variants), with logopenic participants demonstrating particular difficulty on tasks involving nonwords. Binary logistic regression revealed that select phonological tasks predicted diagnostic group membership in the less fluent variants of PPA with a high degree of accuracy, particularly in conjunction with a motor speech measure. Brain-behavior correlations indicated a significant association between the integrity of gray matter in frontal and temporoparietal regions of the left hemisphere and phonological skill. Findings confirm the critical role of dorsal stream structures in phonological processing and demonstrate unique patterns of impaired phonological processing in logopenic and nonfluent/agrammatic variants of PPA. PMID:26544920

  2. Phonological Processing in Primary Progressive Aphasia.

    PubMed

    Henry, Maya L; Wilson, Stephen M; Babiak, Miranda C; Mandelli, Maria Luisa; Beeson, Pelagie M; Miller, Zachary A; Gorno-Tempini, Maria Luisa

    2016-02-01

    Individuals with primary progressive aphasia (PPA) show selective breakdown in regions within the proposed dorsal (articulatory-phonological) and ventral (lexical-semantic) pathways involved in language processing. Phonological STM impairment, which has been attributed to selective damage to dorsal pathway structures, is considered to be a distinctive feature of the logopenic variant of PPA. By contrast, phonological abilities are considered to be relatively spared in the semantic variant and are largely unexplored in the nonfluent/agrammatic variant. Comprehensive assessment of phonological ability in the three variants of PPA has not been undertaken. We investigated phonological processing skills in a group of participants with PPA as well as healthy controls, with the goal of identifying whether patterns of performance support the dorsal versus ventral functional-anatomical framework and to discern whether phonological ability differs among PPA subtypes. We also explored the neural bases of phonological performance using voxel-based morphometry. Phonological performance was impaired in patients with damage to dorsal pathway structures (nonfluent/agrammatic and logopenic variants), with logopenic participants demonstrating particular difficulty on tasks involving nonwords. Binary logistic regression revealed that select phonological tasks predicted diagnostic group membership in the less fluent variants of PPA with a high degree of accuracy, particularly in conjunction with a motor speech measure. Brain-behavior correlations indicated a significant association between the integrity of gray matter in frontal and temporoparietal regions of the left hemisphere and phonological skill. Findings confirm the critical role of dorsal stream structures in phonological processing and demonstrate unique patterns of impaired phonological processing in logopenic and nonfluent/agrammatic variants of PPA.

  3. Agrammatic aphasia verb and argument patterns in Kiswahili-English spontaneous language.

    PubMed

    Sang, Hillary K

    2015-06-08

    The spontaneous and narrative language of Kiswahili agrammatic aphasic and non-brain-damaged speakers was analysed. The bilingual participants were also tested in English to enable comparisons of verb production in the two languages. The significance of this study was to characterise bilingual Kiswahili-English spontaneous agrammatic output. This was done by describing Kiswahili-English bilingual output data with a specific focus on the production of verbs. The description involves comparison of verb and argument production in Kiswahili and English. The participants recruited for this study were drawn from two groups of participants (six non-fluent aphasic/agrammatic speakers and six non-brain-damaged). From each participant, a sample of spontaneous output was tape-recorded in English and Kiswahili based on the description and narration of the Flood rescue picture' and the 'Cookie theft picture'. The data elicited were compared for each subject and between the participants and relevant verb parameters have been analysed. The variables that were studied included mean length of utterance (MLU), inflectional errors, verb tokens and types, copulas and auxiliaries. Further, all verbs produced were classified as per their argument structure. The results from English data supported previous findings on agrammatic output. The agrammatic participants produced utterances with shorter MLU and simpler sentence structure. However, Kiswahili data surprisingly showed reversed results, with agrammatic speakers producing longer utterances than non-brain-damaged (NBD) controls. The results also revealed selective impairment in some agrammatic speakers who made inflectional errors. The verb argument structure showed contrasting results, with agrammatic speakers preferring transitive verbs whilst the NBD speakers used more intransitive verbs. The study attempts for the first time to characterise English-Kiswahili bilingual spontaneous and narrative output. A quantitative analysis of

  4. Wh interrogative production in agrammatic aphasia: an experimental analysis of auditory-visual stimulation and direct-production treatment.

    PubMed

    Thompson, C K; McReynolds, L V

    1986-06-01

    The effects of auditory-visual stimulation treatment derived from principles associated with a stimulation approach for aphasia treatment and direct-production treatment derived from a behavioral or learning approach were examined in 4 neurologically stable agrammatic aphasic subjects. Subjects were trained to produce selected exemplars of wh interrogative morphemes in complete sentence contexts, while the acquisition, response generalization (both within and across interrogative forms), stimulus generalization (to language samples), and maintenance effects of the two treatments were assessed. An alternating treatments design (ATD) in combination with a multiple-baseline design across behaviors and a multiple-baseline design across subjects was employed. Interrogative constructions were counterbalanced across subjects and treatments, and probes were administered daily to assess treatment effects. Results indicated that direct-production treatment was consistently more effective than auditory-visual stimulation treatment in facilitating acquisition of target responses for all subjects. Response generalization within interrogative forms paralleled acquisition regardless of treatment approach. Stimulus generalization to the elicited language-sample condition was not evident, however, trained responses were maintained subsequent to treatment. These data provided support for using direct-production treatment for interrogative intervention with agrammatic aphasic patients and indicated that training a selected number of exemplars of target interrogatives results in generalization of that question form to novel language responses. However, the lack of generalization across interrogatives indicated that wh interrogatives do not constitute a response class and, thus, pointed out a need for programming generalization to untrained members of that linguistic class and to spontaneous language.

  5. Neural mechanisms of verb argument structure processing in agrammatic aphasic and healthy age-matched listeners

    PubMed Central

    Thompson, C.K.; Bonakdarpour, B.; Fix, S.F.

    2010-01-01

    Processing of lexical verbs involves automatic access to argument structure entries entailed within the verb's representation. Recent neuroimaging studies with young normal listeners suggest that this involves bilateral posterior perisylvian tissue, with graded activation in these regions based on argument structure complexity. The aim of the present study was to examine the neural mechanisms of verb processing using functional magnetic resonance imaging (fMRI) in older normal volunteers and patients with stroke-induced agrammatic aphasia, a syndrome in which verb, as compared to noun, production often is selectively impaired, but verb comprehension in both on-line and off-line tasks is spared. Fourteen healthy listeners and five age-matched aphasic patients performed a lexical decision task, which examined verb processing by argument structure complexity, i.e., one-argument (i.e., intransitive (v1)); two-argument (i.e., transitive (v2)), and three-argument (v3) verbs. Results for the age-matched listeners largely replicated those for younger participants studied by Thompson et al. (2007): v3-v1 comparisons showed activation of the angular gyrus in both hemispheres and this same heteromodal region was activated in the left hemisphere in the (v2+v3)-v1 contrast. Similar results were derived for the agrammatic aphasic patients, however, activation was unilateral (in the right hemisphere for 3 participants) rather than bilateral likely because these patients' lesions extended to the left temporoparietal region. All performed the task with high accuracy and, despite differences in lesion site and extent, they recruited spared tissue in the same regions as healthy normals. Consistent with psycholinguistic models of sentence processing, these findings indicate that the posterior language network is engaged for processing verb argument structure and is crucial for semantic integration of argument structure information. PMID:19702460

  6. Case assignment in agrammatism.

    PubMed

    Ruigendijk, E; van Zonneveld, R; Bastiaanse, R

    1999-08-01

    Agrammatic speech is characterized by the omission and substitution of grammatical morphemes. Some recent papers suggest that certain patterns of omission and substitution are ruled by linguistic, that is, syntactic processes (e.g., Hagiwara, 1995; Friedmann & Grodzinsky, 1997; Bastiaanse & Van Zonneveld, 1998). In the present paper, the omission pattern of case markers in the spontaneous speech of Dutch and German speakers with agrammatic aphasia is analyzed within the framework of Chomsky's (1986) case theory, which says that every phonetically realized NP must receive (abstract) case. The inflected verb (I) assigns nominative case to the subject in the sentence, and the verb (V) assigns dative and accusative case to the indirect and direct object, respectively. This, in combination with the knowledge that verbs and verb inflections are notoriously difficult for speakers with agrammatism, served as the basis for this study. We hypothesize that, if no case assigner is produced, the noun will receive nominative case by default or the case marking morpheme (i.e., the determiner) will be omitted. This hypothesis has been tested and was supported by the data.

  7. Training wh-question production in agrammatic aphasia: analysis of argument and adjunct movement.

    PubMed

    Thompson, C K; Shapiro, L P; Tait, M E; Jacobs, B J; Schneider, S L

    1996-01-01

    The present research utilized aspects of the Principles and Parameters Approach (P&PA; Chomsky, 1991, 1993) in linguistic theory as well as findings from the psycholinguistic literature as a basis for examining sentence production in aphasic individuals. We examined the production of particular wh-movement constructions--wh-questions requiring movement of an argument noun phrase (i.e., who and what questions) and those which require adjunct movement (i.e., when and where questions). Using a single-subject experimental treatment paradigm, subjects were sequentially trained to produce these wh-questions and, throughout training, generalization to untrained wh-questions relying on similar wh-movement processes was tested. As well, the influence of training on aspects of narrative and conversational discourse was examined. Seven agrammatic aphasic subjects who evinced difficulty producing (and comprehending) "complex" sentences (e.g., passives, object relative clauses, wh-questions)--sentences that involve movement of noun phrases (NPs) out of their canonical positions, leaving behind a "trace" of that movement or "gap"--participated in the study. Subjects were trained to produce wh-questions by taking them through a series of steps emphasizing the lexical and syntactic properties (e.g., thematic role assignment, movement processes, and proper selection of wh-morpheme) of declarative sentence counterparts of target sentences. Results revealed improved sentence production abilities in all subjects under study in both constrained sentence production and, importantly, in discourse tasks. The argument/adjunct distinction was observed in the sentence production recovery patterns noted in six of the seven subjects. Three of the subjects evinced correct argument movement across trained and untrained question structures when wh-questions relying on argument movement were trained; similarly, for these subjects, training structures relying of adjunct movement resulted in

  8. The On-Line Processing of Unaccusativity in Greek Agrammatism

    ERIC Educational Resources Information Center

    Peristeri, Eleni; Tsimpli, Ianthi-Maria; Tsapkini, Kyrana

    2013-01-01

    We investigated the on-line processing of unaccusative and unergative sentences in a group of eight Greek-speaking individuals diagnosed with Broca aphasia and a group of language-unimpaired subjects used as the baseline. The processing of unaccusativity refers to the reactivation of the postverbal trace by retrieving the mnemonic representation…

  9. Disruption of large-scale neural networks in non-fluent/agrammatic variant primary progressive aphasia associated with frontotemporal degeneration pathology.

    PubMed

    Grossman, Murray; Powers, John; Ash, Sherry; McMillan, Corey; Burkholder, Lisa; Irwin, David; Trojanowski, John Q

    2013-11-01

    Non-fluent/agrammatic primary progressive aphasia (naPPA) is a progressive neurodegenerative condition most prominently associated with slowed, effortful speech. A clinical imaging marker of naPPA is disease centered in the left inferior frontal lobe. We used multimodal imaging to assess large-scale neural networks underlying effortful expression in 15 patients with sporadic naPPA due to frontotemporal lobar degeneration (FTLD) spectrum pathology. Effortful speech in these patients is related in part to impaired grammatical processing, and to phonologic speech errors. Gray matter (GM) imaging shows frontal and anterior-superior temporal atrophy, most prominently in the left hemisphere. Diffusion tensor imaging reveals reduced fractional anisotropy in several white matter (WM) tracts mediating projections between left frontal and other GM regions. Regression analyses suggest disruption of three large-scale GM-WM neural networks in naPPA that support fluent, grammatical expression. These findings emphasize the role of large-scale neural networks in language, and demonstrate associated language deficits in naPPA. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. DISRUPTION OF LARGE-SCALE NEURAL NETWORKS IN NON-FLUENT/AGRAMMATIC VARIANT PRIMARY PROGRESSIVE APHASIA ASSOCIATED WITH FRONTOTEMPORAL DEGENERATION PATHOLOGY

    PubMed Central

    Grossman, Murray; Powers, John; Ash, Sherry; McMillan, Corey; Burkholder, Lisa; Irwin, David; Trojanowski, John Q.

    2012-01-01

    Non-fluent/agrammatic primary progressive aphasia (naPPA) is a progressive neurodegenerative condition most prominently associated with slowed, effortful speech. A clinical imaging marker of naPPA is disease centered in the left inferior frontal lobe. We used multimodal imaging to assess large-scale neural networks underlying effortful expression in 15 patients with sporadic naPPA due to frontotemporal lobar degeneration (FTLD) spectrum pathology. Effortful speech in these patients is related in part to impaired grammatical processing, and to phonologic speech errors. Gray matter (GM) imaging shows frontal and anterior-superior temporal atrophy, most prominently in the left hemisphere. Diffusion tensor imaging reveals reduced fractional anisotropy in several white matter (WM) tracts mediating projections between left frontal and other GM regions. Regression analyses suggest disruption of three large-scale GM-WM neural networks in naPPA that support fluent, grammatical expression. These findings emphasize the role of large-scale neural networks in language, and demonstrate associated language deficits in naPPA. PMID:23218686

  11. The Time-Course of Lexical Activation During Sentence Comprehension in People With Aphasia

    PubMed Central

    Ferrill, Michelle; Love, Tracy; Walenski, Matthew; Shapiro, Lewis P.

    2012-01-01

    Purpose To investigate the time-course of processing of lexical items in auditorily presented canonical (subject–verb–object) constructions in young, neurologically unimpaired control participants and participants with left-hemisphere damage and agrammatic aphasia. Method A cross modal picture priming (CMPP) paradigm was used to test 114 control participants and 8 participants with agrammatic aphasia for priming of a lexical item (direct object noun) immediately after it is initially encountered in the ongoing auditory stream and at 3 additional time points at 400-ms intervals. Results The control participants demonstrated immediate activation of the lexical item, followed by a rapid loss (decay). The participants with aphasia demonstrated delayed activation of the lexical item. Conclusion This evidence supports the hypothesis of a delay in lexical activation in people with agrammatic aphasia. The delay in lexical activation feeds syntactic processing too slowly, contributing to comprehension deficits in people with agrammatic aphasia. PMID:22355007

  12. Case Assignment in Agrammatism.

    ERIC Educational Resources Information Center

    Ruigendijk, Esther; van Zonneveld, Ron; Bastiaanse, Roelien

    1999-01-01

    This study evaluated the omission patterns of case markers in the spontaneous speech of 12 Dutch and German adult speakers with agrammatic aphasia within the framework of Chomsky's case theory. Data supported the hypothesis that, if no case assigner is produced, the noun will receive nominative case by default or the case-marking morpheme will be…

  13. Syntactic and morphosyntactic processing in stroke-induced and primary progressive aphasia.

    PubMed

    Thompson, Cynthia K; Meltzer-Asscher, Aya; Cho, Soojin; Lee, Jiyeon; Wieneke, Christina; Weintraub, Sandra; Mesulam, M-Marsel

    2013-01-01

    The paper reports findings derived from three experiments examining syntactic and morphosyntactic processing in individuals with agrammatic and logopenic variants of primary progressive aphasia (PPA-G and PPA-L, respectively) and stroke-induced agrammatic and anomic aphasia (StrAg and StrAn, respectively). We examined comprehension and production of canonical and noncanonical sentence structures and production of tensed and nontensed verb forms using constrained tasks in experiments 1 and 2, using the Northwestern Assessment of Verbs and Sentences (NAVS [57]) and the Northwestern Assessment of Verb Inflection (NAVI, Thompson and Lee, experimental version) test batteries, respectively. Experiment 3 examined free narrative samples, focusing on syntactic and morphosyntactic measures, i.e. production of grammatical sentences, noun to verb ratio, open-class to closed-class word production ratio, and the production of correctly inflected verbs. Results indicate that the two agrammatic groups (i.e., PPA-G and StrAg) pattern alike on syntactic and morphosyntactic measures, showing more impaired noncanonical compared to canonical sentence comprehension and production and greater difficulties producing tensed compared to nontensed verb forms. Their spontaneous speech also contained significantly fewer grammatical sentences and correctly inflected verbs, and they produced a greater proportion of nouns compared to verbs, than healthy speakers. In contrast, PPA-L and StrAn individuals did not display these deficits, and performed significantly better than the agrammatic groups on these measures. The findings suggest that agrammatism, whether induced by degenerative disease or stroke, is associated with characteristic deficits in syntactic and morphosyntactic processing. We therefore recommend that linguistically sophisticated tests and narrative analysis procedures be used to systematically evaluate the linguistic ability of individuals with PPA, contributing to our

  14. Syntactic and Morphosyntactic Processing in Stroke-Induced and Primary Progressive Aphasia

    PubMed Central

    Thompson, Cynthia K.; Meltzer-Asscher, Aya; Cho, Soojin; Lee, Jiyeon; Wieneke, Christina; Weintraub, Sandra; Mesulam, M.-Marsel

    2013-01-01

    The paper reports findings derived from three experiments examining syntactic and morphosyntactic processing in individuals with agrammatic and logopenic variants of primary progressive aphasia (PPA-G and PPA-L, respectively) and stroke-induced agrammatic and anomic aphasia (StrAg and StrAn, respectively). We examined comprehension and production of canonical and noncanonical sentence structures and production of tensed and nontensed verb forms using constrained tasks in experiments 1 and 2, using the Northwestern Assessment of Verbs and Sentences (NAVS [57]) and the Northwestern Assessment of Verb Inflection (NAVI, Thompson and Lee, experimental version) test batteries, respectively. Experiment 3 examined free narrative samples, focusing on syntactic and morphosyntactic measures, i.e. production of grammatical sentences, noun to verb ratio, open-class to closed-class word production ratio, and the production of correctly inflected verbs. Results indicate that the two agrammatic groups (i.e., PPA-G and StrAg) pattern alike on syntactic and morphosyntactic measures, showing more impaired noncanonical compared to canonical sentence comprehension and production and greater difficulties producing tensed compared to nontensed verb forms. Their spontaneous speech also contained significantly fewer grammatical sentences and correctly inflected verbs, and they produced a greater proportion of nouns compared to verbs, than healthy speakers. In contrast, PPA-L and StrAn individuals did not display these deficits, and performed significantly better than the agrammatic groups on these measures. The findings suggest that agrammatism, whether induced by degenerative disease or stroke, is associated with characteristic deficits in syntactic and morphosyntactic processing. We therefore recommend that linguistically sophisticated tests and narrative analysis procedures be used to systematically evaluate the linguistic ability of individuals with PPA, contributing to our

  15. Neural plasticity and treatment-induced recovery of sentence processing in agrammatism

    PubMed Central

    Thompson, Cynthia K.; Ouden, Dirk-Bart den; Bonakdarpour, Borna; Garibaldi, Kyla; Parrish, Todd B.

    2010-01-01

    This study examined patterns of neural activation associated with treatment-induced improvement of complex sentence production (and comprehension) in six individuals with stroke-induced agrammatic aphasia, taking into account possible alterations in blood flow often associated with stroke, including delayed time-to-peak of the hemodynamic response function (HRF) and hypoperfused tissue. Aphasic participants performed an auditory verification fMRI task, processing object cleft, subject cleft, and simple active sentences, prior to and following a course of Treatment of Underlying Forms (TUF; Thompson et al., 2003), a linguistically based approach for treating aphasic sentence deficits, which targeted object relative clause constructions. The patients also were scanned in a long-trials task to examine HRFs, to account for any local deviations resulting from stroke, and perfusion images were obtained to evaluate regions of hypoperfused tissue. Region-of-interest (ROI) analyses were conducted (bilaterally), modeling participant-specific local HRFs in left hemisphere areas activated by 12 healthy age-matched volunteers performing the same task, including the middle and inferior frontal gyri, precentral gyrus, middle and superior temporal gyri, and insula, and additional regions associated with complex syntactic processing, including the posterior perisylvian and superior parietal cortices. Results showed that, despite individual variation in activation differences from pre- to post-treatment scans in the aphasic participants, main-effects analyses revealed a general shift from left superior temporal activation to more posterior temporoparietal areas, bilaterally. Time-to-peak of these responses correlated negatively with blood flow, as measured with perfusion imaging. PMID:20603138

  16. Agrammatism in aphasiology.

    PubMed

    Goodglass, H

    1997-01-01

    Agrammatism is a pattern of syntactically defective speech that is frequently observed as a prominent feature in Broca's aphasia. It may range in severity from one-word utterances, completely lacking in grammatical organization, to mildly 'telegraphic' speech. First described in the early 19th century, it was originally interpreted by Pick as being due to economy of effort in finding words. Beginning with Jakobson, in 1956, there have been a succession of efforts to give an account of it in terms of linguistic theory. While the theories are still controversial, they have led to much more detailed and systematic description of the linguistic output in agrammatic speech. Cross linguistic comparisons have revealed that the features of agrammatism are not fixed, but are conditioned by the grammatical structure of the speaker's language.

  17. Features of Patients With Nonfluent/Agrammatic Primary Progressive Aphasia With Underlying Progressive Supranuclear Palsy Pathology or Corticobasal Degeneration.

    PubMed

    Santos-Santos, Miguel A; Mandelli, Maria Luisa; Binney, Richard J; Ogar, Jennifer; Wilson, Stephen M; Henry, Maya L; Hubbard, H Isabel; Meese, Minerva; Attygalle, Suneth; Rosenberg, Lynne; Pakvasa, Mikhail; Trojanowski, John Q; Grinberg, Lea T; Rosen, Howie; Boxer, Adam L; Miller, Bruce L; Seeley, William W; Gorno-Tempini, Maria Luisa

    2016-06-01

    We provide novel evidence of specific clinical and neuroimaging features that may help for the in vivo prediction of underlying pathology in patients with nonfluent/agrammatic primary progressive aphasia (nfvPPA) and progressive supranuclear palsy (PSP) or corticobasal degeneration (CBD) proved by autopsy. To characterize the neurological, cognitive, and neuroimaging features of patients with nfvPPA-in whom either PSP or CBD was eventually confirmed at autopsy-at initial presentation and at 1-year follow-up. A prospective longitudinal clinical-pathological study was conducted in a tertiary research clinic that specialized in cognitive disorders. Fourteen patients were evaluated between January 2002 and December 2014. Inclusion criteria for the study were a clinical diagnosis of nfvPPA; the availability of speech, language, and cognitive testing for at least 1 evaluation; magnetic resonance imaging within 6 months of initial evaluation; and a postmortem pathological diagnosis of PSP or CBD. Ten matched healthy control participants were also included. Clinical, cognitive, and neuroimaging longitudinal data were analyzed to characterize the whole nfvPPA-4-repeat-tau group and identify differences between nfvPPA-PSP and nfvPPA-CBD both at presentation and longitudinally. Patient groups did not differ significantly in age, sex, or handedness (nfvPPA-PSP group: median [interquartile range (IQR)] age, 74 [67-76] years; 1 of 5 male [20%]; 1 of 5 left-handed [20%]; and nfvPPA-CBD group: mean [IQR] age, 65 [54-81] years; 3 of 9 male [33%]; 0 left-handed). Motor speech impairment and left frontal white matter atrophy were the most prominent common features. At presentation, dysarthria (Motor Speech Examination median [IQR] score: nfvPPA-PSP, 4 [2-7]; nfvPPA-CBD, 0 [0-4]; P = .02), depression (Geriatric Depression Scale median [IQR] score: nfvPPA-PSP, 19 [3-28]; nfvPPA-CBD, 4 [0-16]; P = .04), and relatively selective white matter atrophy were typical of the nfv

  18. Morphological and Phonological Factors in the Production of Verbal Inflection in Adult L2 Learners and Patients with Agrammatic Aphasia

    ERIC Educational Resources Information Center

    Szupica-Pyrzanowski, Malgorzata

    2009-01-01

    Failure to supply inflection is common in adult L2 learners of English and agrammatic aphasics (AAs), who are known to resort to bare verb forms. Among attempts to explain the absence of inflection are competing morphological and phonological explanations. In the L2 acquisition literature, omission of inflection is explained in terms of: mapping…

  19. Core auditory processing deficits in primary progressive aphasia

    PubMed Central

    Grube, Manon; Bruffaerts, Rose; Schaeverbeke, Jolien; Neyens, Veerle; De Weer, An-Sofie; Seghers, Alexandra; Bergmans, Bruno; Dries, Eva; Griffiths, Timothy D.

    2016-01-01

    The extent to which non-linguistic auditory processing deficits may contribute to the phenomenology of primary progressive aphasia is not established. Using non-linguistic stimuli devoid of meaning we assessed three key domains of auditory processing (pitch, timing and timbre) in a consecutive series of 18 patients with primary progressive aphasia (eight with semantic variant, six with non-fluent/agrammatic variant, and four with logopenic variant), as well as 28 age-matched healthy controls. We further examined whether performance on the psychoacoustic tasks in the three domains related to the patients’ speech and language and neuropsychological profile. At the group level, patients were significantly impaired in the three domains. Patients had the most marked deficits within the rhythm domain for the processing of short sequences of up to seven tones. Patients with the non-fluent variant showed the most pronounced deficits at the group and the individual level. A subset of patients with the semantic variant were also impaired, though less severely. The patients with the logopenic variant did not show any significant impairments. Significant deficits in the non-fluent and the semantic variant remained after partialling out effects of executive dysfunction. Performance on a subset of the psychoacoustic tests correlated with conventional verbal repetition tests. In sum, a core central auditory impairment exists in primary progressive aphasia for non-linguistic stimuli. While the non-fluent variant is clinically characterized by a motor speech deficit (output problem), perceptual processing of tone sequences is clearly deficient. This may indicate the co-occurrence in the non-fluent variant of a deficit in working memory for auditory objects. Parsimoniously we propose that auditory timing pathways are altered, which are used in common for processing acoustic sequence structure in both speech output and acoustic input. PMID:27060523

  20. Treatment of Aphasia: A Process Approach.

    ERIC Educational Resources Information Center

    Hagen, Chris

    1988-01-01

    The recommended treatment approach for aphasia involves increasing the efficiency of language processing by manipulating the patient's processing of stimuli. Discussed are assessment, identification of the point of processing breakdown, identification of facilitory stimulus parameters, and treatment through stimulus manipulation. Two case studies…

  1. Therapy-Induced Neuroplasticity of Language in Chronic Post Stroke Aphasia: A Mismatch Negativity Study of (A)Grammatical and Meaningful/less Mini-Constructions

    PubMed Central

    Lucchese, Guglielmo; Pulvermüller, Friedemann; Stahl, Benjamin; Dreyer, Felix R.; Mohr, Bettina

    2017-01-01

    Clinical language performance and neurophysiological correlates of language processing were measured before and after intensive language therapy in patients with chronic (time post stroke >1 year) post stroke aphasia (PSA). As event-related potential (ERP) measure, the mismatch negativity (MMN) was recorded in a distracted oddball paradigm to short spoken sentences. Critical ‘deviant’ sentence stimuli where either well-formed and meaningful, or syntactically, or lexico-semantically incorrect. After 4 weeks of speech-language therapy (SLT) delivered with high intensity (10.5 h per week), clinical language assessment with the Aachen Aphasia Test battery demonstrated significant linguistic improvements, which were accompanied by enhanced MMN responses. More specifically, MMN amplitudes to grammatically correct and meaningful mini-constructions and to ‘jabberwocky’ sentences containing a pseudoword significantly increased after therapy. However, no therapy-related changes in MMN responses to syntactically incorrect strings including agreement violations were observed. While MMN increases to well-formed meaningful strings can be explained both at the word and construction levels, the neuroplastic change seen for ‘jabberwocky’ sentences suggests an explanation in terms of constructions. The results confirm previous reports that intensive SLT leads to improvements of linguistic skills in chronic aphasia patients and now demonstrate that this clinical improvement is associated with enhanced automatic brain indexes of construction processing, although no comparable change is present for ungrammatical strings. Furthermore, the data confirm that the language-induced MMN is a useful tool to map functional language recovery in PSA. PMID:28111545

  2. The neural correlates of agrammatism: Evidence from aphasic and healthy speakers performing an overt picture description task

    PubMed Central

    Schönberger, Eva; Heim, Stefan; Meffert, Elisabeth; Pieperhoff, Peter; da Costa Avelar, Patricia; Huber, Walter; Binkofski, Ferdinand; Grande, Marion

    2014-01-01

    Functional brain imaging studies have improved our knowledge of the neural localization of language functions and the functional reorganization after a lesion. However, the neural correlates of agrammatic symptoms in aphasia remain largely unknown. The present fMRI study examined the neural correlates of morpho-syntactic encoding and agrammatic errors in continuous language production by combining three approaches. First, the neural mechanisms underlying natural morpho-syntactic processing in a picture description task were analyzed in 15 healthy speakers. Second, agrammatic-like speech behavior was induced in the same group of healthy speakers to study the underlying functional processes by limiting the utterance length. In a third approach, five agrammatic participants performed the picture description task to gain insights in the neural correlates of agrammatism and the functional reorganization of language processing after stroke. In all approaches, utterances were analyzed for syntactic completeness, complexity, and morphology. Event-related data analysis was conducted by defining every clause-like unit (CLU) as an event with its onset-time and duration. Agrammatic and correct CLUs were contrasted. Due to the small sample size as well as heterogeneous lesion sizes and sites with lesion foci in the insula lobe, inferior frontal, superior temporal and inferior parietal areas the activation patterns in the agrammatic speakers were analyzed on a single subject level. In the group of healthy speakers, posterior temporal and inferior parietal areas were associated with greater morpho-syntactic demands in complete and complex CLUs. The intentional manipulation of morpho-syntactic structures and the omission of function words were associated with additional inferior frontal activation. Overall, the results revealed that the investigation of the neural correlates of agrammatic language production can be reasonably conducted with an overt language production paradigm

  3. Agrammatism in Jordanian-Arabic Speakers

    ERIC Educational Resources Information Center

    Albustanji, Yusuf Mohammed

    2009-01-01

    Agrammatism is a frequent sequela of Broca's aphasia that manifests itself in omission and/or substitution of the grammatical morphemes in spontaneous and constrained speech. The hierarchical structure of syntactic trees has been proposed as an account for difficulty across grammatical morphemes (e.g., tense, agreement, and negation). Supporting…

  4. Cross-sectional and longitudinal features of non-fluent/agrammatic primary progressive aphasia with underlying corticobasal degeneration or progressive supranuclear palsy pathology

    PubMed Central

    Santos-Santos, Miguel A.; Mandelli, Maria Luisa; Binney, Richard J.; Ogar, Jennifer; Wilson, Stephen M.; Henry, Maya L.; Hubbard, H. Isabel; Meese, Minerva; Attygalle, Suneth; Rosenberg, Lynne; Pakvasa, Mikhail; Trojanowski, John Q.; Grinberg, Lea T.; Rosen, Howie; Boxer, Adam L.; Miller, Bruce L.; Seeley, William W; Gorno-Tempini, Maria Luisa

    2016-01-01

    Importance We provide novel evidence of specific clinical and neuroimaging features that may help for the in vivo prediction of underlying pathology in non-fluent/agrammatic primary progressive aphasia (nfvPPA) patients with progressive supranuclear palsy (PSP) or corticobasal degeneration (CBD) proved by autopsy. Objective To characterize the neurological, cognitive and neuroimaging features of patients with nvfPPA- in whom either PSP or CBD was eventually confirmed at autopsy- at initial presentation and at 1-year follow-up. Design, Setting, and Participants Prospective longitudinal clinical-pathological study was conducted in a tertiary research clinic that specialized in cognitive disorders. Patients (n=14) were evaluated between January 2002 and December 2014. Inclusion criteria were: a clinical diagnosis of nfvPPA; the availability of speech, language, and cognitive testing for at least one evaluation; magnetic resonance imaging within 6 months of initial evaluation, and a postmortem pathological diagnosis of PSP or CBD. Main Outcomes and Measures Clinical, cognitive, and neuroimaging longitudinal data were analyzed to characterize the whole nfvPPA-4R tau group and identify differences between nfvPPA-PSP and nfvPPA-CBD at presentation and longitudinally. Results Patient groups did not differ significantly in age, gender or handedness (nfvPPA-PSP: median [interquartile range] age 74 [67–76] years, 1/5 male: 1/4 left-handed; nfvPPA-CBD 65 [54–81] years, 3/9 male, 0/9 left-handed). Motor speech impairment and left frontal white matter atrophy were the most prominent common features. At presentation, dysarthria (Motor Speech Examination score median [interquartile range] nfvPPA-PSP: 4 [2–7], nfvPPA-CBD 0 [0–4]; p=0.02), depression (Geriatric Depression Scale score median [interquartile range] nfvPPA-PSP 19 [3–28], nfvPPA-CBD 4 [0–16]; p=0.04) and relatively selective white matter atrophy were typical of nfvPPA-PSP, while greater grey matter atrophy

  5. Real-time production of unergative and unaccusative sentences in normal and agrammatic speakers: An eyetracking study.

    PubMed

    Lee, Jiyeon; Thompson, Cynthia K

    2011-01-01

    BACKGROUND: Speakers with agrammatic aphasia have greater difficulty producing unaccusative (float) compared to unergative (bark) verbs (Kegl, 1995; Lee & Thompson, 2004; Thompson, 2003), putatively because the former involve movement of the theme to the subject position from the post-verbal position, and are therefore more complex than the latter (Burzio, 1986; Perlmutter, 1978). However, it is unclear if and how sentence production processes are affected by the linguistic distinction between these two types of verbs in normal and impaired speakers. AIMS: This study examined real-time production of sentences with unergative (the black dog is barking) vs unaccusative (the black tube is floating) verbs in healthy young speakers and individuals with agrammatic aphasia, using eyetracking. METHODS #ENTITYSTARTX00026; PROCEDURES: Participants' eye movements and speech were recorded while they produced a sentence using computer displayed written stimuli (e.g., black, dog, is barking). OUTCOMES #ENTITYSTARTX00026; RESULTS: Both groups of speakers produced numerically fewer unaccusative sentences than unergative sentences. However, the eye movement data revealed significant differences in fixations between the adjective (black) vs the noun (tube) when producing unaccusatives, but not when producing unergatives for both groups. Interestingly, whereas healthy speakers showed this difference during speech, speakers with agrammatism showed this difference prior to speech onset. CONCLUSIONS: These findings suggest that the human sentence production system differentially processes unaccusatives vs unergatives. This distinction is preserved in individuals with agrammatism; however, the time course of sentence planning appears to differ from healthy speakers (Lee & Thompson, 2010).

  6. The Time-Course of Lexical Activation during Sentence Comprehension in People with Aphasia

    ERIC Educational Resources Information Center

    Ferrill, Michelle; Love, Tracy; Walenski, Matthew; Shapiro, Lewis P.

    2012-01-01

    Purpose: To investigate the time-course of processing of lexical items in auditorily presented canonical (subject-verb-object) constructions in young, neurologically unimpaired control participants and participants with left-hemisphere damage and agrammatic aphasia. Method: A cross modal picture priming (CMPP) paradigm was used to test 114 control…

  7. The Time-Course of Lexical Activation during Sentence Comprehension in People with Aphasia

    ERIC Educational Resources Information Center

    Ferrill, Michelle; Love, Tracy; Walenski, Matthew; Shapiro, Lewis P.

    2012-01-01

    Purpose: To investigate the time-course of processing of lexical items in auditorily presented canonical (subject-verb-object) constructions in young, neurologically unimpaired control participants and participants with left-hemisphere damage and agrammatic aphasia. Method: A cross modal picture priming (CMPP) paradigm was used to test 114 control…

  8. Aphasia and the Process of Revision in Writing a Text

    ERIC Educational Resources Information Center

    Behrns, Ingrid; Ahlsen, Elisabeth; Wengelin, Asa

    2008-01-01

    Most of the previous research on aphasia and writing ability concentrates on the production of words in isolation. The purpose of the current study was to examine the process of producing written texts by clients with aphasia. By using keystroke logging, it was possible to analyse the participants' ongoing work during text writing. Results showed…

  9. Training agrammatic subjects on passive sentences: implications for syntactic deficit theories.

    PubMed

    Weinrich, M; Boser, K I; McCall, D; Bishop, V

    2001-01-01

    We trained two subjects with chronic agrammatic aphasia on production of passive sentences using a computerized, iconic-based communication system. After training, one of the subjects demonstrated significant improvements in his abilities to comprehend and verbally produce English passive voiced sentences, including sentences with conjoined subjects and objects. These results suggest that agrammatism does not represent a fixed syntactic deficit.

  10. Prosody as a Compensatory Strategy in the Conversations of People with Agrammatism

    ERIC Educational Resources Information Center

    Beeke, Suzanne; Wilkinson, Ray; Maxim, Jane

    2009-01-01

    Historically, agrammatism, a symptom of Broca's aphasia, has been associated with dysprosody, on account of speakers' slow, halting, and effortful speech. Almost all investigations of this phenomenon use experimental methods (reading, repetition). Thus, little is known about how prosody is used by speakers with agrammatism and understood by their…

  11. Prosody as a Compensatory Strategy in the Conversations of People with Agrammatism

    ERIC Educational Resources Information Center

    Beeke, Suzanne; Wilkinson, Ray; Maxim, Jane

    2009-01-01

    Historically, agrammatism, a symptom of Broca's aphasia, has been associated with dysprosody, on account of speakers' slow, halting, and effortful speech. Almost all investigations of this phenomenon use experimental methods (reading, repetition). Thus, little is known about how prosody is used by speakers with agrammatism and understood by their…

  12. Aphasia

    MedlinePlus

    ... trouble understanding speech, and difficulty with reading and writing. Aphasia is not a disease, but a symptom ... involves difficulty in conveying thoughts through speech or writing. The person knows what she/he wants to ...

  13. Neural correlates of syntactic processing in the nonfluent variant of primary progressive aphasia.

    PubMed

    Wilson, Stephen M; Dronkers, Nina F; Ogar, Jennifer M; Jang, Jung; Growdon, Matthew E; Agosta, Federica; Henry, Maya L; Miller, Bruce L; Gorno-Tempini, Maria Luisa

    2010-12-15

    The left posterior inferior frontal cortex (IFC) is important for syntactic processing, and has been shown in many functional imaging studies to be differentially recruited for the processing of syntactically complex sentences relative to simpler ones. In the nonfluent variant of primary progressive aphasia (PPA), degeneration of the posterior IFC is associated with expressive and receptive agrammatism; however, the functional status of this region in nonfluent PPA is not well understood. Our objective was to determine whether the atrophic posterior IFC is differentially recruited for the processing of syntactically complex sentences in nonfluent PPA. Using structural and functional magnetic resonance imaging, we quantified tissue volumes and functional responses to a syntactic comprehension task in eight patients with nonfluent PPA, compared to healthy age-matched controls. In controls, the posterior IFC showed more activity for syntactically complex sentences than simpler ones, as expected. In nonfluent PPA patients, the posterior IFC was atrophic and, unlike controls, showed an equivalent level of functional activity for syntactically complex and simpler sentences. This abnormal pattern of functional activity was specific to the posterior IFC: the mid-superior temporal sulcus, another region modulated by syntactic complexity in controls, showed normal modulation by complexity in patients. A more anterior inferior frontal region was recruited by patients, but did not support successful syntactic processing. We conclude that in nonfluent PPA, the posterior IFC is not only structurally damaged, but also functionally abnormal, suggesting a critical role for this region in the breakdown of syntactic processing in this syndrome.

  14. Recovery of Sentence Production Processes Following Language Treatment in Aphasia: Evidence from Eyetracking

    PubMed Central

    Mack, Jennifer E.; Nerantzini, Michaela; Thompson, Cynthia K.

    2017-01-01

    Introduction: Sentence production impairments in aphasia often improve with treatment. However, little is known about how cognitive processes supporting sentence production, such as sentence planning, are impacted by treatment. Methods: The present study used eyetracking to examine changes in sentence production resulting from a 12-week language treatment program focused on passive sentences (Treatment of Underlying Forms (TUF); Thompson and Shapiro, 2005). In two pre-treatment and two post-treatment sessions, nine participants with mild-to-moderate agrammatic aphasia performed a structural priming task, which involved repeating primed sentences (actives or passives) and then, using the same verb, producing sentences describing pictured events. Two individuals with aphasia performed the eyetracking task on the same schedule without intervening language treatment. Ten unimpaired older adults also performed the task to identify normal performance patterns. Sentence production accuracy and speech onset latencies were examined, and eye movements to the pictured Agent and Theme characters were analyzed in the first 400 ms after picture onset, reflecting early sentence planning, and in the regions preceding the production of the sentence subject and post-verbal noun, reflecting lexical encoding. Results: Unimpaired controls performed with high accuracy. Their early eye movements (first 400 ms) indicated equal fixations to the Agent and Theme, consistent with structural sentence planning (i.e., initial construction of an abstract structural frame). Subsequent eye movements occurring prior to speech onset were consistent with encoding of the correct sentence subject (i.e., the Agent in actives, Theme in passives), with encoding of the post-verbal noun beginning at speech onset. In participants with aphasia, accuracy improved significantly with treatment, and post-treatment (but not pre-treatment) eye movements were qualitatively similar to those of unimpaired controls

  15. Recovery of Sentence Production Processes Following Language Treatment in Aphasia: Evidence from Eyetracking.

    PubMed

    Mack, Jennifer E; Nerantzini, Michaela; Thompson, Cynthia K

    2017-01-01

    Introduction: Sentence production impairments in aphasia often improve with treatment. However, little is known about how cognitive processes supporting sentence production, such as sentence planning, are impacted by treatment. Methods: The present study used eyetracking to examine changes in sentence production resulting from a 12-week language treatment program focused on passive sentences (Treatment of Underlying Forms (TUF); Thompson and Shapiro, 2005). In two pre-treatment and two post-treatment sessions, nine participants with mild-to-moderate agrammatic aphasia performed a structural priming task, which involved repeating primed sentences (actives or passives) and then, using the same verb, producing sentences describing pictured events. Two individuals with aphasia performed the eyetracking task on the same schedule without intervening language treatment. Ten unimpaired older adults also performed the task to identify normal performance patterns. Sentence production accuracy and speech onset latencies were examined, and eye movements to the pictured Agent and Theme characters were analyzed in the first 400 ms after picture onset, reflecting early sentence planning, and in the regions preceding the production of the sentence subject and post-verbal noun, reflecting lexical encoding. Results: Unimpaired controls performed with high accuracy. Their early eye movements (first 400 ms) indicated equal fixations to the Agent and Theme, consistent with structural sentence planning (i.e., initial construction of an abstract structural frame). Subsequent eye movements occurring prior to speech onset were consistent with encoding of the correct sentence subject (i.e., the Agent in actives, Theme in passives), with encoding of the post-verbal noun beginning at speech onset. In participants with aphasia, accuracy improved significantly with treatment, and post-treatment (but not pre-treatment) eye movements were qualitatively similar to those of unimpaired controls

  16. Aphasia

    MedlinePlus

    ... caused by damage to the parts of the brain that control language. It can make it hard for you to ... recover from aphasia without treatment. Most, however, need language therapy as soon as possible. NIH: National Institute of Neurological Disorders and Stroke

  17. Linguistic Complexity and Frequency in Agrammatic Speech Production

    ERIC Educational Resources Information Center

    Bastiaanse, Roelien; Bouma, Gosse; Post, Wendy

    2009-01-01

    There is a long standing debate between aphasiologists on the essential factor that constitutes the behavioral patterns of loss and preservation in agrammatic Broca's aphasia. It has been suggested that linguistic complexity plays a crucial role: linguistically complex structures are more difficult to produce than linguistically simple ones.…

  18. [Degenerative aphasia].

    PubMed

    Assal, G; Favre, C; Regli, F

    1985-01-01

    A woman had difficulties in word finding since age 59, this became a Broca's aphasia then a global aphasia. The only possible expression was written and agrammatic with many semantic errors. Calculation was preserved as well as constructional praxis. Ideomotor praxis was slightly impaired. Visual recognition and somatagnosia were normal. Neurological examination showed neither motor nor sensitive impairment. Visual fields were normal. CT scan at onset was normal. Later a slight cortical atrophy appeared predominating on the sylvian fissures, slightly more severe on the left side. Reviewing the literature the authors draw attention on the possible occurrence of an evolutive aphasia being the first evidence of a dementia. The impairment of the other cognitive functions would only appear after several years.

  19. Syntactic facilitation in agrammatic sentence production.

    PubMed

    Hartsuiker, R J; Kolk, H H

    1998-04-01

    Recently, proposals have been made to relate processing difficulties in aphasic language performance to limitations in resources for grammatical processing (Carpenter et al., 1994; Hagiwara, 1995; Kolk, 1995; Martin & Romani, 1994). Such proposals may account for a defining characteristic of agrammatic sentence production: reduced syntactic complexity. Syntactic structures that require deep hierarchical processing or reversals of canonical word order make demands exceeding limited resources. In the present study, we investigate the possibility of counteracting hypothesized resource limitations by increasing the availability of relatively complex sentences (i.e., datives and passives). The phenomenon of "syntactic priming" has been observed in a number of studies with healthy adults (e.g., Bock, 1986). With respect to Broca's aphasia, we hypothesized that increased availability of a syntactic structure, due to syntactic priming, results in a lesser demand on (limited) resources for sentence production. We elicited speech from 12 Broca's aphasics and 12 control subjects in three different conditions: spontaneous speech, picture description without priming, and picture description with priming. In addition, we varied instructions, in order to determine the role of strategies. The main findings were that (a) Brocas show stronger syntactic priming effects than controls; (b) the effects are automatic rather than strategic; and (c) in conditions with priming, Brocas produce relatively complex sentences (e.g., passives). We discuss these results in relation to capacity theories.

  20. Temporal Processing Capabilities in Repetition Conduction Aphasia

    ERIC Educational Resources Information Center

    Sidiropoulos, Kyriakos; Ackermann, Hermann; Wannke, Michael; Hertrich, Ingo

    2010-01-01

    This study investigates the temporal resolution capacities of the central-auditory system in a subject (NP) suffering from repetition conduction aphasia. More specifically, the patient was asked to detect brief gaps between two stretches of broadband noise (gap detection task) and to evaluate the duration of two biphasic (WN-3) continuous noise…

  1. Temporal Processing Capabilities in Repetition Conduction Aphasia

    ERIC Educational Resources Information Center

    Sidiropoulos, Kyriakos; Ackermann, Hermann; Wannke, Michael; Hertrich, Ingo

    2010-01-01

    This study investigates the temporal resolution capacities of the central-auditory system in a subject (NP) suffering from repetition conduction aphasia. More specifically, the patient was asked to detect brief gaps between two stretches of broadband noise (gap detection task) and to evaluate the duration of two biphasic (WN-3) continuous noise…

  2. Does agrammatic speech constitute a regression to child language? A three-way comparison between agrammatic, child, and normal ellipsis.

    PubMed

    Kolk, H

    2001-06-01

    When children are in the process of learning their mother tongue, they show frequent use of nonfinite clauses, even though they produce finite clauses at the same time, thereby demonstrating the availability of the functional domain associated with finiteness. In this study the hypothesis was tested that this behavior results from an overuse of the normal elliptical repertoire that has also been observed in agrammatic aphasia. The purpose of this overuse is prevention of computational overload. In support of the hypothesis it was found that children behaved very similar to aphasics and normal adults with respect to the following parameters: (a) distribution of types of ellipsis, (b) elaboration of ellipses, (c) word order, (d) subject omission, (e) frequency of weak subject pronouns, and (f) verb type (eventivity). The results also support the Jackson/Jakobson regression hypothesis, at least at the grammatical level.

  3. Effects of syntactic and semantic argument structure on sentence repetition in agrammatism: Things we can learn from particles and prepositions.

    PubMed

    Kohen, Francine; Milsark, Gary; Martin, Nadine

    2011-01-01

    Sentence production impairment in aphasia has been attributed to several possible sources that are not mutually exclusive. Linguistic accounts often attribute the difficulty to the complexity of a verb's syntactic and/or semantic argument structure. Cognitive processing accounts emphasise the reduced processing capacity observed in agrammatic aphasia, which in turn has been attributed to reduced semantic short-term memory (STM) or slowed processing. In this study we used verb particles and prepositions to investigate effects of differences in syntactic and semantic argument structure on sentence repetition in aphasia. We predicted that verb particles and sentences containing verb-particle constructions would be easier to repeat than prepositions and prepositional transitive sentences, as the former have a less-complex semantic and syntactic argument structure than the latter. Also, semantic and phonological spans were assessed to determine if a reduction in either capacity correlates with repetition ability. Participants were eight individuals with chronic aphasia. The experimental task was repetition of transitive sentences balanced for length and lexical content containing either verb particles or prepositional object structures. Accuracy of sentence repetition and repetition of verb particles and prepositions within sentences was examined. We calculated the effect of structural complexity on the sentence repetition task as the difference between proportion correct of verb-particle constructions and prepositional transitives. Semantic and phonological STM spans and word spans were also assessed and correlated with this measure of the structural complexity effect on sentence repetition. Verb-particle sentences were repeated correctly significantly more often than prepositional transitive sentences, and within those sentences verbal particles were repeated correctly significantly more often than prepositions. The effect was strongly associated with fluency scores

  4. Exploring the Processing Continuum of Single-Word Comprehension in Aphasia

    ERIC Educational Resources Information Center

    Moineau, Suzanne; Dronkers, Nina F.; Bates, Elizabeth

    2005-01-01

    This study investigated the vulnerability of lexical processing in individuals with aphasia. Though classical teaching of aphasia syndromes holds that people with Broca's aphasia have intact comprehension at the single-word level, the nature and extent of this purported sparing were explored under suboptimal processing conditions. A combination of…

  5. Neural correlates of syntactic processing in the non-fluent variant of primary progressive aphasia

    PubMed Central

    Wilson, Stephen M.; Dronkers, Nina F.; Ogar, Jennifer M.; Jang, Jung; Growdon, Matthew E.; Agosta, Federica; Henry, Maya L.; Miller, Bruce L.; Gorno-Tempini, Maria Luisa

    2010-01-01

    The left posterior inferior frontal cortex (IFC) is important for syntactic processing, and has been shown in many functional imaging studies to be differentially recruited for the processing of syntactically complex sentences relative to simpler ones. In the non-fluent variant of primary progressive aphasia (PPA), degeneration of the posterior IFC is associated with expressive and receptive agrammatism, however the functional status of this region in non-fluent PPA is not well understood. Our objective was to determine whether the atrophic posterior IFC is differentially recruited for the processing of syntactically complex sentences in non-fluent PPA. Using structural and functional magnetic resonance imaging, we quantified tissue volumes and functional responses to a syntactic comprehension task in eight patients with non-fluent PPA, compared to healthy age-matched controls. In controls, the posterior IFC showed more activity for syntactically complex sentences than simpler ones, as expected. In non-fluent PPA patients, the posterior IFC was atrophic and, unlike controls, showed an equivalent level of functional activity for syntactically complex and simpler sentences. This abnormal pattern of functional activity was specific to the posterior IFC: the mid superior temporal sulcus, another region modulated by syntactic complexity in controls, showed normal modulation by complexity in patients. A more anterior inferior frontal region was recruited by patients, but did not support successful syntactic processing. We conclude that in non-fluent PPA, the posterior IFC is not only structurally damaged, but is also functionally abnormal, suggesting a critical role for this region in the breakdown of syntactic processing in this syndrome. PMID:21159955

  6. Understanding discourse-linked elements in aphasia: a threefold study in Russian.

    PubMed

    Bos, L S; Dragoy, O; Avrutin, S; Iskra, E; Bastiaanse, R

    2014-05-01

    Agrammatic speakers have problems with grammatical encoding and decoding. However, not all syntactic processes are equally problematic: present time reference, who questions, and reflexives can be processed by narrow syntax alone and are relatively spared compared to past time reference, which questions, and personal pronouns, respectively. The latter need additional access to discourse and information structures to link to their referent outside the clause (Avrutin, 2006). Linguistic processing that requires discourse-linking is difficult for agrammatic individuals: verb morphology with reference to the past is more difficult than with reference to the present (Bastiaanse et al., 2011). The same holds for which questions compared to who questions and for pronouns compared to reflexives (Avrutin, 2006). These results have been reported independently for different populations in different languages. The current study, for the first time, tested all conditions within the same population. We had two aims with the current study. First, we wanted to investigate whether discourse-linking is the common denominator of the deficits in time reference, wh questions, and object pronouns. Second, we aimed to compare the comprehension of discourse-linked elements in people with agrammatic and fluent aphasia. Three sentence-picture-matching tasks were administered to 10 agrammatic, 10 fluent aphasic, and 10 non-brain-damaged Russian speakers (NBDs): (1) the Test for Assessing Reference of Time (TART) for present imperfective (reference to present) and past perfective (reference to past), (2) the Wh Extraction Assessment Tool (WHEAT) for which and who subject questions, and (3) the Reflexive-Pronoun Test (RePro) for reflexive and pronominal reference. NBDs scored at ceiling and significantly higher than the aphasic participants. We found an overall effect of discourse-linking in the TART and WHEAT for the agrammatic speakers, and in all three tests for the fluent speakers. Scores

  7. The Trouble with Nouns and Verbs in Greek Fluent Aphasia

    ERIC Educational Resources Information Center

    Kambanaros, Maria

    2008-01-01

    In the past verb retrieval problems were associated primarily with agrammatism and noun retrieval difficulties with fluent aphasia. With regards to fluent aphasia, so far in the literature, three distinct patterns of verb/noun dissociations have been described for individuals with fluent anomic aphasia in languages with different underlying forms;…

  8. The phonology-morphosyntax interface: affixed words in agrammatism.

    PubMed

    Obler, L K; Harris, K; Meth, M; Centeno, J; Mathews, P

    In three experiments with nondysarthric agrammatics, we explored the association between phonology and morphosyntax. (1) Contrasting phonological and nonphonological factors on inflectional-affix production of English verbs across three tasks in eight agrammatics, longer stem-syllabic length and stem-final-CC status resulted in poorer affix-production. (2) Studying verb inflections in six agrammatic Spanish-speakers, affix-length and affix-stress correlated with poorer repetition, as did low affix frequency. (3) Four English-speaking agrammatics read aloud and repeated derived words varying in syllable-length and stem-stress reassignment; both contributed independently to word-production difficulty. Phonological complexity of affixes and stems appears to reduce resources for morphological processing in nondysarthric agrammatics.

  9. Morpho-syntactic processing of Arabic plurals after aphasia: dissecting lexical meaning from morpho-syntax within word boundaries.

    PubMed

    Khwaileh, Tariq; Body, Richard; Herbert, Ruth

    2015-01-01

    Within the domain of inflectional morpho-syntax, differential processing of regular and irregular forms has been found in healthy speakers and in aphasia. One view assumes that irregular forms are retrieved as full entities, while regular forms are compiled on-line. An alternative view holds that a single mechanism oversees regular and irregular forms. Arabic offers an opportunity to study this phenomenon, as Arabic nouns contain a consonantal root, delivering lexical meaning, and a vocalic pattern, delivering syntactic information, such as gender and number. The aim of this study is to investigate morpho-syntactic processing of regular (sound) and irregular (broken) Arabic plurals in patients with morpho-syntactic impairment. Three participants with acquired agrammatic aphasia produced plural forms in a picture-naming task. We measured overall response accuracy, then analysed lexical errors and morpho-syntactic errors, separately. Error analysis revealed different patterns of morpho-syntactic errors depending on the type of pluralization (sound vs broken). Omissions formed the vast majority of errors in sound plurals, while substitution was the only error mechanism that occurred in broken plurals. The dissociation was statistically significant for retrieval of morpho-syntactic information (vocalic pattern) but not for lexical meaning (consonantal root), suggesting that the participants' selective impairment was an effect of the morpho-syntax of plurals. These results suggest that irregular plurals forms are stored, while regular forms are derived. The current findings support the findings from other languages and provide a new analysis technique for data from languages with non-concatenative morpho-syntax.

  10. Working Memory in Aphasia: Considering Discourse Processing and Treatment Implications.

    PubMed

    Henderson, Amy; Kim, Hana; Kintz, Stephen; Frisco, Nicole; Wright, Heather Harris

    2017-02-01

    Evidence suggests that persons with aphasia (PWAs) present with working memory impairments that affect a variety of language tasks. Most of these studies have focused on the phonological loop component of working memory and little attention has been paid to the episodic buffer component. The episodic buffer, as a limited capacity, multimodal system that binds and integrates information from the phonological loop, visuospatial sketchpad, and long-term memory would likely be involved in discourse processing. The purposes of this article were to (1) review discourse level deficits associated with aphasia, (2) describe how a deficit at the level of the episodic buffer could cause such deficits, (3) to review discourse treatment approaches for PWAs, and (4) present preliminary results from a novel discourse treatment study for PWAs.

  11. Production of modal and negative particles in Greek aphasia.

    PubMed

    Koukoulioti, Vasiliki

    2010-08-01

    This study aims at investigating the production of the Greek modal and negative particles by non-fluent aphasic patients. These particles belong to the highest part of the verb periphrasis, so they are likely to be impaired in non-fluent aphasia, according to some hypotheses about agrammatic language. Moreover, there is an agreement relation between modality and negation, allowing the examination of agreement relationships in the clause domain. The data are compared to the predictions of recent theories on agrammatic language. The data provide evidence that modality is impaired in agrammatic aphasia, whilst agreement relations between clausal elements are spared.

  12. Processing distinct linguistic information types in working memory in aphasia.

    PubMed

    Wright, Heather Harris; Downey, Ryan A; Gravier, Michelle; Love, Tracy; Shapiro, Lewis P

    2007-06-01

    BACKGROUND: Recent investigations have suggested that adults with aphasia present with a working memory deficit that may contribute to their language-processing difficulties. Working memory capacity has been conceptualised as a single "resource" pool for attentional, linguistic, and other executive processing-alternatively, it has been suggested that there may be separate working memory abilities for different types of linguistic information. A challenge in this line of research is developing an appropriate measure of working memory ability in adults with aphasia. One candidate measure of working memory ability that may be appropriate for this population is the n-back task. By manipulating stimulus type, the n-back task may be appropriate for tapping linguistic-specific working memory abilities. AIMS: The purposes of this study were (a) to measure working memory ability in adults with aphasia for processing specific types of linguistic information, and (b) to examine whether a relationship exists between participants' performance on working memory and auditory comprehension measures. METHOD #ENTITYSTARTX00026; PROCEDURES: Nine adults with aphasia participated in the study. Participants completed three n-back tasks, each tapping different types of linguistic information. They included the PhonoBack (phonological level), SemBack (semantic level), and SynBack (syntactic level). For all tasks, two n-back levels were administered: a 1-back and 2-back. Each level contained 20 target items; accuracy was recorded by stimulus presentation software. The Subject-relative, Object-relative, Active, Passive Test of Syntactic Complexity (SOAP) was the syntactic sentence comprehension task administered to all participants. OUTCOMES #ENTITYSTARTX00026; RESULTS: Participants' performance declined as n-back task difficulty increased. Overall, participants performed better on the SemBack than PhonoBack and SynBack tasks, but the differences were not statistically significant. Finally

  13. [Specificities of the logopenic variant of primary progressive aphasia].

    PubMed

    Magnin, E; Teichmann, M; Martinaud, O; Moreaud, O; Ryff, I; Belliard, S; Pariente, J; Moulin, T; Vandel, P; Démonet, J-F

    2015-01-01

    The logopenic variant of primary progressive aphasia is a syndrome with neuropsychological and linguistic specificities, including phonological loop impairment for which diagnosis is currently mainly based on the exclusion of the two other variants, semantic and nonfluent/agrammatic primary progressive aphasia. The syndrome may be underdiagnosed due (1) to mild language difficulties during the early stages of the disease or (2) to being mistaken for mild cognitive impairment or Alzheimer's disease when the evaluation of episodic memory is based on verbal material and (3) finally, it is not uncommon that the disorders are attributed to psychiatric co-morbidities such as, for example, anxiety. Moreover, compared to other variants of primary progressive aphasia, brain abnormalities are different. The left temporoparietal junction is initially affected. Neuropathology and biomarkers (cerebrospinal fluid, molecular amyloid nuclear imaging) frequently reveal Alzheimer's disease. Consequently this variant of primary progressive aphasia does not fall under the traditional concept of frontotemporal lobar degeneration. These distinctive features highlight the utility of correct diagnosis, classification, and use of biomarkers to show the neuropathological processes underlying logopenic primary progressive aphasia. The logopenic variant of primary progressive aphasia is a specific form of Alzheimer's disease frequently presenting a rapid decline; specific linguistic therapies are needed. Further investigation of this syndrome is needed to refine screening, improve diagnostic criteria and better understand the epidemiology and the biological mechanisms involved. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  14. Non-verbal communication in severe aphasia: influence of aphasia, apraxia, or semantic processing?

