1
|
Modarres Zadeh A, Mehri A, Murray LL, Nejati V, Khatoonabadi AR. The effects of adding attention training to naming treatment for individuals with aphasia. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-15. [PMID: 38359428 DOI: 10.1080/23279095.2024.2315555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
AIM Given the ever-increasing evidence for the co-occurrence of attention impairments and language disorders in chronic aphasia, this study aimed to compare the effects of two naming treatment programs, one with and one without attention training components, on the naming performance of participants with aphasia. MATERIALS AND METHODS This was a single-subject crossover study in which six people with chronic aphasia and different degrees of naming and attention impairments participated. Two treatment programs were implemented for each participant, with the sequence of the treatments with crossover design. Each program consisted of 12 treatment sessions plus pre- and post-treatment assessment sessions (15 weeks for each participant). The visual analysis and WEighted STatistics methods were employed for data analysis. RESULTS Based on visual analysis, both treatments improved in comparison to the baseline phase. Statistical analysis revealed that the number of participants with significant naming improvement following combined program (5 participants) was larger than the number of participants showing improvement following completion of the single, program. CONCLUSION Although integrating attention training into a conventional treatment for anomia can increase the effect of treatment on naming ability, more studies are required to clarify the role of attention in remediating naming impairments in aphasia.
Collapse
Affiliation(s)
- Amin Modarres Zadeh
- Tehran University of Medical Sciences, School of Rehabilitation, Speech Therapy Department, Tehran, Iran
| | - Azar Mehri
- Tehran University of Medical Sciences, School of Rehabilitation, Speech Therapy Department, Tehran, Iran
| | - Laura L Murray
- School of Communication Sciences and Disorders, Western University, Ontario, Canada
| | - Vahid Nejati
- Faculty of Psychology and Educational Sciences, Shahid Beheshti University, Tehran, Iran
| | - Ahmad Reza Khatoonabadi
- Tehran University of Medical Sciences, School of Rehabilitation, Speech Therapy Department, Tehran, Iran
| |
Collapse
|
2
|
Summaka M, Elias E, Zein H, Naim I, Daoud R, Fares Y, Nasser Z. Computed tomography findings as early predictors of long-term language impairment in patients with traumatic brain injury. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:686-695. [PMID: 34487454 DOI: 10.1080/23279095.2021.1971982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study aims to assess the relationship between computed tomography (CT) findings, during the acute phase of hospitalization, and long-term language impairment in people with traumatic brain injury (TBI). Another aim was to assess the receptive and expressive abilities of subjects with TBI based on the location of the injury. This is a retrospective observational study including 49 participants with TBI due to war injuries. The Arabic Diagnostic Aphasia Battery (A-DAB-1) was administered to the participants and the Helsinki CT score was computed to quantify brain damage. The results showed that the Helsinki CT score was negatively correlated with the total score of the A-DAB-1 (r = -0.544, p-value < 0.0001). Simple linear regression supported such findings and reflected an inversely proportional relationship between both variables (p-value < 0.0001). When compared with subjects having right hemisphere damage, subjects with left hemisphere and bilateral brain damage performed more poorly on language tasks respectively as follows: A-DAB-1 overall score (92.08-66.08-70.28, p-value = 0.021), Content of descriptive speech (9.57-6.69-7.22, p-value = 0.034), Verbal fluency (6.57-3.54-3.89, p-value = 0.002), Auditory comprehension (9.71-7.54-7.78, p-value = 0.039), Complex auditory commands (9.71-7.65-7.56, p-value = 0.043), Repetition (9.75-7.08-7.61, p-value = 0.036), Naming (9.93-7.15-8.11, p-value = 0.046). Following TBI, CT findings on admission can significantly predict long-term language abilities, with left side lesions inducing poorer outcomes.
Collapse
Affiliation(s)
- Marwa Summaka
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Hadath, Lebanon
| | - Elias Elias
- Department of Complex and minimally invasive spine surgery, Swedish Neuroscience Institute, Seattle, WA, USA
| | - Hiba Zein
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Hadath, Lebanon
| | - Ibrahim Naim
- Health, Rehabilitation, Iintegration and Research Center (HRIR), Beirut, Lebanon
| | - Rama Daoud
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
| | - Youssef Fares
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Hadath, Lebanon
| | - Zeina Nasser
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Hadath, Lebanon
| |
Collapse
|
3
|
Crumlish L, Wallace SJ, Copley A, Rose TA. Exploring the measurement of pediatric cognitive-communication disorders in traumatic brain injury research: A scoping review. Brain Inj 2022; 36:1207-1227. [PMID: 36303459 DOI: 10.1080/02699052.2022.2111026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To synthesize information about the constructs measured, measurement instruments used, and the timing of assessment of cognitive-communication disorders (CCDs) in pediatric traumatic brain injury (TBI) research. METHODS AND PROCEDURES Scoping review conducted in alignment with Arksey and O'Malley's five-stage methodological framework and reported per the PRISMA extension for Scoping Reviews. Inclusion criteria: (a) cohort description, case-control, and treatment studies; (b) participants with TBI aged 5-18 years; (c) communication or psychosocial outcomes; and (d) English full-text journal articles. The first author reviewed all titles, abstracts, and full-text articles; 10% were independently reviewed. OUTCOMES AND RESULTS Following screening, a total of 687 articles were included and 919 measurement instruments, measuring 2134 unique constructs, were extracted. The Child Behavior Checklist was the most used measurement instrument and 'Global Outcomes/Recovery' was the construct most frequently measured. The length of longitudinal monitoring ranged between ≤3 months and 16 years. CONCLUSIONS AND IMPLICATIONS We found considerable heterogeneity in the constructs measured, the measurement instruments used, and the timing of CCD assessment in pediatric TBI research. A consistent approach to measurement may support clinical decision-making and the efficient use of data beyond individual studies in systematic reviews and meta-analyses.
