Showing papers on "Aphasia published in 2003"
TL;DR: This review focuses on syntax, using recent neuroimaging data and cognitive theory to propose a specific point of convergence between syntactic processing in language and music, which leads to testable predictions, including the prediction that that syntactic comprehension problems in Broca's aphasia are not selective to language but influence music perception as well.
Abstract: The comparative study of music and language is drawing an increasing amount of research interest. Like language, music is a human universal involving perceptually discrete elements organized into hierarchically structured sequences. Music and language can thus serve as foils for each other in the study of brain mechanisms underlying complex sound processing, and comparative research can provide novel insights into the functional and neural architecture of both domains. This review focuses on syntax, using recent neuroimaging data and cognitive theory to propose a specific point of convergence between syntactic processing in language and music. This leads to testable predictions, including the prediction that that syntactic comprehension problems in Broca's aphasia are not selective to language but influence music perception as well.
1,089 citations
TL;DR: Intense therapy over a short amount of time can improve outcomes of speech and language therapy for stroke patients with aphasia.
Abstract: Background— It has been speculated that the conflicting results demonstrated across poststroke aphasia therapy studies might be related to differences in intensity of therapy provided across studies. The aim of this study is to investigate the relationship between intensity of aphasia therapy and aphasia recovery. Methods— A MEDLINE literature search was conducted to retrieve clinical trials investigating aphasia therapy after stroke. Changes in mean scores from each study were recorded. Intensity of therapy was recorded in terms of length of therapy, hours of therapy provided per week, and total hours of therapy provided. Pearson correlation was used to assess the relationship between changes in mean scores of outcome measures and intensity of therapy. Results— Studies that demonstrated a significant treatment effect provided 8.8 hours of therapy per week for 11.2 weeks versus the negative studies that only provided ≈2 hours per week for 22.9 weeks. On average, positive studies provided a total of 98.4 h...
672 citations
TL;DR: Primary progressive aphasia is an atypical dementia in which language abilities deteriorate while memory is relatively preserved, and neuropsychological testing can help establish the correct diagnosis.
Abstract: Primary progressive aphasia is an atypical dementia in which language abilities deteriorate while memory is relatively preserved. For many years, the principal signs and symptoms may be confined to the area of language. Patients may come to medical attention because of the onset of word-finding difficulties, abnormal speech patterns, or prominent errors in spelling. Neuropsychological testing can help establish the correct diagnosis.
409 citations
TL;DR: The SAQOL-39 is an acceptable, reliable, and valid measure of HRQL in people with long-term aphasia and its usefulness in evaluative research and routine clinical practice is investigated.
Abstract: Background and Purpose— Health-related quality of life (HRQL) is a key outcome in stroke clinical trials. Stroke-specific HRQL scales (eg, SS-QOL, SIS) have generally been developed with samples of stroke survivors that exclude people with aphasia. We adapted the SS-QOL for use with people with aphasia to produce the Stroke and Aphasia Quality of Life Scale (SAQOL). We report results from the psychometric evaluation of the initial 53-item SAQOL and the item-reduced SAQOL-39. Methods— We studied 95 people with long-term aphasia to evaluate the acceptability, reliability, and validity of the SAQOL and SAQOL-39 using standard psychometric methods. Results— A total of 83 of 95 (87%) were able to complete the SAQOL by self-report; their results are reported here. Results supported the reliability and validity of the overall score on the 53-item SAQOL, but there was little support for hypothesized subdomains. Using factor analysis, we derived a shorter version (SAQOL-39) that identified 4 subdomains (physical, ...
387 citations
TL;DR: Findings offer anatomical evidence that the breakdown in fluency is due to a motor articulatory planning deficit (speech apraxia) combined with a variable degree of agrammatism in the light of current theories of fluent language production.
