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1.
PLoS One ; 17(8): e0272207, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35944041

RESUMO

Previous studies of multiple languages have found processing differences between patient-first and agent-first word orders. However, the results are inconsistent as they do not identify a specific ERP component as a unique correlate of thematic role processing. Furthermore, these studies generally confound word order with frequency, as patient-first structures tend to be infrequent in the languages that have been investigated. There is evidence that frequency at the sentence level plays a significant role in language processing. To address this potential confounding variable, we will test a language where the non-canonical sentences are more frequent and are comparable to the canonical sentences, namely Standard Indonesian. In this language, there is evidence from acquisition, corpus, and clinical data indicates that the use of passive is frequent and salient. One instance of this difference can be demonstrated by the fact that it has been suggested that frequency may be the reason why Indonesian-speaking aphasic speakers do not have impairments in the comprehension of passives, whereas speakers of other languages with aphasia often do. In the present study, we will test 50 native speakers of Indonesian using 100 sentences (50 active and 50 passive sentences). If the neural correlates of thematic role processing are not observed in the critical region of the sentence (the prefix of the verb), this would suggest that the previous results were indeed influenced by frequency, but if we find that specific ERPs are connected to the hypothesized syntactic operations, this would further reinforce the existing evidence of the increased cognitive load required to process more syntactically complicated sentences.


Assuntos
Afasia , Idioma , Compreensão , Humanos , Indonésia , Testes de Linguagem , Semântica
2.
Folia Neuropathol ; 60(2): 257-260, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35950478

RESUMO

Aphasia is a common consequence of stroke and repetitive transcranial magnetic stimulation (rTMS) may be a promising brain stimulation technique in the treatment of aphasia. However, there are few reports about the therapeutic effect of rTMS for Broca's area in patients with sensory aphasia. This study reported one stroke patient with sensory aphasia who received 6 treatment sessions of low-frequency rTMS before speech and language therapy. The target area was the Broca mirror area in the right hemisphere. After treatment, the auditory comprehension of the patient improved from 46 to 112, the naming improved from 18 to 32, and the AQ improved from 34.2 to 42.6. However, the level of functional language, spontaneous speech and repetition did not show obvious improvement.


Assuntos
Afasia , Acidente Vascular Cerebral , Afasia/etiologia , Afasia/terapia , Afasia de Wernicke/complicações , Área de Broca , Compreensão , Humanos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/terapia , Estimulação Magnética Transcraniana/métodos
3.
Geriatr Psychol Neuropsychiatr Vieil ; 20(2): 261-270, 2022 06 01.
Artigo em Francês | MEDLINE | ID: mdl-35929393

RESUMO

Word finding difficulties, particularly for verbs, are a common symptom in post-stroke aphasia and people with neurodegenerative diseases, such as Alzheimer's disease. Word finding difficulties for verbs are mainly assessed by action naming tasks, using often images depicting actions. However, videos seem to be more adapted than images for action naming. To date, there are no action naming tests using videos available in French. The aim of this study is to present the T-DAV, an action naming test with videos, and its psychometric properties (validity and reliability). The T-DAV is composed of 20 videos (10 high frequency and 10 low frequency actions). High and low frequency stimuli are matched for several relevant psycholinguistic variables (e.g., length in phonemes). Performance on the T-DAV is associated with performance on the DVL-38 test, a French action naming test using images (concurrent validity). The T-DAV allows to differentiate the performance of healthy individuals from that of Alzheimer's Disease patients (discriminant validity). The items of the T-DAV show good internal consistency (reliability). In sum, the T-DAV shows good pshychometric properties and counts with norms for French-speaking adults. The T-DAV fulfills a clinical need of action naming tests with videos in French.


