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1.
Cien Saude Colet ; 27(8): 3355-3364, 2022 Aug.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-35894344

RESUMO

This text is the result of an ethnographic research conducted in the neurological rehabilitation service at the Center for Mental and Neurological Health Care in Mexico City. This work focuses its problematic on elucidating how the body language of people with motor aphasia is reconstructed and what senses they generate. The analysis of the collected information led us to identify that language rehabilitation reconstructs a body grammar and uses the ability to narrate in order to restore language and communication. In this sense, we follow Goffman's notion of strip of activity, Csordas' embodiment and Bakhtin's polyphony, in order to understand the discursive construction of language that is introjected into the body and reproduced during clinical interaction. The employed methodology was an ethnography of the clinical context using narratives as a suitable tool to describe the meaning constructed between therapists and people affected with motor aphasia.


El presente texto es el resultado de una investigación etnográfica en el servicio de rehabilitación neurológica en el Centro de Atención de Salud Mental y Neurológica en la Ciudad de México. Este trabajo centra su problemática en dilucidar cómo se reconstruye el lenguaje corporal de las personas con afasia motora y qué sentidos generan. El análisis de la información recopilada nos llevó a identificar que la rehabilitación del lenguaje reconstruye una gramática corporal y emplea a la capacidad de narrar con el fin de restaurar el lenguaje y la comunicación. En ese sentido, retomamos la noción de franjas de actividad de Goffman, de embodiment de Csordas y de polifonía de Bajtín, para comprender la construcción discursiva del lenguaje que se introyecta en el cuerpo y se reproduce durante la interacción clínica. La metodología empleada fue la realización de una etnografía del contexto clínico que emplea a las narrativas como herramienta idónea para describir el sentido construido entre terapeutas y personas afectadas con afasia motora.


Assuntos
Afasia de Broca , Linguística , Antropologia Cultural , Hospitais , Humanos , Linguística/métodos , México
2.
Neurol India ; 70(3): 1125-1130, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35864649

RESUMO

Background: Communication difficulties in aphasia can result in social isolation, challenges with interpersonal relationships, emotional changes, inability to return to work, and lack of independence. Therefore, intervention is essential particularly in the context of functional communication for persons with aphasia (PwAs). Studies have also indicated that quality of communication life (QoCL) is a valid measure of the impact of communication difficulty on quality of life. Objective: To estimate the relationship between communication intervention and QoCL in individuals with expressive aphasia. Methods and Material: Twenty PwAs were divided into two groups: group I individuals had undergone at least 3 months of speech and language intervention whereas group II individuals did not have any formal communication intervention. Tamil version of the QoCL scale was administered for all participants. Statistical analysis was carried out using Mann-Whitney U test and Spearman's rho correlation coefficient. Results: Individuals with speech and language intervention in group I had higher scores in overall QoCL domains as well as in overall QoL when compared to group II. The results of correlation analysis indicated that individuals with greater therapy duration had significantly high scores. Conclusions: The results prove that communication intervention is necessary for PwAs to improve QoCL and can be used to raise awareness of its importance. The findings can also guide treatment planning, counseling the PwA, and caregivers. It also indicates the importance of using patient-related outcome measures during the intervention process.


Assuntos
Afasia de Broca , Terapia da Linguagem , Qualidade de Vida , Fonoterapia , Afasia de Broca/etiologia , Afasia de Broca/reabilitação , Cuidadores , Barreiras de Comunicação , Humanos , Índia , Avaliação de Resultados da Assistência ao Paciente
3.
Nihon Ronen Igakkai Zasshi ; 59(2): 219-224, 2022.
Artigo em Japonês | MEDLINE | ID: mdl-35650055

RESUMO

The patient was an 83-year-old woman with a history of breast cancer, distal right radial edge bone fracture, and cervical spine symptoms who had been diagnosed with an arachnoid cyst 9 years previously. She was examined by a nearby doctor, because of an approximately 1-year history of reduced verbal output; she also begun experiencing difficulties with walking. However, she was diagnosed with aging, a history of cervical spondylosis, and the effects of past fractures.At the time of this consultation, she was conscious and lucid, with mild right-sided hemiparesis, was unable to write, and had mild motor aphasia. Head magnetic resonance imaging revealed an arachnoid cyst (longer axis: 10 cm) in the left frontal lobe that did not take up contrast media. There was also a midline shift. The cause of the right hemiparesis and motor aphasia was probably compression of the left frontal lobe by the arachnoid cyst.We performed excision of the cyst wall by craniotomy and placed a cyst-peritoneal shunt under general anesthesia. At approximately one week after surgery, the patient was able to write and her motor aphasia improved. She was discharged 20 days after the operation.It is rare for an arachnoid cyst to increase in size after childhood. In the present case, surgical treatment led to a good outcome in an elderly patient with a symptomatic arachnoid cyst. Arachnoid cysts rarely increase in size. These cysts may become symptomatic in elderly people after lying clinically dormant for a long time.