    PubMed

    Hogrefe, Katharina; Ziegler, Wolfram; Weidinger, Nicole; Goldenberg, Georg

    2012-09-01

    Patients suffering from severe aphasia have to rely on non-verbal means of communication to convey a message. However, to date it is not clear which patients are able to do so. Clinical experience indicates that some patients use non-verbal communication strategies like gesturing very efficiently whereas others fail to transmit semantic content by non-verbal means. Concerns have been expressed that limb apraxia would affect the production of communicative gestures. Research investigating if and how apraxia influences the production of communicative gestures, led to contradictory outcomes. The purpose of this study was to investigate the impact of limb apraxia on spontaneous gesturing. Further, linguistic and non-verbal semantic processing abilities were explored as potential factors that might influence non-verbal expression in aphasic patients. Twenty-four aphasic patients with highly limited verbal output were asked to retell short video-clips. The narrations were videotaped. Gestural communication was analyzed in two ways. In the first part of the study, we used a form-based approach. Physiological and kinetic aspects of hand movements were transcribed with a notation system for sign languages. We determined the formal diversity of the hand gestures as an indicator of potential richness of the transmitted information. In the second part of the study, comprehensibility of the patients' gestural communication was evaluated by naive raters. The raters were familiarized with the model video-clips and shown the recordings of the patients' retelling without sound. They were asked to indicate, for each narration, which story was being told and which aspects of the stories they recognized. The results indicate that non-verbal faculties are the most important prerequisites for the production of hand gestures. Whereas results on standardized aphasia testing did not correlate with any gestural indices, non-verbal semantic processing abilities predicted the formal diversity

  15. Time Course of Grammatical Encoding in Agrammatism

    ERIC Educational Resources Information Center

    Lee, Jiyeon

    2011-01-01

    Producing a sentence involves encoding a preverbal message into a grammatical structure by retrieving lexical items and integrating them into a functional (semantic-to-grammatical) structure. Individuals with agrammatism are impaired in this grammatical encoding process. However, it is unclear what aspect of grammatical encoding is impaired and…

  16. Verb Deficits in Alzheimer's Disease and Agrammatism: Implications for Lexical Organization

    ERIC Educational Resources Information Center

    Kim, Mikyong; Thompson, Cynthia K.

    2004-01-01

    This study examined the nature of verb deficits in 14 individuals with probable Alzheimer's Disease (PrAD) and nine with agrammatic aphasia. Production was tested, controlling both semantic and syntactic features of verbs, using noun and verb naming, sentence completion, and narrative tasks. Noun and verb comprehension and a grammaticality…

  17. Recovery of Online Sentence Processing in Aphasia: Eye Movement Changes Resulting from Treatment of Underlying Forms

    ERIC Educational Resources Information Center

    Mack, Jennifer E.; Thompson, Cynthia K.

    2017-01-01

    Purpose: The present study tested whether (and how) language treatment changed online sentence processing in individuals with aphasia. Method: Participants with aphasia (n = 10) received a 12-week program of Treatment of Underlying Forms (Thompson & Shapiro, 2005) focused on production and comprehension of passive sentences. Before and after…

  18. Neural Mechanisms of Verb Argument Structure Processing in Agrammatic Aphasic and Healthy Age-Matched Listeners

    ERIC Educational Resources Information Center

    Thompson, Cynthia K.; Bonakdarpour, Borna; Fix, Stephen F.

    2010-01-01

    Processing of lexical verbs involves automatic access to argument structure entries entailed within the verb's representation. Recent neuroimaging studies with young normal listeners suggest that this involves bilateral posterior peri-sylvian tissue, with graded activation in these regions on the basis of argument structure complexity. The aim of…

  19. Neural Mechanisms of Verb Argument Structure Processing in Agrammatic Aphasic and Healthy Age-Matched Listeners

    ERIC Educational Resources Information Center

    Thompson, Cynthia K.; Bonakdarpour, Borna; Fix, Stephen F.

    2010-01-01

    Processing of lexical verbs involves automatic access to argument structure entries entailed within the verb's representation. Recent neuroimaging studies with young normal listeners suggest that this involves bilateral posterior peri-sylvian tissue, with graded activation in these regions on the basis of argument structure complexity. The aim of…

  20. Production and Comprehension of Time Reference in Korean Nonfluent Aphasia

    PubMed Central

    Lee, Jiyeon; Kwon, Miseon; Na, Hae Ri; Bastiaanse, Roelien; Thompson, Cynthia K.

    2015-01-01

    Objectives Individuals with nonfluent agrammatic aphasia show impaired production and comprehension of time reference via verbal morphology. However, cross-linguistic findings to date suggest inconsistent evidence as to whether tense processing in general is impaired or time reference to the past is selectively difficult in this population. This study examined production and comprehension of time reference via verb morphology in Korean-speaking individuals with nonfluent aphasia. Methods A group of 9 healthy controls and 8 individuals with nonfluent aphasia (5 for the production task) participated in the study. Sentence priming production and auditory sentence to picture matching tasks were used, parallel with the previous cross-linguistic experiments in English, Chinese, Turkish, and others. Results The participants with nonfluent aphasia showed different patterns of impairment in production and comprehension. In production, they were impaired in all time references with errors being dominated by substitution of incorrect time references and other morpho-phonologically well-formed errors, indicating a largely intact morphological affixation process. In comprehension, they showed selective impairment of the past, consistent with the cross-linguistic evidence from English, Chinese, Turkish, and others. Conclusion The findings suggest that interpretation of past time reference poses particular difficulty in nonfluent aphasia irrespective of typological characteristics of languages; however, in production, language-specific morpho-semantic functions of verbal morphology may play a significant role in selective breakdowns of time reference. PMID:26290861

  1. Artificial grammar learning in vascular and progressive non-fluent aphasias.

    PubMed

    Cope, Thomas E; Wilson, Benjamin; Robson, Holly; Drinkall, Rebecca; Dean, Lauren; Grube, Manon; Jones, P Simon; Patterson, Karalyn; Griffiths, Timothy D; Rowe, James B; Petkov, Christopher I

    2017-08-24

    Patients with non-fluent aphasias display impairments of expressive and receptive grammar. This has been attributed to deficits in processing configurational and hierarchical sequencing relationships. This hypothesis had not been formally tested. It was also controversial whether impairments are specific to language, or reflect domain general deficits in processing structured auditory sequences. Here we used an artificial grammar learning paradigm to compare the abilities of controls to participants with agrammatic aphasia of two different aetiologies: stroke and frontotemporal dementia. Ten patients with non-fluent variant primary progressive aphasia (nfvPPA), 12 with non-fluent aphasia due to stroke, and 11 controls implicitly learned a novel mixed-complexity artificial grammar designed to assess processing of increasingly complex sequencing relationships. We compared response profiles for otherwise identical sequences of speech tokens (nonsense words) and tone sweeps. In all three groups the ability to detect grammatical violations varied with sequence complexity, with performance improving over time and being better for adjacent than non-adjacent relationships. Patients performed less well than controls overall, and this was related more strongly to aphasia severity than to aetiology. All groups improved with practice and performed well at a control task of detecting oddball nonwords. Crucially, group differences did not interact with sequence complexity, demonstrating that aphasic patients were not disproportionately impaired on complex structures. Hierarchical cluster analysis revealed that response patterns were very similar across all three groups, but very different between the nonsense word and tone tasks, despite identical artificial grammar structures. Overall, we demonstrate that agrammatic aphasics of two different aetiologies are not disproportionately impaired on complex sequencing relationships, and that the learning of phonological and non

  2. Verb deficits in Alzheimer’s disease and agrammatism: Implications for lexical organization☆

    PubMed Central

    Kim, Mikyong; Thompson, Cynthia K.

    2011-01-01

    This study examined the nature of verb deficits in 14 individuals with probable Alzheimer’s Disease (PrAD) and nine with agrammatic aphasia. Production was tested, controlling both semantic and syntactic features of verbs, using noun and verb naming, sentence completion, and narrative tasks. Noun and verb comprehension and a grammaticality judgment task also were administered. Results showed that while both PrAD and agrammatic subjects showed impaired verb naming, the syntactic features of verbs (i.e., argument structure) influenced agrammatic, but not Alzheimer’s disease patients’ verb production ability. That is, agrammatic patients showed progressively greater difficulty with verbs associated with more arguments, as has been shown in previous studies (e.g., Kim & Thompson, 2000; Thompson, 2003; Thompson, Lange, Schneider, & Shapiro, 1997), and suggest a syntactic basis for verb production deficits in agrammatism. Conversely, the semantic complexity of verbs affected PrAD, but not agrammatic, patients’ performance, suggesting “bottom-up” breakdown in their verb lexicon, paralleling that of nouns, resulting from the degradation or loss of semantic features of verbs. PMID:14698726

  3. Adaptation to Aphasia: Grammar, Prosody and Interaction

    ERIC Educational Resources Information Center

    Rhys, Catrin S.; Ulbrich, Christiane; Ordin, Mikhail

    2013-01-01

    This paper investigates recurrent use of the phrase "very good" by a speaker with non-fluent agrammatic aphasia. Informal observation of the speaker's interaction reveals that she appears to be an effective conversational partner despite very severe word retrieval difficulties that result in extensive reliance on variants of the phrase "very…

  4. Semantic Weight and Verb Retrieval in Aphasia

    ERIC Educational Resources Information Center

    Barde, Laura H. F.; Schwartz, Myrna F.; Boronat, Consuelo B.

    2006-01-01

    Individuals with agrammatic aphasia may have difficulty with verb production in comparison to nouns. Additionally, they may have greater difficulty producing verbs that have fewer semantic components (i.e., are semantically "light") compared to verbs that have greater semantic weight. A connectionist verb-production model proposed by Gordon and…

  5. Semantic Weight and Verb Retrieval in Aphasia

    ERIC Educational Resources Information Center

    Barde, Laura H. F.; Schwartz, Myrna F.; Boronat, Consuelo B.

    2006-01-01

    Individuals with agrammatic aphasia may have difficulty with verb production in comparison to nouns. Additionally, they may have greater difficulty producing verbs that have fewer semantic components (i.e., are semantically "light") compared to verbs that have greater semantic weight. A connectionist verb-production model proposed by Gordon and…

  6. Adaptation to Aphasia: Grammar, Prosody and Interaction

    ERIC Educational Resources Information Center

    Rhys, Catrin S.; Ulbrich, Christiane; Ordin, Mikhail

    2013-01-01

    This paper investigates recurrent use of the phrase "very good" by a speaker with non-fluent agrammatic aphasia. Informal observation of the speaker's interaction reveals that she appears to be an effective conversational partner despite very severe word retrieval difficulties that result in extensive reliance on variants of the phrase "very…

  7. Impaired Artificial Grammar Learning in Agrammatism

    ERIC Educational Resources Information Center

    Christiansen, Morten H.; Kelly, M. Louise; Shillcock, Richard C.; Greenfield, Katie

    2010-01-01

    It is often assumed that language is supported by domain-specific neural mechanisms, in part based on neuropsychological data from aphasia. If, however, language relies on domain-general mechanisms, it would be expected that deficits in non-linguistic cognitive processing should co-occur with aphasia. In this paper, we report a study of sequential…

  8. Structure, Processes, and Retrospective Outcomes From an Intensive Comprehensive Aphasia Program.

    PubMed

    Babbitt, Edna M; Worrall, Linda; Cherney, Leora R

    2015-11-01

    This study describes the structure, processes, and outcomes of an intensive comprehensive aphasia program (ICAP). The aim was to identify treatment gains and determine if outcomes were significantly different between participants grouped according to severity and type of aphasia, and time postonset. Data from 74 first-time ICAP participants were analyzed. Pre- and posttreatment scores on the Western Aphasia Battery-Revised and other impairment and participation measures were compared using paired t tests. Analyses of variance were used to compare outcomes related to aphasia severity (severe, moderate, and mild aphasia), aphasia type (fluent, nonfluent), and chronicity (0-6 months postonset, 7-12 months postonset, and 12+ months postonset). Participants made significant changes on all impairment and participation measures. Large effect sizes were noted for one participation and three impairment measures. Medium effect sizes were noted for one impairment and three participation measures. There was no significant difference among groups on any factor. ICAPs can have a significant effect on the language impairment and participation of people with aphasia, but further research is required to determine if the effect is comparable to other types of service delivery.

  9. Understanding semantic and phonological processing deficits in adults with aphasia: Effects of category and typicality

    PubMed Central

    Meier, Erin L.; Lo, Melody

    2015-01-01

    Background Semantic and phonological processing deficits are often present in aphasia. The degree of interdependence between the deficits has been widely studied with variable findings. Semantic variables such as category and typicality have been found to influence semantic processing in healthy individuals and persons with aphasia but their influence on phonological processing is unknown. Aims This study examined the nature of semantic and phonological access in aphasia by comparing adults with aphasia to healthy control participants. Semantic and phonological tasks were used to assess the difference in processing requirements between and within each group as well as examine the effects of category and typicality on different stages of semantic and phonological processing. Methods & Procedures Thirty-two persons with aphasia and ten neurologically healthy adults were administered nine tasks: Category Superordinate, Category Coordinate, Semantic Feature, Rhyme Judgment (No-Name), Syllable Judgment (No-Name), Phoneme Verification (No-Name), Rhyme Judgment (Name-Provided), Syllable Judgment (Name-Provided), and Phoneme Verification (Name-Provided). Accuracy and reaction time data were collected for each of these tasks and between-group and within-group differences were analyzed via MANOVA/MANCOVA and hierarchical clustering analyses. Outcomes & Results Persons with aphasia performed with significantly lower accuracy than controls on phonological tasks but performed comparably on semantic tasks. Participants with aphasia were significantly slower than controls on all semantic and phonological tasks. Clustering of the nine tasks by accuracy revealed different processing requirements in the participants with aphasia compared to the control group while clustering by reaction time revealed similar trends in both groups in that phonological (no-name) items required the most processing time. Significant effects of category and typicality were noted in the semantic tasks but

  10. The effect of literacy on oral language processing: Implications for aphasia tests.

    PubMed

    Tsegaye, Mulugeta Tarekegne; De Bleser, Ria; Iribarren, Carolina

    2011-06-01

    Most studies investigating the impact of literacy on oral language processing have shown that literacy provides phonological awareness skills in the processing of oral language. The implications of these results on aphasia tests could be significant and pose questions on the adequacy of such tools for testing non-literate individuals. Aiming at examining the impact of literacy on oral language processing and its implication on aphasia tests, this study tested 12 non-literate and 12 literate individuals with a modified Amharic version of the Bilingual Aphasia Test (Paradis and Amberber, 1991, Bilingual Aphasia Test. Amharic version. Hillsdale, NJ: Lawrence Erlbaum.). The problems of phonological awareness skills in oral language processing in non-literates are substantiated. In addition, compared with literate participants, non-literate individuals demonstrated difficulties in the word/sentence-picture matching tasks. This study has also revealed that the Amharic version of the Bilingual Aphasia Test may be viable for testing Amharic-speaking non-literate individuals with aphasia when modifications are incorporated.

  11. Parallel functional category deficits in clauses and nominal phrases: The case of English agrammatism

    PubMed Central

    Wang, Honglei; Yoshida, Masaya; Thompson, Cynthia K.

    2015-01-01

    Individuals with agrammatic aphasia exhibit restricted patterns of impairment of functional morphemes, however, syntactic characterization of the impairment is controversial. Previous studies have focused on functional morphology in clauses only. This study extends the empirical domain by testing functional morphemes in English nominal phrases in aphasia and comparing patients’ impairment to their impairment of functional morphemes in English clauses. In the linguistics literature, it is assumed that clauses and nominal phrases are structurally parallel but exhibit inflectional differences. The results of the present study indicated that aphasic speakers evinced similar impairment patterns in clauses and nominal phrases. These findings are consistent with the Distributed Morphology Hypothesis (DMH), suggesting that the source of functional morphology deficits among agrammatics relates to difficulty implementing rules that convert inflectional features into morphemes. Our findings, however, are inconsistent with the Tree Pruning Hypothesis (TPH), which suggests that patients have difficulty building complex hierarchical structures. PMID:26379370

  12. Parallel functional category deficits in clauses and nominal phrases: The case of English agrammatism.

    PubMed

    Wang, Honglei; Yoshida, Masaya; Thompson, Cynthia K

    2014-01-01

    Individuals with agrammatic aphasia exhibit restricted patterns of impairment of functional morphemes, however, syntactic characterization of the impairment is controversial. Previous studies have focused on functional morphology in clauses only. This study extends the empirical domain by testing functional morphemes in English nominal phrases in aphasia and comparing patients' impairment to their impairment of functional morphemes in English clauses. In the linguistics literature, it is assumed that clauses and nominal phrases are structurally parallel but exhibit inflectional differences. The results of the present study indicated that aphasic speakers evinced similar impairment patterns in clauses and nominal phrases. These findings are consistent with the Distributed Morphology Hypothesis (DMH), suggesting that the source of functional morphology deficits among agrammatics relates to difficulty implementing rules that convert inflectional features into morphemes. Our findings, however, are inconsistent with the Tree Pruning Hypothesis (TPH), which suggests that patients have difficulty building complex hierarchical structures.

  13. The trouble with nouns and verbs in Greek fluent aphasia.

    PubMed

    Kambanaros, Maria

    2008-01-01

    In the past verb retrieval problems were associated primarily with agrammatism and noun retrieval difficulties with fluent aphasia. With regards to fluent aphasia, so far in the literature, three distinct patterns of verb/noun dissociations have been described for individuals with fluent anomic aphasia in languages with different underlying forms; better verb retrieval, poorer verb retrieval and equal retrieval difficulties for verbs and nouns. Verbs and nouns in Greek are considered of similar morphological complexity thus it was predicted that anomic aphasic individuals would suffer from a non-dissociated impairment of verbs and nouns. Problems with verbs and/or nouns may arise at any stage in the process of lexical retrieval, i.e. lexical-semantic, lemma, lexeme or articulation. The aim of this research was to investigate verb and noun retrieval using a picture-naming task to explore any possible selective noun and/or verb comprehension or retrieval deficits in Greek individuals with anomic aphasia. The results revealed a significant verb/noun dichotomy with verbs significantly more difficult to retrieve than nouns. These findings lend support for the growing body of evidence showing a specific verb impairment in fluent anomic individuals as well as Broca's patients. Given the prevailing view, that anomic patients experience difficulty retrieving the morpho-phonological form of the target word, the results show that specific information of the grammatical category is also important during word form retrieval. LEARNER OUTCOMES: The reader will become familiar with (i) studies investigating grammatical word class breakdown in individuals with aphasia who speak different languages, (ii) the application of the serial model to word production breakdown in aphasia and (iii) the characteristics of verbs and nouns in Greek. It will be concluded that successful verb retrieval for fluent aphasic individuals who speak Greek is dependant on the retrieval of the morpho

  14. A Study of Syntactic Processing in Aphasia II: Neurological Aspects

    ERIC Educational Resources Information Center

    Caplan, David; Waters, Gloria; Kennedy, David; Alpert, Nathanial; Makris, Nikos; DeDe, Gayle; Michaud, Jennifer; Reddy, Amanda

    2007-01-01

    This paper presents the results of a study of the effects of left hemisphere strokes on syntactically-based comprehension in aphasic patients. We studied 42 patients with aphasia secondary to left hemisphere strokes and 25 control subjects for the ability to assign and interpret three syntactic structures (passives, object extracted relative…

  15. A Study of Syntactic Processing in Aphasia II: Neurological Aspects

    ERIC Educational Resources Information Center

    Caplan, David; Waters, Gloria; Kennedy, David; Alpert, Nathanial; Makris, Nikos; DeDe, Gayle; Michaud, Jennifer; Reddy, Amanda

    2007-01-01

    This paper presents the results of a study of the effects of left hemisphere strokes on syntactically-based comprehension in aphasic patients. We studied 42 patients with aphasia secondary to left hemisphere strokes and 25 control subjects for the ability to assign and interpret three syntactic structures (passives, object extracted relative…

  16. Variable disruption of a syntactic processing network in primary progressive aphasia.

    PubMed

    Wilson, Stephen M; DeMarco, Andrew T; Henry, Maya L; Gesierich, Benno; Babiak, Miranda; Miller, Bruce L; Gorno-Tempini, Maria Luisa

    2016-08-23

    Syntactic processing deficits are highly variable in individuals with primary progressive aphasia. Damage to left inferior frontal cortex has been associated with syntactic deficits in primary progressive aphasia in a number of structural and functional neuroimaging studies. However, a contrasting picture of a broader syntactic network has emerged from neuropsychological studies in other aphasic cohorts, and functional imaging studies in healthy controls. To reconcile these findings, we used functional magnetic resonance imaging to investigate the functional neuroanatomy of syntactic comprehension in 51 individuals with primary progressive aphasia, composed of all clinical variants and a range of degrees of syntactic processing impairment. We used trial-by-trial reaction time as a proxy for syntactic processing load, to determine which regions were modulated by syntactic processing in each patient, and how the set of regions recruited was related to whether syntactic processing was ultimately successful or unsuccessful. Relationships between functional abnormalities and patterns of cortical atrophy were also investigated. We found that the individual degree of syntactic comprehension impairment was predicted by left frontal atrophy, but also by functional disruption of a broader syntactic processing network, comprising left posterior frontal cortex, left posterior temporal cortex, and the left intraparietal sulcus and adjacent regions. These regions were modulated by syntactic processing in healthy controls and in patients with primary progressive aphasia with relatively spared syntax, but they were modulated to a lesser extent or not at all in primary progressive aphasia patients whose syntax was relatively impaired. Our findings suggest that syntactic comprehension deficits in primary progressive aphasia reflect not only structural and functional changes in left frontal cortex, but also disruption of a wider syntactic processing network.

  17. Event-related potentials indicate bi-hemispherical changes in speech sound processing during aphasia rehabilitation.

    PubMed

    Becker, Frank; Reinvang, Ivar

    2007-10-01

    To investigate changes in brain activation related to tone and speech sound processing during aphasia rehabilitation. Longitudinal study investigating patients with stroke, subarachnoid hemorrhage and traumatic brain injury 3 and 7 months post-injury. Eight patients with aphasia, reflecting a wide range of auditory comprehension impairment. Token test and Norwegian Basic Aphasia Assessment were used to measure auditory comprehension function. Brain event-related potentials were recorded in passive paradigms with harmonically rich tones and syllables in order to obtain the mismatch negativity component that reflects automatic stimulus discrimination. In an active syllable discrimination paradigm, stimulus feature integration (N1), attended stimulus discrimination and classification (N2), and target detection (P3) were studied. Auditory comprehension scores improved approximately 10% during the observation period. Ipsilesional frontal P3- and N2-amplitude increased significantly. A significant shift in topographical distribution from the contralesional to the ipsilesional hemisphere was observed for the N2 component. The study of individual waveforms indicates inter-individual differences in reorganization after brain injury. Hemispherical distribution of brain activation correlating with speech sound processing in aphasia can change during the first months after brain injury. Event-related potentials are a potentially useful method for detecting individual activation patterns relevant to recovery in aphasia rehabilitation.

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

    PubMed

    Glozman, Zh M; Kalita, N G

    1975-01-01

    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.

  19. Speech-language therapists' process of including significant others in aphasia rehabilitation.

    PubMed

    Hallé, Marie-Christine; Le Dorze, Guylaine; Mingant, Anne

    2014-11-01

    Although aphasia rehabilitation should include significant others, it is currently unknown how this recommendation is adopted in speech-language therapy practice. Speech-language therapists' (SLTs) experience of including significant others in aphasia rehabilitation is also understudied, yet a better understanding of clinical reality would be necessary to facilitate implementation of best evidence pertaining to family interventions. To explore the process through which SLTs work with significant others of people with aphasia in rehabilitation settings. Individual semi-structured interviews were conducted with eight SLTs who had been working with persons with aphasia in rehabilitation centres for at least 1 year. Grounded theory principles were applied in analysing interview transcripts. A theoretical model was developed representing SLTs' process of working with significant others of persons with aphasia in rehabilitation. Including significant others was perceived as challenging, yet a bonus to their fundamental patient-centred approach. Basic interventions with significant others when they were available included information sharing. If necessary, significant others were referred to social workers or psychologists or the participants collaborated with those professionals. Participants rarely and only under specific conditions provided significant others with language exercises or trained them to communicate better with the aphasic person. As a result, even if participants felt satisfied with their efforts to offer family and friends interventions, they also had unachieved ideals, such as having more frequent contacts with significant others. If SLTs perceived work with significant others as a feasible necessity, rather than as a challenging bonus, they could be more inclined to include family and friends within therapy with the aim to improve their communication with the person with aphasia. SLTs could also be more satisfied with their practice. In order to

  20. Frontal-opercular aphasia.

    PubMed

    Taubner, R W; Raymer, A M; Heilman, K M

    1999-11-01

    The standard nomenclature divides nonfluent aphasic syndromes with relatively spared comprehension into Broca's aphasia and transcortical motor aphasia. We report on a patient with a persistent nonfluent aphasia from a discrete, primarily cortical, frontal-opercular lesion who had impaired syntax but intact repetition and, therefore, did not conform to the traditional classification. Based on this patient's behavior and a review of other cases, we have divided the nonfluent aphasias with intact comprehension into five disorders. (1) Verbal akinesia-exhibiting diminished intention or drive to speak and associated with medial frontal lesions (supplementary motor area and cingulate gyrus) or with lesions damaging the efferent projections from these areas. (2) Disorders of syntax-telegraphic and agrammatic utterances that may be associated with dominant pars opercularis lesions. (3) Phonemic disintegration-a failure to correctly produce phonemes, which may be associated with injury to the opercular primary motor cortex or efferent projections from this area. (4) Defects of lexical access-patients who struggle to find words and are impaired at timed word-generation tasks. Defects of lexical access may be associated with lesions of the pars triangularis and adjacent prefrontal cortex. (5) Mixed defects. According to this model, the traditional patient with Broca's aphasia would exhibit disorders of syntax, phonemic disintegration, and defects of lexical access, whereas the traditional patient with transcortical motor aphasia would have verbal akinesia or defects of lexical access or both. Our patient had defects of lexical access and syntax, but only mild symptoms of phonemic disintegration, suggesting that his opercular primary motor cortex was relatively intact. Our patient's ability to repeat normally while his propositional speech remained telegraphic suggests that different neural mechanisms subserve these functions. Copyright 1999 Academic Press.

  1. Production of Modal and Negative Particles in Greek Aphasia

    ERIC Educational Resources Information Center

    Koukoulioti, Vasiliki

    2010-01-01

    This study aims at investigating the production of the Greek modal and negative particles by non-fluent aphasic patients. These particles belong to the highest part of the verb periphrasis, so they are likely to be impaired in non-fluent aphasia, according to some hypotheses about agrammatic language. Moreover, there is an agreement relation…

  2. Production of Modal and Negative Particles in Greek Aphasia

    ERIC Educational Resources Information Center

    Koukoulioti, Vasiliki

    2010-01-01

    This study aims at investigating the production of the Greek modal and negative particles by non-fluent aphasic patients. These particles belong to the highest part of the verb periphrasis, so they are likely to be impaired in non-fluent aphasia, according to some hypotheses about agrammatic language. Moreover, there is an agreement relation…

  3. Mapping Common Aphasia Assessments to Underlying Cognitive Processes and Their Neural Substrates.

    PubMed

    Lacey, Elizabeth H; Skipper-Kallal, Laura M; Xing, Shihui; Fama, Mackenzie E; Turkeltaub, Peter E

    2017-05-01

    Understanding the relationships between clinical tests, the processes they measure, and the brain networks underlying them, is critical in order for clinicians to move beyond aphasia syndrome classification toward specification of individual language process impairments. To understand the cognitive, language, and neuroanatomical factors underlying scores of commonly used aphasia tests. Twenty-five behavioral tests were administered to a group of 38 chronic left hemisphere stroke survivors and a high-resolution magnetic resonance image was obtained. Test scores were entered into a principal components analysis to extract the latent variables (factors) measured by the tests. Multivariate lesion-symptom mapping was used to localize lesions associated with the factor scores. The principal components analysis yielded 4 dissociable factors, which we labeled Word Finding/Fluency, Comprehension, Phonology/Working Memory Capacity, and Executive Function. While many tests loaded onto the factors in predictable ways, some relied heavily on factors not commonly associated with the tests. Lesion symptom mapping demonstrated discrete brain structures associated with each factor, including frontal, temporal, and parietal areas extending beyond the classical language network. Specific functions mapped onto brain anatomy largely in correspondence with modern neural models of language processing. An extensive clinical aphasia assessment identifies 4 independent language functions, relying on discrete parts of the left middle cerebral artery territory. A better understanding of the processes underlying cognitive tests and the link between lesion and behavior may lead to improved aphasia diagnosis, and may yield treatments better targeted to an individual's specific pattern of deficits and preserved abilities.

  4. Aphasia in Persian: Implications for cognitive models of lexical processing.

    PubMed

    Bakhtiar, Mehdi; Jafary, Reyhane; Weekes, Brendan S

    2017-09-01

    Current models of oral reading assume that different routes (sublexical, lexical, and semantic) mediate oral reading performance and reliance on different routes during oral reading depends on the characteristics of print to sound mappings. Studies of single cases of acquired dyslexia in aphasia have contributed to the development of such models by revealing patterns of double dissociation in object naming and oral reading skill that follow brain damage in Indo-European and Sino-Tibetan languages. Print to sound mapping in Persian varies in transparency because orthography to phonology translation depends uniquely on the presence or absence of vowel letters in print. Here a hypothesis is tested that oral reading in Persian requires a semantic reading pathway that is independent of a direct non-semantic reading pathway, by investigating whether Persian speakers with aphasia show selective impairments to object naming and reading aloud. A sample of 21 Persian speakers with aphasia ranging in age from 18 to 77 (mean = 53, SD = 16.9) was asked to name a same set of 200 objects and to read aloud the printed names of these objects in different sessions. As an additional measure of sublexical reading, patients were asked to read aloud 30 non-word stimuli. Results showed that oral reading is significantly more preserved than object naming in Persian speakers with aphasia. However, more preserved object naming than oral reading was also observed in some cases. There was a moderate positive correlation between picture naming and oral reading success (p < .05). Mixed-effects logistic regression revealed that word frequency, age of acquisition and imageability predict success across both tasks and there is an interaction between these variables and orthographic transparency in oral reading. Furthermore, opaque words were read less accurately than transparent words. The results reveal different patterns of acquired dyslexia in some cases that closely resemble phonological

  5. Aphasia(s) in Alzheimer.

    PubMed

    Teichmann, M; Ferrieux, S

    2013-10-01

    Language disorders of degenerative origin are frequently tied to Alzheimer disease (AD) the different variants of which can result in primary and secondary aphasia syndromes. More specifically, Alzheimer pathology can primarily erode frontal, temporal or parietal language cortices resulting in three genuine AD language variants which account for about 30% of primary degenerative aphasias. Likewise, it can spread from non-language to language cortices leading to secondary language disorders like in typical amnesic AD and in several atypical AD variants. This paper reviews the whole set of AD variants by characterising their impact on the neural language system and on linguistic functioning. It also provides cues for diagnostic strategies which are essential for linguistic, syndromic and nosological patient classification, for adequate clinical follow-up and for guiding language rehabilitation. Such diagnostic approaches, founded on detailed linguistic phenotyping while integrating anatomical and neuropathological findings, also represent a crucial issue for future drug trials targeting the physio-pathological processes in degenerative aphasias.

  6. Processing of disyllabic compound words in Chinese aphasia: evidence for the processing limitations account.

    PubMed

    Lee, Chia-Lin; Hung, Daisy L; Tse, John K-P; Lee, Chia-Ying; Tsai, Jie-Li; Tzeng, Ovid J-L

    2005-02-01

    The current study addresses the debate between so-called 'structural' and 'processing limitation' accounts of aphasia, i.e., whether language impairments reflect the 'loss' of linguistic knowledge or its representations, or instead reflect a limitation in processing resources. Confrontation-naming task and category-judgment tasks were used to examine and compare the performance of non-fluent and fluent aphasics on different compound types of nouns and verbs. We demonstrate that aphasic patients' performance is modulated by the canonicity of the particular compound type, a result that holds true even for the category in which patients show a 'selective category deficit.' These findings weigh against the 'loss' of linguistic representations as the underlying cause of noun-verb deficits, instead supporting a 'processing limitations' approach.

  7. Agrammatism in Jordanian-Arabic Speakers

    ERIC Educational Resources Information Center

    Albustanji, Yusuf M.; Milman, Lisa H.; Fox, Robert A.; Bourgeois, Michelle S.

    2013-01-01

    The studies of agrammatism show that not all morpho-syntactic elements are impaired to the same degree and that some of this variation may be due to language-specific differences. This study investigated the production of morpho-syntactic elements in 15 Jordanian-Arabic (JA) speaking individuals with agrammatism and 15 age-matched neurologically…

  8. Agrammatism in Jordanian-Arabic Speakers

    ERIC Educational Resources Information Center

    Albustanji, Yusuf M.; Milman, Lisa H.; Fox, Robert A.; Bourgeois, Michelle S.

    2013-01-01

    The studies of agrammatism show that not all morpho-syntactic elements are impaired to the same degree and that some of this variation may be due to language-specific differences. This study investigated the production of morpho-syntactic elements in 15 Jordanian-Arabic (JA) speaking individuals with agrammatism and 15 age-matched neurologically…

  9. Real-time comprehension of wh- movement in aphasia: Evidence from eyetracking while listening

    PubMed Central

    Dickey, Michael Walsh; Choy, JungWon Janet; Thompson, Cynthia K.

    2007-01-01

    Sentences with non-canonical wh- movement are often difficult for individuals with agrammatic Broca's aphasia to understand (Caramazza & Zurif, 1976, inter alia). However, the explanation of this difficulty remains controversial, and little is known about how individuals with aphasia try to understand such sentences in real time. This study uses an eyetracking while listening paradigm (Tanenhaus, et al., 1995) to examine agrammatic aphasic individuals' on-line comprehension of movement sentences. Participants' eye-movements were monitored while they listened to brief stories. These stories were followed by comprehension probes involving wh- movement, and looked at visual displays depicting elements mentioned in the story. In line with previous results for young normal listeners (Sussman & Sedivy, 2003), the study finds that both older unimpaired control participants (n=8) and aphasic individuals (n=12) showed visual evidence of successful automatic comprehension of wh- questions (like “Who did the boy kiss that day at school?”). Specifically, both groups fixated on a picture corresponding to the moved element (“who,” the person kissed in the story) at the position of the verb. Interestingly, aphasic participants showed qualitatively different fixation patterns for trials eliciting correct and incorrect responses. Aphasic individuals looked to first the moved-element picture and then to a competitor following the verb in the incorrect trials, indicating initially correct automatic processing. However, they only showed looks to the moved-element picture for the correct trials, parallel to control participants. Furthermore, aphasic individuals' fixations during movement sentences were just as fast as control participants' fixations. These results are unexpected under slowed-processing accounts of aphasic comprehension deficits, in which the source of failed comprehension should be delayed application of the same processing routines used in successful

  10. Effects of working memory load on processing of sounds and meanings of words in aphasia

    PubMed Central

    Martin, Nadine; Kohen, Francine; Kalinyak-Fliszar, Michelene; Soveri, Anna; Laine, Matti

    2011-01-01

    Background Language performance in aphasia can vary depending on several variables such as stimulus characteristics and task demands. This study focuses on the degree of verbal working memory (WM) load inherent in the language task and how this variable affects language performance by individuals with aphasia. Aims The first aim was to identify the effects of increased verbal WM load on the performance of judgments of semantic similarity (synonymy) and phonological similarity (rhyming). The second aim was to determine if any of the following abilities could modulate the verbal WM load effect: semantic or phonological access, semantic or phonological short-term memory (STM) and any of the following executive processing abilities: inhibition, verbal WM updating, and set shifting. Method and Procedures Thirty-one individuals with aphasia and 11 controls participated in this study. They were administered a synonymy judgment task and a rhyming judgment task under high and low verbal WM load conditions that were compared to each other. In a second set of analyses, multiple regression was used to identify which factors (as noted above) modulated the verbal WM load effect. Outcome and Results For participants with aphasia, increased verbal WM load significantly reduced accuracy of performance on synonymy and rhyming judgments. Better performance in the low verbal WM load conditions was evident even after correcting for chance. The synonymy task included concrete and abstract word triplets. When these were examined separately, the verbal WM load effect was significant for the abstract words, but not the concrete words. The same pattern was observed in the performance of the control participants. Additionally, the second set of analyses revealed that semantic STM and one executive function, inhibition ability, emerged as the strongest predictors of the verbal WM load effect in these judgment tasks for individuals with aphasia. Conclusions The results of this study have

  11. Quantitative classification of primary progressive aphasia at early and mild impairment stages.

    PubMed

    Mesulam, M-Marsel; Wieneke, Christina; Thompson, Cynthia; Rogalski, Emily; Weintraub, Sandra

    2012-05-01

    The characteristics of early and mild disease in primary progressive aphasia are poorly understood. This report is based on 25 patients with aphasia quotients >85%, 13 of whom were within 2 years of symptom onset. Word-finding and spelling deficits were the most frequent initial signs. Diagnostic imaging was frequently negative and initial consultations seldom reached a correct diagnosis. Functionality was preserved, so that the patients fit current criteria for single-domain mild cognitive impairment. One goal was to determine whether recently published classification guidelines could be implemented at these early and mild disease stages. The quantitative testing of the recommended core and ancillary criteria led to the classification of ∼80% of the sample into agrammatic, logopenic and semantic variants. Biological validity of the resultant classification at these mild impairment stages was demonstrated by clinically concordant cortical atrophy patterns. A two-dimensional template based on orthogonal mapping of word comprehension and grammaticality provided comparable accuracy and led to a flexible road map that can guide the classification process quantitatively or qualitatively. Longitudinal evaluations of initially unclassifiable patients showed that the semantic variant can be preceded by a prodromal stage of focal left anterior temporal atrophy during which prominent anomia exists without word comprehension or object recognition impairments. Patterns of quantitative tests justified the distinction of grammar from speech abnormalities and the desirability of using the 'agrammatic' designation exclusively for loss of grammaticality, regardless of fluency or speech status. Two patients with simultaneous impairments of grammatical sentence production and word comprehension displayed focal atrophy of the inferior frontal gyrus and the anterior temporal lobe. These patients represent a fourth variant of 'mixed' primary progressive aphasia. Quantitative criteria

  12. A preliminary investigation into the application of processing instruction as therapy for aphasia in Spanish speakers.

    PubMed

    Santamaria, Kindra D; Muñoz, Maria L; Atkins, Jenny L; Hobbs, Dianne R; O'Donald, Karla

    2013-01-01

    This study was a preliminary investigation into the use of processing instruction (PI) to improve the use of the personal 'a' to assign thematic roles in Spanish sentences for second language (L2) learners and persons with aphasia (PWA). Evidence suggests that PI is an effective teaching method for L2 learners with errant processing strategies. However its use with PWA with an acquired inability to process syntactic cues is unknown. Thirty non-impaired Spanish as a second language learners and two Spanish-speaking PWA participated in this study. PI involved the use of explicit instruction and structured input activities with nouns and pronouns. Each participant's performance was assessed pre and post treatment. Two experimental and one control groups of L2 learners completed the PI activities over two days. PWA completed PI in individual sessions over four day and received additional cues. L2 learners who received PI demonstrated significant improvement in the comprehension and production of 'a'. However, the Spanish-speaking PWA demonstrated mixed results. Both of the PWA exhibited gains in the comprehension of 'a' on referential tasks. One participant with aphasia demonstrated improved comprehension post-testing, and neither participant demonstrated gains on production post-testing. Results suggest that PI may be useful for increasing syntactic comprehension in people with aphasia. Findings from the current study are used to guide suggestions for further modification and use of PI as a treatment strategy for PWA. Readers will be able to: (a) define processing instruction, (b) discuss the role of specific syntactic cues in Spanish comprehension, and (c) explain how PI might be modified for use with Spanish speakers with aphasia. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Aphasia and Auditory Processing after Stroke through an International Classification of Functioning, Disability and Health Lens

    PubMed Central

    Purdy, Suzanne C.; Wanigasekara, Iruni; Cañete, Oscar M.; Moore, Celia; McCann, Clare M.

    2016-01-01

    Aphasia is an acquired language impairment affecting speaking, listening, reading, and writing. Aphasia occurs in about a third of patients who have ischemic stroke and significantly affects functional recovery and return to work. Stroke is more common in older individuals but also occurs in young adults and children. Because people experiencing a stroke are typically aged between 65 and 84 years, hearing loss is common and can potentially interfere with rehabilitation. There is some evidence for increased risk and greater severity of sensorineural hearing loss in the stroke population and hence it has been recommended that all people surviving a stroke should have a hearing test. Auditory processing difficulties have also been reported poststroke. The International Classification of Functioning, Disability and Health (ICF) can be used as a basis for describing the effect of aphasia, hearing loss, and auditory processing difficulties on activities and participation. Effects include reduced participation in activities outside the home such as work and recreation and difficulty engaging in social interaction and communicating needs. A case example of a young man (M) in his 30s who experienced a left-hemisphere ischemic stroke is presented. M has normal hearing sensitivity but has aphasia and auditory processing difficulties based on behavioral and cortical evoked potential measures. His principal goal is to return to work. Although auditory processing difficulties (and hearing loss) are acknowledged in the literature, clinical protocols typically do not specify routine assessment. The literature and the case example presented here suggest a need for further research in this area and a possible change in practice toward more routine assessment of auditory function post-stroke. PMID:27489401

  14. Anatomy of language impairments in primary progressive aphasia.

    PubMed

    Rogalski, Emily; Cobia, Derin; Harrison, Theresa M; Wieneke, Christina; Thompson, Cynthia K; Weintraub, Sandra; Mesulam, M-Marsel

    2011-03-02

    Primary progressive aphasia (PPA) is a clinical dementia syndrome characterized by progressive decline in language function but relative sparing of other cognitive domains. There are three recognized PPA variants: agrammatic, semantic, and logopenic. Although each PPA subtype is characterized by the nature of the principal deficit, individual patients frequently display subtle impairments in additional language domains. The present study investigated the distribution of atrophy related to performance in specific language domains (i.e., grammatical processing, semantic processing, fluency, and sentence repetition) across PPA variants to better understand the anatomical substrates of language. Results showed regionally specific relationships, primarily in the left hemisphere, between atrophy and impairments in language performance. Most notable was the neuroanatomical distinction between fluency and grammatical processing. Poor fluency was associated with regions dorsal to the traditional boundaries of Broca's area in the inferior frontal sulcus and the posterior middle frontal gyrus, whereas grammatical processing was associated with more widespread atrophy, including the inferior frontal gyrus and supramarginal gyrus. Repetition performance was correlated with atrophy in the posterior superior temporal gyrus. The correlation of atrophy with semantic processing impairment was localized to the anterior temporal poles. Atrophy patterns were more closely correlated with domain-specific performance than with subtype. These results show that PPA reflects a selective disruption of the language network as a whole, with no rigid boundaries between subtypes. Further, these atrophy patterns reveal anatomical correlates of language that could not have been surmised in patients with aphasia resulting from cerebrovascular lesions.

  15. The influence of event-related knowledge on verb-argument processing in aphasia.

    PubMed

    Dickey, Michael Walsh; Warren, Tessa

    2015-01-01

    Event-related conceptual knowledge outside the language system rapidly affects verb-argument processing in unimpaired adults (McRae and Matsuki, 2009). Some have argued that verb-argument processing is in fact reducible to the activation of such event-related knowledge. However, data favoring this conclusion have come primarily from college-aged healthy adults, for whom both linguistic and conceptual semantic processing is fast and automatic. This study examined the influence of event-related knowledge on verb-argument processing among adults with aphasia (n = 8) and older unimpaired controls (n = 60), in two self-paced reading studies. Participants read sentences containing a plausible verb-argument combination (Mary used a knife to chop the large carrots before dinner), a combination that violated event-related world knowledge (Mary used some bleach to clean the large carrots before dinner), or a combination that violated the verb's selectional restrictions (Mary used a pump to inflate the large carrots before dinner). The participants with aphasia naturally split into two groups: Group 1 (n = 4) had conceptual-semantic impairments (evidenced by poor performance on tasks like Pyramids & Palm Trees) but reasonably intact language processing (higher Western Aphasia Battery Aphasia Quotients), while Group 2 (n = 4) had intact conceptual semantics but poorer language processing. Older unimpaired controls and aphasic Group 1 showed rapid on-line disruption for sentences with selectional-restriction violations (SRVs) and event-related knowledge violations, and also showed SRV-specific penalties in sentence-final acceptability judgments (Experiment 1) and comprehension questions (Experiment 2). In contrast, Group 2 showed very few reliable differences across conditions in either on-line or off-line measures. This difference between aphasic groups suggests that verb-related information and event-related knowledge may be dissociated in aphasia. Furthermore, it suggests

  16. The influence of event-related knowledge on verb-argument processing in aphasia

    PubMed Central

    Dickey, Michael Walsh; Warren, Tessa

    2014-01-01

    Event-related conceptual knowledge outside the language system rapidly affects verb-argument processing in unimpaired adults (McRae & Matsuki, 2009). Some have argued that verb-argument processing is in fact reducible to the activation of such event-related knowledge. However, data favoring this conclusion have come primarily from college-aged healthy adults, for whom both linguistic and conceptual semantic processing is fast and automatic. This study examined the influence of event-related knowledge on verb-argument processing among adults with aphasia (n=8) and older unimpaired controls (n=60), in two self-paced reading studies. Participants read sentences containing a plausible verb-argument combination (Mary used a knife to chop the large carrots before dinner), a combination that violated event-related world knowledge (Mary used some bleach to clean the large carrots before dinner), or a combination that violated the verb’s selectional restrictions (Mary used a pump to inflate the large carrots before dinner). The participants with aphasia naturally split into two groups: Group 1 (n=4) had conceptual-semantic impairments (evidenced by poor performance on tasks like Pyramids & Palm Trees) but reasonably intact language processing (higher Western Aphasia Battery Aphasia Quotients), while Group 2 (n=4) had intact conceptual semantics but poorer language processing. Older unimpaired controls and aphasic Group 1 showed rapid on-line disruption for sentences with selectional-restriction violations (SRVs) and event-related knowledge violations, and also showed SRV-specific penalties in sentence-final acceptability judgments (Experiment 1) and comprehension questions (Experiment 2). In contrast, Group 2 showed very few reliable differences across conditions in either on-line or off-line measures. This difference between aphasic groups suggests that verb-related information and event-related knowledge may be dissociated in aphasia. Furthermore, it suggests that

  17. [Dominant Thalamus and Aphasia].

    PubMed

    Nakano, Akiko; Shimomura, Tatsuo

    2015-12-01

    Many studies have shown that lesions of the dominant thalamus precipitate language disorders in a similar manner to transcortical aphasias, in a phenomenon known as "thalamic aphasia." In some cases, however, aphasia may not occur or may appear transiently following thalamic lesions. Furthermore, dominant thalamic lesions can produce changes in character, as observed in patients with amnesic disorder. Previous work has explored the utility of thalamic aphasia as a discriminative feature for classification of aphasia. Although the thalamus may be involved in the function of the brainstem reticular activating system and play a role in attentional network and in memory of Papez circuit or Yakovlev circuit, the mechanism by which thalamic lesion leads to the emergence of aphasic disorders is unclear. In this review, we we survey historical and recent literature on thalamic aphasia in an attempt to understand the neural processes affected by thalamic lesions.

  18. Gesture discrimination in primary progressive aphasia: the intersection between gesture and language processing pathways.

    PubMed

    Nelissen, Natalie; Pazzaglia, Mariella; Vandenbulcke, Mathieu; Sunaert, Stefan; Fannes, Katrien; Dupont, Patrick; Aglioti, Salvatore M; Vandenberghe, Rik

    2010-05-05

    The issue of the relationship between language and gesture processing and the partial overlap of their neural representations is of fundamental importance to neurology, psychology, and social sciences. Patients suffering from primary progressive aphasia, a clinical syndrome characterized by comparatively isolated language deficits, may provide direct evidence for anatomical and functional association between specific language deficits and gesture discrimination deficits. A consecutive series of 16 patients with primary progressive aphasia and 16 matched control subjects participated. Our nonverbal gesture discrimination task consisted of 19 trials. In each trial, participants observed three video clips showing the same gesture performed correctly in one clip and incorrectly in the other two. Subjects had to indicate which of the three versions was correct. Language and gesture production were evaluated by means of conventional tasks. All participants underwent high-resolution structural and diffusion tensor magnetic resonance imaging. Ten of the primary progressive aphasia patients showed a significant deficit on the nonverbal gesture discrimination task. A factor analysis revealed that this deficit clustered with gesture imitation, word and pseudoword repetition, and writing-to-dictation. Individual scores on this cluster correlated with volume in the left anterior inferior parietal cortex extending into the posterior superior temporal gyrus. Probabilistic tractography indicated this region comprised the cortical relay station of the indirect pathway connecting the inferior frontal gyrus and the superior temporal cortex. Thus, the left perisylvian temporoparietal area may underpin verbal imitative behavior, gesture imitation, and gesture discrimination indicative of a partly shared neural substrate for language and gesture resonance.

  19. Verb and noun deficits in stroke-induced and primary progressive aphasia: The Northwestern Naming Battery().

    PubMed

    Thompson, Cynthia K; Lukic, Sladjana; King, Monique C; Mesulam, M Marsel; Weintraub, Sandra

    2012-05-01

    compared to nouns, but no comprehension impairment for either word class. Whereas, three of the four PPA-S participants showed poorer noun compared to verb production, as well as comprehension. However, neither the StrAn or PPA-L participants showed significant differences between the two word classes in production or comprehension. In addition, similar to the agrammatic participants, the StrAn participants showed a significant transitivity effect, producing intransitive (one-argument) verbs with greater accuracy than transitive (two- and three-argument) verbs. However, no transitivity effects were found for the PPA-L or PPA-S participants. There were significant correlations between NNB scores and all external validation measures. CONCLUSIONS: These data indicate that the NNB is sensitive to word class deficits in stroke and neurodegenerative aphasia. This is important both clinically for treatment planning and theoretically to inform both psycholinguistic and neural models of language processing.

  20. A Comparison of Two Theoretically Driven Treatments for Verb Inflection Deficits in Aphasia

    ERIC Educational Resources Information Center

    Faroqi-Shah, Yasmeen

    2008-01-01

    Errors in the production of verb inflections, especially tense inflections, are pervasive in agrammatic Broca's aphasia ("*The boy eat"). The neurolinguistic underpinnings of these errors are debated. One group of theories attributes verb inflection errors to disruptions in encoding the verb's morphophonological form, resulting from either a…

  1. Anatomic, Clinical, and Neuropsychological Correlates of Spelling Errors in Primary Progressive Aphasia

    ERIC Educational Resources Information Center

    Shim, HyungSub; Hurley, Robert S.; Rogalski, Emily; Mesulam, M.-Marsel

    2012-01-01

    This study evaluates spelling errors in the three subtypes of primary progressive aphasia (PPA): agrammatic (PPA-G), logopenic (PPA-L), and semantic (PPA-S). Forty-one PPA patients and 36 age-matched healthy controls were administered a test of spelling. The total number of errors and types of errors in spelling to dictation of regular words,…

  2. Anatomic, Clinical, and Neuropsychological Correlates of Spelling Errors in Primary Progressive Aphasia

    ERIC Educational Resources Information Center

    Shim, HyungSub; Hurley, Robert S.; Rogalski, Emily; Mesulam, M.-Marsel

    2012-01-01

    This study evaluates spelling errors in the three subtypes of primary progressive aphasia (PPA): agrammatic (PPA-G), logopenic (PPA-L), and semantic (PPA-S). Forty-one PPA patients and 36 age-matched healthy controls were administered a test of spelling. The total number of errors and types of errors in spelling to dictation of regular words,…

  3. The classifier problem in Chinese aphasia.

    PubMed

    Tzeng, O J; Chen, S; Hung, D L

    1991-08-01

    In recent years, research on the relationship between brain organization and language processing has benefited tremendously from cross-linguistic comparisons of language disorders among different types of aphasic patients. Results from these cross-linguistic studies have shown that the same aphasic syndromes often look very different from one language to another, suggesting that language-specific knowledge is largely preserved in Broca's and Wernicke's aphasics. In this paper, Chinese aphasic patients were examined with respect to their (in)ability to use classifiers in a noun phrase. The Chinese language, in addition to its lack of verb conjugation and an absence of noun declension, is exceptional in yet another respect: articles, numerals, and other such modifiers cannot directly precede their associated nouns, there has to be an intervening morpheme called a classifier. The appropriate usage of nominal classifiers is considered to be one of the most difficult aspects of Chinese grammar. Our examination of Chinese aphasic patients revealed two essential points. First, Chinese aphasic patients experience difficulty in the production of nominal classifiers, committing a significant number of errors of omission and/or substitution. Second, two different kinds of substitution errors are observed in Broca's and Wernicke's patients, and the detailed analysis of the difference demands a rethinking of the distinction between agrammatism and paragrammatism. The result adds to a growing body of evidence suggesting that grammar is impaired in fluent as well as nonfluent aphasia.

  4. Auditory and Linguistic Interaction in Developmental Aphasia: Evidence from Two Studies of Auditory Processing. Papers and Reports on Child Language Development, No. 4.

    ERIC Educational Resources Information Center

    Rosenthal, William S.

    This paper describes the results of two studies of auditory processing in child aphasia, and their implication for understanding deviant language development. The term "aphasia" is discussed as it is used to describe adult and child language disorders. A first experiment on the auditory functioning in aphasic and nonaphasic children suggests that…

  5. Diffusion-tensor imaging of major white matter tracts and their role in language processing in aphasia.

    PubMed

    Ivanova, Maria V; Isaev, Dmitry Yu; Dragoy, Olga V; Akinina, Yulia S; Petrushevskiy, Alexey G; Fedina, Oksana N; Shklovsky, Victor M; Dronkers, Nina F

    2016-12-01

    A growing literature is pointing towards the importance of white matter tracts in understanding the neural mechanisms of language processing, and determining the nature of language deficits and recovery patterns in aphasia. Measurements extracted from diffusion-weighted (DW) images provide comprehensive in vivo measures of local microstructural properties of fiber pathways. In the current study, we compared microstructural properties of major white matter tracts implicated in language processing in each hemisphere (these included arcuate fasciculus (AF), superior longitudinal fasciculus (SLF), inferior longitudinal fasciculus (ILF), inferior frontal-occipital fasciculus (IFOF), uncinate fasciculus (UF), and corpus callosum (CC), and corticospinal tract (CST) for control purposes) between individuals with aphasia and healthy controls and investigated the relationship between these neural indices and language deficits. Thirty-seven individuals with aphasia due to left hemisphere stroke and eleven age-matched controls were scanned using DW imaging sequences. Fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), axial diffusivity (AD) values for each major white matter tract were extracted from DW images using tract masks chosen from standardized atlases. Individuals with aphasia were also assessed with a standardized language test in Russian targeting comprehension and production at the word and sentence level. Individuals with aphasia had significantly lower FA values for left hemisphere tracts and significantly higher values of MD, RD and AD for both left and right hemisphere tracts compared to controls, all indicating profound impairment in tract integrity. Language comprehension was predominantly related to integrity of the left IFOF and left ILF, while language production was mainly related to integrity of the left AF. In addition, individual segments of these three tracts were differentially associated with language production and

  6. From Time to Time: Processing Time Reference Violations in Dutch

    ERIC Educational Resources Information Center

    Dragoy, Olga; Stowe, Laurie A.; Bos, Laura S.; Bastiaanse, Roelien

    2012-01-01

    Time reference in Indo-European languages is marked on the verb. With tensed verb forms, the speaker can refer to the past (wrote, has written), present (writes, is writing) or future (will write). Reference to the past through verb morphology has been shown to be particularly vulnerable in agrammatic aphasia and both agrammatic and…

  7. From Time to Time: Processing Time Reference Violations in Dutch

    ERIC Educational Resources Information Center

    Dragoy, Olga; Stowe, Laurie A.; Bos, Laura S.; Bastiaanse, Roelien

    2012-01-01

    Time reference in Indo-European languages is marked on the verb. With tensed verb forms, the speaker can refer to the past (wrote, has written), present (writes, is writing) or future (will write). Reference to the past through verb morphology has been shown to be particularly vulnerable in agrammatic aphasia and both agrammatic and…

  8. Individual variation in agrammatism: a single case study of the influence of interaction.

    PubMed

    Beeke, Suzanne; Wilkinson, Ray; Maxim, Jane

    2007-01-01

    Agrammatic speech can manifest in different ways in the same speaker if task demands change. Individual variation is considered to reflect adaptation, driven by psycholinguistic factors such as underlying deficit. Recently, qualitative investigations have begun to show ways in which conversational interaction can influence the form of an agrammatic speaker's output. To explore qualitative patterns of individual variation in the output of a single case, in order to address the following questions: (1) in what ways do grammatical structure, verbs and argument structure differ qualitatively between data samples?; and (2) what is the influence of interaction on the structure of utterances? A man with severe and chronic agrammatism is videotaped completing tests of spoken sentence construction, composite, and cartoon strip picture descriptions and a story telling task. In addition, he independently videotapes a sample of conversation with a family member at home. Analyses of these data draw on cognitive neuropsychological, linguistic and psycholinguistic methodologies as well as the data-driven procedures of conversation analysis. The qualitative analysis uncovers considerable variation between data sets with respect to grammatical structure, verbs and argument structure. The agrammatic speaker appears more skilled at imposing order on his spontaneous speech than the results of sentence construction tests might predict. Interaction influences his output style. Adaptation is found to be a collaborative process that occurs between two speakers in the quest for mutual understanding, not something that takes place within an individual. It is concluded that an interactional approach to agrammatism has the potential to yield important insights into the characteristics of telegraphic speech and individual variation. The failure of sentence-level tests to capture this individual's skill in producing systematically structured utterances in conversation implies that the

  9. Speech-Language Therapists' Process of Including Significant Others in Aphasia Rehabilitation

    ERIC Educational Resources Information Center

    Hallé, Marie-Christine; Le Dorze, Guylaine; Mingant, Anne

    2014-01-01

    Background: Although aphasia rehabilitation should include significant others, it is currently unknown how this recommendation is adopted in speech-language therapy practice. Speech-language therapists' (SLTs) experience of including significant others in aphasia rehabilitation is also understudied, yet a better understanding of clinical…

  10. Speech-Language Therapists' Process of Including Significant Others in Aphasia Rehabilitation

    ERIC Educational Resources Information Center

    Hallé, Marie-Christine; Le Dorze, Guylaine; Mingant, Anne

    2014-01-01

    Background: Although aphasia rehabilitation should include significant others, it is currently unknown how this recommendation is adopted in speech-language therapy practice. Speech-language therapists' (SLTs) experience of including significant others in aphasia rehabilitation is also understudied, yet a better understanding of clinical…

  11. Clause Structure and Verb Movement in a Greek-English Speaking Bilingual Patient with Broca's Aphasia: Evidence from Adverb Placement

    ERIC Educational Resources Information Center

    Alexiadou, Artemis; Stavrakaki, Stavroula

    2006-01-01

    In this paper, we investigate the performance of a Greek-English bilingual patient with Broca's aphasia and mild agrammatism on the placement of CP, MoodP, AspectP, and NegP-related adverbs, labeled specifier-type adverbs, and VP-related adverbs, labeled complement-type adverbs, by means of a constituent ordering task and a grammaticality judgment…

  12. Clause Structure and Verb Movement in a Greek-English Speaking Bilingual Patient with Broca's Aphasia: Evidence from Adverb Placement

    ERIC Educational Resources Information Center

    Alexiadou, Artemis; Stavrakaki, Stavroula

    2006-01-01

    In this paper, we investigate the performance of a Greek-English bilingual patient with Broca's aphasia and mild agrammatism on the placement of CP, MoodP, AspectP, and NegP-related adverbs, labeled specifier-type adverbs, and VP-related adverbs, labeled complement-type adverbs, by means of a constituent ordering task and a grammaticality judgment…

  13. Quantitative classification of primary progressive aphasia at early and mild impairment stages

    PubMed Central

    Wieneke, Christina; Thompson, Cynthia; Rogalski, Emily; Weintraub, Sandra

    2012-01-01

    The characteristics of early and mild disease in primary progressive aphasia are poorly understood. This report is based on 25 patients with aphasia quotients >85%, 13 of whom were within 2 years of symptom onset. Word-finding and spelling deficits were the most frequent initial signs. Diagnostic imaging was frequently negative and initial consultations seldom reached a correct diagnosis. Functionality was preserved, so that the patients fit current criteria for single-domain mild cognitive impairment. One goal was to determine whether recently published classification guidelines could be implemented at these early and mild disease stages. The quantitative testing of the recommended core and ancillary criteria led to the classification of ∼80% of the sample into agrammatic, logopenic and semantic variants. Biological validity of the resultant classification at these mild impairment stages was demonstrated by clinically concordant cortical atrophy patterns. A two-dimensional template based on orthogonal mapping of word comprehension and grammaticality provided comparable accuracy and led to a flexible road map that can guide the classification process quantitatively or qualitatively. Longitudinal evaluations of initially unclassifiable patients showed that the semantic variant can be preceded by a prodromal stage of focal left anterior temporal atrophy during which prominent anomia exists without word comprehension or object recognition impairments. Patterns of quantitative tests justified the distinction of grammar from speech abnormalities and the desirability of using the ‘agrammatic’ designation exclusively for loss of grammaticality, regardless of fluency or speech status. Two patients with simultaneous impairments of grammatical sentence production and word comprehension displayed focal atrophy of the inferior frontal gyrus and the anterior temporal lobe. These patients represent a fourth variant of ‘mixed’ primary progressive aphasia. Quantitative

  14. Analysis of Abstract and Concrete Word Processing in Persons with Aphasia and Age-Matched Neurologically Healthy Adults Using fMRI

    PubMed Central

    Sandberg, Chaleece; Kiran, Swathi

    2013-01-01

    The concreteness effect occurs in both normal and language-disordered populations. Research suggests that abstract and concrete concepts elicit differing neural activation patterns in healthy young adults, but this is undocumented in persons with aphasia. Three persons with aphasia and three age-matched controls were scanned using fMRI while processing abstract and concrete words. Consistent with current theories of abstract and concrete word processing, abstract words elicited activation in verbal areas whereas concrete words additionally activated multi-modal association areas. Persons with aphasia show greater differences in neural activation than age-matched controls between abstract and concrete words, possibly due to an exaggerated concreteness effect. PMID:23548150

  15. Primary progressive aphasia: diagnosis, varieties, evolution.

    PubMed

    Kertesz, Andrew; Davidson, Wilda; McCabe, Patricia; Takagi, Kenji; Munoz, David

    2003-07-01

    A referred cohort of 67 clinically defined PPA patients were compared to 99 AD patients with formal language and nonverbal cognitive tests in a case control design. Language fluency was determined at the first and last follow up visits. Quantitation of sulcal and ventricular atrophy on MRI was carried out in 46 PPA and 53 AD patients. Most PPA patients (57%) are relatively fluent when first examined. Visuospatial and memory functions are initially preserved. Aphemic, stuttering, "pure motor" presentation, or agrammatic aphasia are seen less frequently. Later most PPAs become logopenic and nonfluent, even those with semantic aphasia (dementia). In contrast, AD patients were more fluent and had relatively lower comprehension, but better overall language performance. MRI showed significant left sided atrophy in most PPA patients. Subsequent to PPA, 25 patients developed behavioral manifestations of frontotemporal dementia and 15 the corticobasal degeneration syndrome, indicating the substantial clinical overlap of these conditions. Language testing, particularly fluency scores supported by neuroimaging are helpful differentiating PPA from AD. The fluent-nonfluent dichotomy in PPA is mostly stage related. The aphemic-logopenic-agrammatic and semantic distinction is useful, but the outcomes converge.

