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Aphasia

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3701. Effectiveness of computerised rehabilitation for long-term aphasia: a case series study. Full Text available with Trip Pro

Effectiveness of computerised rehabilitation for long-term aphasia: a case series study. Seven participants with long-standing aphasia following cerebrovascular accident were serially recruited to a case series study where language therapy was delivered at home and monitored via the Internet. All participants improved in word finding, and four improved in general communication.

2004 British Journal of General Practice

3702. Conduction aphasia as a function of the dominant posterior perisylvian cortex. Report of two cases. (Abstract)

Conduction aphasia as a function of the dominant posterior perisylvian cortex. Report of two cases. Assessment of eloquent functions during brain mapping usually relies on testing reading, speech, and comprehension to uncover transient deficits during electrical stimulation. These tests stem from findings predicted by the Geschwind-Wernicke hypothesis of receptive and expressive cortices connected by white matter tracts. Later work, however, has emphasized cortical mechanisms of language (...) function. The authors report two cases that demonstrate that conduction aphasia is cortically mediated and can be inadequately assessed if not specifically evaluated during brain mapping. To determine the distribution of language on the dominant cortex, electrical cortical stimulation was performed in two cases by using implanted subdural electrodes during brain mapping before epilepsy surgery. A transient isolated deficit in repetition of language was reported during stimulation of the posterior

2006 Journal of Neurosurgery

3703. The logopenic/phonological variant of primary progressive aphasia. Full Text available with Trip Pro

The logopenic/phonological variant of primary progressive aphasia. Primary progressive aphasia (PPA) is characterized by isolated decline in language functions. Semantic dementia and progressive nonfluent aphasia are accepted PPA variants. A "logopenic" variant (LPA) has also been proposed, but its cognitive and anatomic profile is less defined. The aim of this study was to establish the cognitive and anatomic features of LPA.Six previously unreported LPA cases underwent extensive (...) was moderately affected. Investigation of phonological loop functions showed that patients were severely impaired in digit, letter, and word span tasks. Performance did not improve with pointing, was influenced by word length, and did not show the normal phonological similarity effect. Atrophy or decreased blood flow was consistently found in the posterior portion of the left superior and middle temporal gyri and inferior parietal lobule.Logopenic progressive aphasia (LPA) is a distinctive variant of primary

2008 Neurology

3704. Alzheimer and frontotemporal pathology in subsets of primary progressive aphasia. Full Text available with Trip Pro

Alzheimer and frontotemporal pathology in subsets of primary progressive aphasia. To identify predictors of Alzheimer's disease (AD) versus frontotemporal lobar degeneration pathology in primary progressive aphasia (PPA), and determine whether the AD pathology is atypically distributed to fit the aphasic phenotype.Neuropsychological and neuropathological analyses of 23 consecutive PPA autopsies. All had qualitative determination of neurofibrillary tangle (NFT) density. Additional quantitation

2008 Annals of Neurology

3705. The merest Logomachy: The 1868 Norwich discussion of aphasia by Hughlings Jackson and Broca. Full Text available with Trip Pro

The merest Logomachy: The 1868 Norwich discussion of aphasia by Hughlings Jackson and Broca. This article reconsiders the events that took place at the 1868 meeting of the British Association for the Advancement of Science (BA) in Norwich. Paul Broca and John Hughlings Jackson were invited to speak on the new and controversial subject of aphasia. Over the ensuing decades, there have been repeated references made to a debate between Broca and Jackson. This meeting has been identified

2008 Brain

3706. Association between therapy outcome and right-hemispheric activation in chronic aphasia. Full Text available with Trip Pro