Abstract: Summary Progressive non-fluent aphasia (PNFA) is a syndrome in which patients lose the ability to communicate fluently in the context of relative preservation of single word comprehension and non-linguistic cognitive abilities. Neuroimaging in case studies with PNFA has failed to identify a consistent neural substrate for the language disorder. In this study of a group of patients (n = 10) whose presenting complaint was progressive dysfluency, resting cerebral metabolism was measured using [ 18 F]fluorodeoxyglucose-PET and analysed with the technique of statistical parametric mapping (SPM). Regional atrophy was assessed with voxel-based morphometry (VBM). Seven patients had a ‘pure’ PNFA syndrome, while the remaining three had additional features of a more pervasive dementia. Compared with controls, the patients showed hypometabolism in several regions that, most notably, included the left anterior insula/frontal opercular region. The VBM analysis revealed only one small area of atrophy in the left periSylvian region. Analysis of the pure PNFA cases (n =7 ) relative to controls yielded qualitatively similar results to those of the whole group, suggesting that these cases were also at risk of a more generalized dementia, a finding borne out in subsequent follow-up of two cases to date. The PNFA group was then compared with a group with Alzheimer’s disease (n = 10) whose clinical profile did not include non-fluent aphasic features. In this analysis, the only persisting hypometabolic region was that centred over the left anterior insula. VBM did not identify any regional differences in atrophy between PNFA and Alzheimer’s disease. In the light of current theories of fluent language production, the findings offer anatomical evidence that the breakdown in fluency is due to a motor articulatory planning deficit (speech apraxia) combined with a variable degree of agrammatism.
311 citations
TL;DR: The findings demonstrated that functional communication ability, and language functioning to a lesser degree, were implicated in QOL, providing evidence for particular speech pathology interventions in addressing clients' QOL.
Abstract: Background: Speech pathologists infrequently address the quality of aphasic people's lives in a direct manner in rehabilitation, most likely due to the difficulty in grasping the role of communication in quality of life (QOL). Despite considerable research into aphasic language impairments and communication disabilities, there is no clear evidence how aphasia impacts on clients' QOL. This paper reports on a comprehensive evaluation of 30 people with mild to moderate aphasia to determine which aspects of communication predict their QOL. A conceptual model of the relationship between communication and QOL was devised, using the disablement framework of the International Classification of Impairment, Activity and Participation Beta-2 Draft (ICIDH-2) (World Health Organisation, 1998). Communication was conceptualised as language impairment, functional communication ability and activity, and social participation. QOL included both health-related QOL (HRQOL) and psychological well-being concepts. Aims: The aim ...
270 citations
Book•
01 Feb 2003TL;DR: The Neuroscience of Language, published in 2003, puts forth a systematic model of language to bridge the gap between linguistics and neuroscience in the form of a computational, connectionist neural network.
Abstract: How is language organized in the human brain? The Neuroscience of Language, published in 2003, puts forth a systematic model of language to bridge the gap between linguistics and neuroscience. Neuronal models of word and serial order processing are presented in the form of a computational, connectionist neural network. The linguistic emphasis is on words and elementary syntactic rules. Introductory chapters focus on neuronal structure and function, cognitive brain processes, the basics of classical aphasia research and modern neuroimaging of language, neural network approaches to language, and the basics of syntactic theories. The essence of the work is contained in chapters on neural algorithms and networks, basic syntax, serial order mechanisms, and neuronal grammar. Throughout, excursuses illustrate the functioning of brain models of language, some of which are accessible as animations on the book's accompanying web site. It will appeal to graduate students and researchers in neuroscience, psychology, linguistics, and computational modeling.
269 citations
TL;DR: The implicit comprehension of simple narrative speech with listening to reversed versions of the narratives was contrasted, demonstrating that normal comprehension, free of task demands that do not form part of everyday discourse, engages regions distributed between the two temporal lobes, more widely on the left.
Abstract: Processing of speech is obligatory. Thus, during normal speech comprehension, the listener is aware of the overall meaning of the speaker's utterance without the need to direct attention to individual linguistic and paralinguistic (intonational, prosodic, etc.) features contained within the speech signal. However, most functional neuroimaging studies of speech perception have used metalinguistic tasks that required the subjects to attend to specific features of the stimuli. Such tasks have demanded a forced-choice decision and a motor response from the subjects, which will engage frontal systems and may include unpredictable top-down modulation of the signals observed in one or more of the temporal lobe neural systems engaged during speech perception. This study contrasted the implicit comprehension of simple narrative speech with listening to reversed versions of the narratives: the latter are as acoustically complex as speech but are unintelligible in terms of both linguistic and paralinguistic information. The result demonstrated that normal comprehension, free of task demands that do not form part of everyday discourse, engages regions distributed between the two temporal lobes, more widely on the left. In particular, comprehension is dependent on anterolateral and ventral left temporal regions, as suggested by observations on patients with semantic dementia, as well as posterior regions described in studies on aphasic stroke patients. The only frontal contribution was confined to the ventrolateral left prefrontal cortex, compatible with observations that comprehension of simple speech is preserved in patients with left posterior frontal infarction.
