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BackgroundAimsMethods & ProceduresOutcomes & ResultsConclusionsThe lack of validated clinical tools to assess the complaint related to anomia in patients with degenerative aphasia is a shortcoming despite recommendations in favour of a patient-centred approach.We aimed to develop and validate a Self- and Hetero-assessment Questionnaire for Anomia (S.H.Q.A.) to be used by patients, caregivers and speech-language pathologists (SLPs).The development of the questionnaire was carried out following a six-stage methodology. Psychometric analysis was carried out on 27 patients with primary progressive aphasia (PPA), 53 patients with Alzheimer’s disease (AD), their caregivers and their SLPs.Composed of 41 questions, it explores five domains: the contexts and evolution of the severity of the word-finding difficulty, the types of errors and difficulties, the discourse consequences, the strategies employed and their effectiveness, the consequences on social life. Psychometric analysis revealed moderate validity (r < −0.50) and excellent sensitivity (>0.95) for both populations. Fidelity was moderate to excellent for the PPA patient, caregiver and SLP versions of the questionnaire (0.74 < r < 0.92) and satisfactory for the AD patient version (r = 0.49).The S.H.Q.A. meets the validation criteria for application as a tool to assess anomia complaints in patients with PPA and AD. Its use will complement objective assessments, integrating the anomia-related complaint into therapeutic choices and fostering partnership with caregivers. It could also be useful in assessing the effectiveness of interventions for daily communication and changes in patients’ needs. [ABSTRACT FROM AUTHOR]

Background: Word-finding difficulties are a common self-reported concern in glioma patients known to negatively affect social participation and life satisfaction. Discrepancies between self-reported difficulties and performance on objective tests have been reported, but studies are seldom conducted longitudinally. Aims: The aim of the present study was to examine the occurrence of self-reported word-finding difficulties before and during the first year after glioma surgery. In addition, we investigated whether self-reported word-finding difficulties were predicted by standardized language tests and psychological distress. Methods and procedures: Twenty-three patients with gliomas (grade 1–3) were assessed pre-surgery, at six and twelve months follow-up. Self-reported word-finding difficulties were addressed with the item I am able to find the right word(s) to say what I mean, from the Functional Assessment of Cancer Therapy – Brain (FACT-Br). Confrontation naming was tested with the Boston Naming Test (BNT), word production with a semantic fluency test and word knowledge with a vocabulary test. Self-reported measures of psychological distress were assessed with the Hospital Anxiety and Depression Scale (HADS). Ordinal regression models were used to examine predictors of self-reported word-finding difficulties. Outcomes and results: Word-finding difficulties were reported by 68% of the patients pre-surgery, increasing to 90% and 85% at the following assessments. Significant changes were observed in the magnitude of reported concerns between pre-surgery assessment and six months follow-up. Regression analyses demonstated that self-reported word-finding difficulties were predicted by psychological distress and vocabulary pre-surgery and vocabulary at six months follow-up, whereas confrontation naming and semantic fluency did not become significant in any of the assessments. Conclusion: Our results indicate that self-reported word-finding difficulties occurred in a high percentage of glioma patients throughout the first year of illness. Patients reported increased difficulties after surgery that were not predicted by confrontation naming or semantic fluency but by vocabulary performance. The results imply further that psychological distress is a factor that should be taken into account. Self-reported function is an important supplement to objective testing and can provide indications about mental health status and the patients' perspective on language related challenges in everyday life. [ABSTRACT FROM AUTHOR]

BackgroundAimsMethods & proceduresOutcomes & resultsConclusionsWhile linguistic deficits are key to diagnosing and treating aphasia, there is growing interest in the cognitive processes important for rehabilitation outcomes, particularly the role of learning. Of relevance to the current study, research has manipulated instructional methods (errorless vs. errorful) to assess their effects on outcomes. However, it is still unclear whether individualized profiles of errorless and errorful learning exist in aphasia and whether they might be meaningful for clinical practice.The current study aimed to examine learning in people with aphasia, manipulating instruction method (errorless, errorful) and linguistic demands of learning.Nine people with stroke-induced aphasia participated in this preliminary study. Participants engaged in errorless and errorful novel object pairing and word retrieval tasks. Learning outcomes were assessed on the same day, next day, and after one week. Participants also completed cognitive-linguistic assessments to investigate the contribution of memory, language, and executive functioning abilities on learning outcomes.At the group level, participants performed significantly better following errorful training for novel object pairing (p = 0.001) relative to errorless training. An errorful advantage was observed at the individual level in 7 participants during same day testing, with the highest overall performers on the task showing the most persistent errorful learning benefits. In the word retrieval practice task, group and individual-level differences in scores following errorless and errorful practice were minimal. Scores in errorful novel object pair learning correlated with verbal short-term memory and nonverbal long-term memory assessments, while no other correlations were found between learning scores and cognitive-linguistic variables.Findings are consistent with prior research that suggests that successful effortful retrieval may pose an advantage over errorless learning when acquiring novel information and the potential contributions of verbal short-term memory and nonverbal long term memory on learning. Results from the word retrieval practice task draw attention to differences between practicing lexical access and novel learning. The lack of an errorful advantage in word retrieval may alternatively be due to task design and merits further research. Results support the hypothesis that people with aphasia display variable learning profiles that may stem from differences in underlying cognitive-linguistic abilities. Continuing research is needed to characterize learning in aphasia to consider its potential influence on rehabilitation outcomes and support speech-language pathologists in considering and accounting for different learning and cognitive-linguistic abilities when individualizing treatment decisions. [ABSTRACT FROM AUTHOR]

Speech and language therapists apply word finding therapies for people with aphasia with good outcomes on treated words but limited evidence of generalisation to untreated words. As generalisation cannot be assumed, there is a need to select words for therapy that are meaningful to people with aphasia. This study sought the views of people with aphasia to inform the stimuli for a word finding in conversation treatment. To this end, the research question was: What conversation topics do people with aphasia find most meaningful to talk about? This qualitative study used focus groups to identify meaningful conversation topics across a sample of 12 people with chronic aphasia (two groups of six). Participants were recruited from three community aphasia groups. The focus groups were videoed and transcribed. The transcription was analysed using framework analysis. A consensus decision process was then used by researchers to identify the themes with high agreement. Twenty conversation topics were generated. Consensus was that eight topics were meaningful. The three topics rated most meaningful were 1) family and friends, 2) food and drink, and 3) living with aphasia. Two topics reached consensus as not meaningful. Ten topics did not reach consensus. The conversation topics, 'family and friends', 'food and drink' and 'living with aphasia' were most meaningful to this sample of people with aphasia. Using therapy stimuli from these conversation topics has the potential to create meaningful treatments. [ABSTRACT FROM AUTHOR]

