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1.
J Neuroeng Rehabil ; 20(1): 12, 2023 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-36694257

RESUMO

BACKGROUND: Stroke is a significant contributor of worldwide disability and morbidity with substantial economic consequences. Rehabilitation is a vital component of stroke recovery, but inpatient stroke rehabilitation programs can struggle to meet the recommended hours of therapy per day outlined by the Canadian Stroke Best Practices and American Heart Association. Mobile applications (apps) are an emerging technology which may help bridge this deficit, however this area is understudied. The purpose of this study is to review the effect of mobile apps for stroke rehabilitation on stroke impairments and functional outcomes. Specifically, this paper will delve into the impact of varying mobile app types on stroke rehabilitation. METHODS: This systematic review included 29 studies: 11 randomized control trials and 18 quasi-experimental studies. Data extrapolation mapped 5 mobile app types (therapy apps, education apps, rehab videos, reminders, and a combination of rehab videos with reminders) to stroke deficits (motor paresis, aphasia, neglect), adherence to exercise, activities of daily living (ADLs), quality of life, secondary stroke prevention, and depression and anxiety. RESULTS: There were multiple studies supporting the use of therapy apps for motor paresis or aphasia, rehab videos for exercise adherence, and reminders for exercise adherence. For permutations involving other app types with stroke deficits or functional outcomes (adherence to exercise, ADLs, quality of life, secondary stroke prevention, depression and anxiety), the results were either non-significant or limited by a paucity of studies. CONCLUSION: Mobile apps demonstrate potential to assist with stroke recovery and augment face to face rehabilitation, however, development of a mobile app should be carefully planned when targeting specific stroke deficits or functional outcomes. This study found that mobile app types which mimicked principles of effective face-to-face therapy (massed practice, task-specific practice, goal-oriented practice, multisensory stimulation, rhythmic cueing, feedback, social interaction, and constraint-induced therapy) and education (interactivity, feedback, repetition, practice exercises, social learning) had the greatest benefits. Protocol registration PROPSERO (ID CRD42021186534). Registered 21 February 2021.


Assuntos
Afasia , Aplicativos Móveis , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Atividades Cotidianas , Canadá , Qualidade de Vida , Reabilitação do Acidente Vascular Cerebral/métodos
2.
Epilepsy Res ; 189: 107069, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36603454

RESUMO

To examine micro- and macrolinguistic underpinnings of circumstantiality in temporal lobe epilepsy (TLE), we examined the elicited narrative output of 15 individuals with TLE and 14 controls. To replicate and extend Field and colleagues' (2000) work, participants were asked to produce five immediately consecutive elicitations of an eight-frame cartoon "Cowboy Story" (Joanette et al., 1986). Following transcription and coding, detailed multi-level discourse analysis demonstrated a typical pattern of compression in controls. The narratives produced by individuals with TLE were less fluent, cohesive, and coherent across trials: producing fewer novel units and more repetitive and extraneous content. Significant group by trial interactions in sample length, spontaneous duration, and statements, were not explained by seizure burden, age, or lexical retrieval deficits. These findings suggest that they do not benefit from repeated engagement with a narrative in the same manner as controls. Disturbed social cognition and pragmatics in TLE might underpin communication inefficiencies.


Assuntos
Afasia , Epilepsia do Lobo Temporal , Humanos , Narração
3.
Sensors (Basel) ; 23(2)2023 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-36679654

RESUMO

The rehabilitation of aphasics is fundamentally based on the assessment of speech impairment. Developing methods for assessing speech impairment automatically is important due to the growing number of stroke cases each year. Traditionally, aphasia is assessed manually using one of the well-known assessment batteries, such as the Western Aphasia Battery (WAB), the Chinese Rehabilitation Research Center Aphasia Examination (CRRCAE), and the Boston Diagnostic Aphasia Examination (BDAE). In aphasia testing, a speech-language pathologist (SLP) administers multiple subtests to assess people with aphasia (PWA). The traditional assessment is a resource-intensive process that requires the presence of an SLP. Thus, automating the assessment of aphasia is essential. This paper evaluated and compared custom machine learning (ML) speech recognition algorithms against off-the-shelf platforms using healthy and aphasic speech datasets on the naming and repetition subtests of the aphasia battery. Convolutional neural networks (CNN) and linear discriminant analysis (LDA) are the customized ML algorithms, while Microsoft Azure and Google speech recognition are off-the-shelf platforms. The results of this study demonstrated that CNN-based speech recognition algorithms outperform LDA and off-the-shelf platforms. The ResNet-50 architecture of CNN yielded an accuracy of 99.64 ± 0.26% on the healthy dataset. Even though Microsoft Azure was not trained on the same healthy dataset, it still generated comparable results to the LDA and superior results to Google's speech recognition platform.


