fluent aphasia
Recently Published Documents


TOTAL DOCUMENTS

272
(FIVE YEARS 47)

H-INDEX

29
(FIVE YEARS 2)

2022 ◽  
Vol 13 ◽  
Author(s):  
Ting-Yu Chou ◽  
Jia-Chi Wang ◽  
Mu-Yun Lin ◽  
Po-Yi Tsai

BackgroundAlthough low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) has shown promise in the treatment of poststroke aphasia, the efficacy of high-frequency rTMS (HF-rTMS) has yet to be determined.PurposeWe investigated the efficacy of intermittent theta burst stimulation (iTBS) in ameliorating chronic non-fluent aphasia and compared it with that of LF-rTMS.MethodsWe randomly assigned patients with poststroke non-fluent aphasia to an ipsilesional iTBS (n = 29), contralesional 1-Hz rTMS (n = 27), or sham (n = 29) group. Each group received the rTMS protocol executed in 10 daily sessions over 2 weeks. We evaluated language function before and after the intervention by using the Concise Chinese Aphasia Test (CCAT).ResultsCompared with the sham group, the iTBS group exhibited significant improvements in conversation, description, and expression scores (P = 0.0004–0.031), which characterize verbal production, as well as in auditory comprehension, reading comprehension, and matching scores (P < 0.01), which characterize language perception. The 1-Hz group exhibited superior improvements in expression, reading comprehension, and imitation writing scores compared with the sham group (P < 0.05). The iTBS group had significantly superior results in CCAT total score, matching and auditory comprehension (P < 0.05) relative to the 1-Hz group.ConclusionOur study findings contribute to a growing body of evidence that ipsilesional iTBS enhances the language recovery of patients with non-fluent aphasia after a chronic stroke. Auditory comprehension was more preferentially enhanced by iTBS compared with the 1-Hz protocol. Our findings highlight the importance of ipsilesional modulation through excitatory rTMS for the recovery of non-fluent aphasia in patients with chronic stroke.Clinical Trial Registration:[www.ClinicalTrials.gov], identifier [NCT03059225].


2021 ◽  
pp. 154596832110642
Author(s):  
Lisa Johnson ◽  
Grigori Yourganov ◽  
Alexandra Basilakos ◽  
Roger David Newman-Norlund ◽  
Helga Thors ◽  
...  

Background Speech entrainment (SE), the online mimicking of an audio-visual speech model, has been shown to increase speech fluency in individuals with non-fluent aphasia. One theory that may explain why SE improves speech output is that it synchronizes functional connectivity between anterior and posterior language regions to be more similar to that of neurotypical speakers. Objectives The present study tested this by measuring functional connectivity between 2 regions shown to be necessary for speech production, and their right hemisphere homologues, in 24 persons with aphasia compared to 20 controls during both free (spontaneous) speech and SE. Methods Regional functional connectivity in participants with aphasia were normalized to the control data. Two analyses were then carried out: (1) normalized functional connectivity was compared between persons with aphasia and controls during free speech and SE and (2) stepwise linear models with leave-one-out cross-validation including normed functional connectivity during both tasks and proportion damage to the left hemisphere as independent variables were created for each language score. Results Left anterior–posterior functional connectivity and left posterior to right anterior functional connectivity were significantly more similar to connectivity of the control group during SE compared to free speech. Additionally, connectivity during free speech was more associated with language measures than connectivity during SE. Conclusions Overall, these results suggest that SE promotes normalization of functional connectivity (i.e., return to patterns observed in neurotypical controls), which may explain why individuals with non-fluent aphasia produce more fluent speech during SE compared to spontaneous speech.