  16. The resolution and recovery of filler-gap dependencies in aphasia: evidence from on-line anomaly detection.

    PubMed

    Dickey, Michael Walsh; Thompson, Cynthia K

    2004-01-01

    This study examines the on-line processing of sentences with movement using an auditory anomaly detection task (after Borland, Tanenhaus, Garnsey, & Carlson, 1995). Eight agrammatic aphasic participants (four of whom had undergone treatment focused on comprehension and production of filler-gap sentences) and 24 young normal participants listened to sentences and pressed a button when the sentences "stopped making sense." Critical sentences contained an anomaly in object relative clauses or conjoined clauses. Results showed that both young normals and aphasic participants were able to reject anomalous sentences of both types. In addition, both groups showed evidence of filler-gap resolution on-line. Importantly, however, there was evidence of a treatment effect for the aphasic patients: those who received treatment showed better performance than those who had not. Treated patients were more successful than the untreated patients in detecting the anomaly in filler-gap conditions, rejecting the anomalous filler-gap sentences reliably more often than the non-anomalous ones, like the young normals. This effect was not noted for untreated participants, i.e., there was no statistical difference between their rejection of anomalous and non-anomalous filler gap sentences. Further, the reaction time data showed that the treated aphasic patients' rejections came before sentence's end (within 2000 ms), while the majority of responses made by untreated patients did not. These results indicate that individuals with agrammatic aphasia appear to retain some gap-filling capacity and that treatment can improve their ability to make use of this capacity.

  17. The Relationships between the Amount of Spared Tissue, Percent Signal Change, and Accuracy in Semantic Processing in Aphasia

    PubMed Central

    Sims, Jordyn A.; Kapse, Kushal; Glynn, Peter; Sandberg, Chaleece; Tripodis, Yorghos; Kiran, Swathi

    2015-01-01

    Recovery from aphasia, loss of language following a cerebrovascular incident (stroke), is a complex process involving both left and right hemispheric regions. In our study, we analyzed the relationships between semantic processing behavioral data, lesion size and location, and functional percent signal change from functional magnetic resonance imaging (fMRI) data. This study included 14 persons with aphasia in the chronic stage of recovery (six or more months post stroke) and eight healthy controls who performed semantic processing tasks of determining whether a written semantic feature matched a picture or whether two written words were related or not. Using region of interest (ROI) analysis, we found that percent signal change in left inferior frontal gyrus pars opercularis and pars triangularis, despite significant damage, were the only regions to correlate with behavioral accuracy. Additionally, the more the damage to LIFG, LMTG and AG/SMG, the higher the percent signal change in bilateral superior frontal gyrus, middle frontal gyrus, and anterior cingulate, suggesting that these regions appear to serve as an assistive network in the case of damage to traditional language regions. Relative to controls who showed mainly positive correlations in activation between and within LH and RH ROIs, patients showed positive and negative correlations. Specifically, the right inferior frontal gyrus pars orbitalis is presumed to serve a monitoring function. These results reinforce the importance of the left hemisphere in language processing in aphasia, and provide a framework for the relative importance of left and right language regions in the brain. PMID:26775192

  18. The relationships between the amount of spared tissue, percent signal change, and accuracy in semantic processing in aphasia.

    PubMed

    Sims, Jordyn A; Kapse, Kushal; Glynn, Peter; Sandberg, Chaleece; Tripodis, Yorghos; Kiran, Swathi

    2016-04-01

    Recovery from aphasia, loss of language following a cerebrovascular incident (stroke), is a complex process involving both left and right hemispheric regions. In our study, we analyzed the relationships between semantic processing behavioral data, lesion size and location, and percent signal change from functional magnetic resonance imaging (fMRI) data. This study included 14 persons with aphasia in the chronic stage of recovery (six or more months post stroke), along with normal controls, who performed semantic processing tasks of determining whether a written semantic feature matched a picture or whether two written words were related. Using region of interest (ROI) analysis, we found that left inferior frontal gyrus pars opercularis and pars triangularis, despite significant damage, were the only regions to correlate with behavioral accuracy. Additionally, bilateral frontal regions including superior frontal gyrus, middle frontal gyrus, and anterior cingulate appear to serve as an assistive network in the case of damage to traditional language regions that include inferior frontal gyrus, middle temporal gyrus, supramarginal gyrus, and angular gyrus. Right hemisphere posterior regions including right middle temporal gyrus, right supramarginal gyrus, and right angular gyrus are engaged in the case of extensive damage to left hemisphere language regions. Additionally, right inferior frontal gyrus pars orbitalis is presumed to serve a monitoring function. These results reinforce the importance of the left hemisphere in language processing in aphasia, and provide a framework for the relative importance of left and right language regions in the brain.

  19. How 'some garlic' becomes 'a garlic' or 'some onion': Mass and count processing in aphasia.

    PubMed

    Fieder, Nora; Nickels, Lyndsey; Biedermann, Britta; Best, Wendy

    2015-08-01

    This paper informs our understanding of the representation and processing of mass and count nouns through an investigation of the underlying causes of mass/count specific impairments in in two people with aphasia, DEH and GEC. The factors influencing the production of mass and count nouns and noun phrases was comprehensively assessed. The results showed that GEC's impairment affected mass noun naming, resulting in the production of semantic paraphasias and no responses. In contrast, DEH frequently substituted mass determiners with count determiners leading to ungrammatical noun phrases. In comparison to younger control group, a control group of older adults showed similar difficulties to DEH with mass noun phrases, although less severe, indicating effects of cognitive ageing on lexical and semantic processing. DEH and the elderly controls' results replicate and support previous findings regarding the lexical-syntactic representation of mass/count information. GEC's difficulties extend these findings by providing additional evidence for a semantic component in the representation of countability (e.g., a semantic feature/concept COUNTABLE for count nouns, UNCOUNTABLE for mass nouns) which contributes to mass and count noun selection. GEC's mass noun difficulties are suggested to result from weaker connection strength between noun lemmas and mass concepts compared to count concepts as a result of the overall lower frequency distribution of mass nouns.

  20. Neuropsychological Profiles Differ among the Three Variants of Primary Progressive Aphasia.

    PubMed

    Butts, Alissa M; Machulda, Mary M; Duffy, Joseph R; Strand, Edythe A; Whitwell, Jennifer L; Josephs, Keith A

    2015-07-01

    The objective of this study was to describe the neuropsychological profiles of the three variants of primary progressive aphasia (PPA). Based on a comprehensive speech and language evaluation, 91 subjects were classified as logopenic (lvPPA=51), semantic (svPPA=13), or agrammatic (agPPA=27). All subjects completed a separate neuropsychological evaluation assessing verbal and visual memory, processing speed, executive function, and visuospatial function. The groups did not differ on demographic variables or on measures of disease duration or aphasia severity. There were group differences on aspects of learning and memory, as well as aspects of executive and visuospatial functions, primarily with the lvPPA group performing lower than the agPPA and svPPA groups. The agPPA group showed subtle deficits consistent with frontal lobe impairment, whereas neurocognitive weaknesses in the svPPA group were restricted to temporal lobe functions. The pattern of neurocognitive dysfunction in lvPPA suggests disease involvement of frontal lobe functions in addition to temporoparietal functions. These neurocognitive findings emphasize the value of a comprehensive neuropsychological evaluation of individuals who present with primary language disturbance, given the pattern of cognitive deficits may provide additive information for differentiating these clinical syndromes.

  1. A novel frontal pathway underlies verbal fluency in primary progressive aphasia.

    PubMed

    Catani, Marco; Mesulam, Marsel M; Jakobsen, Estrid; Malik, Farah; Martersteck, Adam; Wieneke, Christina; Thompson, Cynthia K; Thiebaut de Schotten, Michel; Dell'Acqua, Flavio; Weintraub, Sandra; Rogalski, Emily

    2013-08-01

    The frontal aslant tract is a direct pathway connecting Broca's region with the anterior cingulate and pre-supplementary motor area. This tract is left lateralized in right-handed subjects, suggesting a possible role in language. However, there are no previous studies that have reported an involvement of this tract in language disorders. In this study we used diffusion tractography to define the anatomy of the frontal aslant tract in relation to verbal fluency and grammar impairment in primary progressive aphasia. Thirty-five patients with primary progressive aphasia and 29 control subjects were recruited. Tractography was used to obtain indirect indices of microstructural organization of the frontal aslant tract. In addition, tractography analysis of the uncinate fasciculus, a tract associated with semantic processing deficits, was performed. Damage to the frontal aslant tract correlated with performance in verbal fluency as assessed by the Cinderella story test. Conversely, damage to the uncinate fasciculus correlated with deficits in semantic processing as assessed by the Peabody Picture Vocabulary Test. Neither tract correlated with grammatical or repetition deficits. Significant group differences were found in the frontal aslant tract of patients with the non-fluent/agrammatic variant and in the uncinate fasciculus of patients with the semantic variant. These findings indicate that degeneration of the frontal aslant tract underlies verbal fluency deficits in primary progressive aphasia and further confirm the role of the uncinate fasciculus in semantic processing. The lack of correlation between damage to the frontal aslant tract and grammar deficits suggests that verbal fluency and grammar processing rely on distinct anatomical networks.

  2. Assessing Syntactic Deficits in Chinese Broca's aphasia using the Northwestern Assessment of Verbs and Sentences-Chinese (NAVS-C)

    PubMed Central

    Wang, Honglei; Thompson, Cynthia K.

    2016-01-01

    Background English-speaking patients with Broca's aphasia and agrammatism evince difficulty with complex grammatical structures, including verbs and sentences. A few studies have found similar patterns among Chinese-speaking patients with broca's aphasia, despite structural differences between these two languages. However, no studies have explicitly examined verb properties, including the number and optionality of arguments (participant roles) selected by the verb, and only a few studies have examined sentence deficits among Chinese patients. In addition, there are no test batteries presently available to assess syntactically important properties of verbs and sentences in Chinese patients. Aims This study used a Chinese version of the Northwestern Assessment of Verbs and Sentences (NAVS; Thompson, 2011), originally developed for English speakers with aphasia, to examine the verb and sentence deficit patterns among Chinese speakers with aphasia. As in the original NAVS, the Chinese version (NAVS-C) assessed verbs by the number and optionality of arguments as well as sentence canonicity, in the both production and comprehension. Methods and Procedures Fifteen Chinese patients with Broca's aphasia and fifteen age-matched healthy normal controls participated in this study. All NAVS-C tests were administered, in which participants were asked either to produce or identify verbs and sentences coinciding with action pictures. Outcomes & results Despite grammatical differences between Chinese and English, the impairment caused by structural complexity of verbs and sentences was replicated in Chinese-speaking patients using the NAVS-C. Verbs with more arguments were significantly more impaired than those with fewer arguments and verbs with optional arguments were significantly more impaired than those with obligatory arguments. One deviation from English-speaking patients, however, is that the Chinese-speaking patients exhibited greater difficulty with subject relative

  3. Elicitation of specific syntactic structures in primary progressive aphasia.

    PubMed

    Deleon, Jessica; Gesierich, Benno; Besbris, Max; Ogar, Jennifer; Henry, Maya L; Miller, Bruce L; Gorno-Tempini, Maria Luisa; Wilson, Stephen M

    2012-12-01

    Many patients with primary progressive aphasia (PPA) are impaired in syntactic production. Because most previous studies of expressive syntax in PPA have relied on quantitative analysis of connected speech samples, which is a relatively unconstrained task, it is not well understood which specific syntactic structures are most challenging for these patients. We used an elicited syntactic production task to identify which syntactic structures pose difficulties for 31 patients with three variants of PPA: non-fluent/agrammatic, semantic and logopenic. Neurodegenerative and healthy age-matched participants were included as controls. As expected, non-fluent/agrammatic patients made the most syntactic errors. The structures that resulted in the most errors were constructions involving third person singular present agreement, and constructions involving embedded clauses. Deficits on this elicited production task were associated with atrophy of the left posterior inferior frontal gyrus.

  4. Transcranial direct current stimulation effects on neural processing in post-stroke aphasia.

    PubMed

    Darkow, Robert; Martin, Andrew; Würtz, Anna; Flöel, Agnes; Meinzer, Marcus

    2017-03-01

    Non-invasive transcranial direct current stimulation (tDCS) can enhance recovery after stroke. However, fundamental knowledge about how tDCS impacts neural processing in the lesioned human brain is currently lacking. In the present study, it was investigated how tDCS modulates brain function in patients with post-stroke language impairment (aphasia). In a cross-over, randomized trial, patients named pictures of common objects during functional magnetic resonance imaging (fMRI). Concurrently, excitatory (anodal-) or sham-tDCS (1 mA, 20 min, or 30 s, respectively) was administered to the left primary motor cortex, a montage with demonstrated potential to improve aphasic language. By choosing stimuli that could reliable be named by the patients, the authors aimed to derive a pure measure of stimulation effects that was independent of treatment or performance effects and to assess how tDCS interacts with the patients' residual language network. Univariate fMRI data analysis revealed reduced activity in domain-general regions mediating high-level cognitive control during anodal-tDCS. Independent component functional network analysis demonstrated selectively increased language network activity and an inter-correlated shift from higher to lower frequency bands, indicative of increased within-network communication. Compared with healthy controls, anodal-tDCS resulted in overall "normalization" of brain function in the patients. These results demonstrate for the first time how tDCS modulates neural processing in stroke patients. Such information is crucial to assure that behavioral treatments targeting specific neural circuits overlap with regions that are modulated by tDCS, thereby maximizing stimulation effects during therapy. Hum Brain Mapp 38:1518-1531, 2017. © 2016 Wiley Periodicals, Inc.

  5. Remediation of language processing in aphasia: Improving activation and maintenance of linguistic representations in (verbal) short-term memory

    PubMed Central

    Kalinyak-Fliszar, Michelene; Kohen, Francine; Martin, Nadine

    2012-01-01

    Background Verbal short-term memory (STM) impairments are invariably present in aphasia. Word processing involves a minimal form of verbal STM, i.e., the time course over which semantic and phonological representations are activated and maintained until they are comprehended, produced, or repeated. Thus it is reasonable that impairments of word processing and verbal STM may co-occur. The co-occurrence of language and STM impairments in aphasia has motivated an active area of research that has revealed much about the relationship of these two systems and the effect of their impairment on language function and verbal learning (Freedman & Martin, 2001; Martin & Saffran, 1999; Trojano & Grossi, 1995). In keeping with this view a number of researchers have developed treatment protocols to improve verbal STM in order to improve language function (e.g., Koenig-Bruhin & Studer-Eichenberger, 2007). This account of aphasia predicts that treatment of a fundamental ability, such as STM, which supports language function, should lead to improvements that generalise to content and tasks beyond those implemented in treatment. Aims We investigated the efficacy of a treatment for language impairment that targets two language support processes: verbal short-term memory (STM) and executive processing, in the context of a language task (repetition). We hypothesised that treatment of these abilities would improve repetition abilities and performance on other language tasks that require STM. Method A single-participant, multiple-baseline, multiple-probe design across behaviours was used with a participant with conduction aphasia. The treatment involved repetition of words and nonwords under three “interval” conditions, which varied the time between hearing and repeating the stimulus. Measures of treatment effects included acquisition, maintenance, and follow-up data, effect sizes, and pre- and post-treatment performance on a test battery that varies the STM and executive function

  6. Functional activation studies of word processing in the recovery from aphasia.

    PubMed

    Zahn, Roland; Schwarz, Michael; Huber, Walter

    2006-06-01

    Some reviews on theories of recovery in aphasia put an emphasis on neural network models based on empirical data from evoked-potentials in aphasia as an approach to mapping recovery of cognitive function to neural structure. We will focus here on what we call an "anatomical" approach to look at recovery in aphasia. "Anatomical" theories of recovery stated by classical aphasiologists have contributed to the understanding of language representations in the human brain. But many aspects of these theories can only be investigated by using modern techniques of lesion analysis, psychometric assessment and functional imaging. Whereas structure-function relations have been primarily established by looking for the association of deficit symptoms with certain lesions, functional activation methods offer a means to study more directly the functional anatomy of recovered or retained functions in neuropsychological patients. To falsify or build up anatomical theories of recovery we will propose a stepwise approach of inference. The methodological pitfalls of this approach will be discussed by focussing on anatomical hypotheses of semantic word comprehension and its impairment and recovery in aphasia.

  7. Update in Aphasia Research.

    PubMed

    Tippett, Donna C

    2015-08-01

    The sequelae of post-stroke aphasia are considerable, with implications at the societal and personal levels. An understanding of the mechanisms of recovery of cognitive and language processes after stroke and the factors associated with increased risk of post-stroke language and cognitive deficits is vital in providing optimal care of individuals with aphasia and in counseling to their families and caregivers. Advances in neuroimaging facilitate the identification of dysfunctional or damaged brain tissue responsible for these cognitive/language deficits and contribute insights regarding the functional neuroanatomy of language. Evidence-based person-centered behavioral therapy remains the mainstay for rehabilitation of aphasia, although emerging evidence shows that neuromodulation is a promising adjunct to traditional therapy. These topics are discussed in this review, illustrating with recent studies from the Stroke Cognitive Outcomes and REcovery (SCORE) lab.

  8. Verb and sentence production and comprehension in aphasia: Northwestern Assessment of Verbs and Sentences (NAVS)

    PubMed Central

    Cho-Reyes, Soojin; Thompson, Cynthia K.

    2015-01-01

    Background Verbs and sentences are often impaired in individuals with aphasia, and differential impairment patterns are associated with different types of aphasia. With currently available test batteries, however, it is challenging to provide a comprehensive profile of aphasic language impairments because they do not examine syntactically important properties of verbs and sentences. Aims This study presents data derived from the Northwestern Assessment of Verbs and Sentences (NAVS; Thompson, 2011), a new test battery designed to examine syntactic deficits in aphasia. The NAVS includes tests for verb naming and comprehension, and production of verb argument structure in simple active sentences, with each examining the effects of the number and optionality of arguments. The NAVS also tests production and comprehension of canonical and non-canonical sentences. Methods & Procedures A total of 59 aphasic participants (35 agrammatic and 24 anomic) were tested using a set of action pictures. Participants produced verbs or sentences for the production subtests and identified pictures corresponding to auditorily provided verbs or sentences for the comprehension subtests. Outcomes & Results The agrammatic group, compared to the anomic group, performed significantly more poorly on all subtests except verb comprehension, and for both groups comprehension was less impaired than production. On verb naming and argument structure production tests both groups exhibited difficulty with three-argument verbs, affected by the number and optionality of arguments. However, production of sentences using three-argument verbs was more impaired in the agrammatic, compared to the anomic, group. On sentence production and comprehension tests, the agrammatic group showed impairments in all types of non-canonical sentences, whereas the anomic group exhibited difficulty primarily with the most difficult, object relative, structures. Conclusions Results show that verb and sentence deficits seen in

  9. Asymmetry and heterogeneity of Alzheimer's and frontotemporal pathology in primary progressive aphasia.

    PubMed

    Mesulam, M-Marsel; Weintraub, Sandra; Rogalski, Emily J; Wieneke, Christina; Geula, Changiz; Bigio, Eileen H

    2014-04-01

    Fifty-eight autopsies of patients with primary progressive aphasia are reported. Twenty-three of these were previously described (Mesulam et al., 2008) but had their neuropathological diagnoses updated to fit current criteria. Thirty-five of the cases are new. Their clinical classification was guided as closely as possible by the 2011 consensus guidelines (Gorno-Tempini et al., 2011). Tissue diagnoses included Alzheimer's disease in 45% and frontotemporal lobar degeneration (FTLD) in the others, with an approximately equal split between TAR DNA binding protein 43 proteinopathies and tauopathies. The most common and distinctive feature for all pathologies associated with primary progressive aphasia was the asymmetric prominence of atrophy, neuronal loss, and disease-specific proteinopathy in the language-dominant (mostly left) hemisphere. The Alzheimer's disease pathology in primary progressive aphasia displayed multiple atypical features. Males tended to predominate, the neurofibrillary pathology was more intense in the language-dominant hemisphere, the Braak pattern of hippocampo-entorhinal prominence was tilted in favour of the neocortex, and the APOE e4 allele was not a risk factor. Mean onset age was under 65 in the FTLD as well as Alzheimer's disease groups. The FTLD-TAR DNA binding protein 43 group had the youngest onset and fastest progression whereas the Alzheimer's disease and FTLD-tau groups did not differ from each other in either onset age or progression rate. Each cellular pathology type had a preferred but not invariant clinical presentation. The most common aphasic manifestation was of the logopenic type for Alzheimer pathology and of the agrammatic type for FTLD-tau. The progressive supranuclear palsy subtype of FTLD-tau consistently caused prominent speech abnormality together with agrammatism whereas FTLD-TAR DNA binding protein 43 of type C consistently led to semantic primary progressive aphasia. The presence of agrammatism made Alzheimer

  10. Asymmetry and heterogeneity of Alzheimer’s and frontotemporal pathology in primary progressive aphasia

    PubMed Central

    Weintraub, Sandra; Rogalski, Emily J.; Wieneke, Christina; Geula, Changiz; Bigio, Eileen H.

    2014-01-01

    Fifty-eight autopsies of patients with primary progressive aphasia are reported. Twenty-three of these were previously described (Mesulam et al., 2008) but had their neuropathological diagnoses updated to fit current criteria. Thirty-five of the cases are new. Their clinical classification was guided as closely as possible by the 2011 consensus guidelines (Gorno-Tempini et al., 2011). Tissue diagnoses included Alzheimer’s disease in 45% and frontotemporal lobar degeneration (FTLD) in the others, with an approximately equal split between TAR DNA binding protein 43 proteinopathies and tauopathies. The most common and distinctive feature for all pathologies associated with primary progressive aphasia was the asymmetric prominence of atrophy, neuronal loss, and disease-specific proteinopathy in the language-dominant (mostly left) hemisphere. The Alzheimer’s disease pathology in primary progressive aphasia displayed multiple atypical features. Males tended to predominate, the neurofibrillary pathology was more intense in the language-dominant hemisphere, the Braak pattern of hippocampo-entorhinal prominence was tilted in favour of the neocortex, and the APOE e4 allele was not a risk factor. Mean onset age was under 65 in the FTLD as well as Alzheimer’s disease groups. The FTLD-TAR DNA binding protein 43 group had the youngest onset and fastest progression whereas the Alzheimer’s disease and FTLD-tau groups did not differ from each other in either onset age or progression rate. Each cellular pathology type had a preferred but not invariant clinical presentation. The most common aphasic manifestation was of the logopenic type for Alzheimer pathology and of the agrammatic type for FTLD-tau. The progressive supranuclear palsy subtype of FTLD-tau consistently caused prominent speech abnormality together with agrammatism whereas FTLD-TAR DNA binding protein 43 of type C consistently led to semantic primary progressive aphasia. The presence of agrammatism made

  11. [Language and aphasias].

    PubMed

    Porta-Etessam, J; Núñez-López, R; Balsalobre, J; López, E; Hernández, A; Luna, A

    1997-08-01

    Approximately 400,000 years ago men started to use language. Initially it was probably poor with few phonemes. With social evolution it became more complex, with the appearance of new phonemes and a more complete grammatical structure. The current concept of the processing of language dates, with little change, from the nineteenth century. With the birth of phrenology language began to be studied. This lead to the hypothesis of Wernicke, with two main areas joined by the fasciculo arcuato, which is still held to be valid with modifications by Gerchwind and Damasio, amongst others. Important advances in the study of language are due to Chomsky and his transformational grammar. This supports the universal structure of language, since one learns it following genetically determined laws. Language has three main aspects: creativity which makes both the transmitter and the receiver active participants in communication, the form from which words are constructed and the content of the message. Aphasia is an alteration in the comprehension and understanding of language, which may be the clinical expression of many different aetiologies. They help us to localize the lesion topographically. They are divided depending on the clinical signs, into motor or Broca's aphasia, in which understanding is conserved but the patient uses a language with poor grammatical structure, although the semantic content is acceptable: sensitive or Wernicke's aphasia, with inability to understand and language which is fluid but unintelligible; conduction aphasia due to limitation in the transmission of impulses from Wernicke's area to that of Broca, with acceptable understanding and fluid language and the trans-cortical aphasias where the main characteristic is indemnity of the capacity of repetition. The aphasias, as the expression of an alteration of language are an important support in the topographical localization of lesions, even before these can be shown on computerized tomography.

  12. Syndromes dominated by apraxia of speech show distinct characteristics from agrammatic PPA

    PubMed Central

    Duffy, Joseph R.; Strand, Edythe A.; Machulda, Mary M.; Senjem, Matthew L.; Lowe, Val J.; Jack, Clifford R.; Whitwell, Jennifer L.

    2013-01-01

    Objective: We assessed whether clinical and imaging features of subjects with apraxia of speech (AOS) more severe than aphasia (dominant AOS) are more similar to agrammatic primary progressive aphasia (agPPA) or to primary progressive AOS (PPAOS). Methods: Sixty-seven subjects (PPAOS = 18, dominant AOS = 10, agPPA = 9, age-matched controls = 30) who all had volumetric MRI, diffusion tensor imaging, F18-fluorodeoxyglucose and C11-labeled Pittsburgh compound B (PiB)-PET scanning, as well as neurologic and speech and language assessments, were included in this case-control study. AOS was classified as either type 1, predominated by sound distortions and distorted sound substitutions, or type 2, predominated by syllabically segmented prosodic speech patterns. Results: The dominant AOS subjects most often had AOS type 2, similar to PPAOS. In contrast, agPPA subjects most often had type 1 (p = 0.01). Both dominant AOS and PPAOS showed focal imaging abnormalities in premotor cortex, whereas agPPA showed widespread involvement affecting premotor, prefrontal, temporal and parietal lobes, caudate, and insula. Only the dominant AOS and PPAOS groups showed midbrain atrophy compared with controls. No differences were observed in PiB binding across all 3 groups, with the majority being PiB negative. Conclusion: These results suggest that dominant AOS is more similar to PPAOS than agPPA, with dominant AOS and PPAOS exhibiting a clinically distinguishable subtype of progressive AOS compared with agPPA. PMID:23803320

  13. Classification and clinicoradiologic features of primary progressive aphasia (PPA) and apraxia of speech.

    PubMed

    Botha, Hugo; Duffy, Joseph R; Whitwell, Jennifer L; Strand, Edythe A; Machulda, Mary M; Schwarz, Christopher G; Reid, Robert I; Spychalla, Anthony J; Senjem, Matthew L; Jones, David T; Lowe, Val; Jack, Clifford R; Josephs, Keith A

    2015-08-01

    The consensus criteria for the diagnosis and classification of primary progressive aphasia (PPA) have served as an important tool in studying this group of disorders. However, a large proportion of patients remain unclassifiable whilst others simultaneously meet criteria for multiple subtypes. We prospectively evaluated a large cohort of patients with degenerative aphasia and/or apraxia of speech using multidisciplinary clinical assessments and multimodal imaging. Blinded diagnoses were made using operational definitions with important differences compared to the consensus criteria. Of the 130 included patients, 40 were diagnosed with progressive apraxia of speech (PAOS), 12 with progressive agrammatic aphasia, 9 with semantic dementia, 52 with logopenic progressive aphasia, and 4 with progressive fluent aphasia, while 13 were unclassified. The PAOS and progressive fluent aphasia groups were least impaired. Performance on repetition and sentence comprehension was especially poor in the logopenic group. The semantic and progressive fluent aphasia groups had prominent anomia, but only semantic subjects had loss of word meaning and object knowledge. Distinct patterns of grey matter loss and white matter changes were found in all groups compared to controls. PAOS subjects had bilateral frontal grey matter loss, including the premotor and supplementary motor areas, and bilateral frontal white matter involvement. The agrammatic group had more widespread, predominantly left sided grey matter loss and white matter abnormalities. Semantic subjects had bitemporal grey matter loss and white matter changes, including the uncinate and inferior occipitofrontal fasciculi, whereas progressive fluent subjects only had left sided temporal involvement. Logopenic subjects had diffuse and bilateral grey matter loss and diffusion tensor abnormalities, maximal in the posterior temporal region. A diagnosis of logopenic aphasia was strongly associated with being amyloid positive (46

  14. Classification and clinicoradiologic features of primary progressive aphasia (PPA) and apraxia of speech

    PubMed Central

    Botha, Hugo; Duffy, Joseph R.; Whitwell, Jennifer L.; Strand, Edythe A.; Machulda, Mary M.; Schwarz, Christopher G.; Reid, Robert I.; Spychalla, Anthony J.; Senjem, Matthew L.; Jones, David T.; Lowe, Val; Jack, Clifford R.; Josephs, Keith A.

    2015-01-01

    The consensus criteria for the diagnosis and classification of primary progressive aphasia (PPA) have served as an important tool in studying this group of disorders. However, a large proportion of patients remain unclassifiable whilst others simultaneously meet criteria for multiple subtypes. We prospectively evaluated a large cohort of patients with degenerative aphasia and/or apraxia of speech using multidisciplinary clinical assessments and multimodal imaging. Blinded diagnoses were made using operational definitions with important differences compared to the consensus criteria. Of the 130 included patients, 40 were diagnosed with progressive apraxia of speech (PAOS), 12 with progressive agrammatic aphasia, 9 with semantic dementia, 52 with logopenic progressive aphasia, and 4 with progressive fluent aphasia, while 13 were unclassified. The PAOS and progressive fluent aphasia groups were least impaired. Performance on repetition and sentence comprehension was especially poor in the logopenic group. The semantic and progressive fluent aphasia groups had prominent anomia, but only semantic subjects had loss of word meaning and object knowledge. Distinct patterns of grey matter loss and white matter changes were found in all groups compared to controls. PAOS subjects had bilateral frontal grey matter loss, including the premotor and supplementary motor areas, and bilateral frontal white matter involvement. The agrammatic group had more widespread, predominantly left sided grey matter loss and white matter abnormalities. Semantic subjects had bitemporal grey matter loss and white matter changes, including the uncinate and inferior occipitofrontal fasciculi, whereas progressive fluent subjects only had left sided temporal involvement. Logopenic subjects had diffuse and bilateral grey matter loss and diffusion tensor abnormalities, maximal in the posterior temporal region. A diagnosis of logopenic aphasia was strongly associated with being amyloid positive, (46

  15. Distinct spatiotemporal patterns of neuronal functional connectivity in primary progressive aphasia variants.

    PubMed

    Ranasinghe, Kamalini G; Hinkley, Leighton B; Beagle, Alexander J; Mizuiri, Danielle; Honma, Susanne M; Welch, Ariane E; Hubbard, Isabel; Mandelli, Maria Luisa; Miller, Zachary A; Garrett, Coleman; La, Alice; Boxer, Adam L; Houde, John F; Miller, Bruce L; Vossel, Keith A; Gorno-Tempini, Maria Luisa; Nagarajan, Srikantan S

    2017-10-01

    Primary progressive aphasia is a syndrome characterized by progressive loss of language abilities with three main phenotypic clinical presentations, including logopenic, non-fluent/agrammatic, and semantic variants. Previous imaging studies have shown unique anatomic impacts within language networks in each variant. However, direct measures of spontaneous neuronal activity and functional integrity of these impacted neural networks in primary progressive aphasia are lacking. The aim of this study was to characterize the spatial and temporal patterns of resting state neuronal synchronizations in primary progressive aphasia syndromes. We hypothesized that resting state brain oscillations will show unique deficits within language network in each variant of primary progressive aphasia. We examined 39 patients with primary progressive aphasia including logopenic variant (n = 14, age = 61 ± 9 years), non-fluent/agrammatic variant (n = 12, age = 71 ± 8 years) and semantic variant (n = 13, age = 65 ± 7 years) using magnetoencephalographic imaging, compared to a control group that was matched in age and gender to each primary progressive aphasia subgroup (n = 20, age = 65 ± 5 years). Each patient underwent a complete clinical evaluation including a comprehensive battery of language tests. We examined the whole-brain resting state functional connectivity as measured by imaginary coherence in each patient group compared to the control cohort, in three frequency oscillation bands-delta-theta (2-8 Hz); alpha (8-12 Hz); beta (12-30 Hz). Each variant showed a distinct spatiotemporal pattern of altered functional connectivity compared to age-matched controls. Specifically, we found significant hyposynchrony of alpha and beta frequency within the left posterior temporal and occipital cortices in patients with the logopenic variant, within the left inferior frontal cortex in patients with the non-fluent/agrammatic variant, and within the left temporo-parietal junction in patients

  16. Real-time production of arguments and adjuncts in normal and agrammatic speakers.

    PubMed

    Lee, Jiyeon; Thompson, Cynthia K

    2011-10-01

    Two eyetracking experiments examined the real-time production of verb arguments and adjuncts in healthy and agrammatic aphasic speakers. Verb argument structure has been suggested to play an important role during grammatical encoding (Bock & Levelt, 1994) and in speech deficits of agrammatic aphasic speakers (Thompson, 2003). However, little is known about how adjuncts are processed during sentence production. The present experiments measured eye movements while speakers were producing sentences with a goal argument (e.g., the mother is applying lotion to the baby) and a beneficiary adjunct phrase (e.g., the mother is choosing lotion for the baby) using a set of computer-displayed written words. Results showed that the sentence production system experiences greater processing cost for producing adjuncts than verb arguments and this distinction is preserved even after brain-damage. In Experiment 1, healthy young speakers showed greater gaze durations and gaze shifts for adjuncts as compared to arguments. The same patterns were found in agrammatic and older speakers in Experiment 2. Interestingly, the three groups of speakers showed different time courses for encoding adjuncts: young speakers showed greater processing cost for adjuncts during speech, consistent with incremental production (Kempen & Hoenkamp, 1987). Older speakers showed this difference both before speech onset and during speech, while aphasic speakers appeared to preplan adjuncts before speech onset. These findings suggest that the degree of incrementality may be affected by speakers' linguistic capacity.

  17. Real-time production of arguments and adjuncts in normal and agrammatic speakers

    PubMed Central

    Lee, Jiyeon; Thompson, Cynthia K.

    2012-01-01

    Two eyetracking experiments examined the real-time production of verb arguments and adjuncts in healthy and agrammatic aphasic speakers. Verb argument structure has been suggested to play an important role during grammatical encoding (Bock & Levelt, 1994) and in speech deficits of agrammatic aphasic speakers (Thompson, 2003). However, little is known about how adjuncts are processed during sentence production. The present experiments measured eye movements while speakers were producing sentences with a goal argument (e.g., the mother is applying lotion to the baby) and a beneficiary adjunct phrase (e.g., the mother is choosing lotion for the baby) using a set of computer-displayed written words. Results showed that the sentence production system experiences greater processing cost for producing adjuncts than verb arguments and this distinction is preserved even after brain-damage. In Experiment 1, healthy young speakers showed greater gaze durations and gaze shifts for adjuncts as compared to arguments. The same patterns were found in agrammatic and older speakers in Experiment 2. Interestingly, the three groups of speakers showed different time courses for encoding adjuncts: young speakers showed greater processing cost for adjuncts during speech, consistent with incremental production (Kempen & Hoenkamp, 1987). Older speakers showed this difference both before speech onset and during speech, while aphasic speakers appeared to preplan adjuncts before speech onset. These findings suggest that the degree of incrementality may be affected by speakers’ linguistic capacity. PMID:22319222

  18. Primary Progressive Aphasia

    MedlinePlus

    Primary progressive aphasia Overview By Mayo Clinic Staff Primary progressive aphasia (uh-FAY-zhuh) is a rare nervous system (neurological) syndrome ... your ability to communicate. People with primary progressive aphasia can have trouble expressing their thoughts and understanding ...

  19. The role of written language in the rehabilitation process of brain injury and aphasia: the memory of the movement in the reacquisition of language.

    PubMed

    Pinhasi-Vittorio, Limor

    2007-01-01

    This qualitative case study describes the use of written language over a period of two years, with a young adult who sustained brain injury and as a result has expressive and receptive aphasia. The study demonstrates the ways in which written language can enhance the development of the expression of thoughts. The "memory of the movement" strategy enabled him to initiate ideation and restore his language. One of the powerful aspects of the research was the natural choice of mediating his thoughts through the writing of poetry. The importance of this research is the encouragement of holistic and interdisciplinary approaches to promote the language rehabilitation process of individuals who have aphasia.

  20. The comprehension of sentences with unaccusative verbs in aphasia: a test of the intervener hypothesis

    PubMed Central

    Sullivan, Natalie; Walenski, Matthew; Love, Tracy; Shapiro, Lewis P.

    2016-01-01

    Background It is well accepted that individuals with agrammatic Broca’s aphasia have difficulty comprehending some sentences with filler-gap dependencies. While investigations of these difficulties have been conducted with several different sentence types (e.g., object relatives, Wh-questions), we explore sentences containing unaccusative verbs, which arguably have a single noun phrase (NP) that is base-generated in object position but then is displaced to surface subject position. Unaccusative verbs provide an ideal test case for a particular hypothesis about the comprehension disorder—the Intervener Hypothesis—that posits that the difficulty individuals with agrammatic Broca’s aphasia have comprehending sentences containing filler-gap dependencies results from similarity-based interference caused by the presence of an intervening NP between the two elements of a syntactic chain. Aim To assess a particular account of the comprehension deficit in agrammatic Broca’s aphasia—the Intervener Hypothesis. Methods & Procedures We used a sentence–picture matching task to determine if listeners with agrammatic Broca’s aphasia (LWBA) and age-matched neurologically unimpaired controls (AMC) have difficulty comprehending unaccusative verbs when placed in subject relative and complement phrase (CP) constructions. Outcomes & Results We found above-chance comprehension of both sentence constructions with the AMC participants. In contrast, we found above-chance comprehension of CP sentences containing unaccusative verbs but poor comprehension of subject relative sentences containing unaccusative verbs for the LWBA. Conclusions These results provide support for the Intervener Hypothesis, wherein the presence of an intervening NP between two elements of a filler-gap dependency adversely affects sentence comprehension. PMID:27909354

  1. Comparison of the Recovery Patterns of Language and Cognitive Functions in Patients with Post-Traumatic Language Processing Deficits and in Patients with Aphasia Following a Stroke

    ERIC Educational Resources Information Center

    Vukovic, Mile; Vuksanovic, Jasmina; Vukovic, Irena

    2008-01-01

    In this study we investigated the recovery patterns of language and cognitive functions in patients with post-traumatic language processing deficits and in patients with aphasia following a stroke. The correlation of specific language functions and cognitive functions was analyzed in the acute phase and 6 months later. Significant recovery of the…

  2. Eye movements as probes of lexico-semantic processing in a patient with primary progressive aphasia.

    PubMed

    Seckin, Mustafa; Mesulam, M-Marsel; Rademaker, Alfred W; Voss, Joel L; Weintraub, Sandra; Rogalski, Emily J; Hurley, Robert S

    2016-01-01

    Eye movement trajectories during a verbally cued object search task were used as probes of lexico-semantic associations in an anomic patient with primary progressive aphasia. Visual search was normal on trials where the target object could be named but became lengthy and inefficient on trials where the object failed to be named. The abnormality was most profound if the noun denoting the object could not be recognized. Even trials where the name of the target object was recognized but not retrieved triggered abnormal eye movements, demonstrating that retrieval failures can have underlying associative components despite intact comprehension of the corresponding noun.

  3. Improved Neural Processing Efficiency in a Chronic Aphasia Patient Following Melodic Intonation Therapy: A Neuropsychological and Functional MRI Study

    PubMed Central

    Tabei, Ken-ichi; Satoh, Masayuki; Nakano, Chizuru; Ito, Ai; Shimoji, Yasuo; Kida, Hirotaka; Sakuma, Hajime; Tomimoto, Hidekazu

    2016-01-01

    Melodic intonation therapy (MIT) is a treatment program for the rehabilitation of aphasic patients with speech production disorders. We report a case of severe chronic non-fluent aphasia unresponsive to several years of conventional therapy that showed a marked improvement following intensive 9-day training on the Japanese version of MIT (MIT-J). The purpose of this study was to verify the efficacy of MIT-J by functional assessment and examine associated changes in neural processing by functional magnetic resonance imaging. MIT improved language output and auditory comprehension, and decreased the response time for picture naming. Following MIT-J, an area of the right hemisphere was less activated on correct naming trials than compared with before training but similarly activated on incorrect trials. These results suggest that the aphasic symptoms of our patient were improved by increased neural processing efficiency and a concomitant decrease in cognitive load. PMID:27698650

  4. Augmentative and Alternative Communication (AAC) for a patient with a nonfluent/agrammatic variant of PPA in the mutism stage.

    PubMed

    Góral-Półrola, Jolanta; Półrola, Paweł; Mirska, Natalia; Mirski, Andrzej; Herman-Sucharska, Izabela; Pąchalska, Maria

    2016-01-01

    The paper presents an example of the successful administration of the Augmentative and Alternative Communication (AAC) system. Such an approach is of particular significance in cases of patients with speech and language deterioration, which is observed in a nonfluent/agrammatic variant of primary progressive aphasia (PPA-G). Regaining the ability to communicate with others proves to be very important for the patients' self-esteem and enables them to restore previously broken social bonds. The patient A.G., aged 73, a right-handed woman, had been a teacher of Polish before suffering from speech disorders of the PPA-G type. As the disease progressed, her communication deteriorated and finally she developed mutism. The patient was given a clinical and imaging-supported diagnosis of an isolated nonfluent/ agrammatic variant of primary progressive aphasia (PPA-G). The Augmentative and Alternative Communication (AAC) system specially designed for her needs was introduced to help the patient to regain the possibility to communicate. After 20 sessions of training with the use of simple equipment she was again able to communicate non-verbally with her son and with the staff of the nursing home. At the same time, a considerable improvements in her social functioning, including daily activities, was observed. Loss of the ability to communicate with others has a serious impact upon a patient's quality of life, and often results in withdrawal and an inability to lead an independent life. The introduction of the Augmentative and Alternative Communication (AAC) system proves to be a great help, not only for regaining the ability to communicate, but also for the restoration of social bonds. In consequence, the previously mute patient begins to show signs of social cooperation.

  5. Healthy brain connectivity predicts atrophy progression in non-fluent variant of primary progressive aphasia.

    PubMed

    Mandelli, Maria Luisa; Vilaplana, Eduard; Brown, Jesse A; Hubbard, H Isabel; Binney, Richard J; Attygalle, Suneth; Santos-Santos, Miguel A; Miller, Zachary A; Pakvasa, Mikhail; Henry, Maya L; Rosen, Howard J; Henry, Roland G; Rabinovici, Gil D; Miller, Bruce L; Seeley, William W; Gorno-Tempini, Maria Luisa

    2016-10-01

    Neurodegeneration has been hypothesized to follow predetermined large-scale networks through the trans-synaptic spread of toxic proteins from a syndrome-specific epicentre. To date, no longitudinal neuroimaging study has tested this hypothesis in vivo in frontotemporal dementia spectrum disorders. The aim of this study was to demonstrate that longitudinal progression of atrophy in non-fluent/agrammatic variant primary progressive aphasia spreads over time from a syndrome-specific epicentre to additional regions, based on their connectivity to the epicentre in healthy control subjects. The syndrome-specific epicentre of the non-fluent/agrammatic variant of primary progressive aphasia was derived in a group of 10 mildly affected patients (clinical dementia rating equal to 0) using voxel-based morphometry. From this region, the inferior frontal gyrus (pars opercularis), we derived functional and structural connectivity maps in healthy controls (n = 30) using functional magnetic resonance imaging at rest and diffusion-weighted imaging tractography. Graph theory analysis was applied to derive functional network features. Atrophy progression was calculated using voxel-based morphometry longitudinal analysis on 34 non-fluent/agrammatic patients. Correlation analyses were performed to compare volume changes in patients with connectivity measures of the healthy functional and structural speech/language network. The default mode network was used as a control network. From the epicentre, the healthy functional connectivity network included the left supplementary motor area and the prefrontal, inferior parietal and temporal regions, which were connected through the aslant, superior longitudinal and arcuate fasciculi. Longitudinal grey and white matter changes were found in the left language-related regions and in the right inferior frontal gyrus. Functional connectivity strength in the healthy speech/language network, but not in the default network, correlated with

  6. Comparing the production of complex sentences in Persian patients with post-stroke aphasia and non-damaged people with normal speaking

    PubMed Central

    Mehri, Azar; Ghorbani, Askar; Darzi, Ali; Jalaie, Shohreh; Ashayeri, Hassan

    2016-01-01

    Background: Cerebrovascular disease leading to stroke is the most common cause of aphasia. Speakers with agrammatic non-fluent aphasia have difficulties in production of movement-derived sentences such as passive sentences, topicalized constituents, and Wh-questions. To assess the production of complex sentences, some passive, topicalized and focused sentences were designed for patients with non-fluent Persian aphasic. Afterwards, patients’ performance in sentence production was tested and compared with healthy non-damaged subjects. Methods: In this cross sectional study, a task was designed to assess the different types of sentences (active, passive, topicalized and focused) adapted to Persian structures. Seven Persian patients with post-stroke non-fluent agrammatic aphasia (5 men and 2 women) and seven healthy non-damaged subjects participated in this study. The computed tomography (CT) scan or magnetic resonance imaging (MRI) showed that all the patients had a single left hemisphere lesion involved middle cerebral artery (MCA), Broca`s area and in its white matter. In addition, based on Bedside version of Persian Western Aphasia Battery (P-WAB-1), all of them were diagnosed with moderate Broca aphasia. Then, the production task of Persian complex sentences was administered. Results: There was a significant difference between four types of sentences in patients with aphasia [Degree of freedom (df) = 3, P < 0.001]. All the patients showed worse performance than the healthy participants in all the four types of sentence production (P < 0.050). Conclusion: In general, it is concluded that topicalized and focused sentences as non-canonical complex sentences in Persian are very difficult to produce for patients with agrammatic non-fluent aphasia. It seems that sentences with A-movement are simpler for the patients than sentences involving A`-movement; since they include shorter movements in compare to topicalized and focused sentences. PMID:27141274

  7. Comparing the production of complex sentences in Persian patients with post-stroke aphasia and non-damaged people with normal speaking.

    PubMed

    Mehri, Azar; Ghorbani, Askar; Darzi, Ali; Jalaie, Shohreh; Ashayeri, Hassan

    2016-01-05

    Cerebrovascular disease leading to stroke is the most common cause of aphasia. Speakers with agrammatic non-fluent aphasia have difficulties in production of movement-derived sentences such as passive sentences, topicalized constituents, and Wh-questions. To assess the production of complex sentences, some passive, topicalized and focused sentences were designed for patients with non-fluent Persian aphasic. Afterwards, patients' performance in sentence production was tested and compared with healthy non-damaged subjects. In this cross sectional study, a task was designed to assess the different types of sentences (active, passive, topicalized and focused) adapted to Persian structures. Seven Persian patients with post-stroke non-fluent agrammatic aphasia (5 men and 2 women) and seven healthy non-damaged subjects participated in this study. The computed tomography (CT) scan or magnetic resonance imaging (MRI) showed that all the patients had a single left hemisphere lesion involved middle cerebral artery (MCA), Broca`s area and in its white matter. In addition, based on Bedside version of Persian Western Aphasia Battery (P-WAB-1), all of them were diagnosed with moderate Broca aphasia. Then, the production task of Persian complex sentences was administered. There was a significant difference between four types of sentences in patients with aphasia [Degree of freedom (df) = 3, P < 0.001]. All the patients showed worse performance than the healthy participants in all the four types of sentence production (P < 0.050). In general, it is concluded that topicalized and focused sentences as non-canonical complex sentences in Persian are very difficult to produce for patients with agrammatic non-fluent aphasia. It seems that sentences with A-movement are simpler for the patients than sentences involving A`-movement; since they include shorter movements in compare to topicalized and focused sentences.

  8. Alexia and agraphia in Wernicke's aphasia.

    PubMed Central

    Kirshner, H S; Webb, W G

    1982-01-01

    Three patients with otherwise typical Wernicke's aphasia showed consistently greater impairment of reading than auditory comprehension. While this syndrome resembles alexia with agraphia, the paraphasia of speech, repetition, and naming underline the aphasic nature of the disorder. Together with previous reports of isolated word deafness in Wernicke's aphasia, these cases suggest a relative independence of auditory and visual language processing. Images PMID:7130996

  9. The role of noun syntax in spoken word production: evidence from aphasia.

    PubMed

    Herbert, Ruth; Best, Wendy

    2010-03-01

    We describe MH who presents with agrammatic aphasia and anomia, and who produces semantic errors in the absence of a central semantic impairment. This pattern of performance implies damage to syntactic processes operating between semantics and phonological output. Damage here may lead to lexical selection errors and a deficit in combining words to form phrases. We investigated MH's knowledge and processing of noun syntax in mass and count nouns. She produced more count nouns than mass nouns. She showed impaired knowledge of noun syntax in judgement tasks and production tasks, with mass noun syntax being more impaired than count. We interpret these results in terms of a two-stage model of lexical retrieval. We propose that syntactic information represented at the lemma level is activated even in bare noun production, and can be differentially impaired across noun categories. That same damage can lead to semantic errors in production. For MH limited syntactic options are available to support production, and these favour count noun production. The data provide a new account of output semantic errors. Copyright (c) 2009 Elsevier Srl. All rights reserved.

  10. Adaptation to aphasia: grammar, prosody and interaction.

    PubMed

    Rhys, Catrin S; Ulbrich, Christiane; Ordin, Mikhail

    2013-01-01

    This paper investigates recurrent use of the phrase very good by a speaker with non-fluent agrammatic aphasia. Informal observation of the speaker's interaction reveals that she appears to be an effective conversational partner despite very severe word retrieval difficulties that result in extensive reliance on variants of the phrase very good. The question that this paper addresses using an essentially conversation analytic framework is: What is the speaker achieving through these variants of very good and what are the linguistic and interactional resources that she draws on to achieve these communicative effects? Tokens of very good in the corpus were first analyzed in a bottom-up fashion, attending to sequential position, structure and participant orientation. This revealed distinct uses that were subsequently subjected to detailed acoustic analysis in order to investigate specific prosodic characteristics within and across the interactional variants. We identified specific clusters of prosodic cues that were exploited by the speaker to differentiate interactional uses of very good. The analysis thus shows how, in the adaptation to aphasia, the speaker exploits the rich interface between prosody, grammar and interaction both to manage the interactional demands of conversation and to communicate propositional content.

  11. A note on the "word-order problem" in agrammatism.

    PubMed

    Caplan, D

    1983-09-01

    This brief note has two parts. First, it presents an analysis of the ability of English agrammatic patients to assign the thematic roles of agent, instrument, theme, and locative to noun phrases in active and passive sentences and prepositional phrases. Data regarding this ability have been presented by Schwartz, Saffran, and Marin (Brain and Language, 10, 149-262 (1980) regarding comprehension, and by Saffran, Schwartz, and Marin (Brain and Language, 10, 263-280 (1980) regarding production. These authors claim their data show that English agrammatic aphasics do not map "word order" onto thematic information. However, a very simple set of principles accounts for all their results, including results which are discrepant in their treatment, but requires that English agrammatics assign thematic roles to NPs in part by virtue of the position of an NP in a sentence or a phrase. In the second part of this note, several issues raised by this re-analysis are briefly discussed.

  12. A case of "order insensitivity"? Natural and artificial language processing in a man with primary progressive aphasia.

    PubMed

    Zimmerer, Vitor C; Varley, Rosemary A

    2015-08-01

    Processing of linear word order (linear configuration) is important for virtually all languages and essential to languages such as English which have little functional morphology. Damage to systems underpinning configurational processing may specifically affect word-order reliant sentence structures. We explore order processing in WR, a man with primary progressive aphasia (PPA). In a previous report, we showed how WR showed impaired processing of actives, which rely strongly on word order, but not passives where functional morphology signals thematic roles. Using the artificial grammar learning (AGL) paradigm, we examined WR's ability to process order in non-verbal, visual sequences and compared his profile to that of healthy controls, and aphasic participants with and without severe syntactic disorder. Results suggested that WR, like some other patients with severe syntactic impairment, was unable to detect linear configurational structure. The data are consistent with the notion that disruption of possibly domain-general linearization systems differentially affects processing of active and passive sentence structures. Further research is needed to test this account, and we suggest hypotheses for future studies. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Change of Accent as an Atypical Onset of non Fluent Primary Progressive Aphasia

    PubMed Central

    Paolini, Susy; Paciaroni, Lucia; Manca, Antonio; Rossi, Roberto; Fornarelli, Daniela; Cappa, Stefano F.; Abbatecola, Angela M.; Scarpino, Osvaldo

    2013-01-01

    Language disorders can be the first symptom of many neurodegenerative diseases, including Alzheimer's disease (AD) and primary progressive aphasia (PPA). The main variants of PPA are: the non-fluent/agrammatic variant, the semantic variant and the logopenic variant. Several additional variants of PPA, however, have been described and are considered as atypical presentations. We describe the case of a woman presenting a progressive isolated language disturbance, characterized by an early dysprosodia, phonological and semantic paraphasias, agrammatism, impairment in repetition, writing of non-words and sentence comprehension. This clinical picture pointed to an atypical presentation of the non-fluent variety. The frequent symptom overlap between the different variants of PPA, most likely reflecting differences in the topography of the pathological changes, needs to be considered in the definition of diagnostic criteria. PMID:23396217

  14. Change of accent as an atypical onset of non fluent primary progressive aphasia.

    PubMed

    Paolini, Susy; Paciaroni, Lucia; Manca, Antonio; Rossi, Roberto; Fornarelli, Daniela; Cappa, Stefano F; Abbatecola, Angela M; Scarpino, Osvaldo

    2013-01-01

    Language disorders can be the first symptom of many neurodegenerative diseases, including Alzheimer's disease (AD) and primary progressive aphasia (PPA). The main variants of PPA are: the non-fluent/agrammatic variant, the semantic variant and the logopenic variant.Several additional variants of PPA, however, have been described and are considered as atypical presentations. We describe the case of a woman presenting a progressive isolated language disturbance, characterized by an early dysprosodia, phonological and semantic paraphasias, agrammatism, impairment in repetition, writing of non-words and sentence comprehension. This clinical picture pointed to an atypical presentation of the non-fluent variety. The frequent symptom overlap between the different variants of PPA, most likely reflecting differences in the topography of the pathological changes, needs to be considered in the definition of diagnostic criteria.

  15. Primary progressive aphasia and the language network: the 2013 H. Houston Merritt Lecture.

    PubMed

    Mesulam, M-Marsel

    2013-07-30

    Review of clinical and biological features of primary progressive aphasia (PPA). The PPA syndrome arises when language-dominant (usually left) hemisphere becomes the principal target of neurodegeneration. Depending on the distribution of neuronal loss within the language network, agrammatic (PPA-G), logopenic (PPA-L), and semantic (PPA-S) subtypes are identified. The most common underlying neuropathology is frontotemporal degeneration with tauopathy in PPA-G, frontotemporal degeneration with TDP-43 proteinopathy in PPA-S, and Alzheimer pathology in PPA-L. When Alzheimer pathology is detected, the neurofibrillary tangles show lower entorhinal-to-neocortical ratios and greater leftward asymmetry in PPA than in the typical amnestic dementia of Alzheimer disease. The ε4 allele of APOE, a major risk factor for Alzheimer pathology in amnestic dementias, is not a risk factor for Alzheimer pathology in PPA. These observations indicate that Alzheimer disease has biological variants with distinct patterns of lesion distribution and perhaps also molecular background. The selective vulnerability of the language network in PPA is likely to reflect complex interactions between factors that determine the type of histopathology, on one hand, and those that influence the resilience of the language network, on the other. A history of learning disability, including dyslexia, is emerging as one of the potential factors in this second group of determinants. Patient care in PPA should be individualized so that speech therapy can address the specific type of language impairment while pharmacologic therapy is directed to the underlying disease process.