Le manque du verbe est un symptôme clinique présent chez les patients aphasiques post-accident vasculaire cérébral et atteints de maladies neurodégénératives comme la maladie d'Alzheimer (MA). L'évaluation du manque du verbe se fait souvent avec des tâches de dénomination d'actions portant sur des images. Or, le support vidéo semble être plus adapté que les images pour la dénomination d'actions. À ce jour, aucun test français n'évalue la dénomination d'actions par vidéos. L'objectif de cet article est de présenter le Test de dénomination d'actions par vidéos (T-DAV) et l'étude de ses propriétés psychométriques (validité et fiabilité). Le T-DAV est composé de 20 vidéos (10 actions de haute fréquence et 10 de basse fréquence), appariées par plusieurs variables psycholinguistiques. La performance au T-DAV est associée à celle du test DVL-38 pour la dénomination d'actions avec images (validité concurrente). Les scores au T-DAV permettent de différencier la performance des personnes saines et celles atteintes de la MA (validité discriminante). Les items du T-DAV montrent une bonne consistance interne (fiabilité). En somme, le T-DAV montre de très bonnes propriétés psychométriques et présente des normes pour une population francophone adulte. Le T-DAV comble ainsi le manque de tests francophones de dénominations d'actions par vidéos.


Assuntos
Doença de Alzheimer , Afasia , Doença de Alzheimer/diagnóstico , Humanos , Testes Neuropsicológicos , Padrões de Referência , Reprodutibilidade dos Testes , Semântica
4.
Handb Clin Neurol ; 187: 69-87, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35964993

RESUMO

Selective disorders of auditory speech processing due to brain lesions are reviewed. Over 120 years after the first anatomic report (Dejerine and Sérieux, 1898), fewer than 80 cumulative cases of generalized auditory agnosia and pure word deafness with documented brain lesions are on record. Most patients (approximately 70%) had vascular lesions. Damage is very frequently bilateral in generalized auditory agnosia, and more frequently unilateral in pure word deafness. In unilateral cases, anatomical disconnection is not a prerequisite, and disorders may be due to functional disconnection. Regardless of whether lesions are unilateral or bilateral, speech processing difficulties emerge in the presence of damage to the superior temporal regions of the language-dominant hemisphere, suggesting that speech input is processed asymmetrically at early stages already. Extant evidence does not allow establishing whether processing asymmetry originates in the primary auditory cortex or in higher associative cortices, nor whether auditory processing in the brainstem is entirely symmetric. Results are consistent with the view that the difficulty in processing auditory input characterized by quick spectral and/or temporal changes is one of the critical dimensions of the disorder. Forthcoming studies should focus on detailed audiologic, neurolinguistic, and neuroanatomic descriptions of each case.


Assuntos
Agnosia , Afasia , Transtornos do Desenvolvimento da Linguagem , Afasia/patologia , Percepção Auditiva , Humanos , Idioma , Fala , Distúrbios da Fala
5.
Brain Lang ; 232: 105163, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35921727

RESUMO

While previous studies have found that white matter damage relates to impairment severity in individuals with aphasia, further study is required to understand the relationship between white matter integrity and treatment response. In this study, 34 individuals with chronic post-stroke aphasia underwent behavioral testing and structural magnetic resonance imaging at two timepoints. Thirty participants within this sample completed typicality-based semantic feature treatment for anomia. Tractography of bi-hemispheric white matter tracts was completed via Automated Fiber Quantification. Associations between microstructural integrity metrics and behavioral measures were evaluated at the tract level and in nodes along the tract. Diffusion measures of the left inferior longitudinal, superior longitudinal, and arcuate fasciculi were related to aphasia severity and diffusion measures of the left inferior longitudinal fasciculus were related to naming and treatment response. This study also found preliminary evidence of left inferior longitudinal fasciculus microstructural changes following treatment.