Collapse
Affiliation(s)
- Lauren Crumlish
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sarah J Wallace
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,Queensland Aphasia Research Centre, Australia
| | - Anna Copley
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Tanya A Rose
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,Queensland Aphasia Research Centre, Australia
| |
Collapse
|
4
|
Ramazanu S, Chisale MRO, Baby P, Wu VX, Mbakaya BC. Meta-synthesis of family communication patterns during post-stroke vascular aphasia: Evidence to guide practice. Worldviews Evid Based Nurs 2022; 19:282-296. [PMID: 35587739 DOI: 10.1111/wvn.12580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 11/14/2021] [Accepted: 02/10/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Previous studies have predominantly focused on the needs of persons with aphasia (PWA), after a stroke diagnosis. However, aphasia is found to cause communication challenges in persons with stroke and their family caregivers as a unit. Evidence is inconclusive about the communication patterns of both persons with aphasia and their family caregivers after a stroke. Studies have not been synthesized on facilitators and barriers of communication patterns between PWA and family caregivers after a stroke. AIMS A meta-synthesis of qualitative evidence was conducted to explore family communication patterns after post-stroke vascular aphasia. METHODS An electronic literature search of PubMed, CINAHL, Cochrane Library, PsyINFO, and Scopus was performed from January to March 2021. The methods of qualitative meta-synthesis were underpinned by Sandelowski and Barosso's guidelines. Data analysis was facilitated by Braun and Clarke thematic analysis, using NVivo 11 software. RESULTS A total of twenty studies were included for meta-synthesis. Three themes with corresponding subthemes were identified: (1) changes in family communication patterns (subthemes: adapting to the changes in PWA after a stroke, striving toward communication recovery); (2) facilitators of family communication patterns (subthemes: supportive communication techniques, hope of recovery, time to re-adjust, and community engagement [recreational activities]); and (3) barriers of communication (subthemes: emotional turmoil and daunting tasks of rehabilitation). LINKING EVIDENCE TO ACTION Although persons with aphasia and family caregivers are striving to achieve normalcy in communication, they are often challenged by communication deficits and protective family behaviors. Therefore, to establish effective communication, it is of paramount importance for nursing professionals to educate PWAs and their caregivers on facilitators and barriers of family communication patterns. Technology-based family communication facilitation and support groups for PWA and their family caregivers are recommended to promote family communication. The review was registered with PROSPERO (CRD42021235519).
Collapse
Affiliation(s)
- Sheena Ramazanu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 3, Clinical Research Centre, Singapore, Singapore
| | | | - Priya Baby
- College of Nursing, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Vivien Xi Wu
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore
| | | |
Collapse
|
5
|
Moyse K, Enderby P, Chadd K, Gadhok K, Bedwell M, Guest P. Outcome measurement in speech and language therapy: a digital journey. BMJ Health Care Inform 2020; 27:bmjhci-2019-100085. [PMID: 32385040 PMCID: PMC7245405 DOI: 10.1136/bmjhci-2019-100085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 11/05/2019] [Accepted: 03/27/2020] [Indexed: 11/06/2022] Open
Abstract
Background Evidencing the impact of speech and language therapy interventions is challenging. The UK’s professional body for speech and language therapists (SLTs) is supporting a consistent approach to outcome measurement and analysis using Therapy Outcome Measures (TOMs). Objective To develop a digital solution for collecting TOMs data, evaluate the impact of therapeutic interventions and explore contributing factors to outcome variation across clinical areas. Method Agile methodology was applied to software development. Organisations were recruited to provide data. Criteria were identified to exemplify outcome variability. Results A digital tool was developed. 21 organisations provided data on 16 356 individuals. Improvement in at least one domain of TOMs occurred in 77.1% of instances. Data for two clinical areas exemplify the tool’s effectiveness in highlighting the impact of speech and language therapy. Conclusion This established outcomes data set can be used to evaluate the impact of speech and language therapy, and explore variation in outcomes.