  16. Differentiating core and co-opted mechanisms in calculation: the neuroimaging of calculation in aphasia.

    PubMed

    Benn, Yael; Wilkinson, Iain D; Zheng, Ying; Cohen Kadosh, Kathrin; Romanowski, Charles A J; Siegal, Michael; Varley, Rosemary

    2013-08-01

    The role of language in exact calculation is the subject of debate. Some behavioral and functional neuroimaging investigations of healthy participants suggest that calculation requires language resources. However, there are also reports of individuals with severe aphasic language impairment who retain calculation ability. One possibility in resolving these discordant findings is that the neural basis of calculation has undergone significant reorganization in aphasic calculators. Using fMRI, we examined brain activations associated with exact addition and subtraction in two patients with severe agrammatic aphasia and retained calculation ability. Behavior and brain activations during two-digit addition and subtraction were compared to those of a group of 11 healthy, age-matched controls. Behavioral results confirmed that both patients retained calculation ability. Imaging findings revealed individual differences in processing, but also a similar activation pattern across patients and controls in bilateral parietal cortices. Patients differed from controls in small areas of increased activation in peri-lesional regions, a shift from left fronto-temporal activation to the contralateral region, and increased activations in bilateral superior parietal regions. Our results suggest that bilateral parietal cortex represents the core of the calculation network and, while healthy controls may recruit language resources to support calculation, these mechanisms are not mandatory in adult cognition.

  17. [Hearing disorders in aphasia].

    PubMed

    Läßig, A K; Kreter, S; Nospes, S; Keilmann, A

    2013-08-01

    Aphasia is an acquired communication disorder that often involves receptive language abilities. After clinical assessment it is often not clear if this is partially due to a hearing loss, which can be compensated by hearing aids facilitating the rehabilitative process.In the present study the hearing ability of 88 male and female patients with aphasia after stroke, all of whom suffered from a left-hemispheric ischemia was assessed in the rehabilitative setting.We found that a majority of patients (72, 82%) was able to perform pure tone audiometry. 15 aphasic patients (21%) showed a hearing loss and were not fitted with hearing aids.Patients with aphasia are due to their central speech disorders in their communication skills limited, so that the therapeutic success is further reduced by an existing hearing loss. Due to the demographic development of our people and with the age increasing prevalence of hearing impairment hearing screening in the post-acute phase in aphasic patients is justified by pure tone audiometry. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Nonfluent/agrammatic PPA with in-vivo cortical amyloidosis and Pick's disease pathology.

    PubMed

    Caso, Francesca; Gesierich, Benno; Henry, Maya; Sidhu, Manu; LaMarre, Amanda; Babiak, Miranda; Miller, Bruce L; Rabinovici, Gil D; Huang, Eric J; Magnani, Giuseppe; Filippi, Massimo; Comi, Giancarlo; Seeley, William W; Gorno-Tempini, Maria Luisa

    2013-01-01

    The role of biomarkers in predicting pathological findings in the frontotemporal dementia (FTD) clinical spectrum disorders is still being explored. We present comprehensive, prospective longitudinal data for a 66 year old, right-handed female who met current criteria for the nonfluent/agrammatic variant of primary progressive aphasia (nfvPPA). She first presented with a 3-year history of progressive speech and language impairment mainly characterized by severe apraxia of speech. Neuropsychological and general motor functions remained relatively spared throughout the clinical course. Voxel-based morphometry (VBM) showed selective cortical atrophy of the left posterior inferior frontal gyrus (IFG) and underlying insula that worsened over time, extending along the left premotor strip. Five years after her first evaluation, she developed mild memory impairment and underwent PET-FDG and PiB scans that showed left frontal hypometabolism and cortical amyloidosis. Three years later (11 years from first symptom), post-mortem histopathological evaluation revealed Pick's disease, with severe degeneration of left IFG, mid-insula, and precentral gyrus. Alzheimer's disease (AD) (CERAD frequent/Braak Stage V) was also detected. This patient demonstrates that biomarkers indicating brain amyloidosis should not be considered conclusive evidence that AD pathology accounts for a typical FTD clinical/anatomical syndrome.

  19. Nonfluent/Agrammatic PPA with In-Vivo Cortical Amyloidosis and Pick’s Disease Pathology

    PubMed Central

    Caso, Francesca; Gesierich, Benno; Henry, Maya; Sidhu, Manu; LaMarre, Amanda; Babiak, Miranda; Miller, Bruce L.; Rabinovici, Gil D.; Huang, Eric J.; Magnani, Giuseppe; Filippi, Massimo; Comi, Giancarlo; Seeley, William W.; Gorno-Tempini, Maria Luisa

    2013-01-01

    The role of biomarkers in predicting pathological findings in the frontotemporal dementia (FTD) clinical spectrum disorders is still being explored. We present comprehensive, prospective longitudinal data for a 66 year old, right-handed female who met current criteria for the nonfluent/agrammatic variant of primary progressive aphasia (nfvPPA). She first presented with a 3-year history of progressive speech and language impairment mainly characterized by severe apraxia of speech. Neuropsychological and general motor functions remained relatively spared throughout the clinical course. Voxel-based morphometry (VBM) showed selective cortical atrophy of the left posterior inferior frontal gyrus (IFG) and underlying insula that worsened over time, extending along the left premotor strip. Five years after her first evaluation, she developed mild memory impairment and underwent PET-FDG and PiB scans that showed left frontal hypometabolism and cortical amyloidosis. Three years later (11 years from first symptom), post-mortem histopathological evaluation revealed Pick's disease, with severe degeneration of left IFG, mid-insula, and precentral gyrus. Alzheimer’s disease (AD) (CERAD frequent/Braak Stage V) was also detected. This patient demonstrates that biomarkers indicating brain amyloidosis should not be considered conclusive evidence that AD pathology accounts for a typical FTD clinical/anatomical syndrome. PMID:22713404

  20. Optic Aphasia: A Case Study

    PubMed Central

    Lee, Jae-Hong

    2006-01-01

    Optic aphasia is a rare syndrome in which patients are unable to name visually presented objects but have no difficulty in naming those objects on tactile or verbal presentation. We report a 79-year-old man who exhibited anomic aphasia after a left posterior cerebral artery territory infarction. His naming ability was intact on tactile and verbal semantic presentation. The results of the systematic assessment of visual processing of objects and letters indicated that he had optic aphasia with mixed features of visual associative agnosia. Interestingly, although he had difficulty reading Hanja (an ideogram), he could point to Hanja letters on verbal description of their meaning, suggesting that the processes of recognizing objects and Hanja share a common mechanism. PMID:20396529

  1. Frontal Lobe Damage Impairs Process and Content in Semantic Memory: Evidence from Category Specific Effects in Progressive Nonfluent Aphasia

    PubMed Central

    Reilly, Jamie; Rodriguez, Amy D.; Peelle, Jonathan E.; Grossman, Murray

    2010-01-01

    Portions of left inferior frontal cortex have been linked to semantic memory both in terms of the content of conceptual representation (e.g., motor aspects in an embodied semantics framework) and the cognitive processes used to access these representations (e.g., response selection). Progressive Nonfluent Aphasia (PNFA) is a neurodegenerative condition characterized by progressive atrophy of left inferior frontal cortex. PNFA can, therefore, provide a lesion model for examining the impact of frontal lobe damage on semantic processing and content. In the current study we examined picture naming in a cohort of PNFA patients across a variety of semantic categories. An embodied approach to semantic memory holds that sensorimotor features such as self-initiated action may assume differential importance for the representation of manufactured artifacts (e.g., naming hand tools). Embodiment theories might therefore predict that patients with frontal damage would be differentially impaired on manufactured artifacts relative to natural kinds, and this prediction was borne out. We also examined patterns of naming errors across a wide range of semantic categories and found that naming error distributions were heterogeneous. Although PNFA patients performed worse overall on naming manufactured artifacts, there was no reliable relationship between anomia and manipulability across semantic categories. These results add to a growing body of research arguing against a purely sensorimotor account of semantic memory, suggesting instead a more nuanced balance of process and content in how the brain represents conceptual knowledge. PMID:20576258

  2. Written language impairments in primary progressive aphasia: A reflection of damage to central semantic and phonological processes

    PubMed Central

    Henry, Maya L.; Beeson, Pélagie M.; Alexander, Gene E.; Rapcsak, Steven Z.

    2012-01-01

    Connectionist theories of language propose that written language deficits arise as a result of damage to semantic and phonological systems that also support spoken language production and comprehension, a view referred to as the “primary systems” hypothesis. The objective of the current study was to evaluate the primary systems account in a mixed group of individuals with primary progressive aphasia (PPA) by investigating the relation between measures of non-orthographic semantic and phonological processing and written language performance, and by examining whether common patterns of cortical atrophy underlie impairments in spoken versus written language domains. Individuals with PPA and healthy controls were administered a language battery including assessments of semantics, phonology, reading, and spelling. Voxel-based morphometry was used to examine the relation between gray matter volumes and language measures within brain regions previously implicated in semantic and phonological processing. In accordance with the primary systems account, our findings indicate that spoken language performance is strongly predictive of reading/spelling profile in individuals with PPA and suggest that common networks of critical left hemisphere regions support central semantic and phonological processes recruited for spoken and written language. PMID:22004048

  3. Progress in the last decade in our understanding of primary progressive aphasia.

    PubMed

    Ratnavalli, Ellajosyula

    2010-12-01

    Primary progressive aphasia (PPA) is a focal neurodegeneration of the brain affecting the language network. Patients can have isolated language impairment for years without impairment in other areas. PPA is classified as primary progressive nonfluent aphasia (PNFA), semantic dementia (SD), and logopenic aphasia, which have distinct patterns of atrophy on neuroimaging. PNFA and SD are included under frontotemporal lobar degenerations. PNFA patients have effortful speech with agrammatism, which is frequently associated with apraxia of speech and demonstrate atrophy in the left Broca's area and surrounding region on neuroimaging. Patients with SD have dysnomia with loss of word and object (or face) meaning with asymmetric anterior temporal lobe atrophy. Logopenic aphasics have word finding difficulties with frequent pauses in conversation, intact grammar, and word comprehension but impaired repetition for sentences. The atrophy is predominantly in the left posterior temporal and inferior parietal regions. Recent studies have described several progranulin mutations on chromosome 17 in PNFA. The three clinical syndromes have a less robust relationship to the underlying pathology, which is heterogeneous and includes tauopathy, ubiquitinopathy, Pick's disease, corticobasal degeneration, progressive supranuclear palsy, and Alzheimer's disease. Recent studies, however, seem to indicate that a better characterization of the clinical phenotype (apraxic, agrammatic, semantic, logopenic, jargon) increases the predictive value of the underlying pathology. Substantial advances have been made in our understanding of PPAs but developing new biomarkers is essential in making accurate causative diagnoses in individual patients. This is critically important in the development and evaluation of disease-modifying drugs.

  4. Varieties of semantic 'access' deficit in Wernicke's aphasia and semantic aphasia.

    PubMed

    Thompson, Hannah E; Robson, Holly; Lambon Ralph, Matthew A; Jefferies, Elizabeth

    2015-12-01

    Comprehension deficits are common in stroke aphasia, including in cases with (i) semantic aphasia, characterized by poor executive control of semantic processing across verbal and non-verbal modalities; and (ii) Wernicke's aphasia, associated with poor auditory-verbal comprehension and repetition, plus fluent speech with jargon. However, the varieties of these comprehension problems, and their underlying causes, are not well understood. Both patient groups exhibit some type of semantic 'access' deficit, as opposed to the 'storage' deficits observed in semantic dementia. Nevertheless, existing descriptions suggest that these patients might have different varieties of 'access' impairment-related to difficulty resolving competition (in semantic aphasia) versus initial activation of concepts from sensory inputs (in Wernicke's aphasia). We used a case series design to compare patients with Wernicke's aphasia and those with semantic aphasia on Warrington's paradigmatic assessment of semantic 'access' deficits. In these verbal and non-verbal matching tasks, a small set of semantically-related items are repeatedly presented over several cycles so that the target on one trial becomes a distractor on another (building up interference and eliciting semantic 'blocking' effects). Patients with Wernicke's aphasia and semantic aphasia were distinguished according to lesion location in the temporal cortex, but in each group, some individuals had additional prefrontal damage. Both of these aspects of lesion variability-one that mapped onto classical 'syndromes' and one that did not-predicted aspects of the semantic 'access' deficit. Both semantic aphasia and Wernicke's aphasia cases showed multimodal semantic impairment, although as expected, the Wernicke's aphasia group showed greater deficits on auditory-verbal than picture judgements. Distribution of damage in the temporal lobe was crucial for predicting the initially 'beneficial' effects of stimulus repetition: cases with

  5. Varieties of semantic ‘access’ deficit in Wernicke’s aphasia and semantic aphasia

    PubMed Central

    Robson, Holly; Lambon Ralph, Matthew A.; Jefferies, Elizabeth

    2015-01-01

    Comprehension deficits are common in stroke aphasia, including in cases with (i) semantic aphasia, characterized by poor executive control of semantic processing across verbal and non-verbal modalities; and (ii) Wernicke’s aphasia, associated with poor auditory–verbal comprehension and repetition, plus fluent speech with jargon. However, the varieties of these comprehension problems, and their underlying causes, are not well understood. Both patient groups exhibit some type of semantic ‘access’ deficit, as opposed to the ‘storage’ deficits observed in semantic dementia. Nevertheless, existing descriptions suggest that these patients might have different varieties of ‘access’ impairment—related to difficulty resolving competition (in semantic aphasia) versus initial activation of concepts from sensory inputs (in Wernicke’s aphasia). We used a case series design to compare patients with Wernicke’s aphasia and those with semantic aphasia on Warrington’s paradigmatic assessment of semantic ‘access’ deficits. In these verbal and non-verbal matching tasks, a small set of semantically-related items are repeatedly presented over several cycles so that the target on one trial becomes a distractor on another (building up interference and eliciting semantic ‘blocking’ effects). Patients with Wernicke’s aphasia and semantic aphasia were distinguished according to lesion location in the temporal cortex, but in each group, some individuals had additional prefrontal damage. Both of these aspects of lesion variability—one that mapped onto classical ‘syndromes’ and one that did not—predicted aspects of the semantic ‘access’ deficit. Both semantic aphasia and Wernicke’s aphasia cases showed multimodal semantic impairment, although as expected, the Wernicke’s aphasia group showed greater deficits on auditory-verbal than picture judgements. Distribution of damage in the temporal lobe was crucial for predicting the initially

  6. Why Reference to the Past Is Difficult for Agrammatic Speakers

    ERIC Educational Resources Information Center

    Bastiaanse, Roelien

    2013-01-01

    Many studies have shown that verb inflections are difficult to produce for agrammatic aphasic speakers: they are frequently omitted and substituted. The present article gives an overview of our search to understanding why this is the case. The hypothesis is that grammatical morphology referring to the past is selectively impaired in agrammatic…

  7. Argument Structure Distribution of Predicates in Korean Agrammatic Speech.

    ERIC Educational Resources Information Center

    Kim, Young-Joo; Kim, Hyanghee; Song, Hong-Ki

    2003-01-01

    Examines production of predicates by Korean agrammatic aphasic patients with respect to argument structure distribution of predicates. Analyzed narrative production and picture/scene description data elicited from three Broca's aphasic patients compared with matched controls. Focused on whether subjects have the same type difficulties that Kegl's…

  8. Sentence Comprehension in Swahili-English Bilingual Agrammatic Speakers

    ERIC Educational Resources Information Center

    Abuom, Tom O.; Shah, Emmah; Bastiaanse, Roelien

    2013-01-01

    For this study, sentence comprehension was tested in Swahili-English bilingual agrammatic speakers. The sentences were controlled for four factors: (1) order of the arguments (base vs. derived); (2) embedding (declarative vs. relative sentences); (3) overt use of the relative pronoun "who"; (4) language (English and Swahili). Two…

  9. Why Reference to the Past Is Difficult for Agrammatic Speakers

    ERIC Educational Resources Information Center

    Bastiaanse, Roelien

    2013-01-01

    Many studies have shown that verb inflections are difficult to produce for agrammatic aphasic speakers: they are frequently omitted and substituted. The present article gives an overview of our search to understanding why this is the case. The hypothesis is that grammatical morphology referring to the past is selectively impaired in agrammatic…

  10. Language as a Stressor in Aphasia

    PubMed Central

    Cahana-Amitay, Dalia; Albert, Martin L.; Pyun, Sung-Bom; Westwood, Andrew; Jenkins, Theodore; Wolford, Sarah; Finley, Mallory

    2012-01-01

    Background Persons with aphasia often report feeling anxious when using language while communicating. While many patients, caregivers, clinicians and researchers would agree that language may be a stressor for persons with aphasia, systematic empirical studies of stress and/or anxiety in aphasia remain scarce. Aim The aim of this paper is to review the existing literature discussing language as a stressor in aphasia, identify key issues, highlight important gaps, and propose a program for future study. In doing so, we hope to underscore the importance of understanding aspects of the emotional aftermath of aphasia, which plays a critical role in the process of recovery and rehabilitation. Main Contribution Post stroke emotional dysregulation in persons with chronic aphasia clearly has adverse effects for language performance and prospects of recovery. However, the specific role anxiety might play in aphasia has yet to be determined. As a starting point, we propose to view language in aphasia as a stressor, linked to an emotional state we term “linguistic anxiety.” Specifically, a person with linguistic anxiety is one in whom the deliberate, effortful production of language involves anticipation of an error, with the imminence of linguistic failure serving as the threat. Since anticipation is psychologically linked to anxiety and also plays an important role in the allostatic system, we suggest that examining physiologic stress responses in persons with aphasia when they are asked to perform a linguistic task would be a productive tool for assessing the potential relation of stress to “linguistic anxiety.” Conclusion Exploring the putative relationship between anxiety and language in aphasia, through the study of physiologic stress responses, could establish a platform for investigating language changes in the brain in other clinical populations, such as in individuals with Alzheimer’s disease or persons with post traumatic stress disorder, or even with

  11. Degenerative jargon aphasia: unusual progression of logopenic/phonological progressive aphasia?

    PubMed

    Caffarra, Paolo; Gardini, Simona; Cappa, Stefano; Dieci, Francesca; Concari, Letizia; Barocco, Federica; Ghetti, Caterina; Ruffini, Livia; Prati, Guido Dalla Rosa

    2013-01-01

    Primary progressive aphasia (PPA) corresponds to the gradual degeneration of language which can occur as nonfluent/agrammatic PPA, semantic variant PPA or logopenic variant PPA. We describe the clinical evolution of a patient with PPA presenting jargon aphasia as a late feature. At the onset of the disease (ten years ago) the patient showed anomia and executive deficits, followed later on by phonemic paraphasias and neologisms, deficits in verbal short-term memory, naming, verbal and semantic fluency. At recent follow-up the patient developed an unintelligible jargon with both semantic and neologistic errors, as well as with severe deficit of comprehension which precluded any further neuropsychological assessment. Compared to healthy controls, FDG-PET showed a hypometabolism in the left angular and middle temporal gyri, precuneus, caudate, posterior cingulate, middle frontal gyrus, and bilaterally in the superior temporal and inferior frontal gyri. The clinical and neuroimaging profile seems to support the hypothesis that the patient developed a late feature of logopenic variant PPA characterized by jargonaphasia and associated with superior temporal and parietal dysfunction.

  12. Degenerative Jargon Aphasia: Unusual Progression of Logopenic/Phonological Progressive Aphasia?

    PubMed Central

    Caffarra, Paolo; Gardini, Simona; Cappa, Stefano; Dieci, Francesca; Concari, Letizia; Barocco, Federica; Ghetti, Caterina; Ruffini, Livia; Prati, Guido Dalla Rosa

    2013-01-01

    Primary progressive aphasia (PPA) corresponds to the gradual degeneration of language which can occur as nonfluent/agrammatic PPA, semantic variant PPA or logopenic variant PPA. We describe the clinical evolution of a patient with PPA presenting jargon aphasia as a late feature. At the onset of the disease (ten years ago) the patient showed anomia and executive deficits, followed later on by phonemic paraphasias and neologisms, deficits in verbal short-term memory, naming, verbal and semantic fluency. At recent follow-up the patient developed an unintelligible jargon with both semantic and neologistic errors, as well as with severe deficit of comprehension which precluded any further neuropsychological assessment. Compared to healthy controls, FDG-PET showed a hypometabolism in the left angular and middle temporal gyri, precuneus, caudate, posterior cingulate, middle frontal gyrus, and bilaterally in the superior temporal and inferior frontal gyri. The clinical and neuroimaging profile seems to support the hypothesis that the patient developed a late feature of logopenic variant PPA characterized by jargonaphasia and associated with superior temporal and parietal dysfunction. PMID:22713376

  13. The Brain Network of Naming: A Lesson from Primary Progressive Aphasia

    PubMed Central

    Migliaccio, Raffaella; Boutet, Claire; Valabregue, Romain; Ferrieux, Sophie; Nogues, Marie; Lehéricy, Stéphane; Dormont, Didier; Levy, Richard; Dubois, Bruno; Teichmann, Marc

    2016-01-01

    Objective Word finding depends on the processing of semantic and lexical information, and it involves an intermediate level for mapping semantic-to-lexical information which also subserves lexical-to-semantic mapping during word comprehension. However, the brain regions implementing these components are still controversial and have not been clarified via a comprehensive lesion model encompassing the whole range of language-related cortices. Primary progressive aphasia (PPA), for which anomia is thought to be the most common sign, provides such a model, but the exploration of cortical areas impacting naming in its three main variants and the underlying processing mechanisms is still lacking. Methods We addressed this double issue, related to language structure and PPA, with thirty patients (11 semantic, 12 logopenic, 7 agrammatic variant) using a picture-naming task and voxel-based morphometry for anatomo-functional correlation. First, we analyzed correlations for each of the three variants to identify the regions impacting naming in PPA and to disentangle the core regions of word finding. We then combined the three variants and correlation analyses for naming (semantic-to-lexical mapping) and single-word comprehension (lexical-to-semantic mapping), predicting an overlap zone corresponding to a bidirectional lexical-semantic hub. Results and Conclusions Our results showed that superior portions of the left temporal pole and left posterior temporal cortices impact semantic and lexical naming mechanisms in semantic and logopenic PPA, respectively. In agrammatic PPA naming deficits were rare, and did not correlate with any cortical region. Combined analyses revealed a cortical overlap zone in superior/middle mid-temporal cortices, distinct from the two former regions, impacting bidirectional binding of lexical and semantic information. Altogether, our findings indicate that lexical/semantic word processing depends on an anterior-posterior axis within lateral

  14. Two insular regions are differentially involved in behavioral variant FTD and nonfluent/agrammatic variant PPA.

    PubMed

    Mandelli, Maria Luisa; Vitali, Paolo; Santos, Miguel; Henry, Maya; Gola, Kelly; Rosenberg, Lynne; Dronkers, Nina; Miller, Bruce; Seeley, William W; Gorno-Tempini, Maria Luisa

    2016-01-01

    The non-fluent/agrammatic variant of primary progressive aphasia (nfvPPA) and the behavioral variant frontotemporal dementia (bvFTD) are focal neurodegenerative disorders belonging to the FTD-spectrum clinical syndromes. NfvPPA is characterized by effortful speech and/or agrammatism and left frontal atrophy, while bvFTD is characterized by social-emotional dysfunction often accompanied by right-lateralized frontal damage. Despite their contrasting clinical presentations, both disorders show prominent left anterior insula atrophy. We investigated differential patterns of insular sub-region atrophy in nfvPPA and bvFTD. Based on knowledge of insular connectivity and physiology, we hypothesized that the left superior precentral region of the dorsal anterior insula (SPGI) would be more atrophic in nvfPPA due to its critical role in motor speech, whereas the ventral anterior region would be more atrophied in bvFTD reflecting its known role in social-emotional-autonomic functions. Early stage nfvPPA and bvFTD patients matched for disease severity, age, gender and education and healthy controls participated in the study. Detailed clinical history, neurological examination, neuropsychological screening evaluation, and high-resolution T1-weighted brain magnetic resonance imaging (MRI) were collected. Voxel-based morphometry (VBM) was applied to perform group comparisons across the whole brain and in bilateral insula region of interest (ROI). Correlation analyses between insular sub-region atrophy and relevant clinical features were performed. Whole brain group comparisons between nfvPPA and bvFTD showed the expected predominantly left or right anterior insular atrophy pattern. ROI analysis of bilateral insula showed that the left SPGI was significantly more atrophied in nfvPPA compared to bvFTD, while the bilateral ventral anterior and right dorsal anterior insula sub-regions were more atrophied in bvFTD than nfvPPA. Only left SPGI volume correlated with speech production

  15. Two insular regions are differentially involved in behavioral variant FTD and nonfluent/agrammatic variant PPA

    PubMed Central

    Mandelli, Maria Luisa; Vitali, Paolo; Santos, Miguel; Henry, Maya; Gola, Kelly; Rosenberg, Lynne; Dronkers, Nina; Miller, Bruce; Seeley, William W.; Gorno-Tempini, Maria Luisa

    2016-01-01

    The non-fluent/agrammatic variant of primary progressive aphasia (nfvPPA) and the behavioral variant frontotemporal dementia (bvFTD) are focal neurodegenerative disorders belonging to the FTD-spectrum clinical syndromes. NfvPPA is characterized by effortful speech and/or agrammatism and left frontal atrophy, while bvFTD is characterized by social-emotional dysfunction often accompanied by right-lateralized frontal damage. Despite their contrasting clinical presentations, both disorders show prominent left anterior insula atrophy. We investigated differential patterns of insular subregion atrophy in nfvPPA and bvFTD. Based on knowledge of insular connectivity and physiology, we hypothesized that the left superior precentral region of the dorsal anterior insula (SPGI) would be more atrophic in nvfPPA due to its critical role in motor speech, whereas the ventral anterior region would be more atrophied in bvFTD reflecting its known role in social-emotional-autonomic functions. Early stage nfvPPA and bvFTD patients matched for disease severity, age, gender and education and healthy controls participated in the study. Detailed clinical history, neurological examination, neuropsychological screening evaluation, and high-resolution T1-weighted brain magnetic resonance images (MRI) were collected. Voxel-based morphometry (VBM) was applied to perform group comparisons across the whole brain and in bilateral insula region of interest (ROI). Correlation analyses between insular subregion atrophy and relevant clinical features were performed. Whole brain group comparisons between nfvPPA and bvFTD showed the expected predominantly left or right anterior insular atrophy pattern. ROI analysis of bilateral insula showed that the left SPGI was significantly more atrophied in nfvPPA compared to bvFTD, while the bilateral ventral anterior and right dorsal anterior insula subregions were more atrophied in bvFTD than nfvPPA. Only left SPGI volume correlated with speech production

  16. [Aphasia: debates].

    PubMed

    Roch Lecours, A

    1999-10-01

    Quarrels over aphasia are no recent phenomena and have not always been explicit. Lordat and Gall can be cited in this respect as well as Dax and Bouillaud. Reference is also made to Broca-Dax and Trousseau-Lordat. The creation of the Chair in honour of Charcot, which contributed so greatly (thanks to Charcot himself, the others Masters and their students) to the birth of neurology, then to that of the neurological sciences and eventually to that of the neurocognitive sciences. Next, the most explicit of quarrels on aphasia is dealt with, namely that in which, during three meetings of the French Society of Neurology in 1908, Joseph Jules Dejerine and Pierre Marie crossed swords. Their duel in the Bois de Boulogne in 1893 having fortunately been cancelled, it was in 1908 merely a battle of words. Fulgence Raymond was soon to retire. Dejerine and Pierre Marie each put forward their proposal to the Society for a discussion program and Dejerine's was accepted following a vote. The meeting on 11th June, in accordance with the program proposed by Dejerine, was largely restricted to clinical facts. Fulgence Raymond was not present. Dejerine always spoke first, but some of the replies from Pierre Marie received a degree of approval from the audience. It was during this meeting that Achille Souques, the future founder of the history of neurology, cleverly defended the ideas of Pierre Marie. A little later, Dejerine went on the defensive and agreed to a change in the program along the lines suggested by Pierre Marie: he then presented his ideas on the manifest clinical difference between Broca's aphasia and that of Wernicke. After Souques, Edouard Brissaud also came to the rescue of Pierre Marie by mentioning the Leborgne case published by Broca in the spring 1861. Matters were unresolved and André-Thomas, the future founder of neuropaediatrics, produced a highly intelligent deference of his Master Dejerine. Gilbert Ballet and Ernest Dupré also came down largely on his side

  17. Analysis of abstract and concrete word processing in persons with aphasia and age-matched neurologically healthy adults using fMRI.

    PubMed

    Sandberg, Chaleece; Kiran, Swathi

    2014-08-01

    The concreteness effect occurs in both normal and language-disordered populations. Research suggests that abstract and concrete concepts elicit differing neural activation patterns in healthy young adults, but this is undocumented in persons with aphasia (PWA). Three PWA and three age-matched controls were scanned using fMRI while processing abstract and concrete words. Consistent with current theories of abstract and concrete word processing, abstract words elicited activation in verbal areas, whereas concrete words additionally activated multimodal association areas. PWA show greater differences in neural activation than age-matched controls between abstract and concrete words, possibly due to an exaggerated concreteness effect.

  18. Inflectional morphology in primary progressive aphasia: an elicited production study.

    PubMed

    Wilson, Stephen M; Brandt, Temre H; Henry, Maya L; Babiak, Miranda; Ogar, Jennifer M; Salli, Chelsey; Wilson, Lisa; Peralta, Karen; Miller, Bruce L; Gorno-Tempini, Maria Luisa

    2014-09-01

    Inflectional morphology lies at the intersection of phonology, syntax and the lexicon, three language domains that are differentially impacted in the three main variants of primary progressive aphasia (PPA). To characterize spared and impaired aspects of inflectional morphology in PPA, we elicited inflectional morphemes in 48 individuals with PPA and 13 healthy age-matched controls. We varied the factors of regularity, frequency, word class, and lexicality, and used voxel-based morphometry to identify brain regions where atrophy was predictive of deficits on particular conditions. All three PPA variants showed deficits in inflectional morphology, with the specific nature of the deficits dependent on the anatomical and linguistic features of each variant. Deficits in inflecting low-frequency irregular words were associated with semantic PPA, with lexical/semantic deficits, and with left temporal atrophy. Deficits in inflecting pseudowords were associated with non-fluent/agrammatic and logopenic variants, with phonological deficits, and with left frontal and parietal atrophy.

  19. Inflectional morphology in primary progressive aphasia: An elicited production study

    PubMed Central

    Wilson, Stephen M.; Brandt, Temre H.; Henry, Maya L.; Babiak, Miranda; Ogar, Jennifer M.; Salli, Chelsey; Wilson, Lisa; Peralta, Karen; Miller, Bruce L.; Gorno-Tempini, Maria Luisa

    2014-01-01

    Inflectional morphology lies at the intersection of phonology, syntax and the lexicon, three language domains that are differentially impacted in the three main variants of primary progressive aphasia (PPA). To characterize spared and impaired aspects of inflectional morphology in PPA, we elicited inflectional morphemes in 48 individuals with PPA and 13 healthy age-matched controls. We varied the factors of regularity, frequency, word class, and lexicality, and used voxel-based morphometry to identify brain regions where atrophy was predictive of deficits on particular conditions. All three PPA variants showed deficits in inflectional morphology, with the specific nature of the deficits dependent on the anatomical and linguistic features of each variant. Deficits in inflecting low-frequency irregular words were associated with semantic PPA, with lexical/semantic deficits, and with left temporal atrophy. Deficits in inflecting pseudowords were associated with non-fluent/agrammatic and logopenic variants, with phonological deficits, and with left frontal and parietal atrophy. PMID:25129631

  20. Demonstrating the Qualitative Differences between Semantic Aphasia and Semantic Dementia: A Novel Exploration of Nonverbal Semantic Processing

    PubMed Central

    Noonan, Krist A.; Garrard, Peter; Jefferies, Elizabeth; Eshan, Sheeba; Lambon Ralph, Matthew A.

    2013-01-01

    Semantic dementia (SD) implicates the anterior temporal lobes (ATL) as a critical substrate for semantic memory. Multi-modal semantic impairment can also be a feature of post-stroke aphasia (referred to here as “semantic aphasia” or SA) where patients show impaired regulatory control accompanied by lesions to the frontal and/or temporo-parietal cortices, and thus the two patient groups demonstrate qualitatively different patterns of semantic impairment [1]. Previous comparisons of these two patient groups have tended to focus on verbal receptive tasks. Accordingly, this study investigated nonverbal receptive abilities via a comparison of reality decision judgements in SD and SA. Pictures of objects were presented alongside non-real distracters whose features were altered to make them more/less plausible for the semantic category. The results highlighted a number of critical differences between the two groups. Compared to SD patients, SA patients: (1) were relatively unimpaired on the two alternative forced choice (2AFC) decisions despite showing a comparable degree of semantic impairment on other assessments; (2) showed minimal effects of the plausibility manipulation; (3) were strongly influenced by variations in the regulatory requirements of tasks; and (4) exhibited a reversed effect of familiarity–i.e., better performance on less commonly encountered items. These results support a distinction between semantic impairments which arise from impaired regulatory processes (e.g., SA) versus those where degraded semantic knowledge is the causal factor (e.g., SD). SA patients performed relatively well because the task structure reduced the requirement for internally generated control. In contrast, SD patients performed poorly because their degraded knowledge did not allow the fine-grained distinctions required to complete the task. PMID:22713375

  1. The Northwestern Anagram Test: Measuring Sentence Production in Primary Progressive Aphasia

    PubMed Central

    Weintraub, Sandra; Mesulam, M.-Marsel; Wieneke, Christina; Rademaker, Alfred; Rogalski, Emily J.; Thompson, Cynthia K.

    2009-01-01

    Primary progressive aphasia (PPA) is a clinical dementia syndrome with early symptoms of language dysfunction. Post mortem findings are varied and include Alzheimer’s disease and frontotemporal lobar degeneration (FTLD), both tauopathies and TDP-43 proteinopathies. Clinical-pathologic correlations in PPA are complex but the presence in the clinical profile of agrammatism has a high association with tauopathy. Grammatical competence is difficult to assess in the clinical setting with available methods. This paper describes the Northwestern Anagram Test (NAT), a new clinical measure of sentence production. Sixteen patients with PPA and their controls assembled single printed words to create sentences describing pictures. NAT performance was significantly correlated with a measure of sentence production and with aphasia severity, but not with measures of naming, single word comprehension, object recognition or motor speech. The NAT can be used to assess syntax competence when patients cannot be tested with measures that requiring intact speech production. PMID:19700669

  2. The northwestern anagram test: measuring sentence production in primary progressive aphasia.

    PubMed

    Weintraub, Sandra; Mesulam, M-Marsel; Wieneke, Christina; Rademaker, Alfred; Rogalski, Emily J; Thompson, Cynthia K

    2009-01-01

    Primary progressive aphasia (PPA) is a clinical dementia syndrome with early symptoms of language dysfunction. Postmortem findings are varied and include Alzheimer disease and frontotemporal lobar degeneration (FTLD), both tauopathies and TAR DNA binding protein (TDP-43) proteinopathies. Clinical-pathological correlations in PPA are complex but the presence in the clinical profile of agrammatism has a high association with tauopathy. Grammatical competence is difficult to assess in the clinical setting with available methods. This article describes the Northwestern Anagram Test (NAT), a new clinical measure of sentence production. A total of 16 patients with PPA and their controls assembled single printed words to create sentences describing pictures. Northwestern Anagram Test performance was significantly correlated with a measure of sentence production and with aphasia severity but not with measures of naming, single word comprehension, object recognition, or motor speech. The NAT can be used to assess syntax competence when patients cannot be tested with measures that require intact speech production.

  3. Telerehabilitation of Anomia in Primary Progressive Aphasia

    PubMed Central

    Meyer, Aaron M.; Getz, Heidi R.; Brennan, David M.; Hu, Tang M.; Friedman, Rhonda B.

    2015-01-01

    Background The efficacy of telerehabilitation-based treatment for anomia has been demonstrated in post-stroke aphasia, but the efficacy of this method of anomia treatment delivery has not been established within the context of degenerative illness. Aims The current study evaluated the feasibility and efficacy of a telerehabilitation-based approach to anomia treatment within the three subtypes of primary progressive aphasia (PPA). Methods & Procedures Each of the three telerehabilitation participants represented a distinct subtype of PPA. Following a baseline evaluation of language and cognition, a phonological treatment and an orthographic treatment were administered to all participants over the course of six months. One month after the end of treatment, a post-treatment evaluation began. All treatment sessions and the majority of the evaluation sessions were administered via telerehabilitation. Treatment effects were examined within each subject, and treatment effects were also compared between each telerehabilitation participant and a group of in-person participants who had the same subtype of PPA. Outcomes & Results All three telerehabilitation participants exhibited positive treatment effects. CGR (nonfluent/agrammatic variant PPA) and WCH (logopenic variant PPA) showed maintenance of naming for prophylaxis items in both treatment conditions, while ACR (semantic variant PPA) demonstrated increased naming of remediation items in the phonological treatment condition. Compared to in-person participants with the same subtype of PPA, each of the telerehabilitation participants typically showed effects that were either within the expected range or larger than expected. Conclusions Telerehabilitation-based anomia treatment is feasible and effective in all three subtypes of PPA. PMID:27087732

  4. National Aphasia Association

    MedlinePlus

    ... challenge. […] National Aphasia Association Response to Statements by Trump Campaign Spokesperson In response to a recent statement by Trump campaign spokesperson, Katrina Pierson, and the article which ...

  5. Tense and Agreement Dissociations in German Agrammatic Speakers: Underspecification Vs. Hierarchy

    ERIC Educational Resources Information Center

    Burchert, F.; Swoboda-Moll, M.; Bleser, R.D.

    2005-01-01

    The aim of the present paper was to investigate whether German agrammatic production data are compatible with the Tree-Pruning-Hypothesis (TPH; Friedmann & Grodzinsky, 1997). The theory predicts unidirectional patterns of dissociation in agrammatic production data with respect to Tense and Agreement. However, there was evidence of a double…

  6. Tense and Agreement Dissociations in German Agrammatic Speakers: Underspecification Vs. Hierarchy

    ERIC Educational Resources Information Center

    Burchert, F.; Swoboda-Moll, M.; Bleser, R.D.

    2005-01-01

    The aim of the present paper was to investigate whether German agrammatic production data are compatible with the Tree-Pruning-Hypothesis (TPH; Friedmann & Grodzinsky, 1997). The theory predicts unidirectional patterns of dissociation in agrammatic production data with respect to Tense and Agreement. However, there was evidence of a double…

  7. A Psychometric Analysis of Functional Category Production in English Agrammatic Narratives

    ERIC Educational Resources Information Center

    Milman, Lisa H.; Dickey, Michael Walsh; Thompson, Cynthia K.

    2008-01-01

    Hierarchical models of agrammatism propose that sentence production deficits can be accounted for in terms of clausal syntactic structure [Friedmann, N., & Grodzinsky, Y. (1997). "Tense and agreement in agrammatic production: Pruning the syntactic tree." "Brain and Language, 56", 397-425; Hagiwara, H. (1995). "The breakdown of functional…

  8. A Psychometric Analysis of Functional Category Production in English Agrammatic Narratives

    ERIC Educational Resources Information Center

    Milman, Lisa H.; Dickey, Michael Walsh; Thompson, Cynthia K.

    2008-01-01

    Hierarchical models of agrammatism propose that sentence production deficits can be accounted for in terms of clausal syntactic structure [Friedmann, N., & Grodzinsky, Y. (1997). "Tense and agreement in agrammatic production: Pruning the syntactic tree." "Brain and Language, 56", 397-425; Hagiwara, H. (1995). "The breakdown of functional…

  9. Primary progressive aphasia: from syndrome to disease.

    PubMed

    Matías-Guiu, J A; García-Ramos, R

    2013-01-01

    Primary progressive aphasia (PPA) is a clinical syndrome characterised by a progressive decline in language and speech of neurodegenerative origin. Major breakthroughs made in recent years have lent us a better understanding of this syndrome, which may be the first manifestation of any of a number of neurodegenerative diseases. We reviewed the main aspects of PPA epidemiology, clinical manifestations, diagnosis, aetiology and treatment. Most cases manifest sporadically and the typical age of onset is between 50 and 70 years. Three clinically distinct variants have been described: nonfluent or agrammatic PPA, semantic PPA and logopenic PPA. Each of these variants tends to be associated with specific histopathological findings, but clinical diagnostic methods are imperfect predictors of underlying pathology. Anatomical and functional neuroimaging can provide useful biomarkers. Several treatments have been proposed, and while no clear benefits have been demonstrated, acetylcholinesterase inhibitors may be useful, especially in the logopenic variant. PPA is an emerging syndrome which may be more prevalent than we might expect. It was previously listed as part of the frontotemporal dementia spectrum, and it is also related to Alzheimer disease. Clinical diagnosis, complemented by a biomarker evaluation, may predict the underlying pathology, which in turn will improve treatment possibilities. Copyright © 2012 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  10. Treating Attention in Mild Aphasia: Evaluation of Attention Process Training-II

    ERIC Educational Resources Information Center

    Murray, Laura L.; Keeton, R. Jessica; Karcher, Laura

    2006-01-01

    This study examined whether attention processing training-II [Sohlberg, M. M., Johnson, L., Paule, L., Raskin, S. A., & Mateer, C. A. (2001). "Attention Process Training-II: A program to address attentional deficits for persons with mild cognitive dysfunction" (2nd ed.). Wake Forest, NC: Lash & Associates.; APT-II], when applied in the context of…

  11. Spoken-Word Processing in Aphasia: Effects of Item Overlap and Item Repetition

    ERIC Educational Resources Information Center

    Janse, Esther

    2008-01-01

    Two studies were carried out to investigate the effects of presentation of primes showing partial (word-initial) or full overlap on processing of spoken target words. The first study investigated whether time compression would interfere with lexical processing so as to elicit aphasic-like performance in non-brain-damaged subjects. The second study…

  12. Treating Attention in Mild Aphasia: Evaluation of Attention Process Training-II

    ERIC Educational Resources Information Center

    Murray, Laura L.; Keeton, R. Jessica; Karcher, Laura

    2006-01-01

    This study examined whether attention processing training-II [Sohlberg, M. M., Johnson, L., Paule, L., Raskin, S. A., & Mateer, C. A. (2001). "Attention Process Training-II: A program to address attentional deficits for persons with mild cognitive dysfunction" (2nd ed.). Wake Forest, NC: Lash & Associates.; APT-II], when applied in the context of…

  13. Semantic control and modality: an input processing deficit in aphasia leading to deregulated semantic cognition in a single modality.

    PubMed

    Thompson, Hannah E; Jefferies, Elizabeth

    2013-08-01

    Research suggests that semantic memory deficits can occur in at least three ways. Patients can (1) show amodal degradation of concepts within the semantic store itself, such as in semantic dementia (SD), (2) have difficulty in controlling activation within the semantic system and accessing appropriate knowledge in line with current goals or context, as in semantic aphasia (SA) and (3) experience a semantic deficit in only one modality following degraded input from sensory cortex. Patients with SA show deficits of semantic control and access across word and picture tasks, consistent with the view that their problems arise from impaired modality-general control processes. However, there are a few reports in the literature of patients with semantic access problems restricted to auditory-verbal materials, who show decreasing ability to retrieve concepts from words when they are presented repeatedly with closely related distractors. These patients challenge the notion that semantic control processes are modality-general and suggest instead a separation of 'access' to auditory-verbal and non-verbal semantic systems. We had the rare opportunity to study such a case in detail. Our aims were to examine the effect of manipulations of control demands in auditory-verbal semantic, non-verbal semantic and non-semantic tasks, allowing us to assess whether such cases always show semantic control/access impairments that follow a modality-specific pattern, or whether there are alternative explanations. Our findings revealed: (1) deficits on executive tasks, unrelated to semantic demands, which were more evident in the auditory modality than the visual modality; (2) deficits in executively-demanding semantic tasks which were accentuated in the auditory-verbal domain compared with the visual modality, but still present on non-verbal tasks, and (3) a coupling between comprehension and executive control requirements, in that mild impairment on single word comprehension was greatly

  14. Predicting primary progressive aphasias with support vector machine approaches in structural MRI data.

    PubMed

    Bisenius, Sandrine; Mueller, Karsten; Diehl-Schmid, Janine; Fassbender, Klaus; Grimmer, Timo; Jessen, Frank; Kassubek, Jan; Kornhuber, Johannes; Landwehrmeyer, Bernhard; Ludolph, Albert; Schneider, Anja; Anderl-Straub, Sarah; Stuke, Katharina; Danek, Adrian; Otto, Markus; Schroeter, Matthias L

    2017-01-01

    Primary progressive aphasia (PPA) encompasses the three subtypes nonfluent/agrammatic variant PPA, semantic variant PPA, and the logopenic variant PPA, which are characterized by distinct patterns of language difficulties and regional brain atrophy. To validate the potential of structural magnetic resonance imaging data for early individual diagnosis, we used support vector machine classification on grey matter density maps obtained by voxel-based morphometry analysis to discriminate PPA subtypes (44 patients: 16 nonfluent/agrammatic variant PPA, 17 semantic variant PPA, 11 logopenic variant PPA) from 20 healthy controls (matched for sample size, age, and gender) in the cohort of the multi-center study of the German consortium for frontotemporal lobar degeneration. Here, we compared a whole-brain with a meta-analysis-based disease-specific regions-of-interest approach for support vector machine classification. We also used support vector machine classification to discriminate the three PPA subtypes from each other. Whole brain support vector machine classification enabled a very high accuracy between 91 and 97% for identifying specific PPA subtypes vs. healthy controls, and 78/95% for the discrimination between semantic variant vs. nonfluent/agrammatic or logopenic PPA variants. Only for the discrimination between nonfluent/agrammatic and logopenic PPA variants accuracy was low with 55%. Interestingly, the regions that contributed the most to the support vector machine classification of patients corresponded largely to the regions that were atrophic in these patients as revealed by group comparisons. Although the whole brain approach took also into account regions that were not covered in the regions-of-interest approach, both approaches showed similar accuracies due to the disease-specificity of the selected networks. Conclusion, support vector machine classification of multi-center structural magnetic resonance imaging data enables prediction of PPA subtypes with

  15. The representation of lexical-syntactic information: evidence from syntactic and lexical retrieval impairments in aphasia.

    PubMed

    Biran, Michal; Friedmann, Naama

    2012-10-01

    This study explored lexical-syntactic information - syntactic information that is stored in the lexicon - and its relation to syntactic and lexical impairments in aphasia. We focused on two types of lexical-syntactic information: predicate argument structure (PAS) of verbs (the number and types of arguments the verb selects) and grammatical gender of nouns. The participants were 17 Hebrew-speaking individuals with aphasia who had a syntactic deficit (agrammatism) or a lexical retrieval deficit (anomia) located at the semantic lexicon, the phonological output lexicon, or the phonological output buffer. After testing the participants' syntactic and lexical retrieval abilities and establishing the functional loci of their deficits, we assessed their PAS and grammatical gender knowledge. This assessment included sentence completion, sentence production, sentence repetition, and grammaticality judgment tasks. The participants' performance on these tests yielded several important dissociations. Three agrammatic participants had impaired syntax but unimpaired PAS knowledge. Three agrammatic participants had impaired syntax but unimpaired grammatical gender knowledge. This indicates that lexical-syntactic information is represented separately from syntax, and can be spared even when syntax at the sentence level, such as embedding and movement are impaired. All 5 individuals with phonological output buffer impairment and all 3 individuals with phonological output lexicon impairment had preserved lexical-syntactic knowledge. These selective impairments indicate that lexical-syntactic information is represented at a lexical stage prior to the phonological lexicon and the phonological buffer. Three participants with impaired PAS (aPASia) and impaired grammatical gender who showed intact lexical-semantic knowledge indicate that the lexical-syntactic information is represented separately from the semantic lexicon. This led us to conclude that lexical-syntactic information is

  16. The On-Line Processing of Verb-Phrase Ellipsis in Aphasia

    ERIC Educational Resources Information Center

    Poirier, Josee; Shapiro, Lewis P.; Love, Tracy; Grodzinsky, Yosef

    2009-01-01

    We investigate the on-line processing of verb-phrase ellipsis (VPE) constructions in two brain injured populations: Broca's and Anomic aphasics. VPE constructions are built from two simple clauses; the first is the antecedent clause and the second is the ellipsis clause. The ellipsis clause is missing its verb and object (i.e., its verb phrase…

  17. How Left Inferior Frontal Cortex Participates in Syntactic Processing: Evidence from Aphasia

    ERIC Educational Resources Information Center

    Love, Tracy; Swinney, David; Walenski, Matthew; Zurif, Edgar

    2008-01-01

    We report on three experiments that provide a real-time processing perspective on the poor comprehension of Broca's aphasic patients for non-canonically structured sentences. In the first experiment we presented sentences (via a Cross Modal Lexical Priming (CMLP) paradigm) to Broca's patients at a normal rate of speech. Unlike the pattern found…

  18. Lexical Competition Effects in Aphasia: Deactivation of Lexical Candidates in Spoken Word Processing

    ERIC Educational Resources Information Center

    Janse, Esther

    2006-01-01

    Research has shown that Broca's and Wernicke's aphasic patients show different impairments in auditory lexical processing. The results of an experiment with form-overlapping primes showed an inhibitory effect of form-overlap for control adults and a weak inhibition trend for Broca's aphasic patients, but a facilitatory effect of form-overlap was…

  19. Neuroscience insights improve neurorehabilitation of poststroke aphasia.

    PubMed

    Berthier, Marcelo L; Pulvermüller, Friedemann

    2011-02-01

    The treatment of aphasias-acquired language disorders-caused by stroke and other neurological conditions has benefitted from insights from neuroscience and neuropsychology. Hebbian mechanisms suggest that massed practice and exploitation of residual neurological capacities can aid neurorehabilitation of patients with poststroke aphasia, and progress in basic neuroscience research indicates that the language system of the human brain is functionally interwoven with perceptual and motor systems. Intensive speech and language therapies, including constraint-induced aphasia therapy, that activate both the linguistic and concordant motor circuits utilize the knowledge gained from these advances in neuroscience research and can lead to surprisingly rapid improvements in language performance, even in patients with chronic aphasia. Drug-based therapies alone and in conjunction with behavioral language therapies also increase language performance in patients with aphasia. Furthermore, noninvasive transcranial magnetic stimulation and electrical stimulation techniques that target neuronal activity within perilesional areas might help patients with aphasia to regain lost language functions. Intensive language-action therapies that lead to rapid improvements in language skills might provide a new opportunity for investigating fast plastic neuronal changes in the areas of the brain associated with language processing. Here, we review progress in basic neuroscience research and its translational impact on the neurorehabilitation of language disorders after stroke.

  20. Cue Recognition and Integration – Eye Tracking Evidence of Processing Differences in Sentence Comprehension in Aphasia

    PubMed Central

    Schumacher, Rahel; Cazzoli, Dario; Eggenberger, Noëmi; Preisig, Basil; Nef, Tobias; Nyffeler, Thomas; Gutbrod, Klemens; Annoni, Jean-Marie; Müri, René M.

    2015-01-01

    Purpose We aimed at further elucidating whether aphasic patients’ difficulties in understanding non-canonical sentence structures, such as Passive or Object-Verb-Subject sentences, can be attributed to impaired morphosyntactic cue recognition, and to problems in integrating competing interpretations. Methods A sentence-picture matching task with canonical and non-canonical spoken sentences was performed using concurrent eye tracking. Accuracy, reaction time, and eye tracking data (fixations) of 50 healthy subjects and 12 aphasic patients were analysed. Results Patients showed increased error rates and reaction times, as well as delayed fixation preferences for target pictures in non-canonical sentences. Patients’ fixation patterns differed from healthy controls and revealed deficits in recognizing and immediately integrating morphosyntactic cues. Conclusion Our study corroborates the notion that difficulties in understanding syntactically complex sentences are attributable to a processing deficit encompassing delayed and therefore impaired recognition and integration of cues, as well as increased competition between interpretations. PMID:26562795

  1. Aphasia and the Diagram Makers Revisited: an Update of Information Processing Models

    PubMed Central

    2006-01-01

    Aphasic syndromes from diseases such as stroke and degenerative disorders are still common and disabling neurobehavioral disorders. Diagnosis, management and treatment of these communication disorders are often dependent upon understanding the neuropsychological mechanisms that underlie these disorders. Since the work of Broca it has been recognized that the human brain is organized in a modular fashion. Wernicke realized that the types of signs and symptoms displayed by aphasic patients reflect the degradation or disconnection of the modules that comprise this speech-language network. Thus, he was the first to propose a diagrammatic or information processing model of this modular language-speech network. Since he first published this model many new aphasic syndromes have been discovered and this has led to modifications of this model. This paper reviews some of the early (nineteenth century) models and then attempts to develop a more up-to-date and complete model. PMID:20396501

  2. Selective impairment of verb processing associated with pathological changes in Brodmann areas 44 and 45 in the motor neurone disease-dementia-aphasia syndrome.

    PubMed

    Bak, T H; O'Donovan, D G; Xuereb, J H; Boniface, S; Hodges, J R

    2001-01-01

    We report six patients with clinically diagnosed and electrophysiologically confirmed motor neurone disease (MND), in whom communication problems were an early and dominant feature. All patients developed a progressive non-fluent aphasia culminating in some cases in complete mutism. In five cases, formal testing revealed deficits in syntactic comprehension. Comprehension and production of verbs were consistently more affected those that of nouns and this effect remained stable upon subsequent testing, despite overall deterioration. The classical signs of MND, including wasting, fasciculations and severe bulbar symptoms, occurred over the following 6-12 months. The behavioural symptoms ranged from mild anosognosia to personality change implicating frontal-lobe dementia. In three cases, post-mortem examination has confirmed the clinical diagnosis of MND-dementia. In addition to the typical involvement of motor and premotor cortex, particularly pronounced pathological changes were observed in the Brodmann areas 44 (Broca's area) and 45. The finding of a selective impairment of verb/action processing in association with the dementia/aphasia syndrome of MND suggests that the neural substrate underlying verb representation is strongly connected to anterior cortical motor systems.

  3. Serial Processing and the "Phonetic Route": Lessons Learned in the Functional Reorganization of Deep Dyslexia.

    ERIC Educational Resources Information Center

    Matthews, Claire

    1991-01-01

    A patient with chronic agrammatic Broca's aphasia exhibited deep dyslexia and was treated with functional reorganization of the phonetic route of reading, with the patient learning consciously to control formerly automatic behaviors. The patient's responses indicated that the phonetic route encompasses at least two dissociable functions:…

  4. Remediation of sentence processing deficits in aphasia using a computer-based microworld.

    PubMed

    Crerar, M A; Ellis, A W; Dean, E C

    1996-01-01

    Byng (1988) has argued that some aphasic patients who show problems in sentence comprehension are unable to "map" a syntactic analysis of the sentence form onto the thematic roles specified by the verb or preposition in the sentence. In Byng's study, therapy aimed at improving the mapping process as applied to sentences containing locative prepositions led to improvements not only in the comprehension of such sentences but also in the comprehension of reversible verb sentences. In the present study, 14 aphasic patients were selected for having problems with sentence-picture matching involving reversible verb and preposition sentences. These problems were shown to be stable across three pre-intervention assessments. All assessments were computer-based and involved the matching of written sentences to pictures. A small vocabulary was used in assessment and therapy which involved a "microworld" of three characters (ball, box, and star) which could engage in a limited number of actions and could occupy a limited set of spatial relationships. Before therapy began, all the patients were given an assessment battery which included a 40-item Verb Test and a 40-item Preposition Test. The patients were then divided into two groups, A and B. Group A received two 1-hr sessions of therapy per week for 3 weeks aimed at improving the comprehension of verb sentences, then a second full assessment, followed by the same amount of therapy aimed at improving the comprehension of preposition sentences, and finally a third assessment. Group B received the preposition therapy first, followed by the verb therapy. The therapy involved the patient and therapist interacting with the computer, either assembling pictures to match written sentences ("picture-building mode") or assembling sentences to match pictures ("sentence-building mode"). Group A showed a classical "cross-over" treatment outcome. Performance on treated verb sentences improved during verb therapy and was retained when therapy

  5. Template construction grammar: from visual scene description to language comprehension and agrammatism.

    PubMed

    Barrès, Victor; Lee, Jinyong

    2014-01-01

    How does the language system coordinate with our visual system to yield flexible integration of linguistic, perceptual, and world-knowledge information when we communicate about the world we perceive? Schema theory is a computational framework that allows the simulation of perceptuo-motor coordination programs on the basis of known brain operating principles such as cooperative computation and distributed processing. We present first its application to a model of language production, SemRep/TCG, which combines a semantic representation of visual scenes (SemRep) with Template Construction Grammar (TCG) as a means to generate verbal descriptions of a scene from its associated SemRep graph. SemRep/TCG combines the neurocomputational framework of schema theory with the representational format of construction grammar in a model linking eye-tracking data to visual scene descriptions. We then offer a conceptual extension of TCG to include language comprehension and address data on the role of both world knowledge and grammatical semantics in the comprehension performances of agrammatic aphasic patients. This extension introduces a distinction between heavy and light semantics. The TCG model of language comprehension offers a computational framework to quantitatively analyze the distributed dynamics of language processes, focusing on the interactions between grammatical, world knowledge, and visual information. In particular, it reveals interesting implications for the understanding of the various patterns of comprehension performances of agrammatic aphasics measured using sentence-picture matching tasks. This new step in the life cycle of the model serves as a basis for exploring the specific challenges that neurolinguistic computational modeling poses to the neuroinformatics community.

  6. What role does the anterior temporal lobe play in sentence-level processing? Neural correlates of syntactic processing in semantic variant primary progressive aphasia.

    PubMed

    Wilson, Stephen M; DeMarco, Andrew T; Henry, Maya L; Gesierich, Benno; Babiak, Miranda; Mandelli, Maria Luisa; Miller, Bruce L; Gorno-Tempini, Maria Luisa

    2014-05-01

    Neuroimaging and neuropsychological studies have implicated the anterior temporal lobe (ATL) in sentence-level processing, with syntactic structure-building and/or combinatorial semantic processing suggested as possible roles. A potential challenge to the view that the ATL is involved in syntactic aspects of sentence processing comes from the clinical syndrome of semantic variant primary progressive aphasia (semantic PPA; also known as semantic dementia). In semantic PPA, bilateral neurodegeneration of the ATLs is associated with profound lexical semantic deficits, yet syntax is strikingly spared. The goal of this study was to investigate the neural correlates of syntactic processing in semantic PPA to determine which regions normally involved in syntactic processing are damaged in semantic PPA and whether spared syntactic processing depends on preserved functionality of intact regions, preserved functionality of atrophic regions, or compensatory functional reorganization. We scanned 20 individuals with semantic PPA and 24 age-matched controls using structural MRI and fMRI. Participants performed a sentence comprehension task that emphasized syntactic processing and minimized lexical semantic demands. We found that, in controls, left inferior frontal and left posterior temporal regions were modulated by syntactic processing, whereas anterior temporal regions were not significantly modulated. In the semantic PPA group, atrophy was most severe in the ATLs but extended to the posterior temporal regions involved in syntactic processing. Functional activity for syntactic processing was broadly similar in patients and controls; in particular, whole-brain analyses revealed no significant differences between patients and controls in the regions modulated by syntactic processing. The atrophic left ATL did show abnormal functionality in semantic PPA patients; however, this took the unexpected form of a failure to deactivate. Taken together, our findings indicate that spared

  7. Quantitative application of the primary progressive aphasia consensus criteria.

    PubMed

    Wicklund, Meredith R; Duffy, Joseph R; Strand, Edythe A; Machulda, Mary M; Whitwell, Jennifer L; Josephs, Keith A

    2014-04-01

    To determine how well the consensus criteria could classify subjects with primary progressive aphasia (PPA) using a quantitative speech and language battery that matches the test descriptions provided by the consensus criteria. A total of 105 participants with a neurodegenerative speech and language disorder were prospectively recruited and underwent neurologic, neuropsychological, and speech and language testing and MRI in this case-control study. Twenty-one participants with apraxia of speech without aphasia served as controls. Select tests from the speech and language battery were chosen for application of consensus criteria and cutoffs were employed to determine syndromic classification. Hierarchical cluster analysis was used to examine participants who could not be classified. Of the 84 participants, 58 (69%) could be classified as agrammatic (27%), semantic (7%), or logopenic (35%) variants of PPA. The remaining 31% of participants could not be classified. Of the unclassifiable participants, 2 clusters were identified. The speech and language profile of the first cluster resembled mild logopenic PPA and the second cluster semantic PPA. Gray matter patterns of loss of these 2 clusters of unclassified participants also resembled mild logopenic and semantic variants. Quantitative application of consensus PPA criteria yields the 3 syndromic variants but leaves a large proportion unclassified. Therefore, the current consensus criteria need to be modified in order to improve sensitivity.

