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post stroke aphasia

Rose Y Hardy, Richard C Lindrooth, Richard K Peach, Charles Ellis
OBJECTIVE: Although residence is a key contributor to cost and utilization in stroke patient care, its contribution to the care of persons with aphasia (PWA) is unknown. The objective of this study was to use discharge-level hospital inpatient data to examine the influence of patient residence (rural vs. urban) and race-ethnicity on service utilization and cost of care among PWA. DESIGN: Cross-sectional SETTING: Administrative data from acute care hospitals in the state of North Carolina PARTICIPANTS: Individuals with post-stroke aphasia INTERVENTIONS: N/A MAIN OUTCOME MEASURES: length of stay, speech-language pathology service utilization, costs of care METHODS: 2011-2012 Healthcare Cost and Utilization Project (HCUP) State Inpatient Database (SID) data were analyzed to examine the impact of rural/urban residence to lengths of stay (LOS), Speech-Language Pathology (SLP) service utilization, as well as total inpatient and SLP service costs...
August 10, 2018: Archives of Physical Medicine and Rehabilitation
Kirstine Shrubsole, Linda Worrall, Emma Power, Denise A O'Connor
BACKGROUND: Effective implementation strategies to improve speech and language therapists' (SLTs) aphasia management practices are needed. Australian SLTs working in the acute setting have reported inconsistent implementation of post-stroke aphasia guideline recommendations. Therefore, implementation efforts to address these gaps are necessary. However, little is known about the effectiveness of behaviour-change strategies in SLTs providing acute aphasia management. AIMS: This study designed and tested the feasibility, acceptability and potential effectiveness of a tailored implementation strategy to improve acute SLTs' uptake of evidence in two areas of practice: aphasia-friendly information provision; and collaborative goal setting...
August 5, 2018: International Journal of Language & Communication Disorders
Anna M Woollams, Ajay Halai, Matthew A Lambon Ralph
The primary systems framework has been used to relate behavioural performance across many different language activities to the status of core underpinning domain-general cognitive systems. This study provided the first quantitative investigation of this account at both behavioural and neural levels in a group of patients with chronic post-stroke aphasia. Principal components analysis was used to distil orthogonal measures of phonological and semantic processing, which were then related to reading performance and the underlying lesion distributions using voxel-based correlational methodology...
August 2, 2018: Brain Structure & Function
Ana M Haro-Martínez, Genny Lubrini, Rosario Madero-Jarabo, Exuperio Díez-Tejedor, Blanca Fuentes
OBJECTIVE: To collect data to estimate the sample size of a definitive randomized controlled trial to evaluate the effects of Melodic Intonation Therapy in post-stroke nonfluent aphasia. DESIGN: A randomized, crossover, interventional pilot trial. SETTING: Departments of Neurology and Rehabilitation from a university general hospital. PARTICIPANTS: Stroke survivors with post-stroke nonfluent aphasia. INTERVENTIONS: Patients randomized to group 1 had treatment with Melodic Intonation Therapy first (12 sessions over six weeks) followed by no treatment; the patients in group 2 started active treatment between three and six months after their inclusion in the study, serving as waiting list controls for the first phase...
July 30, 2018: Clinical Rehabilitation
Sophe Kimonides, Marina G Cavuoto, Laksiri De Silva, Glynda J Kinsella
Background For long-term stroke survivors, objective neuropsychological impairments and subjective cognitive difficulties are common, and may contribute to ongoing difficulties in community reintegration. However, subjective cognitive complaints have been as much associated with low mood as with actual cognitive performance. Objective The objective of our study was to investigate the extent to which subjective cognitive complaints predicted community reintegration following a stroke, and whether this relationship would be mediated by emotional status...
July 24, 2018: Topics in Stroke Rehabilitation
Ajay D Halai, Anna M Woollams, Matthew A Lambon Ralph
There is an ever-increasing wealth of knowledge arising from basic cognitive and clinical neuroscience on how speech and language capabilities are organised in the brain. It is, therefore, timely to use this accumulated knowledge and expertise to address critical research challenges, including the ability to predict the pattern and level of language deficits found in aphasic patients (a third of all stroke cases). Previous studies have mainly focused on discriminating between broad aphasia dichotomies from purely anatomically-defined lesion information...
2018: NeuroImage: Clinical
Valentina Fiori, Lisa Kunz, Philipp Kuhnke, Paola Marangolo, Gesa Hartwigsen
Recent studies have shown that the left inferior frontal gyrus (IFG) plays a key role in language learning. Facilitatory stimulation over this region by means of anodal transcranial direct current stimulation (tDCS) can modulate linguistic abilities in healthy individuals and improve language performance in patients with post-stroke aphasia. Neuroimaging studies in healthy participants have suggested that anodal tDCS decreases task-related activity at the stimulated site when applied during different language tasks, and changes resting-state connectivity in a larger network of areas associated with language processing...