Assuntos
Afasia , Percepção da Fala , Acidente Vascular Cerebral , Humanos , Afasia/diagnóstico , Afasia/reabilitação , Distúrbios da Fala , Idioma , Fala
5.
Zhongguo Zhen Jiu ; 43(1): 25-8, 2023 Jan 01.
Artigo em Chinês | MEDLINE | ID: mdl-36633235

RESUMO

OBJECTIVE: To observe the effect of Kaiqiao Jieyin acupuncture (acupuncture for opening orifices and relieving aphasia) combined with repetitive transcranial magnetic stimulation (rTMS) on language ability and daily life communication ability in patients with post-stroke aphasia (PSA). METHODS: Fifty-six patients with PSA were randomly divided into an observation group and a control group, 28 cases in each group. Both groups received routine symptomatic treatment. The control group was treated with speech rehabilitation training and rTMS. On the basis of the treatment in the control group, the observation group was treated with Kaiqiao Jieyin acupuncture at the speech area Ⅰ, Fengchi (GB 20), Tongli (HT 5), Lianquan (CV 23), Panglianquan (Extra), etc. Panglianquan (Extra) on both sides were connected to electroacupuncture, with intermittent wave, 2 Hz in frequency. The above treatment was performed once a day for 5 consecutive days, followed by 2 days of rest for 2 weeks. The scores of western aphasia battery (WAB, including scores of spontaneous speech, auditory comprehension, repetition, naming and score of aphasia quotient [AQ]) and communication abilities in daily living (CADL) in the two groups were compared before and after treatment. RESULTS: After treatment, the spontaneous speech, auditory comprehension, repetition, naming scores and AQ scores in both groups were higher than those before treatment (P<0.05), and the increase in the observation group was greater than the control group (P<0.05). The CADL scores of the two groups were higher than those before treatment (P<0.05). CONCLUSION: Kaiqiao Jieyin acupuncture combined with rTMS can improve the language ability and daily life communication ability of PSA patients.


Assuntos
Terapia por Acupuntura , Afasia , Reabilitação do Acidente Vascular Cerebral , Humanos , Estimulação Magnética Transcraniana , Resultado do Tratamento , Afasia/etiologia , Afasia/terapia
6.
Magn Reson Imaging ; 95: 19-26, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36252694

RESUMO

PURPOSE: Using constrained spherical deconvolution (CSD)-based tractography, we aimed to obtain conjoint analysis of diffusion measures of major language white matter (WM) tracts in post-stroke aphasic patients bilaterally, and to correlate the measures of each tract to the different language deficits. MATERIAL AND METHODS: 17 aphasic patients with left hemispheric stroke, at the subacute stage, and ten age- matched controls underwent diffusion MRI examination. CSD-based tractography was performed. Diffusion measures [fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), axial diffusivity (AD)] were extracted after dissection of major language tracts bilaterally. Aphasia was assessed using language subset of hemispheric stroke scale. Comparisons of diffusion measures, for all tracts, between the two groups were performed. Partial correlations between the diffusion measures and different language components were obtained. RESULTS: In the left hemisphere, significant lower FA and or higher MD with higher RD of patients' WM tracts compared to the control group. Significant differences of diffusion measures were also evident in the right hemisphere yet, less prominent. All changes reflected damage of the tracts' integrity. Significant correlations were found between comprehension and FA of the left arcuate fasciculus (AF) and left inferior longitudinal fasciculus. Additionally, a significant correlation was found between MD of the right AF and repetition. CONCLUSION: Conjoint analysis of diffusion measures, based on CSD tractography, can provide important markers for the underlying WM changes bilaterally. Moreover, our findings emphasize that language processing can be mediated by both ventral and dorsal streams and further highlight the contribution of the right AF in repetition.


