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There are many different approaches to the rehabilitation of aphasia, a communication disorder that affects a person's understanding and expression of spoken and written language. One approach called “functional communication interventions” aims to enhance communication success as opposed to solely improve linguistic abilities. This approach encompasses many skills (e.g., gesturing) and factors (e.g., access to communication supports) that support sending and receiving messages in “real world” daily activities and environments. Functional communication treatments are highly diverse and not always well described. A framework that may provide structure to the description of functional communication interventions for aphasia is the Rehabilitation Treatment Specification System (RTSS). The RTSS was developed by an interdisciplinary research team to describe interventions across any rehabilitation discipline and in any setting or format. The RTSS uses a common language and a systematic approach to describing treatment and includes three connected elements – a single target, one or more ingredients, and a mechanism of action – that, taken together, attempt to explain how and why a treatment works. While the RTTS has been described previously within the field of speech-language pathology, it has not yet been applied to the field of aphasiology. We applied the RTSS framework to a sample of peer-reviewed studies that represent functional communication treatments, including Promoting Aphasics’ Communicative Effectiveness (PACE), Modified Response Elaboration Training (M-RET), Script Training, Conversation Treatment, and Communication Partner Training. We discuss both the advantages and disadvantages of using the RTSS framework to better understand the important elements of functional communication treatment approaches for aphasia.

Purpose Aphasia is a complex, neurogenic language disorder, with different aphasia syndromes hallmarked by impairment in fluency, auditory comprehension, naming, and/or repetition. Broad, standardized assessments of language domains and specific language and cognitive assessments provide a holistic impairment profile of a person with aphasia. While many recognize the correlations between assessments, there remains a need to continue understanding the complexity of relationships between assessments for the purpose of better characterization of language impairment profiles of persons with aphasia. We explored the use of network analysis to identify the complex relationships between a variety of language assessments. Method We computed a regularized partial correlation network and a directed acyclic graph network to estimate the relations between different aphasia assessments in 128 persons with aphasia. Results Western Aphasia Battery–Revised Comprehension subtest was the most central assessment in the aphasia symptom network, whereas the Philadelphia Naming Test had the most putative causal influence on other assessments. Additionally, the language assessments segregated into three empirically derived communities denoting phonology, semantics, and syntax. Furthermore, several assessments, including the Philadelphia Naming Test, belonged to multiple communities, suggesting that certain assessments may capture multiple language impairments. Conclusion We discuss the implications of using a network analysis approach for clinical intervention and driving forward novel questions in the field of clinical aphasiology. Supplemental Material https://doi.org/10.23641/asha.16620229

BACKGROUND Many speakers with non-fluent aphasia (NFA) are able to produce some well-formed word combinations such as 'I like it' or 'I don't know', although they may not use variations such as 'He likes it' or 'I don't know that person'. This suggests that these utterances represent fixed forms. AIMS This case series investigation explored the impact of a novel intervention aimed at enhancing the connected speech of individuals with NFA. The intervention, motivated by usage-based principles, involved filling open slots in semi-fixed sentence frames. METHODS & PROCEDURES Five participants with NFA completed a 6-week intervention programme. The intervention trained participants to insert a range of different lexical items into the open slots of high-frequency phrases such as 'I like it' to enable more productive sentences (e.g., 'they like flowers'). The outcomes and acceptability were examined: The primary outcome measure focused on changes in connected narrative, and the availability of trained constructions (e.g., 'I like it') was explored through a story completion test. Two baseline measures of behaviour were taken prior to intervention, and outcomes assessed immediately after intervention and at a 6-week maintenance assessment. OUTCOME & RESULTS A pre-/post-treatment comparison of connected speech measures showed evidence of enhanced connected speech for two of the five participants (P2 and P5). An analysis of story completion test scores revealed positive change for two participants (P1 and P2). Findings were mixed with regard to baseline stability of outcome measures and post-intervention stability of language changes. The intervention was acceptable to all participants. CONCLUSION & IMPLICATIONS While this pilot study yielded promising findings with regard to the intervention's acceptability and increased connected speech for some participants, the findings were mixed across the sample of five participants. This research helps inform hypotheses and selection criteria for future studies. WHAT THIS PAPER ADDS What is already known on the subject Despite difficulties producing grammatically correct sentences, many speakers with aphasia are able to produce well-formed utterances, often representing familiar expressions such as 'I don't know' and 'I like it'. In usage-based Construction Grammar (CxG) theories, familiar utterances are assumed to be processed as one unit and are therefore more resilient to brain damage. CxG assumes that residual utterances such as 'I like it' map onto more abstract sentence frames (e.g., '[REFERENT] like-TENSE [THING]'). What this paper adds to existing knowledge Sentence therapy, informed by CxG principles, is novel in aphasiology, and usage-based interventions need to be evaluated with regard to their impact on language processing at the connected speech level. This case series report explores the acceptability and outcomes of a usage-based sentence therapy. We also introduce and explore the value of an automated, frequency-based analysis tool for evaluating connected speech outcomes in aphasia therapy. What are the potential or actual clinical implications of this work? The findings inform further development of usage-based aphasia interventions targeting word combinations.

