Effect of speech therapy intervention program for non-fluent aphasic patients after stroke.

PURPOSE: the objective of this paper is to verify the effect of speech therapy intervention program in patients with non-fluent aphasia due to stroke in language tasks related to verbal fluency in semantic and phonological categories. METHODS: Patients with aphasia due to stroke were selected to take part in this study. Two groups were formed: diagnosed patients with Broca/transcortical motor aphasia (GA), and a control group (healthy individuals). GA took a fluency verbal task (FAS, other complementary categories: phonological /p/ /l/ and semantic: "fruits" and "names"). These patients were all engaged in a language intervention program developed by the authors of this study. GA received speech therapy sessions (ten sessions lasting for an hour once a week), following a specific language program. After the sessions, the patients were re-evaluated. RESULTS: GA had statistical significant improvement in the verbal fluency task after the speech therapy program (p-value < 0,001). CONCLUSION: The speech language therapy program we proposed was efficient enough to show improvement in the results for GA in the verbal fluency task.

Transcranial direct current stimulation: a study on naming performance in aphasic individuals. / Estimulação transcraniana por corrente contínua: estudo sobre respostas em tarefas de nomeação em afásicos.

PURPOSE: Compare the results in naming tasks of after-stroke aphasic individuals divided into active and placebo groups pre- and post-transcranial direct current stimulation. METHODS: A double-blind, randomized, controlled study conducted with 14 individuals. Patients underwent five 20-min sessions with stimulation of 2mA's on consecutive days. The cathode was placed over the Broca's homologous area and the anode was placed over the supraorbital region of the left hemisphere. Boston and Snodgrass naming tasks were assessed before and after the stimulation sessions and the results were compared between the groups. RESULTS: No significant results were observed for sequences 1 and 2 in the Snodgrass test. The Boston test results indicated significant difference related to mean time for correct responses with strategy. CONCLUSION: The results suggest that simultaneous transcranial direct current stimulation (anodic and cathodic) is a method that can improve the rehabilitation of patients with anomic and Broca's aphasia after stroke, and that language strategies should be considered in the analysis of naming task responses.

OBJETIVO: Comparar os resultados nas tarefas de nomeação de pacientes afásicos após AVC dos grupos ativo e controle. MÉTODO: Estudo duplo-cego, randomizado controlado com 14 pacientes. Os indivíduos foram submetidos a cinco sessões de 20 minutos de 2 mA em dias consecutivos. O catodo foi posicionado na área homóloga à Broca e o anodo sobre a região supraorbital do hemisfério esquerdo. Os testes de Boston e Snodgrass foram aplicados e os resultados comparados entre os grupos. RESULTADOS: Não houve resultados significativos para as sequências 1 e 2 no teste do Snodgrass. No teste de Boston, os dados indicaram uma diferença significativa para o tempo médio de acertos com estratégia. CONCLUSÃO: Os resultados sugerem que a ETCC simultânea (anódica e catódica) é um método que pode auxiliar a reabilitação de pacientes com afasia do tipo anômica e de Broca, após AVC, e que as estratégias linguísticas deveriam ser consideradas nas análises das respostas dos testes de nomeação.

Estimulação transcraniana por corrente contínua: estudo sobre respostas em tarefas de nomeação em afásicos / Transcranial direct current stimulation: a study on naming performance in aphasic individuals

RESUMO Objetivo Comparar os resultados nas tarefas de nomeação de pacientes afásicos após AVC dos grupos ativo e controle. Método Estudo duplo-cego, randomizado controlado com 14 pacientes. Os indivíduos foram submetidos a cinco sessões de 20 minutos de 2 mA em dias consecutivos. O catodo foi posicionado na área homóloga à Broca e o anodo sobre a região supraorbital do hemisfério esquerdo. Os testes de Boston e Snodgrass foram aplicados e os resultados comparados entre os grupos. Resultados Não houve resultados significativos para as sequências 1 e 2 no teste do Snodgrass. No teste de Boston, os dados indicaram uma diferença significativa para o tempo médio de acertos com estratégia. Conclusão Os resultados sugerem que a ETCC simultânea (anódica e catódica) é um método que pode auxiliar a reabilitação de pacientes com afasia do tipo anômica e de Broca, após AVC, e que as estratégias linguísticas deveriam ser consideradas nas análises das respostas dos testes de nomeação.

ABSTRACT Purpose Compare the results in naming tasks of after-stroke aphasic individuals divided into active and placebo groups pre- and post-transcranial direct current stimulation. Methods A double-blind, randomized, controlled study conducted with 14 individuals. Patients underwent five 20-min sessions with stimulation of 2mA's on consecutive days. The cathode was placed over the Broca's homologous area and the anode was placed over the supraorbital region of the left hemisphere. Boston and Snodgrass naming tasks were assessed before and after the stimulation sessions and the results were compared between the groups. Results No significant results were observed for sequences 1 and 2 in the Snodgrass test. The Boston test results indicated significant difference related to mean time for correct responses with strategy. Conclusion The results suggest that simultaneous transcranial direct current stimulation (anodic and cathodic) is a method that can improve the rehabilitation of patients with anomic and Broca's aphasia after stroke, and that language strategies should be considered in the analysis of naming task responses.