Assuntos
Afasia , Acidente Vascular Cerebral , Substância Branca , Humanos , Substância Branca/diagnóstico por imagem , Idioma , Imagem de Tensor de Difusão , Vias Neurais , Afasia/diagnóstico por imagem , Afasia/etiologia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico por imagem
7.
Stroke ; 54(1): 5-9, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36542073

RESUMO

Cognition is a central feature of human existence and brain function. Cognitive deficits are common after stroke and may strongly impact functional outcome. Recent years have seen substantial advances in our understanding of cognitive functions in the healthy state, and this new body of knowledge promises to open new avenues for understanding and treating poststroke impairments, including cognitive deficits. The 5 reviews in this Focused Update from an international cast of experts provide excellent updates on cognitive syndromes that commonly contribute to poststroke disability: neglect, aphasia, apraxia, loss of executive function, and memory disorders. Cognitive impairment remains a major source of morbidity after stroke; these reviews approach this problem by considering clinical presentations, pathophysiology, measurement tools, and treatment approaches. In doing so, they highlight a number of key questions and critical gaps. A number of issues emerge as common across cognitive domains poststroke and are summarized herein. There is a need for improved methods to measure cognitive impairments, as well as for improved insights into pathophysiology of symptom onset and mechanisms of recovery after stroke, including validated biomarkers. These 5 state of the art summaries are sure to prove useful toward these goals.


Assuntos
Afasia , Transtornos Cognitivos , Disfunção Cognitiva , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Transtornos Cognitivos/psicologia , Disfunção Cognitiva/etiologia , Cognição , Testes Neuropsicológicos
8.
Stroke ; 54(1): 55-66, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36542078

RESUMO

Although language deficits are the primary area of weakness, people with poststroke aphasia often experience challenges with nonlinguistic cognitive skills, including attention processing. The purpose of this review is to synthesize the evidence for the relationship between attention deficits and language deficits in people with poststroke aphasia. Three different types of studies are reviewed: (1) studies exploring whether people with poststroke aphasia exhibit concomitant attention and language deficits, (2) studies explicitly exploring the relationship between attention and language deficits in people with poststroke aphasia, and (3) either language or attention (or both) treatment studies exploring whether treatment gains in one domain generalize to the other. In the last section, we briefly review research evidence for the neural basis of the attention-language relationship in aphasia.


Assuntos
Afasia , Acidente Vascular Cerebral , Humanos , Acidente Vascular Cerebral/complicações , Afasia/etiologia , Idioma
9.
J Speech Lang Hear Res ; 66(1): 206-220, 2023 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-36492294

RESUMO

PURPOSE: ParAlg (Paraphasia Algorithms) is a software that automatically categorizes a person with aphasia's naming error (paraphasia) in relation to its intended target on a picture-naming test. These classifications (based on lexicality as well as semantic, phonological, and morphological similarity to the target) are important for characterizing an individual's word-finding deficits or anomia. In this study, we applied a modern language model called BERT (Bidirectional Encoder Representations from Transformers) as a semantic classifier and evaluated its performance against ParAlg's original word2vec model. METHOD: We used a set of 11,999 paraphasias produced during the Philadelphia Naming Test. We trained ParAlg with word2vec or BERT and compared their performance to humans. Finally, we evaluated BERT's performance in terms of word-sense selection and conducted an item-level discrepancy analysis to identify which aspects of semantic similarity are most challenging to classify. RESULTS: Compared with word2vec, BERT qualitatively reduced word-sense issues and quantitatively reduced semantic classification errors by almost half. A large percentage of errors were attributable to semantic ambiguity. Of the possible semantic similarity subtypes, responses that were associated with or category coordinates of the intended target were most likely to be misclassified by both models and humans alike. CONCLUSIONS: BERT outperforms word2vec as a semantic classifier, partially due to its superior handling of polysemy. This work is an important step for further establishing ParAlg as an accurate assessment tool.