BackgroundObjectiveMethodsResultsConclusionsPrevious systematic reviews and meta-analyses have only mentioned a few confrontational naming treatment methods. There is no recent literature on the effect of different treatment methods and on comparing their efficacy with each other.The purpose of this study was to: a) collect treatment methods for addressing confrontational naming deficits in patients with aphasia; b) examine the number of studies on treatment methods; c) evaluate the level of evidence for these treatment methods; d) determine the efficacy of the explored treatment methods; and e) compare various treatment methods.We searched Scopus, ISI Web of Sciences, PubMed, Cochrane Library, ProQuest, Clinical Key, Science Direct, and Springer electronic databases for articles published from January 2009 to March 2023. A meta-analysis was conducted using comprehensive meta-analysis (CMA2) software. A funnel plot was applied to examine the influence of outliers. Furthermore, Cochran’s Q test and the I-square (I2) index were utilized to assess the homogeneity of effect sizes in the included studies.Of the 1808 articles identified, 66 were included in the final synthesis (1496 participants). Among the studies reviewed, 62.69% were found to have high effect sizes, 19.40% had medium effect sizes, and 17.91% showed an effect size of less than 0.3, indicating low efficacy. The syntactic cueing method, errorless learning, and action observation methods had high effect sizes (E.S = 0.93, E.S = 0.89, E.S = 0.88, respectively). The personalized cueing method had low effect sizes (E.S = 0.22).This systematic review extracted and compared various treatment methods for naming deficits in individuals with aphasia. Evidence has shown that syntactic cueing, errorless learning, and action observation methods have the highest effect size and are, therefore, the most effective. Additionally, the SFA and gestural methods are effective interventions, considering the abundance of studies, high level of evidence, and substantial effect size. [ABSTRACT FROM AUTHOR]

Background: Previous studies have demonstrated that naming treatments can improve language abilities in people with aphasia (PWA). However, there is currently a lack of protocols for evidencebased naming treatment in Hebrew. Aims: This study aims to evaluate the efficacy of a novel morphology-based naming treatment for Hebrew-speaking PWA and to investigate subject-related factors influence responsiveness to the treatment. Method & Procedures: Twelve chronic stroke PWA and moderate to severe anomia participated in 20 treatment sessions focused on the root-structure morphology of Hebrew. Treatment stimuli incorporated morphologically complex words comprising root and template. Treatment effects were assessed at both subject level and group level. Outcomes & Results: The treatment showed promising results, with a significant increase in correct naming for both treated and untreated complex words. These gains were maintained for at least 10 weeks post-treatment. Most of the benefit was achieved during the first 10 treatment sessions. Additionally, the group demonstrated generalization effects to naming simple words. Pre-treatment performance in naming morphologically complex words predicted higher treatment gains during the follow-up session, irrespective of word type. Conclusions: These findings provide preliminary evidence supporting the efficacy of root-based naming treatment for Hebrew-speaking PWA. Future research should compare this treatment to an untreated control group and to other treatment methods in Hebrew speakers to further validate its benefits. [ABSTRACT FROM AUTHOR]

Roughly 30% of stroke survivors suffer from aphasia—a communication disorder that affects the ability to communicate effectively—but little is known about their healthcare expenditure or how it varies between aphasia subtypes. This study evaluates the relative differential in healthcare expenditure of anomic, Broca's, Wernicke's and Conduction aphasia and assesses expenditure between demographic cohorts Individual level data from the 2010 Moss Aphasia Psycholinguistic Project Database was matched with the 2010 Medical Expenditure Panel Survey using a propensity score algorithm based on functional, health, and demographic characteristics. Multilevel, generalized, nonlinear regression models were applied to the resulting data set to assess the correlation between annual healthcare expenditure, time post onset (tpo), sex, race, family size, marital status, income, education, aphasia type, and region of residence. Results were used to predict expenditure by aphasia subtype, race, and sex. Multiple distributional specifications tested the sensitivity and ensured the robustness of estimates. Regression results indicate that individuals with Broca's aphasia had statistically higher healthcare expenditures paying an average of $10,896.45 annually when compared to anomic ($7,927.60), Wernicke's ($7,096.22), and Conduction ($9,447.19) aphasias. Additionally, healthcare expenditure increased with each year of age (β=0.004, SE=0.005), but decreased with each year after stroke (β=-0.002, SE=0.001). Females (β=0.358, SE=0.131) and Blacks (β=0.103, SE=0.200) paid significantly more annually compared to males and Whites, respectively. Neither region of residence, income, nor level of education were significantly correlated with healthcare expenditure. This study showed that, while individuals with Broca's aphasia had higher average healthcare expenditure than other subtypes, the differential was not statistically significant. Sex and race cohorts did, however, show statistically significant differences in healthcare expenditures. While causality is outside the scope of this analysis, additional work is needed to determine the best strategy to mitigate these disparities. [ABSTRACT FROM AUTHOR]

An individual's diagnostic subtype may fail to predict the efficacy of a given type of treatment for anomia. Classification by conceptual-semantic impairment may be more informative. This study examined the effects of conceptual-semantic impairment and diagnostic subtype on anomia treatment effects in primary progressive aphasia (PPA) and Alzheimer's disease (AD). At baseline, the picture and word versions of the Pyramids and Palm Trees and Kissing and Dancing tests were used to measure conceptual-semantic processing. Based on norming that was conducted with unimpaired older adults, participants were classified as being impaired on both the picture and word versions (i.e., modality-general conceptual-semantic impairment), the picture version (Objects or Actions) only (i.e., visual-conceptual impairment), the word version (Nouns or Verbs) only (i.e., lexical-semantic impairment), or neither the picture nor the word version (i.e., no impairment). Following baseline testing, a lexical treatment and a semantic treatment were administered to all participants. The treatment stimuli consisted of nouns and verbs that were consistently named correctly at baseline (Prophylaxis items) and/or nouns and verbs that were consistently named incorrectly at baseline (Remediation items). Naming accuracy was measured at baseline, and it was measured at three, seven, eleven, fourteen, eighteen, and twenty-one months. Compared to baseline naming performance, lexical and semantic treatments both improved naming accuracy for treated Remediation nouns and verbs. For Prophylaxis items, lexical treatment was effective for both nouns and verbs, and semantic treatment was effective for verbs, but the pattern of results was different for nouns – the effect of semantic treatment was initially nonsignificant or marginally significant, but it was significant beginning at 11 Months, suggesting that the effects of prophylactic semantic treatment may become more apparent as the disorder progresses. Furthermore, the interaction between baseline Conceptual-Semantic Impairment and the Treatment Condition (Lexical vs. Semantic) was significant for verb Prophylaxis items at 3 and 18 Months, and it was significant for noun Prophylaxis items at 14 and 18 Months. The pattern of results suggested that individuals who have modality-general conceptual-semantic impairment at baseline are more likely to benefit from lexical treatment, while individuals who have unimpaired conceptual-semantic processing at baseline are more likely to benefit from semantic treatment as the disorder progresses. In contrast to conceptual-semantic impairment, diagnostic subtype did not typically predict the treatment effects. [ABSTRACT FROM AUTHOR]

