Preoperative word-finding difficulties in children with posterior fossa tumours: a European cross-sectional study.

PURPOSE: Posterior fossa tumour surgery in children entails a high risk for severe speech and language impairments, but few studies have investigated the effect of the tumour on language prior to surgery. The current crosslinguistic study addresses this gap. We investigated the prevalence of preoperative word-finding difficulties, examined associations with medical and demographic characteristics, and analysed lexical errors. METHODS: We included 148 children aged 5-17 years with a posterior fossa tumour. Word-finding ability was assessed by means of a picture-naming test, Wordrace, and difficulties in accuracy and speed were identified by cut-off values. A norm-based subanalysis evaluated performance in a Swedish subsample. We compared the demographic and medical characteristics of children with slow, inaccurate, or combined slow and inaccurate word finding to the characteristics of children without word-finding difficulties and conducted a lexical error analysis. RESULTS: Thirty-seven percent (n = 55) presented with slow word finding, 24% (n = 35) with inaccurate word finding, and 16% (n = 23) with both slow and inaccurate word finding. Children with posterior fossa tumours were twice as slow as children in the norming sample. Right-hemisphere and brainstem location posed a higher risk for preoperative word-finding difficulties, relative to left-hemisphere location, and difficulties were more prevalent in boys than in girls. The most frequent errors were lack of response and semantically related sideordinated words. CONCLUSION: Word-finding difficulties are frequent in children with posterior fossa tumours, especially in boys and in children with right-hemisphere and brainstem tumours. Errors resemble those observed in typical development and children with word-finding difficulties.

Anomia in left hemisphere stroke, multiple sclerosis and Parkinson's disease - a comparative study.

PURPOSE: To explore quantitative and qualitative features of anomia in participants with left-hemisphere stroke, Parkinson's disease, or multiple sclerosis. MATERIALS AND METHODS: This descriptive cross-sectional study compares signs of anomia within and across participants (n = 87), divided into four groups; moderate to severe anomia after stroke (MSAS, n = 19), mild anomia after stroke (MAS, n = 22), PD (n = 19) and MS (n = 27). Aspects analysed include naming accuracy and speed, the nature of incorrect responses, semantic and phonemic verbal fluency, information content in re-telling, and the relationship between test results and self-reports on word-finding difficulties and communicative participation. RESULTS: All groups had impaired verbal fluency, prolonged response times and reduced information content in re-telling. The MSAS group had significantly more signs of anomia than the other groups. Results from the other groups overlapped on a MAS-PD-MS continuum. Both semantically and phonologically incorrect responses were common in the stroke groups, while semantically incorrect ones predominated in the PD and MS groups. All four groups reported a similar negative impact on self-perceived communicative participation. Correlations between self-reports and test results were inconsistent. CONCLUSIONS: Anomia features have quantitative and qualitative similarities and differences across neurological conditions.

People with moderate or severe anomia after stroke not only exhibit more severe symptoms of word-finding difficulties but also manifest a wide variety of such symptoms, compared to people with Parkinson's disease or multiple sclerosis.The present findings underscore the need to ask patients about their self-perceived word-finding difficulties.Regardless of the degree of difficulties or the underlying condition, self-perceived word-finding difficulties can have a negative impact on communicative participation and should therefore be appropriately addressed.An assessment comprising aspects such as verbal fluency, connected-speech tasks and the measurement of response times in naming tasks may serve to affirm the self-reported word-finding difficulties.

Word-finding difficulties in Parkinson's disease: Complex verbal fluency, executive functions and other influencing factors.