Collapse
Affiliation(s)
- Kathryn Moyse
- Royal College of Speech and Language Therapists, London, United Kingdom
| | - Pamela Enderby
- Health Services Research, The University of Sheffield, Sheffield, UK
| | - Katie Chadd
- Royal College of Speech and Language Therapists, London, United Kingdom
| | - Kamini Gadhok
- Royal College of Speech and Language Therapists, London, United Kingdom
| | - Mark Bedwell
- Different Class Solutions Ltd, Keele, United Kingdom
| | - Patrick Guest
- Different Class Solutions Ltd, Keele, United Kingdom
| |
Collapse
|
6
|
Calvillo M, Irimia A. Neuroimaging and Psychometric Assessment of Mild Cognitive Impairment After Traumatic Brain Injury. Front Psychol 2020; 11:1423. [PMID: 32733322 PMCID: PMC7358255 DOI: 10.3389/fpsyg.2020.01423] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 05/27/2020] [Indexed: 12/13/2022] Open
Abstract
Traumatic brain injury (TBI) can be serious partly due to the challenges of assessing and treating its neurocognitive and affective sequelae. The effects of a single TBI may persist for years and can limit patients’ activities due to somatic complaints (headaches, vertigo, sleep disturbances, nausea, light or sound sensitivity), affective sequelae (post-traumatic depressive symptoms, anxiety, irritability, emotional instability) and mild cognitive impairment (MCI, including social cognition disturbances, attention deficits, information processing speed decreases, memory degradation and executive dysfunction). Despite a growing amount of research, study comparison and knowledge synthesis in this field are problematic due to TBI heterogeneity and factors like injury mechanism, age at or time since injury. The relative lack of standardization in neuropsychological assessment strategies for quantifying sequelae adds to these challenges, and the proper administration of neuropsychological testing relative to the relationship between TBI, MCI and neuroimaging has not been reviewed satisfactorily. Social cognition impairments after TBI (e.g., disturbed emotion recognition, theory of mind impairment, altered self-awareness) and their neuroimaging correlates have not been explored thoroughly. This review consolidates recent findings on the cognitive and affective consequences of TBI in relation to neuropsychological testing strategies, to neurobiological and neuroimaging correlates, and to patient age at and assessment time after injury. All cognitive domains recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are reviewed, including social cognition, complex attention, learning and memory, executive function, language and perceptual-motor function. Affect and effort are additionally discussed owing to their relationships to cognition and to their potentially confounding effects. Our findings highlight non-negligible cognitive and affective impairments following TBI, their gravity often increasing with injury severity. Future research should study (A) language, executive and perceptual-motor function (whose evolution post-TBI remains under-explored), (B) the effects of age at and time since injury, and (C) cognitive impairment severity as a function of injury severity. Such efforts should aim to develop and standardize batteries for cognitive subdomains—rather than only domains—with high ecological validity. Additionally, they should utilize multivariate techniques like factor analysis and related methods to clarify which cognitive subdomains or components are indeed measured by standardized tests.
Collapse
Affiliation(s)
- Maria Calvillo
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States
| | - Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States.,Denney Research Center, Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
| |
Collapse
|
7
|
Lee MS, Kim BS. Characteristics of Word Fluency in Healthy Aging and Alzheimer’s Disease. ACTA ACUST UNITED AC 2019. [DOI: 10.21848/asr.2019.15.2.135] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
8
|
Murray LL. Sentence Processing in Aphasia: An Examination of Material-Specific and General Cognitive Factors. JOURNAL OF NEUROLINGUISTICS 2018; 48:26-46. [PMID: 30686860 PMCID: PMC6345386 DOI: 10.1016/j.jneuroling.2018.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The purpose of this study was to characterize further the nature of sentence processing deficits in acquired aphasia. Adults with aphasia and age-and education-matched adults with no brain damage completed a battery of formal cognitive-linguistic tests and an experimental sentence judgment task, which was performed alone and during focused attention and divided attention or dual-task conditions. The specific aims were to determine whether (a) increased extra-linguistic cognitive demands (i.e., focused and divided conditions) differentially affected the sentence judgement performances of the aphasic and control groups, (b) increased extra- linguistic cognitive demands interact with stimulus parameters (i.e., syntactic complexity, number of propositions) known to influence sentence processing, and (c) syntactic- or material specific resource limitations (e.g., sentence judgment in isolation), general cognitive abilities (e.g., short-term and working memory test scores), or both share a significant relationship with dual-task outcomes. Accuracy, grammatical sensitivity, and reaction time findings were consistent with resource models of aphasia and processing accounts of aphasic syntactic limitations, underscoring the theoretical and clinical importance of acknowledging and specifying the strength and nature of interactions between linguistic and extra-linguistic cognitive processes in not only individuals with aphasia, but also other patient and typical aging populations.