Neurolinguistics is a fresh and profoundly interdisciplinary field, with impacts from psycholinguistics, brain science, aphasiology, (psychological) neuroscience, and some more. The degree and point of neurolinguistics is to furnish understudies and researchers with brief outlines of the cutting edge specifically subject regions, and to draw in a wide crowd with an interest in the neurobiology of language. The parts don't struggle to give thorough inclusion, but instead present conversations of noticeable inquiries presented by a given theme. Based on a qualitative document analysis technique, this paper clarifies neurolinguistics and the related specific characteristics.

This project aims to build capacity for research into acquired language impairments in adults (aphasia). The project aims to provide a web-resource with access to anonymised behavioural data collected from adults with aphasia. This data can then be used by scholars and researchers across disciplines for analysis and data-mining projects.

This study investigated the underlying nature of apraxia of speech (AOS) by testing two competing hypotheses. The Reduced Buffer Capacity Hypothesis argues that people with AOS can plan speech only one syllable at a time Rogers and Storkel [1999. Planning speech one syllable at a time: The reduced buffer capacity hypothesis in apraxia of speech. Aphasiology, 13(9-11), 793-805. https://doi.org/10.1080/026870399401885]. The Program Retrieval Deficit Hypothesis states that selecting a motor programme is difficult in face of competition from other simultaneously activated programmes Mailend and Maas [2013. Speech motor programming in apraxia of speech: Evidence from a delayed picture-word interference task. American Journal of Speech-Language Pathology, 22(2), S380-S396. https://doi.org/10.1044/1058-0360(2013/12-0101)]. Speakers with AOS and aphasia, aphasia without AOS, and unimpaired controls were asked to prepare and hold a two-word utterance until a go-signal prompted a spoken response. Phonetic similarity between target words was manipulated. Speakers with AOS had longer reaction times in conditions with two similar words compared to two identical words. The Control and the Aphasia group did not show this effect. These results suggest that speakers with AOS need additional processing time to retrieve target words when multiple motor programmes are simultaneously activated.

Although facilitated group conversations for aphasia are a popular practice within contemporary clinical aphasiology, only a small number of published studies have shed some light on how interactio...

A.R. Luria is one of the most prestigious scientists in neuroscience, neuropsychology in particular. His contribution to aphasiology and neurolinguistics is well known. However, today some researchers believe that A.R. Luria's main ideas have lost their relevance and have little influence on contemporary discussions. The paper presents the views of A.R. Luria on the brain organization of speech and aphasia. Although he developed his concept of the relationship between cognitive processes and brain work several decades ago, scientific and technological achievements in our days largely confirm many of his ideas and hypotheses. A.R. Luria's basic views of the brain and language are considered in this article in the light of modern neuroscience. Two main monographs and some works of A.R. Luria, which are dedicated to the brain organization of speech and to the classification of aphasia, are analyzed. In particular, comparisons are made between his initial assumptions about aphasia and their theoretical rationale in the book «Traumatic Aphasia» (1947) and his more complex interpretation of the cerebral organization of speech, which is presented in his work «Basic Problems of Neurolinguistics» (1975). The paper discusses differences between these two books and also linguistic issues, which received much attention in his later publication. It considers the concepts of functional systems, systemic and dynamic organization of speech, proposed by A.R. Luria. It is shown that his interpretation of the cerebral organization of speech as a specific contribution of various brain regions to the speech system continues to be widely used, and his significant contribution to neurolinguistics is widely recognized. Many ideas of A.R. Luria have been integrated into contemporary aphasiology, while some questions of his proposed classification of aphasia remain debatable.