Assuntos
Cistos Aracnóideos , Idoso , Idoso de 80 Anos ou mais , Afasia de Broca , Cistos Aracnóideos/complicações , Cistos Aracnóideos/diagnóstico , Cistos Aracnóideos/patologia , Criança , Feminino , Humanos , Imageamento por Ressonância Magnética , Paresia
4.
Soins Gerontol ; 27(155): 38-42, 2022.
Artigo em Francês | MEDLINE | ID: mdl-35738764

RESUMO

Aphasia, resulting from a brain lesion, leads to a partial or total loss of language in the elderly. By affecting communication abilities, it has repercussions on the life of the subject and his family. There are two types of aphasia. The roles of the caregiver and the speech therapist are in all cases essential. Depending on the communication difficulties encountered by the patient, specific supports can be recommended.


Assuntos
Afasia de Wernicke , Geriatria , Idoso , Afasia de Broca/patologia , Humanos
5.
Trials ; 23(1): 540, 2022 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-35773693

RESUMO

BACKGROUND: Motor aphasia after stroke is a common and intractable complication of stroke. Acupuncture and language training may be an alternative and effective approach. However, the efficacy of acupuncture and language training for motor aphasia after stroke has not been confirmed. The main objectives of this trial are to evaluate the effectiveness and safety of acupuncture and low-intensity, low-dose language training in treating ischemic motor aphasia after stroke from 15 to 90 days. METHODS: This is a multicenter randomized sham-controlled clinical trial. We will allocate 252 subjects aged between 45 and 75 years diagnosed with motor aphasia after stroke with an onset time ranging from 15 to 90 days into two groups randomly in a 1:1 ratio. Patients in the experimental group will be treated with "Xing-Nao Kai-Qiao" acupuncture therapy plus language training, and those in the control group will be treated with sham-acupoint (1 cun next to the acupoints) acupuncture therapy plus language training. All the patients will be given acupuncture and language training for 6 weeks, with a follow-up evaluation 6 weeks after the end of the treatment and 6 months after the onset time. The patients will mainly be evaluated using the Western Aphasia Battery and Chinese Functional Communication Profile, and the incidence of treatment-related adverse events at the 2nd, 4th, and 6th weeks of treatment will be recorded. The baseline characteristics of the patients will be summarized by group, the chi-squared test will be used to compare categorical variables, and repeated measures of analysis of variance or a linear mixed model will be applied to analyze the changes measured at different time points. DISCUSSION: The present study is designed to investigate the effectiveness and safety of traditional acupuncture therapy and language training in ischemic motor aphasia after stroke and explore the correlation between the treatment time and clinical effect of acupuncture. We hope our results will help doctors understand and utilize acupuncture combined with language training. TRIAL REGISTRATION: ChiCTR ChiCTR1900026740 . Registered on 20 October 2019.


Assuntos
Terapia por Acupuntura , Afasia de Broca , Terapia da Linguagem , Acidente Vascular Cerebral , Pontos de Acupuntura , Terapia por Acupuntura/efeitos adversos , Terapia por Acupuntura/métodos , Idoso , Afasia de Broca/etiologia , Afasia de Broca/terapia , Terapia Combinada/efeitos adversos , Humanos , Terapia da Linguagem/métodos , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Acidente Vascular Cerebral/complicações , Resultado do Tratamento
6.
Am J Speech Lang Pathol ; 31(3): 1188-1204, 2022 05 10.
Artigo em Inglês | MEDLINE | ID: mdl-35363995

