Neuronavigated repetitive transcranial magnetic stimulation as novel mapping technique provides insights into language function in primary progressive aphasia

Navigated repetitive transcranial magnetic stimulation (nrTMS) is an innovative technique that provides insight into language function with high accuracy in time and space. So far, nrTMS has mainly been applied in presurgical language mapping of patients with intracranial neoplasms. For the present study, nrTMS was used for language mapping in primary progressive aphasia (PPA). Seven patients (median age: 70 years, 4 males) with the non-fluent variant of PPA (nfvPPA) were included in this pilot study. Trains of nrTMS (5 Hz, 100% resting motor threshold) caused virtual lesions at 46 standardized cortical stimulation targets per hemisphere. Patients’ errors in a naming task during stimulation were counted. The majority of errors induced occurred during frontal lobe stimulation (34.3%). Timing errors and non-responses were most frequent. More errors were induced in the right hemisphere (58%) than in the left hemisphere (42%). Mapping was tolerated by all patients, however, discomfort or pain was reported for stimulation of frontal areas. The elevated right-hemispheric error rate in our study could be due to a partial shift of language function to the right hemisphere in neurodegenerative aphasia during the course of disease and therefore points to the existence of neuronal plasticity in nfvPPA. While this is an interesting finding for neurodegenerative disorders per se, its promotion might also harbor future therapeutic targets.

EFL supervisors’ written feedback focus and language functions: a mixed methods study

The objectives of this study were to examine the EFL supervisors’ written feedback focus, and language functions at selected public universities in Ethiopia. To address the objectives of the study, qualitative and quantitative approaches with concurrent mixed methods design was adopted. 55 supervisees were randomly selected out of 205 for the questionnaire survey. Besides, four supervisors were selected for interviews. Moreover, feedback comments on five theses drafts were utilized as data sources. To decide the language functions and feedback foci, frequency counts and percentages were used. Nonetheless, content analysis was used to analyze the interview data. The results showed that thesis supervisors used the directive feedback language function most prevailingly over the expressive function. Besides, the result indicated there was no balance of praise, criticism, and suggestions in the provision of feedback comments. The supervisors largely focused on content knowledge, followed by genre knowledge, and then linguistic accuracy and appropriateness (forms), respectively. Based on the results, supervisors were recommended to write their feedback comments in helpful and constructive ways based on the needs and preferences of their supervisees for the development of writing skills.

A "Core Skills" Approach to the Assessment of Acquired Language Disorders: Exploration and Cross-Validation

<p>The majority of diagnostic assessments of aphasia—an acquired language disorder that commonly occurs after stroke or brain injury—are based upon the classical model of language. A major limitation of these diagnostic assessments is that they are based upon a very simple neuroanatomical model of language function. In the decades since the classical model, cognitive theories of language function have developed considerably, which provides a much richer framework for the assessment of acquired language disorders. On the basis of this framework, Faulkner, Wilshire, Parker, and Cunningham (2015) developed the Brief Language Assessment for Surgical Tumours (BLAST) for the assessment of language function in brain tumour patients, based upon the notion that language can be decomposed into core cognitive skills. In the current thesis, we evaluate the efficacy of the BLAST in individuals with chronic post-stroke aphasia, cross-validate the core cognitive skills identified by the BLAST with independent measures argued to index the same theoretical construct, and evaluate whether an individual’s linguistic profile on the BLAST is predictive of performance on a more naturalistic sentence production task. The results from the current research can be divided into three primary findings. First, we found that the BLAST could be administered to individuals with post-stroke aphasia, and that the linguistic profiles provided by the BLAST extend far beyond the predictions derived from neural localization and classical diagnostic assessments. Second, we found support for the validity of five of the core cognitive skills. Third, we found some support for the notion that performance on the BLAST may be predictive of performance on a more naturalistic sentence production task. In short, the current findings suggest that the BLAST holds potential as a clinical tool for the assessment of language function in a range of different neurological populations.</p>

A "Core Skills" Approach to the Assessment of Acquired Language Disorders: Exploration and Cross-Validation