People with aphasia vary considerably in response to aphasia treatments. Treatment dose is likely to be an important factor in understanding treatment response variability and optimising aphasia recovery; however, there is limited empirical evidence to guide dose prescription in post-stroke aphasia rehabilitation. In the present study, we used a novel approach to personalise dose prescription and explored the effect of dose on treatment response in chronic post-stroke aphasia. Examine the effect of providing personalised doses of a cued picture naming treatment (Kendall et al., 2014) on acquisition and maintenance of picture naming outcomes. This pilot study used a multiple-baselines design with follow-up at 4- and 12-weeks with replication across four people with chronic post-stroke anomia. Prior to treatment, a comprehensive battery of cognitive and language tests was completed. Participants then undertook a period of cued picture naming treatment (45-minute sessions, five days per week for three weeks) totalling 15 sessions (11.25 hours). Participants were allocated four picture sets – one each for three treated conditions (low dose, moderate dose, and high dose) and one for an untreated control set. The number of naming opportunities provided per dose condition was calibrated against individuals' pre-treatment picture naming accuracy and speed. Generalised linear mixed effects models were used to evaluate learning effects during treatment, maintenance of these effects, and dose-response relationships. Participants received 99% of prescribed treatment doses (i.e., number of naming opportunities provided over the course of treatment). As anticipated, individual treatment responses varied substantially. Three participants demonstrated significantly improved picture naming accuracy on probed items during treatment, with varying response profiles by participant and dose. All participants were able to name more pictures accurately on a bespoke 298-item object picture naming test following treatment. However, no participant demonstrated significant pre-post treatment gains relative to untreated items, although one person demonstrated improved naming four weeks after treatment for items treated under the high dose condition. Dose-response relationships amongst these participants exhibited a greater number of significant results on naming probes in the high dose condition, possibly suggesting superiority of the high dose condition over lower doses of cued picture naming treatment. Modest treatment effects and variable dose-response relationships were observed. We explore the role of dose, cognitive factors such as self-monitoring abilities, and linguistic factors such as underlying lexical-semantic and phonological processing that may have influenced treatment response in these participants. Avenues for future research are identified. [ABSTRACT FROM AUTHOR]

New technologies show promise in the construction of self-administered home-based programs for targeting language impairments, in overcoming mobility problems and in providing access to care in a cost-effective and time-saving way. In the present study, we investigated the feasibility and effectiveness of a self-administered home-based program for treating word-finding difficulties in persons with Alzheimer's disease. Ten participants practised word repetition training on a smart tablet for two weeks. Two slightly different training conditions were adopted; they varied as to the order of the presentation of the word to be repeated and the corresponding picture. Both training modalities proved effective in improving naming accuracy on the treated items. There were hints of greater treatment efficacy when the picture was presented before the word to be repeated. Furthermore, when the trial started with the word, the degree of general cognitive impairment and lexical semantic deficits correlated with the effect size of the training benefit. By contrast, the picture first training did not have this modulatory effect. Finally, no generalisation to untreated items was observed in naming accuracy, but was detectable with a more sensitive stem completion task. Our study provides compelling evidence in favour of the feasibility and efficacy of a homebased program for remediating anomia in AD. [ABSTRACT FROM AUTHOR]

The majority of patients with primary progressive aphasia (PPA) can be distinguished into one of three variants: semantic, non-fluent/agrammatic, or logopenic. However, many do not meet criteria for any one variant. To identify aspects of cognitive-linguistic performance that yield an early unclassifiable PPA designation that predicted the later emergence of a given variant. Of 256 individuals with PPA evaluated, 19 initially were unclassifiable and later met criteria for a variant. Receiver operating characteristic curves were used to evaluate the binary ability of a given task to predict eventual classification as a given variant. Tasks with a high area under the curve were examined using regression analyses to determine their ability to predict variant. High mean predictive value was observed for multiple naming assessments targeting nouns and verbs. The Boston Naming Test (BNT) was the only test that, in isolation, resulted in a significant model and high classification accuracy. Although naming impairment is common across PPA variants, very low initial BNT scores emerged as a uniquely accurate basis for predicting eventual semantic variant, and normal BNT scores predicted eventual nonfluent/agrammatic variant. High performance on picture-verb verification was useful in identifying future lvPPA. [ABSTRACT FROM AUTHOR]

Researchers have identified many assessment and treatment options for word retrieval impairments in individuals with aphasia. The extent to which these options are used in clinical practice is not well understood. We surveyed speech-language pathologists to better understand their use and familiarity with word retrieval assessment and treatment approaches for individuals with aphasia. We developed a brief survey examining 12 assessment and 14 treatment approaches used in clinical practice for aphasic word retrieval impairments. An anonymous survey link was disseminated to speech-language pathologists. The experienced pool of 81 respondents report they commonly address word retrieval impairments. In assessment they primarily employ standardized aphasia and naming tests (e.g., Boston Naming Test; Kaplan et al., 2001). Many also use informal naming tools to supplement standardized testing. Three treatment approaches were used by the majority of respondents. Two approaches incorporate single word picture naming, cueing hierarchies and Semantic Feature Analysis, and a third fosters word retrieval in sentences, Verb Network Strengthening Treatment. While word retrieval impairments are commonly addressed in clinical practice, further implementation science work is needed to examine clinical use of the many empirically-supported word retrieval assessment and treatment methods, including how their fidelity is maintained to foster positive outcomes across clinical settings. [ABSTRACT FROM AUTHOR]

Contemporary models of aphasia predominantly attribute lexical retrieval deficits to impaired access and/or maintenance of semantic, lexical, and phonological representations of words. A central hypothesis of language-emergent models of verbal short-term memory (STM) is that temporary storage and maintenance of verbal information arises from activation of linguistic representations in long-term memory. This close relationship between short-term retention and linguistic representations has prompted accounts of aphasia that include impairments to both these components. We investigated associations between measures of input semantic and phonological verbal STM and corresponding output processing measures. We hypothesised that both input and output functions of verbal STM rely on a common substrate (i.e., temporary activation and maintenance of long-term linguistic representations). Twenty adults with aphasia completed a series of semantic and phonological probe spans. Results were compared with naming performance in immediate and delayed conditions. The data were analysed using correlations, principal components analysis and linear regressions. Input semantic and phonological verbal STM abilities were predictive of naming accuracy. Greater input semantic and phonological STM spans were associated with fewer semantic and phonological naming errors. Latent factors identified by principal components analysis of probe span data were consistent with a two-step interactive model of word retrieval. Probe spans measuring access to semantic and initial consonant-vowel representations aligned with lexical-semantic abilities (lexical-semantic factor). Probe spans assessing access to the rhyme component of a word measured lexical-phonological abilities (lexical-phonological factor). The principal components analysis indicated that stronger lexical-semantic abilities were associated with fewer semantic and nonword errors, and stronger lexical phonological abilities were associated with fewer formal and unrelated errors. In addition, our results were consistent with models that postulate serial access to phonology, proceeding from initial to final phonemes. The span measuring access to initial consonant-vowel was associated with lexical selection, while the span measuring access to rhyme information was associated with phonological selection. Performance on input semantic and phonological tasks predicts accuracy of picture naming performance and types of errors made by people with aphasia. These results indicate overlap in input and output semantic and phonological processing, which must be accounted for in models of lexical processing. These findings also have implications for approaches to diagnosis and treatments for lexical comprehension and production that capitalise on the overlap of input and output processing. [ABSTRACT FROM AUTHOR]