255 citations
TL;DR: This article investigated the effect of typicality of category exemplars on naming using a single subject experimental design across participants and behaviors in 4 patients with fluent aphasia and found that patients trained on typical items demonstrated no generalized naming effect to intermediate or atypical examples.
Abstract: The effect of typicality of category exemplars on naming was investigated using a single subject experimental design across participants and behaviors in 4 patients with fluent aphasia. Participants received a semantic feature treatment to improve naming of either typical or atypical items within semantic categories, while generalization was tested to untrained items of the category. The order of typicality and category trained was counterbalanced across participants. Results indicated that patients trained on naming of atypical exemplars demonstrated generalization to naming of intermediate and typical items. However, patients trained on typical items demonstrated no generalized naming effect to intermediate or atypical examples. Furthermore, analysis of errors indicated an evolution of errors throughout training, from those with no apparent relationship to the target to primarily semantic and phonemic paraphasias. Performance on standardized language tests also showed changes as a function of treatment. Theoretical and clinical implications regarding the impact of considering semantic complexity on rehabilitation of naming deficits in aphasia are discussed.
220 citations
TL;DR: This article examined the hypothesis that training production of syntactically complex sentences results in generalization to less complex sentences that have processes in common with treated sentences and found that the hypothesis was false.
Abstract: This experiment examined the hypothesis that training production of syntactically complex sentences results in generalization to less complex sentences that have processes in common with treated st...
TL;DR: It is suggested that processing of meaningful verbal and nonverbal auditory information break down together in stroke and that subsequent recovery of function applies to both domains, which suggests that language shares neural resources with those used for processing information in other domains.
Abstract: Summary Although aphasia is often characterized as a selective impairment in language function, left hemisphere lesions may cause impairments in semantic processing of auditory information, not only in verbal but also in nonverbal domains. We assessed the ‘online’ relationship between verbal and nonverbal auditory processing by examining the ability of 30 left hemisphere-damaged aphasic patients to match environmental sounds and linguistic phrases to corresponding pictures. The verbal and nonverbal task components were matched carefully through a norming study; 21 age-matched controls and five right hemisphere-damaged patients were also tested to provide further reference points. We found that, while the aphasic groups were impaired relative to normal controls, they were impaired to the same extent in both domains, with accuracy and reaction time for verbal and nonverbal trials revealing unusually high correlations (r = 0.74 for accuracy, r = 0.95 for reaction time). Severely aphasic patients tended to perform worse in both domains, but lesion size did not correlate with performance. Lesion overlay analysis indicated that damage to posterior regions in the left middle and superior temporal gyri and to the inferior parietal lobe was a predictor of deficits in processing for both speech and environmental sounds. The lesion mapping and further statistical assessments reliably revealed a posterior superior temporal region (Wernicke’s area, traditionally considered a language-specific region) as being differentially more important for processing nonverbal sounds compared with verbal sounds. These results suggest that, in most cases, processing of meaningful verbal and nonverbal auditory information break down together in stroke and that subsequent recovery of function applies to both domains. This suggests that language shares neural resources with those used for processing information in other domains.
TL;DR: The study of artistic development in the setting of FTD suggests that language is not required for, and may even inhibit, certain types of visual creativity.
Abstract: A talented artist developed a progressive aphasia syndrome associated with frontotemporal dementia (FTD). As her disease progressed, language and executive skills declined, but her paintings became freer and more original. She demonstrates that artistic development can occur in the setting of language-dominant types of FTD. The study of artistic development in the setting of FTD suggests that language is not required for, and may even inhibit, certain types of visual creativity.
TL;DR: Assessment of the pattern of brain activity during covert word retrieval to letter and semantic cues in five aphasic patients after stroke suggests that the performance in letter fluency is dependent on the integrity of the left inferior frontal cortex, with the participation of the homologous right hemispheric region when the left superior frontal cortex is entirely of partially damaged.
TL;DR: The study of sequential cognition will provide a new paradigm for the investigation of the neurophysiological bases of language, as it is predicted that impaired syntactic processing will be associated with impairments in corresponding non-linguistic cognitive sequencing tasks.
TL;DR: Results showed that in narrative tasks a hierarchy of verb production difficulty emerged for the aphasic participants, with a preference noted for production of verbs with a fewer number of arguments, leading to the 'argument structure complexity hypothesis'.
Book•
01 Jan 2003
TL;DR: In this article, the authors present an interactive view on the Extended Speaking Turns of Persons with Wernicke's Aphasia. But they focus on the interaction and assessment of communicative success in aphasic conversations.
