Jane Lapham, MS, SLP

BACKGROUND AND PURPOSE: Prediction of functional outcome after stroke rehabilitation (SR) is a growing field of interest. The association between SR and survival still remains elusive. We sought to investigate the factors associated with functional outcome after SR and whether the magnitude of functional improvement achieved with rehabilitation is associated with long-term mortality risk. METHODS: The study population consisted of 722 patients admitted for SR within 90 days of stroke onset, with an admission functional independence measure (FIM) score of <80 points...

PURPOSE: The importance of personalization in script training in aphasia has been assumed but never tested. This study compared acquisition and generalization of personally relevant versus generic words or phrases appearing in the same scripts. METHOD: Eight individuals (6 men; 2 women) with chronic aphasia received 3 weeks of intensive computer-based script training. For each participant, 2 scripts, a trained and an untrained generalization script, were embedded with 4 personally relevant word choices and 2-4 generic items that were similar across participants...

OBJECTIVE: Detailed features of chronic subdural haematoma (cSDH) associated with disturbance of consciousness and acute-on-chronic subdural haematoma (a/cSDH), in which acute subdural haematoma overlaps cSDH, remain poorly understood. The object of this study was to clarify both characteristics of cSDH associated with disturbance of consciousness and the significance of a/cSDH. METHODS: Clinical factors and computed tomography (CT) findings were retrospectively investigated in 349 consecutive patients admitted between 2006 and 2013 and diagnosed with cSDH...

BACKGROUND: Transcranial direct current stimulation (tDCS), a non-invasive method of brain stimulation, is an adjunctive research-therapy for aphasia. The concept supporting translational application of tDCS is that brain plasticity, facilitated by language intervention, can be enhanced by non-invasive brain stimulation. This study combined tDCS with an ecologically focused behavioral approach that involved training nouns and verbs in sentences. METHOD: PARTICIPANT: A 43-year-old, right-handed male with fluent-anomic aphasia who sustained a single-left-hemisphere-temporal-parietal stroke was recruited...

The new tendency in rehabilitation involves non-invasive tools that, if applied early after stroke, promote neurorecovery. Repetitive transcranial magnetic stimulation and transcranial direct current stimulation may correct the disruption of cortical excitability and effectively contribute to the restoration of movement and speech. The present paper analyses the results of non-invasive brain stimulation (NIBS) trials, highlighting different aspects related to the repetitive transcranial magnetic stimulation frequency, transcranial direct current stimulation polarity, the period and stimulation places in acute and subacute ischemic strokes...

Approximately 24% of stroke survivors experience co-occurring aphasia and hemiparesis. These individuals typically attend back-to-back therapy sessions. However, sequentially scheduled therapy may trigger physical and mental fatigue and have an adverse impact on treatment outcomes. The current study tested a hypothesis that exerting less effort during a therapy session would reduce overall fatigue and enhance functional recovery. Two stroke survivors chronically challenged by non-fluent aphasia and right hemiparesis sequentially completed verbal naming and upper-limb tasks on their home computers...

The rehabilitation study described here sets out to test the premise of Abutalebi and Green's neurocognitive model--specifically, that language selection and control are components of overall cognitive control. We follow a trilingual woman (first language, L1: Amharic; second language, L2: English; third language, L3: French) with damage to the left frontal lobe and left basal ganglia who presented with cognitive control and naming deficits, through two periods of semantic treatment (French, followed by English) to alleviate naming deficits...

PURPOSE: We investigated from a theoretically motivated perspective what information differentiated sufficient from insufficient descriptions of objects provided by persons with aphasia. METHOD: Twenty-one adults with aphasia consequent to single left-hemisphere stroke verbally described 9 living and 9 nonliving objects. Responses were scored for accuracy (i.e., sufficiency) and tallied for type and quantity of semantic feature information provided. Main effects and interactions were identified using repeated measures analyses of variance, with significant findings followed up with planned comparisons...

PURPOSE: There is a lot of evidence that people with aphasia have more difficulty understanding structurally complex sentences (e.g., object clefts) than simpler sentences (subject clefts). However, subject clefts also occur more frequently in English than object clefts. Thus, it is possible that both structural complexity and frequency affect how people with aphasia understand these structures. METHOD: Nine people with aphasia and 8 age-matched controls participated in the study...

PURPOSE: The purpose of the study was to determine (a) reliability of the spatial span as a nonverbal working memory (WM) task in individuals with aphasia, (b) whether participation in anomia treatment changed spatial span scores, and (c) the degree to which visuospatial WM predicted response to anomia treatment. METHOD: Eight individuals with chronic aphasia were repeatedly assessed on the forward and backward conditions of the spatial span over 4 weeks while undergoing treatment for anomia...

