University of Pittsburgh

The Aphasiology Archive
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    1666 research outputs found

    The Effect of Contextual Bias on the Production of Negative Emotion Words in Patients with Right Hemisphere Brain Damage

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    Previous research has shown that damage to the right cerebral hemisphere (RHD) often manifests as higher-level cognitive-linguistic problems in domains such as emotion processing1,2,3,6,10,14. However, these studies employ metalinguistic tasks that obscure the nature of processing strengths and weaknesses because of the relatively high cognitive processing demand. Individuals with RHD often do not appear to have substantial deficits, and in fact facilitative effects have been observed8,16,17,20, when they are assessed in a manner that reduces this demand, via methods such as priming or contextual bias. The current study investigated the effect of contextual bias on the production of emotions conveyed via video input in individuals with RHD. Prior work reported adults with RHD deficient in producing negative emotion words in narrated descriptions of a video stimulus6. By inducing a negatively-toned bias prior to the video description task, we expected that negative affect words would increase in RHD subjects’ descriptions, as compared to their descriptions when no bias was induced. We also expected non-brain-damaged (NBD) control participants to use more negative affect words than participants with RHD in a No-Bias Condition, with this between-group difference decreasing in the Bias Condition. No differences were expected between conditions on a control measure, the use of motion words

    Investigating the role of intensity in a comprehensive, aphasia therapy program: A non-intensive trial of Aphasia LIFT

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    Intensive, comprehensive aphasia programs (ICAPs) are an emerging service delivery in aphasia rehabilitation (Rose, Cherney, & Worrall, 2013). Positive therapeutic outcomes for the ICAP Aphasia LIFT (Language Impairment and Functioning Therapy) have been demonstrated across World Health Organisation International Classification of Functioning and Disability (ICF) domains (Rodriguez et al., 2013). Within aphasia rehabilitation, there is evidence favouring intensive treatment models (Cherney, Patterson, & Raymer, 2011; Robey, 1998); however, the optimal treatment intensity for even one type of aphasia therapy is yet to be established (Cherney, 2012). Evidence from the neurosciences literature, based predominantly on animal studies of stroke rehabilitation, suggests that optimal learning outcomes are achieved when training is provided intensively (i.e., many hours per day) (Kleim & Jones, 2008). In contrast, studies of learning in healthy humans suggest that optimal long-term learning is achieved when training is distributed over time (Cepeda, Pashler, Vul, Wixted, & Rohrer, 2006). This study evaluated the therapeutic effect of non-intensive Aphasia LIFT (NiLIFT) on impairment and functional communication outcomes in adults with chronic aphasia

    Difficulty linking macro- and microlinguistic processes for narrative production following TBI

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    Substantial evidence has accumulated over the past 35 years suggesting deficient intersentential cohesion in the narrative discourse of many individuals with traumatic brain injury (TBI). Since Mentis and Prutting (1987) reported significantly fewer cohesive ties in the narratives of brain-injured versus normal speakers, a number of reports have replicated and expanded upon these findings (e.g., Coelho, Liles, & Duffy, 1995; Davis & Coelho, 2004; Hartley & Jensen, 1991; Liles, Coelho, Duffy, & Zalagans, 1989; Marini et al., 2011). At the same time, several studies have not found evidence of deficient intersentential cohesion in these adults (Coelho, 2002; Glosser & Deser, 1991; Hough & Barrow, 2003). It can be said then that the narratives produced by at least some speakers with TBI tend to show less adequate intersentential cohesion than that observed in normal speakers (Cannizzaro & Coelho, 2012; Coelho, 2007). Variable microlinguistic impairment has also been observed in narrative discourse following TBI. Sentences produced by speakers with TBI have been reported to include more lexical and syntactic errors, increased mazes, more frequent pausing, and greater reductions in content when compared to normal speakers (Ellis & Peach, 2009; Glosser & Deser, 1991; Hartley & Jensen, 1991; Peach, 2013; Peach & Schaude, 1986; Stout, Yorkston, & Pimenthal, 2000). Such narratives also tend to be less efficient (i.e., lengthier and containing more words per maze) (Erlich, 1988; Hartley & Jensen, 1991; Stout et al., 2000) and less complex (Coelho, Grela, Corso, Gamble, & Feinn, 2005; Peach, Shapiro, Rubin, & Schaude, 1990) than those produced by normal speakers. Nonetheless, other studies have not found few, if any, such microlinguistic disturbances in speakers with TBI (Hough & Barrow, 2003; Marini et al., 2011). It has been suggested that brain injury produces a dissociation between the macrolinguistic and microlinguistic components of narrative production (Glosser & Deser, 1991; Hough & Barrow, 2003) and thus, that the processing of discourse and the processing of sentences are based on different cognitive devices (Consentino, Adornetti, & Ferretti, 2013). Alternatively, it might be that the macrolinguistic structure of narratives produced by brain injured speakers is affected by their microlinguistic impairments (see, e.g., Boyle, 2011; Christiansen, 1995). Given the variable patterns that have been observed in the narratives of speakers with TBI, it may be that narrative production following TBI is the result of an effortful interaction between macrolinguistic and microlinguistic processes rather than dissociation of separate cognitive mechanisms. However, few studies exist that attempt to establish the connections between these different levels of language. As a result, there is little information available to describe how specific changes at either level may influence the processing of narrative discourse. Armstrong (2000) has suggested that cohesion analysis is one of the few methods which directly attempts to link the macro- and microlinguistic aspects of discourse. This study therefore investigated the relationship between intersentential cohesion and microlinguistic impairments in discourse produced by speakers with severe traumatic brain injury (TBI)

