Clinical Aspects of Dysphasia

Albert, Martin L.; Goodglass, Harold; Helm, Nancy A.; Rubens, Alan B.; Alexander, Michael P.

doi:10.1007/978-3-7091-8605-3

Cited by 155 publications

(55 citation statements)

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“…Five SA patients completed the ISR tasks. These five all fit the diagnostic criteria of transcortical sensory aphasia (TSA), characterised by good repetition, fluent speech and poor comprehension (Albert, Goodglass, Helms, Rubens, & Alexander, 1981;Berthier, 2000). Therefore, they could complete list repetition tasks without deficits of phonology or speech output dominating their results.…”

Section: Background Neuropsychologymentioning

confidence: 90%

Selective short-term memory deficits arise from impaired domain-general semantic control mechanisms.

Hoffman¹,

Jefferies²,

Ehsan³

et al. 2009

Journal of Experimental Psychology: Learning, Memory, and Cogni

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Semantic short-term memory (STM) patients have a reduced ability to retain semantic information over brief delays but perform well on other semantic tasks; this pattern suggests damage to a dedicated buffer for semantic information. Alternatively, these difficulties may arise from mild disruption to domaingeneral semantic processes that have their greatest impact on demanding STM tasks. In this study, mild semantic processing impairments were demonstrated in 2 semantic STM patients. They performed well on untimed semantic tasks but were deficient in accuracy and reaction times on speeded tasks. Demanding semantic production tasks were also affected. These patients were compared with a case series of individuals with semantic aphasia whose multimodal semantic difficulties stemmed from poor cognitive control. STM and semantic performance were more impaired in this group, but there were qualitative similarities to the semantic STM patients. The difference between the 2 patient types may be a matter of degree. In semantic aphasia, severe disruption to semantic control leads to global semantic impairments, whereas in semantic STM milder disruption might impact mainly on STM tests because of the high control demands of these tasks.

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Section: Background Neuropsychologymentioning

confidence: 90%

Selective short-term memory deficits arise from impaired domain-general semantic control mechanisms.

Hoffman¹,

Jefferies²,

Ehsan³

et al. 2009

Journal of Experimental Psychology: Learning, Memory, and Cogni

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show abstract

“…patients with Wernicke's aphasia) because the TSA patients had a language profile similar to that seen in SD: i.e. poor comprehension of both verbal and non-verbal stimuli in the context of fluent speech and good repetition (Albert, Goodglass, Helms, Rubens, & Alexander, 1981;Berthier, 2000). This made it possible to test the two patient groups on exactly the same lists for the first time, circumventing the difficulties in interpretation mentioned above.…”

Section: Introductionmentioning

confidence: 99%

The impact of semantic impairment on verbal short-term memory in stroke aphasia and semantic dementia: A comparative study

Jefferies

Hoffman

Jones

et al. 2008

Journal of Memory and Language

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This study presents the first direct comparison of immediate serial recall in semantic dementia (SD) and transcortical sensory aphasia (TSA). Previous studies of the effect of semantic impairment on verbal short-term memory (STM) have led to important theoretical advances. However, different conclusions have been drawn from these two groups. This research aimed to explain these inconsistencies. We observed (a) qualitative differences between SD and TSA in the nature of the verbal STM impairment and (b) considerable variation within the TSA group. The SD and TSA patients all had poor semantic processing and good phonology. Reflecting this, both groups remained sensitive to phonological similarity and showed a reduced effect of lexicality in immediate serial recall. The SD patients showed normal serial position effects; in contrast, the TSA patients had poor recall of the initial list items and exhibited large recency effects on longer lists. The error patterns of the two groups differed: the SD patients made numerous phoneme migration errors whereas the TSA group were more likely to produce entire words in the wrong order, often initiating recall with terminal list items. The SD cases also showed somewhat larger effects of word frequency and imageability. We propose that these contrasting performance patterns are explicable in terms of the nature of the underlying semantic impairment. SD is associated with anterior lobe atrophy and produces degradation of semantic knowledge -this is more striking for less frequent/imageable items, accentuating the effects of these lexical/semantic variables in STM. SD patients frequently recombine the phonemes of different list items due to the reduced semantic constraint upon phonology (semantic binding: Patterson et al., 1994). In contrast, the semantic impairment in TSA follows frontal or temporoparietal lesions and is associated with poor executive control of semantic processing (deregulated semantic cognition: Jefferies and Lambon , explaining why these patients are liable to recall entire words out of serial order.