Association between therapy outcome and right-hemispheric activation in chronic aphasia. The role of the right hemisphere for language processing and successful therapeutic interventions in aphasic patients is a matter of debate. This study explored brain activation in right-hemispheric areas and left-hemispheric perilesional areas in response to language tasks in chronic non-fluent aphasic patients before and after constraint-induced aphasia therapy (CIAT). In particular, we analysed (...) across all aphasic subjects. However, therapeutic success correlated with a relative decrease of activation in right-hemispheric areas, including the IFG/IC. Most importantly, initial activation in right IFG/IC and other right-hemispheric areas correlated positively with subsequent therapy success. Thus, right-hemispheric activation prior to aphasia therapy strongly predicts therapeutic success, suggesting that brain activation in chronic aphasia indicates the patients' potential for further language

2008 Brain

3707. Word-finding difficulty: a clinical analysis of the progressive aphasias. Full Text available with Trip Pro

Word-finding difficulty: a clinical analysis of the progressive aphasias. The patient with word-finding difficulty presents a common and challenging clinical problem. The complaint of 'word-finding difficulty' covers a wide range of clinical phenomena and may signify any of a number of distinct pathophysiological processes. Although it occurs in a variety of clinical contexts, word-finding difficulty generally presents a diagnostic conundrum when it occurs as a leading or apparently isolated (...) symptom, most often as the harbinger of degenerative disease: the progressive aphasias. Recent advances in the neurobiology of the focal, language-based dementias have transformed our understanding of these processes and the ways in which they breakdown in different diseases, but translation of this knowledge to the bedside is far from straightforward. Speech and language disturbances in the dementias present unique diagnostic and conceptual problems that are not fully captured by classical models

2007 Brain

3708. Corticobasal syndrome and primary progressive aphasia as manifestations of LRRK2 gene mutations. Full Text available with Trip Pro

Corticobasal syndrome and primary progressive aphasia as manifestations of LRRK2 gene mutations. Mutations in the LRRK2 gene are an important cause of familial and nonfamilial parkinsonism. Despite pleomorphic pathology, LRRK2 mutations are believed to manifest clinically as typical Parkinson disease (PD). However, most genetic screens have been limited to PD clinic populations.To clinically characterize LRRK2 mutations in cases recruited from a spectrum of neurodegenerative diseases.We

2007 Neurology

3709. Sign language aphasia due to left occipital lesion in a deaf signer. (Abstract)

Sign language aphasia due to left occipital lesion in a deaf signer. Localization of sign language production and comprehension in deaf people has been described as similar to that of spoken language aphasia. However, sign language employs a visuospatial modality through visual information. We present the first report of a deaf signer who showed substantial sign language aphasia with severe impairment in word production due to a left occipital lesion. This case may indicate the possibility

2007 Neurology

3710. Increased frequency of learning disability in patients with primary progressive aphasia and their first-degree relatives. Full Text available with Trip Pro

Increased frequency of learning disability in patients with primary progressive aphasia and their first-degree relatives. Although risk factors for Alzheimer disease have been well studied, much less is known about risk factors for primary progressive aphasia (PPA).To demonstrate that learning disabilities (LDs) are more common in patients with PPA and their first-degree family members.Self-report endorsement of an individual and family history of an LD in a sample of 699 subjects from

2008 Archives of Neurology

3711. Progressive aphasia secondary to Alzheimer disease vs FTLD pathology. Full Text available with Trip Pro

Progressive aphasia secondary to Alzheimer disease vs FTLD pathology. The pathology causing progressive aphasia is typically a variant of frontotemporal lobar degeneration, especially with ubiquitin-positive inclusions (FTLD-U). Less commonly the underlying pathology is Alzheimer disease (AD).To compare clinicopathologic and MRI features of subjects with progressive aphasia and AD pathology to subjects with aphasia and FTLD-U pathology and subjects with typical AD.We identified 5 subjects (...) with aphasia and AD pathology and 5 with aphasia and FTLD-U pathology with an MRI from a total of 216 aphasia subjects. Ten subjects with typical AD clinical features and AD pathology were also identified. All subjects with AD pathology underwent pathologic reanalysis with TDP-43 immunohistochemistry. Voxel-based morphometry (VBM) was used to assess patterns of gray matter atrophy in the aphasia cases with AD pathology, aphasia cases with FTLD-U, and typical AD cases with AD pathology, compared