July 17, 2018: NeuroImage
Tamer Abou-Elsaad, Hemmat Baz, Tamer Belal, Sara Elsherbeny
AIM: To develop a time-efficient Arabic test battery for adult-onset chronic aphasia that provides information about the type and the severity of the disorder. PATIENT AND METHODS: A total of 90 participants were recruited and divided into 3 groups. The groups consisted of 30 adult-onset post-stroke chronic aphasic patients, 30 adult non-aphasic adults with central neurological disorders, and a group of 30 non-brain-damaged healthy adults. All participants were assessed using the Mansoura Arabic Screening Aphasia Test (MASAT), which consists of 4 main sections: (1) language expression abilities including repetition and naming items, (2) language comprehension questions, (3) fluency, and (4) reading, writing and calculation items...
July 17, 2018: Folia Phoniatrica et Logopaedica
Rebecca Palmer, Helen Witts, Timothy Chater
BACKGROUND: Speech and language therapy provision for aphasia (a language disorder) post stroke has been studied over time through surveys completed by speech and language therapists. This paper revisits provision based on what was received by 278 patients in 21 UK speech and language therapy departments in 2014-2016. AIMS: To explore the speech and language therapy received by community dwelling people with post stroke aphasia in the UK. METHODS AND PROCEDURES: A quantitative content analysis was conducted by two speech and language therapist researchers...
2018: PloS One
Xiaoyan Zhang, Bohui Shu, Dongdong Zhang, Lina Huang, Qizhi Fu, Ganqin Du
Background Aphasia is a common complication after stroke , and traditional speech and language therapy (SLT) have a limited effect on post-stroke aphasia. An increasing number of controlled clinical trials on the efficacy of drugs in the treatment of post-stroke aphasia. However, there have been very few systematic reviews on the effectiveness and safety of pharmacological treatments in people with aphasia after stroke. Objective To evaluate the effectiveness and safety of pharmacological interventions for post- stroke aphasia...
July 6, 2018: CNS & Neurological Disorders Drug Targets
Basil C Preisig, Noëmi Eggenberger, Dario Cazzoli, Thomas Nyffeler, Klemens Gutbrod, Jean-Marie Annoni, Jurka R Meichtry, Tobias Nef, René M Müri
The role of nonverbal communication in patients with post-stroke language impairment (aphasia) is not yet fully understood. This study investigated how aphasic patients perceive and produce co-speech gestures during face-to-face interaction, and whether distinct brain lesions would predict the frequency of spontaneous co-speech gesturing. For this purpose, we recorded samples of conversations in patients with aphasia and healthy participants. Gesture perception was assessed by means of a head-mounted eye-tracking system, and the produced co-speech gestures were coded according to a linguistic classification system...
2018: Frontiers in Human Neuroscience
Miguel Tábuas-Pereira, Sandra Freitas, José Beato-Coelho, Joana Ribeiro, Joana Parra, Cristina Martins, Miguel Silva, Maria Assunção Matos, Ana Rita Nogueira, Fernando Silva, João Sargento-Freitas, Gustavo Cordeiro, Luís Cunha, Isabel Santana
INTRODUCTION: Classical aphasia evaluation scales are too long to use in the context of acute stroke or as a monitoring tool. The Aphasia Rapid Test is a 26-point scale developed as a bedside assessment to rate aphasia severity in acute stroke patients in less than 3 minutes. We aimed to adapt and validate this scale for European Portuguese. MATERIAL AND METHODS: We evaluated 56 acute stroke patients in the first and in the seventh days post-stroke. In the seventh day, patients were evaluated by two independent raters, to evaluate inter-rater agreement...
May 30, 2018: Acta Médica Portuguesa
Zoe V J Woodhead, Sheila J Kerry, Oscar M Aguilar, Yean-Hoon Ong, John S Hogan, Katerina Pappa, Alex P Leff, Jennifer T Crinion
Central alexia is an acquired reading disorder co-occurring with a generalized language deficit (aphasia). We tested the impact of a novel training app, 'iReadMore', and anodal transcranial direct current stimulation of the left inferior frontal gyrus, on word reading ability in central alexia. The trial was registered at (NCT02062619). Twenty-one chronic stroke patients with central alexia participated. A baseline-controlled, repeated-measures, crossover design was used. Participants completed two 4-week blocks of iReadMore training, one with anodal stimulation and one with sham stimulation (order counterbalanced between participants)...