RESUMO

PURPOSE: There is mounting evidence that the agrammatism that defines Broca's aphasia can be explained in processing terms. However, the extant approach simply describes agrammatism as disparate deficits in a static, mature system. This tutorial aims to motivate and outline a developmental alternative. This alternative is processability theory (PT), a root-to-apex theory of language development, with its origins in the field of second language acquisition, which can connect the findings of aphasia research. METHOD: This tutorial critically reviews research on agrammatism as a language deficit, a representational deficit, and a processing phenomenon. Given evidence from research applying PT to language disorders, this tutorial outlines PT's multidimensional architecture of language processing. Using an emergence (onset) criterion, PT predicts fixed developmental stages in word order (syntax) and inflection (morphology) and individual differences in the timing of syntax and morphology. To link PT to agrammatism, this theory's applications to diagnosis and teaching are overviewed, and a case study of five individuals with moderate agrammatism is presented. RESULTS: Analysis showed that all individuals were positioned in the early PT stages and differed in their timing of syntax and morphology consistent with theoretical predictions. CONCLUSIONS: Evidence from the case study suggests that, although agrammatism results from neural damage and associated language loss, the processing procedures necessary for relearning remain and can be exploited for recovery. A program of diagnosis and intervention is proposed, and future research directions are discussed. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.19416488.


Assuntos
Afasia de Broca , Transtornos da Linguagem , Afasia de Broca/diagnóstico , Afasia de Broca/terapia , Humanos , Idioma
7.
Brain ; 145(6): e59-e60, 2022 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-35383833
8.
Brain Nerve ; 74(4): 393-399, 2022 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-35437292

RESUMO

We report a case of Broca's aphasia in a left-handed patient with a right brain infarction. The patient's speech is consistent with a particular type of aphemia, that is, without vocalization except for a few phonemes or words. The patient presented with aphonia in an early stage. The lack of speech could be due to the impairment of the phonological-speech process or speech initialization. This type of aphemia has been reported to involve the right inferior precentral gyrus or right middle and inferior frontal gyri. Our patient had both lesions. The symptom and the lesion of this type of aphemia could differ from those of another type of aphemia corresponding to apraxia of speech, and the speech of Broca's aphasia could have multiple mechanisms. Our case shows Alexander's anomalous type with atypical lateralization and distribution of the lesion. Verbal intrahemispheric dissociation apraxia was suspected in our patient. The coexistence of aphasia, anosodiaphoria of hemiplegia is a dual symptom in which bilateral hemispheric functions exist in a unilateral hemisphere. (Received 1 December, 2021; Accepted 1 February, 2022; Published 1 April, 2022).


Assuntos
Afonia , Apraxias , Afasia de Broca/etiologia , Afasia de Broca/patologia , Apraxias/etiologia , Infarto Encefálico , Humanos , Fala
9.
Arch Phys Med Rehabil ; 103(7S): S205-S214, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35304120

RESUMO

OBJECTIVE: To explore the effect of complexity and feedback on script training outcomes in aphasia DESIGN: Randomized balanced single-blind 2 × 2 factorial design. SETTING: Freestanding urban rehabilitation hospital. PARTICIPANTS: Adults with fluent and nonfluent aphasia (at least 6 months post onset). INTERVENTIONS: Experimental treatment was AphasiaScripts, a computer-based script training program. Scripts were 10-turns long and developed at different complexity levels to allow for comparison of high vs low complexity. The program was modified to contrast high vs low feedback conditions during sentence practice. Participants were instructed to practice three 30-minute sessions per day, 6 days per week for 3 weeks. MAIN OUTCOME MEASURES: Gains achieved from baseline in accuracy and rate of production of trained and untrained script sentences at post treatment and at 3-, 6-, and 12-weeks after the end of treatment. RESULTS: Sixteen participants completed the intervention. On the trained script, gains were statistically significant for both accuracy and words per minute at post treatment and 3-, 6-, and 12-week maintenance. Gains on the untrained script were smaller than on the trained script; they were statistically significant only for accuracy at post treatment and 3-week maintenance. Complexity had an influence on accuracy at post-treatment (F1=4.8391, P=.0501) and at maintenance (F1=5.3391, P=.0413). Practicing scripts with high complexity increased accuracy by 11.33% at post treatment and by 9.90% at maintenance compared with scripts with low complexity. Participants with nonfluent aphasia made greater gains than those with fluent aphasia. There was no significant effect of feedback. CONCLUSIONS: This study reinforces script training as a treatment option for aphasia. Results highlight the use of more complex scripts to better promote acquisition and maintenance of script production skills. There is a need for further investigation of these variables with larger samples and with other types of aphasia treatments.