PURPOSE: The purpose of this investigation was to systematically examine outcomes associated with Semantic feature analysis, which is an established treatment for word-retrieval deficits in aphasia. Attributes of the experimental design and stimuli were manipulated to evaluate generalized naming of semantically related and unrelated items. In addition, the study was designed to examine changes in production of semantic information. METHOD: Semantic feature analysis was applied in the context of multiple-baseline designs with 5 persons with chronic aphasia...

The neural mechanisms that underlie generalization of treatment-induced improvements in word finding in persons with aphasia (PWA) are currently poorly understood. This study aimed to shed light on changes in functional network connectivity underlying generalization in aphasia. To this end, we used fMRI and graph theoretic analyses to examine changes in functional connectivity after a theoretically-based word-finding treatment in which abstract words were used as training items with the goal of promoting generalization to concrete words...

BACKGROUND: To provide a preliminary estimate of efficacy of constraint-induced aphasia therapy (CIAT) when compared to no-intervention in patients with chronic (>1 year) post-stroke aphasia in order to plan an appropriately powered randomized controlled trial (RCT). MATERIAL AND METHODS: We conducted a pilot single-blinded RCT. 24 patients were randomized: 14 to CIAT and 10 to no-intervention. CIAT groups received up to 4 hours/day of intervention for 10 consecutive business days (40 hours or therapy)...

Language reorganisation following stroke has been studied widely. However, while studies of brain activation and grey matter examined both hemispheres, studies of white matter changes have mostly focused on the left hemisphere. Here we examined the relationship between bilateral hemispheric white matter and aphasia symptoms. 15 chronic stroke patients with aphasia and 18 healthy adults were studied using Diffusion Weighted Imaging data. By applying histogram analysis, Tract-Based Spatial Statistics, tractography and lesion-tract overlap methods, it was found that damage to the left hemisphere in general, and to the arcuate fasciculus in particular, correlated with impairments on word repetition, object naming, sentence comprehension and homophone and rhyme judgement...

BACKGROUND: Communication supports, referred to as augmentative and alternative communication (AAC), are an integral part of medical speech-language pathology practice, yet many providers remain unfamiliar with assessment and intervention principles. For patients with complex communication impairments secondary to neurodegenerative disease, AAC services differ depending on whether their condition primarily affects speech and motor skills (ALS), language (primary progressive aphasia) or cognition (Alzheimer's disease)...

BACKGROUND: Patients with primary progressive aphasia (PPA) usually develop significant behavioral disturbances with progression of the disease. We tested our clinical observation that development of disruptive agitation is more likely in semantic than in nonfluent PPA and examined which clinical variables could be associated with this behavior. METHODS: We retrospectively analyzed neuropsychiatric scores and the need for behavioral treatments in semantic PPA (n = 41) and nonfluent PPA (n = 39) cases and compared first (1-3 years since the onset of symptoms) and last (5-13 years since the onset) evaluations...

BACKGROUND: The Lee Silverman Voice Treatment (LSVT®) was specifically created and tested to comply with the needs of individuals with Parkinson's disease (PD) and other neurological problems. This is a high effort intensive treatment that aims at increasing vocal intensity through the increase of subglottal air pressure, i.e. respiratory effort, for a better cordal adduction and vibration, following the motto "think loud". AIM: The main goal of this study is to inspect the efficacy of LSVT® treatment in progressive supranuclear palsy (PSP) patients...

A prior study (Bruder, G.E., Stewart, J.W., Mercier, M.A., Agosti, V., Leite, P., Donovan, S., Quitkin, F.M., 1997. Outcome of cognitive-behavioral therapy for depression: relation of hemispheric dominance for verbal processing. Journal of Abnormal Psychology 106, 138-144.) found left hemisphere advantage for verbal dichotic listening was predictive of clinical response to cognitive behavioral therapy (CBT) for depression. This study aimed to confirm this finding and to examine the value of neuropsychological tests, which have shown promise for predicting antidepressant response...

BACKGROUND: The present study aimed to evaluate the relation between the National Institutes of Health Stroke Scale (NIHSS) score and the presence of laryngeal penetration and/or laryngotracheal aspiration in ischemic stroke patients and to verify what factors are predictors of the occurrence of pneumonia in the evaluated patients. METHODS: This was an observational study of ischemic stroke in the acute or subacute phases. Neurologic examination included anamnesis, Bamford classification, and application of the NIHSS...

Psychogenic speech and voice disorders (PSVDs) may occur in isolation but more typically are encountered in the setting of other psychogenic disorders. We aimed to characterize the phenomenology, frequency, and correlates of PSVDs in a cohort of patients with psychogenic movement disorders (PMDs). We studied 182 consecutive patients with PMDs, 30 of whom (16.5 %) also exhibited PSVD. Stuttering was the most common speech abnormality (n = 16, 53.3 %), followed by speech arrests (n = 4, 13.3 %), foreign accent syndrome (n = 2, 6...