Abstract: PART ONE: GENERAL PERSPECTIVES 1. Introduction 2. Conservation Analysis and Communication Disorders PART TWO: MAKING MEANING TOGETHER 3. Adapting to Conversation: On the User of Pro-Forms by Aphaisa Speakers in the Construction of Turns at Talk 4. Conversational Frameworks for the Accomplishment of Meaning in Aphasia 5. Collaborating in Aphasic Group Conversation: Striving for Mutual Understanding PART THREE: REPAIR 6. Negotiating Repair in Aphasic Conversation: Interactional Issues 7. Collaborating Construction of Repair in Aphasic Conversation: An Interactive View on the Extended Speaking Turns of Persons with Wernicke's Aphasia 8. Own Words: On Achieving Normality through Paraphasias 9. Word Searches in Aphasia: A Study of the Collaborative Responses of Communicative Partners PART FOUR: INTERACTION AND ASSESSMENT 10. Aphasic Agrammatism as Interactional Artifact and Achievement 11. Co-Constructing Lucy: Adding a Social Perspective to the Assessment of Communicative Success in Aphasia
TL;DR: Although the language disorder in PPA may interfere with the ability to memorize word lists or solve reasoning tasks, the patient typically has no difficulty recalling daily events or behaving with sound judgment, indicating that explicit memory, reasoning, and social skills remain relatively intact.
Abstract: Primary progressive aphasia (PPA) is a language-based dementia. It is diagnosed by distinctive clinical features that set it apart from typical forms of Alzheimer’s disease (AD). In contrast to the patient with AD, who usually comes with a history of forgetfulness, the patient with PPA comes with reports of word-finding difficulties, abnormal speech patterns, or a deterioration of spelling. The clinical diagnosis of PPA is made when other mental faculties such as memory for daily events, visuospatial skills, and comportment display no major deficits; when language is the only area of salient and progressive dysfunction for at least the first 2 years of the disease; and when brain imaging does not show a specific lesion, other than atrophy, that can account for the language deficit. Standardized neuropsychological tests of language function are helpful for detecting early stages of the disease. However, a strict reliance on neuropsychological tests, most of which depend on verbal instructions, verbal responses, or covert verbal reasoning, may occasionally lead to the erroneous conclusion that areas other than language are also impaired. Scores on the Mini-Mental Status Examination, for example, can greatly exaggerate the degree of disability. Although the language disorder in PPA may interfere with the ability to memorize word lists or solve reasoning tasks, the patient typically has no difficulty recalling daily events or behaving with sound judgment, indicating that explicit memory, reasoning, and social skills remain relatively intact. PPA is a form of dementia because it causes a gradual cognitive decline to the point at which daily living functions become compromised. It is also an unusual dementia because core memory functions, which are severely impaired in AD, remain largely preserved.
TL;DR: Therapy that focuses on situation-specific communication and societal participation appears to be most appropriate for enhancing the QOL of people with chronic aphasia.
Abstract: Background: Although the social approach to managing aphasia is designed to improve the quality of life (QOL) of the aphasic person, the influence of being aphasic on different facets of QOL is unknown. Aims: To delineate socially valid therapy targets, we examined 24 facets of QOL proposed by the World Health Organisation (WHO) to determine which facets differentiate QOL between aphasic and nonaphasic people. Methods & Procedures: A prospective, observational, non-randomised group design was employed. Two measures--the WHO QOL Instrument, Short Form (WHOQOL-BREF) and the Psychosocial Well-Being Index (PWI)--were administered to 18 adults with chronic aphasia and 18 nonaphasic adults. Indices of determination (ID) and degrees of overlap (DO) were calculated to determine which of the 24 facets were best in differentiating between the aphasic and nonaphasic groups. Outcomes & Results: Facets within three domains--level of independence, social relationships, and environment--were best in distinguishing QOL b...
TL;DR: Although the use of functional imaging to inform methods of improving aphasia rehabilitation remains underdeveloped, there are strong indicators that this methodology will provide the means to research a very imperfectly developed area of therapy.
Abstract: The old neurological model of language, based on the writings of Broca, Wernicke and Lichtheim in the 19th century, is now undergoing major modifications. Observations on the anatomy and physiology of auditory processing in non-human primates are giving strong indicators as to how speech perception is organised in the human brain. In the light of this knowledge, functional activation studies with positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) are achieving a new level of precision in the investigation of language organisation in the human brain, in a manner not possible with observations on patients with aphasic stroke. Although the use of functional imaging to inform methods of improving aphasia rehabilitation remains underdeveloped, there are strong indicators that this methodology will provide the means to research a very imperfectly developed area of therapy.