<p>The majority of diagnostic assessments of aphasia—an acquired language disorder that commonly occurs after stroke or brain injury—are based upon the classical model of language. A major limitation of these diagnostic assessments is that they are based upon a very simple neuroanatomical model of language function. In the decades since the classical model, cognitive theories of language function have developed considerably, which provides a much richer framework for the assessment of acquired language disorders. On the basis of this framework, Faulkner, Wilshire, Parker, and Cunningham (2015) developed the Brief Language Assessment for Surgical Tumours (BLAST) for the assessment of language function in brain tumour patients, based upon the notion that language can be decomposed into core cognitive skills. In the current thesis, we evaluate the efficacy of the BLAST in individuals with chronic post-stroke aphasia, cross-validate the core cognitive skills identified by the BLAST with independent measures argued to index the same theoretical construct, and evaluate whether an individual’s linguistic profile on the BLAST is predictive of performance on a more naturalistic sentence production task. The results from the current research can be divided into three primary findings. First, we found that the BLAST could be administered to individuals with post-stroke aphasia, and that the linguistic profiles provided by the BLAST extend far beyond the predictions derived from neural localization and classical diagnostic assessments. Second, we found support for the validity of five of the core cognitive skills. Third, we found some support for the notion that performance on the BLAST may be predictive of performance on a more naturalistic sentence production task. In short, the current findings suggest that the BLAST holds potential as a clinical tool for the assessment of language function in a range of different neurological populations.</p>

Associations between Upper Extremity Motor Function and Aphasia after Stroke: A Multicenter Cross-Sectional Study

Background and Purpose. Poststroke aphasia (PSA) often coexists with upper extremity (UE) motor dysfunction. However, whether the presence of PSA affects UE motor performance, and if language function associates with UE motor performance, are unclear. This study is aimed at (1) comparing the motor status of UE between patients with PSA and without PSA and (2) investigating the association between language function and UE motor status in patients with PSA. Methods. Patients with stroke were compared and correlated from overall and three periods (1-3 months, 4-6 months, and >6 months). Fugl-Meyer assessment for the upper extremity (FMA-UE) and action research and arm test (ARAT) were used to compare the UE motor status between patients with PSA and without PSA through a cross-sectional study among 435 patients. Then, the correlations between the evaluation scale scores of UE motor status and language function of patients with PSA were analyzed in various dimensions, and the language subfunction most closely related to UE motor function was analyzed by multiple linear regression analysis. Results. We found that the scores of FMA-UE and ARAT in patients with PSA were 14 points ((CI) 10 to 18, p < 0.001 ) and 11 points lower ((CI) 8 to 13, p < 0.001 ), respectively, than those without PSA. Their FMA-UE ( r = 0.70 , p < 0.001 ) and ARAT ( r = 0.62 , p < 0.001 ) scores were positively correlated with language function. Regression analysis demonstrated that spontaneous speech ability may account for UE motor function ( R 2 = 0.51 , p < 0.001 ; R 2 = 0.42 , p < 0.001 ). Consistent results were also obtained from the analyses within the three time subgroups. Conclusion. Stroke patients with PSA have worse UE motor performance. UE motor status and language function showed positive correlations, in which spontaneous speech ability significantly accounts for the associations.

A new fMRI localizer for preoperative language mapping using a sentence completion task: Validity, choice of baseline condition, and test-retest reliability

To avoid post-neurosurgical language deficits, intraoperative mapping of the language function in the brain can be complemented with preoperative mapping with fMRI. The validity of an fMRI language localizer paradigm crucially depends on the choice of an optimal language task and baseline condition. This study presents a new fMRI language localizer in Russian using overt sentence completion, a task that comprehensively engages the language function by involving both production and comprehension at the word and sentence level. The paradigm was validated in 18 neurologically healthy volunteers who participated in two scanning sessions, for estimating test-retest reliability. For the first time, two baseline conditions for the sentence completion task were compared. At the group level, the paradigm significantly activated both anterior and posterior language-related regions. Individual-level analysis showed that activation was elicited most consistently in the inferior frontal regions, followed by posterior temporal regions and the angular gyrus. Test-retest reliability of activation location, as measured by Dice coefficients, was moderate and thus comparable to previous studies. Test-retest reliability was higher in the frontal than temporo-parietal region and with the most liberal statistical thresholding compared to two more conservative thresholding methods. Lateralization indices were expectedly left-hemispheric, with greater lateralization in the frontal than temporo-parietal region, and showed moderate test-retest reliability. Finally, the pseudoword baseline elicited more extensive and more reliable activation, although the syllable baseline appears more feasible for future clinical use. Overall, the study demonstrated the validity and reliability of the sentence completion task for mapping the language function in the brain. The paradigm needs further validation in a clinical sample of neurosurgical patients. Additionally, the study contributes to general evidence on test-retest reliability of fMRI.