Assuntos
Afasia , Substância Branca , Anomia/patologia , Afasia/diagnóstico por imagem , Afasia/etiologia , Afasia/terapia , Imagem de Tensor de Difusão , Humanos , Rede Nervosa , Substância Branca/diagnóstico por imagem , Substância Branca/patologia
6.
Semin Speech Lang ; 43(3): 198-207, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35858605

RESUMO

In recent years, stakeholders engaged in the study, treatment, and understanding of aphasia outcomes have emphasized the need for greater transparency regarding the economics of aphasia rehabilitation. Most notably, third-party payers and clinicians have a keen interest in understanding the resources used to treat aphasia, particularly the cost-effectiveness and value of aphasia treatments. In this article, we review the current literature related to the economic burden of aphasia and the cost and cost-effectiveness of aphasia treatments. To date, relatively few scholars have attempted to study the efficiency, scale, and scope related to the economics of aphasia and the cost-effectiveness of aphasia treatment. While studies of the cost-effectiveness of aphasia treatments have shown rehabilitative treatments conform to established quality and cost benchmarks, the continued progress and developments in the treatment of aphasia and measurement of clinical outcomes has left many areas unstudied. We highlight the need for greater emphasis on the cost-effectiveness of aphasia treatments in addition to the traditional focus on the efficacy of treatment outcomes.


Assuntos
Afasia , Acidente Vascular Cerebral , Afasia/reabilitação , Humanos , Fala , Fonoterapia , Resultado do Tratamento
7.
J Neural Transm (Vienna) ; 129(8): 1039-1048, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35821453

RESUMO

Language impairments, hallmarks of speech/language variant progressive supranuclear palsy, also occur in Richardson's syndrome (PSP-RS). Impaired communication may interfere with daily activities. Therefore, assessment of language functions is crucial. It is uncertain whether the Aachen Aphasia Test (AAT) is practicable in PSP-RS, behavioral variant frontotemporal dementia (bvFTD) and Alzheimer's dementia (AD) and language deficits differ in these disorders. 28 PSP-RS, 24 AD, and 24 bvFTD patients were investigated using the AAT and the CERAD-Plus battery. 16-25% of all patients failed in AAT subtests for various reasons. The AAT syndrome algorithm diagnosed amnestic aphasia in 5 (23%) PSP-RS, 7 (36%) bvFTD and 6 (30%) AD patients, Broca aphasia in 1 PSP-RS and 1 bvFTD patient, Wernicke aphasia in 1 bvFTD and 3 (15%) AD patients. However, aphasic symptoms resembled non-fluent primary progressive aphasia in 14 PSP-RS patients. In up to 46% of PSP-RS patients, 61% of bvFTD and 64% of AD patients significant impairments were found in the AAT subtests spontaneous speech, written language, naming, language repetition, language comprehension and the Token subtest. The CERAD-Plus subtest semantic fluency revealed significant impairment in 81% of PSP-RS, 61% of bvFTD, 44% of AD patients, the phonemic fluency subtest in 31, 40 and 31%, respectively. In contrast to bvFTD and AD, severity of language impairment did not correlate with cognitive decline in PSP-RS. In summary, the patterns of aphasia differ between the diagnoses. Local frontal language networks might be impaired in PSP-RS, whereas in AD and bvFTD, more widespread neuropathology might underly language impairment.


Assuntos
Doença de Alzheimer , Afasia , Demência Frontotemporal , Transtornos do Desenvolvimento da Linguagem , Paralisia Supranuclear Progressiva , Doença de Alzheimer/complicações , Doença de Alzheimer/diagnóstico , Afasia/etiologia , Demência Frontotemporal/complicações , Humanos , Testes Neuropsicológicos , Paralisia Supranuclear Progressiva/complicações , Paralisia Supranuclear Progressiva/diagnóstico
8.
Chin J Integr Med ; 28(8): 743-752, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35907173