    In Pursuit of Communication without Broca's or Wernicke's area

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    This case study presents a treatment approach with innovative software for an individual with apraxia of speech and global aphasia from a severe anoxic injury. This paper proposes that aspects of the ability to communicate are available even when core capacities of the language system are dysfunctional (Willems, Benn, Hagoort, Toni, & Varley, 2011). Most of the literature reports that prognosis is bleak for individuals diagnosed as globally aphasic and remain so at one month post. The expected course of recovery is improved comprehension but little functional speech (Sarno, Silverman & Sands, 1970). As such, this treatment was designed to use non-lexical routes toward communication and thereby achieve a better outcome

    Using neuroimaging to classify aphasia

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    The proper classification of aphasia based on clinical symptoms has been debated for well over a century. Much of the early debates centered on relating localized brain damage to a constellation of speech and language impairments. The premise behind much of this work was based on the notion that lesion-symptom mapping could reveal how language was organized in the brain (Broca, 1861, 1865; Dejarine, 1906; Marie, 1906). Although the principle for classifying aphasia based on specific symptoms has been fervently challenged (e.g. Head, 1926) it is still customary to report aphasia types in clinical studies of aphasia. Similar symptoms in sub-groups of patients suggests a similar pattern of brain damage. Nevertheless, it remains unclear if specific aphasia types can be diagnosed simply based on the location of cortical damage. One way to examine this issue would be to relate lesion patterns to aphasia types using multivariate pattern analysis (MVPA). MVPA of neuroimaging data has been successfully used to diagnose diseases such as dementia, schizophrenia, and Parkinson's disease (Orru et al., 2012). In the present study, we demonstrate how MVPA can be used to predict aphasia type in persons with chronic stroke. Unlike previous studies that perform the analysis on voxels (using MRI scans), we trained a classifier on the proportional damage to brain areas (defined with a brain atlas). In addition, we computed the loadings that reflect the contribution of each brain area to classification

    EVAL: A computerized language analysis program for clinicians

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    Clinicians generally have limited time to evaluate their aphasic clients, and thus are often unable to include discourse-level language in their assessments. Sampling and analyzing language at the discourse level by hand can be very time-consuming, but since it is the level at which day-to-day communication occurs, it provides important information about language use and competence in context. It can also point the way to functional goals for therapy. In this presentation we will illustrate the use of EVAL, a recent addition to the wide array of CLAN computerized language analysis programs freely available from TalkBank (MacWhinney, 2000). EVAL is designed for quick and simple use by clinicians. It measures 25 language characteristics in a transcription of discourse and displays them in an Excel spreadsheet. It can then compare the results with those of a comparison group selected from the AphasiaBank database, or it can compare the results with those of the same participant at earlier or later measurement times (e.g., pre- and post-therapy). It is based on a simplified system of transcription and error coding, designed with the time constraints of busy clinicians in mind. While transcription is done in the CHAT format required for CLAN programs, it can be less detailed

