Sign language aphasia from a neurodegenerative disease

Bimodal aphasia and dysgraphia: Phonological output buffer aphasia and orthographic output buffer dysgraphia in spoken and sign language

We report a case of crossmodal bilingual aphasia-aphasia in two modalities, spoken and sign language-and dysgraphia in both writing and fingerspelling. The patient, Sunny, was a 42 year-old woman after a left temporo-parietal stroke, a speaker of Hebrew, Romanian, and English and an adult learner, daily user of Israeli Sign language (ISL). We assessed Sunny's spoken and sign languages using a comprehensive test battery of naming, reading, and repetition tasks, and also analysed her spontaneous-speech and sign. Her writing and fingerspelling were assessed using tasks of dictation, naming, and delayed copying. In spoken language production, Sunny showed a classical phonological output buffer (POB) impairment in naming, reading, repetition, and spontaneous production, with phonological errors (transpositions, substitutions, insertions, and omissions) in words and pseudo-words, and whole-unit errors in morphological affixes, function-words, and number-words, with a length effect. Importantly, her error pattern in ISL was remarkably similar in the parallel tasks, with phonological errors in signs and pseudo-signs, affecting all the phonological parameters of the sign (movement, handshape, location, and orientation), and whole-unit errors in morphemes, function-signs, and number-signs. Sunny's impairment was selective to the POB, without phonological input, semantic-conceptual, or syntactic deficits. This shows for the first time how POB impairment, a kind of conduction aphasia, manifests itself in a sign language, and indicates that the POB for sign-language has the same cognitive architecture as the one for spoken language. It may also indicate similar neural underpinnings for spoken and sign languages. In writing, Sunny forms the first case of a selective type of dysgraphia in fingerspelling, orthographic (graphemic) output buffer dysgraphia. In both writing and fingerspelling, she made letter errors (letter transpositions, substitutions, insertions, and omissions), as well as morphological errors and errors in function words, and showed length effect. Sunny's impairment was selective to the orthographic output buffer, whereas her reading, including orthographic input processing, was intact. This suggests that the orthographic output buffer is shared for writing and fingerspelling, at least in a late learner of sign language. The results shed further light on the architecture of phonological and orthographic production.

Formal caregivers' perceptions of everyday interaction with Deaf people with dementia

OBJECTIVES

Deteriorating interactive ability of people with dementia challenges formal caregivers. In Finland, Deaf people with advanced dementia may live in a nursing home designed for their care where the staff use Finnish Sign Language (FiSL). This study describes the perceptions of formal caregivers, focusing on the challenges, how they solve the challenges, and what support they need to improve interaction with Deaf residents.

METHODS

Semi-structured interviews with 13 formal caregivers who work with Deaf people with dementia were conducted and analyzed using qualitative content analysis. A purposive sampling was used.

RESULTS

Three key themes were challenges in interaction, strategies in supporting interaction, and support for coping. Caregivers perceived challenges in interaction caused by linguistic changes, deteriorating physical mobility and memory, and Deaf residents' behavioral challenges. Caregivers supported Deaf residents by learning to know them and using personal and linguistic strategies. Support for coping comprised supporting family members and other caregivers.

CONCLUSIONS

Efficient skills in sign language (SL) and knowledge of dementia are essential in interacting with Deaf residents and to build interpersonal relationships for care.

CLINICAL IMPLICATIONS

Supporting Deaf residents requires learning the way they interact which can be achieved over time.

Characterization of the Secretome from Spheroids of Adipose-Derived Stem Cells (SASCs) and Its Potential for Tissue Regeneration

INTRODUCTION

Spheroids are spherical aggregates of cells that mimic the three-dimensional (3D) architecture of tissues more closely than traditional two dimensional (2D) cultures. Spheroids of adipose stem cells (SASCs) show special features such as high multilineage differentiation potential and immunomodulatory activity. These properties have been attributed to their secreted factors, such as cytokines and growth factors. Moreover, a key role is played by the extracellular vesicles (EVs), which lead a heterogeneous cargo of proteins, mRNAs, and small RNAs that interfere with the pathways of the recipient cells.

PURPOSE

The aim of this work was to characterize the composition of the secretome and exosome from SASCs and evaluate their regenerative potential.

MATERIALS AND METHODS

SASCs were extracted from adipose samples of healthy individuals after signing informed consent. The exosomes were isolated and characterized by Dinamic Light Scattering (DLS), Scanning Electron Microscopy (SEM), and Western blotting analyses. The expression of mRNAs and miRNAs were evaluated through real-time PCR. Lastly, a wound-healing assay was performed to investigate their regenerative potential on different cell cultures.

RESULTS

The SASCs' exosomes showed an up-regulation of NANOG and SOX2 mRNAs, typical of stemness maintenance, as well as miR126 and miR146a, related to angiogenic and osteogenic processes. Moreover, the exosomes showed a regenerative effect.

CONCLUSIONS

The SASCs' secretome carried paracrine signals involved in stemness maintenance, pro-angiogenic and pro-osteogenic differentiation, immune system regulation, and regeneration.