Augmentative and Alternative Communication (AAC) for a patient with a nonfluent/ agrammatic variant of PPA in the mutism stage

Introduction The paper presents an example of the successful administration of the Augmentative and Alternative Communication (AAC) system. Such an approach is of particular significance in cases of patients with speech and language deterioration, which is observed in a nonfluent/agrammatic variant of primary progressive aphasia (PPA-G). Regaining the ability to communicate with others proves to be very important for the patients’ self-esteem and enables them to restore previously broken social bonds. Case history The patient A.G., aged 73, a right-handed woman, had been a teacher of Polish before suffering from speech disorders of the PPA-G type. As the disease progressed, her communication deteriorated and finally she developed mutism. The patient was given a clinical and imaging-supported diagnosis of an isolated nonfluent/ agrammatic variant of primary progressive aphasia (PPA-G). The Augmentative and Alternative Communication (AAC) system specially designed for her needs was introduced to help the patient to regain the possibility to communicate. After 20 sessions of training with the use of simple equipment she was again able to communicate non-verbally with her son and with the staff of the nursing home. At the same time, a considerable improvements in her social functioning, including daily activities, was observed. Conclusions Loss of the ability to communicate with others has a serious impact upon a patient’s quality of life, and often results in withdrawal and an inability to lead an independent life. The introduction of the Augmentative and Alternative Communication (AAC) system proves to be a great help, not only for regaining the ability to communicate, but also for the restoration of social bonds. In consequence, the previously mute patient begins to show signs of social cooperation

Hyper-frontality in an OCD patient – evidence from event-related potentials in a cued GO/NOGO task

Objective The study aimed to evaluate the hyperactivity of the frontal lobes in a patient with obsessive-compulsive disorders. Case description A 21-year-old female met the diagnostic criteria of DSM-5 since her behaviour was characterized by a preoccupations with negative thoughts and by repetitive attempts to decrease or stop those behaviours. Two working hypotheses were tested to find neuromarkers of OCD and anxiety in the patient described. In agreement with the ‘OCD hypothesis’ an increase of the frontal beta activity and an increase of the parietalalpha activity pattern was found. The ‘anxiety’ hypothesis found confirmation in an increased left temporal P1 wave in response to the visual stimuli observed in ERPs. In all three conditions (EO, EC, GO/NOGO task), two characteristics were deviant from the normative average data in EEG spectra. First, an increase of frontal beta activity and the increase of parietal alpha activity was noted. The independent component analysis applied for 700 ms EEG fragments in GO and NOGO conditions revealed a strong activation over the central areas. Conclusions pecific patterns of QEEG and ERPs, the increase of beta activity frontally, and the increase of parietal alpha activity pattern which produce hyper-frontality, might be useful in the diagnosis of an OCD patient. ERPs in a GO/NOGO task can be used in the assessment of functional brain changes in OCD patients

Speech disfluencies in Parkinson's disease Zaburzenia płynności mówienia w chorobie Parkinsona

Abstract Introduction: Even though speech disfluency is listed in the clinical description of Parkinson's disease (PD), its nature, intensity, symptomatology, and the effect on verbal communication have not hitherto been defined. Aim of the research: The research paper presents the results of studies aimed at the description of speech disfluencies in PD and the influence on verbal communication. Material and methods: The tests involved 10 patients from 54 to 72 years of age with documented PD, responsive to L-dopa preparations. The principal method of the study was based on the linguistic analysis of the utterances produced by the people with PD. Results: The intensity of the speech disfluency observed in the utterances of persons with PD ranged from 6.6% to 23.0%, so it was significantly higher than that which is assumed as acceptable (3-5%); the speaking rate of the examined persons ranged from 0.7 syllabes (syl.)/s to 4.0 syl./s, and only 2 examined persons spoke with a rate considered to be correct (4-6 syl./s). This demonstrates that speech disfluency is a communication barrier in PD. Conclusions: The absence of differentiation in the speech disfluency (SD) severity between different types of verbal utterances (difference not statistically significant) and a specified hierarchy of SD symptoms indicate that the speech disfluency in PD has an essentially organic background and is generated by cognitive, linguistic, and motor deficits resulting from the damage to the central nervous system. This is also confirmed by the established hierarchy of utterances with respect to the SD intensity, not excluding the simultaneous participation of the emotional factor

