A comparison of drill- and communication-based treatment for aphasia.
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ABSTRACT:
SUBMITTER: Kempler D
PROVIDER: S-EPMC3349434 | biostudies-literature | 2011 Nov
REPOSITORIES: biostudies-literature
Publications
A comparison of drill- and communication-based treatment for aphasia.
Aphasiology 20111101 11
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Project description:Connectome-based lesion-symptom mapping relates behavioural impairments to disruption of structural brain connectivity. Connectome-based lesion-symptom mapping can be based on different approaches (diffusion MRI versus lesion mask), network scales (whole brain versus regions of interest) and measure types (tract-based, parcel-based, or network-based metrics). We evaluated the similarity of different connectome-based lesion-symptom mapping processing choices and identified factors that influence the results using multiverse analysis-the strategy of conducting and displaying the results of all reasonable processing choices. Metrics derived from lesion masks and diffusion-weighted images were tested for association with Boston Naming Test and Token Test performance in a sample of 50 participants with aphasia following left hemispheric stroke. 'Direct' measures were derived from diffusion-weighted images. 'Indirect' measures were derived by overlaying lesion masks on a white matter atlas. Parcel-based connectomes were constructed for the whole brain and regions of interest (14 language-relevant parcels). Numerous tract-based and network-based metrics were calculated. There was a high discrepancy across processing approaches (diffusion-weighted images versus lesion masks), network scales (whole brain versus regions of interest) and metric types. Results indicate weak correlations and different connectome-based lesion-symptom mapping results across the processing choices. Substantial methodological work is needed to validate the various decision points that arise when conducting connectome-based lesion-symptom mapping analyses. Multiverse analysis is a useful strategy for evaluating the similarity across different processing choices in connectome-based lesion-symptom mapping.
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Project description:BackgroundTranscranial direct current stimulation (tDCS) has emerged as a possible neuromodulatory tool to augment language therapy in post-stroke aphasia. However, there is limited information on whether tDCS may help to improve everyday functional communication.AimsTo investigate whether cerebellar tDCS combined with computerized aphasia treatment improves functional communication skills in individuals with chronic aphasia.Methods and proceduresIn a randomized, double-blind, sham-controlled, within-subject crossover study, participants received 15 sessions of anodal (n=14) or cathodal (n=14) cerebellar tDCS plus computerized aphasia treatment then sham plus computerized aphasia treatment, or the opposite order. Linear mixed-effects regression models were performed to evaluate (1) the effect of tDCS treatment on change in functional communication skills on the two dimensions of the American Speech-Language-Hearing Association Functional Assessment of Communication Skills for Adults (ASHA-FACS): Communication Independence (CI) scale and Qualitative Dimension of Communication (QDC) scale, and (2) the relationship between functional communication skills and trained and untrained naming abilities.Outcomes and resultsThe results showed significant tDCS-induced gains for the overall QDC mean score, but not for the overall CI mean score. Cerebellar stimulation was more effective than sham for the overall QDC mean score immediately post-treatment, 2-weeks post-treatment and 2-months post-treatment. Follow up analysis separated by group showed that the change in the overall QDC mean score (combining both phases) were similar in participants receiving anodal or cathodal stimulation. We also found a significant linear association between ASHA-FACS overall CI mean change scores and trained and untrained naming change scores for the tDCS condition but not sham.ConclusionsOur study provides preliminary evidence that cerebellar tDCS coupled with computerized aphasia treatment has the potential to improve the overall qualitative dimensions of functional communication skills in individuals with chronic aphasia.