This Master Thesis deals with a typology of aphasia (Broca's, Wernicke's, conductive, transcortical-motor and sensory) and also with various variables that affect the type of aphasia. The thesis also deals with linguistics specifics of aphasia symptoms (circulation, perseveration, semantic and phonemic paraphasias, agramatism). In a practical part of the thesis, the symptoms of aphasia are observed in particular aphasic patients while their speech has been recorded. An author of the thesis is responsible for the correct citations of all sources used. key words: aphasia; aphasiology; agrammatism; cognitive science; Czech; syntax

Inflection impairments are commonly noted in aphasia, particularly non-fluent variants, where descriptions of such difficulties often focus on inflection omission. This aligns withrule-basedtheory, in which inflected forms should be more difficult to produce than their uninflected counterparts. Recent studies address noun inflection for number and potential effects of the relative frequency of singular and plural forms (dominance effects). However, none examine number errors qualitatively or in spontaneous speech. We present quantitative and qualitative analyses of such errors in nouns produced by twelve people with aphasia in spoken Cinderella narratives, examining: error rate; error types and nouns involved; relationship between error production and dominance; and speakers’ consistency with error production and flexibility in varying the noun forms concerned. Twelve unimpaired speakers provide comparison data. While error rates were low, arguably more important is error type. Singularisation and pluralisation errors were observed, all on regular nouns and involving production of the dominant form. The pluralisation errors, all occurring on references to Cinderella’s glass slipper, arguably challenge rule-based predictions that the singular is easier to retrieve than the plural. We suggestconstructivist, usage-basedtheory as a promising framework to characterise such productions. Implications for aphasiology and clinical practice are also discussed.

A multidisciplinary team of experts took stock of the current state of affairs about many aspects of aphasia in India, including community burden, diagnostic assessment, therapy, rehabilitation, research, education, and advocacy. The broad spectrum of aphasiology was matched by the types of participants ranging from neurologists, speech-language pathologists, clinical psychologists, linguists, to experts in neuroimaging and computer sciences. Threadbare discussion in 16 sessions over 3 days leads to the identification of pressing problems and possible solutions. Many action plans have been envisaged and recommendations made. A few examples with high priority are community-based and hospital-based study incidence and prevalence of aphasia, development of test batteries for the assessment of many components of speech and communication in Indian languages which are validated on rigorous psychometric, and linguistic criteria, national registry for aphasia, educational modules about aphasia for different target groups, resources for advocacy and its training, a bank of research questions and outlines of research protocols for young professionals to pursue. The expert group will continue to oversee execution of some of the actionable plans in short and long term.

Of all the nineteenth-century physicians whose names still resonate today, Armand Trousseau is perhaps the one most familiar, for his description of carpal spasm as a sign of hypocalcemia (Trousseau's sign) and his description of the hypercoagulable state associated with cancer (Trousseau's syndrome). In the last three years of his life, Trousseau turned his attention to aphasia, which he included in his 1864 and 1865 lectures given at Hotel-Dieu Hospital in Paris and which he discussed in an address to the Imperial Academy of Medicine in 1865. Trousseau preceded Wernicke in describing aphasia as a symptom complex, in which he included Broca's aphemia, receptive aphasia, the inability to read with and without the inability to write (alexia with and without agraphia), the inability to name common objects (amnesic aphasia or anomia) and to recognize numbers (acalculia), and the inability to draw. Trousseau concluded that such a varied symptomatology could not arise from a single area, and he proposed that lesions of the posterior inferior frontal convolution identified by Broca, of the insula and corpus striatum and of the temporal and parietal lobes, could give rise to aphasia. The role of the posterior temporal lobe in receptive aphasia was confirmed by Wernicke in 1874, and the role of the inferior parietal lobule in agraphia and alexia was confirmed by Dejerine in 1891. Trousseau thought that aphasia resulted from the loss of the memory for words and for the synergistic actions of the movements of articulations learned in early childhood. Trousseau added inattention, lack of comprehension, and cognitive decline to amnesia as contributing factors to the verbal and nonverbal expression of thought. Trousseau constructed a comprehensive theory of aphasia that unified its semiology, localization, and pathophysiology. This construct had the virtue of being predictive and falsifiable by the clinico-pathological method. Through insight born of observation, Trousseau identified the issues that dominated aphasiology into the twenty-first century.