2021 ◽  
Author(s):  
◽  
Paula Speer

<p>Individuals with nonfluent aphasia are able to produce many words in isolation, but have great difficulty producing sentences. Most research to date has compared accuracy across different types of sentence structures, focussing on grammatical aspects that may be compromised in nonfluent aphasia. However, based on the premise that lexical elements activate their associated grammatical frames as well as vice versa, lexical content may also be of vital importance. For example, rapid access to lexical elements – particularly ones appearing early in the sentence - may be crucial, especially if the sentence plan is weakly activated or rapidly decaying. The current study investigated the effect of different aspects of lexical content on nonfluent aphasic sentence production. Five participants with nonfluent aphasia, four participants with fluent aphasia and eight controls completed two picture description tasks eliciting subject-verb-object sentences (e.g., the dog is chasing the fox). Based on existing evidence suggesting that common words are accessed more rapidly than rarer ones, Experiment 1 manipulated the frequency of sentence nouns, thereby varying their speed of lexical retrieval by varying the frequency of sentence nouns. Nonfluent participants' accuracy was consistently higher for sentences commencing with a high frequency subject noun, even when errors on those nouns were themselves excluded. This was not the case for the fluent participants. Experiment 2 manipulated the semantic relationship between subject and object nouns. Previous research suggests that phrases containing related words may be challenging for individuals with nonfluent aphasia, possibly because lexical representations are inadequately tied to appropriate structural representations. The nonfluent participants produced sentences less accurately when they contained related lexical items, even when those items were in different noun phrases. The fluent participants exhibited the opposite trend. Finally, the relationship between the patterns observed in Experiment 1 and 2 and lesion location in the aphasic participants was explored by analysing magnetic resonance scans. We discuss the implications of our findings for theoretical accounts of sentence production more generally, and of nonfluent aphasia in particular. More precisely, we propose that individuals with nonfluent aphasia are disproportionately reliant on activated lexical representations to drive the sentence generation process, an idea we call the Content Drives Structure (COST) hypothesis.</p>


2021 ◽  
Author(s):  
◽  
Paula Speer

<p>Individuals with nonfluent aphasia are able to produce many words in isolation, but have great difficulty producing sentences. Most research to date has compared accuracy across different types of sentence structures, focussing on grammatical aspects that may be compromised in nonfluent aphasia. However, based on the premise that lexical elements activate their associated grammatical frames as well as vice versa, lexical content may also be of vital importance. For example, rapid access to lexical elements – particularly ones appearing early in the sentence - may be crucial, especially if the sentence plan is weakly activated or rapidly decaying. The current study investigated the effect of different aspects of lexical content on nonfluent aphasic sentence production. Five participants with nonfluent aphasia, four participants with fluent aphasia and eight controls completed two picture description tasks eliciting subject-verb-object sentences (e.g., the dog is chasing the fox). Based on existing evidence suggesting that common words are accessed more rapidly than rarer ones, Experiment 1 manipulated the frequency of sentence nouns, thereby varying their speed of lexical retrieval by varying the frequency of sentence nouns. Nonfluent participants' accuracy was consistently higher for sentences commencing with a high frequency subject noun, even when errors on those nouns were themselves excluded. This was not the case for the fluent participants. Experiment 2 manipulated the semantic relationship between subject and object nouns. Previous research suggests that phrases containing related words may be challenging for individuals with nonfluent aphasia, possibly because lexical representations are inadequately tied to appropriate structural representations. The nonfluent participants produced sentences less accurately when they contained related lexical items, even when those items were in different noun phrases. The fluent participants exhibited the opposite trend. Finally, the relationship between the patterns observed in Experiment 1 and 2 and lesion location in the aphasic participants was explored by analysing magnetic resonance scans. We discuss the implications of our findings for theoretical accounts of sentence production more generally, and of nonfluent aphasia in particular. More precisely, we propose that individuals with nonfluent aphasia are disproportionately reliant on activated lexical representations to drive the sentence generation process, an idea we call the Content Drives Structure (COST) hypothesis.</p>


2021 ◽  
Vol 429 ◽  
pp. 119407
Author(s):  
Lorenzo Fontanelli ◽  
Francesca Bianchi ◽  
Alessandro Galgani ◽  
Daniela Frosini ◽  
Irene Ghicopulos ◽  
...  

Author(s):  
Claudia Bruns ◽  
Suzanne Beeke ◽  
Vitor C. Zimmerer ◽  
Carolyn Bruce ◽  
Rosemary A. Varley

2021 ◽  
Vol 12 ◽  
Author(s):  
Ana Haro-Martínez ◽  
Carmen M. Pérez-Araujo ◽  
Juan M. Sanchez-Caro ◽  
Blanca Fuentes ◽  
Exuperio Díez-Tejedor

