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

Localization patterns of speech and language errors during awake brain surgery:a systematic review

Awake craniotomy with direct electrical stimulation (DES) is the standard treatment for patients with eloquent area gliomas. DES detects speech and language errors, which indicate functional boundaries that must be maintained to preserve quality of life. During DES, traditional object naming or other linguistic tasks such as tasks from the Dutch Linguistic Intraoperative Protocol (DuLIP) can be used. It is not fully clear which speech and language errors occur in which brain locations. To provide an overview and to update DuLIP, a systematic review was conducted in which 102 studies were included, reporting on speech and language errors and the corresponding brain locations during awake craniotomy with DES in adult glioma patients up until 6 July 2020. The current findings provide a crude overview on language localization. Even though subcortical areas are in general less often investigated intraoperatively, still 40% out of all errors was reported at the subcortical level and almost 60% at the cortical level. Rudimentary localization patterns for different error types were observed and compared to the dual-stream model of language processing and the DuLIP model. While most patterns were similar compared to the models, additional locations were identified for articulation/motor speech, phonology, reading, and writing. Based on these patterns, we propose an updated DuLIP model. This model can be applied for a more adequate “location-to-function” language task selection to assess different linguistic functions during awake craniotomy, to possibly improve intraoperative language monitoring. This could result in a better postoperative language outcome in the future. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10143-022-01943-9

Differential contribution of language and executive functioning to verbal fluency performance in glioma patients

Glioma patients often suffer from deficits in language and executive functioning. Performance in verbal fluency (generating words within one minute according to a semantic category–category fluency, or given letter–letter fluency) is typically impaired in this patient group. While both language and executive functioning play a role in verbal fluency, the relative contribution of both domains remains unclear. We aim to retrospectively investigate glioma patients' performance on verbal and nonverbal fluency and to explore the influence of language and executive functioning on verbal fluency. Sixty-nine adults with gliomas in eloquent areas underwent a neuropsychological test battery (verbal fluency, nonverbal fluency, language, and executive functioning tests) before surgery (T1) and a subgroup of 31 patients also at three (T2) and twelve months (T3) after surgery. Preoperatively, patients were impaired in all verbal fluency tasks and dissociations were found based on tumour location. In contrast, nonverbal fluency was intact. Different language and executive functioning tests predicted performance on category fluency animals and letter fluency, while no significant predictors for category fluency professions were found. The longitudinal results indicated that category fluency professions deteriorated after surgery (T1–T2, T1–T3) and that nonverbal fluency improved after surgery (T1–T3, T2–T3). Verbal fluency performance can provide information on different possible underlying deficits in language and executive functioning in glioma patients, depending on verbal fluency task selection. Efficient task (order) selection can be based on complexity. Category fluency professions can be selected to detect more permanent long-term deficits.</p

Recovery of linguistic deficits in stroke patients: a three-year-follow-up study

In a three-year-follow-up study aphasic patients (n=17) received the ScreeLing, a screeningstest for semantic, phonological and syntactic processing, the Token Test and an interview at 2-4 days, 9-12 days, 2 months, 3 months, 6 months and 3 years post onset. The greatest improvement on all measures occurred between 9-12 days and 2 months post onset. The severity at 2 months post onset was decisive for the final outcome at 3 years p.o

Melodic Intonation Therapy in subacute aphasia

Melodic Intonation Therapy (MIT) is based on the observation that persons with severe nonfluent aphasia are often able to sing words or even short phrases they cannot produce during speech. MIT uses the melodic elements of speech, such as intonation and rhythm, to facilitate and improve language production. Although clinicians disagree about the usefulness of MIT, it has been translated into several languages and is frequently applied worldwide. Many studies have reported successful application of MIT. However, most studies are case-studies without control condition in chronic patients. Hence, the level of evidence for MIT is low and little is known about its effect in earlier phases post stroke, when treatment interacts with processes of spontaneous recovery. We examined MIT in the subacute phase post stroke. The purpose of this multicenter study was threefold. First, we evaluated the efficacy of MIT in the subacute phase. Further, we examined the effect of the timing of MIT in this early phase post stroke. Thirdly, we investigated potential determinants influencing therapy outcome

Stability of spontaneous speech in chronic mild aphasia

Een spontane-taalanalyse bij afasie is een belangrijke toevoeging om de linguïstische en communicatieve mogelijkheden in kaart te brengen, een passend therapieplan op te stellen en de mate van vooruitgang te meten. In het onderhavige onderzoek wordt bij een groep van tien mensen met een milde afasie in de chronische fase onderzocht hoe stabiel de spontane taal is binnen een interview. Uit de spontane-taalinterviews zijn twee keer 300 woorden getranscribeerd en geanalyseerd volgens de Analyse voor Spontane Taal bij Afasie (ASTA; Boxum, Van der Scheer &amp; Zwaga, 2010). Van veertien linguïstische variabelen is bekeken of er verschil is tussen de scores in de eerste en tweede 300 woorden. Ook is onderzocht of het gespreksonderwerp en de emotionele lading ervan invloed hebben op het taalgebruik. De scores op de linguïstische maten blijken stabiel te zijn gedurende een interview, met uitzondering van het aantal semantische parafasieën en het aantal seconden onverstaanbaar. Een verandering van het gespreksonderwerp blijkt geen significante invloed te hebben, maar de emotie die erbij beleefd wordt wel. Bij een negatieve emotie worden meer lexicale werkwoorden en minder zelfstandige naamwoorden gebruikt dan bij een positieve emotie. Toch lijkt een spontane-taalanalyse een stabiel en betrouwbaar beeld te geven van de taalproductie. Vervolgonderzoek kan uitwijzen of dit ook geldt voor andere fasen van afasie.In aphasia, an analysis of spontaneous speech provides opportunities to establish the linguistic and communicative abilities, to create suitable therapy plans and to measure language progress. The current study investigated the stability of spontaneous speech within an interview of ten mild aphasic participants in the chronic stage. Stability is important in order to enable making justified decisions about the underlying deficit(s). Two 300 words samples of spontaneous speech gathered during interviews were transcribed and analysed according to the ‘Analyse voor Spontane Taal bij Afasie’ (ASTA; Boxum, Van der Scheer &amp; Zwaga, 2010). A comparison of the scores on fifteen linguistic variables between the first 300 words and the second 300 words was made. Also,it was investigated whether the conversation topic and its emotional charge influenced language usage. Results showed that the scores on the linguistic variables remained stable during an interview, except for the amount of semantic paraphasias and the number of seconds of incomprehensible speech. A change in the topic of conversation did not appear to have a significant influence; however, the emotion experienced with the topic did have an effect on language usage. More lexical verbs and fewer nouns were used when a negative emotion was experienced, compared to a positive emotion. An analysis of spontaneous speech seems to give a stable and reliable profile of language production in people with mild aphasia in the chronic stage, as long as the emotional charge of the topic remains stable. Further research could explore whether this also holds for other stages of aphasia