  8. What matters in semantic feature processing for persons with stroke-aphasia: Evidence from an auditory concept-feature verification task

    PubMed Central

    Antonucci, Sharon M.

    2014-01-01

    Background The relationship between object concept domains (living vs. nonliving) and their underlying feature structures is a frequent area of investigation regarding semantic processing in healthy individuals and some individuals with neuropsychological impairment resulting from herpes simplex encephalitis, semantic dementia and Alzheimer's disease. However, this relationship has been less well-investigated in persons with stroke-aphasia (PWA), even though many treatments for anomia following stroke are predicated on the use of semantic feature cues. Aims As part of a larger investigation into the influence of semantic feature processing on naming for PWA, this study examined the ability of PWA to confirm the relations between object concepts and associated semantic features. Methods & Procedures 15 native English-speaking, right handed individuals with post-stroke-aphasia responded yes or no via button press to feature-verification questions designed to probe the relationships between concept domain and feature type and distinctiveness. Outcomes & Results PWA were more accurate and quicker to confirm concept-feature relationships when features contained function/action, rather than visual-perceptual, information about concepts and when features were distinctive to concepts rather than shared. The truthfulness (i.e., veracity) of concept-feature pairings was demonstrated to differentially affect living versus nonliving concepts. Within domain, only nonliving concepts were verified more accurately and more quickly when pairings were true (rather than false). Between domains, true nonliving concept-feature pairings were more accurately and more quickly verified than true living concept-feature pairings. Also with respect to veracity, correlations were observed between aphasia severity and accuracy and speed of response to false concept-feature pairings. Conclusions Findings have implications for the way in which semantic processing is probed with PWA, as well as

  9. What matters in semantic feature processing for persons with stroke-aphasia: Evidence from an auditory concept-feature verification task.

    PubMed

    Antonucci, Sharon M

    The relationship between object concept domains (living vs. nonliving) and their underlying feature structures is a frequent area of investigation regarding semantic processing in healthy individuals and some individuals with neuropsychological impairment resulting from herpes simplex encephalitis, semantic dementia and Alzheimer's disease. However, this relationship has been less well-investigated in persons with stroke-aphasia (PWA), even though many treatments for anomia following stroke are predicated on the use of semantic feature cues. As part of a larger investigation into the influence of semantic feature processing on naming for PWA, this study examined the ability of PWA to confirm the relations between object concepts and associated semantic features. 15 native English-speaking, right handed individuals with post-stroke-aphasia responded yes or no via button press to feature-verification questions designed to probe the relationships between concept domain and feature type and distinctiveness. PWA were more accurate and quicker to confirm concept-feature relationships when features contained function/action, rather than visual-perceptual, information about concepts and when features were distinctive to concepts rather than shared. The truthfulness (i.e., veracity) of concept-feature pairings was demonstrated to differentially affect living versus nonliving concepts. Within domain, only nonliving concepts were verified more accurately and more quickly when pairings were true (rather than false). Between domains, true nonliving concept-feature pairings were more accurately and more quickly verified than true living concept-feature pairings. Also with respect to veracity, correlations were observed between aphasia severity and accuracy and speed of response to false concept-feature pairings. Findings have implications for the way in which semantic processing is probed with PWA, as well as providing preliminary information regarding responsivity of PWA to

  10. Ambient Experience in Restitutive Treatment of Aphasia

    PubMed Central

    McClung, Jill S.; Rothi, Leslie J. Gonzalez; Nadeau, Stephen E.

    2010-01-01

    One of the greatest challenges to language rehabilitation is reconciling the fact that the same therapeutic intervention, provided to different individuals with similar types of stroke-induced aphasia, may result in divergent outcomes. In this paper, the authors reviewed existing literature to identify relevant ambient factors – those outside the control of the clinician – that may potentially influence functional language recovery in aphasia and response to treatment. The goal was to develop a clinical history-taking tool to assist clinicians in gathering information germane to each individual's unique circumstances and environment, elements that may have previously been underestimated, to provide a complete inventory of potentially potent prognostic factors. First, two of the authors, speech–language pathologists experienced in aphasia rehabilitation, identified and categorized factors that seemed likely to influence aphasia outcomes. Then, a wide range of literature was reviewed in an effort to identify factors empirically found to be potent influences on aphasia recovery. Where studies relating these factors to aphasia were not found, relevant research from allied fields that examined recovery from brain injury is reported. Moreover, some factors thought to be potentially potent have yet to be examined. Finally, the ambient factors supported by evidence were categorized as facilitators or barriers to functional improvement, and the Ambient Influences on Outcome Checklist (AOC) was developed, including only those factors shown to be potent in the recovery process. It is hoped that this checklist can be used to more broadly assess potential prognostic influences in aphasia restitution, as well as spawn further research. PMID:21103021

  11. Family Adjustment to Aphasia

    MedlinePlus

    ... this time. Seek additional counseling services as necessary. Communication Skills Family members also can help the person ... aphasia develop new skills to compensate for the communication problems. Some suggestion include: Continue to talk to ...

  12. Aphasia vs. Apraxia

    MedlinePlus

    ... express a thought. Understanding grammatical sentences. Reading or writing words or sentences. Therapy approaches for aphasia: Restoring ... size or shape) Learning compensating communication methods Using writing or gestures Training conversation partners so they may ...

  13. Stroke rehabilitation using noninvasive cortical stimulation: aphasia.

    PubMed

    Mylius, Veit; Zouari, Hela G; Ayache, Samar S; Farhat, Wassim H; Lefaucheur, Jean-Pascal

    2012-08-01

    Poststroke aphasia results from the lesion of cortical areas involved in the motor production of speech (Broca's aphasia) or in the semantic aspects of language comprehension (Wernicke's aphasia). Such lesions produce an important reorganization of speech/language-specific brain networks due to an imbalance between cortical facilitation and inhibition. In fact, functional recovery is associated with changes in the excitability of the damaged neural structures and their connections. Two main mechanisms are involved in poststroke aphasia recovery: the recruitment of perilesional regions of the left hemisphere in case of small lesion and the acquisition of language processing ability in homotopic areas of the nondominant right hemisphere when left hemispheric language abilities are permanently lost. There is some evidence that noninvasive cortical stimulation, especially when combined with language therapy or other therapeutic approaches, can promote aphasia recovery. Cortical stimulation was mainly used to either increase perilesional excitability or reduce contralesional activity based on the concept of reciprocal inhibition and maladaptive plasticity. However, recent studies also showed some positive effects of the reinforcement of neural activities in the contralateral right hemisphere, based on the potential compensatory role of the nondominant hemisphere in stroke recovery.

  14. Varieties of progressive non-fluent aphasia.

    PubMed

    Cappa, S F; Perani, D; Messa, C; Miozzo, A; Fazio, F

    1996-01-17

    We report four patients with progressive aphasia of the non-fluent type as the presenting clinical manifestation. The patients were included in a longitudinal study of focal progressive neuropsychological syndromes, and were periodically submitted to neuropsychological evaluations and neuroimaging studies (TC, MRI, SPET or PET). The pattern of neuropsychological impairment was in good agreement with the results of functional imaging studies, which indicated involvement of the anterior regions of the left hemisphere. The evolution of the clinical picture was extremely heterogeneous in the four patients, ranging from a relatively stable picture of transcortical motor aphasia to a severe progressive frontal lobe syndrome. Progressive non-fluent aphasia appears to be a reliable clinical marker of the localization of the pathological process; whether this is related to specific neuropathological conditions, such as Pick's disease, remains for the moment a matter of speculation.

  15. Algebra in a man with severe aphasia.

    PubMed

    Klessinger, Nicolai; Szczerbinski, Marcin; Varley, Rosemary

    2007-04-09

    We report a dissociation between higher order mathematical ability and language in the case of a man (SO) with severe aphasia. Despite severely impaired abilities in the language domain and difficulties with processing both phonological and orthographic number words, he was able to judge the equivalence of and to transform and simplify mathematical expressions in algebraic notation. SO was sensitive to structure-dependent properties of algebraic expressions and displayed considerable capacity to retrieve algebraic facts, rules and principles, and to apply them to novel problems. He demonstrated similar capacity in solving expressions containing either solely numeric or abstract algebraic symbols (e.g., 8-(3-5)+3 versus b-(a-c)+a). The results show the retention of elementary algebra despite severe aphasia and provide evidence for the preservation of symbolic capacity in one modality and hence against the notion of aphasia as asymbolia.

  16. QUANTITATIVE TEMPLATE FOR SUBTYPING PRIMARY PROGRESSIVE APHASIA

    PubMed Central

    Mesulam, Marsel; Wieneke, Christina; Rogalski, Emily; Cobia, Derin; Thompson, Cynthia; Weintraub, Sandra

    2009-01-01

    Objective To provide a quantitative algorithm for classifying primary progressive aphasia (PPA) into agrammatic (PPA-G), semantic (PPA-S) and logopenic (PPA-L) variants, each of which is known to have a different probability of association with Alzheimer’s disease (AD) versus frontotemporal lobar degeneration (FTLD). Design Prospectively and consecutively enrolled 16 PPA patients tested with neuropsychological instruments and magnetic resonance imaging (MRI). Setting University medical center. Participants PPA patients recruited nationally in the USA as part of a longitudinal study. Results A two-dimensional template, reflecting performance on tests of syntax (Northwestern Anagram Test) and lexical semantics (Peabody Picture Vocabulary Test), classified all 16 patients in concordance with a clinical diagnosis that had been made prior to the administration of the quantitative tests. All three subtypes had distinctly asymmetrical atrophy of the left perisylvian language network. Each subtype also had distinctive peak atrophy sites. Only PPA-G had peak atrophy in the IFG (Broca’s area), only PPA-S had peak atrophy in the anterior temporal lobe, and only PPA-L had peak atrophy in area 37. Conclusions Once an accurate root diagnosis of PPA is made, subtyping can be quantitatively guided using a two-dimensional template based on orthogonal tasks of grammatical competence and word comprehension. Although the choice of tasks and precise cut-off levels may evolve in time, this set of 16 patients demonstrates the feasibility of using a simple algorithm for clinico-anatomical classification in PPA. Prospective studies will show whether this suptyping can improve the clinical prediction of underlying neuropathology. PMID:20008661

  17. Quantitative template for subtyping primary progressive aphasia.

    PubMed

    Mesulam, Marsel; Wieneke, Christina; Rogalski, Emily; Cobia, Derin; Thompson, Cynthia; Weintraub, Sandra

    2009-12-01

    The syndrome of primary progressive aphasia (PPA) is diagnosed when a gradual failure of word usage or comprehension emerges as the principal feature of a neurodegenerative disease. To provide a quantitative algorithm for classifying PPA into agrammatic (PPA-G), semantic (PPA-S), and logopenic (PPA-L) variants, each of which is known to have a different probability of association with Alzheimer disease vs frontotemporal lobar degeneration. Prospective study. University medical center. Sixteen consecutively enrolled patients with PPA who underwent neuropsychological testing and magnetic resonance imaging recruited nationally in the United States as part of a longitudinal study. A 2-dimensional template that reflects performance on tests of syntax (Northwestern Anagram Test) and lexical semantics (Peabody Picture Vocabulary Test-Fourth Edition) classified all 16 patients in concordance with a clinical diagnosis that had been made before the administration of quantitative tests. All 3 PPA subtypes had distinctly asymmetrical atrophy of the left perisylvian language network. Each subtype also had distinctive peak atrophy sites: PPA-G in the inferior frontal gyrus (Broca area), PPA-S in the anterior temporal lobe, and PPA-L in Brodmann area 37. Once an accurate root diagnosis of PPA is made, subtyping can be quantitatively guided using a 2-dimensional template based on orthogonal tasks of grammatical competence and word comprehension. Although the choice of tasks and the precise cutoff levels may need to be adjusted to fit linguistic and educational backgrounds, these 16 patients demonstrate the feasibility of using a simple algorithm for clinicoanatomical classification in PPA. Prospective studies will show whether this subtyping can improve clinical prediction of the underlying neuropathologic condition.

  18. The anterior temporal lobes support residual comprehension in Wernicke's aphasia.

    PubMed

    Robson, Holly; Zahn, Roland; Keidel, James L; Binney, Richard J; Sage, Karen; Lambon Ralph, Matthew A

    2014-03-01

    Wernicke's aphasia occurs after a stroke to classical language comprehension regions in the left temporoparietal cortex. Consequently, auditory-verbal comprehension is significantly impaired in Wernicke's aphasia but the capacity to comprehend visually presented materials (written words and pictures) is partially spared. This study used functional magnetic resonance imaging to investigate the neural basis of written word and picture semantic processing in Wernicke's aphasia, with the wider aim of examining how the semantic system is altered after damage to the classical comprehension regions. Twelve participants with chronic Wernicke's aphasia and 12 control participants performed semantic animate-inanimate judgements and a visual height judgement baseline task. Whole brain and region of interest analysis in Wernicke's aphasia and control participants found that semantic judgements were underpinned by activation in the ventral and anterior temporal lobes bilaterally. The Wernicke's aphasia group displayed an 'over-activation' in comparison with control participants, indicating that anterior temporal lobe regions become increasingly influential following reduction in posterior semantic resources. Semantic processing of written words in Wernicke's aphasia was additionally supported by recruitment of the right anterior superior temporal lobe, a region previously associated with recovery from auditory-verbal comprehension impairments. Overall, the results provide support for models in which the anterior temporal lobes are crucial for multimodal semantic processing and that these regions may be accessed without support from classic posterior comprehension regions.

  19. Discourse Characteristics in Aphasia Beyond the Western Aphasia Battery Cutoff.

    PubMed

    Fromm, Davida; Forbes, Margaret; Holland, Audrey; Dalton, Sarah Grace; Richardson, Jessica; MacWhinney, Brian

    2017-08-15

    This study examined discourse characteristics of individuals with aphasia who scored at or above the 93.8 cutoff on the Aphasia Quotient subtests of the Western Aphasia Battery-Revised (WAB-R; Kertesz, 2007). They were compared with participants without aphasia and those with anomic aphasia. Participants were from the AphasiaBank database and included 28 participants who were not aphasic by WAB-R score (NABW), 92 participants with anomic aphasia, and 177 controls. Cinderella narratives were analyzed using the Computerized Language Analysis programs (MacWhinney, 2000). Outcome measures were words per minute, percent word errors, lexical diversity using the moving average type-token ratio (Covington, 2007b), main concept production, number of utterances, mean length of utterance, and proposition density. Results showed that the NABW group was significantly different from the controls on all measures except MLU and proposition density. These individuals were compared to participants without aphasia and those with anomic aphasia. Individuals with aphasia who score above the WAB-R Aphasia Quotient cutoff demonstrate discourse impairments that warrant both treatment and special attention in the research literature.

  20. Rehabilitation of aphasia.

    PubMed

    Basso, Anna; Forbes, Margaret; Boller, François

    2013-01-01

    Aphasia is one of the most striking cognitive sequels of strokes and other cerebral lesions, and attempts to rehabilitate aphasic patients have been undertaken for many years. Following a brief overview of the epidemiology and the clinical characteristics of aphasia, the chapter presents the major traditional approaches to rehabilitation. They include the stimulation approach (also called classic), the behavior modification approach, Luria's approach (functional reorganization), the pragmatic approach, as well as the neurolinguistic approach. The next section illustrates some of the current approaches to aphasia rehabilitation, specifically the syndromic approach (also called neoassociationist), the cognitive neuropsychological approach, and the social approach. The chapter then provides examples of specific methods. While all intervention strategies may be classified, more or less correctly, into one or another of the above categories, it is not possible to mention the hundreds of specific interventions to be found in the literature, some of which have been described only briefly and in reference to a single case. The chapter concludes with a review of efficacy studies on aphasia therapy. Despite some opinions to the contrary, the current consensus is that sufficient experimental evidence of efficacy exists to recommend treatment of aphasia. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. Study on Language Rehabilitation for Aphasia.

    PubMed

    Yu, Zeng-Zhi; Jiang, Shu-Jun; Jia, Zi-Shan; Xiao, Hong-Yu; Zhou, Mei-Qi

    2017-06-20

    The aim is to update our clinical recommendations for evidence-based language rehabilitation of people with aphasia, based on a systematic review of the literature from 1999 to 2015. Articles referred to in this systematic review of the Medline and PubMed published in English language literatures were from 1998 to 2015. The terms used in the literature searches were aphasia and evidenced-based. The task force initially identified citations for 51 published articles. Of the 51 articles, 44 studies were selected after further detailed review. Six articles, which were not written in English, and one study related to laryngectomy rehabilitation interventions, were excluded from the study. This study referred to all the important and English literature in full. Aphasia is the linguistic disability, which usually results from injuries to the dominant hemisphere of the brain. The rehabilitation of aphasia is until in the process of being debated and researched. Evidence-based medicine (EBM), EBM based on the clinical evidence, promotes the practice of combining the clinicians' first-hand experience and the existing objective and scientific evidence encouraging making decisions based on both empirical evidence and the scientific evidence. Currently, EBM is being gradually implemented in the clinical practice as the aim of the development of modern medicine. At present, the research for the aphasia rehabilitation mainly focuses on the cognitive language rehabilitation and the intensive treatment and the precise treatment, etc. There is now sufficient information to support evidence-based protocols and implement empirically-supported treatments for linguistic disability after traumatic brain injury and stroke, which can be used to develop linguistic rehabilitation guidelines for patients with aphasia.

  2. Study on Language Rehabilitation for Aphasia

    PubMed Central

    Yu, Zeng-Zhi; Jiang, Shu-Jun; Jia, Zi-Shan; Xiao, Hong-Yu; Zhou, Mei-Qi

    2017-01-01

    Objective: The aim is to update our clinical recommendations for evidence-based language rehabilitation of people with aphasia, based on a systematic review of the literature from 1999 to 2015. Data Sources: Articles referred to in this systematic review of the Medline and PubMed published in English language literatures were from 1998 to 2015. The terms used in the literature searches were aphasia and evidenced-based. Study Selection: The task force initially identified citations for 51 published articles. Of the 51 articles, 44 studies were selected after further detailed review. Six articles, which were not written in English, and one study related to laryngectomy rehabilitation interventions, were excluded from the study. This study referred to all the important and English literature in full. Results: Aphasia is the linguistic disability, which usually results from injuries to the dominant hemisphere of the brain. The rehabilitation of aphasia is until in the process of being debated and researched. Evidence-based medicine (EBM), EBM based on the clinical evidence, promotes the practice of combining the clinicians’ first-hand experience and the existing objective and scientific evidence encouraging making decisions based on both empirical evidence and the scientific evidence. Currently, EBM is being gradually implemented in the clinical practice as the aim of the development of modern medicine. Conclusions: At present, the research for the aphasia rehabilitation mainly focuses on the cognitive language rehabilitation and the intensive treatment and the precise treatment, etc. There is now sufficient information to support evidence-based protocols and implement empirically-supported treatments for linguistic disability after traumatic brain injury and stroke, which can be used to develop linguistic rehabilitation guidelines for patients with aphasia. PMID:28584214

  3. Acute aphasia in multiple sclerosis.

    PubMed

    Devere, T R; Trotter, J L; Cross, A H

    2000-08-01

    Acute aphasia is rare in multiple sclerosis. We describe 3 patients with multiple sclerosis who had acute exacerbations presenting as aphasias. One patient had a mixed transcortical aphasia, 1 had a transcortical motor aphasia, and 1 had a Broca aphasia. Magnetic resonance imaging scans of the brain with contrast enhancement revealed new white matter lesions in the left hemisphere in all 3 patients. Two of the 3 patients had a good response to treatment with methylprednisolone sodium succinate. Arch Neurol. 2000;57:1207-1209

  4. Where are aphasia theory and management “headed”?

    PubMed Central

    Tippett, Donna C.; Hillis, Argye E.

    2017-01-01

    The sequelae of post-stroke aphasia are considerable, necessitating an understanding of the functional neuroanatomy of language, cognitive processes underlying various language tasks, and the mechanisms of recovery after stroke. This knowledge is vital in providing optimal care of individuals with aphasia and counseling to their families and caregivers. The standard of care in the rehabilitation of aphasia dictates that treatment be evidence-based and person-centered. Promising techniques, such as cortical stimulation as an adjunct to behavioral therapy, are just beginning to be explored. These topics are discussed in this review. PMID:28713549

  5. Gesturing by speakers with aphasia: how does it compare?

    PubMed

    Mol, Lisette; Krahmer, Emiel; van de Sandt-Koenderman, Mieke

    2013-08-01

    To study the independence of gesture and verbal language production. The authors assessed whether gesture can be semantically compensatory in cases of verbal language impairment and whether speakers with aphasia and control participants use similar depiction techniques in gesture. The informativeness of gesture was assessed in 3 forced-choice studies, in which raters assessed the topic of the speaker's message in video clips of 13 speakers with moderate aphasia and 12 speakers with severe aphasia, who were performing a communication test (the Scenario Test). Both groups were compared and contrasted with 17 control participants, who either were or were not allowed to communicate verbally. In addition, the representation techniques used in gesture were analyzed. Gestures produced by speakers with more severe aphasia were less informative than those by speakers with moderate aphasia, yet they were not necessarily uninformative. Speakers with more severe aphasia also tended to use fewer representation techniques (mostly relying on outlining gestures) in co-speech gesture than control participants, who were asked to use gesture instead of speech. It is important to note that limb apraxia may be a mediating factor here. These results suggest that in aphasia, gesture tends to degrade with verbal language. This may imply that the processes underlying verbal language and co-speech gesture production, although partly separate, are closely linked.

  6. Global aphasia without hemiparesis.

    PubMed

    Tranel, D; Biller, J; Damasio, H; Adams, H P; Cornell, S H

    1987-03-01

    Three patients acutely developed global aphasia, but did not manifest the typical accompanying right hemiparesis. Computed tomography and magnetic resonance imaging studies demonstrated that the patients had two discrete left hemisphere lesions, one in the anterior language cortices or language-related subcortical areas, and one in the posterior language cortices. Cerebral angiography showed that two patients had complete occlusion of the left internal carotid artery, and the third had an intraluminal "clot" in the supraclinoid portion of the left internal carotid, findings suggestive of an embolic etiology. Our cases indicate that global aphasia without hemiparesis predicts two discrete lesions and a particularly good recovery of speech and language.

  7. Aphasia in Clinical Practice

    PubMed Central

    Kertesz, Andrew

    1983-01-01

    Aphasia is a central language impairment with word finding and comprehension deficit and paraphasias. The highlights of the essential language tests and the classification based on a scorable assessment are presented. The clinical syndromes of Broca's, global, Wernicke, conduction, anomic and transcortical aphasias are detailed with definition, localization, and prognosis. Modality specific disorders associated with aphasic syndromes are discussed. The management of the aphasic patient, consisting of informed support and coordination of available services, is often the responsibility of the family physician. ImagesFig. 1Fig. 2 PMID:21286589

  8. Frontal lobe damage impairs process and content in semantic memory: evidence from category-specific effects in progressive non-fluent aphasia.

    PubMed

    Reilly, Jamie; Rodriguez, Amy D; Peelle, Jonathan E; Grossman, Murray

    2011-06-01

    Portions of left inferior frontal cortex have been linked to semantic memory both in terms of the content of conceptual representation (e.g., motor aspects in an embodied semantics framework) and the cognitive processes used to access these representations (e.g., response selection). Progressive non-fluent aphasia (PNFA) is a neurodegenerative condition characterized by progressive atrophy of left inferior frontal cortex. PNFA can, therefore, provide a lesion model for examining the impact of frontal lobe damage on semantic processing and content. In the current study we examined picture naming in a cohort of PNFA patients across a variety of semantic categories. An embodied approach to semantic memory holds that sensorimotor features such as self-initiated action may assume differential importance for the representation of manufactured artifacts (e.g., naming hand tools). Embodiment theories might therefore predict that patients with frontal damage would be differentially impaired on manufactured artifacts relative to natural kinds, and this prediction was borne out. We also examined patterns of naming errors across a wide range of semantic categories and found that naming error distributions were heterogeneous. Although PNFA patients performed worse overall on naming manufactured artifacts, there was no reliable relationship between anomia and manipulability across semantic categories. These results add to a growing body of research arguing against a purely sensorimotor account of semantic memory, suggesting instead a more nuanced balance of process and content in how the brain represents conceptual knowledge.

  9. Differentiating primary progressive aphasias in a brief sample of connected speech

    PubMed Central

    Evans, Emily; O'Shea, Jessica; Powers, John; Boller, Ashley; Weinberg, Danielle; Haley, Jenna; McMillan, Corey; Irwin, David J.; Rascovsky, Katya; Grossman, Murray

    2013-01-01

    Objective: A brief speech expression protocol that can be administered and scored without special training would aid in the differential diagnosis of the 3 principal forms of primary progressive aphasia (PPA): nonfluent/agrammatic PPA, logopenic variant PPA, and semantic variant PPA. Methods: We used a picture-description task to elicit a short speech sample, and we evaluated impairments in speech-sound production, speech rate, lexical retrieval, and grammaticality. We compared the results with those obtained by a longer, previously validated protocol and further validated performance with multimodal imaging to assess the neuroanatomical basis of the deficits. Results: We found different patterns of impaired grammar in each PPA variant, and additional language production features were impaired in each: nonfluent/agrammatic PPA was characterized by speech-sound errors; logopenic variant PPA by dysfluencies (false starts and hesitations); and semantic variant PPA by poor retrieval of nouns. Strong correlations were found between this brief speech sample and a lengthier narrative speech sample. A composite measure of grammaticality and other measures of speech production were correlated with distinct regions of gray matter atrophy and reduced white matter fractional anisotropy in each PPA variant. Conclusions: These findings provide evidence that large-scale networks are required for fluent, grammatical expression; that these networks can be selectively disrupted in PPA syndromes; and that quantitative analysis of a brief speech sample can reveal the corresponding distinct speech characteristics. PMID:23794681

  10. Primary progressive aphasia and the evolving neurology of the language network

    PubMed Central

    Mesulam, M.-Marsel; Rogalski, Emily J.; Wieneke, Christina; Hurley, Robert S.; Geula, Changiz; Bigio, Eileen H.; Thompson, Cynthia K.; Weintraub, Sandra

    2014-01-01

    Primary progressive aphasia (PPA) is caused by selective neurodegeneration of the language-dominant cerebral hemisphere; a language deficit initially arises as the only consequential impairment and remains predominant throughout most of the course of the disease. Agrammatic, logopenic and semantic subtypes, each reflecting a characteristic pattern of language impairment and corresponding anatomical distribution of cortical atrophy, represent the most frequent presentations of PPA. Such associations between clinical features and the sites of atrophy have provided new insights into the neurology of fluency, grammar, word retrieval, and word comprehension, and have necessitated modification of concepts related to the functions of the anterior temporal lobe and Wernicke’s area. The underlying neuropathology of PPA is, most commonly, frontotemporal lobar degeneration in the agrammatic and semantic forms, and Alzheimer disease (AD) pathology in the logopenic form; the AD pathology often displays atypical and asymmetrical anatomical features consistent with the aphasic phenotype. The PPA syndrome reflects complex interactions between disease-specific neuropathological features and patient-specific vulnerability. A better understanding of these interactions might help us to elucidate the biology of the language network and the principles of selective vulnerability in neurodegenerative diseases. We review these aspects of PPA, focusing on advances in our understanding of the clinical features and neuropathology of PPA and what they have taught us about the neural substrates of the language network. PMID:25179257

  11. Differentiating primary progressive aphasias in a brief sample of connected speech.

    PubMed

    Ash, Sharon; Evans, Emily; O'Shea, Jessica; Powers, John; Boller, Ashley; Weinberg, Danielle; Haley, Jenna; McMillan, Corey; Irwin, David J; Rascovsky, Katya; Grossman, Murray

    2013-07-23

    A brief speech expression protocol that can be administered and scored without special training would aid in the differential diagnosis of the 3 principal forms of primary progressive aphasia (PPA): nonfluent/agrammatic PPA, logopenic variant PPA, and semantic variant PPA. We used a picture-description task to elicit a short speech sample, and we evaluated impairments in speech-sound production, speech rate, lexical retrieval, and grammaticality. We compared the results with those obtained by a longer, previously validated protocol and further validated performance with multimodal imaging to assess the neuroanatomical basis of the deficits. We found different patterns of impaired grammar in each PPA variant, and additional language production features were impaired in each: nonfluent/agrammatic PPA was characterized by speech-sound errors; logopenic variant PPA by dysfluencies (false starts and hesitations); and semantic variant PPA by poor retrieval of nouns. Strong correlations were found between this brief speech sample and a lengthier narrative speech sample. A composite measure of grammaticality and other measures of speech production were correlated with distinct regions of gray matter atrophy and reduced white matter fractional anisotropy in each PPA variant. These findings provide evidence that large-scale networks are required for fluent, grammatical expression; that these networks can be selectively disrupted in PPA syndromes; and that quantitative analysis of a brief speech sample can reveal the corresponding distinct speech characteristics.

  12. Primary progressive aphasia and the evolving neurology of the language network.

    PubMed

    Mesulam, M-Marsel; Rogalski, Emily J; Wieneke, Christina; Hurley, Robert S; Geula, Changiz; Bigio, Eileen H; Thompson, Cynthia K; Weintraub, Sandra

    2014-10-01

    Primary progressive aphasia (PPA) is caused by selective neurodegeneration of the language-dominant cerebral hemisphere; a language deficit initially arises as the only consequential impairment and remains predominant throughout most of the course of the disease. Agrammatic, logopenic and semantic subtypes, each reflecting a characteristic pattern of language impairment and corresponding anatomical distribution of cortical atrophy, represent the most frequent presentations of PPA. Such associations between clinical features and the sites of atrophy have provided new insights into the neurology of fluency, grammar, word retrieval, and word comprehension, and have necessitated modification of concepts related to the functions of the anterior temporal lobe and Wernicke's area. The underlying neuropathology of PPA is, most commonly, frontotemporal lobar degeneration in the agrammatic and semantic forms, and Alzheimer disease (AD) pathology in the logopenic form; the AD pathology often displays atypical and asymmetrical anatomical features consistent with the aphasic phenotype. The PPA syndrome reflects complex interactions between disease-specific neuropathological features and patient-specific vulnerability. A better understanding of these interactions might help us to elucidate the biology of the language network and the principles of selective vulnerability in neurodegenerative diseases. We review these aspects of PPA, focusing on advances in our understanding of the clinical features and neuropathology of PPA and what they have taught us about the neural substrates of the language network.

  13. Aphasia: Current Concepts in Theory and Practice

    PubMed Central

    Tippett, Donna C.; Niparko, John K.; Hillis, Argye E.

    2014-01-01

    Recent advances in neuroimaging contribute to a new insights regarding brain-behavior relationships and expand understanding of the functional neuroanatomy of language. Modern concepts of the functional neuroanatomy of language invoke rich and complex models of language comprehension and expression, such as dual stream networks. Increasingly, aphasia is seen as a disruption of cognitive processes underlying language. Rehabilitation of aphasia incorporates evidence based and person-centered approaches. Novel techniques, such as methods of delivering cortical brain stimulation to modulate cortical excitability, such as repetitive transcranial magnetic stimulation and transcranial direct current stimulation, are just beginning to be explored. In this review, we discuss the historical context of the foundations of neuroscientific approaches to language. We sample the emergent theoretical models of the neural substrates of language and cognitive processes underlying aphasia that contribute to more refined and nuanced concepts of language. Current concepts of aphasia rehabilitation are reviewed, including the promising role of cortical stimulation as an adjunct to behavioral therapy and changes in therapeutic approaches based on principles of neuroplasticity and evidence-based/person-centered practice to optimize functional outcomes. PMID:24904925

  14. MAAS (Multi-axial Aphasia System): realistic goal setting in aphasia rehabilitation.

    PubMed

    van de Sandt-Koenderman, Wilhelmina M E; van Harskamp, Frans; Duivenvoorden, Hugo J; Remerie, Sylvia C; van der Voort-Klees, Yvonne A; Wielaert, Sandra M; Ribbers, Gerard M; Visch-Brink, Evy G

    2008-12-01

    Treatment success in aphasia is influenced by various factors. Clinical decisions, including patient selection and decisions on frequency and content, are often guided by a clinician's implicit opinions. The Multi-axial Aphasia System (MAAS) was developed to structure linguistic, somatic, neuropsychological, psychosocial and socio-economic information on five separate axes, enabling an explicit and interdisciplinary process of clinical decision-making. The objectives of this study were to investigate the potentialities of MAAS in predicting the outcome of cognitive-linguistic treatment. A group of 58 aphasic patients were investigated prospectively. All received cognitive-linguistic treatment during a randomized, controlled study on the efficacy of lexical semantic treatment. An interdisciplinary aphasia team rated the pretreatment MAAS profiles of all patients. The team was blinded for treatment allocation and outcome. A multiple linear regression analysis was performed with the posttreatment verbal communication score as the variable to be predicted and the overall MAAS rating, age and type of treatment as predictor variables. In a second multiple regression analysis, the ratings for each of the five MAAS axes were used as candidate predictors. The team's overall rating contributed significantly to the prediction of verbal communicative ability after linguistic treatment. Of the five MAAS axes, the neuropsychological axis contributed to the prediction. An interdisciplinary approach to aphasia assessment may contribute to realistic goal setting in aphasia rehabilitation. The results of this study stress the importance of neuropsychological assessment of aphasic patients before treatment.

  15. Reading words and other people: A comparison of exception word, familiar face and affect processing in the left and right temporal variants of primary progressive aphasia.

    PubMed

    Binney, Richard J; Henry, Maya L; Babiak, Miranda; Pressman, Peter S; Santos-Santos, Miguel A; Narvid, Jared; Mandelli, Maria Luisa; Strain, Paul J; Miller, Bruce L; Rankin, Katherine P; Rosen, Howard J; Gorno-Tempini, Maria Luisa

    2016-09-01

    Semantic variant primary progressive aphasia (svPPA) typically presents with left-hemisphere predominant rostral temporal lobe (rTL) atrophy and the most significant complaints within the language domain. Less frequently, patients present with right-hemisphere predominant temporal atrophy coupled with marked impairments in processing of famous faces and emotions. Few studies have objectively compared these patient groups in both domains and therefore it is unclear to what extent the syndromes overlap. Clinically diagnosed svPPA patients were characterized as left- (n = 21) or right-predominant (n = 12) using imaging and compared along with 14 healthy controls. Regarding language, our primary focus was upon two hallmark features of svPPA; confrontation naming and surface dyslexia. Both groups exhibited naming deficits and surface dyslexia although the impairments were more severe in the left-predominant group. Familiarity judgments on famous faces and affect processing were more profoundly impaired in the right-predominant group. Our findings suggest that the two syndromes overlap significantly but that early cases at the tail ends of the continuum constitute a challenge for current clinical criteria. Correlational neuroimaging analyses implicated a mid portion of the left lateral temporal lobe in exception word reading impairments in line with proposals that this region is an interface between phonology and semantic knowledge.

  16. Reading words and other people: a comparison of exception word, familiar face and affect processing in the left and right temporal variants of primary progressive aphasia

    PubMed Central

    Binney, Richard J.; Henry, Maya L.; Babiak, Miranda; Pressman, Peter S.; Santos-Santos, Miguel A.; Narvid, Jared; Mandelli, Maria Luisa; Strain, Paul J.; Miller, Bruce L.; Rankin, Katherine P.; Rosen, Howard J.; Gorno-Tempini, Maria Luisa

    2016-01-01

    Semantic variant primary progressive aphasia (svPPA) typically presents with left-hemisphere predominant rostral temporal lobe atrophy and the most significant complaints within the language domain. Less frequently, patients present with right-hemisphere predominant temporal atrophy coupled with marked impairments in processing of famous faces and emotions. Few studies have objectively compared these patient groups in both domains and therefore it is unclear to what extent the syndromes overlap. Clinically diagnosed svPPA patients were characterized as left- (n= 21) or right-predominant (n = 12) using imaging and compared along with 14 healthy controls. Regarding language, our primary focus was upon two hallmark features of svPPA; confrontation naming and surface dyslexia. Both groups exhibited naming deficits and surface dyslexia although the impairments were more severe in the left-predominant group. Familiarity judgments on famous faces and affect processing were more profoundly impaired in the right-predominant group. Our findings suggest that the two syndromes overlap significantly but that early cases at the tail ends of the continuum constitute a challenge for current clinical criteria. Correlational neuroimaging analyses implicated a mid portion of the left lateral temporal lobe in exception word reading impairments in line with proposals that this region is an interface between phonology and semantic knowledge. PMID:27389800

  17. Temporal acoustic measures distinguish primary progressive apraxia of speech from primary progressive aphasia.

    PubMed

    Duffy, Joseph R; Hanley, Holly; Utianski, Rene; Clark, Heather; Strand, Edythe; Josephs, Keith A; Whitwell, Jennifer L

    2017-02-07

    The purpose of this study was to determine if acoustic measures of duration and syllable rate during word and sentence repetition, and a measure of within-word lexical stress, distinguish speakers with primary progressive apraxia of speech (PPAOS) from nonapraxic speakers with the agrammatic or logopenic variants of primary progressive aphasia (PPA), and control speakers. Results revealed that the PPAOS group had longer durations and reduced rate of syllable production for most words and sentences, and the measure of lexical stress. Sensitivity and specificity indices for the PPAOS versus the other groups were highest for longer multisyllabic words and sentences. For the PPAOS group, correlations between acoustic measures and perceptual ratings of AOS were moderately high to high. Several temporal measures used in this study may aid differential diagnosis and help quantify features of PPAOS that are distinct from those associated with PPA in which AOS is not present.

  18. Neuroplasticity: Evidence from Aphasia.

    ERIC Educational Resources Information Center

    Thompson, Cynthia K.

    2000-01-01

    This article presents data showing that two of the four forms of neuroplasticity, homologous area adaptation and map extension, are relevant to recovery from aphasia. It discusses factors related to neuroplastic activity during language recovery, including neurophysiological, subject, and environmental treatment variables. (Contains references.)…

  19. Neuroplasticity: Evidence from Aphasia.

    ERIC Educational Resources Information Center

    Thompson, Cynthia K.

    2000-01-01

    This article presents data showing that two of the four forms of neuroplasticity, homologous area adaptation and map extension, are relevant to recovery from aphasia. It discusses factors related to neuroplastic activity during language recovery, including neurophysiological, subject, and environmental treatment variables. (Contains references.)…

  20. The Resolution and Recovery of Filler-Gap Dependencies in Aphasia: Evidence from On-Line Anomaly Detection

    ERIC Educational Resources Information Center

    Dickey, Michael Walsh; Thompson, Cynthia K.

    2004-01-01

    This study examines the on-line processing of sentences with movement using an auditory anomaly detection task (after Boland, Tanenhaus, Garnsey, & Carlson, 1995). Eight agrammatic aphasic participants (four of whom had undergone treatment focused on comprehension and production of filler-gap sentences) and 24 young normal participants listened to…

  1. Asymmetry of cortical decline in subtypes of primary progressive aphasia

    PubMed Central

    Cobia, Derin; Martersteck, Adam; Rademaker, Alfred; Wieneke, Christina; Weintraub, Sandra; Mesulam, M.-Marsel

    2014-01-01

    Objective: The aim of this study was to provide quantitative measures of changes in cortical atrophy over a 2-year period associated with 3 subtypes of primary progressive aphasia (PPA) using whole-brain vertex-wise and region-of-interest (ROI) neuroimaging methods. The purpose was to quantitate disease progression, establish an empirical basis for clinical expectations, and provide outcome measures for therapeutic trials. Methods: Changes in cortical thickness and volume loss as well as neuropsychological performance were assessed at baseline and 2-year follow-up in 26 patients who fulfilled criteria for logopenic (8 patients), agrammatic (10 patients), and semantic (8 patients) PPA subtypes. Whole-brain vertex-wise and ROI imaging analysis were conducted using the FreeSurfer longitudinal pipeline. Results: Clinical deficits and cortical atrophy patterns showed distinct patterns of change among the subtypes over 2 years. Results confirmed that progression for each of the 3 subtypes showed left greater than right hemisphere asymmetry. An ROI analysis also revealed that progression was greater within, rather than outside, the language network. Conclusions: Preferential neurodegeneration of the left hemisphere language network is a common denominator for all 3 PPA subtypes, even as the disease progresses. Using a focal cortical language network ROI as an outcome measure of disease progression appears to be more sensitive than whole-brain or ventricular volume measures of change and may be helpful for designing future clinical trials in PPA. PMID:25165386

  2. Asymmetry of cortical decline in subtypes of primary progressive aphasia.

    PubMed

    Rogalski, Emily; Cobia, Derin; Martersteck, Adam; Rademaker, Alfred; Wieneke, Christina; Weintraub, Sandra; Mesulam, M-Marsel

    2014-09-23

    The aim of this study was to provide quantitative measures of changes in cortical atrophy over a 2-year period associated with 3 subtypes of primary progressive aphasia (PPA) using whole-brain vertex-wise and region-of-interest (ROI) neuroimaging methods. The purpose was to quantitate disease progression, establish an empirical basis for clinical expectations, and provide outcome measures for therapeutic trials. Changes in cortical thickness and volume loss as well as neuropsychological performance were assessed at baseline and 2-year follow-up in 26 patients who fulfilled criteria for logopenic (8 patients), agrammatic (10 patients), and semantic (8 patients) PPA subtypes. Whole-brain vertex-wise and ROI imaging analysis were conducted using the FreeSurfer longitudinal pipeline. Clinical deficits and cortical atrophy patterns showed distinct patterns of change among the subtypes over 2 years. Results confirmed that progression for each of the 3 subtypes showed left greater than right hemisphere asymmetry. An ROI analysis also revealed that progression was greater within, rather than outside, the language network. Preferential neurodegeneration of the left hemisphere language network is a common denominator for all 3 PPA subtypes, even as the disease progresses. Using a focal cortical language network ROI as an outcome measure of disease progression appears to be more sensitive than whole-brain or ventricular volume measures of change and may be helpful for designing future clinical trials in PPA. © 2014 American Academy of Neurology.

  3. Thrombolysis in Stroke Patients with Isolated Aphasia.

    PubMed

    Denier, C; Chassin, O; Vandendries, C; Bayon de la Tour, L; Cauquil, C; Sarov, M; Adams, D; Flamand-Roze, C

    2016-01-01

    Data about evolution of aphasia following stroke are rare and controversial especially following fibrinolysis. The aim of this study was to describe the early clinical patterns of isolated aphasia in consecutive stroke patients with or without thrombolysis. Clinical and radiological data of consecutive stroke patients were routinely entered in prospective registry. Patients were considered aphasic when NIHSS (National Institutes of Health Stroke Scale) item 9 >0. 'Isolated aphasia' was defined by aphasic patients without motor limb deficit. We created a 'composite language score' obtained by summing the NIHSS items 1b, 1c and 9, which reflects language-processing ability. Recovery of functions was evaluated as measured by global NIHSS, composite language score and language screening test (LAST) at baseline, H24 and day 7 (D7). 'Mild deficit' was defined as global NIHSS <5. A total of 100 consecutive patients met study criteria for isolated aphasia. Twenty-five underwent thrombolysis and 75 did not. There was no difference between the 2 groups concerning demographic characteristics, involved territories and presence of arterial occlusion, initial median NIHSS, composite language and LAST scores at entrance. Evolution was significantly better in thrombolysed patient for the 3 testings: NIHSS, composite language score and LAST at D7 (respective p = 0.0002; p = 0.01 and p = 0.004). Similar results were found when we focused on the subgroups of patients with initial 'mild' deficits (p = 0.01; p = 0.0003 and p = 0.007). No symptomatic hemorrhagic transformation occurred following thrombolysis. These data strongly suggest that thrombolysis is safe and effective in patients with 'isolated aphasia,' even if the global NIHSS score is <5. © 2016 S. Karger AG, Basel.

  4. [Broca aphasia with neologisms].

    PubMed

    Iizuka, Osamu; Suzuki, Kyoko; Fujii, Toshikatsu; Endo, Yoshiko; Mori, Etsuro; Yamadori, Atsushi

    2004-07-01

    Patients with jargon aphasia generally have fluent speech with poor comprehension. However, outstanding jargons may appear in non-fluent aphasics. We report a 69-year-old left-handed woman with non-fluent jargon aphasia due to lesions in the right frontoparietal area. Features of her speech included non-fluent meaningless sequences of syllables, i. e., phonetic jargon, which was obvious in all the tasks including spontaneous speech, repetition, naming and reading. Her utterance was sparse, but not effortful or anarthric. She understood most of spoken single words, but was confused by complex sentences. Brain CTs revealed acute lesions affecting the inferior and middle frontal gyri, insular cortex, precentral and postcentral gyri, and a part of the angular gyrus in the right hemisphere. Old infarcts were also noted in the right frontal pole and prefrontal area. The unique feature of her language impairment suggested somewhat deviated lateralization and localization of her language function.

  5. First Aid for Aphasia: Home Exercises.

    ERIC Educational Resources Information Center

    Keenan, Joseph S.

    This pamphlet is designed for use by nonprofessionals as a guide to providing speech therapy for persons with aphasia. It includes an introduction that reviews the causes of aphasia, its immediate effects at onset, and the reactions typical to persons who develop aphasia. Uncomplicated aphasia is described first with eleven specific therapy…

  6. [Aphasia and artistic creation].

    PubMed

    Kornyey, E

    1977-01-01

    An artist active drawing and waterpainting, most prominent in sculpture, suffered an apopleptic insult at 66 years of age. Right hemiparesis and severe motor aphasia remained but this with rare unexpected and sometimes rather complicated productions in spoken, and also in written language in spite of modest progress in writing exercise. His behaviour witnessed of the memory of remote and complicated stored material. Some months after the insult he resumed his artistic activity using his left hand and continued it principally in the same manner as before his illness. His drawing and water-painting displayed some uncertainty of lines and sometimes coarseness of the stain spots. His pieces of sculpture regained the quality of his earlier works, as proven already by the first statue he made after the insult. While it is generally accepted that the motor aphasia does not essentially affect the artistic production, even of high quality, in painting, this is the first instance which proves that the same holds true for sculpture. In this case the mechanisms inciting the finest innervation on the side of the cortical center of the left hand, can work with promptness. In motor aphasia the mechanisms indispensable for the correct realisation of the function are affected without a final extinction of the function itself. Motor asphasia is an instrumental disorder not necessarily accompanied by disturbances of the intelligence.

  7. Dopaminergic therapy in aphasia

    PubMed Central

    Gill, Sumanjit K.

    2013-01-01

    Background The dopaminergic system is involved in a wide range of cognitive functions including motor control, reward, memory, attention, problem-solving and learning. This has stimulated interest in investigating the potential of dopaminergic drugs as cognitive enhancers in aphasic patients. Aim To discuss the evidence for the use of dopaminergic agents in patients with aphasia. Levodopa (L-dopa) and the dopamine agonist bromocriptine are the two drugs that have been trialled to date. We discuss, in some detail, the 15 studies that have been published on this topic from the first case report in 1988 to the present (2012), and assess the evidence from each. Main contribution In addition to summarising the effectiveness of the drugs that have been tried, we examine the possible cognitive mechanisms by which dopaminergic drugs may act on language function and aphasia recovery. Given the wide range of dopaminergic drugs, it is surprising that such a narrow range has been trialled in aphasic patients. Important lessons are to be learned from published studies and we discuss optimal trial designs to help guide future work. Conclusions The evidence for the efficacy of dopaminergic agents in aphasia therapy is mixed. Further trials with better tolerated agents are required. Optimal trial designs with appropriate control groups or blocks should be used. The mechanism of action is unclear, but at the cognitive level the evidence points towards either (re)learning of word-forms or their improved retrieval. PMID:25076804

  8. The development of modern approaches to aphasia: a concise overview.

    PubMed

    Vandenborre, Dorien; Visch-Brink, Evy; Mariën, Peter

    2015-09-01

    The aim of this article is to review the rationale on which modern aphasia test batteries are based. Since the mid-1950s, a starting point chosen because the discipline of speech (language) pathology was created during that period, a corpus of English aphasia tests was identified through searches of electronic databases. The tests were critically evaluated in terms of their theoretical roots and influences. During the past 50 years, the fundamentals of aphasia assessment remained basically unchanged, that is, to identify and gain insight into the nature and the degree of a language disturbance. However, the way in which the assessment has taken place has shifted back and forth from a purely medical approach to a more neurolinguistic or social approach depending on the influence exerted by different scientific fields. Not a single model on which aphasia assessments rely covers the many and multifaceted problems of individuals with aphasia. At several points in time during the rehabilitation process, the clinician and the patient will encounter a crossroad, where it has to be decided which path to follow next and how to evaluate the covered path. Besides application of formal test batteries, observations in different natural settings, evaluations of functional communication and insights into psychosocial coping contribute towards a holistic approach to aphasia.

  9. A Behavioral Conceptualization of Aphasia

    ERIC Educational Resources Information Center

    Baker, Jonathan C.; LeBlanc, Linda A.; Raetz, Paige B.

    2008-01-01

    Aphasia is an acquired language impairment that affects over 1 million individuals, the majority of whom are over age 65 (Groher, 1989). This disorder has typically been conceptualized within a cognitive neuroscience framework, but a behavioral interpretation of aphasia is also possible. Skinner's (1957) analysis of verbal behavior proposes a…

  10. A Behavioral Conceptualization of Aphasia

    ERIC Educational Resources Information Center

    Baker, Jonathan C.; LeBlanc, Linda A.; Raetz, Paige B.

    2008-01-01

    Aphasia is an acquired language impairment that affects over 1 million individuals, the majority of whom are over age 65 (Groher, 1989). This disorder has typically been conceptualized within a cognitive neuroscience framework, but a behavioral interpretation of aphasia is also possible. Skinner's (1957) analysis of verbal behavior proposes a…

  11. Word deafness in Wernicke's aphasia.

    PubMed Central

    Kirshner, H S; Webb, W G; Duncan, G W

    1981-01-01

    Three patients with otherwise typical Wernicke's aphasia showed consistent superiority of visual over auditory comprehension. The precedents for and anatomical basis of a selective auditory deficit in Wernicke's aphasia are discussed, including the relationship to pure word deafness. One implication of spared visual language function may be the use of gesture in language therapy for such patients. Images PMID:7229641

  12. Closed-class words as first syllables do interfere with lexical decisions for nonwords: implications for theories of agrammatism.

    PubMed

    Petocz, A; Oliphant, G

    1988-05-01

    It has been proposed that a principal cause of the agrammatism of some Broca's aphasics is that such patients, unlike normal subjects, are unable to make use of a special retrieval mechanism for closed-class ("function") words (D. C. Bradley, 1978, Computational distinctions of vocabulary type, Unpublished Ph.D. thesis; D. C. Bradley, M. F. Garrett, & E. B. Zurif, 1980. In D. Caplan (Ed.), Biological studies of mental processes). The main evidence for the existence of such a mechanism consisted of two observations: (1) the recognition of open-class words was observed to be frequency-sensitive, but that of closed-class words was not; and (2) lexical decisions for nonwords which began with open-class words were delayed, whereas there was no such interference for nonwords which began with closed-class words. However, the first of these observations has proved nonreplicable (e.g., B. Gordon & A. Caramazza, 1982, Brain and Language, 15, 143-160, 1983, Brain and Language, 19, 335-345; J. Segui, J. Mehler, W. Frauenfelder, & J. Morton, 1982, Neuropsychologia, 20, 615-627), and in the present paper, three lexical decision experiments are reported in which it is found that, when certain confounding variables are controlled, nonwords which begin with closed-class words are subject to interference. Moreover, contrary to a suggestion of Kolk and Blomert (1985, Brain and Language, 26, 94-105) the interference is independent of the presence of closed-class items in the lexical decision word list. It seems, then, that closed-class words are not qualitatively different from open-class words with respect either to frequency sensitivity or to nonword interference, and in consequence, the above proposed explanation of agrammatism is left without major empirical support.

  13. The Production of Turkish Relative Clauses in Agrammatism: Verb Inflection and Constituent Order

    ERIC Educational Resources Information Center

    Duman, Tuba Yarbay; Aygen, Gulsat; Bastiaanse, Roelien

    2008-01-01

    This study presents results from a sentence completion test that examines the production of finite main clauses and non-finite relative clauses in Turkish agrammatic speech. In main clauses, the verb is finite and all its constituents are in their base positions. In relative clauses, the verb is a participle and the NP undergoes overt movement to…

  14. Narrative discourse in anomic aphasia.

    PubMed

    Andreetta, Sara; Cantagallo, Anna; Marini, Andrea

    2012-07-01

    Anomic aphasia is a disturbance affecting lexical retrieval. Nonetheless, persons with this disorder may also experience difficulties in the construction of coherent narratives. Whether this symptom is a sign of a macrolinguistic difficulty per se or reflects the lexical disorder is still an open debate. In order to analyze the effect of the lexical impairment on macrolinguistic processing, we compared the narrative skills of a group of ten participants with chronic anomic aphasia with those of ten healthy control individuals matched for age and educational level. The anomic participants produced narratives with lowered speech rate, reduced mean length of utterance, fewer grammatically well-formed sentences, more semantic paraphasias. The macrolinguistic analysis showed that they also produced more errors of cohesion and global coherence and fewer lexical information units. Interestingly, their levels of thematic selection were normal. A bivariate correlational analysis showed a strong correlation between the production of errors of cohesion and production of complete sentences, and between production of errors of global coherence and lexical information units. These correlations showed that aspects related to lexical retrieval may affect macrolinguistic processing during the construction of a narrative. Indeed, it is suggested that lexical deficits lead to two main consequences: First, patients with anomia frequently interrupt the utterances they are producing and this reduces the levels of sentence completeness and the overall degree of cohesion across the utterances; Second, they use strategies to cope with the lexical impairment and produce a quantity of lexical fillers and repetitions that, clustered in utterances, reduce the levels of global coherence.

  15. Speech-Like and Non-Speech Lip Kinematics and Coordination in Aphasia

    ERIC Educational Resources Information Center

    Bose, Arpita; van Lieshout, Pascal

    2012-01-01

    Background: In addition to the well-known linguistic processing impairments in aphasia, oro-motor skills and articulatory implementation of speech segments are reported to be compromised to some degree in most types of aphasia. Aims: This study aimed to identify differences in the characteristics and coordination of lip movements in the production…

  16. Changes in N400 Topography Following Intensive Speech Language Therapy for Individuals with Aphasia

    ERIC Educational Resources Information Center

    Wilson, K. Ryan; O'Rourke, Heather; Wozniak, Linda A.; Kostopoulos, Ellina; Marchand, Yannick; Newman, Aaron J.

    2012-01-01

    Our goal was to characterize the effects of intensive aphasia therapy on the N400, an electrophysiological index of lexical-semantic processing. Immediately before and after 4 weeks of intensive speech-language therapy, people with aphasia performed a task in which they had to determine whether spoken words were a "match" or a "mismatch" to…

  17. Effects of Word Frequency and Modality on Sentence Comprehension Impairments in People with Aphasia

    ERIC Educational Resources Information Center

    DeDe, Gayle

    2012-01-01

    Purpose: It is well known that people with aphasia have sentence comprehension impairments. The present study investigated whether lexical factors contribute to sentence comprehension impairments in both the auditory and written modalities using online measures of sentence processing. Method: People with aphasia and non brain-damaged controls…

  18. The Auditory Comprehension of "Wh"-Questions in Aphasia: Support for the Intervener Hypothesis

    ERIC Educational Resources Information Center

    Sheppard, Shannon M.; Walenski, Matthew; Love, Tracy; Shapiro, Lewis P.

    2015-01-01

    Purpose: This study examines 3 hypotheses about the processing of "wh"-questions in both neurologically healthy adults and adults with Broca's aphasia. Method: We used an eye tracking while listening method with 32 unimpaired participants (Experiment 1) and 8 participants with Broca's aphasia (Experiment 2). Accuracy, response time, and…

  19. Speech-Like and Non-Speech Lip Kinematics and Coordination in Aphasia

    ERIC Educational Resources Information Center

    Bose, Arpita; van Lieshout, Pascal

    2012-01-01

    Background: In addition to the well-known linguistic processing impairments in aphasia, oro-motor skills and articulatory implementation of speech segments are reported to be compromised to some degree in most types of aphasia. Aims: This study aimed to identify differences in the characteristics and coordination of lip movements in the production…

  20. Changes in N400 Topography Following Intensive Speech Language Therapy for Individuals with Aphasia

    ERIC Educational Resources Information Center

    Wilson, K. Ryan; O'Rourke, Heather; Wozniak, Linda A.; Kostopoulos, Ellina; Marchand, Yannick; Newman, Aaron J.

    2012-01-01

    Our goal was to characterize the effects of intensive aphasia therapy on the N400, an electrophysiological index of lexical-semantic processing. Immediately before and after 4 weeks of intensive speech-language therapy, people with aphasia performed a task in which they had to determine whether spoken words were a "match" or a "mismatch" to…

  1. Effects of Word Frequency and Modality on Sentence Comprehension Impairments in People with Aphasia

    ERIC Educational Resources Information Center

    DeDe, Gayle

    2012-01-01

    Purpose: It is well known that people with aphasia have sentence comprehension impairments. The present study investigated whether lexical factors contribute to sentence comprehension impairments in both the auditory and written modalities using online measures of sentence processing. Method: People with aphasia and non brain-damaged controls…

  2. The Auditory Comprehension of "Wh"-Questions in Aphasia: Support for the Intervener Hypothesis

    ERIC Educational Resources Information Center

    Sheppard, Shannon M.; Walenski, Matthew; Love, Tracy; Shapiro, Lewis P.

    2015-01-01

    Purpose: This study examines 3 hypotheses about the processing of "wh"-questions in both neurologically healthy adults and adults with Broca's aphasia. Method: We used an eye tracking while listening method with 32 unimpaired participants (Experiment 1) and 8 participants with Broca's aphasia (Experiment 2). Accuracy, response time, and…

  3. Conceptualizing and Measuring Working Memory and its Relationship to Aphasia

    PubMed Central

    Wright, Heather Harris; Fergadiotis, Gerasimos

    2011-01-01

    Background General agreement exists in the literature that individuals with aphasia can exhibit a working memory deficit that contributes to their language processing impairments. Though conceptualized within different working memory frameworks, researchers have suggested that individuals with aphasia have limited working memory capacity, impaired attention-control processes as well as impaired inhibitory mechanisms. However, across studies investigating working memory ability in individuals with aphasia, different measures have been used to quantify their working memory ability and identify the relationship between working memory and language performance. Aims The primary objectives of this article are to (1) review current working memory theoretical frameworks, (2) review tasks used to measure working memory, and (3) discuss findings from studies that have investigated working memory as they relate to language processing in aphasia. Main Contribution Though findings have been consistent across studies investigating working memory ability in individuals with aphasia, discussion of how working memory is conceptualized and defined is often missing, as is discussion of results within a theoretical framework. This is critical, as working memory is conceptualized differently across the different theoretical frameworks. They differ in explaining what limits capacity and the source of individual differences as well as how information is encoded, maintained, and retrieved. When test methods are considered within a theoretical framework, specific hypotheses can be tested and stronger conclusions that are less susceptible to different interpretations can be made. Conclusions Working memory ability has been investigated in numerous studies with individuals with aphasia. To better understand the underlying cognitive constructs that contribute to the language deficits exhibited by individuals with aphasia, future investigations should operationally define the cognitive

  4. Decoding speech for understanding and treating aphasia.

    PubMed

    Pasley, Brian N; Knight, Robert T

    2013-01-01

    Aphasia is an acquired language disorder with a diverse set of symptoms that can affect virtually any linguistic modality across both the comprehension and production of spoken language. Partial recovery of language function after injury is common but typically incomplete. Rehabilitation strategies focus on behavioral training to induce plasticity in underlying neural circuits to maximize linguistic recovery. Understanding the different neural circuits underlying diverse language functions is a key to developing more effective treatment strategies. This chapter discusses a systems identification analytic approach to the study of linguistic neural representation. The focus of this framework is a quantitative, model-based characterization of speech and language neural representations that can be used to decode, or predict, speech representations from measured brain activity. Recent results of this approach are discussed in the context of applications to understanding the neural basis of aphasia symptoms and the potential to optimize plasticity during the rehabilitation process. © 2013 Elsevier B.V. All rights reserved.