A considerable body of research supports the use of behavioral communication treatment as the standard of care for aphasia. In spite of robust progress in clinical aphasiology, many questions regarding optimal care remain unanswered. One of the major challenges to progress in the field is the lack of a common framework to adequately describe individual treatments, which, if available, would allow comparisons across studies as well as improved communication among researchers, clinicians, and other stakeholders. Here, we describe how aphasia treatment approaches can be systematically characterized using the Rehabilitation Treatment Specification System (RTSS). At the core of the RTSS is a tripartite structure that focuses on targets (the behavior that is expected to change as a result of treatment), ingredients (what a clinician does to affect change in the target), and mechanism(s) of action (why a given treatment works by linking the ingredients to the target). Three separate articles in the current issue specifically describe how the RTSS can be used to describe different kinds of aphasia treatment approaches: functional approaches, cognitive-linguistic approaches, and biological approaches. It is our hope that the application of the RTSS in clinical aphasiology will improve communication in published studies, grant proposals, and in the clinical care of persons with aphasia.

Original manuscript received November 11, 2021. Revised manuscript accepted February 05, 2022. First published online April 11, 2022. Distinguished Professor of Neuropsychology at the Florida International University in Miami and Albizu University (USA, Miami) Alfredo Ardila (4.09.1946–9.01.2021) was President of the Latin American Association of Neuropsychology, member of the Board of Governors of the International Neuropsychological Society and of the Editorial Board of the International publication Lurian Journal. A. Ardila was a leading thinker bringing and developing the ideas of A. R. Luria’s school of neuropsychology to North and Latin America. He joined the community of students and disciples of A. R. Luria in the mid‑1970s while studying at Moscow State University where he earned a PhD degree under the supervision of E. D. Homskaya. In this article, dedicated to the memory of A. Ardila, the authors analyze his contribution to development of the systemic-dynamic approach in neuropsychology, and share personal memories of a lifelong friendship, recalling his memorable charm and personal modesty as well as his renewed scientific cooperation with colleagues from his alma mater in 2008–2020. Профессор Университета Альбизу (США, Майами) Альфредо Ардила (4.09.1946–9.01.2021), президент Латиноамериканской ассоциации нейропсихологии, член Совета управляющих Международного нейропсихологического общества, член редакционного совета международного журнала «Lurian Journal», сыграл большую роль в развитии и популяризации идей школы А. Р. Лурия в Южной и Северной Америке. Он приобщился к сообществу учеников и последователей А. Р. Лурия в середине 1970‑х, когда, обучаясь в МГУ, подготовил диссертацию под руководством Е. Д. Хомской. В статье памяти Альфредо Ардила авторы анализируют его вклад в развитие системно- динамического подхода в нейропсихологии, делятся воспоминаниями о многолетней дружбе с ним и его участии в научном сотрудничестве с московскими коллегами в alma mater в 2008–2020 гг., отмечают его личные качества, незабываемые обаяние и скромность.

The annual Clinical Aphasiology Conference (CAC) provides a forum for clinicians and researchers engaged in the study and clinical management of persons with acquired neurologic language disorders ...

Background Evaluating patients in the acute phase of brain damage allows for the early detection of cognitive and linguistic impairments and the implementation of more effective interventions. However, few cross-cultural instruments are available for the bedside assessment of language abilities. The aim of this study was to develop a brief assessment instrument and evaluate its content validity. Methods Stimuli for the new assessment instrument were selected from the M1-Alpha and MTL-BR batteries (Stage 1). Sixty-five images were redesigned and analyzed by non-expert judges (Stage 2). This was followed by the analysis of expert judges (Stage 3), where nine speech pathologists with doctoral training and experience in aphasiology and/or linguistics evaluated the images, words, nonwords, and phrases for inclusion in the instrument. Two pilot studies (Stage 4) were then conducted in order to identify any remaining errors in the instrument and scoring instructions. Results Sixty of the 65 figures examined by the judges achieved inter-rater agreement rates of at least 80%. Modifications were suggested to 22 images, which were therefore reanalyzed by the judges, who reached high levels of inter-rater agreement (AC1 = 0.98 [CI = 0.96–1]). New types of stimuli such as nonwords and irregular words were also inserted in the Brief Battery and favorably evaluated by the expert judges. Optional tasks were also developed for specific diagnostic situations. After the correction of errors detected in Stage 4, the final version of the instrument was obtained. Conclusion This study confirmed the content validity of the Brief MTL-BR Battery. The method used in this investigation was effective and can be used in future studies to develop brief instruments based on preexisting assessment batteries.