Research just started to combine behavioural, computational, and neural accounts to investigate the nature of post-stroke aphasia, but the dynamic aspect of aphasia recovery has rarely been integrated. Moreover, executive functions in aphasia recently gained attention as an important contributor to language performance. Lexical picture/word interference embraces both executive control and language processing through distracted confrontation naming, as revealed by functional magnetic resonance imaging. Thus, we for the first time applied this complex paradigm in diagnostic and therapeutic settings for persons with aphasia (PWA) on the group level. In consideration of behavioural and computational data, we aimed at investigating the neural responses of persons with aphasia (a) to a novel treatment method targeting both word processing and language control by means of interfered-naming, and (b) to the interfering stimuli to determine preserved and impaired processing and changes thereof. Nineteen PWA at a mean age of 51 years (range 21–74) and 26 months post-onset (4–63) as well as 22 matched healthy controls were included in a diagnostic fMRI study comprising a pure naming test and the lexical fMRI interference paradigm with five distractor conditions (phonological, associative-semantic, categorical-semantic, unrelated word, unrelated noise) in a 3 T Philips scanner. Twelve participants completed the 4-weeks therapy, 11 the fMRI therapy study. During therapy, both comprehension of the interfering words and distracted but cued picture naming were trained. The distribution of lexical-semantic and -phonological impairments of PWA in the computational model was well balanced. The novel linguistic-executive treatment significantly improved pure and interfered naming for the PWA group, fostering generalisation to untrained items, reducing repetition of distractors, and ameliorating lexical-semantic processing. The predicted behavioural effects of distractor types were only found for the two semantic conditions. Neuroimaging revealed right-hemisphere compensation before treatment, activation decrease related to enhanced efficiency due to treatment, and both differential and overlapping responses to distractor types. Key brain regions encompassed inferior frontal gyrus and right posterior middle temporal gyrus as well as the basal temporal language area, cerebellum, and anterior cingulate cortex. The novel interfered-naming in aphasia therapy revealed to be effective, but differential effects of distractor types were less prominent than expected. Behavioural, computational, and neural findings converge on identifying semantic-executive processing as the core source of improvements. This account of linguistic-executive processing in aphasia offers a step towards a comprehensive theory of neurorehabilitation. [ABSTRACT FROM AUTHOR]

The Boston Naming Test (BNT) is a neuropsychological tool that is widely utilized in clinical practice to detect naming difficulties (i.e., anomia) in patients with language disorders and to evaluate the semantic memory integrity in patients with cognitive impairment (i.e., Alzheimer's Disease). The complete version of the test includes 60 items, but several abbreviated forms have been developed in order to shorten the time of administration. These shortened versions have also been translated and adapted in countries where English is not the primary language. It is still necessary, however, to collect normative data from other languages, including Italian. The purpose of the current study was to introduce the first Italian version of the 15-item BNT for adults that is comparable to the original English version and to provide normative data based on 275 healthy Italian-speaking adults stratified by age, sex and education. Finally, we assessed the qualitative differences in erroneous answers in order to detect normal incorrect patterns of response. The 15-item Form 4 proposed by Mack and collaborators, which is included in the latest version of the BNT (2001), was administered to 130 males and 145 females, aged between 18 and 85 years, with a formal education ranging from 5 to 32 years. The 15 items of the original English BNT were double translated, achieving an appropriate cross-linguistic and cross-cultural comparison. The statistical analysis was performed applying a generalized linear regression model with inverse Gaussian distribution of the response variables. Pearson's correlation coefficient was utilized to investigate the relationship between the pattern of responses and the demographic variables. We provided data for educated Italian adults from multiple age groups stratified by gender and educational background. In addition, our results demonstrate that demographic variables, mostly at the schooling level, play an important role in naming performance, with higher levels of education being strongly associated with better performance We suggest that this 15-item BNT is a suitable tool for the assessment of naming ability in the adult Italian population. [ABSTRACT FROM AUTHOR]

Stroke lesion size and location are understood to be more accurate predictors of recovery from aphasia than demographic variables such as age, education, or socioeconomic status. We hypothesise that markedly high premorbid language function can influence functional recovery from aphasia. This case study reports the recovery of a 64-year-old right-handed male, with large left posterior cerebral artery territory infarct involving the thalamus, occipital lobe and posteromedial temporal lobe. The report is informed by retrospective review of clinical notes, language assessment, and interviews with the participant and his family. Premorbidly, he had acquired fluency in five additional languages in early adulthood, followed by a career in senior roles within corporate communications. Following severe expressive aphasia in the acute period, the subacute and chronic phases were characterised by residual mild anomia and cognitive communication difficulties apparent on formal assessment, yet masked in functional contexts through compensatory strategies and preservation of an authoritative premorbid communication style. The current report provides single-case evidence that individuals with markedly high premorbid metalinguistic skills may, in functional contexts, be able to compensate for expressive aphasic deficits and preserve their communicative competence. The discrepancy between the participant's performance on formal versus informal language assessment underscores the necessity for both perspectives for accurate diagnosis of aphasia. Consideration of premorbid language function can usefully guide clinical decision-making about intervention for individuals with aphasia. [ABSTRACT FROM AUTHOR]

Multiple sclerosis (MS) commonly includes anomia and other communicative deficits that affect communicative participation and quality of life. Anomia treatment in MS is currently unexplored. Owing to the degenerative nature of MS, compensatory treatment might be preferable to restorative treatment. Semantic feature analysis (SFA) has been reported to have a treatment effect in aphasia and traumatic brain injury, and it can also be used as a compensatory word-finding strategy. SFA might therefore be effective on anomia in MS. The aim of this study was to evaluate the treatment effects of SFA on mild anomia in MS. Hypotheses were that, if used as a strategy, SFA may improve word-retrieval ability in connected speech, reduce self-perceived word-finding difficulties and increase communicative participation. Two participants (one with relapsing-remitting MS, one with progressive MS) experiencing anomia and reduced communicative participation took part in this early-phase study with a single-case experimental design (SCED). Outcome measures included accuracy and speed in confrontation naming of treated items, correct information units (CIUs) in a re-telling task, self-reported strategy use in everyday communication, self-reported occurrence of anomia and related nuisance, and self-reported communicative participation. Measurements were carried out before treatment, at the beginning of every third treatment session, once directly after treatment, repeatedly during a maintenance phase, and once at a follow-up session ten weeks after treatment. No treatment effects on confrontation-naming ability, re-telling ability or self-reported measures were evident in either participant after treatment with SFA. Effects of repeated measures appeared as reduced response time in confrontation naming. SFA as the sole element of treatment may not be sufficient to obtain treatment effects on mild anomia in MS. Further research is warranted. [ABSTRACT FROM AUTHOR]

Stimulus selection is important to anomia treatment because similarity between trained and untrained words in the mental lexicon may influence treatment generalization. We focused on phonological similarity between trained and untrained words from a clinical trial of Phonomotor Treatment (PMT) that showed gains in confrontation naming accuracy of untrained words post-treatment. One way to capture the amount of similarity between the trained and untrained words is to consider the phonological network path distance between words. We posited that the distance between trained and untrained words in a phonological network could account for the improvement in confrontation naming accuracy post-treatment. To define the phonological network distance between trained and untrained words that influences change in confrontation naming accuracy post-treatment. We retrospectively analyzed data from 28 people with aphasia who received PMT as part of a clinical trial. Participants completed confrontation naming (baseline, post-treatment, and 3-months post-treatment) of words varying in phonological distance to the treatment stimuli. We used a phonological network to calculate the average shortest path length (ASPL), defined by the number of phoneme differences, between an untrained word and all trained words. We used mixed effects regression models to predict change in confrontation naming accuracy of untrained words post-treatment from ASPL. Several post-hoc analyses were also conducted. We found no effect of ASPL on change in confrontation naming accuracy of untrained words immediately post- and 3-months post-treatment. However, post-hoc analyses indicated significant subject heterogeneity and limitations in observable path distance between trained and untrained words. Despite the clinical trial report that confrontation naming of untrained words improved after PMT, we found no overall effect of ASPL on the amount of improvement. We discuss further investigation of the entire domain of phonological sequence knowledge (the phonological sequence knowledge landscape) and its influence on treatment generalization, and the potential importance of identifying predictors of treatment response to enhance the effects of treatment generalization. [ABSTRACT FROM AUTHOR]