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Project description:Purpose Individuals with primary progressive apraxia of speech (AOS) have AOS in which disruptions in articulation and prosody predominate the speech pattern. Many develop aphasia and/or dysarthria later in the disease course. The aim of this study was to describe the communication limitations in these patients, as measured by (a) the patient via the Communicative Participation Item Bank (CPIB) and (b) the speech-language pathologist via the American Speech-Language-Hearing Association's (ASHA) Functional Communication Measures (FCMs) and an adapted motor speech disorder (MSD) severity rating. Method Speech and language evaluations were completed for 24 patients with progressive AOS (n = 7 with isolated AOS; n = 17 with a combination of AOS and aphasia). Descriptive comparisons were utilized to evaluate differences in communication measures among patients with various combinations of MSDs and aphasia. Differences associated with phonetic predominant or prosodic predominant AOS were also examined. Across the entire cohort, correlations were calculated between the participation ratings and other clinical assessment measures. Results The CPIB reflected greater limitations for those with aphasia and AOS compared to isolated AOS, but was not notably different when dysarthria occurred with AOS (n = 9/24). Across the cohort, there were statistically significant correlations between the CPIB and ASHA FCM-Motor Speech and Language Expression ratings and the MSD severity rating. The CPIB did not correlate with the ASHA FCM-Language Comprehension or other speech-language measures. Conclusions Patients with neurodegenerative AOS experience reduced participation in communication that is further exacerbated by co-occurring language deficits. The study suggests measures of severity cannot be assumed to correlate with measures of participation restrictions and offers a foundation for further research examining the day-to-day sequela of progressive speech and language disorders. Supplemental Material https://doi.org/10.23641/asha.12743252.
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Project description:Drill core lithology is an important indicator reflecting the geological conditions of the drilling area. Traditional lithology identification usually relies on manual visual inspection, which is time-consuming and professionally demanding. In recent years, the rapid development of convolutional neural networks has provided an innovative way for the automatic prediction of drill core images. In this work, a core dataset containing a total of 10 common lithology categories in underground engineering was constructed. ResNeSt-50 we adopted uses a strategy of combining channel-wise attention and multi-path network to achieve cross-channel feature correlations, which significantly improves the model accuracy without high model complexity. Transfer learning was used to initialize the model parameters, to extract the feature of core images more efficiently. The model achieved superior performance on testing images compared with other discussed CNN models, the average value of its Precision, Recall, F1-score for each category of lithology is 99.62%, 99.62%, and 99.59%, respectively, and the prediction accuracy is 99.60%. The test results show that the proposed method is optimal and effective for automatic lithology classification of borehole cores.
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Project description:ObjectiveTo determine the aims, participants, and outcomes of training communication partners of Chinese-speaking persons with aphasia (PWA).Data sourcesSixty search terms related to communication partner training (CPT) in Chinese characters were searched in 8 electronic databases (published 1991-2020).Study selectionJournal articles written in Chinese that primarily target the Chinese audience and university theses were selected for review. Studies involving CPT and training to enable communication partner to deliver language tasks were included, but reports without PWA or direct training of communication partners were excluded. A final corpus of 37 articles, representing publications of group studies, case studies, qualitative studies, and opinion articles, were selected for full review.Data extractionFor all articles, 2 reviewers independently reviewed abstracts, excluding those without PWA or those that did not involve training of communication partners. One reviewer extracted descriptive data of participants with aphasia, communication partners, intervention details of the intervention (purpose, amount, setting, description), outcome measures, results, and clinical guidelines. A second reviewer performed accuracy verifications.Data synthesisQuality of reviewed articles were classified using the American Academy of Neurology levels of evidence. The current review suggested an evidence base of low to medium quality supporting 2 intervention groups: (1) training partners to deliver therapy tasks and (2) training to improve communication between PWA and their communication partners. There was a higher proportion of persons with acute and subacute aphasia involved in these investigations, suggesting evidence on treatment efficacy of CPT in the acute stage.ConclusionsAdditional high-quality research with a better methodological quality, for example, randomized controlled trials or experimental design, are required to strengthen the current evidence of CPT. This systematic review suggests that the inclusion of studies published in languages other than English may influence the findings of mainstream reviews relating to aphasia.
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Project description:Mounting evidence suggests that, in parallel with well-defined changes in language, primary progressive aphasia (PPA) syndromes display co-occurring social cognitive impairments. Here, we explored multidimensional profiles of carer-rated social communication using the La Trobe Communication Questionnaire (LCQ) in 11 semantic dementia (SD), 12 logopenic progressive aphasia (LPA) and 9 progressive non-fluent aphasia (PNFA) cases and contrasted their performance with 19 Alzheimer's disease (AD) cases, 26 behavioural variant frontotemporal dementia (bvFTD) cases and 31 healthy older controls. Relative to the controls, the majority of patient groups displayed significant overall social communication difficulties, with common and unique profiles of impairment evident on the LCQ subscales. Correlation analyses revealed a differential impact of social communication disturbances on functional outcomes in patient and carer well-being, most pronounced for SD and bvFTD. Finally, voxel-based morphometry analyses based on a structural brain MRI pointed to the degradation of a distributed brain network in mediating social communication dysfunction in dementia. Our findings suggest that social communication difficulties are an important feature of PPA, with significant implications for patient function and carer well-being. The origins of these changes are likely to be multifactorial, reflecting the breakdown of fronto-thalamic brain circuits specialised in the integration of complex information.