A afasia é um distúrbio adquirido da linguagem resultante de uma lesão cerebral focal no hemisfério dominante da linguagem que afeta o funcionamento comunicativo e social da pessoa e sua qualidade de vida. O objetivo desse estudo foi realizar uma revisão narrativa sobre as descobertas históricas na afasiologia, destacando os principais teóricos e trabalhos até o século XX. Foram consultados livros, as bases de dados disponíveis no Portal de Periódicos da CAPES e, para complementar, o Google Acadêmico. A compreensão da afasia como um distúrbio de linguagem teve início ainda na Idade Antiga. No século XIX, o estudo da relação entre linguagem e cérebro foi dominado pela questão da localização funcional. No século XX, o foco mudou lentamente para modelos de produção e compreensão da linguagem formulados psicolinguisticamente

During the nineteenth century, linguistics and aphasiology both underwent rapid, but allegedly unrelated developments. In this article, I present a somewhat more differentiated picture of their relationship. In linguistics, interest in aphasiology was almost, but not altogether absent. And despite a general lack of linguistic interest in medical circles, aphasiologists occasionally appealed to linguistic ideas. This appeal was scarce and variable, however. The situation of predominant disconnectedness raises some questions: why was there only a minimal contact between disciplines in a situation of spectacular scientific developments at their intersection? And how can exceptions to this general pattern be explained?A closer look at the intellectual situation in both disciplines will yield some clues to answering these questions. Special attention will be paid to Steinthal’s contribution to aphasiology. His chapter on language disorders has been referred to as the great exception: a unique and promising example of interdisciplinary neurolinguistics-avant-la-lettre. I will argue that this is an overstatement. Steinthal’s text bears witness of linguistic-psychological sophistication, but is not a programmatic plea for a new linguistically-informed approach to aphasiology.

Luria’s interpretation of brain organization for language and aphasia is analyzed. He published two major books and a myriad of papers devoted to this topic. Luria is one of the major founders of contemporary aphasiology, as from the fundamental point of view as from the clinical perspective. His significant influence has continued during the 21st century. Many of Luria’s ideas have been integrated into contemporary aphasiology. His aphasia classification, however, remains partially controversial.

ObjectiveTo explore atrophy–deficit correlations of word comprehension and repetition in temporoparietal cortices encompassing the Wernicke area, based on patients with primary progressive aphasia (PPA).MethodsCortical thickness in regions within and outside the classical Wernicke area, measured by FreeSurfer, was correlated with repetition and single word comprehension scores in 73 right-handed patients at mild to moderate stages of PPA.ResultsAtrophy in the Wernicke area was correlated with repetition (r = 0.42, p = 0.001) but not single word comprehension (r = −0.072, p = 0.553). Correlations with word comprehension were confined to more anterior parts of the temporal lobe, especially its anterior third (r = 0.60, p < 0.001). A single case with postmortem autopsy illustrated preservation of word comprehension but not repetition 6 months prior to death despite nearly 50% loss of cortical volume and severe neurofibrillary degeneration in core components of the Wernicke area.ConclusionsTemporoparietal cortices containing the Wernicke area are critical for language repetition. Contrary to the formulations of classic aphasiology, their role in word and sentence comprehension is ancillary rather than critical. Thus, the Wernicke area is not sufficient to sustain word comprehension if the anterior temporal lobe is damaged. Traditional models of the role of the Wernicke area in comprehension are based almost entirely on patients with cerebrovascular lesions. Such lesions also cause deep white matter destruction and acute network diaschisis, whereas progressive neurodegenerative diseases associated with PPA do not. Conceptualizations of the Wernicke area that appear to conflict, therefore, can be reconciled by considering the hodologic and physiologic differences of the underlying lesions.