Assuntos
Afasia de Broca , Adulto , Afasia de Broca/terapia , Estudos de Viabilidade , Retroalimentação , Humanos , Método Simples-Cego
10.
J Speech Lang Hear Res ; 65(4): 1521-1542, 2022 04 04.
Artigo em Inglês | MEDLINE | ID: mdl-35271379

RESUMO

PURPOSE: Aphasia fluency is multiply determined by underlying impairments in lexical retrieval, grammatical formulation, and speech production. This poses challenges for establishing a reliable and feasible tool to measure fluency in the clinic. We examine the reliability and validity of perceptual ratings and clinical perspectives on the utility and relevance of methods used to assess fluency. METHOD: In an online survey, 112 speech-language pathologists rated spontaneous speech samples from 181 people with aphasia (PwA) on eight perceptual rating scales (overall fluency, speech rate, pausing, effort, melody, phrase length, grammaticality, and lexical retrieval) and answered questions about their current practices for assessing fluency in the clinic. RESULTS: Interrater reliability for the eight perceptual rating scales ranged from fair to good. The most reliable scales were speech rate, pausing, and phrase length. Similarly, clinicians' perceived fluency ratings were most strongly correlated to objective measures of speech rate and utterance length but were also related to grammatical complexity, lexical diversity, and phonological errors. Clinicians' ratings reflected expected aphasia subtype patterns: Individuals with Broca's and transcortical motor aphasia were rated below average on fluency, whereas those with anomic, conduction, and Wernicke's aphasia were rated above average. Most respondents reported using multiple methods in the clinic to measure fluency but relying most frequently on subjective judgments. CONCLUSIONS: This study lends support for the use of perceptual rating scales as valid assessments of speech-language production but highlights the need for a more reliable method for clinical use. We describe next steps for developing such a tool that is clinically feasible and helps to identify the underlying deficits disrupting fluency to inform treatment targets. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.19326419.


Assuntos
Afasia , Afasia/diagnóstico , Afasia de Broca/diagnóstico , Afasia de Wernicke , Humanos , Linguística , Reprodutibilidade dos Testes , Fala
11.
Neuromodulation ; 25(4): 528-537, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35088736

RESUMO

BACKGROUND: Although repetitive transcranial magnetic stimulation (rTMS) has exhibited promising efficacy in treating stroke-related aphasia, changes in neuroimaging in response to this therapy remain unclear. MATERIALS AND METHODS: By using resting-state functional magnetic resonance imaging (rsfMRI), we examined brain activations associated with language recovery in patients with poststroke nonfluent aphasia during an rTMS intervention. Twenty-six stroke patients with nonfluent aphasia were recruited in this randomized double-blinded study. The patients received real (n = 13) or sham (n = 13) 1-Hz inhibitory rTMS to the right pars triangularis (PTr) for ten consecutive weekdays. They underwent rsfMRI and completed the Concise Chinese Aphasia Test (CCAT) before and after the rTMS intervention. RESULT: The fractional amplitude of low-frequency fluctuation (fALFF) was calculated to investigate spontaneous neural activity in the brain. After treatment, the language function in the experimental group was higher than that in the sham group in terms of total CCAT score (p = 0.014) and the CCAT subscores of conversation (p = 0.012), description (p = 0.006), and expression (p = 0.003). Postintervention intergroup comparisons revealed that fALFF was significantly increased in the right superior temporal gyrus, right dorsolateral prefrontal gyrus, insular cortex, and caudate nucleus. Clusters in the right thalamus exhibited suppressed fALFF. The enhanced clusters in the frontotemporal region were significantly correlated with CCAT score improvements. CONCLUSIONS: Our findings provide empirical evidence for the vital role of the right frontotemporal and subcortical regions in language recovery after rTMS interventions in patients with aphasia. Inhibitory rTMS may improve language expression by promoting involvement of the right frontotemporal region. The results can be further used to refine rTMS protocols and optimize brain stimulation treatments. CLINICAL TRIAL REGISTRATION: The Clinicaltrials.gov registration number for the study is NCT03059225.


