scholarly journals Lesion correlates of auditory sentence comprehension deficits in post-stroke aphasia

2022 ◽  
Vol 2 (1) ◽  
pp. 100076
Author(s):  
Erica Adezati ◽  
Melissa Thye ◽  
Amelia J. Edmondson-Stait ◽  
Jerzy P. Szaflarski ◽  
Daniel Mirman
2020 ◽  
Author(s):  
Rosemary Varley ◽  
Claudia Heilemann ◽  
Jane Warren ◽  
Ewa Dąbrowska ◽  
Amir-Homayoun Javadi

Background: We explore the efficacy of a new computer therapy for sentence comprehension and production impairments in post-stroke aphasia. The intervention is based upon the theoretical framework of usage-based Construction Grammar, which has yet to be systematically applied to the management of sentence processing disorders in aphasia. Components of the intervention were trialled in two small case series, with the results of one pilot used to inform a power calculation. The aims of the study are: (1) To determine if UTILISE therapy (Unification Therapy Integrating LexIcon and SEntences) for aphasic sentence processing impairment is more effective than usual care; (2) To determine if non-invasive transcranial direct current stimulation (tDCS) enhances treatment outcomes; (3) To determine if improvements are evident in functional use of language after treatment; (4) To determine if any treatment effects are apparent after an 8-week maintenance period. Methods: We will conduct a Phase II prospective randomised control trial. The behavioural component of the study (computer therapy) is single-blinded on the primary outcome measure, while the tDCS element is double-blinded. The trial is conducted within a university setting and aims to recruit 66 participants with post-stroke aphasia from community and post-acute rehabilitation settings. After first baseline evaluation, participants are randomised on a 2:2:1:1 basis to one of four conditions: 1) immediate treatment + active tDCS; 2) immediate treatment + sham tDCS; 3) deferred treatment + active tDCS; 4) deferred treatment + sham tDCS. A second baseline assessment is completed prior to start of treatment with a gap of four weeks between baselines for the immediate groups, and eight weeks for the deferred groups. The deferred trial entry conditions act as a usual care control across their extended baseline phase. Treatment is administered in 12 x 60-minute sessions over a four-week period. Outcomes are assessed immediately at the end of intervention and after an eight week no treatment period. Participants will also undergo a structural magnetic resonance (MR) brain scan to determine lesion location and extent. The primary outcome measure is degree of connectivity (ratio of three-word combinations to total number of words) in spontaneous narrative speech (personal narratives and narration of picture cartoon series). Speech samples will be audio-recorded and subsequently transcribed and tagged by raters blind to allocation and phase. Analysis will be performed by automated analysis software (Frequency in Language Analysis Tool, FLAT; Zimmerer, Newman, Thomson, Coleman, & Varley, 2018). Secondary outcome measures are spoken sentence comprehension (Test of Reception of Grammar, TROG-2; Bishop, 2003), a study-specific story completion test (adapted from Goodglass, Gleason, Ackerman Bernholtz, & Hyde, 1972), and the Stroke and Aphasia Quality of Life Scale (SAQOL-39; Hilari, Byng, Lamping, & Smith, 2003). A shortened form of a written synonym judgement task (adapted from the Action for Dysphasic Adults Auditory Comprehension Battery, A.D.A.; Franklin, Turner, & Ellis, 1992) is administered as a probe of an untreated behaviour.Discussion: In a series of planned comparisons, we will first determine the stability of behaviour between the two baseline evaluations. We will examine the efficacy of UTILISE through comparison of change in scores between the immediate and deferred entry group, and subsequent maintenance of any behavioural gains by change between the immediate outcome and the follow-up maintenance measures. We will explore the effect of active vs. sham tDCS, and the relationship between outcomes and demographic and behavioural profiles, and lesion size and location.


2021 ◽  
Vol 12 ◽  
Author(s):  
Sandy J. Lwi ◽  
Timothy J. Herron ◽  
Brian C. Curran ◽  
Maria V. Ivanova ◽  
Krista Schendel ◽  
...  