Assuntos
Afasia , Semântica , Humanos , Idioma , Anomia , Linguística
10.
J Speech Lang Hear Res ; 66(1): 276-295, 2023 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-36538505

RESUMO

BACKGROUND: Researchers have used eye-tracking technology to investigate eye movements in neurotypical adults (NAs) when reading. The technology can provide comparable information about people with aphasia (PWA). Eye fixations occurring when PWA do and do not have access to text-to-speech (TTS) technology are of interest because the support improves reading comprehension and decreases processing time for at least some PWA. AIMS: This study's purpose was to examine forward, regressive, and off-track eye fixations when PWA and NAs read narratives in read-only (RO) and TTS conditions. A secondary aim was to examine the influence of eye fixations on processing time. METHOD AND PROCEDURE: A Tobii Dynavox Pro Spectrum eye tracker recorded eye movements of nine PWA and nine NAs while reading narratives in two conditions. Movements of interest were forward fixations; within-word, within-sentence, and previous-sentence regressive fixations; and off-track fixations. OUTCOMES AND RESULTS: PWA exhibited significantly more forward and regressive fixations in the RO than TTS condition, whereas NAs showed opposite behaviors. NAs had significantly more off-track fixations in the TTS than RO condition, whereas PWA exhibited no difference across conditions. PWA took significantly longer to process content in the RO condition, whereas NAs took longer in the TTS condition. CONCLUSIONS: PWA and NAs differ in important ways when processing texts with and without TTS support. Examining eye-tracking data provides a means of gaining insight into the decoding and reading comprehension challenges of PWA and helps elucidate how assistive technology can mediate these challenges.


Assuntos
Afasia , Fala , Humanos , Adulto , Leitura , Afasia/etiologia , Fixação Ocular , Distúrbios da Fala/complicações , Compreensão
11.
Brain Lang ; 236: 105216, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36525719

RESUMO

Repetitive transcranial magnetic stimulation (rTMS) shows promise in improving speech production in post-stroke aphasia. Limited evidence suggests pairing rTMS with speech therapy may result in greater improvements. Twenty stroke survivors (>6 months post-stroke) were randomized to receive either sham rTMS plus multi-modality aphasia therapy (M-MAT) or rTMS plus M-MAT. For the first time, we demonstrate that rTMS combined with M-MAT is feasible, with zero adverse events and minimal attrition. Both groups improved significantly over time on all speech and language outcomes. However, improvements did not differ between rTMS or sham. We found that rTMS and sham groups differed in lesion location, which may explain speech and language outcomes as well as unique patterns of BOLD signal change within each group. We offer practical considerations for future studies and conclude that while combination therapy of rTMS plus M-MAT in chronic post-stroke aphasia is safe and feasible, personalized intervention may be necessary.


Assuntos
Afasia , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Estimulação Magnética Transcraniana , Projetos Piloto , Afasia/etiologia , Afasia/terapia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/terapia , Fonoterapia , Dano Encefálico Crônico , Resultado do Tratamento
12.
Brain Lang ; 236: 105205, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36495749

RESUMO

This study explored the feasibility and effectiveness of a short-term (10-week) intervention trial using Donepezil administered alone and combined with intensive language action therapy (ILAT) for the treatment of apathy and depression in ten people with chronic post-stroke aphasia. Outcome measures were the Western Aphasia Battery and the Stroke Aphasia Depression Questionnaire-21. Structural magnetic resonance imaging and 18fluorodeoxyglucose positron emission tomography were acquired at baseline and after two endpoints (Donepezil alone and Donepezil-ILAT). The intervention was found to be feasible to implement. Large treatment effects were found. Donepezil alone and combined with ILAT reduced aphasia severity, while apathy and depression only improved with Donepezil-ILAT. Structural and functional neuroimaging data did not show conclusive results but provide hints for future research. Given these overall positive findings on feasibility, language and behavioral benefits, further studies in larger sample sizes and including a placebo-control group are indicated.


