Showing papers on "Aphasia published in 2008"

Structural priming: a critical review.

Abstract: Repetition is a central phenomenon of behavior, and researchers have made extensive use of it to illuminate psychological functioning. In the language sciences, a ubiquitous form of such repetition is structural priming, a tendency to repeat or better process a current sentence because of its structural similarity to a previously experienced ("prime") sentence (J. K. Bock, 1986). The recent explosion of research in structural priming has made it the dominant means of investigating the processes involved in the production (and increasingly, comprehension) of complex expressions such as sentences. This review considers its implications for the representation of syntax and the mechanisms of production and comprehension and their relationship. It then addresses the potential functions of structural priming, before turning to its implications for first language acquisition, bilingualism, and aphasia. The authors close with theoretical and empirical recommendations for future investigations.

The logopenic/phonological variant of primary progressive aphasia

Abstract: Objective: Primary progressive aphasia (PPA) is characterized by isolated decline in language functions. Semantic dementia and progressive nonfluent aphasia are accepted PPA variants. A “logopenic” variant (LPA) has also been proposed, but its cognitive and anatomic profile is less defined. The aim of this study was to establish the cognitive and anatomic features of LPA. Methods: Six previously unreported LPA cases underwent extensive neuropsychological evaluation and an experimental study of phonological loop functions, including auditory and visual span tasks with digits, letters, and words. For each patient, a voxel-wise, automated analysis of MRI or SPECT data were conducted using SPM2. Results: In LPA, speech rate was slow, with long word-finding pauses. Grammar and articulation were preserved, although phonological paraphasias could be present. Repetition and comprehension were impaired for sentences but preserved for single words, and naming was moderately affected. Investigation of phonological loop functions showed that patients were severely impaired in digit, letter, and word span tasks. Performance did not improve with pointing, was influenced by word length, and did not show the normal phonological similarity effect. Atrophy or decreased blood flow was consistently found in the posterior portion of the left superior and middle temporal gyri and inferior parietal lobule. Conclusions: Logopenic progressive aphasia (LPA) is a distinctive variant of primary progressive aphasia. Cognitive and neuroimaging data indicate that a deficit in phonological loop functions may be the core mechanism underlying the LPA clinical syndrome. Recent studies suggest that Alzheimer disease may be the most common pathology underlying the LPA clinical syndrome. GLOSSARY: AD = Alzheimer disease; BA = Brodmann area; CDR = Clinical Dementia Rating; CVLT-MS = California Verbal Learning Test–Mental Status Edition; ECD = ethyl cysteinate dimer; FWHM = full-width at half-maximum; GM = gray matter; LPA = logopenic progressive aphasia; MMSE = Mini-Mental State Examination; PNFA = progressive nonfluent aphasia; PPA = primary progressive aphasia; Rey-O = Rey–Osterrieth; SemD = semantic dementia; VBM = voxel-based morphometry; WAB = Western Aphasia Battery; WAIS-III = Wechsler Adult Intelligence Scale, Third Edition.

Language intervention strategies in aphasia and related neurogenic communication disorders

Abstract: I:Basic Considerations II:Principles of Language Intervention III:Psychosocial/Functional Approaches to Intervention:Focus on Improving Ability to Perform Communication Activities of Daily Living IV:Traditional Approaches to Language Intervention Stimulation Approaches Cognitive Neuropsychological Approaches to Treatment of Language Disorders Cognitive Neurolinguistic Approaches to Treatment of Language Disorders Specilized Interventions for Aphasic Patients Therapy for Associated Neuropathologies of Speech and Language Related Functions Inde

Aβ amyloid and glucose metabolism in three variants of primary progressive aphasia

Abstract: OBJECTIVE Alzheimer’s disease (AD) is found at autopsy in up to one-third of patients with primary progressive aphasia (PPA), but clinical features that predict AD pathology in PPA are not well defined. We studied the relationships between language presentation, Aβ amyloidosis and glucose metabolism in three variants of PPA using [11C]PIB and [18F]FDG-PET.