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Project description:Predicting language therapy outcomes in bilinguals with aphasia (BWA) remains challenging due to the multiple pre- and poststroke factors that determine the deficits and recovery of their two languages. Computational models that simulate language impairment and treatment outcomes in BWA can help predict therapy response and identify the optimal language for treatment. Here we used the BiLex computational model to simulate the behavioral profile of language deficits and treatment response of a retrospective sample of 13 Spanish-English BWA who received therapy in one of their languages. Specifically, we simulated their prestroke naming ability and poststroke naming impairment in each language, and their treatment response in the treated and the untreated language. BiLex predicted treatment effects accurately and robustly in the treated language and captured different degrees of cross-language generalization in the untreated language in BWA. Our cross-validation approach further demonstrated that BiLex generalizes to predict treatment response for patients whose data were not used in model training. These findings support the potential of BiLex to predict therapy outcomes for BWA and suggest that computational modeling may be helpful to guide individually tailored rehabilitation plans for this population.
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Project description:Semantic feature-based treatments (SFTs) are effective rehabilitation strategies for word retrieval deficits in bilinguals with aphasia (BWA). However, few studies have prospectively evaluated the effects of key parameters of these interventions on treatment outcomes. This study examined the influence of intervention-level (i.e., treatment language and treatment sessions), individual-level (baseline naming severity and age), and stimulus-level (i.e., lexical frequency, phonological length, and phonological neighborhood density) factors on naming improvement in a treated and untreated language for 34 Spanish-English BWA who completed 40 hours of SFT. Results revealed significant improvement over time in both languages. In the treated language, individuals who received therapy in their L1 improved more. Additionally, higher pre-treatment naming scores predicted greater response to treatment. Finally, a frequency effect on baseline naming accuracy and phonological effects on accuracy over time were associated with differential treatment gains. These findings indicate that multilevel factors are influential predictors of bilingual treatment outcomes.
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Project description:The ability to communicate, functionally, after stroke or other types of acquired brain injury is crucial for the person involved and the people around them. Accordingly, assessment of functional communication is increasingly used in large-scale randomized controlled trials as the primary outcome measure. Despite the importance of functional communication abilities to everyday life and their centrality to the measured efficacy of aphasia interventions, there is little knowledge about how commonly used measures of functional communication relate to each other, whether they capture and grade the full range of patients' remaining communication skills and how these abilities relate to the patients' verbal and non-verbal impairments as well as the underpinning lesions. Going beyond language-only factors is essential given that non-verbal abilities can play a crucial role in an individual's ability to communicate effectively. This study, based on a large sample of patients covering the full range and types of post-stroke aphasia, addressed these important, open questions. The investigation combined data from three established measures of functional communication with a thorough assessment of verbal and non-verbal cognition as well as structural neuroimaging. The key findings included: (i) due to floor or ceiling effects, the full range of patients' functional communication abilities was not captured by a single assessment alone, limiting the utility of adopting individual tests as outcome measures in randomized controlled trials; (ii) phonological abilities were most strongly related to all measures of functional communication and (iii) non-verbal cognition was particularly crucial when language production was relatively impaired and other modes of communication were allowed, when patients rated their own communication abilities, and when carers rated patients' basic communication abilities. Finally, in addition to lesion load being significantly related to all measures of functional communication, lesion analyses showed partially overlapping clusters in language regions for the functional communication tests. Moreover, mirroring the findings from the regression analyses, additional regions previously associated with non-verbal cognition emerged for the Scenario Test and for the Patient Communication Outcome after Stroke rating scale. In conclusion, our findings elucidated the cognitive and neural bases of functional communication abilities, which may inform future clinical practice regarding assessments and therapy. In particular, it is necessary to use more than one measure to capture the full range and multifaceted nature of patients' functional communication abilities and a therapeutic focus on non-verbal cognition might have positive effects on this important aspect of activity and participation.
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Project description: Not available
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