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Background: Acquired brain injury (ABI), especially to the right hemisphere, can result in difficulty using or understanding prosodic contours in speech. Prosody is used to convey emotional connotation or linguistic intent and includes pitch, loudness, rate, and voice quality. A disorder in the comprehension or production of prosody is known as aprosodia; despite the communication disability caused by prosodic disorders, the assessment and treatment of aprosodia following ABI has received scant attention. Aims: The aim of this scoping review is to gather and synthesise useful knowledge on aprosodia and provide therapists with an exhaustive document in order to guide clinical decision-making encouraging active identification and treatment of this disorder. Methods & Procedures: This scoping review, conducted in accordance with PRISMA-ScR guidelines, investigated the existing literature concerning the assessment and treatments of linguistic and affective aprosodia in adult patients after ABI. A systematic search in four electronic databases (PubMed, CINAHL, Web of Science, ScienceDirect) was conducted for articles written in English, French, or Italian published between 1970 and 2020. After all evaluative criteria were applied, 15 articles were included for final review. Outcomes & Results: Results show the presence of six assessment tools for affective aprosodia and five evaluation tools targeting affective and linguistic prosody. Assessment of aprosodia is generally accomplished through acoustic and perceptual approaches. Current treatments for prosodic disorders focus on expressive aprosodia and have applied mostly two different approaches: imitative and cognitive-linguistic methods. Conclusion & Implications: Findings suggest that aprosodia can be assessed by therapists through various techniques and may be amenable to behavioural treatments. Nevertheless, although there are several assessment tools available, no one currently offers a comprehensive assessment that incorporates an ecological dimension. It therefore seems necessary to continue research in this direction. The rehabilitation of receptive prosody abilities also remains to be explored.

Purpose: Repetitive transcranial magnetic stimulation (rTMS) can enhance aphasia recovery. Most studies have used inhibitory stimulation targeting the right inferior frontal gyrus. However, the motor cortex, observed to contribute to the prediction of aphasia recovery, is involved in word production and could be an appropriate target for rTMS. We aimed to observe behavioral changes in a picture naming task induced by inhibitory rTMS targeting the right motor cortex of the lips in people with poststroke aphasia. Method: Using a single-case experimental design, we included three participants with chronic poststroke aphasia who had phonological deficits. Each participant performed a verbal picture naming task 3 times a week for 2, 3, or 4 weeks (pseudorandom across participants) to establish a baseline naming ability for each participant. These were not therapy sessions, and no feedback was provided. Then, each participant received the intervention, inhibitory continuous theta burst stimulation targeting the right motor cortex of the lips, 3 times a week for 2 weeks. Naming testing continued 3 times a week, for these latter 2 weeks. No therapy was performed at any time during the study. Results: Visual analysis of the graphs showed a positive effect of rTMS for P2 and P3 on picture naming accuracy and a tendency toward improvement for P1. Statistical analysis showed an improvement after rTMS for P1 (τ = 0.544, p = .013, SETau = 0.288) and P2 (τ = 0.708, p = .001, SETau = 0.235). For P3, even if the intervention allowed some improvement, this was statistically nonsignificant due to a learning effect during the baseline naming testing, which lasted the longest, 4 weeks. Regarding specific language features, phonological errors significantly decreased in all patients. Conclusions: The motor cortex of the lips could be an appropriate target for rTMS to improve naming in people with poststroke aphasia suffering from a phonological deficit. This suggests the possibility to individualize the target for rTMS, according to the patient's linguistic impairment. [ABSTRACT FROM AUTHOR]

Background: Despite its potentially significant functional and emotional impact, acalculia is still too rarely assessed and managed by speech and language therapists. Research on the rehabilitation of numerical transcoding remains scarce in the literature and, despite positive results, presents a low level of evidence. Aims: The present study aims to evaluate the effectiveness of a targeted rehabilitation of numerical transcoding in two patients suffering from a chronic secondary acalculia. Methods & Procedures: Two post‐brain injury females with secondary acalculia took part in a single‐case experimental design with multiple baseline across subjects according to a three‐phase experimental protocol: baseline involving global cognitive rehabilitation (5–7 measurements with randomized sequential introduction); targeted intervention (10 measurements); follow‐up (2 immediate measurements and 1 month after the end of the intervention). Repeated outcome measures consisted of six lists composed of numbers of equivalent difficulty that were used alternately to assess numerical transcoding. We used a reverse digit span as a control measure to assess the specificity of the intervention. Rehabilitation lasted 5 weeks and consisted of errorless learning with colour cues, tables and number–words cards. Outcomes & Results: During baseline period involving global cognitive rehabilitation, transcoding scores remained unchanged. In contrast, there was a significant improvement in scores for both patients during the intervention phase targeting transcoding and maintenance of benefits 1‐month post‐intervention. Conclusions & Implications: This study demonstrates that a specific rehabilitation targeting numerical transcoding following chronic secondary acalculia can be effective in improving transcoding skills. WHAT THIS PAPER ADDS: What is already known on the subject: Transcoding difficulties in patients with acalculia can cause a significant disability in everyday life activities. In secondary acalculia, rehabilitation of cognitive functions associated with number processing (attention, working memory, language) is not sufficient for improvement of transcoding. What this paper adds to existing knowledge: An intervention specifically targeting numerical transcoding significantly and durably improves the skills of patients with chronic secondary acalculia. What are the potential or actual clinical implications of this work?: Procedural error‐free intervention using colour cueing, tables, cards with number–words, copy and repetition seems effective to improve transcoding skills in chronic acalculia. [ABSTRACT FROM AUTHOR]