    Effects of increased memory load on short-term facilitation of repetition in persons with aphasia

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    The ability to repeat a word involves activation of phonological and semantic representations of words that must be maintained until the utterance is produced. In aphasia, the language and verbal STM impairment frequently co-occur and studies indicate that the severity of these impairments are highly correlated (Martin & Ayala, 2004). One account of this co-occurrence is that the word processing impairment in aphasia is due to an inability to maintain activation of semantic and phonological representations of words over the time course of comprehending, repeating, or producing a word. When severe, this impairment affects single and multiple word processing as well as verbal STM capacity, as measured by verbal span. When milder, the impairment affects multiple word processing and verbal STM capacity. This intimate relationship of lexical access/retrieval and the ability to maintain activation of a word’s representations suggests a need to consider the role of verbal memory load on language performance. For example, it has been shown recently that performance on semantic judgment tasks is significantly reduced when memory load on the task is increased (Martin, Kohen, Kalinyak-Fliszar, Soveri & Laine, 2012). This study also identified two factors contributing to this effect, semantic STM capacity and an executive function, inhibition (performance on the Simon Task). Additionally, it has been shown that performance on phonological and lexical-semantic tasks is compromised by imposing an interval between stimulus and response (Martin, Kohen & Kalinayk-Fliszar, 2010; Martin, 2012). Evidence that increased memory load impairs language performance has prompted some researchers to target the ability to tolerate increased memory load in language tasks as a means of improving language function as well as increasing verbal STM capacity. For example, Majerus, Van der Kaa, Renard, Van der Linden, & Poncelet (2005) treated a phonological STM deficit using delayed repetition of word pairs. There were improvements in digit and nonword span, nonword repetition, rhyme judgments, and by the client’s self-report, comprehension in conversational contexts. Fridriksson, Holland, Beeson, & Morrow (2005) treated three cases of anomia using spaced-retrieval treatment, which varied interval time between presentations of a picture to be named (more time when named correctly and less time when named incorrectly). Compared to a cueing hierarchy treatment, the spaced retrieval approach showed more lasting improvements in follow-up testing. Kalinyak-Fliszar, Kohen & Martin (2011) used nonword and multisyllabic word repetition tasks combined with a delayed response (5 seconds) to improve phonological abilities of a person with conduction aphasia. Improvements were noted in repetition of treated stimuli and other language and verbal STM measures: rhyming and synonymy judgments, word pair repetition and seven verbal span tasks (of eleven administered). These studies indicate that incorporation of variations in verbal memory load into language treatments can improve language function. However, it has not been demonstrated that the addition of STM load provides any greater benefit over and above the language treatment task. In this study, we use a short-term repetition facilitation paradigm to determine if increased memory load added to a repetition task improves performance more than repetition alone

    What can speech production errors tell us about cross-linguistic processing in bilingual aphasia? Evidence from 4 English/Afrikaans speaking individuals with aphasia.

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    In an effort to inform clinical practice and our understanding of bilingual aphasia, we examined differential performance in lexical retrieval abilities between first (L1) and second acquired language (L2), types of errors produced, and if performance was influenced by degree of cognate overlap in 4 bilingual aphasic individuals. Methods: A case series analysis of four Afrikaans/English bilingual aphasic individuals whose confrontation naming data were subjected to broad phonetic transcription was employed. Research questions were directed toward between language differences in lexical retrieval abilities, the influence of performance by degree of cognate overlap and types of errors produced. Results: Three participants showed significantly higher whole word confrontation naming accuracy in L1 relative to L2. One participant showed no difference. Performance for everyone was the poorest for low cognate overlap words. The largest proportion of error type for 3 participants in both L1 and L2 was omission. Discussion: These findings show that while all participants had aphasia, their relative naming impairments were consistent with their relative proficiency and use patterns prior to their stroke. The participant without between language differences was equally proficient in both languages and the remaining 3 participants showed an advantage consistent with the language used most frequently


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