Collapse
Affiliation(s)
- Laura L Murray
- School of Communication Sciences and Disorders Western University
| |
Collapse
|
9
|
Steel J, Ferguson A, Spencer E, Togher L. Language and cognitive communication disorder during post-traumatic amnesia: Profiles of recovery after TBI from three cases. Brain Inj 2017; 31:1889-1902. [DOI: 10.1080/02699052.2017.1373200] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Joanne Steel
- Speech Pathology, The University of Newcastle, Newcastle, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Moving Ahead, Sydney, Australia
| | - Alison Ferguson
- Speech Pathology, The University of Newcastle, Newcastle, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Moving Ahead, Sydney, Australia
| | | | - Leanne Togher
- Speech Pathology, The University of Sydney, Sydney, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Moving Ahead, Sydney, Australia
| |
Collapse
|
10
|
Elbourn E, Togher L, Kenny B, Power E. Strengthening the quality of longitudinal research into cognitive-communication recovery after traumatic brain injury: A systematic review. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 19:1-16. [PMID: 27315590 DOI: 10.1080/17549507.2016.1193896] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 04/23/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE (i) To systematically review longitudinal and prognostic studies relating to the trajectory of cognitive-communication recovery after TBI and (ii) to provide recommendations to strengthen future research. METHOD Thirteen health literature databases were accessed up until July 2014. MAIN MEASURES Articles were screened systematically against pre-determined inclusion and exclusion criteria. Quality reviews were performed on the selected articles using a modified Downs & Black Rating Scale. Two independent reviewers performed the reviews. RESULT Sixteen longitudinal and prognostic articles met the inclusion criteria. There was evidence of either maintenance or improvement of cognitive-communication skills during the first 3 years post-injury. However, the studies did not provide detailed recovery trajectories, by failing to evaluate numerous data points over time. No studies evaluated recovery beyond 3 years post-injury. Injury severity, lesion location, brain volume loss and conversation skills may predict specific cognitive-communication outcomes. There was high variability in study characteristics and measures. CONCLUSION There is currently scarce evidence regarding cognitive-communication recovery and prognosis. People with TBI may recover or maintain pre-morbid cognitive-communication skills during the early rehabilitation stage. Further research detailing the recovery trajectory with a view to evaluating predictive factors is strongly indicated. Guidelines for future research are provided.
Collapse
Affiliation(s)
- Elise Elbourn
- a Faculty of Health Sciences; Disability and Communication Research Group Australia , The University of Sydney , Sydney , Australia ; and
- b National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, The University of New South Wales , Sydney , Australia
| | - Leanne Togher
- a Faculty of Health Sciences; Disability and Communication Research Group Australia , The University of Sydney , Sydney , Australia ; and
- b National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, The University of New South Wales , Sydney , Australia
| | - Belinda Kenny
- a Faculty of Health Sciences; Disability and Communication Research Group Australia , The University of Sydney , Sydney , Australia ; and
- b National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, The University of New South Wales , Sydney , Australia
| | - Emma Power
- a Faculty of Health Sciences; Disability and Communication Research Group Australia , The University of Sydney , Sydney , Australia ; and
- b National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, The University of New South Wales , Sydney , Australia
| |
Collapse
|
11
|
Murray L, Salis C, Martin N, Dralle J. The use of standardised short-term and working memory tests in aphasia research: a systematic review. Neuropsychol Rehabil 2016; 28:309-351. [PMID: 27143500 DOI: 10.1080/09602011.2016.1174718] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Impairments of short-term and working memory (STM, WM), both verbal and non-verbal, are ubiquitous in aphasia. Increasing interest in assessing STM and WM in aphasia research and clinical practice as well as a growing evidence base of STM/WM treatments for aphasia warrant an understanding of the range of standardised STM/WM measures that have been utilised in aphasia. To date, however, no previous systematic review has focused on aphasia. Accordingly, the goals of this systematic review were: (1) to identify standardised tests of STM and WM utilised in the aphasia literature, (2) to evaluate critically the psychometric strength of these tests, and (3) to appraise critically the quality of the investigations utilising these tests. Results revealed that a very limited number of standardised tests, in the verbal and non-verbal domains, had robust psychometric properties. Standardisation samples to elicit normative data were often small, and most measures exhibited poor validity and reliability properties. Studies using these tests inconsistently documented demographic and aphasia variables essential to interpreting STM/WM test outcomes. In light of these findings, recommendations are provided to foster, in the future, consistency across aphasia studies and confidence in STM/WM tests as assessment and treatment outcome measures.