Background: Acquired brain injury (ABI), especially to the right hemisphere, can result in difficulty using or understanding prosodic contours in speech. Prosody is used to convey emotional connotation or linguistic intent and includes pitch, loudness, rate, and voice quality. A disorder in the comprehension or production of prosody is known as aprosodia; despite the communication disability caused by prosodic disorders, the assessment and treatment of aprosodia following ABI has received scant attention. Aims: The aim of this scoping review is to gather and synthesise useful knowledge on aprosodia and provide therapists with an exhaustive document in order to guide clinical decision‐making encouraging active identification and treatment of this disorder. Methods & Procedures: This scoping review, conducted in accordance with PRISMA‐ScR guidelines, investigated the existing literature concerning the assessment and treatments of linguistic and affective aprosodia in adult patients after ABI. A systematic search in four electronic databases (PubMed, CINAHL, Web of Science, ScienceDirect) was conducted for articles written in English, French, or Italian published between 1970 and 2020. After all evaluative criteria were applied, 15 articles were included for final review. Outcomes & Results: Results show the presence of six assessment tools for affective aprosodia and five evaluation tools targeting affective and linguistic prosody. Assessment of aprosodia is generally accomplished through acoustic and perceptual approaches. Current treatments for prosodic disorders focus on expressive aprosodia and have applied mostly two different approaches: imitative and cognitive–linguistic methods. Conclusion & Implications: Findings suggest that aprosodia can be assessed by therapists through various techniques and may be amenable to behavioural treatments. Nevertheless, although there are several assessment tools available, no one currently offers a comprehensive assessment that incorporates an ecological dimension. It therefore seems necessary to continue research in this direction. The rehabilitation of receptive prosody abilities also remains to be explored. What this paper adds: What is already known on the subject: Prosody has a fundamental role in communication and conveys speakers' intentions and emotions. Therefore, a deficit of prosody (aprosodia) after acquired brain injury can reduce social participation and engagement. Assessment tools and rehabilitation treatments are necessary in order to improve this disorder and patients' quality of life. What this paper adds to existing knowledge: The evaluation tools currently available focuses mostly on affective aprosodia, whereas the linguistic prosody is less assessed. There exist two treatments for expressive aprosodia: motoric–imitative and cognitive–linguistic treatments; however, their efficacy is tested on small groups of patients. No treatments targeting receptive aprosodia were found. What are the potential or actual clinical implications of this work?: We need more sensitive and reliable tools and systematic evaluations of all the components of prosody (affective and linguistic, receptive and expressive prosody). We need researches who analyse bigger samples of patients after right hemisphere brain injury and we identified the need of more well‐designed studies and better understanding of the pathophysiology of aprosodia. [ABSTRACT FROM AUTHOR]

Background: Recovery from aphasia impacts the quality of life in stroke patients but remains difficult to predict. Some neuroanatomical factors combined with anagraphical factors contribute to the prediction of longitudinal outcomes, but still fail to predict changes in severity of symptoms. Among the language features predicting recovery from aphasia, production scores such as repetition or phonology seem to be more relevant predictors than only severity. As motor cortex is strongly involved in language processes, both production and perception, the present study builds on the hypothesis that assessment of the anatomo-functional motor pathways could improve predictive models on top of factors based on neuroanatomy. Aim: In this prospective longitudinal study, we aimed to determine whether the integration of an electrophysiological measure of the motor network using Motor Evoked Potentials (MEPs) with an anatomical approach—diffusion-weighted MRI— in the acute phase of stroke can improve the prediction of recovery from post-stroke aphasia. Methods and Procedures: Fifteen aphasic patients were included in the post-stroke acute phase. Electrophysiological assessment exploring resting motor threshold ratio (rMTr) of the two upper-limbs and neuroanatomy exploration using MRI and diffusion tensor imaging were performed in the acute phase. Language impairment was assessed at the same stage and six months after the stroke. Multivariate regression analyses were carried out on aphasia severity score at M6, on recovery rates (change of severity) and on speech and language features as the dependent variables. Outcomes and Results: A first-level model, including only clinical variables (i.e., the initial severity) predicted severity at six months. When the rMTr of upper limbs was added in a second-level model, the predictive power significantly increased from 51% to 79%, as well as adding in a third-level model rMTr of upper limbs and the initial fibers number ratio (iFNr) of the corticospinal tracts (51% to 80%). With the changes in severity as the dependent variable, the same factors made a significant contribution and the predictive power of a second-level model increased from 23% to 50% to the same extent as in a third-level model (23% to 51%). A similar improvement when adding MEPs was noted for the prediction of articulatory agility and naming skills. Conclusions: Our results suggest that MEPs of upper limbs measured within 15days post-stroke are strong determinants of the prediction of longitudinal severity of post-stroke aphasia as well as of changes in symptoms and that the combination of electrophysiological and anatomical biomarkers improve this prediction. [ABSTRACT FROM AUTHOR]