Lexical retrieval models help to determine the locus of difficulty in individuals with anomia. It is generally assumed that phonological cueing facilitates naming in individuals with phonological output lexicon deficits while semantic cueing facilitates naming in those with semantic lexical deficits. Evidence from treatment studies is not always consistent with this assumption, showing positive effects for both types of cues regardless of the types of deficits in some studies. Recently, behavioural and electrophysiological markers for patient engagement and effort during motor rehabilitation have been suggested. Thus, we set out to evaluate, in a preliminary manner, whether there is an association between the locus of the naming difficulty, the relevancy of the type of cue to this locus and the degree of patient cognitive engagement and effort, as measured by these markers. To evaluate the applicability of a behavioural marker of temporary functional change (TFC) and of a single-channel EEG marker, the Brain Engagement Index (BEI), during naming treatment specifically designed to test the efficacy of semantic and phonological cueing treatment in 23 individuals with phonological output lexicon anomia and in four individuals with lexico-semantic anomia following acquired brain damage. Two-hundred pictures of nouns were divided into five blocks of 40 pictures each. The blocks were matched in the frequency of use and number of letters. Three of the blocks were non-cued blocks: the pre-treatment block (first block), the 3rd block and the 5th block. The 2nd and the 4th blocks provided either semantic cues or phonological cues simultaneously with the presentation of the picture. The order of the cued sessions varied among the patients. Participants underwent BEI monitoring (EEG) during all sessions. Most of the individuals, whether with predominantly semantic or phonological impairment, profited immediately from both types of cues. In addition, generalization to non-cued pictures was observed for 23 of the 27 individuals following the cueing blocks. Importantly, this generalization was related to the type of impairment for most participants, but this effect was transient. Finally, it was found that the patients' impairment interactions with the type of cue used were associated with the degree of patient cue type-induced effort, as could be measured by this temporary generalization (or TFC) and by the BEI. [ABSTRACT FROM AUTHOR]

It is not conclusively explored what kind of reorganisation processes are set off after a stroke with resulting aphasia. Since the development of functional Magnetic Resonance Imaging (fMRI), linguistic processes and their neural representation have been researched, especially in aphasic patients after left hemispheric insult. The situation differs in aphasic patients with crossed aphasia or aphasia after a right hemispheric lesion, for which only few studies have been carried out. In order to close this gap, the present study deals with the localisation of language functions in the brain of patients with crossed aphasia and right hemispheric language dominance. The objective of the current study was to provide insights into the neural correlates of continuous aphasic language production of patients with right hemispheric language dominance. Based on the current state of research, a mirror image representation was expected. Two patients with fluent aphasia due to right hemisphere lesions, one presenting with crossed aphasia, described complex pictures. The continuous language output was transcribed and categorised into events. Lexical search (i.e. the difference between unimpaired speaking and word-finding difficulties) was analysed using fMRI. The neural activation clusters were compared with the corresponding areas of a control group consisting of 12 patients with left hemispheric aphasia. The analysis of the behavioural data revealed word-finding difficulties as one of the most limiting factors in the spontaneous language output of the patients. The neural correlates of lexical search (unimpaired minus impaired) were observed in four activation clusters both patients had in common. Each cluster was predominantly localised in the contra-lesional hemisphere. Compared to the corresponding areas of the control group, in general, a mirrored image representation could be confirmed. The combination of detailed linguistic analysis and fMRI confirmed the assumption of mirrored language organisation for anomia in continuous language production. Moreover, the study might add to a more general understanding of the contribution of the contra-lesional hemisphere to language recovery in aphasia after left or right hemisphere damage. [ABSTRACT FROM AUTHOR]

A correction is presented to the article "Integrity of input verbal short-term memory ability predicts naming accuracy in aphasia" which appeared in the March 15, 2022 issue.

Background: The pattern of post-stroke aphasia in Spanish speakers has not previously been reported. Furthermore, the association between aphasia type and demographic variables is not clearly understood. Aims: To investigate the incidence and type of aphasia in first-ever acute stroke during the early chronic and later chronic periods in native Spanish speakers and the effect of demographic variables. Methods & Procedures: Spanish versions of Western Aphasia Battery and Boston Diagnostic Aphasia Examination were used for language assessment. Lesion localization was done by using computerized axial tomography and magnetic resonance imaging. Final simple included 243 (97.98%) right-handed, and five (2.02%) left-handed participants; 143 men and 105 women with a mean age of 58.68 years. Outcomes & Results: The types of aphasia included – 14.1% Broca's, 15.3% Wernicke's, 10.1% Conduction, 9.3% Transcortical Sensory, 1.6% Transcortical Motor, 28.2% Anomic, 4.8% Global, and 16.5% Mixed non-fluent. Wernicke's aphasia, along with Transcortical Sensory aphasia was more frequently observed in older people. Broca's aphasia was more prevalent but less severe in women than in men. Auditory Comprehension and Naming negatively correlated with age, while schooling positively correlated with Auditory Comprehension. Time since onset did not significantly affect the type of aphasia. Schooling correlated with the severity of Anomic aphasia. Conclusions: The most common type of aphasia in our sample was Anomic aphasia. Older people had an increased probability to present a fluent type of aphasia. Broca's aphasia was more frequent but less severe in women. [ABSTRACT FROM AUTHOR]

Background: Generalization of treatment effects is the ultimate goal of therapy. However, treatment generalization across language modalities is not well understood in the aphasia literature and requires further investigation. This work examined the generalization effects of two word retrieval therapies, Phonomotor Treatment (PMT) and Semantic Feature Analysis (SFA), to reading performance in individuals with aphasia. Aims: This cross-modal generalization investigation was motivated by the Primary Systems Hypothesis, which proposes reading ability is related to and dependent upon underlying phonological and semantic abilities. Therefore, this study sought to determine if enhanced phonological or semantic knowledge following anomia treatment could influence reading ability. Methods & Procedures: Reading data collected in a randomized control trial for anomia treatment were retrospectively analyzed. Fifty-eight participants with chronic aphasia were randomly assigned to receive intensive PMT (n = 28) or SFA (n = 30) treatment for 56–60 hours over 6–7 weeks. Reading measures were administered pre-, post- and 3 months after treatment. To identify and compare the extent of treatment generalization to reading, within-group and between-group analyses of variance were performed. Outcomes & Results: On average, participants in both groups showed positive changes in reading. The PMT group demonstrated significantly improved reading of regularly and irregularly spelled words. The SFA group showed significant gains in reading of regularly spelled words and sentence-level reading comprehension. No statistically significant differences in oral reading or reading comprehension were found between the groups before or after therapy. Conclusions: These preliminary findings support the Primary Systems Hypothesis and suggest a link between reading ability and phonological and semantic abilities. Results show that one anomia treatment was not superior to the other and the positive influence of both PMT and SFA suggests that reading might be enhanced via intensively delivered treatments that focus on the underlying phonological or semantic impairment. Further investigations of cross-modal treatment generalization are needed to help better understand this relationship between word retrieval and reading and its implication for aphasia treatment. [ABSTRACT FROM AUTHOR]