Background: There are many validated and widely used assessments within aphasiology. Few, however, describe language and life with aphasia from the perspective of the person with aphasia. Across healthcare, patient experience and user involvement are increasingly acknowledged as fundamental to person-centred care. As part of this movement, Patient Reported Outcome Measures (PROMs) are being used in service evaluation and planning.\ud \ud Aims: This paper reports the quantitative aspects of a mixed methods study that developed and validated a concise PROM, the Aphasia Impact Questionnaire (AIQ), co-produced with People with Aphasia (PWA).\ud \ud Methods & Procedures: The AIQ was developed within the social model of disability and all stages of the development of the AIQ were performed in partnership with PWA. It was adapted from a pre-existing and lengthier PROM for PWA, the Communication Disability Profile. The first iterations of the AIQ focused on domains of communication, participation and well-being/emotional state. Subsequently the AIQ was extended to include additional items relating to reading and writing (AIQ-21). The research design was iterative. Initially, concurrent validity, internal consistency, and sensitivity of the AIQ-prototype were obtained. The AIQ-prototype was modified to become the AIQ-21. Statistical testing with a new group of PWA was performed, investigating internal consistency and concurrent validity of the AIQ-21.\ud \ud Outcomes & Results: Results for both the AIQ-prototype and AIQ-21 showed statistically significant concurrent validity and good internal consistency. Repeated measurement using the AIQ-prototype demonstrated statistically significant change after PWA accessed a community intervention.\ud \ud Conclusions: The AIQ-21 is a PROM that has great potential to be one of the core set of aphasia tests for clinical and research use. Results can be used alongside language assessment to enable person-centred goal setting and partnership working for people with aphasia.

Aphasia is an acquired neurological disorder of communication with a range of language impairments. Aphasia rehabilitation is becoming an important concern in clinical aphasiology. Traditional approaches for rehabilitation are being practiced. In addition to this, computer-based strategies are also employed in aphasiology. In this study, a qualitative phenomenological research approach is used to gain an understanding on how the SLPs of Pakistan perceive the changing trends of clinical practice in aphasia towards technology-based treatment method. This study presents lived experiences and preferences of the SLPs regarding changing trends from the traditional approach to the technology-based method. Ten SLPs participated and were recruited through purposive sampling. The participants were included if they were qualified SLPs and had at least 2 years of experience. The data was collected through audiotapes of detailed group discussions with the participants. The data was analyzed by using thematic analysis. The findings were grouped into five themes: traditional rehab activities, auditory and visual input, cost-effective approach, access and prognosis note. A range of sub-themes were also identified. The findings suggest the SLPs’ preferences are showing limited trends towards adapting the technology-based method.

Almost 70 years ago, Alexander Luria incorporated semantic aphasia among his aphasia classifications by demonstrating that deficits in linking the logical relationships of words in a sentence could co-occur with non-linguistic disorders of calculation, spatial gnosis and praxis deficits. In line with his comprehensive approach to the assessment of language and other cognitive functions, he argued that deficits in understanding semantically reversible sentences and prepositional phrases, for example, were in line with a single neuropsychological factor of impaired spatial analysis and synthesis, since understanding such grammatical relationships would also draw on their spatial relationships. Critically, Luria demonstrated the neural underpinnings of this syndrome with the critical implication of the cortex of the left temporal-parietal-occipital (TPO) junction. In this study, we report neuropsychological and lesion profiles of 10 new cases of semantic aphasia. Modern neuroimaging techniques provide support for the relevance of the left TPO area for semantic aphasia, but also extend Luria's neuroanatomical model by taking into account white matter pathways. Our findings suggest that tracts with parietal connectivity the arcuate fasciculus (long and posterior segments), the inferior fronto-occipital fasciculus, the inferior longitudinal fasciculus, the superior longitudinal fasciculus II and III, and the corpus callosum are implicated in the linguistic and non-linguistic deficits of patients with semantic aphasia. (C) 2016 Elsevier Ltd. All rights reserved.

The global interest in discourse within aphasiology is undisputed. Attention to holistic health frameworks, to the interface between language and communication, to the pursuit of ecological validit...

• Characterization of mixed cases of aphasia, the most commonly attested in clinical practice.