2008 Neurology

3712. Improved Naming After Transcranial Direct Current Stimulation in Aphasia. (Abstract)

Improved Naming After Transcranial Direct Current Stimulation in Aphasia. Transcranial direct current stimulation (tDCS) has been proposed as an adjuvant technique to improve functional recovery after ischaemic stroke. This study evaluated the effect of tDCS over the left frontotemporal areas in eight chronic non-fluent post-stroke aphasic patients. The protocol consisted of the assessment of picture naming (accuracy and response time) before and immediately after anodal or cathodal tDCS (2 mA

2007 Neurosurgery and Psychiatry

3713. Right hemisphere activation in recovery from aphasia: lesion effect or function recruitment? (Abstract)

Right hemisphere activation in recovery from aphasia: lesion effect or function recruitment? Some neuroimaging studies have suggested that specific right hemispheric regions can compensate deficits induced by left hemispheric lesions in vascular aphasia. In particular, the right inferior frontal cortex might take part in lexical retrieval in patients presenting left-sided lesions involving the homologous area.To address whether the involvement of the right inferior frontal cortex is either (...) in right-sided areas observed in recovering aphasia is not the mere consequence of damage to left-sided homologous areas and could reflect the neural correlates of lexical learning also observed in control subjects.

2008 Neurology

3714. Unravelling Bolero: progressive aphasia, transmodal creativity and the right posterior neocortex. Full Text available with Trip Pro

Unravelling Bolero: progressive aphasia, transmodal creativity and the right posterior neocortex. Most neurological lesion studies emphasize performance deficits that result from focal brain injury. Here, we describe striking gains of function in a patient with primary progressive aphasia, a degenerative disease of the human language network. During the decade before her language deficits arose, Anne Adams (AA), a lifelong scientist, developed an intense drive to produce visual art. Paintings (...) from AA's artistic peak revealed her capacity to create expressive transmodal art, such as renderings of music in paint, which may have reflected an increased subjective relatedness among internal perceptual and conceptual images. AA became fascinated with Maurice Ravel, the French composer who also suffered from a progressive aphasia, and painted his best-known work, 'Boléro', by translating its musical elements into visual form. Later paintings, achieved when AA was nearly mute, moved towards

2007 Brain

3715. Steroid treatment of primary progressive aphasia. Full Text available with Trip Pro

Steroid treatment of primary progressive aphasia. To learn if oral steroid treatment can alter the signs of primary progressive aphasia (PPA). Many patients with PPA have had a vasectomy and there is a possible link between vasectomy and autoimmune diseases. If PPA is, at least in part, an autoimmune disease, patients might improve with immunosuppressant treatment.Case report.Cognitive and memory clinic.A 68-year-old right-handed man with a 2.5-year history of progressive speech impairment who (...) had a vasectomy 25 years prior.Examination revealed that he had a nonfluent aphasia with intact repetition and comprehension. Before and during oral prednisone treatment, he was assessed for speech fluency, naming, and episodic and working memory. All assessments except episodic memory showed a dramatic improvement. On reassessment 1 month after discontinuing treatment, the patient's performance on cognitive testing had regressed toward baseline.Although this patient's improvement with steroid

2008 Archives of Neurology

3716. Abeta amyloid and glucose metabolism in three variants of primary progressive aphasia. Full Text available with Trip Pro