  5. AphasiaBank: A resource for clinicians

    PubMed Central

    Forbes, Margaret M.; Fromm, Davida; MacWhinney, Brian

    2014-01-01

    AphasiaBank is a shared, multimedia database containing videos and transcriptions of approximately 180 aphasic individuals and 140 non-aphasic controls performing a uniform set of discourse tasks. The language in the videos is transcribed in CHAT format and coded for analysis with CLAN programs, which can perform a wide variety of language analyses. The database and the CLAN programs are freely available to aphasia researchers and clinicians for educational, clinical and scholarly uses. This paper describes the database, suggests some ways in which clinicians and clinician-researchers might find these materials useful, and introduces a new language analysis program, EVAL, designed to streamline the transcription and coding processes, while still producing an extensive and useful language profile. PMID:22851343

  6. Decoding Speech for Understanding and Treating Aphasia

    PubMed Central

    Pasley, Brian N.; Knight, Robert T.

    2014-01-01

    Aphasia is an acquired language disorder with a diverse set of symptoms that can affect virtually any linguistic modality across both the comprehension and production of spoken language. Partial recovery of language function after injury is common but typically incomplete. Rehabilitation strategies focus on behavioral training to induce plasticity in underlying neural circuits to maximize linguistic recovery. Understanding the different neural circuits underlying diverse language functions is a key to developing more effective treatment strategies. This chapter discusses a systems identification analytic approach to the study of linguistic neural representation. The focus of this framework is a quantitative, model-based characterization of speech and language neural representations that can be used to decode, or predict, speech representations from measured brain activity. Recent results of this approach are discussed in the context of applications to understanding the neural basis of aphasia symptoms and the potential to optimize plasticity during the rehabilitation process. PMID:24309265

  7. Factors predicting post-stroke aphasia recovery.

    PubMed

    M M, Watila; S A, Balarabe

    2015-05-15

    Aphasia is an important stroke sequel that impacts negatively on the HQoL of stroke patients. Although a number of stroke patients with aphasia will have good functional recovery, many are left with language deficits. Papers were identified through PubMed and MEDLINE search, with keywords such as: 'stroke', 'aphasia', 'post-stroke aphasia', 'factors that predict aphasia recovery', 'aphasia outcomes' and 'aphasia prognosis'. The most important factors that determine recovery are the lesion location and size, aphasia type and severity and to some extent the nature of early haemodynamic response, and treatment received. Anagraphic factors like gender, age, handedness and education have not been found to be robust predictors of recovery. Predicting post-stroke aphasia recovery is difficult, because of the interplay between lesion, anagraphic, and treatment-related factors, in addition to the role of neuroplasticity. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. [Patients's with aphasia communication problems].

    PubMed

    Matuszak, Katarzyna; Bonikowska, Agata; Kuczma, Monika; Hagner, Wojciech

    2011-01-01

    Aphasia is a speech disorder caused by disorders of speech centre in brain cortex. Patient with aphasia compensates communication disorders by communication strategy, witch are spontaneous mechanisms, and uses individual rehabilitation methods. Compensation mechanisms are divided in to: phonetic, inflective, formative, semantic, discursive and structural. Patients with aphasia early therapy have to be individual and consists in not only articulation correction, but in establish over verbal contact or verbal, and improvement this contacts, to create patients ability of communication with society. Later therapy is oriented on improvement of cognitive functions for possibility of participation in social live and if it is possible for return to work.

  9. The origins of age of acquisition and typicality effects: Semantic processing in aphasia and the ageing brain.

    PubMed

    Räling, Romy; Schröder, Astrid; Wartenburger, Isabell

    2016-06-01

    Age of acquisition (AOA) has frequently been shown to influence response times and accuracy rates in word processing and constitutes a meaningful variable in aphasic language processing, while its origin in the language processing system is still under debate. To find out where AOA originates and whether and how it is related to another important psycholinguistic variable, namely semantic typicality (TYP), we studied healthy, elderly controls and semantically impaired individuals using semantic priming. For this purpose, we collected reaction times and accuracy rates as well as event-related potential data in an auditory category-member-verification task. The present results confirm a semantic origin of TYP, but question the same for AOA while favouring its origin at the phonology-semantics interface. The data are further interpreted in consideration of recent theories of ageing. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Postictal mixed transcortical aphasia.

    PubMed

    Yankovsky, A E; Treves, T A

    2002-06-01

    Postictal aphasia has been described in left temporal lobe seizures. It may be of fluent, non-fluent or global type. We present here a patient who displayed signs of mixed transcortical aphasia (MTCA). The patient was a 67 year old man who underwent excision of a left frontal parasagittal meningioma in 1987. Since then he has been treated with phenytoin for generalized tonic-clonic seizures (GTCS). He was admitted in status epilepticus. On awakening, the patient was non-fluent with palilalia and echolalia. His repetition was relatively preserved but all the other language functions were impaired. This picture faded away within a few hours. Brain CT, performed during this postictal state, was normal except for signs related to frontal craniotomy. SPECT, which was performed after language functions returned to normal, displayed left frontal, cingular and insular hypoperfusion. The postictal language dysfunction of the patient corresponded to MTCA. Although our case has frontal, he had no other structural lesion that could explain either diffuse ischemia of the left hemisphere or watershed areas secondary to the generalized seizures. The uniqueness of this case is the combination of postictal MTCA with good prognosis. Copyright 2002 BEA Trading Ltd. Published by Elsevier Science Ltd. All rights reserved.

  11. Chapter 36: history of aphasia: from brain to language.

    PubMed

    Eling, Paul; Whitaker, Harry

    2010-01-01

    An historical overview is presented that focuses on the changes both in approach and topics with respect to language disturbances due to brain lesions. Early cases of language disorders were described without any theorizing about language or its relation to the brain. Also, three forms of speech disorder were distinguished: traulotes, psellotes and ischophonia, which are only marginally related to aphasia. In the 18th century some authors, in particular Gesner and Crichton, attempted to explain language disorders in terms of mental processes. The great debate on both the anatomical (Broca, Wernicke) and functional (Wernicke, Lichtheim) aspects of aphasia dominated late 19th century discussion of localization of function, leading to the development of what we now call the cognitive neurosciences. In this period, language processing was described in terms of a simple functional model of word recognition and production; linguistic principles played no role. At the beginning of the 20th century the discussion on language disorders waned due to a decrease of interest in the issue of localization; aphasia became primarily a clinical issue of how best to classify patients. In the second half of the 20th century, the field of aphasia developed rapidly due to studies performed at the Boston Aphasia Unit and, more importantly, to a change of orientation to linguistic notions of language structure, as introduced by Chomsky.

  12. Communicating with someone with aphasia

    MedlinePlus

    ... cases, aphasia will not get better. Improving Daily Communication There are many ways to help people with ... words about common topics or people so that communication is easier. Always try to keep people with ...

  13. Living successfully with aphasia: a qualitative meta-analysis of the perspectives of individuals with aphasia, family members, and speech-language pathologists.

    PubMed

    Brown, Kyla; Worrall, Linda E; Davidson, Bronwyn; Howe, Tami

    2012-04-01

    The concept of living successfully with aphasia has recently emerged as an alternative to more traditional "deficit" models in aphasiology, encouraging a focus on positive rather than negative outcomes. This research aimed to integrate findings from studies exploring the perspectives of three participant groups (individuals with aphasia, speech-language pathologists, and family members) about living successfully with aphasia. Qualitative meta-analysis of three studies conducted by the authors was used to integrate perspectives across the participant groups. Steps in the qualitative meta-analysis were based on those described in the process of "meta-ethnography" by Noblit and Hare (1988) . Analysis was an inductive process, in which data from each study were re-analysed and translated into each other in order to identify higher-level overarching themes that accounted for similarities and discrepancies across the original studies. A total of seven overarching themes related to living successfully with aphasia were identified. These were: participation, meaningful relationships, support, communication, positivity, independence and autonomy, and living successfully with aphasia as a journey over time. Findings indicate the need for a holistic, client-centred approach that considers communication in the broader context of an individual's daily life. The overarching themes may act as guides for areas of importance to be addressed in clinical practice, as well as in future research. By working in partnership with individuals with aphasia and their families, speech-language pathologists are challenged to continue to improve services and assist clients on their journey of living successfully with aphasia.

  14. Audiovisual integration of speech in a patient with Broca's Aphasia

    PubMed Central

    Andersen, Tobias S.; Starrfelt, Randi

    2015-01-01

    Lesions to Broca's area cause aphasia characterized by a severe impairment of the ability to speak, with comparatively intact speech perception. However, some studies have found effects on speech perception under adverse listening conditions, indicating that Broca's area is also involved in speech perception. While these studies have focused on auditory speech perception other studies have shown that Broca's area is activated by visual speech perception. Furthermore, one preliminary report found that a patient with Broca's aphasia did not experience the McGurk illusion suggesting that an intact Broca's area is necessary for audiovisual integration of speech. Here we describe a patient with Broca's aphasia who experienced the McGurk illusion. This indicates that an intact Broca's area is not necessary for audiovisual integration of speech. The McGurk illusions this patient experienced were atypical, which could be due to Broca's area having a more subtle role in audiovisual integration of speech. The McGurk illusions of a control subject with Wernicke's aphasia were, however, also atypical. This indicates that the atypical McGurk illusions were due to deficits in speech processing that are not specific to Broca's aphasia. PMID:25972819

  15. [Psychometric properties and diagnostic value of 'lexical screening for aphasias'].

    PubMed

    Pena-Chavez, R; Martinez-Jimenez, L; Lopez-Espinoza, M

    2014-09-16

    INTRODUCTION. Language assessment in persons with brain injury makes it possible to know whether they require language rehabilitation or not. Given the importance of a precise evaluation, assessment instruments must be valid and reliable, so as to avoid mistaken and subjective diagnoses. AIM. To validate 'lexical screening for aphasias' in a sample of 58 Chilean individuals. SUBJECTS AND METHODS. A screening-type language test, lasting 20 minutes and based on the lexical processing model devised by Patterson and Shewell (1987), was constructed. The sample was made up of two groups containing 29 aphasic subjects and 29 control subjects from different health centres in the regions of Biobio and Maule, Chile. Their ages ranged between 24 and 79 years and had between 0 and 17 years' schooling. Tests were carried out to determine discriminating validity, concurrent validity with the aphasia disorder assessment battery, reliability, sensitivity and specificity. RESULTS. The statistical analysis showed a high discriminating validity (p < 0.001), an acceptable mean concurrent validity with aphasia disorder assessment battery (rs = 0.65), high mean reliability (alpha = 0.87), moderate mean sensitivity (69%) and high mean specificity (86%). CONCLUSION. 'Lexical screening for aphasias' is valid and reliable for assessing language in persons with aphasias; it is sensitive for detecting aphasic subjects and is specific for precluding language disorders in persons with normal language abilities.

  16. A new modified listening span task to enhance validity of working memory assessment for people with and without aphasia

    PubMed Central

    Ivanova, Maria V.; Hallowell, Brooke

    2014-01-01

    Deficits in working memory (WM) are an important subset of cognitive processing deficits associated with aphasia. However, there are serious limitations to research on WM in aphasia largely due to the lack of an established valid measure of WM impairment for this population. The aim of the current study was to address shortcomings of previous measures by developing and empirically evaluating a novel WM task with a sentence-picture matching processing component designed to circumvent confounds inherent in existing measures of WM in aphasia. The novel WM task was presented to persons with (n = 27) and without (n = 33) aphasia. Results demonstrated high concurrent validity of a novel WM task. Individuals with aphasia performed significantly worse on all conditions of the WM task compared to individuals without aphasia. Different patterns of performance across conditions were observed for the two groups. Additionally, WM capacity was significantly related to auditory comprehension abilities in individuals with mild aphasia but not those with moderate aphasia. Strengths of the novel WM task are that it allows for differential control for length versus complexity of verbal stimuli and indexing of the relative influence of each, minimizes metalinguistic requirements, enables control for complexity of processing components, allows participants to respond with simple gestures or verbally, and eliminates reading requirements. Results support the feasibility and validity of using a novel task to assess WM in individuals with and without aphasia. PMID:24986153

  17. Genetics Home Reference: epilepsy-aphasia spectrum

    MedlinePlus

    ... seizures (epilepsy), and some have mild to severe intellectual disability. The conditions in the epilepsy-aphasia spectrum , which ... Information & Resources MedlinePlus (5 links) Encyclopedia: EEG Encyclopedia: Intellectual Disability Health Topic: Aphasia Health Topic: Epilepsy Health Topic: ...

  18. Let's Talk about Stroke and Aphasia

    MedlinePlus

    ... the effects of aphasia? Aphasia does not affect intelligence. Stroke survivors remain mentally alert, even though their ... sender plissen.” Thousands of alert, intelligent men and women are suddenly plunged into a world of jumbled ...

  19. Lesion correlates of patholinguistic profiles in chronic aphasia: comparisons of syndrome-, modality- and symptom-level assessment.

    PubMed

    Henseler, Ilona; Regenbrecht, Frank; Obrig, Hellmuth

    2014-03-01

    One way to investigate the neuronal underpinnings of language competence is to correlate patholinguistic profiles of aphasic patients to corresponding lesion sites. Constituting the beginnings of aphasiology and neurolinguistics over a century ago, this approach has been revived and refined in the past decade by statistical approaches mapping continuous variables (providing metrics that are not simply categorical) on voxel-wise lesion information (voxel-based lesion-symptom mapping). Here we investigate whether and how voxel-based lesion-symptom mapping allows us to delineate specific lesion patterns for differentially fine-grained clinical classifications. The latter encompass 'classical' syndrome-based approaches (e.g. Broca's aphasia), more symptom-oriented descriptions (e.g. agrammatism) and further refinement to linguistic sub-functions (e.g. lexico-semantic deficits for inanimate versus animate items). From a large database of patients treated for aphasia of different aetiologies (n = 1167) a carefully selected group of 102 first ever ischaemic stroke patients with chronic aphasia (∅ 12 months) were included in a VLSM analysis. Specifically, we investigated how performance in the Aachen Aphasia Test-the standard clinical test battery for chronic aphasia in German-relates to distinct brain lesions. The Aachen Aphasia Test evaluates aphasia on different levels: a non-parametric discriminant procedure yields probabilities for the allocation to one of the four 'standard' syndromes (Broca, Wernicke, global and amnestic aphasia), whereas standardized subtests target linguistic modalities (e.g. repetition), or even more specific symptoms (e.g. phoneme repetition). Because some subtests of the Aachen Aphasia Test (e.g. for the linguistic level of lexico-semantics) rely on rather coarse and heterogeneous test items we complemented the analysis with a number of more detailed clinically used tests in selected mostly mildly affected subgroups of patients. Our results

  20. White matter damage in primary progressive aphasias: a diffusion tensor tractography study.

    PubMed

    Galantucci, Sebastiano; Tartaglia, Maria Carmela; Wilson, Stephen M; Henry, Maya L; Filippi, Massimo; Agosta, Federica; Dronkers, Nina F; Henry, Roland G; Ogar, Jennifer M; Miller, Bruce L; Gorno-Tempini, Maria Luisa

    2011-10-01

    Primary progressive aphasia is a clinical syndrome that encompasses three major phenotypes: non-fluent/agrammatic, semantic and logopenic. These clinical entities have been associated with characteristic patterns of focal grey matter atrophy in left posterior frontoinsular, anterior temporal and left temporoparietal regions, respectively. Recently, network-level dysfunction has been hypothesized but research to date has focused largely on studying grey matter damage. The aim of this study was to assess the integrity of white matter tracts in the different primary progressive aphasia subtypes. We used diffusion tensor imaging in 48 individuals: nine non-fluent, nine semantic, nine logopenic and 21 age-matched controls. Probabilistic tractography was used to identify bilateral inferior longitudinal (anterior, middle, posterior) and uncinate fasciculi (referred to as the ventral pathway); and the superior longitudinal fasciculus segmented into its frontosupramarginal, frontoangular, frontotemporal and temporoparietal components, (referred to as the dorsal pathway). We compared the tracts' mean fractional anisotropy, axial, radial and mean diffusivities for each tract in the different diagnostic categories. The most prominent white matter changes were found in the dorsal pathways in non-fluent patients, in the two ventral pathways and the temporal components of the dorsal pathways in semantic variant, and in the temporoparietal component of the dorsal bundles in logopenic patients. Each of the primary progressive aphasia variants showed different patterns of diffusion tensor metrics alterations: non-fluent patients showed the greatest changes in fractional anisotropy and radial and mean diffusivities; semantic variant patients had severe changes in all metrics; and logopenic patients had the least white matter damage, mainly involving diffusivity, with fractional anisotropy altered only in the temporoparietal component of the dorsal pathway. This study demonstrates

  1. White matter damage in primary progressive aphasias: a diffusion tensor tractography study

    PubMed Central

    Galantucci, Sebastiano; Tartaglia, Maria Carmela; Wilson, Stephen M.; Henry, Maya L.; Filippi, Massimo; Agosta, Federica; Dronkers, Nina F.; Henry, Roland G.; Ogar, Jennifer M.; Miller, Bruce L.

    2011-01-01

    Primary progressive aphasia is a clinical syndrome that encompasses three major phenotypes: non-fluent/agrammatic, semantic and logopenic. These clinical entities have been associated with characteristic patterns of focal grey matter atrophy in left posterior frontoinsular, anterior temporal and left temporoparietal regions, respectively. Recently, network-level dysfunction has been hypothesized but research to date has focused largely on studying grey matter damage. The aim of this study was to assess the integrity of white matter tracts in the different primary progressive aphasia subtypes. We used diffusion tensor imaging in 48 individuals: nine non-fluent, nine semantic, nine logopenic and 21 age-matched controls. Probabilistic tractography was used to identify bilateral inferior longitudinal (anterior, middle, posterior) and uncinate fasciculi (referred to as the ventral pathway); and the superior longitudinal fasciculus segmented into its frontosupramarginal, frontoangular, frontotemporal and temporoparietal components, (referred to as the dorsal pathway). We compared the tracts’ mean fractional anisotropy, axial, radial and mean diffusivities for each tract in the different diagnostic categories. The most prominent white matter changes were found in the dorsal pathways in non-fluent patients, in the two ventral pathways and the temporal components of the dorsal pathways in semantic variant, and in the temporoparietal component of the dorsal bundles in logopenic patients. Each of the primary progressive aphasia variants showed different patterns of diffusion tensor metrics alterations: non-fluent patients showed the greatest changes in fractional anisotropy and radial and mean diffusivities; semantic variant patients had severe changes in all metrics; and logopenic patients had the least white matter damage, mainly involving diffusivity, with fractional anisotropy altered only in the temporoparietal component of the dorsal pathway. This study demonstrates

  2. Agnosia for accents in primary progressive aphasia.

    PubMed

    Fletcher, Phillip D; Downey, Laura E; Agustus, Jennifer L; Hailstone, Julia C; Tyndall, Marina H; Cifelli, Alberto; Schott, Jonathan M; Warrington, Elizabeth K; Warren, Jason D

    2013-08-01

    As an example of complex auditory signal processing, the analysis of accented speech is potentially vulnerable in the progressive aphasias. However, the brain basis of accent processing and the effects of neurodegenerative disease on this processing are not well understood. Here we undertook a detailed neuropsychological study of a patient, AA with progressive nonfluent aphasia, in whom agnosia for accents was a prominent clinical feature. We designed a battery to assess AA's ability to process accents in relation to other complex auditory signals. AA's performance was compared with a cohort of 12 healthy age and gender matched control participants and with a second patient, PA, who had semantic dementia with phonagnosia and prosopagnosia but no reported difficulties with accent processing. Relative to healthy controls, the patients showed distinct profiles of accent agnosia. AA showed markedly impaired ability to distinguish change in an individual's accent despite being able to discriminate phonemes and voices (apperceptive accent agnosia); and in addition, a severe deficit of accent identification. In contrast, PA was able to perceive changes in accents, phonemes and voices normally, but showed a relatively mild deficit of accent identification (associative accent agnosia). Both patients showed deficits of voice and environmental sound identification, however PA showed an additional deficit of face identification whereas AA was able to identify (though not name) faces normally. These profiles suggest that AA has conjoint (or interacting) deficits involving both apperceptive and semantic processing of accents, while PA has a primary semantic (associative) deficit affecting accents along with other kinds of auditory objects and extending beyond the auditory modality. Brain MRI revealed left peri-Sylvian atrophy in case AA and relatively focal asymmetric (predominantly right sided) temporal lobe atrophy in case PA. These cases provide further evidence for the

  3. Oral Reading in Bilingual Aphasia: Evidence from Mongolian and Chinese

    ERIC Educational Resources Information Center

    Weekes, Brendan Stuart; Su, I. Fan; Yin, Wengang; Zhang, Xihong

    2007-01-01

    Cognitive neuropsychological studies of bilingual patients with aphasia have contributed to our understanding of how the brain processes different languages. The question we asked is whether differences in script have any impact on language processing in bilingual aphasic patients who speak languages with different writing systems: Chinese and…

  4. Asymmetric pathology in primary progressive aphasia with progranulin mutations and TDP inclusions

    PubMed Central

    Kim, Garam; Ahmadian, Saman S.; Peterson, Melanie; Parton, Zach; Memon, Rohail; Weintraub, Sandra; Rademaker, Alfred; Bigio, Eileen; Mesulam, M.-Marsel

    2016-01-01

    Objective: To investigate quantitative regional distribution and hemispheric asymmetry of TDP-43 (TAR DNA-binding protein 43) inclusions, neurons, and activated microglia in primary progressive aphasia (PPA) with progranulin (GRN) mutations, and to determine concordance between distribution of pathology, clinical phenotype, and known atrophy patterns. Methods: Antibodies to phospho–TDP-43, NeuN (neuronal nuclei), and HLA-DR were used to visualize inclusions, neurons, and activated microglia in paraffin-embedded tissue sections from 4 participants with PPA: 2 of the agrammatic and 2 of the logopenic subtype. Unbiased stereological counting techniques were used for quantitation of immunoreactive profiles in language- and memory-related cortical areas bilaterally. Patterns of pathology across cortical areas and hemispheres were compared and their relationships with known patterns of atrophy investigated. Results: Numerical densities of TDP-43 inclusions, and less so of activated microglia, were greater in language-related areas compared with memory-related areas. In language areas, neuronal density displayed a pattern opposite to inclusions and activated microglia. Densities of inclusions and microglia were greater (p < 0.05), and densities of neurons were lower (p < 0.005), in the left hemisphere compared with the right. In agrammatic PPA, the highest densities of TDP-43 inclusions were observed in left inferior or middle frontal gyri, and in logopenic participants, the highest density of inclusions was seen in left inferior parietal lobule. This distribution is consistent with subtype-specific peak atrophy sites. Conclusions: Distribution of TDP-43 inclusions and neurons, and to a smaller extent of activated microglia, show a regional and hemispheric pattern consistent with disease phenotype and known patterns of atrophy in PPA with GRN mutations. PMID:26791154

  5. Clinical and MRI models predicting amyloid deposition in progressive aphasia and apraxia of speech.

    PubMed

    Whitwell, Jennifer L; Weigand, Stephen D; Duffy, Joseph R; Strand, Edythe A; Machulda, Mary M; Senjem, Matthew L; Gunter, Jeffrey L; Lowe, Val J; Jack, Clifford R; Josephs, Keith A

    2016-01-01

    Beta-amyloid (Aβ) deposition can be observed in primary progressive aphasia (PPA) and progressive apraxia of speech (PAOS). While it is typically associated with logopenic PPA, there are exceptions that make predicting Aβ status challenging based on clinical diagnosis alone. We aimed to determine whether MRI regional volumes or clinical data could help predict Aβ deposition. One hundred and thirty-nine PPA (n = 97; 15 agrammatic, 53 logopenic, 13 semantic and 16 unclassified) and PAOS (n = 42) subjects were prospectively recruited into a cross-sectional study and underwent speech/language assessments, 3.0 T MRI and C11-Pittsburgh Compound B PET. The presence of Aβ was determined using a 1.5 SUVR cut-point. Atlas-based parcellation was used to calculate gray matter volumes of 42 regions-of-interest across the brain. Penalized binary logistic regression was utilized to determine what combination of MRI regions, and what combination of speech and language tests, best predicts Aβ (+) status. The optimal MRI model and optimal clinical model both performed comparably in their ability to accurately classify subjects according to Aβ status. MRI accurately classified 81% of subjects using 14 regions. Small left superior temporal and inferior parietal volumes and large left Broca's area volumes were particularly predictive of Aβ (+) status. Clinical scores accurately classified 83% of subjects using 12 tests. Phonological errors and repetition deficits, and absence of agrammatism and motor speech deficits were particularly predictive of Aβ (+) status. In comparison, clinical diagnosis was able to accurately classify 89% of subjects. However, the MRI model performed well in predicting Aβ deposition in unclassified PPA. Clinical diagnosis provides optimum prediction of Aβ status at the group level, although regional MRI measurements and speech and language testing also performed well and could have advantages in predicting Aβ status in unclassified PPA subjects.

  6. Neuroimaging and Recovery of Language in Aphasia

    PubMed Central

    Thompson, Cynthia K.; den Ouden, Dirk-Bart

    2010-01-01

    The use of functional neuroimaging techniques has advanced what is known about the neural mechanisms used to support language processing in aphasia resulting from brain damage. This paper highlights recent findings derived from neuroimaging studies focused on neuroplasticity of language networks, the role of the left and right hemispheres in this process, and studies examining how treatment affects the neurobiology of recovery. We point out variability across studies as well as factors related to this variability, and we emphasize challenges that remain for research. PMID:18957184

  7. Developing a Clinician-Friendly Aphasia Test

    ERIC Educational Resources Information Center

    Marshall, Robert C.; Wright, Heather Harris

    2007-01-01

    Purpose: The Kentucky Aphasia Test (KAT) is an objective measure of language functioning for persons with aphasia. This article describes materials, administration, and scoring of the KAT; presents the rationale for development of test items; reports information from a pilot study; and discusses the role of the KAT in aphasia assessment. Method:…

  8. Developing a Clinician-Friendly Aphasia Test

    ERIC Educational Resources Information Center

    Marshall, Robert C.; Wright, Heather Harris

    2007-01-01

    Purpose: The Kentucky Aphasia Test (KAT) is an objective measure of language functioning for persons with aphasia. This article describes materials, administration, and scoring of the KAT; presents the rationale for development of test items; reports information from a pilot study; and discusses the role of the KAT in aphasia assessment. Method:…

  9. The anterior temporal lobes support residual comprehension in Wernicke’s aphasia

    PubMed Central

    Robson, Holly; Zahn, Roland; Keidel, James L.; Binney, Richard J.; Sage, Karen; Lambon Ralph, Matthew A.

    2014-01-01

    Wernicke’s aphasia occurs after a stroke to classical language comprehension regions in the left temporoparietal cortex. Consequently, auditory–verbal comprehension is significantly impaired in Wernicke’s aphasia but the capacity to comprehend visually presented materials (written words and pictures) is partially spared. This study used functional magnetic resonance imaging to investigate the neural basis of written word and picture semantic processing in Wernicke’s aphasia, with the wider aim of examining how the semantic system is altered after damage to the classical comprehension regions. Twelve participants with chronic Wernicke’s aphasia and 12 control participants performed semantic animate–inanimate judgements and a visual height judgement baseline task. Whole brain and region of interest analysis in Wernicke’s aphasia and control participants found that semantic judgements were underpinned by activation in the ventral and anterior temporal lobes bilaterally. The Wernicke’s aphasia group displayed an ‘over-activation’ in comparison with control participants, indicating that anterior temporal lobe regions become increasingly influential following reduction in posterior semantic resources. Semantic processing of written words in Wernicke’s aphasia was additionally supported by recruitment of the right anterior superior temporal lobe, a region previously associated with recovery from auditory-verbal comprehension impairments. Overall, the results provide support for models in which the anterior temporal lobes are crucial for multimodal semantic processing and that these regions may be accessed without support from classic posterior comprehension regions. PMID:24519979

  10. Global aphasia without hemiparesis may be caused by blunt head trauma: An adolescent boy with transient aphasia.

    PubMed

    Şahin, Sevim; Türkdoğan, Dilşad; Hacıfazlıoğlu, Nilüfer Eldeş; Yalçın, Emek Uyur; Eksen, Zehra Yılmaz; Ekinci, Gazanfer

    2017-05-01

    Global aphasia without hemiparesis is a rare condition often associated with embolic stroke. Posttraumatic causes have not been reported, in the literature, to our knowledge. We report a 15-year old boy with transient global aphasia without hemiparesis due to blunt head trauma. In our case, clinical findings occurred 1week later following head trauma. Emergence of the symptoms after a period of the first mechanical head trauma, draws attention to the importance of secondary process in traumatic brain injury. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Noun and verb processing in Greek-English bilingual individuals with anomic aphasia and the effect of instrumentality and verb-noun name relation.

    PubMed

    Kambanaros, Maria; van Steenbrugge, Willem

    2006-05-01

    Noun and verb comprehension and production was investigated in two groups of late bilingual, Greek-English speakers: individuals with anomic aphasia and a control group of non-brain injured individuals matched for age and gender. There were no significant differences in verb or noun comprehension between the two groups in either language. However, verb and noun production during picture naming was significantly worse in the bilingual individuals with anomic aphasia in both languages, who also showed a specific verb impairment in Greek and English. The potential underlying level of breakdown of the specific verb impairment was further investigation with reference to two specific features of verbs: instrumentality and verb-noun relationship. Additional results revealed a facilitatory effect of Instrumentality in both languages. However, there was no effect of verb-noun name relation in Greek, and a negative effect of verb-noun name relation was observed in English. Lemma retrieval seemed to be intact in this group of bilingual individuals whose main problem seemed to arise during the retrieval of the phonological representation of the target word. This impairment was greater in English. The findings are discussed in terms of three current models of word production.

  12. Neologistic jargon aphasia and agraphia in primary progressive aphasia.

    PubMed

    Rohrer, Jonathan D; Rossor, Martin N; Warren, Jason D

    2009-02-15

    The terms 'jargon aphasia' and 'jargon agraphia' describe the production of incomprehensible language containing frequent phonological, semantic or neologistic errors in speech and writing, respectively. Here we describe two patients with primary progressive aphasia (PPA) who produced neologistic jargon either in speech or writing. We suggest that involvement of the posterior superior temporal-inferior parietal region may lead to a disconnection between stored lexical representations and language output pathways leading to aberrant activation of phonemes in neologistic jargon. Parietal lobe involvement is relatively unusual in PPA, perhaps accounting for the comparative rarity of jargon early in the course of these diseases.

  13. Working Memory in Aphasia: Theory, Measures, and Clinical Implications

    ERIC Educational Resources Information Center

    Wright, Heather Harris; Shisler, Rebecca J.

    2005-01-01

    Recently, researchers have suggested that deficits in working memory capacity contribute to language-processing difficulties observed in individuals with aphasia (e.g., I. Caspari, S. Parkinson, L. LaPointe, & R. Katz, 1998; R. A. Downey et al., 2004; N. Friedmann & A. Gvion, 2003; H. H. Wright, M. Newhoff, R. Downey, & S. Austermann, 2003). A…

  14. The Neural Basis of Syntactic Deficits in Primary Progressive Aphasia

    ERIC Educational Resources Information Center

    Wilson, Stephen M.; Galantucci, Sebastiano; Tartaglia, Maria Carmela; Gorno-Tempini, Maria Luisa

    2012-01-01

    Patients with primary progressive aphasia (PPA) vary considerably in terms of which brain regions are impacted, as well as in the extent to which syntactic processing is impaired. Here we review the literature on the neural basis of syntactic deficits in PPA. Structural and functional imaging studies have most consistently associated syntactic…

  15. Working Memory in Aphasia: Theory, Measures, and Clinical Implications

    ERIC Educational Resources Information Center

    Wright, Heather Harris; Shisler, Rebecca J.

    2005-01-01

    Recently, researchers have suggested that deficits in working memory capacity contribute to language-processing difficulties observed in individuals with aphasia (e.g., I. Caspari, S. Parkinson, L. LaPointe, & R. Katz, 1998; R. A. Downey et al., 2004; N. Friedmann & A. Gvion, 2003; H. H. Wright, M. Newhoff, R. Downey, & S. Austermann, 2003). A…

  16. The Neural Basis of Syntactic Deficits in Primary Progressive Aphasia

    ERIC Educational Resources Information Center

    Wilson, Stephen M.; Galantucci, Sebastiano; Tartaglia, Maria Carmela; Gorno-Tempini, Maria Luisa

    2012-01-01

    Patients with primary progressive aphasia (PPA) vary considerably in terms of which brain regions are impacted, as well as in the extent to which syntactic processing is impaired. Here we review the literature on the neural basis of syntactic deficits in PPA. Structural and functional imaging studies have most consistently associated syntactic…

  17. A new modified listening span task to enhance validity of working memory assessment for people with and without aphasia.

    PubMed

    Ivanova, Maria V; Hallowell, Brooke

    2014-01-01

    Deficits in working memory (WM) are an important subset of cognitive processing deficits associated with aphasia. However, there are serious limitations to research on WM in aphasia largely due to the lack of an established valid measure of WM impairment for this population. The aim of the current study was to address shortcomings of previous measures by developing and empirically evaluating a novel WM task with a sentence-picture matching processing component designed to circumvent confounds inherent in existing measures of WM in aphasia. The novel WM task was presented to persons with (n=27) and without (n=33) aphasia. Results demonstrated high concurrent validity of a novel WM task. Individuals with aphasia performed significantly worse on all conditions of the WM task compared to individuals without aphasia. Different patterns of performance across conditions were observed for the two groups. Additionally, WM capacity was significantly related to auditory comprehension abilities in individuals with mild aphasia but not those with moderate aphasia. Strengths of the novel WM task are that it allows for differential control for length versus complexity of verbal stimuli and indexing of the relative influence of each, minimizes metalinguistic requirements, enables control for complexity of processing components, allows participants to respond with simple gestures or verbally, and eliminates reading requirements. Results support the feasibility and validity of using a novel task to assess WM in individuals with and without aphasia. Readers will be able to (1) discuss the limitations of current working memory measures for individuals with aphasia; (2) describe how task design features of a new working memory task for people with aphasia address shortcomings of existing measures; (3) summarize the evidence supporting the validity of the novel working memory task. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Clinicoanatomical correlation in stroke related aphasia

    PubMed Central

    Bohra, Vikram; Khwaja, Geeta Anjum; Jain, Sneh; Duggal, Ashish; Ghuge, Vijay Vishwanath; Srivastava, Abhilekh

    2015-01-01

    Context: With advances in neuroimaging, traditional views regarding the clinicoanatomic correlation in stroke patients with aphasia are being challenged and it has been observed that lesions at a given cortical or subcortical site may manifest with different aphasia profiles. Aims: To study as to whether there is a strict clinicoanatomical correlation between the type of aphasia and lesion site in patients with first ever stroke. Settings and Design: Observational study, based in a tertiary care center. Materials and Methods: Stroke patient's ≥18 years of age were screened and those with first ever stroke and aphasia were subjected to a detailed stroke workup and language assessment using the Hindi version of Western Aphasia Battery (WAB). Statistical analysis was done with χ2 test with Yates correction and Kruskal-Wallis test. The level of significance was set at P < 0.05. Results: Overall aphasia was detected in 27.9% of the 260 screened cases with stroke. Amongst 60 cases with first ever stroke and aphasia, the aphasia type was: Global (33.33%), Broca's (28.3%), transcortical motor (13.33%), transcortical sensory (10%), Wernicke's (8.33%), anomic (5%), and conduction (1.67%) aphasia. A definite correlation between the lesion site and the type of aphasia as per the traditional classification was observed in 35% cases only. Conclusions: No absolute correlation exists between the lesion site and the type of clinical aphasia syndrome in majority of the patients with cortical and subcortical stroke. PMID:26713015

  19. Exploring speech-language pathologists' perspectives about living successfully with aphasia.

    PubMed

    Brown, Kyla; Worrall, Linda; Davidson, Bronwyn; Howe, Tami

    2011-01-01

    Exploring the concept of living successfully with aphasia challenges researchers and clinicians to identify positive rather than negative adaptive processes and factors that may inform clinical interventions and other community-based services for people with aphasia. Previous research on this topic has focused on the perspectives of individuals with aphasia, and identified a number of core components of living successfully with aphasia, including doing things, meaningful relationships, striving for a positive way of living, and communication. As service providers, speech-language pathologists may also contribute valuable insights regarding components of living successfully with aphasia and factors influencing individuals' abilities to achieve this goal. This research aimed to explore speech-language pathologists' perspectives about the meaning of living successfully with aphasia, and factors they perceive to influence individuals' abilities to live successfully with aphasia. Twenty-five speech-language pathologists from around Australia participated in semi-structured in-depth interviews on the topic of living successfully with aphasia. All interviews were transcribed verbatim and analysed using interpretative phenomenological analysis to identify themes of relevance. Through the analysis of speech-language pathologist participant transcripts, the following themes emerged as components of living successfully with aphasia: participation and community engagement; communication; meaningful relationships; autonomy or independence; acceptance and embracement of aphasia; self-esteem; happiness; and purpose or meaningfulness. A wide variety of factors were perceived to influence individuals' abilities to live successfully with aphasia. These included support, acceptance, and understanding; personal factors; and speech-language pathology services. Further research is required to extend findings by investigating how speech-language pathologists address identified themes in

  20. The mental representation of singular and plural nouns in Algerian Arabic as revealed through auditory priming in agrammatic aphasic patients.

    PubMed

    Mimouni, Z; Kehayia, E; Jarema, G

    1998-01-01

    Working within the theoretical framework of prosodic nonconcatenative morphology developed by McCarthy (1975) for Semitic languages, we addressed, in the present paper, the issues of lexical representation, morphological relatedness, and modes of access in Algerian Arabic--a dialect of Standard Arabic--in an auditory morphological priming experiment. More specifically, we investigated the process of word recognition of singular and plural nouns in the performance of 24 non-brain-damaged subjects and 2 Algerian-speaking agrammatic aphasics. Plurals in Arabic involve either suffixation as in the sound plural (e.g., lbas "dress"/lbasat "dresses"), or stem-internal changes as in the broken plurals (e.g., kursi "chair"/krasa "chairs"). Our findings reveal a differential processing of the two forms, indicating whole word access for broken plurals and decomposition into word and suffix for suffixed plurals. Further, the evidence suggests for Algerian Arabic an architecture of the lexicon reflecting a family-like organization which takes into account language-specific features.

  1. Training sentence production in agrammatism: implications for normal and disordered language.

    PubMed

    Thompson, C K; Shapiro, L P

    1995-08-01

    This paper presents an overview of our work concerned with treatment of sentence production deficits seen in agrammatic (Broca's) aphasic individuals. Using a single-subject experimental research paradigm, we examined emergent sentence production patterns in a subset of Broca's subjects who evinced sentence production (and comprehension) deficits involving "complex" sentences in which noun phrases (NPs) have been moved out of their canonical positions. We used aspects of Chomsky's Principles and Parameters approach of Government Binding (GB) Theory (Chomsky, 1986, Chomsky & Lasnik, 1991), as well as findings from the psycholinguistic and neurolinguistic literature as a basis for selecting sentences entered into our experiments and for designing our intervention approach, in general. Subjects were trained to produce sentences which rely on NP-movement (i.e., passives) or WH-movement (i.e., wh-questions, object clefts)--sentences formed by applying the rule "Move-alpha" in which moved constituents leave behind a "trace" or "gap" of their movement. Training emphasized the lexical and syntactic properties (e.g., thematic role assignment, NP-movement) of target sentences. Throughout this training we carefully measured generalization to untrained sentences relying on similar movement operations and error patterns were examined as they evolved over time. Results of our work indicated not only improved sentence production abilities in all subjects under study, but also--in many cases--generalization of sentence production across linguistic lines. That is, training WH-movement structures (e.g., object clefts) improved production of untrained WH-movement constructions (e.g., wh-questions) that are very different in their s-structure representation; however, no effect of this training on NP-movement structures occurred. In addition, within the class of wh-questions, generative production across questions relying on argument (direct object NP) movement (i.e., what- and who

  2. Novel word acquisition in aphasia: Facing the word-referent ambiguity of natural language learning contexts.

    PubMed

    Peñaloza, Claudia; Mirman, Daniel; Tuomiranta, Leena; Benetello, Annalisa; Heikius, Ida-Maria; Järvinen, Sonja; Majos, Maria C; Cardona, Pedro; Juncadella, Montserrat; Laine, Matti; Martin, Nadine; Rodríguez-Fornells, Antoni

    2016-06-01

    Recent research suggests that some people with aphasia preserve some ability to learn novel words and to retain them in the long-term. However, this novel word learning ability has been studied only in the context of single word-picture pairings. We examined the ability of people with chronic aphasia to learn novel words using a paradigm that presents new word forms together with a limited set of different possible visual referents and requires the identification of the correct word-object associations on the basis of online feedback. We also studied the relationship between word learning ability and aphasia severity, word processing abilities, and verbal short-term memory (STM). We further examined the influence of gross lesion location on new word learning. The word learning task was first validated with a group of forty-five young adults. Fourteen participants with chronic aphasia were administered the task and underwent tests of immediate and long-term recognition memory at 1 week. Their performance was compared to that of a group of fourteen matched controls using growth curve analysis. The learning curve and recognition performance of the aphasia group was significantly below the matched control group, although above-chance recognition performance and case-by-case analyses indicated that some participants with aphasia had learned the correct word-referent mappings. Verbal STM but not word processing abilities predicted word learning ability after controlling for aphasia severity. Importantly, participants with lesions in the left frontal cortex performed significantly worse than participants with lesions that spared the left frontal region both during word learning and on the recognition tests. Our findings indicate that some people with aphasia can preserve the ability to learn a small novel lexicon in an ambiguous word-referent context. This learning and recognition memory ability was associated with verbal STM capacity, aphasia severity and the integrity

  3. Novel word acquisition in aphasia: Facing the word-referent ambiguity of natural language learning contexts

    PubMed Central

    Peñaloza, Claudia; Mirman, Daniel; Tuomiranta, Leena; Benetello, Annalisa; Heikius, Ida-Maria; Järvinen, Sonja; Majos, Maria C.; Cardona, Pedro; Juncadella, Montserrat; Laine, Matti; Martin, Nadine; Rodríguez-Fornells, Antoni

    2017-01-01

    Recent research suggests that some people with aphasia preserve some ability to learn novel words and to retain them in the long-term. However, this novel word learning ability has been studied only in the context of single word-picture pairings. We examined the ability of people with chronic aphasia to learn novel words using a paradigm that presents new word forms together with a limited set of different possible visual referents and requires the identification of the correct word-object associations on the basis of online feedback. We also studied the relationship between word learning ability and aphasia severity, word processing abilities, and verbal short-term memory (STM). We further examined the influence of gross lesion location on new word learning. The word learning task was first validated with a group of forty-five young adults. Fourteen participants with chronic aphasia were administered the task and underwent tests of immediate and long-term recognition memory at 1 week. Their performance was compared to that of a group of fourteen matched controls using growth curve analysis. The learning curve and recognition performance of the aphasia group was significantly below the matched control group, although above-chance recognition performance and case-by-case analyses indicated that some participants with aphasia had learned the correct word-referent mappings. Verbal STM but not word processing abilities predicted word learning ability after controlling for aphasia severity. Importantly, participants with lesions in the left frontal cortex performed significantly worse than participants with lesions that spared the left frontal region both during word learning and on the recognition tests. Our findings indicate that some people with aphasia can preserve the ability to learn a small novel lexicon in an ambiguous word-referent context. This learning and recognition memory ability was associated with verbal STM capacity, aphasia severity and the integrity

  4. Non-linguistic learning and aphasia: Evidence from a paired associate and feedback-based task

    PubMed Central

    Vallila-Rohter, Sofia; Kiran, Swathi

    2013-01-01

    Though aphasia is primarily characterized by impairments in the comprehension and/or expression of language, research has shown that patients with aphasia also show deficits in cognitive-linguistic domains such as attention, executive function, concept knowledge and memory (Helm-Estabrooks, 2002 for review). Research in aphasia suggests that cognitive impairments can impact the online construction of language, new verbal learning, and transactional success (Freedman & Martin, 2001; Hula & McNeil, 2008; Ramsberger, 2005). In our research, we extend this hypothesis to suggest that general cognitive deficits influence progress with therapy. The aim of our study is to explore learning, a cognitive process that is integral to relearning language, yet underexplored in the field of aphasia rehabilitation. We examine non-linguistic category learning in patients with aphasia (n=19) and in healthy controls (n=12), comparing feedback and non-feedback based instruction. Participants complete two computer-based learning tasks that require them to categorize novel animals based on the percentage of features shared with one of two prototypes. As hypothesized, healthy controls showed successful category learning following both methods of instruction. In contrast, only 60% of our patient population demonstrated successful non-linguistic category learning. Patient performance was not predictable by standardized measures of cognitive ability. Results suggest that general learning is affected in aphasia and is a unique, important factor to consider in the field of aphasia rehabilitation. PMID:23127795

  5. 'You needed to rehab … families as well': family members' own goals for aphasia rehabilitation.

    PubMed

    Howe, Tami; Davidson, Bronwyn; Worrall, Linda; Hersh, Deborah; Ferguson, Alison; Sherratt, Sue; Gilbert, Jocelyn

    2012-01-01

    Aphasia affects family members in addition to the individuals with the communication disorder. In order to develop appropriate services for the relatives of people with aphasia post-stroke, their rehabilitation goals need to be identified. The aim of the current investigation was to identify the rehabilitation goals that family members of individuals with aphasia have for themselves. Forty-eight family members of adults with aphasia post-stroke participated in in-depth semi-structured interviews to identify the rehabilitation goals they had for themselves. All the interviews were transcribed verbatim and analysed using qualitative content analysis. Analysis revealed seven categories of goals that the family members had for themselves: to be included in rehabilitation, to be provided with hope and positivity, to be able to communicate and maintain their relationship with the person with aphasia, to be given information, to be given support, to look after their own well-being, and to be able to cope with new responsibilities. A few participants reported that, at certain times during the rehabilitation process, they did not have any goals for themselves. This study highlights that family members of individuals with aphasia have a number of aphasia-related rehabilitation goals for themselves. In order to provide a family-centred approach to rehabilitation, health professionals, including speech-language pathologists, need systematically to identify and address family members' goals in light of the categories revealed in this investigation. © 2012 Royal College of Speech and Language Therapists.

  6. Non-linguistic learning and aphasia: evidence from a paired associate and feedback-based task.

    PubMed

    Vallila-Rohter, Sofia; Kiran, Swathi

    2013-01-01

    Though aphasia is primarily characterized by impairments in the comprehension and/or expression of language, research has shown that patients with aphasia also show deficits in cognitive-linguistic domains such as attention, executive function, concept knowledge and memory. Research in aphasia suggests that cognitive impairments can impact the online construction of language, new verbal learning, and transactional success. In our research, we extend this hypothesis to suggest that general cognitive deficits influence progress with therapy. The aim of our study is to explore learning, a cognitive process that is integral to relearning language, yet underexplored in the field of aphasia rehabilitation. We examine non-linguistic category learning in patients with aphasia (n=19) and in healthy controls (n=12), comparing feedback and non-feedback based instruction. Participants complete two computer-based learning tasks that require them to categorize novel animals based on the percentage of features shared with one of two prototypes. As hypothesized, healthy controls showed successful category learning following both methods of instruction. In contrast, only 60% of our patient population demonstrated successful non-linguistic category learning. Patient performance was not predictable by standardized measures of cognitive ability. Results suggest that general learning is affected in aphasia and is a unique, important factor to consider in the field of aphasia rehabilitation. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. [Aphasia: a neuronal network disorder].

    PubMed

    Stockert, A; Saur, D

    2017-06-08

    Language processing requires the coordinated interaction of local and distant neural populations within distributed networks of the temporal, frontal and parietal brain regions. Poststroke aphasia is the consequence of both local as well as remote dysfunction within language-specific and domain-general networks. Language recovery, in turn, rests on reorganization processes within these networks. These comprise the resolution of an acute network failure (i. e. diaschisis), the subacute activation of right hemisphere homologous regions and the gradual reintegration of left hemisphere remote and perilesional areas. The application of unifocal noninvasive brain stimulation over these regions provides a means of modulating neural plasticity in order to enhance the reorganization processes underlying language recovery. The lack of knowledge as to the optimal stimulation site, the appropriate stimulation protocol and the proper timing of interventions might explain the only marginal effects of brain stimulation adjunct to speech and language therapy. In addition, individually different contributions of left and right hemisphere regions to recovery due to heterogeneous lesion sites among patients limit the possibility to identify general principles for brain stimulation. The assumption that aphasia is not only the consequence of the focal effect of a brain lesion but arises from remote dysfunctions within associated functional networks ignites the concept for individualized, potentially multifocal therapeutic network modulation.

  8. Aphasia in a prelingually deaf woman.

    PubMed

    Chiarello, C; Knight, R; Mandel, M

    1982-03-01

    A left parietal infarct in a prelingually deaf person resulted in an aphasia for both American Sign Language (ASL) and written and finger-spelled English. Originally the patient had a nearly global aphasia affecting all language systems. By five to seven weeks post-onset her symptoms resembled those of hearing aphasics with posterior lesions: fluent but paraphasic signing, anomia, impaired comprehension and repetition, alexia, and agraphia with elements of neologistic jargon. In addition, there was a pronounced sequential movement copying disorder, reduced short-term verbal memory and acalculia. In general, the patient's sign errors showed a consistent disruption in the structure of ASL signs which parallels the speech errors of oral aphasic patients. We conclude that most aphasic symptoms are not modality-dependent, but rather reflect a disruption of linguistic processes common to all human languages. This case confirms the importance of the left hemisphere in the processing of sign language. Furthermore, the results indicate that the left supramarginal and angular gyri are necessary substrates for the comprehension of visual/gestural languages.

  9. Novel Ways to Study Aphasia

    ERIC Educational Resources Information Center

    Mostofsky, David; And Others

    1971-01-01

    Summarized are several nonverbal assessment techniques for aphasics. Two experiments concern speech perception (the scaling of speech and the relationship between aphasic's performance and level of auditory impairment) and one concerns the impact of aphasia on one's affective or attitudinal response to a symbol (connotative meaning). (KW)

  10. Training and generalization of agrammatic aphasic adults' wh-interrogative productions.

    PubMed

    Wambaugh, J L; Thompson, C K

    1989-11-01

    The stimulus and response generalization effects of training wh-interrogative production were examined in 4 agrammatic Broca's aphasic subjects using a multiple baseline design across behaviors and subjects. Throughout treatment, response generalization to untrained questions and stimulus generalization to several nontraining conditions were assessed. Variable response generalization to untrained exemplars of trained wh-interrogative forms and little generalization to grammatically different wh constructions occurred. Stimulus generalization to only one of three conditions was noted. However, generalization treatment involving sequential modification of training across conditions was found to be effective in facilitating generalization to an additional stimulus condition for 2 of the 4 subjects.

  11. Aphasia Centers and the Life Participation Approach to Aphasia: A Paradigm Shift

    ERIC Educational Resources Information Center

    Elman, Roberta J.

    2016-01-01

    The Aphasia Center is a service delivery model that provides an interactive community for persons with aphasia. This model has been increasing in popularity over the last 20 years. Aphasia Centers are consistent with a social model of health care and disability. They offer the potential for linguistic, communicative, and psychosocial benefits. The…

  12. An Aphasia Mentoring Program: Perspectives of Speech-Language Pathology Students and of Mentors with Aphasia

    ERIC Educational Resources Information Center

    Purves, Barbara A.; Petersen, Jill; Puurveen, Gloria

    2013-01-01

    Purpose: In contrast to clinician-as-expert models, social models of clinical practice typically acknowledge people with aphasia as equal partners in intervention. Given this, there may be a place within speech-language pathology education for programs situating people with aphasia as experts. This paper describes an aphasia mentoring program that…

  13. Aphasia Centers and the Life Participation Approach to Aphasia: A Paradigm Shift

    ERIC Educational Resources Information Center

    Elman, Roberta J.

    2016-01-01

    The Aphasia Center is a service delivery model that provides an interactive community for persons with aphasia. This model has been increasing in popularity over the last 20 years. Aphasia Centers are consistent with a social model of health care and disability. They offer the potential for linguistic, communicative, and psychosocial benefits. The…

  14. Severity of Post-stroke Aphasia According to Aphasia Type and Lesion Location in Koreans

    PubMed Central

    Kang, Eun Kyoung; Sohn, Hae Min; Han, Moon-Ku; Kim, Won; Han, Tai Ryoon

    2010-01-01

    To determine the relations between post-stroke aphasia severity and aphasia type and lesion location, a retrospective review was undertaken using the medical records of 97 Korean patients, treated within 90 days of onset, for aphasia caused by unilateral left hemispheric stroke. Types of aphasia were classified according to the validated Korean version of the Western Aphasia Battery (K-WAB), and severities of aphasia were quantified using WAB Aphasia Quotients (AQ). Lesion locations were classified as cortical or subcortical, and were determined by magnetic resonance imaging. Two-step cluster analysis was performed using AQ values to classify aphasia severity by aphasia type and lesion location. Cluster analysis resulted in four severity clusters: 1) mild; anomic type, 2) moderate; Wernicke's, transcortical motor, transcortical sensory, conduction, and mixed transcortical types, 3) moderately severe; Broca's aphasia, and 4) severe; global aphasia, and also in three lesion location clusters: 1) mild; subcortical 2) moderate; cortical lesions involving Broca's and/or Wernicke's areas, and 3) severe; insular and cortical lesions not in Broca's or Wernicke's areas. These results revealed that within 3 months of stroke, global aphasia was the more severely affected type and cortical lesions were more likely to affect language function than subcortical lesions. PMID:20052357

  15. Severity of post-stroke aphasia according to aphasia type and lesion location in Koreans.

    PubMed

    Kang, Eun Kyoung; Sohn, Hae Min; Han, Moon-Ku; Kim, Won; Han, Tai Ryoon; Paik, Nam-Jong

    2010-01-01

    To determine the relations between post-stroke aphasia severity and aphasia type and lesion location, a retrospective review was undertaken using the medical records of 97 Korean patients, treated within 90 days of onset, for aphasia caused by unilateral left hemispheric stroke. Types of aphasia were classified according to the validated Korean version of the Western Aphasia Battery (K-WAB), and severities of aphasia were quantified using WAB Aphasia Quotients (AQ). Lesion locations were classified as cortical or subcortical, and were determined by magnetic resonance imaging. Two-step cluster analysis was performed using AQ values to classify aphasia severity by aphasia type and lesion location. Cluster analysis resulted in four severity clusters: 1) mild; anomic type, 2) moderate; Wernicke's, transcortical motor, transcortical sensory, conduction, and mixed transcortical types, 3) moderately severe; Broca's aphasia, and 4) severe; global aphasia, and also in three lesion location clusters: 1) mild; subcortical 2) moderate; cortical lesions involving Broca's and/or Wernicke's areas, and 3) severe; insular and cortical lesions not in Broca's or Wernicke's areas. These results revealed that within 3 months of stroke, global aphasia was the more severely affected type and cortical lesions were more likely to affect language function than subcortical lesions.

  16. An Aphasia Mentoring Program: Perspectives of Speech-Language Pathology Students and of Mentors with Aphasia

    ERIC Educational Resources Information Center

    Purves, Barbara A.; Petersen, Jill; Puurveen, Gloria

    2013-01-01

    Purpose: In contrast to clinician-as-expert models, social models of clinical practice typically acknowledge people with aphasia as equal partners in intervention. Given this, there may be a place within speech-language pathology education for programs situating people with aphasia as experts. This paper describes an aphasia mentoring program that…

  17. Aphasia and literacy—the insider's perspective

    PubMed Central

    Kjellén, Emma; Laakso, Katja

    2016-01-01

    Abstract Background Few studies have investigated how people with aphasia (PWA) experience literacy skills. Taking the insider's perspective is a way to increase understanding of the individual experiences of literacy among PWA, which may have clinical implications. Aims To describe how literacy, i.e., reading and writing, is experienced in everyday life by PWA and to gain insight into the part played by literacy skills in their lives. Methods & Procedures A qualitative descriptive research approach was taken. In‐depth interviews were conducted with 12 PWA (six women and six men) who had all lived with aphasia for at least 6 months post‐stroke. The interviews were analysed using qualitative content analysis. Outcomes & Results One overarching theme emerged from the data: literacy as an ongoing recovery process. Based on this overarching theme, two subthemes were identified: changes in conditions for literacy (experiences of reading and writing initially post‐onset compared with experiences at the time of the interview); and facing expectations about literacy (participants’ own and other people's expectations of them in terms of literacy). Conclusions & Implications The findings are important at a general level in that they indicate that PWA are able to articulate their individual experiences and thoughts about literacy, i.e., reading and writing. Specifically, PWA in this study experience literacy as playing an essential part in their lives and the findings imply that personal experiences are important in the design of reading and writing interventions in speech and language therapy. PMID:28039933

  18. Mixed transcortical aphasia in nonfamilial dysphasic dementia.

    PubMed

    Mehler, M F

    1988-12-01

    The neurolinguistic and cognitive profiles of a patient with mixed transcortical aphasia and non-familial dysphasic dementia associated with progressive, left perisylvian involution are presented. This clinicopathological entity has recently been shown to be an example of a novel class of intrinsic, focal cortical degenerations with sparing of the basal forebrain. The characteristics of the aphasia were unusual. There were occasional literal and verbal paraphasic errors, but no completion phenomenon, embellishment or significant echolalia. Evidence of a generalized lexical disruption was found on detailed analysis of residual abilities in reading, writing and spelling. A newly described form of non-lexical repetition was present, resulting in the patient's inability to correct syntactical and semantic errors. Affective prosodic repetition was intact. A combined paraphasic word-production and semantic anomia was found. These observations combined with evidence of evolving region-specific cognitive impairments suggest that the pathological process resulted in a relative disconnection of integral frontal and parieto-occipital areas from adjacent perisylvian language zones.

  19. Nonverbal oral apraxia in primary progressive aphasia and apraxia of speech

    PubMed Central

    Botha, Hugo; Duffy, Joseph R.; Strand, Edythe A.; Machulda, Mary M.; Whitwell, Jennifer L.

    2014-01-01

    Objective: The goal of this study was to explore the prevalence of nonverbal oral apraxia (NVOA), its association with other forms of apraxia, and associated imaging findings in patients with primary progressive aphasia (PPA) and progressive apraxia of speech (PAOS). Methods: Patients with a degenerative speech or language disorder were prospectively recruited and diagnosed with a subtype of PPA or with PAOS. All patients had comprehensive speech and language examinations. Voxel-based morphometry was performed to determine whether atrophy of a specific region correlated with the presence of NVOA. Results: Eighty-nine patients were identified, of which 34 had PAOS, 9 had agrammatic PPA, 41 had logopenic aphasia, and 5 had semantic dementia. NVOA was very common among patients with PAOS but was found in patients with PPA as well. Several patients exhibited only one of NVOA or apraxia of speech. Among patients with apraxia of speech, the severity of the apraxia of speech was predictive of NVOA, whereas ideomotor apraxia severity was predictive of the presence of NVOA in those without apraxia of speech. Bilateral atrophy of the prefrontal cortex anterior to the premotor area and supplementary motor area was associated with NVOA. Conclusions: Apraxia of speech, NVOA, and ideomotor apraxia are at least partially separable disorders. The association of NVOA and apraxia of speech likely results from the proximity of the area reported here and the premotor area, which has been implicated in apraxia of speech. The association of ideomotor apraxia and NVOA among patients without apraxia of speech could represent disruption of modules shared by nonverbal oral movements and limb movements. PMID:24727315

  20. Treatment of primary progressive aphasias by transcranial direct current stimulation combined with language training.