BACKGROUND: Persons with Parkinson's disease (PD) frequently report word-finding difficulties. Many of the established tests are, however, insufficient in detecting mild cases of such symptoms. Results from earlier research have suggested that controlled oral word association tests (COWATs) with high demands on cognitive processing resources could prove helpful in detecting the more subtle (language-related) problems seen in neurological disorders such as PD. AIMS: First, to examine whether persons with PD (PwPD) differ in performance on different types of COWATs compared with non-brain-damaged controls. Second, to investigate possible relationships between executive functions and the novel complex oral semantic fluency (COSEF) task performance scores in the PwPD group. Third, to investigate whether age, years of education, severity of motor symptoms and self-perceived severity of word-finding difficulties influenced the COSEF task results. METHODS & PROCEDURES: A total of 17 PwPD participated in the study. Their results were compared with a matched control group (n = 17) at both group and individual levels. One phonemic and two types of semantic COWATs were used. Correlations between the COSEF task and executive function results, age, education and severity of motor symptoms were analysed in the PwPD group. OUTCOMES & RESULTS: The PwPD group had significantly lower scores on the COSEF task compared with the control group, but not on the other COWATs. A variation in the results was seen on an individual level. In the PwPD group, large significant correlations were seen between the COSEF task and verbally based tasks measuring working memory and cognitive flexibility. Both age and education, but neither self-perceived severity of word-finding difficulties nor motor symptoms, were correlated with the COSEF task result in the group of PwPD. CONCLUSIONS & IMPLICATIONS: The results are in line with the predictions that a relatively more cognitive demanding COWAT such as the COSEF task could prove valuable when assessing word-finding difficulties in PD in research and clinical assessment. WHAT THIS PAPER ADDS: What is already known on the subject Varying degrees of word-finding difficulties are a common symptom in PD and may affect everyday communication. Discreet word-finding difficulties can be hard to detect with the established language assessment tools. What this paper adds to existing knowledge This study adds insights into how PwPD perform on different types of COWATs compared with a control group. It also sheds light on the relationships between a novel, more cognitive complex COWAT and executive functions in PD. What are the potential or actual clinical implications of this work? More cognitively complex COWATs can contribute significantly to the assessment of discreet word-finding difficulties, but it is important to include a thorough anamnesis regarding language and communication in PwPD.

Neuroanatomic Correlates of Anomia: A Scoping Review / Correlatos neuroanatómicos de la anomia: révisions de tema

Abstract Anomia is the inability to access the lexicon of names, it is one of the most common symptoms of aphasia, but it often appears as a symptom of other disorders and diseases such as Alzheimer's. There are several studies on the anatomical bases of anomie, but they are not conclusive. The objective of this study is to identify, compile and analyze investigations that relate neuroanatomical areas with anomie. We conducted a scoping review and we selected ten articles from scientific databases (EBSCOhost and Science Direct) published during the period 2009 - 2016. It was found that there are different areas related to the denomination processes according to the phase of presentation of the anomie: before and after an intervention. 1n the previous moment there are the temporary and frontal gyrus in the left hemisphere, while after intervention they find activation in the temporal gyrus, precuneus, supramarginal gyrus of the right hemisphere.

Resumen La anomia es la incapacidad para acceder al léxico de nombres, es uno de los síntomas más comunes de las afasias, pero muchas veces se presenta como síntoma de otros trastornos y enfermedades como el Alzheimer. Existen diversos estudios sobre las bases anatómicas de la anomia, pero no son concluyentes. El objetivo de este estudio es identificar, compilar y analizar investigaciones que relacionen las áreas neuroanatómicas con la anomia. Realizamos un estudio de revisión focalizada (scoping review) y seleccionados diez artículos de bases de datos científicas (EBSCOhost y Science Direct) publicados durante el periodo 2009-2016. Se encontró que hay diferentes áreas relacionadas a los procesos de denominación de acuerdo a la fase de presentación de la anomia: antes y después de una intervención. En el momento previo se encuentran los giros temporales y frontales en el hemisferio izquierdo, mientras que después de una intervención se encuentra activación de los giros temporales, el precuneus, y el giro supramarginal en el hemisferio derecho.

How distributed processing produces false negatives in voxel-based lesion-deficit analyses.

In this study, we hypothesized that if the same deficit can be caused by damage to one or another part of a distributed neural system, then voxel-based analyses might miss critical lesion sites because preservation of each site will not be consistently associated with preserved function. The first part of our investigation used voxel-based multiple regression analyses of data from 359 right-handed stroke survivors to identify brain regions where lesion load is associated with picture naming abilities after factoring out variance related to object recognition, semantics and speech articulation so as to focus on deficits arising at the word retrieval level. A highly significant lesion-deficit relationship was identified in left temporal and frontal/premotor regions. Post-hoc analyses showed that damage to either of these sites caused the deficit of interest in less than half the affected patients (76/162 = 47%). After excluding all patients with damage to one or both of the identified regions, our second analysis revealed a new region, in the anterior part of the left putamen, which had not been previously detected because many patients had the deficit of interest after temporal or frontal damage that preserved the left putamen. The results illustrate how (i) false negative results arise when the same deficit can be caused by different lesion sites; (ii) some of the missed effects can be unveiled by adopting an iterative approach that systematically excludes patients with lesions to the areas identified in previous analyses, (iii) statistically significant voxel-based lesion-deficit mappings can be driven by a subset of patients; (iv) focal lesions to the identified regions are needed to determine whether the deficit of interest is the consequence of focal damage or much more extensive damage that includes the identified region; and, finally, (v) univariate voxel-based lesion-deficit mappings cannot, in isolation, be used to predict outcome in other patients.