New Treatment Strategy Using Repetitive Transcranial Magnetic Stimulation for Post-Stroke Aphasia

Repetitive transcranial magnetic stimulation (rTMS) for post-stroke aphasia (PSA) has been suggested to promote improvement of language function when used in combination with rehabilitation. However, many challenges remain. In some reports examined by category of language function, only naming has good evidence of improvement, and the improvement effect on other language modalities is low. Therefore, it is necessary to establish methods that contribute to the improvement of language functions other than naming. Therapeutic methods for PSA based on the mechanism of rTMS are mainly inhibitory stimulation methods for language homologous areas. However, the mechanisms of these methods are controversial when inferred from the process of recovery of language function. Low-frequency rTMS applied to the right hemisphere has been shown to be effective in the chronic phase of PSA, but recent studies of the recovery process of language function indicate that this method is unclear. Therefore, it has been suggested that evaluating brain activity using neuroimaging contributes to confirming the effect of rTMS on PSA and the elucidation of the mechanism of functional improvement. In addition, neuroimaging-based stimulation methods (imaging-based rTMS) may lead to further improvements in language function. Few studies have examined neuroimaging and imaging-based rTMS in PSA, and further research is required. In addition, the stimulation site and stimulation parameters of rTMS are likely to depend on the time from onset to intervention. However, there are no reports of studies in patients between 90 and 180 days after onset. Therefore, research during this period is required. New stimulation methods, such as multiple target methods and the latest neuroimaging methods, may contribute to the establishment of new knowledge and new treatment methods in this field.

Languange function found in mulan movie

The data source was taken from conversation among the characters in Mulan movie. The data was collected by using observation method based on library research. There were some steps in collecting the data. The qualitative method was the method that was used in analysing the data in this study. The conversation among the characters analysed in the category types of language function that was according to the book written by Blundell (1987) entitled Function in English. The data was presented by the formal method which presented the language function. The research finding showed that there are four type of Language Function: main function, social formula, making communication work and finding out about language. Based on the data, there are 33 data for main function, 15 data for social formulas and 2 data for making communication work. The study concluded that the most used language function was main function and the least used language function was finding out about language

Monitoring Cortico-cortical Evoked Potentials using Only Two 6-strand Strip Electrodes for Gliomas Extending to the Dominant Side of Frontal Operculum During One-step Tumor Removal Surgery

Resection of the dominant side of gliomas extending to the frontal operculum has a high-risk of permanent language dysfunction. Here, we report recording cortico-cortical evoked potentials (CCEP) using only two 6-strand strip electrodes to monitor language-related fibers intraoperatively. We examined whether this simple procedure is useful for removing gliomas extending to the dominant side of frontal operculum. This study included five cases of glioma extending to the left frontal operculum. The frontal language area (FLA) was first identified by functional mapping during awake craniotomy. Next, a 6-strand strip electrode was placed just above the FLA, while on the temporal lobe side, an electrode was placed so as to slide parallel to the Sylvian fissure toward the posterior language area. Electrical stimulation was performed using the electrode on the frontal side, and CCEPs were measured from the electrode on the temporal side. CCEPs were detected in all cases. Immediately after surgery, all patients demonstrated language dysfunction to varying degrees. CCEP decreased up to 10% in one patient, who recovered language function after 24 months. CCEP decreased slightly up to 80% in one, and in the three other cases, CCEPs did not change. These four patients soon recovered language function within 2 weeks to 1 month. This study confirmed the utility of CCEP monitoring using only two 6-strand strip electrodes during one-step surgery. We believe this simple method helped in monitoring intraoperative language function and aided predicting its postoperative recovery, in patients with gliomas extending to the dominant side of frontal operculum.