TL;DR: It seems as if pantomime of object use taps a central aspect of left hemisphere function which is compromised by any LBD, and it is proposed that this may be the ability to select and combine distinctive features of objects and actions.
TL;DR: A circumscribed deficit in the selective attentional engagement of the semantic network on the basis of meaning frequency is suggested, possibly implicating a disturbance of frontal–subcortical systems influencing inhibitory semantic mechanisms.
Abstract: The impact of basal ganglia dysfunction on semantic processing was investigated by comparing the performance of individuals with nonthalamic subcortical (NS) vascular lesions, Parkinson’s disease (PD), cortical lesions, and matched controls on a semantic priming task. Unequibiased lexical ambiguity primes were used in auditory prime-target pairs comprising 4 critical conditions; dominant related (e.g., bank‐money ), subordinate related (e.g., bank‐river), dominant unrelated (e.g., foot‐money) and subordinate unrelated (e.g., bat‐river). Participants made speeded lexical decisions (word0nonword) on targets using a go‐no-go response. When a short prime‐target interstimulus interval (ISI) of 200 ms was employed, all groups demonstrated priming for dominant and subordinate conditions, indicating nonselective meaning facilitation and intact automatic lexical processing. Differences emerged at the long ISI (1250 ms), where control and cortical lesion participants evidenced selective facilitation of the dominant meaning, whereas NS and PD groups demonstrated a protracted period of nonselective meaning facilitation. This finding suggests a circumscribed deficit in the selective attentional engagement of the semantic network on the basis of meaning frequency, possibly implicating a disturbance of frontal‐subcortical systems influencing inhibitory semantic mechanisms. (JINS, 2003, 9, 1041‐1052.)
TL;DR: Language testing, particularly fluency scores supported by neuroimaging are helpful differentiating PPA from AD, indicating the substantial clinical overlap of these conditions.
Abstract: 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.
TL;DR: A preliminary investigation has found that aphasia‐friendly material does assist people with aphasIA to comprehend health information and a greater understanding of people withaphasia's reactions to aphasic‐friendly materials and also the social impact of providing aphasian‐friendly information is required.
Abstract: Background: Provision of health information to people with aphasia is inadequate. Current practice in providing printed health education materials to people with aphasia does not routinely take into consideration their language and associated reading difficulties. Aims: This study aimed to investigate if people with aphasia can comprehend health information contained in printed health education materials and if the application of aphasia‐friendly principles is effective in assisting them to comprehend health information. It was hypothesised that participants with aphasia would comprehend significantly more information from aphasia‐friendly materials than from existing materials. Other aims included investigating if the effectiveness of the aphasia‐friendly principles is related to aphasia severity, if people with aphasia are more confident in responding to health information questions after they have read the aphasia‐friendly material, if they prefer to read the aphasia‐friendly brochures, and if they pre...
Book•
01 Jan 2003
TL;DR: A history of aphasia therapy from World War I to the 1970's can be found in this paper, with a focus on the treatment of lexical and sentence disorders, as well as severe aphasias.
Abstract: 1. A historical overview 2. Classification of the aphasias 3. Aphasia therapy from World War I to the 1970's 4. Efficacy of aphasia therapy 5. Cognitive neuropsychology 6. The lexicon 7. Cognitive rehabilitation 8. In search of a theory of aphasia therapy 9. Rehabilitation of lexical and sentence disorders 10. Severe aphasia and pragmatics 11. Final remarks Appendix 1 Appendix 2
TL;DR: Primary Progressive Aphasia patients with impaired word finding but intact comprehension of conversational speech and their matched control subjects were examined using voxel‐based morphometry and functional magnetic resonance imaging (fMRI).
Abstract: Primary Progressive Aphasia (PPA) is a behaviorally focal dementia syndrome with deterioration of language functions but relative preservation of other cognitive domains for at least the first two years of disease. In this study, PPA patients with impaired word finding but intact comprehension of conversational speech and their matched control subjects were examined using voxel-based morphometry (VBM) and functional magnetic resonance imaging (fMRI). fMRI compared signal changes during phonological and semantic language tasks with those during a control task (matching letters). PPA patients showed longer reaction times and reduced accuracy versus controls on the language tasks, but no performance differences on the control task. VBM demonstrated reduced gray matter in left superior temporal and inferior parietal regions in the PPA group. However, these patients showed a normal pattern of activation within the classical language regions. In addition, PPA patients showed activations, not seen in normals, in fusiform gyrus, precentral gyrus, and intra-parietal sulcus. These activations were found to correlate negatively with measures of naming and task performance. The additional activations in PPA may therefore represent a compensatory spread of language-related neural activity or a failure to suppress activity in areas normally inhibited during language tasks.