Objective To evaluate the types and severity of subcortical aphasia after stroke and to determine the predictors of the degree of aphasic impairment. Methods Medical records of 38 patients with post-stroke subcortical aphasia (19 males; mean age, 61.7±13.8 years) were reviewed retrospectively with respect to the following tests: the Korean version of the Western Aphasia Battery (K-WAB), the Korean version of the Modified Barthel Index (K-MBI), and the Fugl-Meyer Index (FMI). The severity of aphasia was evaluated by the aphasia quotient (AQ) and the language quotient (LQ). Results Anomic aphasia was the most frequent type of aphasia (n=15, 39.5%), and the lesion most frequently observed in subcortical aphasia was located in the basal ganglia (n=19, 50.0%). Patients with lesions in the basal ganglia exhibited the lowest scores on the FMI for the upper extremities (p=0.04). Severity of aphasia was significantly correlated with the K-MBI (Pearson correlation coefficient: γ=0.45, p=0.01 for AQ and γ=0.53, p=0.01 for LQ) and FMI scores for the lower extremities (γ=0.43, p=0.03 for AQ and γ=0.49, p=0.05 for LQ). In a multivariate logistic regression analysis, K-MBI remained the only explanatory variable closely associated with aphasia severity. Conclusion This study showed the general characteristics of post-stroke subcortical aphasia, and it revealed that K-MBI was an associated and explanatory factor for aphasia severity.

Many stroke survivors with aphasia in the acute period experience spontaneous recovery within the first six months after the stroke. However, approximately 30–40% sustain permanent aphasia and the factors determining incomplete recovery are unclear. Suboptimal recovery may be influenced by disruption of areas seemingly spared by the stroke due to loss of white matter connectivity and network integrity. We reconstructed individual anatomical whole-brain connectomes from 90 left hemisphere stroke survivors using diffusion MR images. We measured the modularity of the residual white matter network organization, the probability of brain regions clustering together, and the degree of fragmentation of left hemisphere networks. Greater post-stroke left hemisphere network fragmentation and higher modularity index were associated with more severe chronic aphasia, controlling for the size of the stroke lesion. Even when the left hemisphere was relatively spared, subjects with disorganized community structure had significantly worse aphasia, particularly when key temporal lobe regions were isolated into segregated modules. These results suggest that white matter integrity and disorganization of neuronal networks could be important determinants of chronic aphasia severity. Connectome white matter organization measured through modularity and other topological features could be used as a personalized variable for clinical staging and aphasia treatment planning.

Comprehension impairments in Wernicke's aphasia are thought to result from a combination of impaired phonological and semantic processes. However, the relationship between these cognitive processes and language comprehension has only been inferred through offline neuropsychological tasks. This study used ERPs to investigate phonological and semantic processing during online single word comprehension. EEG was recorded in a group of Wernicke's aphasia n=8 and control participants n=10 while performing a word-picture verification task. The N400 and Phonological Mapping Negativity/Phonological Mismatch Negativity (PMN) event-related potential components were investigated as an index of semantic and phonological processing, respectively. Individuals with Wernicke's aphasia displayed reduced and inconsistent N400 and PMN effects in comparison to control participants. Reduced N400 effects in the WA group were simulated in the control group by artificially degrading speech perception. Correlation analyses in the Wernicke's aphasia group found that PMN but not N400 amplitude was associated with behavioural word-picture verification performance. The results confirm impairments at both phonological and semantic stages of comprehension in Wernicke's aphasia. However, reduced N400 responses in Wernicke's aphasia are at least partially attributable to earlier phonological processing impairments. The results provide further support for the traditional model of Wernicke's aphasia which claims a causative link between phonological processing and language comprehension impairments.

Aphasia is a serious consequence of stroke but aphasics patients have been routinely excluded from participation in some areas of stroke research.To assess the role of specific linguistic and non-verbal cognitive abilities on the short-term motor recovery of patients with aphasia due to first-ever stroke to the left hemisphere after an intensive rehabilitation treatment.48 post-acute aphasic patients, who underwent physiotherapy and speech language therapy, were enrolled for this retrospective cohort-study. Four types of possible predictive factors were taken into account: clinical variables, functional status, language and non-verbal cognitive abilities. The motor FIM at discharge was used as the main dependent variable.Patients were classified as follows: 6 amnestic, 9 Broca's, 7 Wernicke's, and 26 global aphasics. Motor FIM at admission (p = 0.003) and at discharge (p = 0.042), all linguistic subtests of Aachener AphasieTest (p = 0.001), and non-verbal reasoning abilities (Raven's CPM, p = 0.006) resulted significantly different across different types of aphasia. Post-hoc analyses showed differences only between global aphasia and the other groups. A Multiple Linear Regression shows that admission motor FIM (p = 0.001) and Token test (p = 0.040), adjusted for clinical, language, and non-verbal reasoning variables, resulted as independent predictors of motor FIM scores at discharge, while Raven's CPM resulted close to statistical significance.Motor function at admission resulted as the variable that most affects the motor recovery of post-stroke patients with aphasia after rehabilitation. A linguistic test requiring also non-linguistic abilities, including attention and working memory (i.e. Token test) is an independent predictor as well.