Assuntos
Apatia , Afasia , Humanos , Afasia/tratamento farmacológico , Afasia/etiologia , Depressão/tratamento farmacológico , Depressão/etiologia , Donepezila/uso terapêutico , Estudos de Viabilidade , Idioma , Terapia da Linguagem/métodos , Resultado do Tratamento
13.
Epilepsy Res ; 189: 107065, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36516565

RESUMO

Language dysfunction is a common and serious comorbidity of epilepsy, especially in individuals with epilepsy aphasia spectrum syndromes. Childhood epilepsy with centrotemporal spikes is on the mild end of the spectrum, while epileptic encephalopathy with continuous spike-and-wave during sleep syndrome is on the severe end. Traditional antiseizure medicines and immunotherapy are currently used to treat severely affected patients, but the results are usually disappointing. The discovery that GRIN2A is the primary monogenic etiology of these diseases has opened the door to precision treatments. The GRIN2A gene encodes GluN2A protein, which constitutes a subunit of the NMDA receptor (NMDAR). The GRIN2A pathogenic variants cause gain or loss of function of NMDAR; the former can be treated with uncompetitive NMDAR antagonists, such as memantine, while the latter with NMDAR co-agonist serine. Hyper-precision therapies with various other effective agents are likely to be developed shortly to target the diverse functional effects of different variants. Precision treatments for GRIN2A-related disorders will benefit those who suffer from the condition and pave the way for new therapeutic approaches to a variety of other NMDAR-linked neurodegenerative and psychiatric diseases (schizophrenia, Parkinson's disease, Alzheimer's disease, and so on). Furthermore, more research into GRIN2A-related disorders will help us better understand the neuroinflammatory and neuroimmunological basis of epilepsy, as well as the pathological and physiological network activation mechanisms that cause sleep activation of central-temporal spikes and language impairment.


Assuntos
Afasia , Epilepsia , Síndromes Epilépticas , Síndrome de Landau-Kleffner , Humanos , Epilepsia/tratamento farmacológico , Epilepsia/genética , Síndrome de Landau-Kleffner/genética , Mutação , Receptores de N-Metil-D-Aspartato/genética , Receptores de N-Metil-D-Aspartato/metabolismo , Distúrbios da Fala
14.
Alzheimers Dement ; 18 Suppl 2: e067739, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36537508

RESUMO

BACKGROUND: Despite the important role of written language in everyday life, abnormalities in functional written communication have been sparsely investigated in PPA. METHOD: We developed a Python program which uses a language parser and quantifies content units (CU) and total utterances in language samples. The program was used to analyze written descriptions of the WAB Picnic scene, based on a pre-defined CU corpus, from a cohort with 95 participants (20 controls, 28 nonfluent variant Primary Progressive Aphasia (nfvPPA), 30 logopenic variant (lvPPA), 17 semantic variant (svPPA)). We then compared written functional communication between the three PPA variants and controls. We analyzed the measurements in relation to aphasia severity (Progressive Aphasia Severity Scale Sum of Boxes (PASS SoB) and Clinical Dementia Rating Supplemental Language (CDR-L) scores), and dementia severity (Clinical Dementia Rating Sum of Boxes (CDR SoB)). RESULT: The reliability of the automated analysis was high as compared to manual scoring of 239 samples (99.6%). One-way ANOVAs revealed patients with lvPPA and svPPA wrote fewer CU than controls (mean+/-SD 11.97+/-7.87 and 10+/-4.5, vs 18.5+/-9.32) (F(3, 91)=[4.897], p=0.003). There was a trend towards a decrease in CU in nfvPPA (13.89+/-6.33) (p=0.144). Patients with all PPA subtypes (nfvPPA mean+/-SD 34.64+/-18.89; lvPPA 38+/-24.54; svPPA 28.88+/-20.36) wrote fewer total utterances than controls (61.7+/-27.86) (F(3, 91)=[7.778], p<0.001). The CU/utterance ratio was higher in nfvPPA and svPPA than in controls and lvPPA (0.42+/-0.14 and 0.43+/0.22 vs 0.3+/-0.05 and 0.32+/-0.12 respectively) (F(3, 91)=[5.592], p=0.001). Considering all PPA samples, regression analysis showed a decrease in CU relative to an increase in PASS SoB (R=0.24, p=0.04), CDR-L (R=0.22, p=0.06), and CDR SoB (R=0.34, p=0.004). CONCLUSION: As expected, we found impairments in informative written language in patients with PPA. Automated CU analysis is a tool that can improve assessment of functional written communication, and may be an objective tool to track aphasia progression. More studies are required to assess individual changes over time and whether these findings could be extrapolated to other forms of cognitive impairment.


