Background and Purpose-Several recent studies have revealed modulation of the left frontal lobe speech areas not only during speech production but also for speech perception. Crucially, the frontal lobe areas highlighted in these studies are the same ones that are involved in nonfluent aphasia. Based on these findings, this study examined the utility of targeting visual speech perception to improve speech production in nonfluent aphasia. Methods-Ten patients with chronic nonfluent aphasia underwent computerized language treatment utilizing picture-word matching. To examine the effect of visual speech perception on picture naming, 2 treatment phases were comparedone that included matching pictures to heard words and another in which pictures were matched to heard words accompanied by a video of the speaker's mouth presented on the computer screen. Results-The results revealed significantly improved picture naming of both trained and untrained items after treatment when it included a visual speech component (ie, seeing the speaker's mouth). In contrast, the treatment phase in which pictures were only matched to heard words did not result in statistically significant improvement of picture naming. Conclusions-The findings suggest that focusing on visual speech perception can significantly improve speech production in nonfluent aphasia and may provide an alternative approach to treat a disorder in which speech production seldom improves much in the chronic phase of stroke.

The MCA was appropriate to be used among native speakers of English. The results also provided further empirical evidence of discourse deficits in aphasia and dementia. Practitioners can use the MCA to evaluate discourse production systemically and objectively.

A new case of Foreign Accent Syndrome is described. This American woman presented with a British- or Australian- sounding accent after stroke, which resulted in a lacunar infarct in the left internal capsule. The atypical etiology and apparent changes in lexical use are described. It is hypothesized that an abnormally tense vocal tract posture may account for phonetic changes in vowel quality and a higher average fundamental frequency.

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