Case report: the effects of cerebellar tDCS in bilingual post-stroke aphasia

Transcranial Direct Current Stimulation may be a useful neuromodulation tool for enhancing the effects of speech and language therapy in people with aphasia, but research so far has focused on monolinguals. We present the effects of 9 sessions of anodal cerebellar tDCS (ctDCS) coupled with language therapy in a bilingual patient with chronic post-stroke aphasia caused by left frontal ischemia, in a double-blind, sham-controlled within-subject design. Language therapy was provided in his second language (L2). Both sham and anodal treatment improved trained picture naming in the treated language (L2), while anodal ctDCS in addition improved picture naming of untrained items in L2 and his first language, L1. Picture description improved in L2 and L1 after anodal ctDCS, but not after sham

Ways to improve communication and support in healthcare centres according to people with aphasia and their relatives: a Dutch perspective

Background: There is an increasing amount of research that investigates the needs and wishes of people with aphasia and their relatives with regards to improving the accessibility of communication with healthcare professionals (HCP). An important way to improve this is by training HCP to use supportive conversation techniques and tools. Objectives: This study aimed to inform the development of such a training, by adding to previous findings in the literature regarding the experiences, needs and wishes of people with aphasia and their relatives. We were interested in their experiences with the accessibility of communication and support from HCP and how they believed this can be improved. Methods: An exploratory qualitative research design was chosen. Data was collected through qualitative semi-structured interviews with 20 people with aphasia and 12 relatives. The time post stroke ranged from 3 months to 41 years. Results: Four themes described the data. According to people with aphasia and relatives (1) information transfer in healthcare settings and (2) the use of supported conversation techniques by HCP are inadequate, (3) there is a lack of shared decision-making in healthcare settings, and (4) support, guidance, counseling and education is mainly targeted at the person with aphasia. Conclusions: People with aphasia and relatives reported a variety of positive and negative experiences in all themes. Even though guidelines and interventions have been developed to improve healthcare for people with aphasia and their relatives, we found that people still encounter substantial challenges in access to- and provision of information, shared decision-making, support and communication with HCP. The findings in this study provide some important recommendations for improvement, including the improvement of transfer of information, shared decision-making and individual support for the relatives

Kā veidot tūrisma pakalpojumus pieejamākus cilvēkiem ar mentāliem apgrūtinājumiem? Rokasgrāmata

Grāmatas nolūks ir būt par pavadoni centienos padarīt tūrisma pakalpojumus pieejamākus cilvēkiem ar mentāliem apgrūtinājumiem un/vai invaliditāti. Šī grāmata var būt noderīga, ja pārstāvat: 1) tūrisma pakalpojumu sniedzēju; 2) tūrisma organizāciju; 3) politikas veidotājus; 4) biedrību personām ar mentāliem apgrūtinājumiem un/vai invaliditāti; 5) plašāku sabiedrību, kas ir ieinteresēta uzlabot tūrisma pakalpojumus cilvēkiem ar mentāliem apgrūtinājumiem un/vai invaliditāti. Šīs rokasgrāmatas saturs tapa, par pamatu ņemot šādi iegūtus datus: datus no sekundāriem avotiem un zinātniskās literatūras, no aptaujām un intervijām ar vairākām NVO, no sarunām ar ekspertiem tūrisma un psihiatriskas invaliditātes jomā, no lauka pētījuma ar pakalpojumu lietotājiem, kā arī no prototipu izstrādes un testēšanas, ko veica universitāšu un tūrisma nozares partneri Beļģijā, Igaunijā un Latvijā. Šī grāmata: 1) ietver izglītojošu informāciju par mentāliem apgrūtinājumiem; 2) var veicināt un iedvesmot strādāt ar cilvēkiem ar mentāliem apgrūtinājumiem; 3) kalpo par instrumentu pieejamības palielināšanai, veidojot inovatī vus pakalpojumus muzejos un citās apskates vietās; 4) piedāvā pašnovērtējuma rīku, kas jums palīdzēs noteikt pakalpojumus, kurus jūsu organizācija vai jūs sadarbībā ar kolēģiem varētu uzlabot vai ieviest. Grāmata tapusi ERASMUS+ pētniecības projektā “Pārdomāti tūrisma pakalpojumi cilvēkiem ar garīga rakstura traucējumiem (MindTour)".Šo projektu fi nansiāli atbalstīja Eiropas Savienības programma Erasmus+. Projekta ID: 2020-1-EE01-KA202-07798