    PubMed

    Cotelli, Maria; Manenti, Rosa; Petesi, Michela; Brambilla, Michela; Cosseddu, Maura; Zanetti, Orazio; Miniussi, Carlo; Padovani, Alessandro; Borroni, Barbara

    2014-01-01

    Primary progressive aphasia (PPA) is an untreatable neurodegenerative disorder that disrupts language functions. Previous studies have demonstrated transcranial direct current stimulation (tDCS) may improve language symptoms in patients with post stroke aphasia or neurodegenerative diseases. The present study investigated whether the application of anodal tDCS (AtDCS) to the scalp overlying the left dorsolateral prefrontal cortex (DLPFC), which may increase cortical excitability, in combination with individualized speech therapy would improve naming accuracy in the agrammatic variant of PPA (avPPA). Sixteen avPPA patients were randomly allocated into two subgroups: AtDCS (n = 8) or placebo tDCS (PtDCS). tDCS was applied over the left DLPFC (BA 8/9) 25 minutes per day for two weeks (10 days). Each patient underwent 25 minutes of individualized speech therapy with either AtDCS or PtDCS during each treatment session. Neuropsychological assessment, experimental naming, and linguistic abilities in daily living were assessed at baseline (T0), after two weeks of intervention (T1) and at a 12-week follow-up (T2). Significant improvement in experimental naming was observed in both groups at T1 and T2, but this effect was significantly greater in AtDCS than PtDCS patients. Naming correctness, as assessed using the Aachener Aphasie Test, increased selectively in the AtDCS group from T0 to T1, and this effect remained significant at T2. The analysis of daily living language abilities improved selectively in AtDCS group. Our results support the beneficial effect of targeted language training in combination with brain stimulation in avPPA patients. tDCS should be considered a useful tool for the improvement of language functions in patients with neurodegenerative diseases in future trials.

  1. Community: the key to building and extending engagement for individuals with aphasia.

    PubMed

    Silverman, Maura English

    2011-08-01

    The response by the aphasia community to the call of the Life Participation Approach to Aphasia Project Team to offer a framework for the management of aphasia was swift and expansive. Speech pathologists across the world accepted the paradigm shift from language goals within the clinic office to the short-term and long-term life objectives of their clients. The definition of service now included access to those communicative barriers that persons with aphasia face within their community. The recruitment, training, and shaping of that engagement must be individualized for successful (re)engagement. This article aims to present perspective on that process from a program that utilizes a unique center without walls concept. © Thieme Medical Publishers.

  2. "Waiting on the words": procedures and outcomes of a drama class for individuals with aphasia.

    PubMed

    Cherney, Leora R; Oehring, Ann K; Whipple, Keith; Rubenstein, Ted

    2011-08-01

    Drama therapy offers an authentic medium through which people with aphasia can interact and share their experiences. We describe the rationale and procedures of a drama class, informed by the principles and practices of drama therapy, in which individuals with chronic aphasia conceptualized, wrote, and produced a play addressing their experiences of having, living with, and coping with the effects of aphasia. Sessions were cofacilitated by a speech-language pathologist and a drama therapist. We describe the drama activities and techniques in each of four distinct stages of a drama therapy process through which the group transitioned. We also summarize patient-reported outcomes of a representational group of seven participants. Subscales of the Burden of Stroke Scale and the Communication Confidence Rating Scale for Aphasia were administered before and after participation in the 18-week class. Means, standard deviations, and effect sizes were computed. Results indicated perceived improvements in both communication and mood. © Thieme Medical Publishers.

  3. Aphasia centers in North America: a survey.

    PubMed

    Simmons-Mackie, Nina; Holland, Audrey L

    2011-08-01

    There is a growing trend toward dedicated programs designed to improve the lives of people with aphasia and their families. We are referring to these programs collectively as "aphasia centers." These programs purportedly differ from more traditional medically based aphasia rehabilitation. However, there is no directory of aphasia centers and no definition of what constitutes such a program. Therefore, an online survey was designed to identify and describe aphasia centers in the United States and Canada. A 37-question survey was posted online via SurveyMonkey. An introductory letter was distributed by electronic mail to a listserv and mailing lists of programs associated with aphasia. Potential respondents who considered themselves an aphasia center were asked to complete the survey. A total of 33 survey responses were analyzed, and descriptive data were compiled resulting in a description of the following aspects of aphasia centers: demographic information, mission, admission and discharge policies, assessment practices, program logistics, staffing patterns, marketing, funding, and services offered. In addition, a qualitative analysis of written text responses revealed the following key themes that appear to characterize the responding programs: services that differ from traditional aphasia rehabilitation; a sense of community; a holistic focus on quality of life, psychosocial well-being, participation, and social support; the centrality of group interaction; and variety/intensity of services.

  4. Computers in the treatment of chronic aphasia.

    PubMed

    Katz, Richard C

    2010-02-01

    Computers and related technology can increase the amount of treatment received by adults with chronic aphasia. Computers used in treatment, however, are only valuable to the patient if the intervention is efficacious. Real and potential applications of computer technology are discussed in the context of three roles of computerized aphasia treatment for adults with chronic aphasia. Pertinent studies regarding Phases 1 and 2 are briefly described. The only Phase 3 study of efficacy of computerized aphasia treatment is more fully described and its implications discussed.

  5. Aphasia and the neuropsychobiology of stress.

    PubMed

    Laures-Gore, Jacqueline S; Buchanan, Tony W

    2015-01-01

    Individuals with aphasia face significant challenges in their lives. These challenges stem from the difficulties caused by impaired language function. Impairment in the ability to successfully communicate could be a significant source of stress to individuals with aphasia. The purpose of the current paper is to present a review of the literature on the neuropsychobiology of stress and aphasia, give a contemporary conceptualization of stress (both neurobiological and psychological), offer a framework and directions for future investigations in stress and aphasia, and finally suggest clinical implications for this line of inquiry.

  6. Classification of primary progressive aphasia: Do unsupervised data mining methods support a logopenic variant?

    PubMed

    Maruta, Carolina; Pereira, Telma; Madeira, Sara C; De Mendonça, Alexandre; Guerreiro, Manuela

    2015-06-01

    Our objective was to test whether data mining techniques, through an unsupervised learning approach, support the three-group diagnostic model of primary progressive aphasia (PPA) versus the existence of two main/classic groups. A series of 155 PPA patients observed in a clinical setting and subjected to at least one neuropsychological/language assessment was studied. Several demographic, clinical and neuropsychological attributes, grouped in distinct sets, were introduced in unsupervised learning methods (Expectation Maximization, K-Means, X-Means, Hierarchical Clustering and Consensus Clustering). Results demonstrated that unsupervised learning methods revealed two main groups consistently obtained throughout all the analyses (with different algorithms and different set of attributes). One group included most of the agrammatic/non-fluent and some logopenic cases while the other was mainly composed of semantic and logopenic cases. Clustering the patients in a larger number of groups (k > 2) revealed some clusters composed mostly of non-fluent or of semantic cases. However, we could not evidence any group chiefly composed of logopenic cases. In conclusion, unsupervised data mining approaches do not support a clear distinction of logopenic PPA as a separate variant.

  7. Unambiguous generalization effects after treatment of non-canonical sentence production in German agrammatism.

    PubMed

    Stadie, Nicole; Schröder, Astrid; Postler, Jenny; Lorenz, Antje; Swoboda-Moll, Maria; Burchert, Frank; De Bleser, Ria

    2008-03-01

    Agrammatism is-among others, characterized by a deficit in producing grammatical structures. Of specific difficulty is the utilization of complex, non-canonical sentence structures (e.g. object-questions, passives, object-clefts). Several studies have documented positive effects when applying a specific treatment protocol in terms of increasingly correct production of target complex sentence structures with some variance in generalization patterns noted across individuals. The objective of this intervention study was to evaluate an intervention program focussing on the production of non-canonical sentences. Hypotheses about the occurrence of treatment effects were formulated on the basis of syntactic complexity, referring to the amount of syntactic phrase structures necessary to generate specific German sentence structures. A multiple single case study with seven agrammatic participants was applied, each participant receiving training in the production of object-relative-clauses and who-questions. The investigation was designed to unambiguously evaluate for each individual, structure specific and generalized learning effects with respect to the production of object-relative-clauses, who-questions and passive sentences. Results showed significant improvements for all sentences types. This outcome is considered within methodological issues of treatment studies. Theoretical and clinical implications are discussed.

  8. Assessment of Aphasia Across the International Classification of Functioning, Disability and Health Using an iPad-Based Application.

    PubMed

    Guo, Yiting Emily; Togher, Leanne; Power, Emma; Hutomo, Edwin; Yang, Yi-Fei; Tay, Arthur; Yen, Shih-Cheng; Koh, Gerald Choon-Huat

    2017-04-01

    Access2Aphasia™ is an iPad™-based aphasia assessment application that enables real-time audiovisual communication between people with aphasia (PWA) and speech-language pathologists (SLPs), and the use of supported conversation techniques. This study aimed to establish the reliability of aphasia assessment across the International Classification of Functioning, Disability and Health (ICF) using Access2Aphasia, and compare it with face-to-face (FTF) assessment. Consumer perspectives of Access2Aphasia were also examined. Thirty PWA were randomized into two conditions: online-led and FTF assessment. Participants in the online-led group were assessed remotely using Access2Aphasia™ in their own homes, while an FTF SLP scored silently simultaneously. Participants in the FTF group were assessed FTF using standard administration materials. Assessment included two subtests of the Psycholinguistic Assessment of Language Processing Activities (PALPA) and the Assessment of Living with Aphasia (ALA) to allow for outcomes to be captured across the ICF domains. Consumer perspectives on Access2Aphasia were obtained from both PWA and research SLPs in the online-led group. Kappa statistics indicated moderate to almost perfect agreement between online and FTF SLPs (k = 0.71-1.00). Intrarater and interrater reliability was excellent (ICC = 0.99-1.00) and equivalent for the online-led and FTF conditions. Both PWA and research SLPs in the online-led group reported being satisfied with the experience overall, with suggestions provided by research SLPs to improve Access2Aphasia. This study supports the provision of iPad-based aphasia assessments across the ICF in the online environment, with comparable reliability to FTF assessments. Future research is warranted to support the development of iPad-based aphasia assessment and treatment as an alternative mode of service delivery to PWA.

  9. Determining the Association between Language and Cognitive Tests in Poststroke Aphasia.

    PubMed

    Wall, Kylie J; Cumming, Toby B; Copland, David A

    2017-01-01

    Individuals with aphasia are often excluded from studies exploring poststroke cognition because so many of the standard cognitive assessments rely on language ability. Our primary objective was to examine the association between performance on cognitive tests and performance on comprehension and naming tests in poststroke aphasia. Second, we aimed to determine the association between language performance and a real-life measure of cognition (Kettle Test). Third, we explored the feasibility of administering cognitive tests in aphasia. Thirty-six participants with poststroke aphasia and 32 controls were assessed on a battery of pen-and-paper cognitive tests recommended in stroke. Auditory comprehension was measured using the Comprehensive Aphasia Test and naming was measured using the Boston Naming Test. Twenty-two community dwelling participants with aphasia and controls were also asked to complete the Kettle Test. Multiple linear regressions were used to explore the relationship between language performance and performance on the cognitive tests. Feasibility was determined by quantifying missing data. The cognitive tests with the highest variance accounted for by auditory comprehension and naming were animal fluency (R(2) = 0.67, R(2) = 0.78) and the Hopkins Verbal Learning Test (recognition discrimination index) (R(2) = 0.65, R(2) = 0.78). All cognitive tests were significantly associated with auditory comprehension and naming, except for the Star Cancellation Test and the Kettle Test. Thirty-three percent of participants with aphasia were unable to complete all the cognitive tests. Language and non-linguistic cognitive processes are often interrelated. Most pen-and-paper cognitive tests were significantly associated with both auditory comprehension and naming, even in tests that do not require a verbal response. Language performance was not significantly associated with a real-life cognitive performance measure. Task instructions, stimuli, and responses

  10. Semantic Dementia and Persisting Wernicke's Aphasia: Linguistic and Anatomical Profiles

    ERIC Educational Resources Information Center

    Ogar, J. M.; Baldo, J. V.; Wilson, S. M.; Brambati, S. M.; Miller, B. L.; Dronkers, N. F.; Gorno-Tempini, M. L.

    2011-01-01

    Few studies have directly compared the clinical and anatomical characteristics of patients with progressive aphasia to those of patients with aphasia caused by stroke. In the current study we examined fluent forms of aphasia in these two groups, specifically semantic dementia (SD) and persisting Wernicke's aphasia (WA) due to stroke. We compared…

  11. Semantic Dementia and Persisting Wernicke's Aphasia: Linguistic and Anatomical Profiles

    ERIC Educational Resources Information Center

    Ogar, J. M.; Baldo, J. V.; Wilson, S. M.; Brambati, S. M.; Miller, B. L.; Dronkers, N. F.; Gorno-Tempini, M. L.

    2011-01-01

    Few studies have directly compared the clinical and anatomical characteristics of patients with progressive aphasia to those of patients with aphasia caused by stroke. In the current study we examined fluent forms of aphasia in these two groups, specifically semantic dementia (SD) and persisting Wernicke's aphasia (WA) due to stroke. We compared…

  12. Borderzone strokes and transcortical aphasia.

    PubMed

    Cauquil-Michon, Cécile; Flamand-Roze, Constance; Denier, Christian

    2011-12-01

    Borderzone infarcts (BZIs) are anatomically defined as ischemic lesions occurring at the junction between two arterial territories, accounting for 2% to 10% of strokes. Three types of hemispheric BZIs are described according to topography (ie, superficial anterior, posterior, and deep). Although published series on related aphasia are rare in the setting of BZI, aphasia is of transcortical (TCA) type, characterized by the preservation of repetition. TCA can be of motor, sensory, or mixed type depending on whether expression, understanding, or both are impaired. Recent studies have reported specific aphasic patterns. BZI patients initially presented with mixed TCA. Aphasia specifically evolved according to the stroke location, toward motor or sensory TCA in patients with respectively anterior or posterior BZI. TCA was associated with good long-term prognosis. This specific aphasic pattern is interesting in clinical practice because it prompts the suspicion of a BZI before the MRI is done, and it helps in the planning of rehabilitation and in providing adapted information to the patient and family concerning the likelihood of language recovery.

  13. Training-induced improvement of noncanonical sentence production does not generalize to comprehension: evidence for modality-specific processes.

    PubMed

    Schröder, Astrid; Burchert, Frank; Stadie, Nicole

    2015-01-01

    The presence or absence of generalization after treatment can provide important insights into the functional relationship between cognitive processes. The aim of the present study was to investigate the relationship between the cognitive processes that underlie sentence comprehension and production in aphasia. Using data from seven participants who took part in a case-series intervention study that focused on noncanonical sentence production [Stadie et al. (2008). Unambiguous generalization effects after treatment of noncanonical sentence production in German agrammatism. Brain and Language, 104, 211-229], we identified patterns of impairments and generalization effects for the two modalities. Results showed (a) dissociations between sentence structures and modalities before treatment, (b) an absence of cross-modal generalization from production to comprehension after treatment, and (c), a co-occurrence of spared comprehension before treatment and generalization across sentence structures within production after treatment. These findings are in line with the assumption of modality-specific, but interacting, cognitive processes in sentence comprehension and production. More specifically, this interaction is assumed to be unidirectional, allowing treatment-induced improvements in production to be supported by preserved comprehension.

  14. Pharmacotherapy of Aphasia: Myth or Reality?

    ERIC Educational Resources Information Center

    de Boissezon, Xavier; Peran, Patrice; de Boysson, Chloe; Demonet, Jean-Francois

    2007-01-01

    Pharmacotherapy of aphasia had been discussed for the last twenty years with first bromocriptine and amphetamine and then serotoninergic, GABAergic and cholinergic agents. Here, we reviewed the MEDLINE available reports of drug therapy for aphasia. So far, proofs of efficiency were found indubitable for none of the studied molecules. However, some…

  15. Aphasia Handbook for Adults and Children.

    ERIC Educational Resources Information Center

    Agranowitz, Aleen; McKeown, Milfred Riddle

    The occurance of aphasia in adults and children is discussed along with therapeutic measures. An orientation of what aphasia is and the problems it presents for adults is followed by a statement of present methods of retraining. Consideration is given to an evaluation of defects, attitudes and techniques in retraining, group therapy, and…

  16. Outcome Assessment in Aphasia: A Survey

    ERIC Educational Resources Information Center

    Simmons-Mackie, Nina; Threats, Travis T.; Kagan, Aura

    2005-01-01

    There has been a marked increase in attention to the measurement of ''outcomes'' after speech-language intervention for adult aphasia. Consumers, speech-language pathologists (SLPs), and funding sources desire evidence of therapy outcomes that improve communication and enhance the quality of life for people with aphasia. While many assessment…

  17. Crossed Wernicke's Aphasia: A Case Report

    ERIC Educational Resources Information Center

    Sheehy, Laurie M.; Haines, Mary E.

    2004-01-01

    Crossed aphasia is a phenomenon in which an individual sustains a lesion in the right hemisphere (typically non-language dominant), but who exhibits an aphasic syndrome. The authors present a case study of an individual with crossed aphasia (CA) in an attempt to provide anecdotal information for four questions posed by Pita, Karavelis, and…

  18. Outcome Assessment in Aphasia: A Survey

    ERIC Educational Resources Information Center

    Simmons-Mackie, Nina; Threats, Travis T.; Kagan, Aura

    2005-01-01

    There has been a marked increase in attention to the measurement of ''outcomes'' after speech-language intervention for adult aphasia. Consumers, speech-language pathologists (SLPs), and funding sources desire evidence of therapy outcomes that improve communication and enhance the quality of life for people with aphasia. While many assessment…

  19. Pharmacotherapy of Aphasia: Myth or Reality?

    ERIC Educational Resources Information Center

    de Boissezon, Xavier; Peran, Patrice; de Boysson, Chloe; Demonet, Jean-Francois

    2007-01-01

    Pharmacotherapy of aphasia had been discussed for the last twenty years with first bromocriptine and amphetamine and then serotoninergic, GABAergic and cholinergic agents. Here, we reviewed the MEDLINE available reports of drug therapy for aphasia. So far, proofs of efficiency were found indubitable for none of the studied molecules. However, some…

  20. Crossed Wernicke's Aphasia: A Case Report

    ERIC Educational Resources Information Center

    Sheehy, Laurie M.; Haines, Mary E.

    2004-01-01

    Crossed aphasia is a phenomenon in which an individual sustains a lesion in the right hemisphere (typically non-language dominant), but who exhibits an aphasic syndrome. The authors present a case study of an individual with crossed aphasia (CA) in an attempt to provide anecdotal information for four questions posed by Pita, Karavelis, and…

  1. [Clinical types of FTLD: progressive nonfluent aphasia; comparative discussions on the associated clinical presentations].

    PubMed

    Fukui, Toshiya

    2009-11-01

    Progressive nonfluent aphasia (PNFA) is one of the 3 clinical presentations of frontotemporal lobar degeneration (FTLD), the other 2 being frontotemporal dementia and semantic dementia (SD). PNFA and SD, both representing relentlessly progressive language impairment in the realm of FTLD, may share a large part with primary progressive aphasia (PPA). A salient distinction between PPA and PNFA or SD is that PPA includes another clinical type, namely, logopenic/phonemic aphasia (LPA), which is not represented in FTLD. This is primarily because LPA is usually caused by Alzheimer's disease (AD) and the brunt of the lesion is localized at the left temporo-parietal region of the brain. Further, PNFA/SD should be limited to the clinical consequencies of FTLD while PPA is more generous with regard to its causal pathology. By definition, PNFA is an expressive language impairment which is characterized by effortful speech, phonemic errors, grammatical impairment, and word-finding difficulties. Reading and writing may be comparatively impaired. Comprehension of single word meaning is normal, while comprehension of sentencies may sometimes be impaired. PNFA should be differentiated from SD, LPA, and pure progressive apraxia of speech (AOS or alternatively referred to as aphemia or anarthria). SD may be distinguished from PNFA by virtue of its fluency, characteristic loss of word meaning and absence of agrammatism. LPA is similar to PNFA, yet differs in that there is preservation of grammatical skills and speech motor function that is devoid of AOS and/or dysarthria. AOS is an impairment at the level of speech motor programming without language impairment. Thus, there may be a double dissociation between AOS and PNFA i. e., PNFA may or may not accompany AOS and vice versa. PNFA is associated with a localized lesion in the left frontotemporal area of the brain. Immunohistochemical investigations have revealed that ubiquitin/TAR DNA binding protein-43 (TDA-43) positive and tau

  2. The relationship of aphasia type and gesture production in people with aphasia.

    PubMed

    Sekine, Kazuki; Rose, Miranda L

    2013-11-01

    For many individuals with aphasia, gestures form a vital component of message transfer and are the target of speech-language pathology intervention. What remains unclear are the participant variables that predict successful outcomes from gesture treatments. The authors examined the gesture production of a large number of individuals with aphasia-in a consistent discourse sampling condition and with a detailed gesture coding system-to determine patterns of gesture production associated with specific types of aphasia. The authors analyzed story retell samples from AphasiaBank (TalkBank, n.d.), gathered from 98 individuals with aphasia resulting from stroke and 64 typical controls. Twelve gesture types were coded. Descriptive statistics were used to describe the patterns of gesture production. Possible significant differences in production patterns according to aphasia type were examined using a series of chi-square, Fisher exact, and logistic regression statistics. A significantly higher proportion of individuals with aphasia gestured as compared to typical controls, and for many individuals with aphasia, this gesture was iconic and was capable of communicative load. Aphasia type impacted significantly on gesture type in specific identified patterns, detailed here. These type-specific patterns suggest the opportunity for gestures as targets of aphasia therapy.

  3. Framing ideas in aphasia: the need for thinking therapy.

    PubMed

    Marshall, Jane

    2009-01-01

    This paper argues that some of the patterns seen in aphasia may reflect difficulties in the cognitive preparations for language. In particular, some individuals might be unable to carry out processes of 'Thinking for Speaking' (Slobin 1996), which frame thoughts for language production. Evidence to support this proposal is presented, together with signs that such thinking can be assisted with cues and therapy. It is argued that these preliminary data need to be pursued via a more comprehensive investigation of thinking therapy.

  4. Effect of aphasia on acute stroke outcomes.

    PubMed

    Boehme, Amelia K; Martin-Schild, Sheryl; Marshall, Randolph S; Lazar, Ronald M

    2016-11-29

    To determine the independent effects of aphasia on outcomes during acute stroke admission, controlling for total NIH Stroke Scale (NIHSS) scores and loss of consciousness. Data from the Tulane Stroke Registry were used from July 2008 to December 2014 for patient demographics, NIHSS scores, length of stay (LOS), complications (sepsis, deep vein thrombosis), and discharge modified Rankin Scale (mRS) score. Aphasia was defined as a score >1 on question 9 on the NIHSS on admission and hemiparesis as >1 on questions 5 or 6. Among 1,847 patients, 866 (46%) had aphasia on admission. Adjusting for NIHSS score and inpatient complications, those with aphasia had a 1.22 day longer LOS than those without aphasia, whereas those with hemiparesis (n = 1,225) did not have any increased LOS compared to those without hemiparesis. Those with aphasia had greater odds of having a complication (odds ratio [OR] 1.44, confidence interval [CI] 1.07-1.93, p = 0.0174) than those without aphasia, which was equivalent to those having hemiparesis (OR 1.47, CI 1.09-1.99, p = 0.0137). Controlling for NIHSS scores, aphasia patients had higher odds of discharge mRS 3-6 (OR 1.42 vs 1.15). Aphasia is independently associated with increased LOS and complications during the acute stroke admission, adding $2.16 billion annually to US acute stroke care. The presence of aphasia was more likely to produce a poor functional outcome than hemiparesis. These data suggest that further research is necessary to determine whether establishing adaptive communication skills can mitigate its consequences in the acute stroke setting. © 2016 American Academy of Neurology.

  5. Asymmetric inhibitory treatment effects in multilingual aphasia.

    PubMed

    Goral, Mira; Naghibolhosseini, Maryam; Conner, Peggy S

    2013-01-01

    Findings from recent psycholinguistic studies of bilingual processing support the hypothesis that both languages of a bilingual are always active and that bilinguals continually engage in processes of language selection. This view aligns with the convergence hypothesis of bilingual language representation. Furthermore, it is hypothesized that when bilinguals perform a task in one language they need to inhibit their other, nontarget language(s) and that stronger inhibition is required when the task is performed in the weaker language than in the stronger one. The study of multilingual individuals who acquire aphasia resulting from a focal brain lesion offers a unique opportunity to test the convergence hypothesis and the inhibition asymmetry. We report on a trilingual person with chronic nonfluent aphasia who at the time of testing demonstrated greater impairment in her first acquired language (Persian) than in her third, later learned language (English). She received treatment in English followed by treatment in Persian. An examination of her connected language production revealed improvement in her grammatical skills in each language following intervention in that language, but decreased grammatical accuracy in English following treatment in Persian. The increased error rate was evident in structures that are used differently in the two languages (e.g., auxiliary verbs). The results support the prediction that greater inhibition is applied to the stronger language than to the weaker language, regardless of their age of acquisition. We interpret the findings as consistent with convergence theories that posit overlapping neuronal representation and simultaneous activation of multiple languages and with proficiency-dependent asymmetric inhibition in multilinguals.

  6. Patterns of breakdown in spelling in primary progressive aphasia.

    PubMed

    Sepelyak, Kathryn; Crinion, Jennifer; Molitoris, John; Epstein-Peterson, Zachary; Bann, Maralyssa; Davis, Cameron; Newhart, Melissa; Heidler-Gary, Jennifer; Tsapkini, Kyrana; Hillis, Argye E

    2011-03-01

    The objective of this study is to determine which cognitive processes underlying spelling are most affected in the three variants of primary progressive aphasia (PPA): Logopenic variant primary progressive aphasia (lvPPA), Semantic variant primary progressive aphasia (svPPA), and Nonfluent variant primary progressive aphasia (nfvPPA). 23 PPA patients were administered The Johns Hopkins Dysgraphia Battery to assess spelling. Subtests evaluate for effects of word frequency, concreteness, word length, grammatical word class, lexicality (words vs pseudowords), and "regularity" by controlling for the other variables. Significant effects of each variable were identified with chi square tests. Responses on all spelling to dictation tests were scored by error type. 16 of the 23 subjects also had a high resolution MRI brain scan to identify areas of atrophy. We identified 4 patterns of spelling that could be explained by damage to one or more cognitive processes underlying spelling. Nine patients (3 unclassifiable, 4 with lvPPA, 2 with svPPA) had dysgraphia explicable by impaired access to lexical representations, with reliance on sublexical phonology-to-orthography conversion (POC). Two patients (with nfvPPA) showed dysgraphia explicable by impaired access to lexical representations and complete disruption of sublexical POC. Seven patients (4 with lvPPA, 1 with svPPA, 2 unclassifiable) showed dysgraphia explicable by impaired access to lexical-semantic representations and/or lexical representations with partially spared sublexical POC mechanisms. Five patients (1 with nfvPPA, 2 with svPPA, 1 with lvPPA, and 1 unclassifiable) showed dysgraphia explicable by impairment of the graphemic buffer. Any cognitive process underlying spelling can be affected in PPA. Predominance of phonologically plausible errors, more accurate spelling of regular words than irregular words, and more accurate spelling of pseudowords than words (indicating spared POC mechanisms) may indicate a low

  7. [Different types of aphasia caused by cerebral hemorrhage in the left frontal lobe: Broca's aphasia and Broca area's aphasia].

    PubMed

    Hiraoka, Chiho; Maeshima, Shinichiro; Osawa, Aiko; Kanai, Naoko; Kohyama, Shinya; Yamane, Fumitaka; Ishihara, Shoichiro

    2009-10-01

    We reported two cases of aphasia that exhibited different characteristics of aphasia following cerebral hemorrhage in the left frontal lobe involving the Broca's area. Case 1 is a 74-year-old right-handed woman. She was hospitalized with speech disturbance. Spontanoues speech was fluent and articulation was normal, but she showed verbal paraphasia and speech perseveration. She demonstrated a preserved ability to repeat short sentences and was able to read words aloud. This type of aphasia is called "Broca area's aphasia". MRI and CT showed hematoma involving the left inferior frontal lobe, operculum and insula cortex. Single-photon emission computed tomography (SPECT) showed low perfusion in the frontal lobe without involvement of the postcentral gyrus. Case 2 is a 76-year-old right-handed man. He was also hospitalized with speech disturbance. Spontanoues speech was non-fluent and articulation was poor. He sometimes showed phonemic paraphasia with anarthria, but he demonstrated a preserved ability to repeat short sentences. He was able to read words aloud in a manner comparatively similar to. This type of aphasia is called "Broca's aphasia". MRI and CT showed hematoma involving the left inferior frontal lobe, operculum and precentral cortex. SPECT revealed low perfusion in the frontal lobe extending to the postcentral gyrus. We supposed that the different characteristics of aphasia in those cases were due to extended lesion in the frontal lobe.

  8. Neologistic jargon aphasia and agraphia in primary progressive aphasia

    PubMed Central

    Rohrer, Jonathan D.; Rossor, Martin N.; Warren, Jason D.

    2009-01-01

    The terms ‘jargon aphasia’ and ‘jargon agraphia’ describe the production of incomprehensible language containing frequent phonological, semantic or neologistic errors in speech and writing, respectively. Here we describe two patients with primary progressive aphasia (PPA) who produced neologistic jargon either in speech or writing. We suggest that involvement of the posterior superior temporal–inferior parietal region may lead to a disconnection between stored lexical representations and language output pathways leading to aberrant activation of phonemes in neologistic jargon. Parietal lobe involvement is relatively unusual in PPA, perhaps accounting for the comparative rarity of jargon early in the course of these diseases. PMID:19033077

  9. Co-verbal gestures among speakers with aphasia: Influence of aphasia severity, linguistic and semantic skills, and hemiplegia on gesture employment in oral discourse.

    PubMed

    Kong, Anthony Pak-Hin; Law, Sam-Po; Wat, Watson Ka-Chun; Lai, Christy

    2015-01-01

    The use of co-verbal gestures is common in human communication and has been reported to assist word retrieval and to facilitate verbal interactions. This study systematically investigated the impact of aphasia severity, integrity of semantic processing, and hemiplegia on the use of co-verbal gestures, with reference to gesture forms and functions, by 131 normal speakers, 48 individuals with aphasia and their controls. All participants were native Cantonese speakers. It was found that the severity of aphasia and verbal-semantic impairment was associated with significantly more co-verbal gestures. However, there was no relationship between right-sided hemiplegia and gesture employment. Moreover, significantly more gestures were employed by the speakers with aphasia, but about 10% of them did not gesture. Among those who used gestures, content-carrying gestures, including iconic, metaphoric, deictic gestures, and emblems, served the function of enhancing language content and providing information additional to the language content. As for the non-content carrying gestures, beats were used primarily for reinforcing speech prosody or guiding speech flow, while non-identifiable gestures were associated with assisting lexical retrieval or with no specific functions. The above findings would enhance our understanding of the use of various forms of co-verbal gestures in aphasic discourse production and their functions. Speech-language pathologists may also refer to the current annotation system and the results to guide clinical evaluation and remediation of gestures in aphasia. None. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Co-verbal gestures among speakers with aphasia: Influence of aphasia severity, linguistic and semantic skills, and hemiplegia on gesture employment in oral discourse

    PubMed Central

    Kong, Anthony Pak-Hin; Law, Sam-Po; Wat, Watson Ka-Chun; Lai, Christy

    2015-01-01

    The use of co-verbal gestures is common in human communication and has been reported to assist word retrieval and to facilitate verbal interactions. This study systematically investigated the impact of aphasia severity, integrity of semantic processing, and hemiplegia on the use of co-verbal gestures, with reference to gesture forms and functions, by 131 normal speakers, 48 individuals with aphasia and their controls. All participants were native Cantonese speakers. It was found that the severity of aphasia and verbal-semantic impairment was associated with significantly more co-verbal gestures. However, there was no relationship between right-sided hemiplegia and gesture employment. Moreover, significantly more gestures were employed by the speakers with aphasia, but about 10% of them did not gesture. Among those who used gestures, content-carrying gestures, including iconic, metaphoric, deictic gestures, and emblems, served the function of enhancing language content and providing information additional to the language content. As for the non-content carrying gestures, beats were used primarily for reinforcing speech prosody or guiding speech flow, while non-identifiable gestures were associated with assisting lexical retrieval or with no specific functions. The above findings would enhance our understanding of the use of various forms of co-verbal gestures in aphasic discourse production and their functions. Speech-language pathologists may also refer to the current annotation system and the results to guide clinical evaluation and remediation of gestures in aphasia. PMID:26186256

  11. Frontotemporal dementia and primary progressive aphasia, a review

    PubMed Central

    Kirshner, Howard S

    2014-01-01

    Frontotemporal dementias are neurodegenerative diseases in which symptoms of frontal and/or temporal lobe disease are the first signs of the illness, and as the diseases progress, they resemble a focal left hemisphere process such as stroke or traumatic brain injury, even more than a neurodegenerative disease. Over time, some patients develop a more generalized dementia. Four clinical subtypes characterize the predominant presentations of this illness: behavioral or frontal variant FTD, progressive nonfluent aphasia, semantic dementia, and logopenic primary progressive aphasia. These clinical variants correlate with regional patterns of atrophy on brain imaging studies such as MRI and PET scanning, as well as with biochemical and molecular genetic variants of the disorder. The treatment is as yet only symptomatic, but advances in molecular genetics promise new therapies. PMID:24966676

  12. Cognition and Anatomy in Three Variants of Primary Progressive Aphasia

    PubMed Central

    Gorno-Tempini, Maria Luisa; Dronkers, Nina F.; Rankin, Katherine P.; Ogar, Jennifer M.; Phengrasamy, La; Rosen, Howard J.; Johnson, Julene K.; Weiner, Michael W.; Miller, Bruce L.

    2008-01-01

    We performed a comprehensive cognitive, neuroimaging, and genetic study of 31 patients with primary progressive aphasia (PPA), a decline in language functions that remains isolated for at least 2 years. Detailed speech and language evaluation was used to identify three different clinical variants: nonfluent progressive aphasia (NFPA; n = 11), semantic dementia (SD; n = 10), and a third variant termed logopenic progressive aphasia (LPA; n = 10). Voxel-based morphometry (VBM) on MRIs showed that, when all 31 PPA patients were analyzed together, the left perisylvian region and the anterior temporal lobes were atrophied. However, when each clinical variant was considered separately, distinctive patterns emerged: (1) NFPA, characterized by apraxia of speech and deficits in processing complex syntax, was associated with left inferior frontal and insular atrophy; (2) SD, characterized by fluent speech and semantic memory deficits, was associated with anterior temporal damage; and (3) LPA, characterized by slow speech and impaired syntactic comprehension and naming, showed atrophy in the left posterior temporal cortex and inferior parietal lobule. Apolipoprotein E ε4 haplotype frequency was 20% in NFPA, 0% in SD, and 67% in LPA. Cognitive, genetic, and anatomical features indicate that different PPA clinical variants may correspond to different underlying pathological processes. PMID:14991811

  13. Agrammatic Comprehension Caused by a Glioma in the Left Frontal Cortex

    ERIC Educational Resources Information Center

    Kinno, Ryuta; Muragaki, Yoshihiro; Hori, Tomokatsu; Maruyama, Takashi; Kawamura, Mitsuru; Sakai, Kuniyoshi L.

    2009-01-01

    It has been known that lesions in the left inferior frontal gyrus (L. IFG) do not always cause Broca's aphasia, casting doubt upon the specificity of this region. We have previously devised a picture-sentence matching task for a functional magnetic resonance imaging (fMRI) study, and observed that both pars triangularis (L. F3t) of L. IFG…

  14. Agrammatic Comprehension Caused by a Glioma in the Left Frontal Cortex

    ERIC Educational Resources Information Center

    Kinno, Ryuta; Muragaki, Yoshihiro; Hori, Tomokatsu; Maruyama, Takashi; Kawamura, Mitsuru; Sakai, Kuniyoshi L.

    2009-01-01

    It has been known that lesions in the left inferior frontal gyrus (L. IFG) do not always cause Broca's aphasia, casting doubt upon the specificity of this region. We have previously devised a picture-sentence matching task for a functional magnetic resonance imaging (fMRI) study, and observed that both pars triangularis (L. F3t) of L. IFG…

  15. Communication confidence in persons with aphasia.

    PubMed

    Babbitt, Edna M; Cherney, Leora R

    2010-01-01

    Communication confidence is a construct that has not been explored in the aphasia literature. Recently, national and international organizations have endorsed broader assessment methods that address quality of life and include participation, activity, and impairment domains as well as psychosocial areas. Individuals with aphasia encounter difficulties in all these areas on a daily basis in living with a communication disorder. Improvements are often reflected in narratives that are not typically included in standard assessments. This article illustrates how a new instrument measuring communication confidence might fit into a broad assessment framework and discusses the interaction of communication confidence, autonomy, and self-determination for individuals living with aphasia.

  16. Systematic review of the quality of clinical guidelines for aphasia in stroke management.

    PubMed

    Rohde, Alexia; Worrall, Linda; Le Dorze, Guylaine

    2013-12-01

    Aphasia affects up to 38% of stroke survivors. Clinical guidelines can improve patient care and outcomes. Given the importance of aphasia management in stroke care, the purpose of this study was to systematically search for, retrieve and assess the quality of currently published clinical guidelines for aphasia in stroke management. Systematic search of bibliographic resources, publications, association websites, databases, Internet and pearling revealed multidisciplinary stroke and speech pathology-specific clinical guidelines, which were evaluated using the Appraisal of Guidelines and Research and Evaluation (AGREE) II tool. Guidelines obtaining a rigour of development score above 66.67% in AGREE II evaluations underwent further ADAPTE Collaboration tool analysis. There was significant variability in methodological rigour, reporting of guideline development processes and scope of coverage of recommendations pertaining to aphasia management provided within the guidelines. The Australian Clinical Guidelines for Stroke Management (2010) and New Zealand Clinical Guidelines for Stroke Management (2010) achieved the highest scores (74% and 81%, respectively) in AGREE II analysis and both obtained a 'yes' in all seven ADAPTE domains. The Scottish Intercollegiate Guideline Network 108 (2008) guideline achieved 73% in AGREE II and six out of seven 'yes' in ADAPTE, however, contained no aphasia-specific recommendations. The Royal College of Speech and Language Therapists (2005) guideline provided the most comprehensive aphasia coverage, however, demonstrated lower methodological rigour in AGREE II (64%) and ADAPTE evaluations (three 'yes' out of seven). Improvement is needed in the quality of methodological rigour in development and reporting within clinical guidelines, and in aphasia-specific recommendations within stroke multidisciplinary clinical guidelines. © 2013 John Wiley & Sons Ltd.

  17. A second chance: Recovering language with aphasia (†).

    PubMed

    Green, Christopher; Waks, Leonie

    2008-01-01

    Dr Christopher Green is a well-known paediatrician and parenting author, who appeared frequently on Australian radio and television and lectured in Australia and many countries around the world. In 1999, Dr Green had a stroke which left him with aphasia and ended his career. After the death of his wife in 2004, Dr Green used exercise and the goal of writing again to lift himself out of his grief. With the help of a gifted editor, he wrote a new edition of his best-selling book Toddler Taming (Green, 2006 ), and in the process recovered much of his language. Dr Green is the Patron of the Australian Aphasia Association, and has in recent years returned to public speaking. In this address, he shares his message that the language gains made with aphasia may occur over decades, not merely one or two years. This article is an edited version of the keynote speech Dr Green presented at the Speech Pathology Australia annual conference in 2007.

  18. Neural Mechanisms Underlying Perilesional Transcranial Direct Current Stimulation in Aphasia: A Feasibility Study

    PubMed Central

    Ulm, Lena; McMahon, Katie; Copland, David; de Zubicaray, Greig I.; Meinzer, Marcus

    2015-01-01

    Little is known about the neural mechanisms by which transcranial direct current stimulation (tDCS) impacts on language processing in post-stroke aphasia. This was addressed in a proof-of-principle study that explored the effects of tDCS application in aphasia during simultaneous functional magnetic resonance imaging (fMRI). We employed a single subject, cross-over, sham-tDCS controlled design, and the stimulation was administered to an individualized perilesional stimulation site that was identified by a baseline fMRI scan and a picture naming task. Peak activity during the baseline scan was located in the spared left inferior frontal gyrus and this area was stimulated during a subsequent cross-over phase. tDCS was successfully administered to the target region and anodal- vs. sham-tDCS resulted in selectively increased activity at the stimulation site. Our results thus demonstrate that it is feasible to precisely target an individualized stimulation site in aphasia patients during simultaneous fMRI, which allows assessing the neural mechanisms underlying tDCS application. The functional imaging results of this case report highlight one possible mechanism that may have contributed to beneficial behavioral stimulation effects in previous clinical tDCS trials in aphasia. In the future, this approach will allow identifying distinct patterns of stimulation effects on neural processing in larger cohorts of patients. This may ultimately yield information about the variability of tDCS effects on brain functions in aphasia. PMID:26500522

  19. Masked Priming Effects in Aphasia: Evidence for Altered Automatic Spreading Activation

    PubMed Central

    Silkes, JoAnn P.; Rogers, Margaret A.

    2015-01-01

    Purpose Previous research has suggested that impairments of automatic spreading activation may underlie some aphasic language deficits. This study further investigated the status of automatic spreading activation in individuals with aphasia as compared with typical adults. Method Participants were 21 individuals with aphasia (12 fluent, 9 non-fluent) and 31 typical adults. Reaction time data were collected on a lexical decision task with masked repetition primes, assessed at 11 different interstimulus intervals (ISIs). Masked primes were used to assess automatic spreading activation without the confound of conscious processing. The various ISIs were used to assess the time to onset, and duration, of priming effects. Results The control group showed maximal priming in the 200 ms ISI condition, with significant priming at a range of ISIs surrounding that peak. Participants with both fluent and non-fluent aphasia showed maximal priming effects in the 250 ms ISI condition, and primed across a smaller range of ISIs than the control group. Conclusions Results suggest that individuals with aphasia have slowed automatic spreading activation, and impaired maintenance of activation over time, regardless of fluency classification. These findings have implications for understanding aphasic language impairment and for development of aphasia treatments designed directly address automatic language processes. PMID:22411281

  20. Transcranial magnetic stimulation and aphasia rehabilitation.

    PubMed

    Naeser, Margaret A; Martin, Paula I; Ho, Michael; Treglia, Ethan; Kaplan, Elina; Bashir, Shahid; Pascual-Leone, Alvaro

    2012-01-01

    Repetitive transcranial magnetic stimulation (rTMS) has been reported to improve naming in chronic stroke patients with nonfluent aphasia since 2005. In part 1, we review the rationale for applying slow, 1-Hz, rTMS to the undamaged right hemisphere in chronic nonfluent aphasia patients after a left hemisphere stroke; and we present a transcranial magnetic stimulation (TMS) protocol used with these patients that is associated with long-term, improved naming post-TMS. In part 2, we present results from a case study with chronic nonfluent aphasia where TMS treatments were followed immediately by speech therapy (constraint-induced language therapy). In part 3, some possible mechanisms associated with improvement after a series of TMS treatments in stroke patients with aphasia are discussed. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  1. Transcranial Magnetic Stimulation and Aphasia Rehabilitation

    PubMed Central

    Naeser, Margaret A.; Martin, Paula I; Ho, Michael; Treglia, Ethan; Kaplan, Elina; Bhashir, Shahid; Pascual-Leone, Alvaro

    2013-01-01

    Repetitive transcranial magnetic stimulation (rTMS) has been reported to improve naming in chronic stroke patients with nonfluent aphasia since 2005. In Part 1, we review the rationale for applying slow, 1 Hz, rTMS to the undamaged right hemisphere in chronic nonfluent aphasia patients following a left hemisphere stroke; and present a TMS protocol used with these patients that is associated with long-term, improved naming post- TMS. In Part, 2 we present results from a case study with chronic nonfluent aphasia where TMS treatments were followed immediately by speech therapy (constraint-induced language therapy). In Part 3, some possible mechanisms associated with improvement following a series of TMS treatments in stroke patients with aphasia are discussed. PMID:22202188

  2. Psychosocial aspects of aphasia: whose perspectives?

    PubMed

    Parr, S

    2001-01-01

    This paper reviews some different meanings of the term 'psychosocial' and identifies the different ways in which the social and psychological sequelae of aphasia can be explored. These include qualitative methods, which seem well suited to addressing such complex issues. Having outlined some features of qualitative research, the paper describes a study in which fifty people talked about the consequences and significance of their long-term aphasia. Their 'insider perspective' on aphasia suggests its impacts are extensive, complex, direct and indirect, interconnected, systemic, dynamic and diversely experienced. The paper discusses the various implications of the study for clinicians and researchers concerned with the psychosocial aspects of aphasia and outlines how some of the issues raised in the interviews might be addressed.

  3. Language deviations in aphasia: a frequency analysis.

    PubMed

    Ardila, A; Rosselli, M

    1993-02-01

    Thirty right-handed left hemisphere-damaged patients were taken and divided into five groups (transcortical motor, Broca, conduction, Wernicke, and anomic aphasia). Language deviations were scored and analyzed for the Picture Description (Plate No. 1, The Cookie Theft), Repetition (Words, High and Low Probability Sentences), and Naming (Responsive Naming, Confrontation, and Body-part naming) subtests of the Boston Diagnostic Aphasia Examination--Spanish version (Goodglass & Kaplan, 1979). A classification of paraphasias is proposed. Language deviations were scores for the following groups: Literal paraphasias (phoneme omissions, additions, displacements, and substitutions), verbal paraphasias (formal, morphologic, semantic, and unrelated), syntagmatic paraphasias, circumlocutions (object description and instrumental function), indefinite anaphors, and neologisms. Frequency of different types of language deviations is presented in the five aphasia groups. It was found that some paraphasic errors appeared in several aphasia groups; others were characteristics of specific aphasic syndromes.

  4. Damage to the anterior arcuate fasciculus predicts non-fluent speech production in aphasia

    PubMed Central

    Guo, Dazhou; Fillmore, Paul; Holland, Audrey; Rorden, Chris

    2013-01-01

    Non-fluent aphasia implies a relatively straightforward neurological condition characterized by limited speech output. However, it is an umbrella term for different underlying impairments affecting speech production. Several studies have sought the critical lesion location that gives rise to non-fluent aphasia. The results have been mixed but typically implicate anterior cortical regions such as Broca’s area, the left anterior insula, and deep white matter regions. To provide a clearer picture of cortical damage in non-fluent aphasia, the current study examined brain damage that negatively influences speech fluency in patients with aphasia. It controlled for some basic speech and language comprehension factors in order to better isolate the contribution of different mechanisms to fluency, or its lack. Cortical damage was related to overall speech fluency, as estimated by clinical judgements using the Western Aphasia Battery speech fluency scale, diadochokinetic rate, rudimentary auditory language comprehension, and executive functioning (scores on a matrix reasoning test) in 64 patients with chronic left hemisphere stroke. A region of interest analysis that included brain regions typically implicated in speech and language processing revealed that non-fluency in aphasia is primarily predicted by damage to the anterior segment of the left arcuate fasciculus. An improved prediction model also included the left uncinate fasciculus, a white matter tract connecting the middle and anterior temporal lobe with frontal lobe regions, including the pars triangularis. Models that controlled for diadochokinetic rate, picture-word recognition, or executive functioning also revealed a strong relationship between anterior segment involvement and speech fluency. Whole brain analyses corroborated the findings from the region of interest analyses. An additional exploratory analysis revealed that involvement of the uncinate fasciculus adjudicated between Broca’s and global aphasia

  5. Damage to the anterior arcuate fasciculus predicts non-fluent speech production in aphasia.

    PubMed

    Fridriksson, Julius; Guo, Dazhou; Fillmore, Paul; Holland, Audrey; Rorden, Chris

    2013-11-01

    Non-fluent aphasia implies a relatively straightforward neurological condition characterized by limited speech output. However, it is an umbrella term for different underlying impairments affecting speech production. Several studies have sought the critical lesion location that gives rise to non-fluent aphasia. The results have been mixed but typically implicate anterior cortical regions such as Broca's area, the left anterior insula, and deep white matter regions. To provide a clearer picture of cortical damage in non-fluent aphasia, the current study examined brain damage that negatively influences speech fluency in patients with aphasia. It controlled for some basic speech and language comprehension factors in order to better isolate the contribution of different mechanisms to fluency, or its lack. Cortical damage was related to overall speech fluency, as estimated by clinical judgements using the Western Aphasia Battery speech fluency scale, diadochokinetic rate, rudimentary auditory language comprehension, and executive functioning (scores on a matrix reasoning test) in 64 patients with chronic left hemisphere stroke. A region of interest analysis that included brain regions typically implicated in speech and language processing revealed that non-fluency in aphasia is primarily predicted by damage to the anterior segment of the left arcuate fasciculus. An improved prediction model also included the left uncinate fasciculus, a white matter tract connecting the middle and anterior temporal lobe with frontal lobe regions, including the pars triangularis. Models that controlled for diadochokinetic rate, picture-word recognition, or executive functioning also revealed a strong relationship between anterior segment involvement and speech fluency. Whole brain analyses corroborated the findings from the region of interest analyses. An additional exploratory analysis revealed that involvement of the uncinate fasciculus adjudicated between Broca's and global aphasia

  6. Transcortical mixed aphasia with left frontoparietal lesions.

    PubMed

    Maeshima, S; Uematsu, Y; Terada, T; Nakai, K; Itakura, T; Komai, N

    1996-05-01

    We present a case of transcortical mixed aphasia following a left frontoparietal infarct caused by vasospasm after subarachnoid haemorrhage. Although CT showed low-density areas in the left frontal lobe and basal ganglia, single photon emission CT revealed a wider area of low perfusion over the entire left hemisphere, except for the left perisylvian speech areas. Hence, transcortical mixed aphasia may be caused by the isolation of perisylvian speech areas due to disconnection from surrounding areas.

  7. Acupuncture therapy on apoplectic aphasia rehabilitation.

    PubMed

    Sun, Youzhi; Xue, Steve An; Zuo, Zhengyun

    2012-09-01

    Acupuncture has often been used for aphasia rehabilitation in China. The purpose of this paper was to: 1) provide a historic overview of acupuncture for aphasia due to stroke; 2) summarize the commonly used acupuncture approaches; and 3) objectively comment on the effectiveness of acupuncture for the rehabilitation of this type of disorder. The Elsevier database and a Chinese database (CNKI) were searched through December, 2010 with the key words "aphasia, acupuncture" in English and Chinese, respectively. Case reports, uncontrolled clinical observations and controlled clinical trials were all included if acupuncture was the sole treatment or the main component of complex intervention for the rehabilitation of aphasia caused by cerebrovascular disease. More than 100 relevant articles were found. After analyzing these articles, we found that acupuncture for apoplectic aphasia most often included tongue, scalp, body and combination acupuncture. Tongue bleeding, deep insertion and strong stimulation were adopted by many practitioners. The ten most frequently used acupoints (or areas) were Lianquan (RN 23), Jinjin (EX-HN 12), Yuye (EX-HN 13), Tongli (HT 5), Fengchi (GB 20), Neiguan (PC 6), Baihui (DU 20), No. 1, 2 and 3 language sections, Sanyinjiao (SP 6) and Yamen (DU 15). Controlled clinical studies and a systematic literature review demonstrate that acupuncture has therapeutic effects on aphasia after stroke.

  8. Use of spatial communication in aphasia.

    PubMed

    Johnson, Sarah; Cocks, Naomi; Dipper, Lucy

    2013-01-01

    Spatial communication consists of both verbal spatial language and gesture. There has been minimal research investigating the use of spatial communication, and even less focussing on people with aphasia. The aims of this exploratory study were to describe the frequency and variability of spatial language and gesture use by three participants with aphasia in comparison to nine control participants. This included: 1) frequency of gestures; 2) types of gesture; 3) number of spatial descriptions described by gestures but no language; and 4) frequency and variety of locative prepositional, verb, and noun phrases. Each participant was videoed undertaking 11 spatial communication tasks: four description tasks, and seven tasks involving directing the researcher in the placement of objects or pictures. Gestures and language produced were transcribed and analysed. Participants with aphasia used significantly more gesture. Participants with aphasia also used more gesture without spoken phrases when spatial vocabulary was unavailable. Finally, there were differences between the participants with regards to the types of gesture that they used when they were unable to access language. The results suggest that the analysis of gesture produced by people with aphasia may provide insight into their underlying language impairment. As this was an exploratory study, with just three participants with aphasia, further research is needed. © 2013 Royal College of Speech and Language Therapists.

  9. AphasiaBank: Methods for Studying Discourse

    PubMed Central

    MacWhinney, Brian; Fromm, Davida; Forbes, Margaret; Holland, Audrey

    2011-01-01

    Background AphasiaBank is a computerized database of interviews between persons with aphasia (PWAs) and clinicians. By February 2011, the database had grown to include 145 PWAs and 126 controls from 12 sites across the United States. The data and related analysis programs are available free over the web. Aims The overall goal of AphasiaBank is the construction of a system for accumulating and sharing data on language usage by PWAs. To achieve this goal, we have developed a standard elicitation protocol and systematic automatic and manual methods for transcription, coding, and analysis. Methods & Procedures We present sample analyses of transcripts from the retelling of the Cinderella story. These analyses illustrate the application of our methods for the study of phonological, lexical, semantic, morphological, syntactic, temporal, prosodic, gestural, and discourse features. Main Contribution AphasiaBank will allow researchers access to a large, shared database that can facilitate hypothesis testing and increase methodological replicability, precision, and transparency. Conclusions AphasiaBank will provide researchers with an important new tool in the study of aphasia. PMID:22923879

  10. Computerized Script Training for Aphasia: Preliminary Results

    PubMed Central

    Cherney, Leora R.; Halper, Anita S.; Holland, Audrey L.; Cole, Ron

    2009-01-01

    Purpose This article describes computer software that was developed specifically for training conversational scripts and illustrates its use with three individuals with aphasia. Methods Three participants with chronic aphasia (Broca’s, Wernicke’s and anomic) were assessed before and after nine weeks of a computer script training program. For each participant, three individualized scripts were developed, recorded on the software, and practiced sequentially at home. Weekly meetings with the speech-language pathologist occurred to monitor practice and assess progress. Baseline and post-treatment scripts were audio-taped, transcribed, and compared to the target scripts for content, grammatical productivity and rate of production of script-related words. Interviews with the person with aphasia and their significant other were conducted at the conclusion of treatment. Results All measures (content, grammatical productivity and rate of production of script-related words) improved for each participant on every script. Two participants gained more than five points on the Aphasia Quotient of the Western Aphasia Battery. Five positive themes were consistently identified from the exit interviews - increased verbal communication, improvements in other modalities and situations, communication changes noticed by others, increased confidence, and satisfaction with the software. Conclusion Computer-based script training potentially may be an effective intervention for persons with chronic aphasia. PMID:18230811

  11. Fluent Aphasia in Telugu: A Case Comparison Study of Semantic Dementia and Stroke Aphasia

    ERIC Educational Resources Information Center

    Alladi, Suvarna; Mridula, Rukmini; Mekala, Shailaja; Rupela, Vani; Kaul, Subhash

    2010-01-01

    This study presents two cases with fluent aphasia in Telugu with semantic dementia and post-stroke fluent aphasia. Comparable scores were obtained on the conventional neuropsychological and language tests that were administered on the two cases. Both cases demonstrated fluent, grammatical and well-articulated speech with little content, impaired…

  12. Fluent Aphasia in Telugu: A Case Comparison Study of Semantic Dementia and Stroke Aphasia

    ERIC Educational Resources Information Center

    Alladi, Suvarna; Mridula, Rukmini; Mekala, Shailaja; Rupela, Vani; Kaul, Subhash

    2010-01-01

    This study presents two cases with fluent aphasia in Telugu with semantic dementia and post-stroke fluent aphasia. Comparable scores were obtained on the conventional neuropsychological and language tests that were administered on the two cases. Both cases demonstrated fluent, grammatical and well-articulated speech with little content, impaired…

  13. Verbal Description of Concrete Objects: A Method for Assessing Semantic Circumlocution in Persons With Aphasia.

    PubMed

    Antonucci, Sharon M; MacWilliam, Colleen

    2015-11-01

    We investigated from a theoretically motivated perspective what information differentiated sufficient from insufficient descriptions of objects provided by persons with aphasia. Twenty-one adults with aphasia consequent to single left-hemisphere stroke verbally described 9 living and 9 nonliving objects. Responses were scored for accuracy (i.e., sufficiency) and tallied for type and quantity of semantic feature information provided. Main effects and interactions were identified using repeated measures analyses of variance, with significant findings followed up with planned comparisons. Differences between correct and incorrect descriptions were identified with respect to both feature type and feature distinctiveness for living and nonliving items, in particular highlighting the importance of distinctive features in descriptions of both domains. These findings add to the relatively small body of literature investigating semantic feature processing in adults with aphasia. This is a critical gap to close when considered in light of the preponderance of semantically based treatments for word-retrieval impairment in stroke-aphasia. Our findings provide preliminary support for the notion that semantically guided treatments for word-retrieval impairment in stroke-aphasia may be geared toward increasing specificity of semantic circumlocution to increase semantic self-cueing and to improve communication of information to conversation partners.

  14. Verbal Description of Concrete Objects: A Method for Assessing Semantic Circumlocution in Persons With Aphasia

    PubMed Central

    MacWilliam, Colleen

    2015-01-01

    Purpose We investigated from a theoretically motivated perspective what information differentiated sufficient from insufficient descriptions of objects provided by persons with aphasia. Method Twenty-one adults with aphasia consequent to single left-hemisphere stroke verbally described 9 living and 9 nonliving objects. Responses were scored for accuracy (i.e., sufficiency) and tallied for type and quantity of semantic feature information provided. Main effects and interactions were identified using repeated measures analyses of variance, with significant findings followed up with planned comparisons. Results Differences between correct and incorrect descriptions were identified with respect to both feature type and feature distinctiveness for living and nonliving items, in particular highlighting the importance of distinctive features in descriptions of both domains. Conclusions These findings add to the relatively small body of literature investigating semantic feature processing in adults with aphasia. This is a critical gap to close when considered in light of the preponderance of semantically based treatments for word-retrieval impairment in stroke-aphasia. Our findings provide preliminary support for the notion that semantically guided treatments for word-retrieval impairment in stroke-aphasia may be geared toward increasing specificity of semantic circumlocution to increase semantic self-cueing and to improve communication of information to conversation partners. PMID:26381474

  15. Effects of Word Frequency and Modality on Sentence Comprehension Impairments in People with Aphasia

    PubMed Central

    DeDe, Gayle

    2014-01-01

    Purpose It is well known that people with aphasia have sentence comprehension impairments. The present study investigated whether lexical factors contribute to sentence comprehension impairments in both the auditory and written modalities using on-line measures of sentence processing. Methods People with aphasia and non-brain-damaged controls participated in the experiment (n=8 per group). Twenty-one sentence pairs containing high and low frequency words were presented in self-paced listening and reading tasks. The sentences were syntactically simple and differed only in the critical words. The dependent variables were response times for critical segments of the sentence and accuracy on the comprehension questions. Results The results showed that word frequency influences performance on measures of sentence comprehension in people with aphasia. The accuracy data on the comprehension questions suggested that people with aphasia have more difficulty understanding sentences containing low frequency words in the written compared to auditory modality. Both group and single case analyses of the response time data also pointed to more difficulty with reading than listening. Conclusions The results show that sentence comprehension in people with aphasia is influenced by word frequency and presentation modality. PMID:22294411

  16. Frontal dynamic aphasia in progressive supranuclear palsy: Distinguishing between generation and fluent sequencing of novel thoughts.