Collapse
Affiliation(s)
- Laura Murray
- a Department of Speech & Hearing Sciences , Indiana University , Bloomington , IN , USA
| | - Christos Salis
- b Speech & Language Sciences , Newcastle University , Newcastle upon Tyne , UK
| | - Nadine Martin
- c Department of Communication Sciences & Disorders , Temple University , Philadelphia , PA , USA
| | - Jenny Dralle
- d Department of Neurology , Brandenburgklinik , Bernau bei Berlin , Germany
| |
Collapse
|
12
|
Steel J, Ferguson A, Spencer E, Togher L. Language and cognitive communication during post-traumatic amnesia: A critical synthesis. NeuroRehabilitation 2015; 37:221-34. [DOI: 10.3233/nre-151255] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Joanne Steel
- Speech Pathology, The University of Newcastle, Newcastle, NSW, Australia
- NHMRC Clinical Centre of Research Excellence in Aphasia Rehabilitation, Brisbane, QLD, Australia
| | - Alison Ferguson
- Speech Pathology, The University of Newcastle, Newcastle, NSW, Australia
- NHMRC Clinical Centre of Research Excellence in Aphasia Rehabilitation, Brisbane, QLD, Australia
| | - Elizabeth Spencer
- Speech Pathology, The University of Newcastle, Newcastle, NSW, Australia
| | - Leanne Togher
- Speech Pathology, The University of Sydney, Sydney, NSW, Australia
- NHMRC Clinical Centre of Research Excellence in Aphasia Rehabilitation, Brisbane, QLD, Australia
| |
Collapse
|
13
|
Yousefzadeh-Chabok S, Ramezani S, Reihanian Z, Safaei M, Alijani B, Amini N. The role of early posttraumatic neuropsychological outcomes in the appearance of latter psychiatric disorders in adults with brain trauma. Asian J Neurosurg 2015; 10:173-80. [PMID: 26396603 PMCID: PMC4553728 DOI: 10.4103/1793-5482.161165] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The objective was to determine the predictors of posttraumatic psychiatric disorders (PTPD) during the first 6 months following traumatic brain injury (TBI) focusing on neuroimaging, clinical and neuropsychological appraisements during acute and discharge phase of TBI. MATERIALS AND METHODS We designed a prospective, longitudinal study in which 150 eligible TBI patients were entered. Postresuscitation brain injury severity and discharged functional outcome were evaluated by standard clinical scales. First neuroimaging was done at a maximum of 24 h after head trauma. Early posttraumatic (PT) neuropsychological outcomes were assessed using Persian neuropsychological tasks at discharge. The standardized psychiatric assessments were carefully implemented 6 months postinjury. A total of 133 patients returned for follow-up assessment at 6 months. They were divided into two groups according to the presence of PTPD. RESULTS Apparently, aggression was the most prevalent type of PTPD (31.48%). There was no significant difference between groups regarding functional outcome at discharge. Diffuse axonal injury (12.96%) and hemorrhages (40.74%) within the cortex (42.59%) and sub-cortex (33.33) significantly occurred more prevalent in PTPD group than non-PTPD ones. Primary postresuscitation TBI severity, early PT lingual deficit and subcortical lesion on first scan were able to predict PTPD at 6 months follow-up. CONCLUSION Almost certainly, the expansive dissociation risk of cortical and subcortical pathways related to linguistic deficits due to severe intracranial lesions over a period of time can augment possibility of subsequent conscious cognitive-emotional processing deficit, which probably contributes to latter PTPD. Hence, early combined therapeutic supplies including neuroprotective pharmacotherapy and neurofeedback for neural function reorganization can dampen the lesion expansion and latter PTPD.
Collapse
Affiliation(s)
- Shahrokh Yousefzadeh-Chabok
- Department of Neurosurgery, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Guilan, Iran
| | - Sara Ramezani
- Department of Neuroscience, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Zoheir Reihanian
- Department of Neurosurgery, Guilan University of Medical Sciences, Rasht, Guilan, Iran
| | - Mohammad Safaei
- Department of Neurosurgery, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Guilan, Iran
| | - Babak Alijani
- Department of Neurosurgery, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Guilan, Iran
| | - Naser Amini
- Department of Neuroscience, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
14
|
Factors predicting post-stroke aphasia recovery. J Neurol Sci 2015; 352:12-8. [DOI: 10.1016/j.jns.2015.03.020] [Citation(s) in RCA: 153] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 03/11/2015] [Accepted: 03/12/2015] [Indexed: 11/21/2022]
|
15
|
Túbero GS, Gobbi S, Teixeira CVL, Pereira JR, Shigematsu R, Canonici AP. Effects of square stepping exercise in patients with sequel of cerebrovascular accident. FISIOTERAPIA EM MOVIMENTO 2014. [DOI: 10.1590/0103-5150.027.002.ao08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction Cerebral stroke is the interruption of blood flow to the brain and can be classified into hemorrhagic and ischemic. It may result in serious body balance and cognition complications. Kinesiotherapy is a privileged means of rehabilitation.Objective Verify the effects of Square Stepping Exercise (SSE) on cognitive functions, depressive symptoms and the body balance of cerebral stroke sequel patients.Methods Thirteen brain stroke sequel patients were divided into two groups: SSE (SSEG n = 8) and conventional physiotherapy group (PG, n = 5). The SSEG participated only of the SSE training protocol, while the PG participated of its physical therapy routine group, both for 4 months. They were evaluated using the Mini Mental State Examination (MMSE), the Brief Cognitive Screening Battery (BBRC), the Geriatric Depression Scale (GDS),Berg Balance Scale(BBS) and Timed Up and Go(TUG).Results The U Mann Whitney test showed no significant differences between groups. In intragroup analysis, the Wilcoxon test showed significant improvement in global cognitive status for PG (p < 0.042), and for SSEG there were positive results for verbal fluency (p < 0.04) and in TUG for number of steps (p < 0.04) and the time (p < 0.02).Conclusion The SSE seems to benefit dynamic balance, influencing gait agility, cognition related to verbal fluency and may have contributed to maintain other cognitive functions.
