Words in Action: retrieval errors in aphasia, a topic for therapy

An aphasia is defined as an acquired impairment of language based on brain damage (Benson & Ardila 1996). All modes of language use may be involved: spontaneous speech, writing and comprehension of written and spoken language. Therefore, aphasia is labelled as a supramodal language disorder. The nature and severity of the disorder in each language mode may vruy between and within individual patients

Linguistic deficits in the acute phase of stroke

Background and Purpose: For the diagnosis of aphasia early after stroke, several screening tests are available to support clinical judgment. None of these tests enables the clinician to assess the underlying linguistic deficits, i. e. semantic, phonological and syntactic deficits, which provides indispensable information for early therapeutic decisions. The ScreeLing was designed as a screening test to detect semantic, phonological and syntactic deficits. The ScreeLing's sensitivity, specificity and accuracy in detecting aphasia and semantic, phonological and syntactic deficits were determined. Methods: The ScreeLing was validated in an acute stroke population against a combined reference diagnosis of aphasia (aphasia according to at least two of the following measures: neurologist's judgment, linguist's judgment, Tokentestscore). The three ScreeLing subtests were validated in the aphasic population against the presence or absence of a semantic, phonological and/or syntactic deficit according to an experienced clinical linguist. Results: From a consecutive series of 215 stroke patients, 63 patients were included. The ScreeLing was an accurate test for the detection of aphasia (0.92), with a sensitivity of 86% and specificity of 96%. Sensitivity of subtests was 62% for semantics, 54% for phonology and 42% for syntax. Specificity was 100% for semantics and phonology and 80% for syntax, and accuracy 0.84 for semantics, 0.87 for phonology and 0.64 for syntax. Conclusions: The ScreeLing is an accurate test that can be easily administered and scored to detect aphasia in the first weeks after stroke. Furthermore, the ScreeLing is suitable for revealing underlying linguistic deficits, especially semantic and phonological deficits

Screening tests for aphasia in patients with stroke: a systematic review

Aphasia has a large impact on the quality of life and adds significantly to the costs of stroke care. Early recognition of aphasia in stroke patients is important for prognostication and well-timed treatment planning. We aimed to identify available screening tests for differentiating between aphasic and non-aphasic stroke patients, and to evaluate test accuracy, reliability, and feasibility. We searched PubMed, EMbase, Web of Science, and PsycINFO for published studies on screening tests aimed at assessing aphasia in stroke patients. The reference lists of the selected articles were scan

Glioma surgery in eloquent areas: can we preserve cognition?

__Background:__ Cognitive preservation is crucial in glioma surgery, as it is an important aspect of daily life functioning. Several studies claimed that surgery in eloquent areas is possible without causing severe cognitive damage. However, this conclusion was relatively ungrounded due to the lack of extensive neuropsychological testing in homogenous patient groups. In this study, we aimed to elucidate the short-term and long-term effects of glioma surgery on cognition by identifying all studies who conducted neuropsychological tests preoperatively and postoperatively in glioma patients. __Methods:__ We systematically searched the electronical databases Embase, Medline OvidSP, Web of Science, PsychINFO OvidSP, PubMed, Cochrane, Google Scholar, Scirius and Proquest aimed at cognitive performance in glioma patients preoperatively and postoperatively. __Results:__ We included 17 studies with tests assessing the cognitive domains: language, memory, attention, executive functions and/or visuospatial abilities. Language was the domain most frequently examined. Immediately postoperatively, all studies except one, found deterioration in one or more cognitive domains. In the longer term (3–6/6–12 months postoperatively), the following tests showed both recovery and deterioration compared with the preoperative level: naming and verbal fluency (language), verbal word learning (memory) and Trailmaking B (executive functions). __Conclusions:__ Cognitive recovery to the preoperative level after surgery is possible to a certain extent; however, the results are too arbitrary to draw definite conclusions and not all studies investigated all cognitive domains. More studies with longer postoperative follow-up with tests for cognitive change are necessary for a better understanding of the conclusive effects of glioma surgery on cognition

Long term cognitive functioning after glioma surgery in eloquent areas

Cognitive performance is an important outcome measure in treatment of lowgrade gliomas (LGGs), since it is a crucial aspect of Quality of Life. LGGs are slow growing brain tumours infiltrating the central nervous system, often in the proximity of eloquent areas. During brain surgery, direct electrocortical stimulation is nowadays used to identify individual functio

The screling: Occurence of linguistic deficits in acute aphasia post-stroke

Objective: To investigate the occurrence of semantic, phonological and syntactic deficits in acute aphasia with the ScreeLing after the establishment of its psychometric properties. To examine the relationship between these deficits and: (i) overall aphasia severity; and (ii) quality of Spontaneous Speech. Methods: The reliability and validity of the ScreeLing was established by investigating 141 subjects with acute aphasia (2 weeks after stroke), 23 with chronic aphasia, and 138 healthy controls. In addition, the acute patients were assessed with the Token Test and a Spontaneous Speech rating (Aphasia Severity Rating Scale). Results: The ScreeLing was found to be valid and reliable for assessing the presence and severity of aphasia and linguistic deficits at 12 days after stroke. In 22.4% of the patients deficits were found in only 1 of the 3 linguistic levels; phonology was most frequently disturbed (16.3%), compared with semantics (2.7%), and syntax (3.4%). The number of impaired linguistic levels was related to aphasia severity: patients with a 3-level disorder had the lowest Token Test scores; patients with a selective phonological disorder had the highest Spontaneous Speech ratings. Phonology alone explained 54.6% of the variance in the Spontaneous Speech rating. Conclusion: In the acute stage, linguistic-level deficits are already present independently of each other, with phonology affected most frequently