Application of ERPs neuromarkers for assessment and treatment of a patient with chronic crossed aphasia after severe TBI and long-term coma – Case Report

Objective The study aimed to evaluate the application of ERPs neuromarkers for the assessment and treatment of a patient with chronic crossed aphasia after severe TBI and a long-term coma. Case report. An ambidextrous female patient, aged 29, suffered from posttraumatic chronic crossed aphasia, severe TBI and a prolonged coma after a car accident. The patient took part in two differentiated rehabilitation programmes of neurotherapy included 20 sessions of relative beta training and 20 sessions of rTMS; both programmes were combined with behavioural training. The patient was tested 3 times: before the experiment, after completion of programme A, and after completion of programme B. Results In the 1st recording, the neuromarker of aphasia was found – an excess of the P2 wave over the left temporal area. There was a cognitive control deficit – an excess of omission errors and an increase of RT variability – all indexes of sporadic ADHD. In the 2nd recording, slight improvements in cognitive control, and language functions were found. In the 3rd recording, after the rTMS sessions most of her cognitive dysfunctions had been resolved, including language functions. It should be stressed that the activation (especially the increase in the ERP potential of the right side over the frontal lobe) was found. The neuromarker of aphasia did not change, only the location had slightly moved frontally. Conclusions The application of ERP neuromarkers assists in the diagnosis, treatment, and academic success of an ambidextrous patient with chronic posttraumatic aphasia and sporadic ADHD. ERPs can be used to assess the functional brain changes induced by neurotherapeutical programme

Speech disfluencies in Parkinson’s disease

Introduction : Even though speech disfluency is listed in the clinical description of Parkinson’s disease (PD), its nature, intensity, symptomatology, and the effect on verbal communication have not hitherto been defined. Aim of the research: The research paper presents the results of studies aimed at the description of speech disfluencies in PD and the influence on verbal communication. Material and methods : The tests involved 10 patients from 54 to 72 years of age with documented PD, responsive to L-dopa preparations. The principal method of the study was based on the linguistic analysis of the utterances produced by the people with PD. Results: The intensity of the speech disfluency observed in the utterances of persons with PD ranged from 6.6% to 23.0%, so it was significantly higher than that which is assumed as acceptable (3–5%); the speaking rate of the examined persons ranged from 0.7 syllabes (syl.)/s to 4.0 syl./s, and only 2 examined persons spoke with a rate considered to be correct (4–6 syl./s). This demonstrates that speech disfluency is a communication barrier in PD. Conclusions : The absence of differentiation in the speech disfluency (SD) severity between different types of verbal utterances (difference not statistically significant) and a specified hierarchy of SD symptoms indicate that the speech disfluency in PD has an essentially organic background and is generated by cognitive, linguistic, and motor deficits resulting from the damage to the central nervous system. This is also confirmed by the established hierarchy of utterances with respect to the SD intensity, not excluding the simultaneous participation of the emotional factor

In search of new methods. Qigong in stuttering therapy

Introduction : Even though stuttering is probably as old a phenomenon as the human speech itself, the stuttering therapy is still a challenge for the therapist and requires constant searching for new methods. Qigong may prove to be one of them. Aim of the research: The research paper presents the results of an experimental investigation evaluating the usefulness of qigong practice in stuttering therapy. Material and methods: Two groups of stuttering adults underwent 6-month therapy. In group I – the experimental one (n = 11) – the therapy consisted of speech fluency training, psychotherapy and qigong practice. In group II – the control one (n = 12) – it included speech fluency training and psychotherapy. In both groups 2-hour sessions of speech fluency training and psychotherapy were conducted twice a week. Two-hour qigong sessions took place once a week. Results: After 6 months the therapy results were compared with regard to the basic stuttering parameters, such as the degree of speech disfluency, the level of logophobia and speech disfluency symptoms. Improvement was observed in both groups, the beneficial effects, however, being more prominent in the qigong-practising group. Conclusions : Qigong exercises used in the therapy of stuttering people along with speech fluency training and psychotherapy give beneficial effects