Background: Primary progressive aphasia (PPA) is aneurodegenerative condition in which isolated language deterioration is the most prominent feature accompanied by relatively preserved cognitive and executive functions. Aims: This case report describes the response of two participants with PPA to an innovative anomia treatment that combines a restorative and compensatory approach. Methods & Procedures: This study used a multiple baseline design (ABCAA) that consisted of a pre- test (A), treatment divided into two phases (BC), post- test (A) and a follow- up 1 month after therapy conclusion (A). Stimuli included 80 training items and 80 control items divided into four semantic categories. The items assigned to therapy were selected by each patient and respective spouse. Patients attended one session per week, for 3 months. Outcomes & Results: After 12 sessions, structured training lead to a significantly increased naming accuracy for therapy items in Case 1, but not Case 2. As opposed to this, successful generalisationonly occurred in Case 2, once improved naming performance was observed for control lexical items. Retention of treated items 1 month after treatment completion was observed in both participants. Globally, the patients considered that their quality of life remained relatively steady throughout the combined anomia treatment. Conclusions: A combined approach to anomia treatment appears to offer a good scope for word relearning. Additionally, it seems to prepare the patients to the future need for use of Alternative and Augmentative Communication (AAC) devices. [ABSTRACT FROM AUTHOR]

Background: Spoken word retrieval therapy forms an integral part of aphasia therapy. Due to the range of therapy options and variations, drawing clear-cut conclusions from the evidence base can be challenging. Aims: This paper consolidates recent findings (2008–2018), pertinent to spoken word-finding interventions. Specifically, we are interested in aphasia interventions: (1) that target single-word spoken naming; (2) whose participants are adults with acquired naming impairments after a stroke; and (3) whose treatment approach focusses on the use of language forms (i.e., semantics, phonology, and orthography). The over-arching objective is to determine the important therapy components underpinning successful single-word naming treatments. Methods and Procedures: A systematic literature search was conducted. This led to the compilation of a large-scale dataset (n=222 participants from 32 papers), with the heterogenous interventions dissected into their "active" therapy components. A detailed framework ("RITA": (1) Regimen; (2) Item(s); (3) Technique(s); and (4) Application of technique(s) with their Adjuncts) was designed to organise these "active therapy ingredients". Using random forest, we identified the crucial components responsible for the successful naming of treated and untreated items, respectively, at short-term and maintenance periods. Outcomes and Results: The role of the written form as therapeutic cues, presented either as a whole word or part-word, emerged to be a consistent and robust predictor, across the outcomes. Semantic tasks were useful in the successful naming of untreated items. Conclusions: Clinicians should consider using written prompts as part of spoken naming therapy. It is possible that the use of orthography underlies the success of multi-component techniques. Other clinical implications (e.g., homework, treatment intensity) are also discussed. In addition, we propose a comprehensive "RITA" framework, which summarises the "active" therapy components. "RITA" (available as a template in Appendix 3) is useful for clinicians and researchers as a guide to unpack language interventions. Furthermore, the paper highlights the strengths of a well-established method, random forest, as a valuable statistical tool to move aphasia research forward. Overall, the study refines our understanding of spoken naming treatment for those with aphasia, specifically individuals with word-finding deficits. Importantly, through the use of a robust statistical approach and an original framework designed to lay out language therapy components, the paper adds new clarity to the evidence base. [ABSTRACT FROM AUTHOR]

Background: Many neurologic conditions, for example multiple sclerosis (MS), are associated with subtle communication and language difficulties. To detect such difficulties, there is a need for valid and reliable methods. While standard aphasia test batteries have been found insufficient, more complex language tasks are believed to be able to distinguish more subtle language difficulties from normal variation in communicative ability. Aims: The aim of this study was to: (1) explore the influence of demographic variables on the results of a novel complex oral semantic fluency task with multiple restrictions in non-brain-damaged (NBD) adults, (2) investigate the construct validity and reliability of the method, and (3) compare the results of NBD individuals and individuals with MS. Method and procedure: One hundred and ten NBD individuals performed the complex task and three standard fluency tasks with single restrictions. Regression analyses were run to assess the influence of demographic factors. Furthermore, 16 individuals with MS and subjective anomia performed the complex task and the results were compared with those for a matched group of NBD individuals. Outcome and results: Age and education influenced the NBD individuals' scores on the complex task. The NBD individuals' results on the complex task correlated with those on the three standard fluency tasks. Furthermore, the subgroup of 16 pair-matched NBD individuals produced statistically significantly more adequate responses in the complex task than the group of individuals with MS. However, on an individual level some of the participants with MS performed at level with, or even better than the pair-matched NBD individuals. Provision of scoring guidelines yielded high interrater-reliability. Conclusions: The results illustrate the challenge in attempts to provide formal measures of subtle language disorders. Still, the complex task is a promising assessment tool which may be a complement to existing standard word fluency tasks, although future studies are required to establish the validity and ability to detect subtle language difficulties in different clinical groups. [ABSTRACT FROM AUTHOR]

A robust finding from language acquisition, adult processing, and individuals with language impairment is that certain types of Object Relatives (ORs) and Object Questions (OQs) are more challenging in both production and comprehension compared to their Subject counterparts. Approaches informed by linguistic theory have been proposed to clarify the source of the difficulties with these sentences in people with aphasia, with recent models supporting the idea of a grammatically based resource reduction selectively affecting sentences that require the processing of an element acting as an intervener. This work presents new evidence to the study of syntactic competence in people with acquired language disorders, from a pilot study exploring in detail the morphosyntactic competence of an Italian speaker with anomia. The clinical diagnosis of anomia in the participant revealed a deficit in lexical retrieval with no deficit at grammatical level. Morphosyntactic competence was investigated through a series of off-line tasks on both comprehension and production. The morphosyntactic abilities of the participant turned out to be for the most part intact with no difficulties such as agrammatism. However, a selective deficit in the computation of certain ORs and OQs emerged. The deficit was selective for structures with an intervener and more specifically for structures in which the featural specification of the intervening subject is included in the specification of the displaced object. Syntactic asymmetries emerged in the performance of an individual with anomia, with no apparent morphosyntactic impairment or sign of agrammatism. The deficit of the syntactic computation was selective and compatible with the grammatical Featural Relativized Minimality approach to the difficulties in the computation of sentences with an intervener. The preliminary results presented in this work suggest that the analysis of sentences with an intervener may be a sensitive test for the diagnosis of a syntactic-based impairment and that formal linguistic models may offer promising tools for exploring linguistic deficits. Further investigation is necessary to strengthen these findings. [ABSTRACT FROM AUTHOR]

Background: Presenting pictures accompanied by the corresponding spoken words to be repeated is a commonly used method for treating naming impairments in aphasic people. Aims: In this study, we investigated whether the presentation order of pictures and words in repetition training affects treatment outcome. Methods & Procedures: We administered a computer-based word repetition protocol at a distance to 12 individuals with chronic pure anomia. The words to be repeated were presented with the corresponding pictures. We manipulated the timing of word and picture presentation. In one condition Picture-Word condition (Pic-Wd), the picture onset preceded that of the corresponding spoken word; in the other condition Word-Picture (Wd-Pic), the presentation order was reversed. Data were analyzed at the group and the single subject level to determine the relative efficacy of the two experimental conditions and the cognitive features predicting therapy success. Outcomes & Results: The study demonstrates the substantial equivalence of the two presentation orders at the group level. At the single subject level in a minority of cases, there are hints of an asymmetrical response favoring either the Pic-Wd or the Wd-Pic treatment. Non-word repetition skills were the only feature in the participants' cognitive profile that was reliably linked to therapy outcome. Conclusions: When pictures are presented alongside the corresponding word in repetition training, stimuli presentation order seems to have only a minor effect on therapy outcome. Potential advantages of both treatments are discussed with reference to the cognitive profile of treated patients. [ABSTRACT FROM AUTHOR]