Assuntos
Acidente Vascular Cerebral , Estimulação Magnética Transcraniana , Afasia de Broca/complicações , Encéfalo/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética/métodos , Descanso , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/terapia , Estimulação Magnética Transcraniana/métodos , Resultado do Tratamento
12.
J Hist Neurosci ; 31(1): 1-19, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34115961

RESUMO

Of all the nineteenth-century physicians whose names still resonate today, Armand Trousseau is perhaps the one most familiar, for his description of carpal spasm as a sign of hypocalcemia (Trousseau's sign) and his description of the hypercoagulable state associated with cancer (Trousseau's syndrome). In the last three years of his life, Trousseau turned his attention to aphasia, which he included in his 1864 and 1865 lectures given at Hôtel-Dieu Hospital in Paris and which he discussed in an address to the Imperial Academy of Medicine in 1865. Trousseau preceded Wernicke in describing aphasia as a symptom complex, in which he included Broca's aphemia, receptive aphasia, the inability to read with and without the inability to write (alexia with and without agraphia), the inability to name common objects (amnesic aphasia or anomia) and to recognize numbers (acalculia), and the inability to draw. Trousseau concluded that such a varied symptomatology could not arise from a single area, and he proposed that lesions of the posterior inferior frontal convolution identified by Broca, of the insula and corpus striatum and of the temporal and parietal lobes, could give rise to aphasia. The role of the posterior temporal lobe in receptive aphasia was confirmed by Wernicke in 1874, and the role of the inferior parietal lobule in agraphia and alexia was confirmed by Dejerine in 1891. Trousseau thought that aphasia resulted from the loss of the memory for words and for the synergistic actions of the movements of articulations learned in early childhood. Trousseau added inattention, lack of comprehension, and cognitive decline to amnesia as contributing factors to the verbal and nonverbal expression of thought. Trousseau constructed a comprehensive theory of aphasia that unified its semiology, localization, and pathophysiology. This construct had the virtue of being predictive and falsifiable by the clinico-pathological method. Through insight born of observation, Trousseau identified the issues that dominated aphasiology into the twenty-first century.


Assuntos
Agrafia , Afasia , Dislexia , Médicos , Afasia/etiologia , Afasia/história , Afasia/psicologia , Afasia de Broca , Afasia de Wernicke , Pré-Escolar , Humanos , Masculino
13.
Brain ; 145(3): 801-804, 2022 04 29.
Artigo em Inglês | MEDLINE | ID: mdl-34919636
14.
Neurorehabil Neural Repair ; 36(2): 164-174, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34968159

RESUMO

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


Assuntos
Afasia de Broca/fisiopatologia , Afasia de Broca/reabilitação , Conectoma , Comportamento Imitativo , Boca , Percepção da Fala/fisiologia , Fonoterapia , Reabilitação do Acidente Vascular Cerebral , Percepção Visual/fisiologia , Adulto , Idoso , Afasia de Broca/etiologia , Doença Crônica , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Boca/diagnóstico por imagem , Avaliação de Resultados em Cuidados de Saúde
15.
Zhongguo Zhen Jiu ; 41(11): 1211-5, 2021 Nov 12.
Artigo em Chinês | MEDLINE | ID: mdl-34762372

RESUMO

OBJECTIVE: To compare the clinical efficacy between scalp acupuncture electrical stimulation and routine scalp acupuncture for motor aphasia in subacute stage of cerebral infarction. METHODS: A total of 54 patients with motor aphasia in subacute stage of cerebral infarction were randomly divided into an observation group (27 cases, 1 case dropped off) and a control group (27 cases, 2 cases dropped off ). Both groups were treated with routine medication and language training. In the observation group, scalp acupuncture was given at bilateral lower 2/5 of the parietal and temporal anterior oblique line and temporal frontline; after the arrival of qi, the electrical stimulation with disperse-dense wave was given at the affected side and continuous wave was given at healthy side. The control group was treated with routine scalp acupuncture at lower 2/5 of the parietal and temporal anterior oblique line and temporal frontline of the affected side, once a day, five times as a course, totaling two courses of treatment. The aphasia battery of Chinese (ABC) score and Boston diagnostic aphasia examination (BDAE) grade were observed before and after treatment. The levels of oxygenated hemoglobin (HbO2), deoxyhemoglobin (D-Hb) and total hemoglobin (T-Hb) in local cerebral cortex of the two groups were measured in real time using functional near-infrared spectroscopy (fNIRS) before and after treatment. The clinical efficacy of the two groups was compared. RESULTS: After treatment, the scores of listening comprehension, retelling, naming, spontaneous conversation and BDAE grade in the two groups were improved compared with those before treatment (P<0.01, P<0.05), and those in the observation group were better than the control group (P<0.05). Compared before treatment, the levels of HbO2 and T-Hb were increased (P<0.01), and the levels of D-Hb were decreased (P<0.01) after treatment in the two groups. The levels of HbO2 and T-Hb in the observation group were higher than those in the control group (P<0.05), and the level of D-Hb was lower than that in the control group (P<0.05). The total effective rate was 92.3% (24/26) in the observation group, which was higher than 84.0% (21/25) in the control group (P<0.05). CONCLUSION: The scalp acupuncture electrical stimulation could improve cerebral circulation, activate specific functional areas of cerebral cortex, and promote the reconstruction and recovery of brain language function. Its curative effect is better than conventional scalp acupuncture.