TL;DR: It is concluded that the emotional impact of aphasia can have a marked negative impact on recovery, response to rehabilitation, and psychosocial adjustment.
Abstract: In this paper we review the relationship between the impact of aphasia and emotional well-being. Depression is one of several types of emotional response that has been researched most and we examine the different causes of depression for people with aphasia. We discuss the relationships between recovery and emotional state and the clinical and psychosocial implications of these relationships. We examine methods for assessment of emotional response and psychosocial evaluation and review implications for rehabilitation. We discuss briefly issues of drug treatment for depression in aphasic people. We conclude that the emotional impact of aphasia can have a marked negative impact on recovery, response to rehabilitation, and psychosocial adjustment.
TL;DR: The findings challenge the current notion that semantic treatment is more effective than phonological treatment for patients with a combined semantic and phonological deficit and suggest that improved verbal communication was achieved in a different way for each treatment group.
Abstract: Background and Purpose— Semantic deficits, deficits in word meaning, have a large impact on aphasic patients’ verbal communication. We investigated the effects of semantic treatment on verbal communication in a randomized controlled trial. Methods— Fifty-eight patients with a combined semantic and phonological deficit were randomized to receive either semantic treatment or the control treatment focused on word sound (phonology). Fifty-five patients completed pretreatment and posttreatment assessment of verbal communication (Amsterdam Nijmegen Everyday Language Test [ANELT]). In an on-treatment analysis (n=46), treatment-specific effects on semantic and phonological measures were explored. Results— Both groups improved on the ANELT, with no difference between groups in overall score (difference, −1.1; 95% confidence interval [CI], −5.3 to 3.1). After semantic treatment, patients improved on a semantic measure (mean improvement, 2.9; 95% CI, 1.2 to 4.6), whereas after phonological treatment, patients improv...
TL;DR: A review of the literature reveals that, although the pattern and severity of neuropsychological impairments can be highly variable across patients, several general trends can be identified: limb apraxia, constructional and visuospatial difficulties, acalculia, frontal dysfunction, and nonfluent aphasia.
Abstract: The presence of cognitive impairment in corticobasal degeneration (CBD) is now widely recognised. Our review of the literature reveals that, although the pattern and severity of neuropsychological impairments can be highly variable across patients, several general trends can be identified. The most characteristic impairments are limb apraxia (usually ideomotor), constructional and visuospatial difficulties, acalculia, frontal dysfunction, and nonfluent aphasia. The limb apraxia is associated with deficits in drawing, copying, and handwriting, but there is emerging evidence that the problems with handwriting are not due exclusively to the apraxia. The findings with respect to episodic memory are more variable, but when there is impairment in this area, it tends to be milder than that seen in Alzheimer's disease. Semantic memory functioning appears relatively preserved but has been poorly studied. Problems with speech are common, and may be due to dysarthria or buccofacial apraxia. Aphasia, although initially considered rare, is in fact a common accompaniment of CBD, may be the presenting feature, and is typically nonfluent in type. More systematic investigation of the clinical and neuropathological overlap between progressive nonfluent aphasia (generally considered to be a form of frontotemporal dementia) and CBD is needed.
TL;DR: Results indicate that older people with aphasia engage in similar communication activities to healthy older people although differences were evident in the frequency of communication and in specific activities such as story telling, writing, commenting, and acknowledging.
Abstract: Background : Increasingly there is a call from clinicians and researchers for measures that document the impact of aphasia on a person's everyday communication. Do existing assessments of communication disability adequately sample communication activities relevant to our clients? Communication skills and networks change with age. A need exists to determine the everyday communication activities of older people and in particular those with aphasia. Aims : The primary aim of this study was to describe and compare the everyday communication activities of older people with aphasia and healthy older people who are living in the community. A secondary aim was to investigate the content validity of the American Speech-Language Hearing Association Functional Assessment of Communication Skills for Adults (ASHA FACS, 1997) for older Australians. Methods & Procedures : Naturalistic observation was the method of choice for detailing the everyday communication of 15 older people with chronic aphasia following stroke an...