Body posture and postural stability of people practicing qigong

Introduction: Correct and stable posture is essential for the implementation of the majority of voluntary movements and locomotion. The study of postural stability is an element of clinical trials evaluating physical activity in order to determine the optimal therapeutic procedures. Qigong exercises are not only a form of prevention, helpful in maintaining wellbeing, but also a means of therapy in many diseases, including disorders of postural stability. Aim of the research: To analyse the association between the quality of posture and postural stability of people practicing qigong. Material and methods : The study involved 32 people. The mean age of those tested was 54 years. Posture study used optoelectronic method Diers formetric III 4D. Postural stability was tested on the platform Biodex Balance System. The studies were performed at the Posture Laboratory of the Institute of Physiotherapy at Jan Kochanowski University in Kielce. Results and conclusions : Spearman rank order correlation showed a positive correlation of relative rotation of the spine area with a general indicator of stability (p = 0.0206) at an average level (R = 0.4075) and with the index of the stability A/P (p = 0.0310), although at a lower level (R = 0.3819). With the increase in the relative rotation of the spine area the overall stability indicator and stability indicator A/P also increased. Significant positive correlations were also seen for the surface rotation (+max) and a general indication of the stability and the stability index A/P. With the increase of surface rotation (+max) of the spine the overall stability indicator and stability indicator A/P also increased

Usage of perioperative anxiety neuromarker for improving the quality of life of a patient operated on for critical stenosis of the internal carotid artery

Objective The aim of the study was to find a neuromarker of perioperative anxiety in a patient with critical carotid stenosis through the use of neuromarkers in Quantitative EEG (QEEG) and Event Related Potentials (ERPs). The indirect purpose of the research was evaluation of improvement in the patient’s quality of life. Case study A 45-year-old woman was admitted to the Department of Vascular Surgery and Endovascular Interventions at the John Paul II Hospital in Krakow, with the diagnosis of critical internal carotid stenosis (over 80%), confirmed by Doppler Ultrasound and Angio-CT examinations. Before hospitalization, the patient had not presented any symptoms of brain ischemia. It was found that severe anxiety on the Hospital Anxiety and Depression Scale (HAD) was worse before the surgery. After the operation, a reduction anxiety in occurred as well as an improvement in the majority of the dimensions of health. Therefore, her quality of life improved. Conclusions Significant changes were observed on the Hospital Anxiety and Depression Scale (HAD). Modern neurotechnologies measures are necessary to capture all the changes in the symptoms of anxiety before and after the operation for a carotid stenosis. ERPs might be used to select patients with neuromarker of perioperative anxiety, and subsequently to serve in proper psychological care and minimalize the perioperative risk of complications

Effects of sauna bathing on stress-related genes expression in athletes and non-athletes

Introduction and objective Heat stress induces the expression of genes encoding heat-shock proteins and immune response mediators. The aim of this study was to determine the differences in the expression of genes encoding heat-shock proteins 70 kDa and27 kDa, interleukin 6, interleukin 10and C-reactive protein, between athletes and non-athletes after sauna bathing. Material and Methods Athletes (n=9) and non-athletes (n=9) were exposed to a Finnish sauna twice during one session at a temperature of 98.2 °C and humidity of 10% ± 2%, with a 5 min break for cooling down under a shower. The groups did not differ in terms of age, height or body mass. Blood samples were taken before and after sauna exposure in order to assess gene expression, using reverse transcription polymerase chain reaction. Results Differences were observed in leukocyte mRNA levels of tested genes between athletes and non-athletes. In the non-athlete group, all the tested genes were expressed at higher levels as a response to the same heat challenge. Conclusions It appears that expression of stress-related genes induced by heat stress is dependent on the level of physical activit