RESUMO

OBJECTIVE: To evaluate the existing randomized controlled trials (RCTs) for evidence of the efficacy and safety of head acupuncture (HA) plus Schuell's language rehabilitation (SLR) in post-stroke aphasia. METHODS: Seven databases including Embase, PubMed, Cochrane Library, Technology Periodical Database, the China National Knowledge Infrastructure, SinoMed and Wanfang Data Information Site were searched for RCTs published from database inception until November 14, 2021. RCTs that compared HA plus SLR with sham (or blank) control, acupuncture therapy alone, certain language rehabilitation therapy alone or other therapies for post-stroke aphasia were included. Data were extracted and assessed, and the quality of RCTs was evaluated. Fixed-effects model was used, with meta-inflfluence analysis, meta-regression, and regression-based sub-group analyses applied for exploration of heterogeneity. Publication bias was estimated by funnel plots and Egger's tests. RESULTS: A total of 32 RCTs with 1,968 patients were included and 51 comparisons were conducted classified as types of strokes and aphasia. (1) For patients with aphasia after ischemic stroke, HA plus PSA showed significantly higher accumulative markedly effective rate [relative risk (RR)=1.55, 95% confidence interval (CI): 1.19-2.02, I2=0%] and accumulative effective rate (RR=1.22, 95% CI: 1.09-1.36, I2=0%). (2) For patients with comprehensive types of stroke, HA plus PSA was more effective in increasing recovery rate (RR=1.89, 95% CI: 1.39-2.56, I2=0%), accumulative markedly effective rate (RR=1.53, 95% CI: 1.36-1.72, I2=9%) and accumulative effective rate (RR=1.14, 95% CI: 1.09-1.19, I2=34%). (3) For patients with aphasia after stroke, HA plus PSA was superior to PSA alone with statistical significance in increasing recovery rate (RR=2.08, 95% CI: 1.24-3.46, I2=0%), accumulative markedly effective rate (RR=1.49, 95% CI: 1.24-1.78, I2=0%) and accumulative effective rate (RR=1.15, 95% CI: 1.06-1.24, I2=39%). (4) For patients with multiple types of aphasia, HA plus PSA also demonstrated significantly higher recovery rate (RR=1.86, 95% CI: 1.28-2.72, I2=0%), accumulative markedly effective rate (RR=1.55, 95% CI: 1.35-1.78, I2=22%), and accumulative effective rate (RR=1.17, 95% CI: 1.11-1.23, I2=41%). (5) For patients with motor aphasia after ischemic stroke, compared with PSA alone, HA plus PSA showed significantly higher accumulative markedly effective rate (RR=1.38, 95% CI: 1.06-1.79, I2=0%) and accumulative effective rate (RR=1.20, 95% CI: 1.05-1.37, I2=0%). Meta-regression analyses were performed without significant difference, and publication bias was found in some comparisons. CONCLUSION: HA plus SLR was significantly associated with better language ability and higher effective rate for patients with post-stroke aphasia, and HA should be operated cautiously especially during acupuncture at eye and neck. (Registration No. CRD42020154475).


Assuntos
Terapia por Acupuntura , Afasia , AVC Isquêmico , Acidente Vascular Cerebral , Afasia/complicações , Afasia/reabilitação , Humanos , Idioma , Antígeno Prostático Específico , Ensaios Clínicos Controlados Aleatórios como Assunto , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/terapia
11.
PLoS One ; 17(6): e0270135, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35749406

RESUMO

A number of pharmaceuticals have been identified as potential adjuvants to speech language therapy following stroke, but it is also important to consider which pharmaceuticals may result in a less robust recovery. Here we examine whether post-stroke language recovery was meaningfully impeded by cholinergic, GABAergic, or dopaminergic medications patients received. Eighty participants with left hemisphere stroke were examined retrospectively to see whether the use of one of these three classes of medication prior to admission for acute stroke, during their inpatient stay, or at discharge was associated with differences in recovery on three common measures of language. While prescription of any of the candidate drugs was relatively uncommon, groups were very well matched for many common factors that impact performance. When age, education, and acute lesion volume were controlled, there were no significant differences in performance among those taking cholinergic, GABAergic, or dopaminergic medications and those who were not. Those who experienced a "good recovery" of language (≥10% improvement on any one language measure over time) had similar exposure to these drugs to those with a poor recovery. This work represents a first look at these drug classes with regard to their effects on the recovery of language after stroke and should not be interpreted as resolving all potential for concern, but these results do offer modest reassurance that these common classes of pharmacotherapy, when given for short periods in this population, do not appear to have marked deleterious effects on post-stroke recovery of language.