Intervention for children with word-finding difficulties: a parallel group randomised control trial.

PURPOSE: The study investigated the outcome of a word-web intervention for children diagnosed with word-finding difficulties (WFDs). METHOD: Twenty children age 6-8 years with WFDs confirmed by a discrepancy between comprehension and production on the Test of Word Finding-2, were randomly assigned to intervention (n = 11) and waiting control (n = 9) groups. The intervention group had six sessions of intervention which used word-webs and targeted children's meta-cognitive awareness and word-retrieval. RESULT: On the treated experimental set (n = 25 items) the intervention group gained on average four times as many items as the waiting control group (d = 2.30). There were also gains on personally chosen items for the intervention group. There was little change on untreated items for either group. CONCLUSION: The study is the first randomised control trial to demonstrate an effect of word-finding therapy with children with language difficulties in mainstream school. The improvement in word-finding for treated items was obtained following a clinically realistic intervention in terms of approach, intensity and duration.

Activations in temporal areas using visual and auditory naming stimuli: A language fMRI study in temporal lobe epilepsy.

OBJECTIVE: Verbal fluency functional MRI (fMRI) is used for predicting language deficits after anterior temporal lobe resection (ATLR) for temporal lobe epilepsy (TLE), but primarily engages frontal lobe areas. In this observational study we investigated fMRI paradigms using visual and auditory stimuli, which predominately involve language areas resected during ATLR. METHODS: Twenty-three controls and 33 patients (20 left (LTLE), 13 right (RTLE)) were assessed using three fMRI paradigms: verbal fluency, auditory naming with a contrast of auditory reversed speech; picture naming with a contrast of scrambled pictures and blurred faces. RESULTS: Group analysis showed bilateral temporal activations for auditory naming and picture naming. Correcting for auditory and visual input (by subtracting activations resulting from auditory reversed speech and blurred pictures/scrambled faces respectively) resulted in left-lateralised activations for patients and controls, which was more pronounced for LTLE compared to RTLE patients. Individual subject activations at a threshold of T>2.5, extent >10 voxels, showed that verbal fluency activated predominantly the left inferior frontal gyrus (IFG) in 90% of LTLE, 92% of RTLE, and 65% of controls, compared to right IFG activations in only 15% of LTLE and RTLE and 26% of controls. Middle temporal (MTG) or superior temporal gyrus (STG) activations were seen on the left in 30% of LTLE, 23% of RTLE, and 52% of controls, and on the right in 15% of LTLE, 15% of RTLE, and 35% of controls. Auditory naming activated temporal areas more frequently than did verbal fluency (LTLE: 93%/73%; RTLE: 92%/58%; controls: 82%/70% (left/right)). Controlling for auditory input resulted in predominantly left-sided temporal activations. Picture naming resulted in temporal lobe activations less frequently than did auditory naming (LTLE 65%/55%; RTLE 53%/46%; controls 52%/35% (left/right)). Controlling for visual input had left-lateralising effects. CONCLUSION: Auditory and picture naming activated temporal lobe structures, which are resected during ATLR, more frequently than did verbal fluency. Controlling for auditory and visual input resulted in more left-lateralised activations. We hypothesise that these paradigms may be more predictive of postoperative language decline than verbal fluency fMRI.

Intervening to alleviate word-finding difficulties in children: case series data and a computational modelling foundation.

We evaluated a simple computational model of productive vocabulary acquisition, applied to simulating two case studies of 7-year-old children with developmental word-finding difficulties across four core behavioural tasks. Developmental models were created, which captured the deficits of each child. In order to predict the effects of intervention, we exposed the computational models to simulated behavioural interventions of two types, targeting the improvement of either phonological or semantic knowledge. The model was then evaluated by testing the predictions from the simulations against the actual results from an intervention study carried out with the two children. For one child it was predicted that the phonological intervention would be effective, and the semantic intervention would not. This was borne out in the behavioural study. For the second child, the predictions were less clear and depended on the nature of simulated damage to the model. The behavioural study found an effect of semantic but not phonological intervention. Through an explicit computational simulation, we therefore employed intervention data to evaluate our theoretical understanding of the processes underlying acquisition of lexical items for production and how they may vary in children with developmental language difficulties.