Collapse
Affiliation(s)
| | - Sebastião Gobbi
- Universidade Estadual Paulista “Júlio Mesquita Filho”, Brazil
| | | | | | | | | |
Collapse
|
16
|
Yu ZZ, Jiang SJ, Li J, Bi S, Li F, Xie T, Wang R, Zhang XT. Clinical application of Loewenstein Occupational Therapy Cognitive Assessment Battery-Second Edition in evaluating of cognitive function of Chinese patients with post-stroke aphasia. ACTA ACUST UNITED AC 2013; 28:167-71. [PMID: 24074619 DOI: 10.1016/s1001-9294(13)60043-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the clinical application value of Loewenstein Occupational Therapy Cognitive Assessment battery in Chinese patients with post-stroke aphasia. METHODS Cognitive functions of 59 Chinese patients with aphasia following a stroke were assessed with the Chinese version of the second edition of LOTCA battery and their linguistic functions were tested with the Western Aphasia Battery (WAB) Scale, respectively. The Results of LOTCA were analyzed and compared across different groups, in the light of gender, age, educational background, the length of illness, and the degree of aphasia. RESULTS Neither the score of subtests of the LOTCA nor the overall scores of LOTCA of aphasia patients with different gender and educational background differed (all P>0.05). In different age groups, apart from thinking operation (F=3.373, P=0.016), visuomotor organization (F=3.124, P=0.022), attention (F=3.729, P=0.009) and the total score (F=2.683, P=0.041), there was no difference in terms of the other subtest scores of LOTCA (all P>0.05). In the groups of different length of time with illness, apart from orientation (F=2.982, P=0.039) and attention (F=3.485, P=0.022), the score of other subtests and the total score of LOTCA were not different (all P>0.05). In the groups of different degree of aphasia, apart from attention (F=2.061, P=0.074), both the score of other subtests and the total score of LOTCA differed (all P<0.05). CONCLUSION LOTCA might be suitable to assessing the cognitive ability of post-stroke Chinese patients with aphasia.
Collapse
Affiliation(s)
- Zeng-zhi Yu
- Rehabilitation Medicine Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | | | | | | | | | | | | | | |
Collapse
|
17
|
El Hachioui H, Visch-Brink EG, Lingsma HF, van de Sandt-Koenderman MWME, Dippel DWJ, Koudstaal PJ, Middelkoop HAM. Nonlinguistic cognitive impairment in poststroke aphasia: a prospective study. Neurorehabil Neural Repair 2013; 28:273-81. [PMID: 24213963 DOI: 10.1177/1545968313508467] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Information on cognitive impairment in aphasic patients is limited. Our aim was to investigate the prevalence and course of nonlinguistic cognitive impairments in the first year after stroke and their association with aphasia and functional outcome. METHODS We included 147 patients with acute aphasia. At 3 months and 1 year, we assessed cognition with a nonlinguistic cognitive examination including abstract reasoning, visual memory, visual perception and construction, and executive functioning. We assessed language with a verbal communication rating (Aphasia Severity Rating Scale), the ScreeLing (a linguistic-level screening test), and the Token Test. We evaluated functional outcome with the modified Rankin scale and registered the use of antidepressants. RESULTS In total, 107 (88%) patients had impairments in at least one nonlinguistic cognitive domain at 3 months and 91 (80%) at 1 year. The most frequently observed impairment concerned visual memory (83% at 3 months; 78% at 1 year) and the least frequent visual perception and construction (19% at 3 months; 14% at 1 year). There was improvement on all cognitive domains including language, except for abstract reasoning. Patients with persisting aphasia had lower cognitive domain scores, worse functional outcome, and were more often depressed than patients who had recovered from aphasia. CONCLUSIONS Standard nonlinguistic cognitive examination is recommended in aphasic stroke patients. Nonlinguistic cognitive impairments are common and associated with poor functional outcome and depression, especially in patients with persisting aphasia.