Assuntos
Afasia , Medicamentos sob Prescrição , Acidente Vascular Cerebral , Afasia/complicações , Afasia/etiologia , Colinérgicos , Humanos , Recuperação de Função Fisiológica , Estudos Retrospectivos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/patologia
12.
Trials ; 23(1): 501, 2022 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-35710437

RESUMO

BACKGROUND: Treatment fidelity is inconsistently reported in aphasia research, contributing to uncertainty about the effectiveness of types of aphasia therapy following stroke. We outline the processes and outcomes of treatment fidelity monitoring in a pre-specified secondary analysis of the VERSE trial. METHODS: VERSE was a 3-arm, single-blinded RCT with a 12-week primary endpoint comparing Usual Care (UC) to two higher intensity treatments: Usual Care-Plus (UC-Plus) and VERSE, a prescribed intervention. Primary outcome results were previously reported. This secondary analysis focused on treatment fidelity. Video-recorded treatment sessions in the higher intensity study arms were evaluated for treatment adherence and treatment differentiation. Treatment components were evaluated using a pre-determined fidelity checklist. PRIMARY OUTCOME: prescribed amount of therapy time (minutes); secondary outcomes: (i) adherence to therapy protocol (%) and (ii) treatment differentiation between control and high intensity groups. RESULTS: Two hundred forty-six participants were randomised to Usual Care (n=81), Usual Care-Plus (n=82), and VERSE (n=83). One hundred thirty-five (82%) participants in higher intensity intervention arms received the minimum prescribed therapy minutes. From 10,805 (UC 7787; UC-Plus 1450; VERSE 1568) service events, 431 treatment protocol deviations were noted in 114 participants. Four hundred thirty-seven videos were evaluated. The VERSE therapists achieved over 84% adherence to key protocol elements. Higher stroke and aphasia severity, older age, and being in the UC-Plus group predicted more treatment deviations. CONCLUSIONS: We found high levels of treatment adherence and differentiation between the intervention arms, providing greater confidence interpreting our results. The comprehensive systems for intervention fidelity monitoring and reporting in this trial make an important contribution to aphasia research and, we argue, should set a new standard for future aphasia studies. TRIAL REGISTRATION: ACTRN 12613000776707.


Assuntos
Afasia , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Afasia/diagnóstico , Afasia/reabilitação , Humanos , Fala , Fonoterapia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Reabilitação do Acidente Vascular Cerebral/métodos
13.
J Commun Disord ; 98: 106231, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35688011

RESUMO

Disparities in social determinants of health (SDOH) such as socioeconomic status and access to quality healthcare present serious barriers to enrollment in clinical rehabilitation programs for individuals who have experienced a stroke, especially for those who identify with a racial-ethnic minority group. Hispanic bilinguals with aphasia (HBWA) are one marginalized group who face even greater enrollment challenges since post-stroke language impairment and limited English proficiency make it difficult to advocate for one's needs and identify appropriate rehabilitation programs. Given the increasing representation of Hispanic individuals in the U.S. (projected to be 30% of the population in 2050), it is imperative that clinicians counter disparities in stroke care by facilitating access to clinical services for HBWA. However, the Hispanic population remains largely understudied in the stroke and aphasia literature, due in part to reduced opportunities to enroll in large-scale clinical research studies. In this paper we highlight how our team at Boston University has designed and implemented a variety of recruitment practices, assessment modifications, and treatment accommodations to circumvent the known barriers to participation in clinical research experienced by HBWA. Furthermore, we discuss the importance of cultural responsiveness and demonstrate how including principles of sensitivity and humility in clinical trial protocols improves participant enrollment and retention. Although clinical adjustments in this study were developed for use with HBWA, the effectiveness of the procedures suggests they may be useful blueprints for expanding access to research opportunities for various marginalized groups.