Background: Multiple Sclerosis (MS) is a neurodegenerative disease that produces plaques throughout the central nervous system. MS can present in four different clinical courses. Of these, Relapsing-Remitting MS (RRMS) is the main clinical course, especially at early stages of the disease. Rapidly evolving severe (RES) RRMS is a form of RRMS in which an individual has two or more disabling relapses in one year and evidence of increasing lesions on two consecutive MRI scans. MS affects the cortical and subcortical pathways of the brain leading to impairment in both physical and cognitive skills. Speech, language and communication deficits more broadly, have been acknowledged in the MS literature, but relatively little research has focused on these symptoms. Aims: To examine communication deficits in people with (RES) RRMS, with specific focus on anomic symptoms – difficulties in word retrieval, examining measures of both accuracy and latency (time intervals for accurate word retrieval). Methods & Procedures: A communication screening assessment was conducted with 100 participants with (RES) RRMS. This screening assessment consisted of the ACE-R cognitive screen, a bespoke picture naming task, reading words aloud from the National Adult Reading Test (NART) and the Pyramids and Palm Trees Test. The picture naming task obtained timed naming responses for sixty pictures of objects from the International Picture Naming Project (IPNP). Results for participants with MS (PWMS) were compared to matched neurotypical control participants (n = 40) and normative test data. Outcomes & Results: The group mean performance for PWMS was below the lower end of the neuro-typical control range for the cognitive screen and picture naming tasks. The reading aloud and semantic association mean scores were within the neuro-typical range but towards the lower end of this range. Anomic symptoms for PWMS presented as both lapses in word retrieval and reduced speed of word retrieval. Word retrieval latency was on average 26% slower for PWMS. Within the anomic symptoms, there were instances of inaccuracy (42% of participants) as well as slow naming latency (31% of participants) in retrieving words. There was evidence of mild dysarthria for 33% of participants. Regression analyses suggested the anomic symptoms were most strongly associated with semantic processing deficits. Conclusions: Anomic symptoms are common in (RES) RRMS, and present as inaccuracy as well as slow word retrieval latency. The prevalence and cognitive nature of anomic symptoms require further research across the range of presentations of MS. [ABSTRACT FROM AUTHOR]

Background: Word retrieval impairments in aphasia can affect a person's ability to communicate his or her needs and ideas. Treatment for these deficits typically focuses on restorative and/or compensatory strategies. While traditionally used as a compensatory strategy, emerging evidence suggests that drawing may also have restorative effects on word retrieval by providing an alternate route to accessing the semantic system. However, the current understanding of this theoretical relationship between the semantic system, drawing, and word retrieval abilities is limited. Aims: The study purpose was to examine the relationship among naming, drawing, and semantic feature generation. Additionally, we examined the influence of drawing quality and content, as well as different performances based on aphasia severity. Methods & Procedures: Ten participants with chronic aphasia completed a series of sequenced tasks measuring confrontation naming accuracy before and after drawing and a semantic feature cueing task for target nouns. Outcomes & Results: Participants significantly increased confrontation naming accuracy when they named targets after completing semantic feature cueing then drawing. Additionally, there were moderate negative relationships between semantic content present in participant drawings and drawing quality with the amount of semantic features participants produced. Conclusions: Drawing, combined with a semantic cue task may result in more accurate naming as compared to confrontation naming alone; however, future research is needed to better understand this relationship. [ABSTRACT FROM AUTHOR]

Background: Many language treatments have been developed to remediate anomia, a debilitating and pervasive symptom of aphasia. The two major types of anomia treatments, semantic and phonological, have been shown to improve spoken production of trained words. However, generalisation to untrained words has been considerably variable and few studies have examined the improvement of untrained words from a different word class despite the presence of unbalanced noun-verb impairments in the majority of people with aphasia. Aim: This retrospective study investigated within and between treatment group effects of two anomia treatments (Semantic Feature Analysis, SFA, and Phonomotor Treatment, PMT) on naming of untrained verbs. Methods & Procedures: The data for this study were retrospectively analysed from a randomised controlled trial with 57 persons with aphasia randomised to one of two treatment groups. Each participant received 56–60 hours of intensively delivered treatment over 6 weeks, with testing before, immediately after, and three months after treatment termination. Outcomes & Results: There was no significant between-group difference on confrontation naming of untrained verbs immediately post-treatment or three months following treatment termination (maintenance). Significant within-group findings were evident immediately post-treatment for the individuals in the SFA group and at maintenance for the PMT group. Conclusions: Our results show that neither SFA nor PMT was superior at inducing generalisation effects across word class (i.e. from nouns to verbs). These findings were consistent with the between-group results from the larger randomised controlled trial from which these data are analysed (Kendall, Oelke, Allen, Torrence, & Nadeau, 2018) in that there was no between-group difference in generalization to untrained words that do not share semantic or phonological sequence features. However, the within-treatment group results in the maintenance phase add to evidence from prior studies that Phonomotor Treatment is more likely to facilitate generalisation. Although generalisation to untrained stimuli was minimally maintained after SFA treatment, there was further improvement to untrained exemplars over time following Phonomotor Treatment. [ABSTRACT FROM AUTHOR]

Background: Primary progressive aphasia (PPA) is a neurodegenerative dementia in which language decline is the first and most prominent symptom. Among several interventions for PPA, language rehabilitation has been the most frequently used. Aims: This narrative review aimed to evaluate existing standardised language tests used in the assessment of PPA, in order to determine whether they are appropriate and psychometrically adequate to detect change over time in the treatment of anomia. Main Contribution: The present findings highlight the scarcity of psychometrically robust instruments used to measure therapy-induced gains in PPA. Additionally, most of these instruments were not validated for use with the PPA population, which consequently might bias the results. There is a need for population-based norms for existing instruments. Conclusions: The accurate assessment of lexico-semantic deficits in PPA should rely on objective, reliable, valid, and responsive outcome measures. Psychometric studies are needed to evaluate and eventually improve the quality of language tests used in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Previous work has investigated extensively the neuroanatomical correlates of lexical retrieval of words for concrete entities. Musical entities, such as musical instruments, are often included in studies of category-specific naming deficits but have rarely been the focus of such work. Aims: This article reviews a program of research investigating the neuroanatomical basis for lexical retrieval of words for unique (i.e., melodies) and nonunique (i.e., musical instruments) musical entities. Main Contribution: We begin by reporting findings on the retrieval of words for unique musical entities, including musical melodies. We then consider work focusing on retrieval of words for nonunique musical entities, specifically musical instruments. We highlight similarities between the two lines of work and then report results from new analyses including direct comparisons between the two. These comparisons suggest that impairments in naming musical melodies and in naming musical instruments are both associated with damage to the left temporal pole (LTP). However, musical instrument naming appears to rely on a more distributed set of brain regions, possibly including those relating to sensorimotor interactions with such instruments, whereas melody naming relies more exclusively on the LTP. Conclusions: Retrieval of names for musical melodies appears to rely on similar neuroanatomical correlates as for other proper nouns, namely the LTP. Musical instrument naming seems to rely on a broader network of regions, including the LTP and sensorimotor areas. Overall, melody naming seems to coincide with naming of other proper nouns, while musical instrument naming appears distinct from other categories of nonunique items. [ABSTRACT FROM AUTHOR]

