Exploratory Study on Hearing, Cognition, and Memory in Aging

Previous studies have shown a connection between hearing status, memory, and cognitive decline in older adults. The current exploratory study investigates the effects of unaided hearing loss on cognition and recall for auditory versus written expository text passages in normal hearing young adults, normal hearing older adults, and older adults with hearing loss. Although all participants performed better on the recall of auditory information regardless of group, hearing loss was associated with several cognitive measures. Findings indicate a need for continued collaborative research into sensory deficits and their effects on cognition and memory, in order to inform clinical practice

Working Memory Treatment for an Individual with Chronic Aphasia: A Case Study

Working memory (WM) is defined as a storage system limited in its capacity and involved in maintaining and manipulating information over short periods of time (Baddeley, 2003). In WM tasks, individuals are required to simultaneously store certain items in memory while updating the contents of their WM. It has been proposed that WM interacts with language abilities and deficits in WM influence language performance (Baddeley, 2003; Carpenter, & Just, 1989; Murray, 2012). Importantly, individuals with aphasia often show WM and short-term memory (STM) deficits, which may negatively affect language symptoms and recovery, and accordingly WM treatment may represent an efficient approach to addressing these individuals’ cognitive and linguistic impairments (Kalinyak-Fliszar, Kohen, & Martin, 2011; Murray, 2012; Martin et al., 2012). WM treatment for individuals with aphasia, however, has not yet been intensively studied (Murray, 2012). Previous results indicate that WM in individuals with aphasia can be improved with training (e.g., Kalinyak-Fliszar et al., 2011; Mayer & Murray, 2002; Vallat et al., 2005). Nonetheless, variable amounts of generalization to language abilities and types of untrained cognitive and linguistic functions responding to the WM treatment have been reported. Accordingly, to examine further the potential of WM training to remediate the cognitive-linguistic symptoms of individuals with aphasia, we administered a treatment with tasks designed not only to target WM skills but also semantic processing, the linguistic ability most compromised in our aphasic participant. The research questions were: a) Would our participant with chronic aphasia demonstrate improved WM through treatment? b) Would our participant demonstrate improved language performance given WM tasks that involved verbal stimuli

Cortical Stimulation and Language Outcomes in Aphasia

With the increased focus on evidenced-based outcomes in Speech-Language Pathology, a trend towards inclusion of instrumentation and technology in the treatment of aphasia has emerged. One technique at the forefront of this movement is the use of cortical stimulation as an adjunct to behavioral interventions. The purposes of this brief analysis are to review articles published over the course of six years (2006-2011) that combine stimulation with language treatment and to report trends that emerge

Word-finding pauses in primary progressive aphasia (PPA): Effects of lexical category

Word-finding pauses are common in logopenic primary progressive aphasia (PPA-L). However, no previous research investigated the distribution of word-finding pauses in PPA or their specificity to PPA-L. We coded pauses preceding nouns and verbs in narrative speech samples from participants with PPA-L, agrammatic (PPA-G) and semantic PPA (PPA-S), and controls, hypothesizing that frequent word-finding pauses, if present, should match previously-observed lexical category deficits (noun deficits in PPA-L and PPA-S; verb deficits in PPA-G).The PPA-L group paused more frequently before nouns than verbs, whereas no other group exhibited lexical category effects, suggesting that frequent word-finding pauses are specific to PPA-L

Phonological processing in primary progressive aphasia

Primary progressive aphasia (PPA) is a debilitating condition wherein speech and language deteriorate as a result of neurodegenerative disease. Three variants of PPA are now recognized, each of which shows a unique constellation of speech-language deficits and pattern of underlying atrophy in the brain (Gorno-Tempini et al., 2011). The variants include a nonfluent/agrammatic type (nfvPPA), characterized by syntactic and motor speech deficits and fronto-insular atrophy in the left hemisphere. The semantic variant (svPPA) shows degradation of semantic knowledge in the context of anterior and inferior temporal lobe atrophy (left hemisphere greater than right). Finally, the more recently characterized logopenic variant (lvPPA) shows impairments in naming and repetition that are thought to be phonological in nature. This variant, associated with atrophy of temporoparietal regions in the left hemisphere, has also been referred to as the “phonological” variant of PPA due to observed deficits on tasks that require phonological storage (i.e., the “phonological loop”) and to the presence of phonological paraphasias in connected speech (Gorno-Tempini et al., 2008). Impaired phonological processing has been considered a unique feature of the logopenic variant of PPA, however, phonological skills have not been thoroughly characterized across the three variants. Recent models of the functional neuroanatomy of language propose two pathways by which speech is processed in the brain (Hickok & Poeppel, 2007). A dorsal pathway involving temporoparietal and posterior frontal structures is thought to be involved in mapping phonological representations onto articulatory representations. A ventral pathway located in the middle and inferior temporal lobes is considered crucial for mapping phonological representations onto lexical-semantic representations. Both the dorsal and ventral streams emanate from a common cortical region in posterior, superior temporal cortex/sulcus that appears critical to the mental representation of phonology. We investigated phonological processing in PPA, with the goal of identifying whether patterns of performance in the different variants support this functional-anatomical framework. Based on our knowledge of the locus of anatomical damage in the subtypes of PPA, we hypothesized that patients with damage to dorsal route structures (nonfluent and logopenic variants) would show greater impairment on phonological processing tasks, whereas patients with damage to ventral route structures (semantic variant) would show relative preservation of phonological abilities