Development of methodology for conducting clinical trials in frontotemporal lobar degeneration

Abstract: To design clinical trials for the frontotemporal lobar degenerations (FTLD), knowledge about measurement of disease progression is needed to estimate power and enable the choice of optimal outcome measures. The aim here was to conduct a multicentre, 1 year replica of a clinical trial in patients with one of four FTLD syndromes, behavioural variant frontotemporal dementia (bvFTD), progressive nonfluent aphasia (PNFA), progressive logopenic aphasia (PLA) and semantic dementia (SMD). Patients with one of the four FTLD syndromes were recruited from five academic medical centres over a 2 year period. Standard operationalized diagnostic criteria were used. In addition to clinical inclusion and exclusion criteria, patients were required to exhibit focal frontal, temporal or insular brain atrophy or dysfunction by neuroimaging. Patients underwent neuropsychological, functional, behavioural, neurological and MR imaging assessment at baseline and approximately 12 months later. Potential outcome measures were examined for their rates of floor and ceiling values at baseline and end of study, their mean changes and variances. The neuropsychological tests were combined into two cognitive composites—one for language functions and the other for executive functions. There were 107 patients who underwent baseline assessment and 78 who completed a follow-up assessment within 10–16 months. Two global measures, the FTLD-modified Clinical Dementia Rating (FTLD-modified CDR) and the Clinical Global Impression of Change (CGIC) demonstrated decline in the majority of patients. Several cognitive measures showed negligible floor or ceiling scores either at baseline or follow-up. Scores declined at follow-up in the majority of patients. The cognitive, executive and combined composites were shown to be sensitive to change across all FTLD syndromes. Patients improved at follow-up on the behavioural scales—the Frontal Behavioural Inventory (22%) and the Neuropsychiatric Inventory (28%)—suggesting that these instruments may not be ideal for clinical trial use. It was feasible to recruit FTLD patients in a simulated multi-centre trial. There are several candidate outcome measures—including the FTLD-CDR and the cognitive composites— that could be used in clinical trials across the spectrum of FTLD.

Counting what counts: A framework for capturing real‐life outcomes of aphasia intervention

Abstract: Background: The initial motivation was our inability to capture the important but often elusive outcomes of interventions that focus on making a difference to the everyday experience of individuals with aphasia and their families In addition, a review of the literature and input from stakeholder focus groups revealed the lack of an integrated approach to outcome evaluation across diverse approaches to aphasia intervention Input from focus groups also indicated that existing classifications and models offering potential solutions are not always easily accessible and user friendly This research has been generously funded by a grant from the Ontario Ministry of Health and Long Term Care The views expressed here do not necessarily reflect those of the Ministry The authors thank staff at the Aphasia Institute and members of the Ontario Aphasia Centres Interest Group for their participation in the project, Drs Audrey Holland and Roberta Elman for useful feedback on earlier drafts of this article, Laura Dic

Evidence-based systematic review: effects of intensity of treatment and constraint-induced language therapy for individuals with stroke-induced aphasia.

Abstract: Purpose This systematic review summarizes evidence for intensity of treatment and constraint-induced language therapy (CILT) on measures of language impairment and communication activity/participat...

Frequency and Prognostic Value of Cognitive Disorders in Stroke Patients

Abstract: Background: Stroke is one of the most common diseases to cause cognitive disorders in adults. Aims: To assess the frequency of cognitive deficits in stroke patients and to evaluate the prognostic value of cognitive syndromes for functional recovery. Methods: 200 consecutive patients were examined using a clinical screening battery for cognitive assessment in the second week after their first-ever stroke. 80 were re-examined after a 1-year follow-up. Results: In the post-acute stage, 78% patients were impaired in one or more cognitive domains. The most frequently affected cognitive abilities were attention (48.5%), language (27%), short-term memory (24.5%) and executive functions (18.5%). At the 1-year follow-up, attention deficits were still the most frequent symptom. In contrast, executive dysfunction, aphasia, and long-term memory disorder were significantly less frequent than in the post-acute period. Logistic regression analysis showed that older age, lower score on the Barthel Index, and the presence of executive dysfunction on initial examination were significant predictors of a poor functional outcome at the 1-year follow-up examination. Conclusions: Cognitive-behavioral syndromes are frequent and often chronic consequences of stroke. Executive deficits proved to be the most robust cognitive predictor of poor functional recovery after stroke.

Aphasia therapy on a neuroscience basis.

Abstract: 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 open new perspectives for research into the plasticity of human language circuits.