Assuntos
Terapia por Acupuntura , Acidente Vascular Cerebral , Pontos de Acupuntura , Afasia de Broca , Infarto Cerebral/complicações , Infarto Cerebral/terapia , Estimulação Elétrica , Humanos , Couro Cabeludo , Resultado do Tratamento
16.
Cogn Behav Neurol ; 34(3): 233-244, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34473676

RESUMO

The logopenic variant of primary progressive aphasia (lvPPA) is the most recent variant of primary progressive aphasia (PPA) to be identified; thus far, it has been poorly investigated. Despite being typically associated with Alzheimer disease (AD), lvPPA has recently been linked to frontotemporal lobe degeneration (FTLD), with distinctive cognitive and neural features that are worthy of further investigation. Here, we describe the neuropsychological and linguistic profile, as well as cerebral abnormalities, of an individual exhibiting PPA and carrying a pathogenetic variant in the GRN gene, from a 3-year longitudinal perspective. The individual's initial profile resembled lvPPA because it was characterized by word-finding difficulties and phonological errors in spontaneous speech in addition to sentence repetition and phonological short-term memory impairments. The individual's structural and metabolic imaging data demonstrated left temporal and bilateral frontal atrophy and hypometabolism, respectively. On follow-up, as the pathology progressed, dysprosody, stereotypical speech patterns, agrammatism, and orofacial apraxia appeared, suggesting an overlap with the nonfluent variant of PPA (nfvPPA). Severe sentence comprehension impairment also became evident. Our longitudinal and multidisciplinary diagnostic approach allowed us to better characterize the progression of a GRN-positive lvPPA profile, providing neuropsychological and imaging indicators that might be helpful to improve classification between different PPA variants and to address a nosological issue. Finally, we discuss the importance of early diagnosis of PPA given the possible overlap between different PPA variants during the progression of the pathology.


Assuntos
Doença de Alzheimer , Afasia Primária Progressiva , Doença de Alzheimer/complicações , Doença de Alzheimer/diagnóstico , Afasia de Broca , Afasia Primária Progressiva/diagnóstico por imagem , Humanos , Estudos Longitudinais , Fala
17.
Neurocase ; 27(3): 297-307, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34338151

RESUMO

The present study reports on the language treatment outcomes from sentence- and story-level linguistic facilitation and its generalization effect on communicative abilities, working memory, and sentence processing in the case of an adult with Moyamoya Disease (MMD). After treatment,the patient's overall performance, including the Aphasia Quotient, and sentence processing ability as measured by language testing, were improved. Furthermore, the treatment effects were generalizable to working memory abilities. Our case study conveys clinically meaningful implications since it is the first report on the effects of language treatment on linguistic and cognitive domains for an individual with MMD-induced agrammatic Broca's aphasia.


Assuntos
Afasia de Broca , Doença de Moyamoya , Adulto , Afasia de Broca/etiologia , Afasia de Broca/terapia , Humanos , Idioma , Memória de Curto Prazo , Doença de Moyamoya/complicações , Doença de Moyamoya/diagnóstico por imagem , Doença de Moyamoya/terapia , República da Coreia
18.
J Stroke Cerebrovasc Dis ; 30(11): 106058, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34450479

RESUMO

We report a symptomatic developmental venous anomaly (DVA) not causing parenchymal abnormality to provide a pathophysiologic clue in patients with recurrent transient neurologic deficit. A 32-year-old male presented with recurrent transient motor aphasia and headache in the left fronto-temporal region for three years. The symptoms usually lasted for one hour. Brain computed tomography (CT) angiography and magnetic resonance imaging using gradient recalled echo showed a prominent penetrating vein at the left frontal periventricular region. Brain CT perfusion imaging performed during the symptoms revealed increased perfusion in the corresponding area with relatively decreased perfusion in the left fronto-temporal cortices. Digital subtraction angiography revealed collecting venous blood from the left septal and thalamostriate veins draining into the left cavernous sinus without early arteriovenous shunting. In this patient, an inciting incident might have led to imbalance of the venous flow surrounding the DVA, causing venous hypertension and the intracerebral steal phenomenon in the surrounding area. The relatively hypoperfused cortical area adjacent to the DVA could be considered the cause of the transient motor aphasia, while venous hypertension could be the cause of the headache.