Assuntos
Afasia Primária Progressiva , Afasia , Humanos , Encéfalo , Afasia Primária Progressiva/psicologia , Cobre , Reprodutibilidade dos Testes , Idioma
15.
Orv Hetil ; 163(50): 2000-2008, 2022 Dec 11.
Artigo em Húngaro | MEDLINE | ID: mdl-36502423

RESUMO

INTRODUCTION: Although aphasia screening tools are widely used internationally, in Hungarian, to date, there have been no aphasia screening tests with reported psychometric properties available. OBJECTIVE: (1) To provide an overview of the international practice and the tools of post-stroke aphasia screening. (2) To present a recently developed aphasia screening test in Hungarian. METHOD: The Hungarian Aphasia Screening Test comprises five tasks assessing speech comprehension and production, and takes 5-10 minutes to complete. The test is easy to score and needs little equipment, therefore it can be useful in any clinical setting that allows for quick test administration and diagnostics. Based on results of two studies, we evaluate the psychometric properties and the diagnostic accuracy of the test, and determine three impairment severity ranks (mild, moderate, severe aphasia) for the test. The severity ranks were defined based on results of 70 people with post-stroke aphasia (35 women; average age: 61.4 years; average postonset: 12.6 months). RESULTS: The test has high diagnostic accuracy, a sensitivity of 92.5% and a specificity of 88.5%. It shows acceptable structural and concurrent (MR = 0.68) validity as well as good internal consistency (Mα = 0.74). The cut-off score for diagnosing aphasia is 17. DISCUSSION: The test can differentiate stroke patients with and without aphasia. With the use of the test, patients' aphasia can be rated as mild (score 14-17), moderate (score 9-13), or severe (score 0-8). Our results suggest that it is a reliable and valid screening tool. CONCLUSION: The test can detect the presence and quantify the severity of aphasia. We discuss the importance of aphasia screening in clinical settings and of the use of the Hungarian Aphasia Screening Test in the context of the international practices. Orv Hetil. 2022; 163(50): 2000-2008.


Assuntos
Afasia , Acidente Vascular Cerebral , Humanos , Feminino , Pessoa de Meia-Idade , Afasia/diagnóstico , Afasia/etiologia , Idioma , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Psicometria , Hungria
17.
Ideggyogy Sz ; 75(11-12): 397-409, 2022 Nov 30.
Artigo em Húngaro | MEDLINE | ID: mdl-36541146

RESUMO

Background and purpose: Reading is a part of the language processes; a strong interaction can be found between them so the damage of the one has a strong impact on the other. It is worth to put emphasis on the exploration of reading disorders which occur with aphasia to have a better outcome of the rehabilitation process. The aim of our study is to explore the main characteristics of aqcuired reading disorders to have a more specialized and individualized language therapy. Methods: 19 ischemic stroke patients with aphasia took part in our study. All participants were right-handed with a lesion of left arteria cerebri media infarct. Due to the Hungarian version of Western Aphasia Battery 10 mild and 9 moderate participated. Reading abilities were investigated with our reading battery which consisted four main tasks: grapheme-phoneme correspondence, reading words, lexical access and reading comprehension. Tobii X120 device was used for recording and analyzing patients' eye-movements. Results: Significant positive correlations were found between the four subscales of Western Aphasia Battery and some part of the reading tasks. Eye-movements were analyzed, especially fixation count and total fixation duration. The severity of language disorder had a strong impact on fixation count and fixation duration. The more serious the language disorder was the more eye movements were detected. Conclusion: Our data support the idea that the severity of aphasia had a strong impact on reading processes and eye-movements. Eye-tracking device can help to have a deeper insight in the background brain mechanisms during reading. Our results contribute to have a more accurate diagnostic process to have a more specialized language therapy with better outcome.