Social Participation for Older People with Aphasia: The Impact of Communication Disability on Friendships

Abstract: Purpose: The language changes experienced by a person with aphasia following a stroke often have sudden and longlasting negative impact on friendships. Friendship relationships are core to social engagement, quality of life, and emotional well-being. The aims of this study were to describe everyday communication with friends for older people with and without aphasia and to examine the nature of actual friendship conversations involving a person with aphasia. Method: This naturalistic inquiry drew data from two phases of research: a participant observation study of 30 older Australians, 15 of whom had aphasia following a stroke, and a collective case study using stimulated recall to examine friendship conversations involving an older person with aphasia. Results: People with aphasia communicated with fewer friends and had smaller social networks. “Friendship” was a core domain of communication for older people and participation in leisure and educational activities was focal in everyday communication with friends. Case study data of conversations between three older people with aphasia and their friends illuminated features of “time,” the role of humour, and friends having shared interests. Conclusion: Aphasia has been found to impact on friendships. A need exists for research and intervention

Variability in language recovery after first-time stroke

Abstract: Background: Predicting aphasia recovery after stroke has been difficult due to substantial variability in outcomes. Few studies have characterised the nature and extent of recovery, beginning with baselines at 24–72 hours after stroke onset. Aim: To characterise the course of language recovery after first-time stroke. Methods: Using our Performance and Recovery in Stroke Study (PARIS) database, we evaluated consecutive first-time stroke patients with aphasia and diffusion-weighted-image-positive lesions on admission and at 90 days. Results: Twenty-two of 91 patients had language disorders. Initial syndrome scores were positively correlated with 90-day scores (r = 0.60) and negatively correlated with the change in score from baseline to follow-up (r = −0.66). Neither lesion size, age nor education correlated with initial syndrome severity or with performance at 90 days. Level of education was not associated with degree of recovery. A multiple regression model that combined lesion size, age and initial syndrome was significant (p = 0.03) but only explained 29% of the variance. Patients with severe deficits at baseline in individual language domains could recover, improve to a less severe deficit or not improve at all. Conclusion: There was significant variability in language recovery after first-time stroke, even in more severe, initial syndromes. Traditional predictors of post-stroke language outcomes did not reliably predict function at 90 days. These data suggest that other factors that account for functional stroke recovery have not yet been identified.

Age of onset and outcome in acquired aphasia with convulsive disorder (Landau-Kleffner syndrome)

Abstract: The relationship between age at onset of language disorder and eventual outcome was examined in 45 cases of Landau-Kleffner syndrome reported in the literature, all of whom had been followed up to at least 12 years of age. A strong relationship was found, which is opposite to that for childhood aphasia after structural lesions of the left hemisphere; i.e. in Landau-Kleffner syndrome, the older the child at onset the better the prognosis for language.

Galantamine in Frontotemporal Dementia and Primary Progressive Aphasia

Abstract: Background/Aims: The treatment of frontotemporal dementia (FTD) has been mainly symptomatic. Small randomized or open-label case control studies of neurotransmitters have been inconclusive. We tried galantamine in the 2 most common varieties of FTD. Method: Thirty-six behavioral variety FTD and primary progressive aphasia (PPA) patients were treated in an open-label period of 18 weeks and a randomized, placebo-controlled phase for 8 weeks with galantamine. The primary efficacy measures were the Frontal Behavioral Inventory, the Aphasia Quotient of the Western Aphasia Battery, the Clinical Global Impression of Severity and the Clinical Global Impression of Improvement. Results: No significant differences in behavior or language were found for the total group. A treatment effect (p = 0.009), in a subgroup of subjects with PPA in the global severity score, in favor of galantamine was detected in the placebo-controlled withdrawal phase but was not considered significant after correction for multiple comparisons. The language scores for the treated PPA group also remained stable compared to the placebo group, which showed deterioration. Conclusion: Galantamine is not effective in the behavioral variety of FTD, but a trend of efficacy is shown in the aphasic subgroup, which may be clinically significant. Galantamine appeared safe in FTD/PPA.

Translational Research in Aphasia: From Neuroscience to Neurorehabilitation

Abstract: Purpose In this article, the authors encapsulate discussions of the Language Work Group that took place as part of the Workshop in Plasticity/NeuroRehabilitation Research at the University of Florida in April 2005. Method In this narrative review, they define neuroplasticity and review studies that demonstrate neural changes associated with aphasia recovery and treatment. The authors then summarize basic science evidence from animals, human cognition, and computational neuroscience that is relevant to aphasia treatment research. They then turn to the aphasia treatment literature in which evidence exists to support several of the neuroscience principles. Conclusion Despite the extant aphasia treatment literature, many questions remain regarding how neuroscience principles can be manipulated to maximize aphasia recovery and treatment. They propose a framework, incorporating some of these principles, that may serve as a potential roadmap for future investigations of aphasia treatment and recovery. In additio...

Models of attention and dual-task performance as explanatory constructs in aphasia.