Assuntos
Veias Cerebrais , Transtornos Cerebrovasculares , Ataque Isquêmico Transitório , Adulto , Afasia de Broca , Veias Cerebrais/anormalidades , Veias Cerebrais/diagnóstico por imagem , Transtornos Cerebrovasculares/complicações , Transtornos Cerebrovasculares/diagnóstico por imagem , Cefaleia , Humanos , Hipertensão , Ataque Isquêmico Transitório/diagnóstico por imagem , Ataque Isquêmico Transitório/etiologia , Imageamento por Ressonância Magnética , Masculino , Recidiva
19.
Codas ; 33(4): e20200019, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34231751

RESUMO

PURPOSE: Aphasia is a common and debilitating manifestation of stroke. Transcranial electrical stimulation uses low-intensity electric currents to induce changes in neuronal activity. Recent evidence suggests that noninvasive techniques can be a valuable rehabilitation tool for patients with aphasia. However, it is difficult to recruit patients with aphasia for trials, and the reasons for this are not well understood. This study aimed to elucidate the main difficulties involved in patient's recruitment and inclusion in a randomized clinical study of neuromodulation in aphasia. METHODS: We evaluated the reasons for the exclusion of patients in a pilot, randomized, double-blinded clinical trial in which patients diagnosed with motor aphasia after stroke were recruited from March to November 2018. A descriptive statistical analysis was performed. RESULTS: Only 12.9% (4) of patients with ischemic stroke were included in the clinical trial. A total of 87.1% (27) of the 31 recruited patients were excluded for various reasons including: sensory aphasia (32.2%), dysarthria (25.8%), spontaneous clinical recovery (16.1%), previous stroke (6.4%), and death or mutism (3.2%). CONCLUSION: The presence of other types of aphasia, dysarthria, spontaneous recovery, deaths, and mutism were barriers to recruiting patients evidenced in this neuromodulation study.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Estimulação Transcraniana por Corrente Contínua , Afasia de Broca , Humanos , Projetos Piloto , Ensaios Clínicos Controlados Aleatórios como Assunto , Acidente Vascular Cerebral/complicações
20.
NeuroRehabilitation ; 49(1): 103-117, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34180428

RESUMO

BACKGROUND: Mirror therapy (MT) has proven to be beneficial for treating patients suffering from motor aphasia after stroke. However, the impacts of MT on neuroplasticity remain unexplored. OBJECTIVE: In this paper we conducted a randomized controlled trial to evaluate the treatment using the MT on motor aphasia following acute cerebral infarction. METHODS: We randomly assigned 30 patients into test and control groups, with test group patients treated with MT, whereas control group patients were treated with sham MT. At 24 hours prior to and after the intervention, we obtained functional magnetic resonance imaging (fMRI) data from study subjects. At baseline, after treatment and 12-week follow-up, we additionally evaluated patients with the Modified Rankin Scale (mRS), the National Institutes of Health Stroke Scale (NIHSS), and the aphasia quotient (AQ) in the western aphasia test. RESULTS: After 2 weeks of treatment, the test group demonstrated significant improvements in AQ values, naming, repetition, spontaneous speech, and mRS scores compared to the control group (P < 0.05). Furthermore, in the follow-up time point (12 weeks), we found that the test group exhibited significantly better NIHSS scores and AQ evaluation indicators than the control group (P < 0.05). Specifically, the fMRI study shows that functional connectivity significantly improved in test group patients mainly among frontal, temporal, and parietal lobes of the left hemisphere with each other than controls group. Meanwhile, we found significantly enhanced functional connectivity with the hippocampus (P < 0.01). CONCLUSIONS: Our results indicate that the MT can expedite the recovery of language function during the early phases of stroke recovery. These findings may elucidate the underlying mechanism of MT and the application of this therapy as an adjunct rehabilitation technique in language recovery.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Afasia de Broca , Infarto Cerebral/complicações , Infarto Cerebral/diagnóstico por imagem , Humanos , Acidente Vascular Cerebral/complicações , Resultado do Tratamento
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