Introduction: Melodic intonation therapy (MIT) is one of the most studied speech and language therapy (SLT) approaches for patients with non-fluent aphasia, although the methodological quality of the studies has been rated as low in previous reviews. The aim of this study is to update current evidence on the possible efficacy of MIT for the treatment of non-fluent post-stroke aphasia.Methods: A systematic review and meta-analysis. We selected randomized clinical trials (RCT) that included adult patients over 18 years of age with non-fluent post-stroke aphasia, whose intervention was MIT vs. no therapy or other therapy. We excluded non-RCT studies, mixed populations including patients with aphasia of non-stroke etiology, studies with no availability of post-stroke aphasia-specific data, and incomplete studies. Three sections of communicative ability were analyzed as outcomes: functional communication, expressive language (naming and repetition), and comprehension.Results: We identified a total of four eligible RCTs involving 94 patients. Despite the heterogeneity in the psychometric tests employed among the trials, a significant effect of MIT on functional communication (evaluated by the Communication Activity Log) was found (SMD 1.47; 95% CI 0.39–2.56). In addition, a positive effect of MIT on expressive language (repetition) was found (SMD 0.45; 95% CI 0.01–0.90). No significant effects on comprehension measurements were found, despite a lack of significant statistical heterogeneity.Conclusion: This systematic review and meta-analysis shows a significant effect of MIT on improving functional communication and on repetition tasks. Future larger RCT specifically addressing those outcomes should provide the definite evidence on the efficacy of MIT on post-stroke aphasia recovery.Systematic Review Registration:PROSPERO-URL https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020144604.


2021 ◽  
Author(s):  
Yi‐Ai Huang ◽  
Ya‐Hui Wang ◽  
Wen‐Hsuan Hou ◽  
Yi‐No Kang

2021 ◽  
Vol 15 ◽  
Author(s):  
Xiao-Ying Zhang ◽  
Wei-Yong Yu ◽  
Wen-Jia Teng ◽  
Meng-Yang Lu ◽  
Xiao-Li Wu ◽  
...  

Melodic intonation therapy (MIT) positively impacts the speech function of patients suffering from aphasia and strokes. Fixed-pitch melodies and phrases formulated in MIT provide the key to the target language to open the language pathway. This randomized controlled trial compared the effects of music therapy-based MIT and speech therapy on patients with non-fluent aphasia. The former is more effective in the recovery of language function in patients with aphasia. Forty-two participants were enrolled in the study, and 40 patients were registered. The participants were randomly assigned to two groups: the intervention group (n = 20; 16 males, 4 females; 52.90 ± 9.08 years), which received MIT, and the control group (n = 20; 15 males, 5 females; 54.05 ± 10.81 years), which received speech therapy. The intervention group received MIT treatment for 30 min/day, five times a week for 8 weeks, and the control group received identical sessions of speech therapy for 30 min/day, five times a week for 8 weeks. Each participant of the group was assessed by a Boston Diagnostic Aphasia Examination (BDAE) at the baseline (t1, before the start of the experiment), and after 8 weeks (t2, the experiment was finished). The Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were also measured on the time points. The best medical care of the two groups is the same. Two-way ANOVA analysis of variance was used only for data detection. In the spontaneous speech (information), the listening comprehension (right or wrong, word recognition, and sequential order) and repetitions of the intervention group were significantly higher than the control group in terms of the cumulative effect of time and the difference between groups after 8 weeks. The intervention group has a significant time effect in fluency, but the results after 8 weeks were not significantly different from those in the control group. In terms of naming, the intervention group was much better than the control group in spontaneous naming. Regarding object naming, reaction naming, and sentence completing, the intervention group showed a strong time accumulation effect. Still, the results after 8 weeks were not significantly different from those in the control group. These results indicate that, compared with speech therapy, MIT based on music therapy is a more effective musical activity and is effective and valuable for the recovery of speech function in patients with non-fluent aphasia. As a more professional non-traumatic treatment method, MIT conducted by qualified music therapists requires deeper cooperation between doctors and music therapists to improve rehabilitating patients with aphasia. The Ethics Committee of the China Rehabilitation Research Center approved this study (Approval No. 2020-013-1 on April 1, 2020) and was registered with the Chinese Clinical Trial Registry (Registration number: Clinical Trials ChiCTR2000037871) on September 3, 2020.


Author(s):  
Chris Code

The aim of this paper is to develop further the idea that symptoms that emerge in speech and language processing following brain damage can make a contribution to discussions of the early evolution of language. These diverse impairments are called aphasia, and this paper proposes that the recovery of a non-fluent aphasia syndrome following stroke could provide insights into the course of the pre-history of human language evolution. The observable symptoms emerge during recovery, crucially enabled by (dis)inhibition in parallel with a range of impairments in action processing (apraxias), including apraxia of speech. They are underpinned by changes in cortical and subcortical status following brain damage. It is proposed that the observed recovery mimics ontogenic and phylogenic processes in human speech and language. The arguments put forward provide insights tending to support the motor-gestural model of speech and language evolution. This article is part of the theme issue ‘Reconstructing prehistoric languages’.


Sign in / Sign up

Export Citation Format

Share Document