Abstract: Aphasia has traditionally been viewed as a loss or impairment of language. However, evidence is presented suggesting that language mechanisms are fundamentally preserved and that aphasic language behaviors are instead due to impairments of cognitive processes supporting their construction. These processes may be understood as a linguistically specialized attentional system that is vulnerable to competition from other processing domains. We present two models of attention that focus on competition for central processing and discuss findings from dual-task studies of normal and aphasic performance. First, competing language and nonlanguage tasks appear to share limited-capacity, parallel processing resources. Second, aphasic individuals demonstrate slowed central processing that could be due to a reduction in processing capacity or ability to allocate that capacity. Third, the attention models discussed bear a coherent relationship to current models of language processing. Clinical implications of a cognitive processing account of aphasia are also considered.

Computerized script training for aphasia: preliminary results.

Abstract: Purpose This article describes computer software that was developed specifically for training conversational scripts and illustrates its use with 3 individuals with aphasia. Method Three participants with chronic aphasia (Broca’s, Wernicke’s, and anomic) were assessed before and after 9 weeks of a computer script training program. For each participant, 3 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 posttreatment scripts were audiotaped, 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 his or her 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. ...

Unravelling Boléro: progressive aphasia, transmodal creativity and the right posterior neocortex

Abstract: Most neurological lesion studies emphasize performance deficits that result from focal brain injury. Here, we describe striking gains of function in a patient with primary progressive aphasia, a degenerative disease of the human language network. During the decade before her language deficits arose, Anne Adams (AA), a lifelong scientist, developed an intense drive to produce visual art. Paintings from AA's artistic peak revealed her capacity to create expressive transmodal art, such as renderings of music in paint, which may have reflected an increased subjective relatedness among internal perceptual and conceptual images. AA became fascinated with Maurice Ravel, the French composer who also suffered from a progressive aphasia, and painted his best-known work, 'Bolero', by translating its musical elements into visual form. Later paintings, achieved when AA was nearly mute, moved towards increasing photographic realism, perhaps because visual representations came to dominate AA's mental landscape during this phase of her illness. Neuroimaging analyses revealed that, despite severe degeneration of left inferior frontal-insular, temporal and striatal regions, AA showed increased grey matter volume and hyperperfusion in right posterior neocortical areas implicated in heteromodal and polysensory integration. The findings suggest that structural and functional enhancements in non-dominant posterior neocortex may give rise to specific forms of visual creativity that can be liberated by dominant inferior frontal cortex injury.

Apraxia of speech and nonfluent aphasia: a new clinical marker for corticobasal degeneration and progressive supranuclear palsy.

Abstract: Purpose of reviewTo highlight the fact that patients with corticobasal degeneration (CBD) and progressive supranuclear palsy (PSP) can sometimes present with a progressive apraxia of speech, nonfluent aphasia, or a combination of the two disorders.Recent findingsCorticobasal degeneration and PSP are

Association between therapy outcome and right-hemispheric activation in chronic aphasia

Abstract: The role of the right hemisphere for language processing and successful therapeutic interventions in aphasic patients is a matter of debate. This study explored brain activation in right-hemispheric areas and left-hemispheric perilesional areas in response to language tasks in chronic non-fluent aphasic patients before and after constraint-induced aphasia therapy (CIAT). In particular, we analysed the relation between brain responses and therapy outcome. Using functional magnetic resonance imaging (fMRI), brain activation was measured during word-reading (REA) and word-stem completion (COM) in 16 chronic non-fluent aphasic and 8 healthy subjects. Before therapy, activation in right inferior frontal gyrus/insula (IFG/IC) was stronger in aphasics compared to controls during REA and in precentral gyrus (PCG) during COM. Therapeutic intervention per se did not change brain activation for either task across all aphasic subjects. However, therapeutic success correlated with a relative decrease of activation in right-hemispheric areas, including the IFG/IC. Most importantly, initial activation in right IFG/IC and other right-hemispheric areas correlated positively with subsequent therapy success. Thus, right-hemispheric activation prior to aphasia therapy strongly predicts therapeutic success, suggesting that brain activation in chronic aphasia indicates the patients' potential for further language improvement.