Assuntos
Afasia , Dislexia , AVC Isquêmico , Transtornos da Linguagem , Acidente Vascular Cerebral , Humanos , Acidente Vascular Cerebral/complicações , Afasia/etiologia
18.
Genes (Basel) ; 13(12)2022 12 14.
Artigo em Inglês | MEDLINE | ID: mdl-36553628

RESUMO

Our aim was to analyze the phenotypic-genetic correlations in a patient diagnosed with early onset corticobasal syndrome with progressive non-fluent aphasia (CBS-PNFA), characterized by predominant apraxia of speech, accompanied by prominent right-sided upper-limb limb-kinetic apraxia, alien limb phenomenon, synkinesis, myoclonus, mild cortical sensory loss, and right-sided hemispatial neglect. Whole-exome sequencing (WES) identified rare single heterozygous variants in ATP7B (c.3207C>A), SORL1 (c.352G>A), SETX (c.2385_2387delAAA), and FOXP1 (c.1762G>A) genes. The functional analysis revealed that the deletion in the SETX gene changed the splicing pattern, which was accompanied by lower SETX mRNA levels in the patient's fibroblasts, suggesting loss-of-function as the underlying mechanism. In addition, the patient's fibroblasts demonstrated altered mitochondrial architecture with decreased connectivity, compared to the control individuals. This is the first association of the CBS-PNFA phenotype with the most common ATP7B pathogenic variant p.H1069Q, previously linked to Wilson's disease, and early onset Parkinson's disease. This study expands the complex clinical spectrum related to variants in well-known disease genes, such as ATP7B, SORL1, SETX, and FOXP1, corroborating the hypothesis of oligogenic inheritance. To date, the FOXP1 gene has been linked exclusively to neurodevelopmental speech disorders, while our study highlights its possible relevance for adult-onset progressive apraxia of speech, which guarantees further study.


Assuntos
Afasia , Apraxias , Degeneração Corticobasal , Degeneração Hepatolenticular , Humanos , DNA Helicases , Fatores de Transcrição Forkhead/genética , Degeneração Hepatolenticular/genética , Proteínas Relacionadas a Receptor de LDL , Proteínas de Membrana Transportadoras , Enzimas Multifuncionais , Proteínas Repressoras , RNA Helicases , Síndrome
19.
Neuroimage Clin ; 36: 103271, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36510409

RESUMO

A disruption of white matter connectivity is negatively associated with language (recovery) in patients with aphasia after stroke, and behavioral gains have been shown to coincide with white matter neuroplasticity. However, most brain-behavior studies have been carried out in the chronic phase after stroke, with limited generalizability to earlier phases. Furthermore, few studies have investigated neuroplasticity patterns during spontaneous recovery (i.e., not related to a specific treatment) in the first months after stroke, hindering the investigation of potential early compensatory mechanisms. Finally, the majority of previous research has focused on damaged left hemisphere pathways, while neglecting the potential protective value of their right hemisphere counterparts for language recovery. To address these outstanding issues, we present a longitudinal study of thirty-two patients with aphasia (21 males and 11 females, M = 69.47 years, SD = 10.60 years) who were followed up for a period of 1 year with test moments in the acute (1-2 weeks), subacute (3-6 months) and chronic phase (9-12 months) after stroke. Constrained Spherical Deconvolution-based tractography was performed in the acute and subacute phase to measure Fiber Bundle Capacity (FBC), a quantitative connectivity measure that is valid in crossing fiber regions, in the bilateral dorsal arcuate fasciculus (AF) and the bilateral ventral inferior fronto-occipital fasciculus (IFOF). First, concurrent analyses revealed positive associations between the left AF and phonology, and between the bilateral IFOF and semantics in the acute - but not subacute - phase, supporting the dual-stream language model. Second, neuroplasticity analyses revealed a decrease in connection density of the bilateral AF - but not the IFOF - from the acute to the subacute phase, possibly reflecting post stroke white matter degeneration in areas adjacent to the lesion. Third, predictive analyses revealed no contribution of acute FBC measures to the prediction of later language outcomes over and above the initial language scores, suggesting no added value ofthe diffusion measures for languageprediction. Our study provides new insights on (changes in) connectivity of damaged and undamaged language pathways in patients with aphasia in the first months after stroke, as well as if/how such measures are related to language outcomes at different stages of recovery. Individual results are discussed in the light of current frameworks of language processing and aphasia recovery.


Assuntos
Afasia , Acidente Vascular Cerebral , Substância Branca , Masculino , Feminino , Humanos , Substância Branca/diagnóstico por imagem , Substância Branca/patologia , Imagem de Tensor de Difusão , Estudos Longitudinais , Vias Neurais/diagnóstico por imagem , Vias Neurais/patologia , Afasia/etiologia , Afasia/complicações , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/patologia
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