Collapse
|
18
|
Operative and nonoperative linguistic outcomes in brain injury patients. J Neurol Sci 2012; 317:130-6. [PMID: 22418055 DOI: 10.1016/j.jns.2012.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 02/03/2012] [Accepted: 02/09/2012] [Indexed: 11/21/2022]
Abstract
OBJECTIVE AND BACKGROUND Linguistic function is one of vulnerable aspects of traumatic brain injury (TBI) which may have destructive effects on patients' communicative activities and daily life, years following trauma. This paper attempts to answer the controversy whether surgery affects increase and decrease of linguistic impairment or not. MATERIALS AND METHODS Two hundred forty-one TBI patients aged 18-65 with abnormal CT findings and at least 20 minute post-trauma amnesia (PTA), who were conscious at discharge, participated in this study. Based on operative intervention, the samples were divided into two groups: operative and nonoperative. Cognitive and aphasic deficits were inspected formally and pragmatic disorder was informally appraised at discharge. RESULTS The groups had no significant differences in aphasia incidence and language pragmatic impairment, though they were significantly distinctive in aphasia subcategories and cognitive deficit after trauma. Fluent aphasia was more common in both groups alike. In aphasia subcategories, however, transcortical sensory aphasia (TSA) in operative and anomia in nonoperative group were the most prevalent. Several variables appeared strikingly related to higher aphasia in operative groups as follows: moderate to severe injury, 18-35 and over 50 years of age, more than 1 week PTA, intracranial surgery of multiple lesions in left or bilateral hemisphere fronto-temporal cortex plus post-trauma cognitive and pragmatic impairments, and diffuse axonal injuries. DISCUSSION Almost certainly, meaningful drop of cognitive function post surgery roots back in significant loss of initial consciousness level. Related factors to postoperative aphasia suggest taking policies through surgery intervention. Discerning the indispensable contributions of neurosurgeons, neurolinguists, and neuroscientists, results inspire more clinical future studies.
Collapse
|
19
|
Effective factors on linguistic disorder during acute phase following traumatic brain injury in adults. Neuropsychologia 2012; 50:1444-50. [PMID: 22410412 DOI: 10.1016/j.neuropsychologia.2012.02.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Revised: 11/27/2011] [Accepted: 02/24/2012] [Indexed: 11/22/2022]
Abstract
Traumatic brain injury (TBI) has been known to be the leading cause of breakdown and long-term disability in people under 45 years of age. This study highlights the effective factors on post-traumatic (PT) linguistic disorder and relations between linguistic and cognitive function after trauma in adults with acute TBI. A cross-sectional design was employed to study 60 post-TBI hospitalized adults aged 18-65 years. Post-traumatic (PT) linguistic disorder and cognitive deficit after TBI were respectively diagnosed using the Persian Aphasia Test (PAT) and Persian version of Mini-Mental State Examination (MMSE) at discharge. Primary post-resuscitation consciousness level was determined using the Glasgow Coma Scale (GCS). Paracilinical data was obtained by CT scan technique. Multiple logistic regression analysis illustrated that brain injury severity was the first powerful significant predictor of PT linguistic disorder after TBI and frontotemporal lesion was the second. It was also revealed that cognitive function score was significantly correlated with score of each language skill except repetition. Subsequences of TBI are more commonly language dysfunctions that demand cognitive flexibility. Moderate, severe and fronto-temporal lesion can increase the risk of processing deficit in linguistic macrostructure production and comprehension. The dissociation risk of cortical and subcortical pathways related to cognitive-linguistic processing due to intracranial lesions can augment possibility of lexical-semantic processing deficit in acute phase which probably contributes to later cognitive-communication disorder.
Collapse
|
20
|
da Costa FA, da Silva DLA, da Rocha VM. [The neurological state and cognition of patients after a stoke]. Rev Esc Enferm USP 2012; 45:1083-8. [PMID: 22031367 DOI: 10.1590/s0080-62342011000500008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2009] [Accepted: 01/24/2011] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to have a multidisciplinary team investigate the neurological state and cognitive performance of patients after a stroke, through a cross-sectional study with 45 patients in rehabilitation after having an acute stroke. The data collection instruments used were an assessment sheet, the Mini Mental-MEEM, and the National International Health Stroke Scale-NIHSS. The sample consisted mostly of women (55.6%), Ischemic Stroke (86.7%), right hemisphere of the brain (60%) and Educated (68.8%). The mean MEEM for educated and illiterate patients was 19.3 ± 5.0 and 15.92 ± 3.7, respectively. The overall mean of the neurological state was 13.0±4.8. A significant difference was found between the cognitive means of patients in terms of education (p value=0.017), and there was a significant relationship between the neurological state and cognitive performance (r=-0.44 p value=0.002). It appears to be a direct relationship between the neurological state and cognition performance of patients after an acute stroke, which evinces the need for greater attention to the cognitive issue involved early in rehabilitation.