Constraint-induced Aphasia Therapy versus Intensive Semantic Treatment in Fluent Aphasia

Objective: To compare the effectiveness of two intensive therapy methods: Constraint- 4 Induced Aphasia Therapy (CIAT) and semantic therapy (BOX). Method: Nine patients with chronic fluent aphasia participated in a therapy programme 6 to establish behavioral treatment outcomes. Participants were randomly assigned to one of two groups (CIAT or BOX). Results: Intensive therapy significantly improved verbal communication. However, BOX 9 treatment showed a more pronounced improvement on two communication measures, namely on a standardized assessment for verbal communication, the Amsterdam Nijmegen Everyday Language Test (Blomert, Koster, & Kean, 1995) and on a subjective rating scale, the Communicative Effectiveness Index (Lomas et al., 1989). All 13 participants significantly improved on one (or more) subtests of the Aachen Aphasia Test (Graetz et al., 1992), an impairment-focused assessment. There was a treatment-specific effect. Therapy with BOX had a significant effect on language comprehension and on semantics, while of CIAT affected language production and phonology. Conclusion: The findings indicate that in patients with fluent aphasia (1) intensive treatment has a significant effect on language and verbal communication, (2) intensive therapy results in selective treatment effects and (3) an intensive semantic treatment shows a more striking mean improvement on verbal communication in comparison to communication-based CIAT-treatment

Case report: the effects of cerebellar tDCS in bilingual post-stroke aphasia

Transcranial Direct Current Stimulation may be a useful neuromodulation tool for enhancing the effects of speech and language therapy in people with aphasia, but research so far has focused on monolinguals. We present the effects of 9 sessions of anodal cerebellar tDCS (ctDCS) coupled with language therapy in a bilingual patient with chronic post-stroke aphasia caused by left frontal ischemia, in a double-blind, sham-controlled within-subject design. Language therapy was provided in his second language (L2). Both sham and anodal treatment improved trained picture naming in the treated language (L2), while anodal ctDCS in addition improved picture naming of untrained items in L2 and his first language, L1. Picture description improved in L2 and L1 after anodal ctDCS, but not after sham.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

A systematic review of transcranial direct current stimulation in primary progressive aphasia : methodological considerations

A variety of tDCS approaches has been used to investigate the potential of tDCS to improve language outcomes, or slow down the decay of language competences caused by Primary Progressive Aphasia (PPA). The employed stimulation protocols and study designs in PPA are generally speaking similar to those deployed in post-stroke aphasic populations. These two etiologies of aphasia however differ substantially in their pathophysiology, and for both conditions the optimal stimulation paradigm still needs to be established. A systematic review was done and after applying inclusion and exclusion criteria, 15 articles were analyzed focusing on differences and similarities across studies especially focusing on PPA patient characteristics (age, PPA variant, language background), tDCS stimulation protocols (intensity, frequency, combined therapy, electrode configuration) and study design as recent reviews and group outcomes for individual studies suggest tDCS is an effective tool to improve language outcomes, while methodological approach and patient characteristics are mentioned as moderators that may influence treatment effects. We found that studies of tDCS in PPA have clinical and methodological and heterogeneity regarding patient populations, stimulation protocols and study design. While positive group results are usually found irrespective of these differences, the magnitude, duration and generalization of these outcomes differ when comparing stimulation locations, and when results are stratified according to the clinical variant of PPA. We interpret the results of included studies in light of patient characteristics and methodological decisions. Further, we highlight the role neuroimaging can play in study protocols and interpreting results and make recommendations for future work

Table_1_Case report: the effects of cerebellar tDCS in bilingual post-stroke aphasia.XLSX

Transcranial Direct Current Stimulation may be a useful neuromodulation tool for enhancing the effects of speech and language therapy in people with aphasia, but research so far has focused on monolinguals. We present the effects of 9 sessions of anodal cerebellar tDCS (ctDCS) coupled with language therapy in a bilingual patient with chronic post-stroke aphasia caused by left frontal ischemia, in a double-blind, sham-controlled within-subject design. Language therapy was provided in his second language (L2). Both sham and anodal treatment improved trained picture naming in the treated language (L2), while anodal ctDCS in addition improved picture naming of untrained items in L2 and his first language, L1. Picture description improved in L2 and L1 after anodal ctDCS, but not after sham.</p