Introduction: One of the most challenging symptoms of aphasia is an impairment in auditory comprehension. The inability to understand others has a direct impact on a person's quality of life and ability to benefit from treatment. Despite its importance, limited research has examined the recovery pattern of auditory comprehension and instead has focused on aphasia recovery more generally. Thus, little is known about the time frame for auditory comprehension recovery following stroke, and whether specific neurologic and demographic variables contribute to recovery and outcome.Methods: This study included 168 left hemisphere chronic stroke patients stroke patients with auditory comprehension impairments ranging from mild to severe. Univariate and multivariate lesion-symptom mapping (LSM) was used to identify brain regions associated with auditory comprehension outcomes on three different tasks: Single-word comprehension, yes/no sentence comprehension, and comprehension of sequential commands. Demographic variables (age, gender, and education) were also examined for their role in these outcomes. In a subset of patients who completed language testing at two or more time points, we also analyzed the trajectory of recovery in auditory comprehension using survival curve-based time compression.Results: LSM analyses revealed that poor single-word auditory comprehension was associated with lesions involving the left mid- to posterior middle temporal gyrus, and portions of the angular and inferior-middle occipital gyri. Poor yes/no sentence comprehension was associated almost exclusively with the left mid-posterior middle temporal gyrus. Poor comprehension of sequential commands was associated with lesions in the left posterior middle temporal gyrus. There was a small region of convergence between the three comprehension tasks, in the very posterior portion of the left middle temporal gyrus. The recovery analysis revealed that auditory comprehension scores continued to improve beyond the first year post-stroke. Higher education was associated with better outcome on all auditory comprehension tasks. Age and gender were not associated with outcome or recovery slopes.Conclusions: The current findings suggest a critical role for the posterior left middle temporal gyrus in the recovery of auditory comprehension following stroke, and that spontaneous recovery of auditory comprehension can continue well beyond the first year post-stroke.


Author(s):  
Margreet Vogelzang ◽  
Christiane M. Thiel ◽  
Stephanie Rosemann ◽  
Jochem W. Rieger ◽  
Esther Ruigendijk

Purpose Adults with mild-to-moderate age-related hearing loss typically exhibit issues with speech understanding, but their processing of syntactically complex sentences is not well understood. We test the hypothesis that listeners with hearing loss' difficulties with comprehension and processing of syntactically complex sentences are due to the processing of degraded input interfering with the successful processing of complex sentences. Method We performed a neuroimaging study with a sentence comprehension task, varying sentence complexity (through subject–object order and verb–arguments order) and cognitive demands (presence or absence of a secondary task) within subjects. Groups of older subjects with hearing loss ( n = 20) and age-matched normal-hearing controls ( n = 20) were tested. Results The comprehension data show effects of syntactic complexity and hearing ability, with normal-hearing controls outperforming listeners with hearing loss, seemingly more so on syntactically complex sentences. The secondary task did not influence off-line comprehension. The imaging data show effects of group, sentence complexity, and task, with listeners with hearing loss showing decreased activation in typical speech processing areas, such as the inferior frontal gyrus and superior temporal gyrus. No interactions between group, sentence complexity, and task were found in the neuroimaging data. Conclusions The results suggest that listeners with hearing loss process speech differently from their normal-hearing peers, possibly due to the increased demands of processing degraded auditory input. Increased cognitive demands by means of a secondary visual shape processing task influence neural sentence processing, but no evidence was found that it does so in a different way for listeners with hearing loss and normal-hearing listeners.


2016 ◽  
Vol 21 (1) ◽  
pp. 55-64 ◽  
Author(s):  
Silvia Convento ◽  
Cristina Russo ◽  
Luca Zigiotto ◽  
Nadia Bolognini

Abstract. Cognitive rehabilitation is an important area of neurological rehabilitation, which aims at the treatment of cognitive disorders due to acquired brain damage of different etiology, including stroke. Although the importance of cognitive rehabilitation for stroke survivors is well recognized, available cognitive treatments for neuropsychological disorders, such as spatial neglect, hemianopia, apraxia, and working memory, are overall still unsatisfactory. The growing body of evidence supporting the potential of the transcranial Electrical Stimulation (tES) as tool for interacting with neuroplasticity in the human brain, in turn for enhancing perceptual and cognitive functions, has obvious implications for the translation of this noninvasive brain stimulation technique into clinical settings, in particular for the development of tES as adjuvant tool for cognitive rehabilitation. The present review aims at presenting the current state of art concerning the use of tES for the improvement of post-stroke visual and cognitive deficits (except for aphasia and memory disorders), showing the therapeutic promises of this technique and offering some suggestions for the design of future clinical trials. Although this line of research is still in infancy, as compared to the progresses made in the last years in other neurorehabilitation domains, current findings appear very encouraging, supporting the development of tES for the treatment of post-stroke cognitive impairments.


2011 ◽  
Author(s):  
K. Takahashi ◽  
N. Maionchi-Pino ◽  
A. Magnan ◽  
R. Kawashima

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