Abeta amyloid and glucose metabolism in three variants of primary progressive aphasia. Alzheimer's disease (AD) is found at autopsy in up to one third of patients with primary progressive aphasia (PPA), but clinical features that predict AD pathology in PPA are not well defined. We studied the relationships between language presentation, Abeta amyloidosis, and glucose metabolism in three PPA variants using [11C]-Pittsburgh compound B ([11C]PIB) and [18F]-labeled fluorodeoxyglucose positron (...) emission tomography ([18F]FDG-PET).Patients meeting PPA criteria (N = 15) were classified as logopenic aphasia (LPA), progressive nonfluent aphasia (PNFA), or semantic dementia (SD) based on language testing. [11C]PIB distribution volume ratios were calculated using Logan graphical analysis (cerebellar reference). [18F]FDG images were normalized to pons. Partial volume correction was applied.Elevated cortical PIB (by visual inspection) was more common in LPA (4/4 patients) than in PNFA (1/6) and SD (1

2008 Annals of Neurology

3717. Functional MRI follow-up study of language processes in healthy subjects and during recovery in a case of aphasia. Full Text available with Trip Pro

Functional MRI follow-up study of language processes in healthy subjects and during recovery in a case of aphasia. The goal of this study was to develop a functional MRI (fMRI) paradigm robust and reproducible enough in healthy subjects to be adapted for a follow-up study aiming at evaluating the anatomical substratum of recovery in poststroke aphasia.Ten right-handed subjects were studied longitudinally using fMRI (7 of them being scanned twice) and compared with a patient with conduction (...) aphasia during the first year of stroke recovery.Controls exhibited reproducible activation patterns between subjects and between sessions during language tasks. In contrast, the patient exhibited dynamic changes in brain activation pattern, particularly in the phonological task, during the 2 fMRI sessions. At 1 month after stroke, language homotopic right areas were recruited, whereas large perilesional left involvement occurred later (12 months).We first demonstrate intersubject robustness

2004 Stroke

3718. Role of the contralateral inferior frontal gyrus in recovery of language function in poststroke aphasia: a combined repetitive transcranial magnetic stimulation and positron emission tomography study. Full Text available with Trip Pro

Role of the contralateral inferior frontal gyrus in recovery of language function in poststroke aphasia: a combined repetitive transcranial magnetic stimulation and positron emission tomography study. Functional neuroimaging studies have demonstrated right inferior frontal gyrus (IFG) activation in poststroke aphasia. It remains unclear whether this activation is essential for language performance. We tested this hypothesis in a positron emission tomography (PET) activation study during (...) a semantic task with repetitive transcranial magnetic stimulation (rTMS) on right-handed patients experiencing poststroke aphasia and examined whether rTMS stimulation over the right and left IFG would interfere with language performance.Eleven patients with left-sided middle cerebral arterial infarction, 50 to 75 years of age, were tested with the Aachen Aphasia Test Battery and underwent (15)O-H2O PET activation during a semantic task within 2 weeks after stroke. PET activation images were coregistered

2005 Stroke

3719. Subcortical aphasia: a longitudinal PET study. Full Text available with Trip Pro

Subcortical aphasia: a longitudinal PET study. Very few neuroimaging studies have focused on follow-up of subcortical aphasia. Here, overt language production tasks were used to correlate regional cerebral blood flow (rCBF) changes and language performance in patients with vascular subcortical lesions.Seven aphasic patients were scanned twice with positron emission tomography (PET) at 1-year interval during a word-generation task. Using SPM2, Language-Rest contrast at PET1 was correlated

2005 Stroke

3720. Language rehabilitation in chronic aphasia and time postonset: a review of single-subject data. Full Text available with Trip Pro

Language rehabilitation in chronic aphasia and time postonset: a review of single-subject data. This article is a comprehensive review of aphasia treatment studies for the purpose of investigating the relationship between time postonset of aphasia and response to treatment for aphasia in chronic patients at >/=1 year after symptom onset.Studies that demonstrated treatment response (defined as a measurable change in task performance compared with a control task performance) through the use (...) (Kruskal-Wallis) were used to compare the relationship between time postonset and improvement. Time postonset at which treatment was initiated did not correlate with response to treatment. No significant differences in response to treatment were found between groups of patients according to times postonset.Time postonset is not related to response to treatment for aphasia in patients >1 year postonset of aphasia.

2006 Stroke

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