Collapse
|
21
|
González-Fernández M, Davis C, Molitoris JJ, Newhart M, Leigh R, Hillis AE. Formal education, socioeconomic status, and the severity of aphasia after stroke. Arch Phys Med Rehabil 2011; 92:1809-13. [PMID: 21840498 DOI: 10.1016/j.apmr.2011.05.026] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Revised: 04/06/2011] [Accepted: 05/26/2011] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To determine the role of education and socioeconomic status on the severity of aphasia after stroke. DESIGN Cross-sectional study. SETTING Stroke units of 2 affiliated medical centers. PARTICIPANTS Stroke patients (n=173) within 24 hours of symptom development and hospitalized controls (n=62) matched for age, education, and socioeconomic status (SES) with normative brain magnetic resonance imaging. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Percent error on 9 language tasks (auditory and written comprehension, naming [oral, written, and tactile], oral reading, oral spelling, written spelling, and repetition). Education was recorded in years and dichotomized as less than 12 years or 12 years and above for data analysis. Demographic characteristics (age, sex, race) and stroke volume were recorded for adjustment. SES was obtained from census tract data as 2 variables: mean neighborhood household income and family income. RESULTS The percentage of errors for participants with 12 or more years of education was significantly lower for auditory and written comprehension, written naming, oral reading, oral spelling, and written spelling of fifth grade vocabulary words, even after adjusting for age, sex, stroke volume, and SES. CONCLUSIONS These findings suggest that even once learned, access to written word forms may become less vulnerable to disruption by stroke with increasing years of education.
Collapse
Affiliation(s)
- Marlís González-Fernández
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, School of Medicine, Baltimore, MD, USA.
| | | | | | | | | | | |
Collapse
|
22
|
Edwards JD, Koehoorn M, Boyd LA, Levy AR. Is health-related quality of life improving after stroke? A comparison of health utilities indices among Canadians with stroke between 1996 and 2005. Stroke 2010; 41:996-1000. [PMID: 20360545 DOI: 10.1161/strokeaha.109.576678] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Recent innovations in diagnosis, management, and rehabilitation have resulted in measurable improvements in clinical and functional outcomes after acute stroke. However, whether gains in health-related quality of life after stroke have also occurred is not well characterized. Using 2 Canadian population surveys, the purpose of this study was to identify changes in health-related quality of life in individuals with stroke from 1996 to 2005. METHODS Data from the public use files of the National Population Health Survey, Cycle 2 (1996), and the Canadian Community Health Survey, Cycle 3.1. (2005), were used. A total of 847 individuals with stroke were included. Self-reported information on health status based on the Health Utilities Index Mark 3 was used to generate single-attribute and overall health-related quality of life scores. Analysis of covariance and multiple logistic regression were used to determine the relationship between survey year and poststroke impairment adjusting for demographic variables and clinical comorbidities. RESULTS A statistically significant and clinically important reduction in mean overall Health Utilities Index Mark 3 scores was observed for respondents with stroke from 1996 to 2005. In addition, 2 of the 8 single-attribute Health Utilities Index Mark 3 domains showed a significant change between survey years. Significantly more individuals with stroke reported dexterity and cognitive impairment in 2005 compared with respondents in 1996, indicating reduced health-related quality of life for these domains. CONCLUSIONS Despite improvements in medical management, quality of life is not improving after stroke in the Canadian population. These findings are useful to generate hypotheses about the impact of advances in management on quality of life after stroke and identify specific domains that may benefit from future study in stroke populations.
Collapse
Affiliation(s)
- Jodi D Edwards
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | |
Collapse
|
23
|
Variations in the presentation of aphasia in patients with closed head injuries. Case Rep Med 2010; 2010:678060. [PMID: 20204182 PMCID: PMC2831203 DOI: 10.1155/2010/678060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2009] [Accepted: 01/05/2010] [Indexed: 11/17/2022] Open
Abstract
Impairments of speech and language are important consequences of head injury as they compromise interaction between the patient and others. A large spectrum of communication deficits can occur. There are few reports in the literature of aphasia following closed head injury despite the common presentation of closed head injury. Herein we report two cases of closed head injuries with differing forms of aphasia. We discuss their management and rehabilitation and present a detailed literature review on the topic. In a busy acute surgical unit one can dismiss aphasia following head injury as behaviour related to intoxication. Early recognition with prolonged and intensive speech and language rehabilitation therapy yields a favourable outcome as highlighted in our experience. These may serve as a reference for clinicians faced with this unusual outcome.
Collapse
|