Differential patterns of white matter disruption have recently been reported in the non-fluent (nfvPPA) and semantic (svPPA) variants of primary progressive aphasia (PPA). No single measure is sufficient to distinguish between the PPA variants, but connected speech allows for the quantification of multiple measures. The aim of the present study was to further investigate the white matter correlates associated with connected speech features in PPA. We examined the relationship between white matter metrics and connected speech deficits using an automated analysis of transcriptions of connected speech and diffusion tensor imaging in language-related tracts. Syntactic, lexical, and semantic features were automatically extracted from transcriptions of topic-directed interviews conducted with groups of individuals with nfvPPA or svPPA as well as with a group of healthy controls. A principal component analysis was performed in order to reduce the number of language measures and yielded a five-factor solution. The results indicated that nfvPPA patients differed from healthy controls on a syntactic factor, and svPPA patients differed from controls on two semantic factors. However, the patient groups did not differ on any factor. Moreover, a correlational analysis revealed that the lexical richness factor was significantly correlated with radial diffusivity in the left inferior longitudinal fasciculus, which suggests that semantic deficits in connected speech reflect a disruption of this ventral pathway, and which is largely consistent with the results of previous studies. Using an automated approach for the analysis of connected speech combined with probabilistic tractography, the present findings demonstrate that nfvPPA patients are impaired relative to healthy controls on syntactic measures and have increased radial diffusivity in the left superior longitudinal fasciculus, whereas the svPPA group was impaired on lexico-semantic measures relative to controls and showed increased radial diffusivity in the uncinate and inferior longitudinal fasciculus bilaterally.

The purpose of the paper is to review the literature on the neurocognitive control in bilingual aphasia and extrapolate research findings into clinical guidelines. Neurocognitive control, as well as bilingualism, are multifaceted phenomena whose complex interaction is disrupted by stroke. Bilingualism is an added factor of complexity to aphasia assessment and rehabilitation. Rehabilitation specialists are more aware of the need to understand language and nonverbal cognitive abilities, for a better treatment outcome (Ansaldo, Saidi, Ruiz, 2010; Green, 2005; Helm-Estabrooks, 2002). Consequently, assessment and management of neurocognitive skills in bilingual aphasia are gradually gaining momentum. Applying principles from language-cognitive control interactions to the rehabilitation of bilingual populations with aphasia appears to be a valuable intervention strategy for this population.

Background/Aims: Verbal fluency is impaired in patients with frontotemporal dementia (FTD) and primary progressive aphasia (PPA). This study explored qualitative differences in verbal fluency (clustering of words, switching between strategies) between FTD and PPA variants. Methods: Twenty-nine patients with behavioral variant FTD (bvFTD) and 50 with PPA (13 nonfluent/agrammatic, 14 semantic, and 23 logopenic) performed a semantic and letter fluency task. Clustering (number of multiword strings) and switching (number of transitions between clustered and nonclustered words) were recorded by two independent raters. Between-group differences, associations with memory, language, and executive functioning, and longitudinal change (subsample) in clustering and switching were examined. Results: Interrater reliability was high (median 0.98). PPA patients generated (a) smaller (number of) clusters on semantic and letter fluency than bvFTD patients (p < 0.05). Semantic variant patients used more switches than nonfluent/agrammatic or logopenic variant patients (p < 0.05). Clustering in semantic fluency was significantly associated with memory and language (range standardized regression coefficients 0.24-0.38). Switching in letter fluency was associated with executive functioning (0.32-0.35). Conclusion: Clustering and switching in verbal fluency differed between patients with subtypes of FTD and PPA. Qualitative aspects of verbal fluency provide additional information on verbal ability and executive control which can be used for clinically diagnostic purposes.