More to Language than Picture Naming: Norms and Patient Data for a Verb Generation Task

Standardized confrontation naming is widely used to measure language impairment in persons with aphasia (PWAs). However, naming often does not reveal severity of language impairment in PWAs. We asked participants to generate verbs, given object picture stimuli. Phase 1 of this study investigates verb generation in 38 non-brain damaged participants (NCs) on 218 objects. Phase 2 examines verb generation performance of three PWAs, post-naming treatment on their subsets of objects (n=60). Preliminary data suggest that domain (i.e., living vs. artifact) affects agreement in NCs. The effects of training and practice on verb generation in PWAs are also discussed

A COMPARISON OF SEMANTIC FEATURE ANALYSIS AND PROMOTING APHASIC COMMUNICATIVE EFFECTIVENESS FOR TREATING ANOMIA IN PATIENTS WITH APHASIA

This study used an alternating single-subject design to compare the effects of SFA and PACE on the long-term naming accuracy of two participants with chronic Broca’s aphasia. Each participant was treated using the traditional form of SFA and PACE independently. Naming probes were taken to provide data in order to compare the two treatments. The results indicated that both procedures produced similar long-term improvements in naming the target stimuli but that both participants preferred PACE over SFA

A Treatment Sequence for “Phonological Aphasias”: Strengthening the Core Deficit

Phonological impairment is a common core deficit in individuals with left perisylvian damage resulting in the classic aphasia syndromes (Broca’s, Wernicke’s, and Conduction aphasia). The impairment is particularly evident on written language tasks that require transcoding of sound-letter correspondences, such as nonwords, but many individuals with these chronic “phonological aphasias” have limited residual ability to write real words as well. We report here on a treatment sequence intended to strengthen phonological skills in individuals with aphasia and global agraphia. Treatment outcomes from a case series of 16 participants demonstrated the value of this approach for written and spoken language

Feedback and Feedforward Control in Speech Production in Apraxia of Speech and Aphasia

Apraxia of speech (AOS) is considered to be a speech motor planning impairment (e.g., McNeil et al., 2009), but the nature of this impairment remains poorly understood. The present study was designed to test two hypotheses about the nature of AOS, framed in the DIVA model (Guenther et al., 2006). The DIVA model assumes that speech targets are regions in auditory space, and combines two control mechanisms to reach those targets: feedback control and feedforward control. The feedback mechanism generates corrective motor commands when the actual speech sound deviates from the intended speech sound. The feedforward mechanism generates predictive motor commands based on past experiences with the speech target. In the context of the DIVA model, we developed two hypotheses about possible underlying deficits in AOS. The Feedforward Control Impairment (FF) hypothesis states that feedforward control is impaired in AOS, with consequently a greater reliance on feedback control (Jacks, 2008). The Feedback Control Impairment (FB) hypothesis states that feedback control is impaired in AOS; concurrent feedback may be disruptive (cf. Ballard & Robin, 2007). We tested these hypotheses by measuring acoustic vowel contrast in two conditions: normal listening and auditory feedback masking. Under masking conditions, unimpaired speakers maintain segmental contrast (suggesting adequate feedforward commands to support speech without auditory feedback) even though contrast is somewhat reduced (suggesting on-line use of auditory feedback) (Perkell et al., 2007). The FF hypothesis predicts a greater reduction of segmental contrast with feedback masking in speakers with AOS than in controls, because effective removal of the auditory feedback control strategy will reveal the impaired feedforward commands. The FB hypothesis, in contrast, predicts increased segmental contrast with feedback masking, because removal of auditory feedback will allow the intact feedforward commands to produce adequate contrasts. One previous study that used feedback masking in AOS examined vowel duration and found longer vowels with masking in AOS and controls (Rogers et al., 1996); the present study also examined vowel duration

The relationship between brain volume loss in TBI and measures of cognition and narrative discourse

The present study of 167 individuals with TBI investigated how well total brain volume loss accounts for performance on cognitive tasks, including WM, immediate memory (IM), EF, and IQ, and on narrative discourse production measures at multiple levels (e.g., intra-sentential, inter-sentential, global) of analysis. An underlying goal of this study was to examine the prognostic potential of a brain lesion metric for outcomes in discourse production. It is hypothesized that brain volume loss will correlate significantly with the cognitive and narrative discourse measures