Right hemisphere activation in recovery from aphasia Lesion effect or function recruitment

Abstract: Background: Some neuroimaging studies have suggested that specific right hemispheric regions can compensate deficits induced by left hemispheric lesions in vascular aphasia. In particular, the right inferior frontal cortex might take part in lexical retrieval in patients presenting left-sided lesions involving the homologous area. Objective: To address whether the involvement of the right inferior frontal cortex is either unique to recovering aphasic patients or present also in other circumstances of enrichment of lexical abilities, i.e., in non–brain-damaged subjects over learning of new vocabulary. Methods: Ten post-stroke aphasic patients experiencing word finding difficulties were intensively trained to retrieve object names in French over a 4-week period. Twenty healthy subjects were similarly trained to name these items in either Spanish or English, i.e., foreign languages that they learned at school but did not master. By analogy to aphasic patients, healthy subjects had to work out the phonetic/phonologic representations of long-acquired but forgotten words. Brain activity changes were assessed in two H 2 15 O PET sessions involving picture naming tasks that were performed before and after training. Results: Comparable post-training performance and changes in regional cerebral blood flow including mainly the right insular and inferior frontal regions were found in both groups. Conclusion: Our results suggest that enhanced activities in right-sided areas observed in recovering aphasia is not the mere consequence of damage to left-sided homologous areas and could reflect the neural correlates of lexical learning also observed in control subjects.

Verbal auditory agnosia in children.

Abstract: Four (possibly five) boys are described with a profound comprehension deficit for acoustic language, leading to severe or complete abolition of expressive speech. One boy had presumed megalencephaly from birth but was of superior intelligence. He had a severe articulation deficit from early childhood, with delayed acquisition of speech. Another boy is thought to have a small angiomatous anomaly in the depth of the left parietal lobe. No brain lesions are known in the other three. Evidence for bilateral brain dysfunction consists of minor motor abnormalities in three boys, oromotor deficits in two boys, and bilaterally synchronous diffuse or independent focal paroxysmal discharges in the EEG of three, possibly four, of the boys. Seizures have occurred in only three boys, and have been easily controlled with anticonvulsants. One boy with a grossly abnormal EEG has had no clinical seizures to date and has not benefited frome one year of anticonvulsant therapy. Two of the boys are brothers, including the boy in whome the diagnosis is questionable since speech was never normal and since he has had neither seizures for an abnormal EEG. The severity of EEG abnormalities did not correlate closely with the course of the language deficit. The relationship of this syndrome to acquired aphasia in children, to Wernicke's aphasia and pure word deafness in adults, and to developmental lagnuage disability with predominantly receptive deficits, is discussed. One child illustrated the close association between writing and phonologic encoding and decoding operations, and two children the preservation of linguistic skills provided the acoustic channel was by-passed and language presented visually. This latter point has been emphasized because of its implications for the remedial education of children with this syndrome.

Language dysfunction after stroke and damage to white matter tracts evaluated using diffusion tensor imaging.

Abstract: BACKGROUND AND PURPOSE: Knowledge of the anatomic basis of aphasia after stroke has both theoretic and clinical implications by informing models of cortical connectivity and providing data for diagnosis and prognosis. In this study we use diffusion tensor imaging to address the relationship between damage to specific white matter tracts and linguistic deficits after left hemisphere stroke. MATERIALS AND METHODS: Twenty patients aged 38–77 years with a history of stroke in the left hemisphere underwent diffusion tensor imaging, structural MR imaging, and language testing. All of the patients were premorbidly right handed and underwent imaging and language testing at least 1 month after stroke. RESULTS: Lower fractional anisotropy (FA) values in the superior longitudinal and arcuate fasciculi of the left hemisphere, an indication of greater damage to these tracts, were correlated with decreased ability to repeat spoken language. Comprehension deficits after stroke were associated with lower FA values in the arcuate fasciculus of the left hemisphere. The findings for repetition were independent of MR imaging ratings of the degree of damage to cortical areas of the left hemisphere involved in language function. There were no findings for homotopic tracts in the right hemisphere. CONCLUSION: This study provides support for a specific role for damage to the superior longitudinal and arcuate fasciculi in the left hemisphere in patients with deficits in repetition of speech in aphasia after stroke.