July 1, 2018: Brain: a Journal of Neurology
Jerzy P Szaflarski, Joseph Griffis, Jennifer Vannest, Jane B Allendorfer, Rodolphe Nenert, Amy W Amara, Victor Sung, Harrison C Walker, Amber N Martin, Victor W Mark, Xiaohua Zhou
PURPOSE: The purpose of this feasibility study was to assess whether combined intermittent theta burst suppression (iTBS) applied to the ipsilesional hemisphere and modified constraint-induced aphasia therapy (mCIAT) are safe and logistically feasible within the time interval associated with iTBS induced long-term potentiation in patients with post-stroke aphasia. We also wanted to determine whether combining priming with iTBS and CIAT improves language functions after treatment. METHODS: Twelve participants received fMRI (semantic decision/tone decision task) and neuropsychological testing of language skills at three time points - before starting the iTBS/mCIAT intervention (T1), immediately after completing 2-week long course of intervention (T2), and at 3-months follow-up (T3)...
2018: Restorative Neurology and Neuroscience
Marija Tochadse, Ajay D Halai, Matthew A Lambon Ralph, Stefanie Abel
Neuropsychological assessment, brain imaging and computational modelling have augmented our understanding of the multifaceted functional deficits in people with language disorders after stroke. Despite the volume of research using each technique, no studies have attempted to assimilate all three approaches in order to generate a unified behavioural-computational-neural model of post-stroke aphasia. The present study included data from 53 participants with chronic post-stroke aphasia and merged: aphasiological profiles based on a detailed neuropsychological assessment battery which was analysed with principal component and correlational analyses; measures of the impairment taken from Dell's computational model of word production; and the neural correlates of both behavioural and computational accounts analysed by voxel-based correlational methodology...
2018: NeuroImage: Clinical
Reem S W Alyahya, Ajay D Halai, Paul Conroy, Matthew A Lambon Ralph
The behavioural and neural processes underpinning different word classes, particularly nouns and verbs, have been a long-standing area of interest in psycholinguistic, neuropsychology and aphasiology research. This topic has theoretical implications concerning the organisation of the language system, as well as clinical consequences related to the management of patients with language deficits. Research findings, however, have diverged widely, which might, in part, reflect methodological differences, particularly related to controlling the psycholinguistic variations between nouns and verbs...
2018: NeuroImage: Clinical
V V Alferova, V M Shklovskij, E G Ivanova, G V Ivanov, L A Mayorova, A G Petrushevsky, S V Kuptsova, A B Guekht
AIM: To determine risk factors and factors of favorable prognosis for regression of post-stroke aphasia in the early recovery period of ischemic stroke (IS). MATERIAL AND METHODS: A cohort study was undertaken with 40 patients with different clinical forms of aphasia. The duration of study was 3-4 months of the disease. The regression of speech and non-speech cognitive impairment was assessed by the Method of a 10-point evaluation of higher mental functions. The method involves a comprehensive assessment of all mental functions with more than 90 subtests at the beginning and at the end of rehabilitation course and the calculation of the difference in the scoring of each mental function as a measure of treatment efficacy...
2018: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Rodolphe Nenert, Jane B Allendorfer, Amber M Martin, Christi Banks, Jennifer Vannest, Scott K Holland, Kimberly W Hart, Christopher J Lindsell, Jerzy P Szaflarski
BACKGROUND: Recovery from stroke-induced aphasia is typically protracted and involves complex functional reorganization. The relative contributions of the lesioned and non-lesioned hemispheres to this process have been examined in several cross-sectional studies but longitudinal studies involving several time-points and large numbers of subjects are scarce. OBJECTIVE: The aim of this study was to address the gaps in the literature by longitudinally studying the evolution of post-stroke lateralization and localization of language-related fMRI activation in the first year after single left hemispheric ischemic stroke...
2018: Restorative Neurology and Neuroscience
Shohre Kaviani, Afshin Samaei, Masoomeh Salmani, Noureddin Nakhostin Ansari, Farnaz Dehnavi, Ehsan Shahverdi
Background and aim: Aphasia as a common consequence of stroke, is an acquired neurologic communication disorder that can affect symbol language processing. Different types of intervention approaches have been introduced. Multimodal Communication Program (MCP) is a new augmentative alternative communication approach in chronic aphasia. The aim of this study was to investigate the effect of MCP on communication skills of patients with chronic aphasia. Methods: This prospective, single subject, A-B-A design study was done during 2016 in Semnan, Iran...
March 2018: Electronic Physician
Jasmina Vuksanović, Tanja Milovanović, Ljubica Konstantinović, Saša R Filipović
BACKGROUND: Constraint-induced (language) aphasia therapy (CIAT), based on constraint usage of the language channel only, massed practice and shaping through therapeutic language games, has been suggested as a more efficient therapy approach than traditional aphasia therapies. AIMS: To examine the comparative efficacy of CIAT and a traditional therapy approach on expressive language ability, with the intensity of therapy controlled and matched, in the treatment of post-stroke aphasia...
July 2018: International Journal of Language & Communication Disorders
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