Non-invasive brain stimulation and computational models in post-stroke aphasic patients: single session of transcranial magnetic stimulation and transcranial direct current stimulation. A randomized clinical trial.

CONTEXT AND OBJECTIVE: Patients undergoing the same neuromodulation protocol may present different responses. Computational models may help in understanding such differences. The aims of this study were, firstly, to compare the performance of aphasic patients in naming tasks before and after one session of transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS) and sham, and analyze the results between these neuromodulation techniques; and secondly, through computational model on the cortex and surrounding tissues, to assess current flow distribution and responses among patients who received tDCS and presented different levels of results from naming tasks. DESIGN AND SETTING: Prospective, descriptive, qualitative and quantitative, double blind, randomized and placebo-controlled study conducted at Faculdade de Ciências Médicas da Santa Casa de São Paulo. METHODS: Patients with aphasia received one session of tDCS, TMS or sham stimulation. The time taken to name pictures and the response time were evaluated before and after neuromodulation. Selected patients from the first intervention underwent a computational model stimulation procedure that simulated tDCS. RESULTS: The results did not indicate any statistically significant differences from before to after the stimulation.The computational models showed different current flow distributions. CONCLUSIONS: The present study did not show any statistically significant difference between tDCS, TMS and sham stimulation regarding naming tasks. The patients'responses to the computational model showed different patterns of current distribution.

Non-invasive brain stimulation and computational models in post-stroke aphasic patients: single session of transcranial magnetic stimulation and transcranial direct current stimulation. A randomized clinical trial

ABSTRACT CONTEXT AND OBJECTIVE: Patients undergoing the same neuromodulation protocol may present different responses. Computational models may help in understanding such differences. The aims of this study were, firstly, to compare the performance of aphasic patients in naming tasks before and after one session of transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS) and sham, and analyze the results between these neuromodulation techniques; and secondly, through computational model on the cortex and surrounding tissues, to assess current flow distribution and responses among patients who received tDCS and presented different levels of results from naming tasks. DESIGN AND SETTING: Prospective, descriptive, qualitative and quantitative, double blind, randomized and placebo-controlled study conducted at Faculdade de Ciências Médicas da Santa Casa de São Paulo. METHODS: Patients with aphasia received one session of tDCS, TMS or sham stimulation. The time taken to name pictures and the response time were evaluated before and after neuromodulation. Selected patients from the first intervention underwent a computational model stimulation procedure that simulated tDCS. RESULTS: The results did not indicate any statistically significant differences from before to after the stimulation.The computational models showed different current flow distributions. CONCLUSIONS: The present study did not show any statistically significant difference between tDCS, TMS and sham stimulation regarding naming tasks. The patients'responses to the computational model showed different patterns of current distribution.

Resultados preliminares do estudo da compreensão em sujeitos disatricos / A preliminary investigation on language assessment outcome in dysarthria

OBJETIVO: apresentar estudo sobre a compreensão de linguagem em sujeitos disártricos. MÉTODO: estudo retrospectivo, descritivo, de caráter qualitativo e quantitativo com 60 sujeitos com idade entre 40 a 70 anos. Foi realizado o cruzamento das tarefas de compreensão do protocolo Montreal Toulouse (versão alfa): compreensão de palavras orais (CPO) e escritas (CPE); frases simples orais (CFSO) e escritas(CFSE); frases complexas orais (CFCO) e escritas (CFCE). RESULTADOS: com respeito à comparação entre a compreensão oral e a escrita, quanto maior a CPO maior a CPE; quanto maior a CFSO, maior CFSE e vice-versa; relativamente à compreensão oral e escrita, quanto maior a CP, maior CF; quanto maior a CFS, maior CFC e vice-versa; em relação à comparação de idade, gênero, e CFCO e CFCE, não se observa relações significativas. CONCLUSÃO: nos pacientes deste estudo, verificou-se que a compreensão das estruturas mais simples favorece a compreensão das mais complexas; a dificuldade de compreensão de estruturas simples apresenta relação direta com a dificuldade de compreensão de estruturas complexas.

PURPOSE: to study language comprehension in dysarthric subjects. METHOD: a retrospective, descriptive and qualitative-quantitative study involving 60 subjects, age ranging from 40-70 years. Data crossing was carried out including sub-tests of comprehension related to: spoken words (SWC), written words (WWC), spoken simple phrases (SSPC), written simple phrases (WSPC), spoken complex phrases (SCPC) and written complex phrases (WCPC). RESULTS: the higher the SWC, the higher the WWC; the higher the SSPC, the higher the WSPC, and vice-versa; the higher the WC, the higher the PC; the higher the SPC, the higher the CPC, and vice-versa. No associations with age, gender, SCPC and WCPC were observed. CONCLUSION: both comprehension and difficulty in comprehension are associated with the degree of complexity of linguistic structure.