Assuntos
Afasia , Acidente Vascular Cerebral , Etnicidade , Hispânico ou Latino , Humanos , Grupos Minoritários , Determinantes Sociais da Saúde
14.
Continuum (Minneap Minn) ; 28(3): 676-701, 2022 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-35678398

RESUMO

PURPOSE OF REVIEW: This article discusses the clinical, neuroimaging, and biomarker profiles of sporadic atypical Alzheimer disease (AD) variants, including early-onset AD, posterior cortical atrophy, logopenic variant primary progressive aphasia, dysexecutive variant and behavioral variant AD, and corticobasal syndrome. RECENT FINDINGS: Significant advances are being made in the recognition and characterization of the syndromically diverse AD variants. These variants are identified by the predominant cognitive and clinical features: early-onset amnestic syndrome, aphasia, visuospatial impairments, dysexecutive and behavioral disturbance, or motor symptoms. Although understanding of regional susceptibility to disease remains in its infancy, visualizing amyloid and tau pathology in vivo and CSF examination of amyloid-ß and tau proteins are particularly useful in atypical AD, which can be otherwise prone to misdiagnosis. Large-scale research efforts, such as LEADS (the Longitudinal Early-Onset Alzheimer Disease Study), are currently ongoing and will continue to shed light on our understanding of these diverse presentations. SUMMARY: Understanding the clinical, neuroimaging, and biomarker profiles of the heterogeneous group of atypical AD syndromes improves diagnostic accuracy in patients who are at increased risk of misdiagnosis. Earlier accurate identification facilitates access to important interventions, social services and disability assistance, and crucial patient and family education.


Assuntos
Doença de Alzheimer , Afasia , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/patologia , Atrofia , Biomarcadores , Humanos , Neuroimagem , Proteínas tau/metabolismo
17.
Neuropsychologia ; 173: 108302, 2022 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-35718138

RESUMO

People use cognitive control across many contexts in daily life, yet it remains unclear how cognitive control is used in contexts involving language. Distinguishing language-specific cognitive control components may be critical to understanding aphasia, which can co-occur with cognitive control deficits. For example, deficits in control of semantic representations (i.e., semantic control), are thought to contribute to semantic deficits in aphasia. Conversely, little is known about control of phonological representations (i.e., phonological control) in aphasia. We developed a switching task to investigate semantic and phonological control in 32 left hemisphere stroke survivors with aphasia and 37 matched controls. We found that phonological and semantic control were related, but dissociate in the presence of switching demands. People with aphasia exhibited group-wise impairment at phonological control, although individual impairments were subtle except in one case. Several individuals with aphasia exhibited frank semantic control impairments, and these individuals had relative deficits on other semantic tasks. The present findings distinguish semantic control from phonological control, and confirm that semantic control impairments contribute to semantic deficits in aphasia.


Assuntos
Afasia , Acidente Vascular Cerebral , Afasia/psicologia , Humanos , Idioma , Semântica , Acidente Vascular Cerebral/complicações
18.
Cortex ; 153: 224-234, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35714388

RESUMO

Theodore H. Weisenburg (1876-1934) and a series of colleagues embarked on a research program in 1927 to develop standardized tests to investigate the nature of language and intellectual impairments in aphasic and non-aphasic individuals. This project culminated in two significant contributions to neuropsychological testing (Weisenburg & McBride, 1935; Weisenburg, Roe and McBride, 1936). After an initial study demonstrated the problematic aspects of Henry Head's aphasia tests (1926), Weisenburg developed a new battery of tests which were given to individuals with aphasia. The significant innovation of this work was the original concept of a matched control group. This included those with other neurological impairments, and a range of non-neurologically impaired individuals with the aim of providing a characterization of what was 'normal'. They identified many crucial participant variables regarding age, education, and socioeconomic status and used population statistics to ensure their control sample was representative. A detailed critical assessment of each of their successive elaborations is examined, focusing on the methodological innovations they represent. The contribution of this work to contemporaries and successive generations of neuropsychologists is examined regarding ongoing issues in clinical testing and research design.