    PubMed

    Robinson, Gail A; Spooner, Donna; Harrison, William J

    2015-10-01

    Frontal dynamic aphasia is characterised by a profound reduction in spontaneous speech despite well-preserved naming, repetition and comprehension. Since Luria (1966, 1970) designated this term, two main forms of dynamic aphasia have been identified: one, a language-specific selection deficit at the level of word/sentence generation, associated with left inferior frontal lesions; and two, a domain-general impairment in generating multiple responses or connected speech, associated with more extensive bilateral frontal and/or frontostriatal damage. Both forms of dynamic aphasia have been interpreted as arising due to disturbances in early prelinguistic conceptual preparation mechanisms that are critical for language production. We investigate language-specific and domain-general accounts of dynamic aphasia and address two issues: one, whether deficits in multiple conceptual preparation mechanisms can co-occur; and two, the contribution of broader cognitive processes such as energization, the ability to initiate and sustain response generation over time, to language generation failure. Thus, we report patient WAL who presented with frontal dynamic aphasia in the context of progressive supranuclear palsy (PSP). WAL was given a series of experimental tests that showed that his dynamic aphasia was not underpinned by a language-specific deficit in selection or in microplanning. By contrast, WAL presented with a domain-general deficit in fluent sequencing of novel thoughts. The latter replicated the pattern documented in a previous PSP patient (Robinson, et al., 2006); however, unique to WAL, generating novel thoughts was impaired but there was no evidence of a sequencing deficit because perseveration was absent. Thus, WAL is the first unequivocal case to show a distinction between novel thought generation and subsequent fluent sequencing. Moreover, WAL's generation deficit encompassed verbal and non-verbal responses, showing a similar (but more profoundly reduced) pattern

  17. Conversation Therapy with People with Aphasia and Conversation Partners using Video Feedback: A Group and Case Series Investigation of Changes in Interaction.

    PubMed

    Best, Wendy; Maxim, Jane; Heilemann, Claudia; Beckley, Firle; Johnson, Fiona; Edwards, Susan I; Howard, David; Beeke, Suzanne

    2016-01-01

    Conversation therapies employing video for feedback and to facilitate outcome measurement are increasingly used with people with post-stroke aphasia and their conversation partners; however the evidence base for change in everyday interaction remains limited. We investigated the effect of Better Conversations with Aphasia (BCA), an intervention that is freely available online at https://extend.ucl.ac.uk/. Eight people with chronic agrammatic aphasia, and their regular conversation partners participated in the tailored 8 week program involving significant video feedback. We explored changes in: (i) conversation facilitators (such as multi-modal turns by people with aphasia); and (ii) conversation barriers (such as use of test questions by conversation partners). The outcome of intervention was evaluated directly by measuring change in video-recorded everyday conversations. The study employed a pre-post design with multiple 5 minute samples of conversation before and after intervention, scored by trained raters blind to the point of data collection. Group level analysis showed no significant increase in conversation facilitators. There was, however, a significant reduction in the number of conversation barriers. The case series data revealed variability in conversation behaviors across occasions for the same dyad and between different dyads. Specifically, post-intervention there was a significant increase in facilitator behaviors for two dyads, a decrease for one and no significant change for five dyads. There was a significant decrease in barrier behaviors for five dyads and no significant change for three dyads. The reduction in barrier behaviors was considerable; on average change from over eight to fewer than three barrier behaviors in 5 minutes of conversation. The pre-post design has the limitation of no comparison group. However, change occurs in targeted conversational behaviors and in people with chronic aphasia and their partners. The findings suggest

  18. Conversation Therapy with People with Aphasia and Conversation Partners using Video Feedback: A Group and Case Series Investigation of Changes in Interaction

    PubMed Central

    Best, Wendy; Maxim, Jane; Heilemann, Claudia; Beckley, Firle; Johnson, Fiona; Edwards, Susan I.; Howard, David; Beeke, Suzanne

    2016-01-01

    Conversation therapies employing video for feedback and to facilitate outcome measurement are increasingly used with people with post-stroke aphasia and their conversation partners; however the evidence base for change in everyday interaction remains limited. We investigated the effect of Better Conversations with Aphasia (BCA), an intervention that is freely available online at https://extend.ucl.ac.uk/. Eight people with chronic agrammatic aphasia, and their regular conversation partners participated in the tailored 8 week program involving significant video feedback. We explored changes in: (i) conversation facilitators (such as multi-modal turns by people with aphasia); and (ii) conversation barriers (such as use of test questions by conversation partners). The outcome of intervention was evaluated directly by measuring change in video-recorded everyday conversations. The study employed a pre-post design with multiple 5 minute samples of conversation before and after intervention, scored by trained raters blind to the point of data collection. Group level analysis showed no significant increase in conversation facilitators. There was, however, a significant reduction in the number of conversation barriers. The case series data revealed variability in conversation behaviors across occasions for the same dyad and between different dyads. Specifically, post-intervention there was a significant increase in facilitator behaviors for two dyads, a decrease for one and no significant change for five dyads. There was a significant decrease in barrier behaviors for five dyads and no significant change for three dyads. The reduction in barrier behaviors was considerable; on average change from over eight to fewer than three barrier behaviors in 5 minutes of conversation. The pre-post design has the limitation of no comparison group. However, change occurs in targeted conversational behaviors and in people with chronic aphasia and their partners. The findings suggest

  19. The Phonomotor Approach to Treating Phonological-Based Language Deficits in People with Aphasia

    ERIC Educational Resources Information Center

    Kendall, Diane L.; Nadeau, Stephen E.

    2016-01-01

    The phonomotor treatment program for treating word-retrieval deficits among people with aphasia is inspired by a parallel distributed processing model of lexical processing and is focused at the level of individual phonemes and phoneme sequences. Because verbal production of words involves the translation of a lexical-semantic representation into…

  20. The Phonomotor Approach to Treating Phonological-Based Language Deficits in People with Aphasia

    ERIC Educational Resources Information Center

    Kendall, Diane L.; Nadeau, Stephen E.

    2016-01-01

    The phonomotor treatment program for treating word-retrieval deficits among people with aphasia is inspired by a parallel distributed processing model of lexical processing and is focused at the level of individual phonemes and phoneme sequences. Because verbal production of words involves the translation of a lexical-semantic representation into…

  1. Treatment of Primary Progressive Aphasia

    PubMed Central

    Tippett, Donna C.; Hillis, Argye E.; Tsapkini, Kyrana

    2015-01-01

    Primary progressive aphasia (PPA) is a neurodegenerative disease that primarily affects language functions and often begins in the fifth or sixth decade of life. The devastating effects on work and home life call for the investigation of treatment alternatives. In this paper, we present a review of the literature on treatment approaches for this neurodegenerative disease. We also present new data from two intervention studies we have conducted, a behavioral one and a neuromodulatory one using transcranial direct current stimulation (tDCS) combined with written production intervention. We show that speech-language intervention improves language outcomes in individuals with PPA; and especially in the short term, tDCS augments generalization and maintenance of positive language outcomes. We also outline current issues and challenges in intervention approaches in PPA. PMID:26062526

  2. Anatomic, clinical, and neuropsychological correlates of spelling errors in primary progressive aphasia.

    PubMed

    Shim, Hyungsub; Hurley, Robert S; Rogalski, Emily; Mesulam, M-Marsel

    2012-07-01

    This study evaluates spelling errors in the three subtypes of primary progressive aphasia (PPA): agrammatic (PPA-G), logopenic (PPA-L), and semantic (PPA-S). Forty-one PPA patients and 36 age-matched healthy controls were administered a test of spelling. The total number of errors and types of errors in spelling to dictation of regular words, exception words and nonwords, were recorded. Error types were classified based on phonetic plausibility. In the first analysis, scores were evaluated by clinical diagnosis. Errors in spelling exception words and phonetically plausible errors were seen in PPA-S. Conversely, PPA-G was associated with errors in nonword spelling and phonetically implausible errors. In the next analysis, spelling scores were correlated to other neuropsychological language test scores. Significant correlations were found between exception word spelling and measures of naming and single word comprehension. Nonword spelling correlated with tests of grammar and repetition. Global language measures did not correlate significantly with spelling scores, however. Cortical thickness analysis based on MRI showed that atrophy in several language regions of interest were correlated with spelling errors. Atrophy in the left supramarginal gyrus and inferior frontal gyrus (IFG) pars orbitalis correlated with errors in nonword spelling, while thinning in the left temporal pole and fusiform gyrus correlated with errors in exception word spelling. Additionally, phonetically implausible errors in regular word spelling correlated with thinning in the left IFG pars triangularis and pars opercularis. Together, these findings suggest two independent systems for spelling to dictation, one phonetic (phoneme to grapheme conversion), and one lexical (whole word retrieval). Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Frontal White Matter Tracts Sustaining Speech Production in Primary Progressive Aphasia

    PubMed Central

    Caverzasi, Eduardo; Binney, Richard J.; Henry, Maya L.; Lobach, Iryna; Block, Nikolas; Amirbekian, Bagrat; Dronkers, Nina; Miller, Bruce L.; Henry, Roland G.; Gorno-Tempini, Maria Luisa

    2014-01-01

    In primary progressive aphasia (PPA), speech and language difficulties are caused by neurodegeneration of specific brain networks. In the nonfluent/agrammatic variant (nfvPPA), motor speech and grammatical deficits are associated with atrophy in a left fronto-insular-striatal network previously implicated in speech production. In vivo dissection of the crossing white matter (WM) tracts within this “speech production network” is complex and has rarely been performed in health or in PPA. We hypothesized that damage to these tracts would be specific to nfvPPA and would correlate with differential aspects of the patients' fluency abilities. We prospectively studied 25 PPA and 21 healthy individuals who underwent extensive cognitive testing and 3 T MRI. Using residual bootstrap Q-ball probabilistic tractography on high angular resolution diffusion-weighted imaging (HARDI), we reconstructed pathways connecting posterior inferior frontal, inferior premotor, insula, supplementary motor area (SMA) complex, striatum, and standard ventral and dorsal language pathways. We extracted tract-specific diffusion tensor imaging (DTI) metrics to assess changes across PPA variants and perform brain–behavioral correlations. Significant WM changes in the left intrafrontal and frontostriatal pathways were found in nfvPPA, but not in the semantic or logopenic variants. Correlations between tract-specific DTI metrics with cognitive scores confirmed the specific involvement of this anterior–dorsal network in fluency and suggested a preferential role of a posterior premotor-SMA pathway in motor speech. This study shows that left WM pathways connecting the speech production network are selectively damaged in nfvPPA and suggests that different tracts within this system are involved in subcomponents of fluency. These findings emphasize the emerging role of diffusion imaging in the differential diagnosis of neurodegenerative diseases. PMID:25031413

  4. Frontal white matter tracts sustaining speech production in primary progressive aphasia.

    PubMed

    Mandelli, Maria Luisa; Caverzasi, Eduardo; Binney, Richard J; Henry, Maya L; Lobach, Iryna; Block, Nikolas; Amirbekian, Bagrat; Dronkers, Nina; Miller, Bruce L; Henry, Roland G; Gorno-Tempini, Maria Luisa

    2014-07-16

    In primary progressive aphasia (PPA), speech and language difficulties are caused by neurodegeneration of specific brain networks. In the nonfluent/agrammatic variant (nfvPPA), motor speech and grammatical deficits are associated with atrophy in a left fronto-insular-striatal network previously implicated in speech production. In vivo dissection of the crossing white matter (WM) tracts within this "speech production network" is complex and has rarely been performed in health or in PPA. We hypothesized that damage to these tracts would be specific to nfvPPA and would correlate with differential aspects of the patients' fluency abilities. We prospectively studied 25 PPA and 21 healthy individuals who underwent extensive cognitive testing and 3 T MRI. Using residual bootstrap Q-ball probabilistic tractography on high angular resolution diffusion-weighted imaging (HARDI), we reconstructed pathways connecting posterior inferior frontal, inferior premotor, insula, supplementary motor area (SMA) complex, striatum, and standard ventral and dorsal language pathways. We extracted tract-specific diffusion tensor imaging (DTI) metrics to assess changes across PPA variants and perform brain-behavioral correlations. Significant WM changes in the left intrafrontal and frontostriatal pathways were found in nfvPPA, but not in the semantic or logopenic variants. Correlations between tract-specific DTI metrics with cognitive scores confirmed the specific involvement of this anterior-dorsal network in fluency and suggested a preferential role of a posterior premotor-SMA pathway in motor speech. This study shows that left WM pathways connecting the speech production network are selectively damaged in nfvPPA and suggests that different tracts within this system are involved in subcomponents of fluency. These findings emphasize the emerging role of diffusion imaging in the differential diagnosis of neurodegenerative diseases.

  5. Anatomic, clinical, and neuropsychological correlates of spelling errors in Primary Progressive Aphasia

    PubMed Central

    Shim, HyungSub; Hurley, Robert S.; Rogalski, Emily; Mesulam, M.-Marsel

    2012-01-01

    This study evaluates spelling errors in the three subtypes of primary progressive aphasia (PPA): agrammatic (PPA-G), logopenic (PPA-L), and semantic (PPA-S). Forty one PPA-patients and 36 age-matched healthy controls were administered a test of spelling. The total number of errors and types of errors in spelling to dictation of regular words, exception words and nonwords, were recorded. Error types were classified based on phonetic plausibility. In the first analysis, scores were evaluated by clinical diagnosis. Errors in spelling exception words and phonetically plausible errors were seen in PPA-S. Conversely, PPA-G was associated with errors in nonword spelling and phonetically implausible errors. In the next analysis, spelling scores were correlated to other neuropsychological language test scores. Significant correlations were found between exception word spelling and measures of naming and single word comprehension. Nonword spelling correlated with tests of grammar and repetition. Global language measures did not correlate significantly with spelling scores, however. Cortical thickness analysis based on MRI showed that atrophy in several language regions of interest were correlated with spelling errors. Atrophy in the left supramarginal gyrus and inferior frontal gyrus (IFG) pars orbitalis correlated with errors in nonword spelling, while thinning in the left temporal pole and fusiform gyrus correlated with errors in exception word spelling. Additionally, phonetically implausible errors in regular word spelling correlated with thinning in the left IFG pars triangularis and pars opercularis. Together, these findings suggest two independent systems for spelling to dictation, one phonetic (phoneme to grapheme conversion), and one lexical (whole word retrieval). PMID:22579708

  6. Phonological Therapy in Jargon Aphasia: Effects on Naming and Neologisms

    ERIC Educational Resources Information Center

    Bose, Arpita

    2013-01-01

    Background: Jargon aphasia is one of the most intractable forms of aphasia with limited recommendation on amelioration of associated naming difficulties and neologisms. The few naming therapy studies that exist in jargon aphasia have utilized either semantic or phonological approaches, but the results have been equivocal. Moreover, the effect of…

  7. The Role of the Arcuate Fasciculus in Conduction Aphasia

    ERIC Educational Resources Information Center

    Bernal, Byron; Ardila, Alfredo

    2009-01-01

    In aphasia literature, it has been considered that a speech repetition defect represents the main constituent of conduction aphasia. Conduction aphasia has frequently been interpreted as a language impairment due to lesions of the arcuate fasciculus (AF) that disconnect receptive language areas from expressive ones. Modern neuroradiological…

  8. Progressive Non-Fluent Aphasia in Malayalam: A Case Study

    ERIC Educational Resources Information Center

    George, Annamma; Mathuranath, P. S.

    2010-01-01

    Primary Progressive Aphasia (PPA) is a degenerative condition characterized by deterioration in language for at least two years without deterioration in other cognitive domains. This report highlights the language profile in a 79-year-old male with progressive nonfluent aphasia (PNFA) who was assessed using the Western Aphasia Battery and the…

  9. The Role of the Arcuate Fasciculus in Conduction Aphasia

    ERIC Educational Resources Information Center

    Bernal, Byron; Ardila, Alfredo

    2009-01-01

    In aphasia literature, it has been considered that a speech repetition defect represents the main constituent of conduction aphasia. Conduction aphasia has frequently been interpreted as a language impairment due to lesions of the arcuate fasciculus (AF) that disconnect receptive language areas from expressive ones. Modern neuroradiological…

  10. Phonological Therapy in Jargon Aphasia: Effects on Naming and Neologisms

    ERIC Educational Resources Information Center

    Bose, Arpita

    2013-01-01

    Background: Jargon aphasia is one of the most intractable forms of aphasia with limited recommendation on amelioration of associated naming difficulties and neologisms. The few naming therapy studies that exist in jargon aphasia have utilized either semantic or phonological approaches, but the results have been equivocal. Moreover, the effect of…

  11. Non-invasive Brain Stimulation in the Treatment of Post-stroke and Neurodegenerative Aphasia: Parallels, Differences, and Lessons Learned

    PubMed Central

    Norise, Catherine; Hamilton, Roy H.

    2017-01-01

    Numerous studies over the span of more than a decade have shown that non-invasive brain stimulation (NIBS) techniques, namely transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), can facilitate language recovery for patients who have suffered from aphasia due to stroke. While stroke is the most common etiology of aphasia, neurodegenerative causes of language impairment—collectively termed primary progressive aphasia (PPA)—are increasingly being recognized as important clinical phenotypes in dementia. Very limited data now suggest that (NIBS) may have some benefit in treating PPAs. However, before applying the same approaches to patients with PPA as have previously been pursued in patients with post-stroke aphasia, it will be important for investigators to consider key similarities and differences between these aphasia etiologies that is likely to inform successful approaches to stimulation. While both post-stroke aphasia and the PPAs have clear overlaps in their clinical phenomenology, the mechanisms of injury and theorized neuroplastic changes associated with the two etiologies are notably different. Importantly, theories of plasticity in post-stroke aphasia are largely predicated on the notion that regions of the brain that had previously been uninvolved in language processing may take on new compensatory roles. PPAs, however, are characterized by slow distributed degeneration of cellular units within the language system; compensatory recruitment of brain regions to subserve language is not currently understood to be an important aspect of the condition. This review will survey differences in the mechanisms of language representation between the two etiologies of aphasia and evaluate properties that may define and limit the success of different neuromodulation approaches for these two disorders. PMID:28167904

  12. Aphasia

    MedlinePlus

    ... communicating, such as gestures, pictures, or use of electronic devices. Individual therapy focuses on the specific needs of ... The use of speech-generating applications on mobile devices like tablets ... activities, such as book clubs, technology groups, and art and drama clubs. ...

  13. An aphasia mentoring program: perspectives of speech-language pathology students and of mentors with aphasia.

    PubMed

    Purves, Barbara A; Petersen, Jill; Puurveen, Gloria

    2013-05-01

    In contrast to clinician-as-expert models, social models of clinical practice typically acknowledge people with aphasia as equal partners in intervention. Given this, there may be a place within speech-language pathology education for programs situating people with aphasia as experts. This paper describes an aphasia mentoring program that was implemented as part of a speech-language pathology graduate program. Qualitative research methods with thematic analysis of interviews, focus groups, questionnaires, and participant observation were used to develop a description of the mentoring program, including the experiences and perspectives of the participants-both mentors (people with chronic aphasia) and students. Five themes, including getting better, aphasia advocacy, group as versus for therapy, we're a team, and focus on mentoring, emerged from the mentors' data. Five themes, including shifting the power dynamic, getting to know the person, seeing members as mentors, making classroom learning real, and connecting with a community, emerged from the students' data. There were significant overlaps and intersections between the 2 data sets. Findings revealed how an aphasia mentoring program that positions people with aphasia as experts can make a significant contribution to student education while supporting mentors' own goals, with implications for improved quality of life.

  14. [Aphasia and related impairments pertaining to FTLD].

    PubMed

    Otsuki, Mika

    2012-01-01

    FTLD consists of three clinical types: behavioural variant FTD, progressive non-fluent aphasia (PNFA) and semantic dementia (SD). The latter two types manifest aphasia. Thus, it is quite important to pertinently assess the symptoms of aphasia and related impairments for diagnosis of FTLD. The most important point for diagnosis of PNFA is existence of anarthria/apraxia of speech, which is a focal symptom of the left prefrontal gyrus and underlying white matter. With the progression of the disease word generation and comprehension is deteriorating. SD shows Gogi aphasia when the lesion have predilection of left temporal lober atrophy. We investigated 28 patients without any antecedents causing speech/language impairments, who developed primary progressive aphasia. All the patients underwent a routine neurological and neuropsychological examinations and related symptoms such as orofacial apraxia, frontal lobe signs, dysphasia and so on were assessed. The results indicated that 20 patients were diagnosed as PNFA, and they were subdivided into three clinical groups. One group developed naming impairment and orofacial apraxia in several years after onset, and followed with various frontal symptoms. Another group showed anterior opereculum syndromes within two years after onset. The third group retained pure anarthria/apraxia of speech for many years without any other symptoms.

  15. Passive imaging technology in aphasia therapy.

    PubMed

    Burke, Kiernan; Franklin, Sue; Gowan, Olive

    2011-10-01

    We describe a brief pilot study undertaken to investigate the potential benefit(s) of using a SenseCam in aphasia therapy. Five post-stroke persons with aphasia and their caregivers agreed to participate. Each person with aphasia wore the SenseCam for 1 day during the daytime. Slide shows and printed images were created from the images obtained and presented at a (videotaped) weekly group conversation session. Therapists' observations, reflections, and opinions were subsequently elicited in a group interview and online survey. Wearable, sensor-triggered automatic imaging devices offer potential advantages over both conventional cameras and generic pictures when used in aphasia therapy. We identified three advantages of a SenseCam over conventional imaging methods: Images can be acquired without the presence of the researcher, no action is required by the wearer for image acquisition and the continuous point of view is that of the wearer. Acquired images are of personal relevance to the wearer and may have greater efficacy for the person with aphasia in aiding conversation, and for the speech language therapist in setting functional language goals.

  16. Personal narratives in aphasia: understanding narrative competence.

    PubMed

    Ulatowska, Hanna K; Reyes, Belinda; Santos, Tricia Olea; Garst, Diane; Vernon, Jessica; McArthur, Julia

    2013-01-01

    Personal narratives have been suggested as a way for persons post stroke to re-establish their identity. To relate tellable personal stories, narrative competence - along with its building blocks - is essential. The objective of this study was to describe narrative competence in persons with mild to moderate aphasia. It addressed the areas of coherence, clarity, temporal-causal structure, and reference in narratives. The study also examined the strategies used (evaluative language) as well as the topics and themes in personal narratives. Sixteen individuals with mild to moderate aphasia were asked to relate the story of their stroke and stories of a memorable and a frightening experience. Stories were elicited using a "willing listener" procedure. Responses were analyzed quantitatively in terms of the number of propositions and the instances of temporal-causal sequences, reference, and evaluation. Qualitative analysis was performed to determine the overall coherence and clarity of the narratives. Narrative competence was present in the majority of participants. Although difficulties with reference were observed, high ratings of narrative coherence and clarity were attributed to sufficient amount of language, preserved temporal-causal sequencing, and the use of strategies (evaluative language). Narrative competence was exhibited in the personal narratives of individuals with mild to moderate aphasia. In addition to pinpointing essential elements of narrative competence, the use of personal narratives was deemed beneficial for both the clinician, by providing a better understanding of the individual with aphasia, and the individual with aphasia, by providing opportunities for self-disclosure.

  17. Living with aphasia: three Indigenous Australian stories.

    PubMed

    Armstrong, Elizabeth; Hersh, Deborah; Hayward, Colleen; Fraser, Joan; Brown, Melita

    2012-06-01

    The incidence of cardiovascular disorders and stroke in Australian Aboriginal communities is more than twice as high as non-Indigenous Australians. Approximately 30% of people who survive stroke are left with some level of aphasia, and yet Indigenous Australians appear to be infrequent users of speech-language pathology services, and there is virtually no research literature about the experiences of aphasia for this group of people. This paper presents the stories of living with aphasia for three Indigenous Australian men living in Perth, Western Australia. Their narratives were collected by an Indigenous researcher through in-depth, supported interviews, and were explored using both within-case and cross-case analyses for common and recurring themes. It is argued that there is value for speech-language pathologists, and other health professionals, to be aware of the broad experiences of living with aphasia for Indigenous Australians because their stories are rarely heard and because, as with people with aphasia generally, they are at risk of social isolation and tend to lack visibility in the community. This study explores the key issues which emerge for these three men and highlights the need for further research in this area.

  18. Treatment of poststroke aphasia: current practice and new directions.

    PubMed

    Fama, Mackenzie E; Turkeltaub, Peter E

    2014-11-01

    Aphasia is an acquired neurologic disorder that impairs an individual's ability to use and/or understand language. It commonly occurs after stroke or other injury to the brain's language network. The authors present the current methods of diagnosis and treatment of aphasia. They include a review of the evidence for the benefits of speech-language therapy, the most widespread approach to aphasia treatment, and a discussion of newer interventions such as medication and brain stimulation. These methods hold much promise for improving patient outcomes in aphasia; however, additional research regarding the best approaches to aphasia treatment will greatly improve our clinical approach.

  19. What makes a therapy? Some parameters of therapeutic intervention in aphasia.

    PubMed

    Byng, S; Black, M

    1995-01-01

    It has often been assumed that detailed analyses of aphasic impairments would be both necessary and sufficient for the development of remediation programmes. In this paper, we argue that the analysis of the impairment is a necessary but not sufficient precondition for therapy. Adequate remediation programmes require the development of an independent theory of therapy that provides a detailed specification of the different components of the therapeutic process. Therapy can be shown to have as many interacting components as the impairment itself. In this paper, we try to identify some of the components of the therapy process by comparing different therapy programmes that have been employed in the remediation of 'mapping deficits' in agrammatism.

  20. Word-Category Violations in Patients with Broca's Aphasia: An ERP Study

    ERIC Educational Resources Information Center

    Wassenaar, Marlies; Hagoort, Peter

    2005-01-01

    An event-related brain potential experiment was carried out to investigate on-line syntactic processing in patients with Broca's aphasia. Subjects were visually presented with sentences that were either syntactically correct or contained violations of word-category. Three groups of subjects were tested: Broca patients (N=11), non-aphasic patients…

  1. Treating Verbs in Aphasia: Exploring the Impact of Therapy at the Single Word and Sentence Levels

    ERIC Educational Resources Information Center

    Webster, Janet; Whitworth, Anne

    2012-01-01

    Background: In recent years there has been significant interest in the differential processing of nouns and verbs in people with aphasia, but more limited consideration about whether the differences have implications for therapy. It remains unclear whether verbs can be treated in a similar way to nouns or should be treated using approaches that…

  2. The Effects of Modified Melodic Intonation Therapy on Nonfluent Aphasia: A Pilot Study

    ERIC Educational Resources Information Center

    Conklyn, Dwyer; Novak, Eric; Boissy, Adrienne; Bethoux, Francois; Chemali, Kamal

    2012-01-01

    Objective: Positive results have been reported with melodic intonation therapy (MIT) in nonfluent aphasia patients with damage to their left-brain speech processes, using the patient's intact ability to sing to promote functional language. This pilot study sought to determine the immediate effects of introducing modified melodic intonation therapy…

  3. Jean-Martin Charcot's Role in the 19th Century Study of Music Aphasia

    ERIC Educational Resources Information Center

    Johnson, Julene K.; Lorch, Marjorie; Nicolas, Serge; Graziano, Amy

    2013-01-01

    Jean-Martin Charcot (1825-93) was a well-known French neurologist. Although he is widely recognized for his discovery of several neurological disorders and his research into aphasia, Charcot's ideas about how the brain processes music are less well known. Charcot discussed the music abilities of several patients in the context of his "Friday…

  4. A Novel Pupillometric Method for Indexing Word Difficulty in Individuals with and without Aphasia

    ERIC Educational Resources Information Center

    Chapman, Laura R.; Hallowell, Brooke

    2015-01-01

    Purpose: Cognitive effort is a clinically important facet of linguistic processing that is often overlooked in the assessment and treatment of people with aphasia (PWA). Furthermore, there is a paucity of valid ways to index cognitive effort in PWA. The construct of cognitive effort has been indexed for decades via pupillometry (measurement of…

  5. Jean-Martin Charcot's Role in the 19th Century Study of Music Aphasia

    ERIC Educational Resources Information Center

    Johnson, Julene K.; Lorch, Marjorie; Nicolas, Serge; Graziano, Amy

    2013-01-01

    Jean-Martin Charcot (1825-93) was a well-known French neurologist. Although he is widely recognized for his discovery of several neurological disorders and his research into aphasia, Charcot's ideas about how the brain processes music are less well known. Charcot discussed the music abilities of several patients in the context of his "Friday…

  6. A Novel Pupillometric Method for Indexing Word Difficulty in Individuals with and without Aphasia

    ERIC Educational Resources Information Center

    Chapman, Laura R.; Hallowell, Brooke

    2015-01-01

    Purpose: Cognitive effort is a clinically important facet of linguistic processing that is often overlooked in the assessment and treatment of people with aphasia (PWA). Furthermore, there is a paucity of valid ways to index cognitive effort in PWA. The construct of cognitive effort has been indexed for decades via pupillometry (measurement of…

  7. The Effects of Modified Melodic Intonation Therapy on Nonfluent Aphasia: A Pilot Study

    ERIC Educational Resources Information Center

    Conklyn, Dwyer; Novak, Eric; Boissy, Adrienne; Bethoux, Francois; Chemali, Kamal

    2012-01-01

    Objective: Positive results have been reported with melodic intonation therapy (MIT) in nonfluent aphasia patients with damage to their left-brain speech processes, using the patient's intact ability to sing to promote functional language. This pilot study sought to determine the immediate effects of introducing modified melodic intonation therapy…

  8. The relationship between novel word learning and anomia treatment success in adults with chronic aphasia.

    PubMed

    Dignam, Jade; Copland, David; Rawlings, Alicia; O'Brien, Kate; Burfein, Penni; Rodriguez, Amy D

    2016-01-29

    Learning capacity may influence an individual's response to aphasia rehabilitation. However, investigations into the relationship between novel word learning ability and response to anomia therapy are lacking. The aim of the present study was to evaluate the novel word learning ability in post-stroke aphasia and to establish the relationship between learning ability and anomia treatment outcomes. We also explored the influence of locus of language breakdown on novel word learning ability and anomia treatment response. 30 adults (6F; 24M) with chronic, post-stroke aphasia were recruited to the study. Prior to treatment, participants underwent an assessment of language, which included the Comprehensive Aphasia Test and three baseline confrontation naming probes in order to develop sets of treated and untreated items. We also administered the novel word learning paradigm, in which participants learnt novel names associated with unfamiliar objects and were immediately tested on recall (expressive) and recognition (receptive) tasks. Participants completed 48 h of Aphasia Language Impairment and Functioning Therapy (Aphasia LIFT) over a 3 week (intensive) or 8 week (distributed) schedule. Therapy primarily targeted the remediation of word retrieval deficits, so naming of treated and untreated items immediately post-therapy and at 1 month follow-up was used to determine therapeutic response. Performance on recall and recognition tasks demonstrated that participants were able to learn novel words; however, performance was variable and was influenced by participants' aphasia severity, lexical-semantic processing and locus of language breakdown. Novel word learning performance was significantly correlated with participants' response to therapy for treated items at post-therapy. In contrast, participants' novel word learning performance was not correlated with therapy gains for treated items at 1 month follow-up or for untreated items at either time point. Therapy intensity

  9. Aphasia therapy on a neuroscience basis

    PubMed Central

    Pulvermüller, Friedemann; Berthier, Marcelo L.

    2008-01-01

    Background Brain research has documented that the cortical mechanisms for language and action are tightly interwoven and, concurrently, new approaches to language therapy in neurological patients are being developed that implement language training in the context of relevant linguistic and non-linguistic actions, therefore taking advantage of the mutual connections of language and action systems in the brain. A further well-known neuroscience principle is that learning at the neuronal level is driven by correlation; consequently, new approaches to language therapy emphasise massed practice in a short time, thus maximising therapy quantity and frequency and, therefore, correlation at the behavioural and neuronal levels. Learned non-use of unsuccessful actions plays a major role in the chronification of neurological deficits, and behavioural approaches to therapy have therefore employed shaping and other learning techniques to counteract such non-use. Aims Advances in theoretical and experimental neuroscience have important implications for clinical practice. We exemplify this in the domain of aphasia rehabilitation. Main Contribution Whereas classical wisdom had been that aphasia cannot be significantly improved at a chronic stage, we here review evidence that one type of intensive language-action therapy (ILAT)—constraint-induced aphasia therapy—led to significant improvement of language performance in patients with chronic aphasia. We discuss perspectives for further improving speech-language therapy, including drug treatment that may be particularly fruitful when applied in conjunction with behavioural treatment. In a final section we highlight intensive and rapid therapy studies in chronic aphasia as a unique tool for exploring the cortical reorganisation of language. Conclusions We conclude that intensive language action therapy is an efficient tool for improving language functions even at chronic stages of aphasia. Therapy studies using this technique can

  10. Vocabulary acquisition in aphasia: Modality can matter

    PubMed Central

    Tuomiranta, Leena; Grönroos, Ann-Mari; Martin, Nadine; Laine, Matti

    2014-01-01

    The present case study investigated modality-specific aspects of novel word acquisition in aphasia. It was prompted by recent aphasia case studies indicating great interindividual variability in the ability to learn and maintain novel words in aphasia. Moreover, two previous case studies revealed a striking effect of input modality by showing effective word learning and re-learning via visual input only (Kohen, Sola, Tuomiranta, Laine, & Martin, 2012; Tuomiranta et al., 2014). The present participant TS with chronic nonfluent aphasia and post-semantic anomia was administered novel word–referent learning tasks. In the first experiment, the learning phase included simultaneous phonological and orthographic input, while the follow-up was probed separately for spoken and written responses. In the second experiment, we studied the effect of four different input and output modality combinations on her ability to learn to name the novel items. In the first experiment, TS’s spoken naming performance during the learning phase was just within the range of healthy controls. Maintenance declined and remained outside that range during the whole 6-month follow-up. However, TS maintained the learned words better in written than in spoken naming throughout the follow-up, and in written naming, her maintenance stayed within the control’s range up to 8 weeks post-training. The second experiment indicated that the best learning outcome was achieved with orthographic input. Orthographic input combined with orthographic output resulted in fast and accurate learning of the novel words. Interestingly, TS’s test profile was opposite to her learning profile, as she repeated better than she read aloud in the linguistic background assessment. The results from the present case highlight the importance of multiple learning channels for word acquisition in individuals with aphasia. Probing the functionality of different input and output channels for learning may also prove valuable in

  11. Vocabulary acquisition in aphasia: Modality can matter.

    PubMed

    Tuomiranta, Leena; Grönroos, Ann-Mari; Martin, Nadine; Laine, Matti

    2014-11-01

    The present case study investigated modality-specific aspects of novel word acquisition in aphasia. It was prompted by recent aphasia case studies indicating great interindividual variability in the ability to learn and maintain novel words in aphasia. Moreover, two previous case studies revealed a striking effect of input modality by showing effective word learning and re-learning via visual input only (Kohen, Sola, Tuomiranta, Laine, & Martin, 2012; Tuomiranta et al., 2014). The present participant TS with chronic nonfluent aphasia and post-semantic anomia was administered novel word-referent learning tasks. In the first experiment, the learning phase included simultaneous phonological and orthographic input, while the follow-up was probed separately for spoken and written responses. In the second experiment, we studied the effect of four different input and output modality combinations on her ability to learn to name the novel items. In the first experiment, TS's spoken naming performance during the learning phase was just within the range of healthy controls. Maintenance declined and remained outside that range during the whole 6-month follow-up. However, TS maintained the learned words better in written than in spoken naming throughout the follow-up, and in written naming, her maintenance stayed within the control's range up to 8 weeks post-training. The second experiment indicated that the best learning outcome was achieved with orthographic input. Orthographic input combined with orthographic output resulted in fast and accurate learning of the novel words. Interestingly, TS's test profile was opposite to her learning profile, as she repeated better than she read aloud in the linguistic background assessment. The results from the present case highlight the importance of multiple learning channels for word acquisition in individuals with aphasia. Probing the functionality of different input and output channels for learning may also prove valuable in tailoring

  12. Shared neural substrates of apraxia and aphasia.

    PubMed

    Goldenberg, Georg; Randerath, Jennifer

    2015-08-01

    Apraxia is regularly associated with aphasia, but there is controversy whether their co-occurrence is the expression of a common basic deficit or results from anatomical proximity of their neural substrates. However, neither aphasia nor apraxia is an indivisible entity. Both diagnoses embrace diverse manifestations that may occur more or less independently from each other. Thus, the question whether apraxia is always accompanied by aphasia may lead to conflicting answers depending on which of their manifestations are considered. We used voxel based lesion symptom mapping (VLSM) for exploring communalities between lesion sites associated with aphasia and with apraxia. Linguistic impairment was assessed by the Aachen Aphasia Test (AAT) subtests naming, comprehension, repetition, written language, and Token Test. Apraxia was examined for imitation of meaningless hand and finger postures and for pantomime of tool use. There were two areas of overlap between aphasia and apraxia. Lesions in the anterior temporal lobe interfered with pantomime of tool use and with all linguistic tests. In the left inferior parietal lobe there was a large area where lesions were associated with defective imitation of hand postures and with poor scores on written language and the Token Test. Within this large area there were also two spots in supramarginal and angular gyrus where lesions were also associated with defective pantomime. We speculate that the coincidence of language impairment and defective pantomime after anterior temporal lesions is due to impaired access to semantic memory. The combination of defective imitation of hand postures with poor scores on Token Test and written language is not easily compatible with a crucial role of parietal regions for the conversion of concepts of intended actions into motor commands. It accords better with a role of left inferior parietal lobe regions for the categorical perception of spatial relationships.

  13. A theoretical account of lexical and semantic naming deficits in bilingual aphasia

    PubMed Central

    Gray, Teresa; Kiran, Swathi

    2013-01-01

    Purpose The purpose of this study is to examine pre-morbid language proficiency and lexical and semantic processing deficits in bilingual aphasia and develop a theoretical account of bilingual language processing. Method Nineteen Spanish-English patients with bilingual aphasia completed a language use questionnaire (LUQ) and were administered Spanish and English standardized language assessments. We analyzed the data to (a) identify patterns of lexical and semantic processing deficits in bilingual aphasia and conceptualize a theoretical framework that accounts for language deficits, (b) determine LUQ measures that predict post-stroke language deficits, and (c) evaluate the relationship between predictive LUQ measures and post-stroke language deficits in order to identify impairment patterns. Results Based on results we obtained significant correlations on several measures between language input and output. We identified pre-stroke language ability rating as the strongest predictor of post-stroke outcomes. Based on this data, two distinct groups were identified: patients who lost the same amount of language in Spanish and English and patients who lost different amounts of Spanish and English. Conclusions Our findings suggest it is possible to identify relationships between language patterns and deficits in patients with bilingual aphasia and that these trends will be instrumental in clinical assessments of this understudied population. PMID:23816660

  14. Lost in translation? Issues of content validity in interpreter-mediated aphasia assessments.

    PubMed

    Roger, Peter; Code, Chris

    2011-02-01

    In many parts of the world, speech-language pathologists (SLPs) are frequently called upon to assess aphasia in bilingual speakers, or in speakers of languages of which they have little or no knowledge. One of the strategies that SLPs employ in these situations is to involve an interpreter in the assessment process. Three authentic interpreter-mediated aphasia assessments were analysed for the present study, which aimed to determine the degree to which the content validity of the individual tests was compromised in the process of their administration through an interpreter. Findings reveal that content validity was frequently weakened either at the point of administration of the test or at the point at which responses were reported back by the interpreter to the SLP. Based on these findings, it is argued that the conduct of interpreter-mediated aphasia assessments needs to be fundamentally re-thought to take account of the limitations inherent in the interpreting process. To this end, this study presents a number of practical recommendations for the involvement of interpreters in aphasia assessments, with a view to making optimal use of existing assessment materials and enhancing the quality of diagnostic information to emerge from such clinical sessions.

  15. Automated MRI-based classification of primary progressive aphasia variants

    PubMed Central

    Wilson, Stephen M.; Ogar, Jennifer M.; Laluz, Victor; Growdon, Matthew; Jang, Jung; Glenn, Shenly; Miller, Bruce L.; Weiner, Michael W.; Gorno-Tempini, Maria Luisa

    2009-01-01

    Degeneration of language regions in the dominant hemisphere can result in primary progressive aphasia (PPA), a clinical syndrome characterized by progressive deficits in speech and/or language function. Recent studies have identified three variants of PPA: progressive non-fluent aphasia (PNFA), semantic dementia (SD) and logopenic progressive aphasia (LPA). Each variant is associated with characteristic linguistic features, distinct patterns of brain atrophy, and different likelihoods of particular underlying pathogenic processes, which makes correct differential diagnosis highly clinically relevant. Evaluation of linguistic behavior can be challenging for non-specialists, and neuroimaging findings in single subjects are often difficult to evaluate by eye. We investigated the utility of automated structural MR image analysis to discriminate PPA variants (N=86) from each other and from normal controls (N=115). T1 images were preprocessed to obtain modulated grey matter (GM) images. Feature selection was performed with principal components analysis (PCA) on GM images as well as images of lateralized atrophy. PC coefficients were classified with linear support vector machines, and a cross-validation scheme was used to obtain accuracy rates for generalization to novel cases. The overall mean accuracy in discriminating between pairs of groups was 92.2%. For one pair of groups, PNFA and SD, we also investigated the utility of including several linguistic variables as features. Models with both imaging and linguistic features performed better than models with only imaging or only linguistic features. These results suggest that automated methods could assist in the differential diagnosis of PPA variants, enabling therapies to be targeted to likely underlying etiologies. PMID:19501654

  16. Where language meets meaningful action: a combined behavior and lesion analysis of aphasia and apraxia.

    PubMed

    Weiss, Peter H; Ubben, Simon D; Kaesberg, Stephanie; Kalbe, Elke; Kessler, Josef; Liebig, Thomas; Fink, Gereon R

    2016-01-01

    It is debated how language and praxis are co-represented in the left hemisphere (LH). As voxel-based lesion-symptom mapping in LH stroke patients with aphasia and/or apraxia may contribute to this debate, we here investigated the relationship between language and praxis deficits at the behavioral and lesion levels in 50 sub-acute stroke patients. We hypothesized that language and (meaningful) action are linked via semantic processing in Broca's region. Behaviorally, half of the patients suffered from co-morbid aphasia and apraxia. While 24% (n = 12) of all patients exhibited aphasia without apraxia, apraxia without aphasia was rare (n = 2, 4%). Left inferior frontal, insular, inferior parietal, and superior temporal lesions were specifically associated with deficits in naming, reading, writing, or auditory comprehension. In contrast, lesions affecting the left inferior frontal gyrus, premotor cortex, and the central region as well as the inferior parietal lobe were associated with apraxic deficits (i.e., pantomime, imitation of meaningful and meaningless gestures). Thus, contrary to the predictions of the embodied cognition theory, lesions to sensorimotor and premotor areas were associated with the severity of praxis but not language deficits. Lesions of Brodmann area (BA) 44 led to combined apraxic and aphasic deficits. Data suggest that BA 44 acts as an interface between language and (meaningful) action thereby supporting parcellation schemes (based on connectivity and receptor mapping) which revealed a BA 44 sub-area involved in semantic processing.

  17. Connected speech production in three variants of primary progressive aphasia

    PubMed Central

    Henry, Maya L.; Besbris, Max; Ogar, Jennifer M.; Dronkers, Nina F.; Jarrold, William; Miller, Bruce L.; Gorno-Tempini, Maria Luisa

    2010-01-01

    Primary progressive aphasia is a clinical syndrome defined by progressive deficits isolated to speech and/or language, and can be classified into non-fluent, semantic and logopenic variants based on motor speech, linguistic and cognitive features. The connected speech of patients with primary progressive aphasia has often been dichotomized simply as ‘fluent’ or ‘non-fluent’, however fluency is a multidimensional construct that encompasses features such as speech rate, phrase length, articulatory agility and syntactic structure, which are not always impacted in parallel. In this study, our first objective was to improve the characterization of connected speech production in each variant of primary progressive aphasia, by quantifying speech output along a number of motor speech and linguistic dimensions simultaneously. Secondly, we aimed to determine the neuroanatomical correlates of changes along these different dimensions. We recorded, transcribed and analysed speech samples for 50 patients with primary progressive aphasia, along with neurodegenerative and normal control groups. Patients were scanned with magnetic resonance imaging, and voxel-based morphometry was used to identify regions where atrophy correlated significantly with motor speech and linguistic features. Speech samples in patients with the non-fluent variant were characterized by slow rate, distortions, syntactic errors and reduced complexity. In contrast, patients with the semantic variant exhibited normal rate and very few speech or syntactic errors, but showed increased proportions of closed class words, pronouns and verbs, and higher frequency nouns, reflecting lexical retrieval deficits. In patients with the logopenic variant, speech rate (a common proxy for fluency) was intermediate between the other two variants, but distortions and syntactic errors were less common than in the non-fluent variant, while lexical access was less impaired than in the semantic variant. Reduced speech rate

  18. Connected speech production in three variants of primary progressive aphasia.

    PubMed

    Wilson, Stephen M; Henry, Maya L; Besbris, Max; Ogar, Jennifer M; Dronkers, Nina F; Jarrold, William; Miller, Bruce L; Gorno-Tempini, Maria Luisa

    2010-07-01

    Primary progressive aphasia is a clinical syndrome defined by progressive deficits isolated to speech and/or language, and can be classified into non-fluent, semantic and logopenic variants based on motor speech, linguistic and cognitive features. The connected speech of patients with primary progressive aphasia has often been dichotomized simply as 'fluent' or 'non-fluent', however fluency is a multidimensional construct that encompasses features such as speech rate, phrase length, articulatory agility and syntactic structure, which are not always impacted in parallel. In this study, our first objective was to improve the characterization of connected speech production in each variant of primary progressive aphasia, by quantifying speech output along a number of motor speech and linguistic dimensions simultaneously. Secondly, we aimed to determine the neuroanatomical correlates of changes along these different dimensions. We recorded, transcribed and analysed speech samples for 50 patients with primary progressive aphasia, along with neurodegenerative and normal control groups. Patients were scanned with magnetic resonance imaging, and voxel-based morphometry was used to identify regions where atrophy correlated significantly with motor speech and linguistic features. Speech samples in patients with the non-fluent variant were characterized by slow rate, distortions, syntactic errors and reduced complexity. In contrast, patients with the semantic variant exhibited normal rate and very few speech or syntactic errors, but showed increased proportions of closed class words, pronouns and verbs, and higher frequency nouns, reflecting lexical retrieval deficits. In patients with the logopenic variant, speech rate (a common proxy for fluency) was intermediate between the other two variants, but distortions and syntactic errors were less common than in the non-fluent variant, while lexical access was less impaired than in the semantic variant. Reduced speech rate was

  19. Aphasia and activities of daily living in stroke patients.

    PubMed

    Gialanella, Bernardo; Prometti, Paola; Vanoglio, Fabio; Comini, Laura; Santoro, Raffaele

    2016-12-01

    Few studies have investigated the relationships between aphasia and activities of daily living (ADLs) in stroke patients. This study was aimed firstly to determine which task within the ADLs has poorer functional recovery in stroke patients with aphasia after rehabilitation, second to identify which specific task is related to aphasia. This is a prospective and observational study. Inpatients of our Rehabilitation Unit. The study was carried out in 219 patients with primary diagnosis of stroke with (104) and without aphasia (115). All patients underwent usual rehabilitation. Aachen Aphasia Test and Functional Independence Measure scale were used to assess severity of aphasia and ADLs, respectively. Gain in ADLs was the main outcome measure. At the end of rehabilitation patients with aphasia had lower gain in bathing, dressing upper body, dressing lower body, toileting, stair climbing, and higher gain in social interaction, problem solving, and memory with respect to patients without aphasia. However, when data were adjusted for side of hemiplegia, Fugl-Meyer score and trunk control test, patients with aphasia showed lower gain in dressing upper body (P=0.027), dressing lower body (P=0.009), lower toileting (P=0.027), and higher gain in social interaction (P<0.001). In the multivariate regression analysis, aphasia was an important determinant of gain in bathing (β=0.26), dressing upper body (β=0.24), dressing lower body (β=0.22), lower toileting (β=0.22), and social interaction (β=-0.29). The current study points out that, after usual rehabilitation, the patients with aphasia show a poor gain in personal care activities and higher gain in social interaction. Knowledge of these findings: 1) can guide the rehabilitation team in selecting specific and appropriate therapies aimed to give patient with aphasia the highest possible functional independence in ADLs; 2) is useful to family members and social rehabilitation services for domiciliary management of patients

  20. Writing Treatment for Severe Aphasia: Who Benefits?

    ERIC Educational Resources Information Center

    Beeson, Pelagie M.; Rising, Kindle; Volk, Jennifer

    2003-01-01

    Writing treatment that involved repeated copying and recall of target words was implemented with 8 individuals with severe aphasia in order to discern the best candidates for the treatment. Four of the 8 participants had strong positive responses to the copy and recall treatment (CART), relearning spellings for 15 targeted words during 10 to 12…

  1. Broca's Aphasia, Verbs and the Mental Lexicon

    ERIC Educational Resources Information Center

    Bastiaanse, Roelien; van Zonneveld, Ron

    2004-01-01

    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…

  2. Comprehension of Passives in Broca's Aphasia

    ERIC Educational Resources Information Center

    Bastiaanse, Roelien; van Zonneveld, Ron

    2006-01-01

    Drai and Grodzinsky have statistically analyzed a large corpus of data on the comprehension of passives by patients with Broca's aphasia. The data come, according to Drai and Grodzinsky, from binary choice tasks. Among the languages that are analyzed are Dutch and German. Drai and Grodzinsky argue that Dutch and German speaking Broca patients…

  3. [Testing aphasia by psychometric methods (author's transl)].

    PubMed

    Lang, C

    1981-04-01

    In a survey of psychometric tests in world-wide use for the examination of aphasia stress is laid on methodological points. Separately for individual tests and tests and test batteries the development and clinical application are delineated, statistical criteria mentioned and diagnostic usefulness evaluated.

  4. Writing Treatment for Severe Aphasia: Who Benefits?

    ERIC Educational Resources Information Center

    Beeson, Pelagie M.; Rising, Kindle; Volk, Jennifer

    2003-01-01

    Writing treatment that involved repeated copying and recall of target words was implemented with 8 individuals with severe aphasia in order to discern the best candidates for the treatment. Four of the 8 participants had strong positive responses to the copy and recall treatment (CART), relearning spellings for 15 targeted words during 10 to 12…

  5. Counseling and Aphasia Treatment: Missed Opportunities

    ERIC Educational Resources Information Center

    Simmons-Mackie, Nina; Damico, Jack S.

    2011-01-01

    During clinical interactions between speech-language pathologists and adults with aphasia, a variety of emotional issues arise. The literature suggests that while counseling is within the scope of practice, SLPs tend to avoid emotional issues in therapy (A. Holland, 2007a). The precise mechanisms employed for circumventing emotional issues in…

  6. A Computational Account of Bilingual Aphasia Rehabilitation

    ERIC Educational Resources Information Center

    Kiran, Swathi; Grasemann, Uli; Sandberg, Chaleece; Miikkulainen, Risto

    2013-01-01

    Current research on bilingual aphasia highlights the paucity in recommendations for optimal rehabilitation for bilingual aphasic patients (Edmonds & Kiran, 2006; Roberts & Kiran, 2007). In this paper, we have developed a computational model to simulate an English-Spanish bilingual language system in which language representations can vary by age…

  7. A Computational Account of Bilingual Aphasia Rehabilitation

    ERIC Educational Resources Information Center

    Kiran, Swathi; Grasemann, Uli; Sandberg, Chaleece; Miikkulainen, Risto

    2013-01-01

    Current research on bilingual aphasia highlights the paucity in recommendations for optimal rehabilitation for bilingual aphasic patients (Edmonds & Kiran, 2006; Roberts & Kiran, 2007). In this paper, we have developed a computational model to simulate an English-Spanish bilingual language system in which language representations can vary by age…

  8. Mindfulness meditation in aphasia: A case report.

    PubMed

    Laures-Gore, Jacqueline; Marshall, Rebecca Shisler

    2016-04-06

    Despite the potential behavioral and neurological benefits of Mindfulness Meditation (MM), its use in treating stroke related communication disabilities appears to be underexplored. Specifically, aphasia, a language disorder resulting from stroke, may be amenable to the benefits of MM because of the observed attention problems often underlying the language symptoms. The current paper presents a case report of an adult with aphasia who was trained in MM. An adult with aphasia completed a five-day mindfulness training, and was assessed on measures of language, attention, and physiological measures of cortisol and heart rate variability. She completed four assessments: two baseline measures, immediately post training, and one week post training (maintenance). Overall, changes were observed in both psychophysiological measures (heart rate and heart rate variability) and behavioral measures (word productivity, phrase length, word generation, decreased impulsivity, and increased attention). Given the psychophysiological and behavioral changes observed in this individual, further exploration of the influence of MM in the treatment of post-stroke aphasia is warranted.

  9. Measuring Working Memory Deficits in Aphasia

    ERIC Educational Resources Information Center

    Mayer, Jamie F.; Murray, Laura L.

    2012-01-01

    Purpose: Many adults with aphasia demonstrate concomitant deficits in working memory (WM), but such deficits are difficult to quantify because of a lack of validated measures as well as the complex interdependence between language and WM. We examined the feasibility, reliability, and internal consistency of an "n"-back task for…

  10. Accent Identification by Adults with Aphasia

    ERIC Educational Resources Information Center

    Newton, Caroline; Burns, Rebecca; Bruce, Carolyn

    2013-01-01

    The UK is a diverse society where individuals regularly interact with speakers with different accents. Whilst there is a growing body of research on the impact of speaker accent on comprehension in people with aphasia, there is none which explores their ability to identify accents. This study investigated the ability of this group to identify the…

  11. Writing Treatment for Aphasia: A Texting Approach

    ERIC Educational Resources Information Center

    Beeson, Pelagie M.; Higginson, Kristina; Rising, Kindle

    2013-01-01

    Purpose: Treatment studies have documented the therapeutic and functional value of lexical writing treatment for individuals with severe aphasia. The purpose of this study was to determine whether such retraining could be accomplished using the typing feature of a cellular telephone, with the ultimate goal of using text messaging for…

  12. Further Evidence of Auditory Extinction in Aphasia

    ERIC Educational Resources Information Center

    Marshall, Rebecca Shisler; Basilakos, Alexandra; Love-Myers, Kim

    2013-01-01

    Purpose: Preliminary research ( Shisler, 2005) suggests that auditory extinction in individuals with aphasia (IWA) may be connected to binding and attention. In this study, the authors expanded on previous findings on auditory extinction to determine the source of extinction deficits in IWA. Method: Seventeen IWA (M[subscript age] = 53.19 years)…

  13. Writing Treatment for Aphasia: A Texting Approach

    ERIC Educational Resources Information Center

    Beeson, Pelagie M.; Higginson, Kristina; Rising, Kindle

    2013-01-01

    Purpose: Treatment studies have documented the therapeutic and functional value of lexical writing treatment for individuals with severe aphasia. The purpose of this study was to determine whether such retraining could be accomplished using the typing feature of a cellular telephone, with the ultimate goal of using text messaging for…

  14. Can Herpes Simplex Virus Encephalitis Cause Aphasia?

    ERIC Educational Resources Information Center

    Naude, H.; Pretorius, E.

    2003-01-01

    Aphasia implies the loss or impairment of language caused by brain damage. The key to understanding the nature of aphasic symptoms is the neuro-anatomical site of brain damage, and not the causative agent. However, because "Herpes simplex" virus (HSV) encephalitis infection usually affects the frontal and temporal lobes, subcortical…

  15. Can Herpes Simplex Virus Encephalitis Cause Aphasia?

    ERIC Educational Resources Information Center

    Naude, H.; Pretorius, E.

    2003-01-01

    Aphasia implies the loss or impairment of language caused by brain damage. The key to understanding the nature of aphasic symptoms is the neuro-anatomical site of brain damage, and not the causative agent. However, because "Herpes simplex" virus (HSV) encephalitis infection usually affects the frontal and temporal lobes, subcortical…

  16. Accent Identification by Adults with Aphasia

    ERIC Educational Resources Information Center

    Newton, Caroline; Burns, Rebecca; Bruce, Carolyn

    2013-01-01

    The UK is a diverse society where individuals regularly interact with speakers with different accents. Whilst there is a growing body of research on the impact of speaker accent on comprehension in people with aphasia, there is none which explores their ability to identify accents. This study investigated the ability of this group to identify the…

  17. Measuring Working Memory Deficits in Aphasia

    ERIC Educational Resources Information Center

    Mayer, Jamie F.; Murray, Laura L.

    2012-01-01

    Purpose: Many adults with aphasia demonstrate concomitant deficits in working memory (WM), but such deficits are difficult to quantify because of a lack of validated measures as well as the complex interdependence between language and WM. We examined the feasibility, reliability, and internal consistency of an "n"-back task for…

  18. Further Evidence of Auditory Extinction in Aphasia

    ERIC Educational Resources Information Center

    Marshall, Rebecca Shisler; Basilakos, Alexandra; Love-Myers, Kim

    2013-01-01

    Purpose: Preliminary research ( Shisler, 2005) suggests that auditory extinction in individuals with aphasia (IWA) may be connected to binding and attention. In this study, the authors expanded on previous findings on auditory extinction to determine the source of extinction deficits in IWA. Method: Seventeen IWA (M[subscript age] = 53.19 years)…

  19. Epidural cortical stimulation and aphasia therapy

    PubMed Central

    Cherney, Leora R.; Harvey, Richard L.; Babbitt, Edna M.; Hurwitz, Rosalind; Kaye, Rosalind C.; Lee, Jaime B.; Small, Steven. L.

    2013-01-01

    Background There are several methods of delivering cortical brain stimulation to modulate cortical excitability and interest in their application as an adjuvant strategy in aphasia rehabilitation after stroke is growing. Epidural cortical stimulation, although more invasive than other methods, permits high frequency stimulation of high spatial specificity to targeted neuronal populations. Aims First, we review evidence supporting the use of epidural cortical stimulation for upper limb recovery after focal cortical injury in both animal models and human stroke survivors. These data provide the empirical and theoretical platform underlying the use of epidural cortical stimulation in aphasia. Second, we summarize evidence for the application of epidural cortical stimulation in aphasia. We describe the procedures and primary outcomes of a safety and feasibility study (Cherney, Erickson & Small, 2010), and provide previously unpublished data regarding secondary behavioral outcomes from that study. Main Contribution In a controlled study comparing epidural cortical stimulation plus language treatment (CS/LT) to language treatment alone (LT), eight stroke survivors with nonfluent aphasia received intensive language therapy for 6 weeks. Four of these participants also underwent surgical implantation of an epidural stimulation device which was activated only during therapy sessions. Behavioral data were collected before treatment, immediately after treatment, and at 6 and 12 weeks following the end of treatment. The effect size for the primary outcome measure, the Western Aphasia Battery Aphasia Quotient, was benchmarked as moderate from baseline to immediately post-treatment, and large from baseline to the 12-week follow-up. Similarly, effect sizes obtained at the 12-week follow-up for the Boston Naming Test, the Communicative Effectiveness Index, and for correct information units on a picture description task were greater than those obtained immediately post treatment

  20. Hemispheric contributions to language reorganisation: An MEG study of neuroplasticity in chronic post stroke aphasia.

    PubMed

    Mohr, Bettina; MacGregor, Lucy J; Difrancesco, Stephanie; Harrington, Karen; Pulvermüller, Friedemann; Shtyrov, Yury

    2016-12-01

    Previous studies have demonstrated that efficient neurorehabilitation in post stroke aphasia leads to clinical language improvements and promotes neuroplasticity. Brain areas frequently implicated in functional restitution of language after stroke comprise perilesional sites in the left hemisphere and homotopic regions in the right hemisphere. However, the neuronal mechanisms underlying therapy-induced language restitution are still largely unclear. In this study, magnetoencephalography was used to investigate neurophysiological changes in a group of chronic aphasia patients who underwent intensive language action therapy (ILAT), also known as constraint-induced aphasia therapy (CIAT). Before and immediately after ILAT, patients' language and communication skills were assessed and their brain responses were recorded during a lexical magnetic mismatch negativity (MMNm) paradigm, presenting familiar spoken words and meaningless pseudowords. After the two-week therapy interval, patients showed significant clinical improvements of language and communication skills. Spatio-temporal dynamics of neuronal changes revealed a significant increase in word-specific neuro-magnetic MMNm activation around 200ms after stimulus identification points. This enhanced brain response occurred specifically for words and was most pronounced over perilesional areas in the left hemisphere. Therapy-related changes in neuromagnetic activation for words in both hemispheres significantly correlated with performance on a clinical language test. The findings indicate that functional recovery of language in chronic post stroke aphasia is associated with neuroplastic changes in both cerebral hemispheres, with stronger left-hemispheric contribution during automatic stages of language processing. Copyright © 2016 Elsevier Ltd. All rights reserved.