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“…As the treating attending physician (AMB) felt that syndromic subtyping of speech and language disorders was necessary to plan theoretically-based treatment, resident physicians were trained to perform a bedside assessment of spontaneous speech, naming, comprehension, repetition, reading and writing on every patient based upon Albert et al (1981) and the Florida Mental Status Examination (Doty et al, 1990), repeated and confirmed in its essential parts by the attending physician. It should be noted that when the combination of nonfluent speech, relatively spared repetition and comprehension were noted on assessment, we did not rigorous distinguish whether nonfluent speech was primarily a result of language abnormality, or it was related to a primary attentional disturbance or abnormal conative function.…”

Section: Subjectsmentioning

confidence: 99%

Amantadine for Adynamic Speech

Barrett

Eslinger

2007

American Journal of Physical Medicine &Amp; Rehabilitation

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OBJECTIVE-Dopaminergic agents may stimulate behavior and verbal expression after frontal lobe dysfunction. Although amantadine is used in neurorehabilitation of motivational disorders and head injury, it is not commonly prescribed to improve aphasia. This pilot study examined verbal fluency on and off amantadine for nonfluent speech.DESIGN-Four participants undergoing inpatient rehabilitation, meeting criteria for transcortical motor aphasia had stroke (2), stroke post-aneurysm surgery (1), or brain tumor resection (1). We administered amantadine 100 mg bid in an open-label, on-off protocol with multiple assessments per on-off period.RESULTS-Off medication, subjects generated a mean 12.62 words (abnormally few) on the Controlled Oral Word Association test. On medication, word generation significantly improved to 17.71 words (p = 0.04), although scores remained psychometrically in the abnormal range.CONCLUSIONS-Further research on amantadine specifically for nonfluent speech and nonfluent aphasia, including effect on functional communication and control conditions, may be warranted. Keywordsamantadine; aphasia; rehabilitation Hypothesis-driven physiological treatment of cognitive disorders, based upon cognitive neuropsychological models, could be considered true translational rehabilitation. Physiological treatment might be defined as somatic interventions to induce bodily changes directly, as contrasted with behavioral treatment consisting of controlling learning experiences in order to induce neurophysiological change indirectly. Unfortunately, a process of scientific translational method is still developing for physiological rehabilitation in the acquired speech and language disorder, aphasia.Nonfluent aphasia occurs with post-stroke brain injury when subjects have 1) abnormal spontaneous speech and communication ability, with a conversation partner making the major portion of the effort supporting verbal communication and 2) nonfluent speech (fewer than 50 words per minute generated in response to an open-ended question such as "How did you come to the hospital?"). Even when subjects have relatively spared comprehension ability, the disability associated with nonfluent aphasia is considerable. Self-initiated verbal messages are a part of almost all daily life settings, and an impairment of spontaneous speech in nonfluent aphasia can significantly limit independence and psychosocial function (Herrmann and Correspondence and reprint requests to:

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Clinical Aspects of Dysphasia

Cited by 155 publications

References 0 publications

Selective short-term memory deficits arise from impaired domain-general semantic control mechanisms.

Selective short-term memory deficits arise from impaired domain-general semantic control mechanisms.

The impact of semantic impairment on verbal short-term memory in stroke aphasia and semantic dementia: A comparative study

Amantadine for Adynamic Speech

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