Assuntos
Afasia , Afasia/diagnóstico , Humanos , Inteligência , Idioma , Testes Neuropsicológicos
19.
Epileptic Disord ; 24(3): 549-554, 2022 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-35653085

RESUMO

Objective Among the clinical manifestations of stroke mimics, isolated aphasia is one of the most challenging due to its aetiopathogenic diagnosis. This short communication describes a specific perfusion and brain oscillatory pattern in a challenging case of prolonged isolated aphasia caused by status epilepticus, jointly investigated by computed tomography (CT) perfusion, single-photon emission computerized tomography (SPECT)/CT and EEG qualitative and quantitative analysis. Methods We discuss the different patterns of perfusion neuroimaging and EEG between SE and ischaemic stroke or postictal (Todd's)-related isolated aphasia, and propose these differences as a basis to support the differential diagnosis. Results The pattern associated with SE was characterized by focal hyperperfusion on CT perfusion maps (the left mean transit time was shorter with >10% asymmetry, and left cerebral blood volume and cerebral blood flow increased or slightly altered, relative to the contralateral side) and SPECT (focal left temporal hyperperfusion), without any early ischaemic signs on non-enhanced CT, while the EEG showed a predominant left hemispheric slow delta power. The aforementioned perfusion pattern contrasts with postictal epileptic Todd's phenomenon, which is characterized by hypoperfusion on CT perfusion (the mean transit time is prolonged and cerebral blood volume and cerebral blood flow are reduced, compared to the contralateral hemisphere) and SPECT (focal hypoperfusion), not restricted to the specific vascular territories. Significance CT perfusion patterns may add valuable information to support the differential diagnosis of status epilepticus, rather than acute ischaemic stroke or postictal Todd's phenomenon, in cases with challenging symptoms of prolonged isolated aphasia.


Assuntos
Afasia , Isquemia Encefálica , Acoplamento Neurovascular , Estado Epiléptico , Acidente Vascular Cerebral , Afasia/diagnóstico por imagem , Afasia/etiologia , Isquemia Encefálica/complicações , Isquemia Encefálica/diagnóstico por imagem , Diagnóstico Diferencial , Eletroencefalografia , Humanos , Perfusão/efeitos adversos , Estado Epiléptico/complicações , Estado Epiléptico/diagnóstico por imagem , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/diagnóstico por imagem , Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada por Raios X/efeitos adversos , Tomografia Computadorizada por Raios X/métodos
20.
Wiad Lek ; 75(5 pt 2): 1229-1233, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35758436

RESUMO

OBJECTIVE: The aim: Assess the impact of neurological SLA on improvement of language functions in post-stroke patients. PATIENTS AND METHODS: Materials and methods: The study covered a total of 82 patients aged 40-80, of both sexes, with stroke-induced cognitive deficits. They were in-patients of the Clinic Of Rehabilitation And Physical Medicine of the "WAM" Teaching Hospital in Lódz. The study comprised two groups. The study group consisted of post-stroke patients with aphasia, who were referred to four-week comprehensive program of neurological SLA therapy earlier (about a month) after experiencing stroke. The group comprised 44 patients. Six months after the stroke, the patients underwent another four weeks of neurological SLA. The control group consisted of post-stroke patients with aphasia. The group comprised 38 patients. The four-week neurological SLA therapy was applied more than six months after stroke ("late therapy"). The patients were ascribed to the groups randomly. Language abilities were evaluated with the Aphasia Dynamics Assessment Scale (Polish: Skala Oceny Dynamiki Afazji, abbrev. SODA). RESULTS: Results: The study showed that neurological SLA helped patients in both the study and control group to significantly regain their language functions. However, greater improvement was found in the study group, which underwent neurological SLA twice, which proves that duration of the therapeutic process is an important factor. CONCLUSION: Conclusions: neurological SLA was beneficial for both groups, regardless of the time that elapsed between stroke and start of the therapy. neurological SLA therapy allowed patients to restore part of their language functions, both in the study and control group. The sooner neurological SLA is implemented and the longer its duration, the more beneficial it is to patients.


Assuntos
Afasia , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Afasia/etiologia , Afasia/psicologia , Afasia/terapia , Feminino , Humanos , Terapia da Linguagem , Masculino , Fala , Fonoterapia , Acidente Vascular Cerebral/complicações
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