Progressive aphasia secondary to Alzheimer disease vs FTLD pathology

Abstract: Background: The pathology causing progressive aphasia is typically a variant of frontotemporal lobar degeneration, especially with ubiquitin-positive inclusions (FTLD-U). Less commonly the underlying pathology is Alzheimer disease (AD). Objective: To compare clinicopathologic and MRI features of subjects with progressive aphasia and AD pathology to subjects with aphasia and FTLD-U pathology and subjects with typical AD. Methods: We identified 5 subjects with aphasia and AD pathology and 5 with aphasia and FTLD-U pathology with an MRI from a total of 216 aphasia subjects. Ten subjects with typical AD clinical features and AD pathology were also identified. All subjects with AD pathology underwent pathologic reanalysis with TDP-43 immunohistochemistry. Voxel-based morphometry (VBM) was used to assess patterns of gray matter atrophy in the aphasia cases with AD pathology, aphasia cases with FTLD-U, and typical AD cases with AD pathology, compared with a normal control group. Results: All aphasic subjects had fluent speech output. However, those with AD pathology had better processing speed than those with FTLD-U pathology. Immunohistochemistry with TDP-43 antibodies was negative. VBM revealed gray matter atrophy predominantly in the temporoparietal cortices, with notable sparing of the hippocampus in the aphasia with AD subjects. In comparison, the aphasic subjects with FTLD-U showed sparing of the parietal lobe. Typical AD subjects showed temporoparietal and hippocampal atrophy. Conclusions: A temporoparietal pattern of atrophy on MRI in patients with progressive fluent aphasia and relatively preserved processing speed is suggestive of underlying Alzheimer disease pathology rather than frontotemporal lobar degeneration with ubiquitin-only immunoreactive changes. GLOSSARY: AD = Alzheimer disease; ADPR = Alzheimer9s Disease Patient Registry; ADRC = Alzheimer9s Disease Research Center; aphasia–AD = subjects with progressive aphasia and Alzheimer disease pathology; aphasia–FTLD-U = subjects with progressive aphasia and frontotemporal lobar degeneration with ubiquitin-only immunoreactive changes pathology; CDR = Clinical Dementia Rating; DCT = discrete cosine transformation; FTLD = frontotemporal lobar degeneration; FTLD-U = frontotemporal lobar degeneration with ubiquitin-only immunoreactive changes; FWHM = full-width at half-maximum; GM = gray matter; MMSE = Mini-Mental State Examination; MNI = Montreal Neurological Institute; NA = not applicable; NIA = National Institute on Aging; NR = not reported; NS = not significant; PPA = primary progressive aphasia; typical AD = subjects with a clinical and pathologic diagnosis of Alzheimer disease; VBM = voxel-based morphometry; WAIS-R = Wechsler Adult Intelligence Scale–Revised; WM = white matter; WMS-R = Wechsler Memory Scale–Revised.

Treating naming impairments in aphasia: Findings from a phonological components analysis treatment

Abstract: Background: A new phonologically based treatment that we developed for addressing naming deficits in aphasia—the phonological components analysis (PCA) treatment—is presented. The PCA was modelled after the semantic feature analysis (SFA) approach (Boyle & Coelho, 1995). The SFA approach was chosen as a model for two reasons. First, results from the semantic therapies that have used SFA have been encouraging (e.g., Boyle, 2004; Boyle & Coelho, 1995; Coelho, McHugh, & Boyle, 2000; Conley & Coelho, 2003; Lowell, Beeson, & Holland, 1995). Second, SFA incorporates the principle of choice, a factor that has been identified by some as being important in producing longer‐lasting effects of treatment (e.g., Hickin, Best, Herbert, Howard, & Osborne, 2002). The PCA was developed to serve as a comparable phonological comparison for the SFA approach with the future goal of comparing the relative effects of both types of therapies. Portions of this work were presented at the Academy of Aphasia meetings in New York, Oc...

Intensive language therapy in chronic aphasia: Which aspects contribute most?

Abstract: Background: Recent research suggests the effectiveness of short‐term highly intensive treatment approaches in the chronic stage of aphasia. However, the effective elements of such treatment need to be determined. This study was supported by the Deutsche Forschungsgemeinschaft (DFG, Grant RO 805/11‐4) and the Kuratorium Zentrales Nervensystem (Kuratorium ZNS, Grant 2001013). The study was carried out in cooperation with the Kliniken Schmieder (Konstanz and Allensbach) and the Hegau Jugendwerk (Gailingen). Aims: The present study's aim was to evaluate which factors attribute to the success of aphasia therapy. An intensive (3 hours/day, 10 consecutive days) model‐orientated aphasia therapy (MOAT), which considers patients' individual symptoms, was evaluated and therapy effects were compared to those of a similarly intensive training focusing on active speaking elements (constraint‐induced aphasia therapy, CIAT) in order to identify the effective elements. Methods & Procedures: 12 patients with chronic aphasi...

Aphasia during the acute phase in ischemic stroke.

Abstract: Objectives: We investigated the incidence, clinical characteristics, outcome and factors associated with aphasia and early improvement in acute ischemic stroke. Methods:<