Background: The preoperative evaluation of drug-resistant focal epilepsy patients considered for epilepsy surgery provides a unique setting to evaluate cortical function and corresponding networks. Aims: Whereas there is a wealth of data on cortical language localization using electrical stimulation with subdural electrodes, there is much less experience with stimulation of depth electrodes in the white matter and an effect on language function via electric stimulation of the corpus callosum has not been demonstrated so far. Methods & Procedures: We report on a 29-year-old epilepsy patient with bilateral language representation who underwent pre-surgical EEG-video-monitoring for drug-resistant, non-lesional right frontal lobe epilepsy. Outcomes & Results: Electric stimulation of a stereotactically implanted depth electrode in the right anterior corpus callosum elicited paraphasia and anomia. The precise mechanism could be an inhibition of cortical language areas in the left hemisphere, the right hemisphere or interference with transcallosal connectivity. Conclusions: This is the first report on language dysfunction through electric stimulation in the corpus callosum, most likely through an inhibition of cortical language areas in the left frontal lobe. [ABSTRACT FROM AUTHOR]

Background: Aphasia is an acquired language disorder that makes it difficult for people to produce and comprehend language, with all people with aphasia (PWA) demonstrating difficulty accessing and selecting words (anomia). While aphasia treatments typically focus on a single aspect of language, such as word retrieval, the ultimate goal of aphasia therapy is to improve communication, which is best seen at the level of discourse. Aims: This retrospective study investigated the effects of one effective anomia therapy, Phonomotor Treatment (PMT), on discourse production. Methods & Procedures: Twenty-six PWA participated in 60 h of PMT, which focuses on building a person's ability to recognize, produce, and manipulate phonemes in progressively longer nonword and real-word contexts. Language samples were collected prior to, immediately after, and 3 months after the treatment program. Percent Correct Information Units (CIUs) and CIUs per minute were calculated. Outcomes & Results: Overall, PWA showed significantly improved CIUs per minute, relative to baseline, immediately after treatment and 3 months later, as well as significantly improved percent CIUs, relative to baseline, 3 months following treatment. Conclusions: PMT, which focuses on phonological processing, can lead to widespread improvement throughout the language system, including to the functionally critical level of discourse production. [ABSTRACT FROM AUTHOR]

Background: Previous research indicates that combining behavioural therapy with transcranial direct current stimulation (tDCS) may be more effective than therapy alone in increasing naming ability in stroke survivors with chronic anomia. Anodal (excitatory) stimulation targeting left perilesional areas and/or cathodal (inhibitory) stimulation targeting right contralesional areas may particularly benefit non-fluent patients with localised damage to the left frontal lobe. However, studies have yet to systematically compare the effects of varying the laterality and polarity of tDCS within individual patients in order to determine optimal stimulation parameters. Aims: The primary purpose of the current study was to determine which tDCS parameters would result in the greatest improvements in naming ability in an individual (JSc) with chronic Broca’s aphasia (9 years post-stroke) due to a left frontal lesion. A range of secondary outcome measures were also collected to explore the potential effects of therapy on JSc’s connected speech, emotional well-being, and communicative effectiveness. Methods & Procedures: Following baseline naming assessment, JSc completed six, 4-week long cycles of therapy, each involving a different stimulation condition: four active (perilesional anodal, perilesional cathodal, contralesional anodal, and contralesional cathodal) and two sham control conditions (perilesional and contralesional). In the first week of each cycle, he completed three, 20-min therapy sessions, during which he carried out a personalised picture name repetition therapy task at the same time as receiving tDCS. Naming ability was measured before, immediately after, 1 week after, and 3 weeks after each week of therapy. The secondary outcome measures were completed before, 1 week after, and 3 weeks after each week of therapy. Outcomes & Results: Naming accuracy immediately after stimulation increased significantly more following perilesional anodal stimulation than following perilesional sham stimulation, and this effect remained significant at 3 weeks post-therapy. Treatment effects on the secondary outcome measures were less consistent. Conclusions: The results agree with previous work demonstrating the importance of activation in left frontal perilesional regions for accurate picture naming in stroke survivors with non-fluent aphasia. We have shown that the effectiveness of a total of 1 h of behavioural anomia therapy can be significantly increased when combined with perilesional anodal tDCS and demonstrated the feasibility of a longitudinal, repeated measures design with multiple outcome measures. Greater understanding of the optimal tDCS parameters to enhance anomia therapy outcomes in individual patients with differing lesion and behavioural profiles may one day assist with the translation of therapy plus tDCS protocols into everyday clinical practice. [ABSTRACT FROM AUTHOR]

Background: Phonological cuing in spoken picture naming is widely used to improve word production accuracy in aphasic participants and to investigate word planning processes in psycholinguistic experiments with healthy participants. However, different paradigms and different modalities have been used across studies and populations, with some contradictory results. Aims: Here, we investigate whether and how the modality in which a phonological cue is delivered impacts on word production in picture naming tasks using the exact same paradigm with healthy and with aphasic participants. Methods & Procedure: In experiment 1, behavioural and electroencephalographic event-related potential (ERP) responses to auditory, visual and audiovisual cues in a picture naming task were investigated in healthy participants. In experiment 2, the impact of the same cue modalities was studied on errors and latencies in 15 aphasic participants. Outcomes & Results: The modality in which the cue is delivered influenced phonological facilitation effects in both populations, the audio modality being the most facilitative on production latencies in healthy participants and in participants with mild aphasia. No further gains were obtained by a double modality audiovisual cue on production latencies, whereas the double cues interfered with production accuracy in aphasic participants. ERP results not only were compatible with facilitation of phonological encoding in all experimental conditions but also showed modulation of a late encoding time period for both the visual and audiovisual cues, likely reflecting interference of the visual modality during monitoring or motor speech encoding. The latter observation is indeed coherent with the interference of the audiovisual modality that was observed on error rates in the more severely impaired aphasic participants. Conclusions: These results suggest that unimodal auditory cuing is the facilitatory condition, while visual cues in unimodal or bimodal conditions give rise to both facilitation and interference which manifest behaviourally depending on the balance of these opposing effects. [ABSTRACT FROM AUTHOR]

Background: Structural imaging has not been used previously to predict the effect of treatment in primary progressive aphasia (PPA). Aims: This study examined relationships between baseline brain volume and the effects of phonological and orthographic treatments for anomia in PPA. It was predicted that lower baseline volume would be associated with lower post-treatment naming accuracy for treated items and smaller generalisation effects. Methods & Procedures: Twenty-one individuals with PPA participated. The treatment stimuli consisted of nouns that were consistently named correctly at baseline (Prophylaxis items) and/or nouns that were consistently named incorrectly at baseline (Remediation items). All 21 participants had Prophylaxis items, while 10 participants had Remediation items. Naming accuracy for Untrained and Trained items (Exemplar set 1) was measured. In addition, stimulus generalisation was examined by having participants name an alternative exemplar of each Untrained and Trained item (Exemplar set 2). Correlational analyses focused on the relationships between naming accuracy and volume of regions previously identified as having a role in naming and semantic processing. Outcomes & Results: Unexpectedly, there were no significant correlations between baseline volume and post-treatment accuracy for treated items. However, baseline volume within the left temporal pole was positively correlated with post-treatment accuracy for Untrained Exemplar set 2 Prophylaxis items, while baseline volume in the left inferior temporal gyrus (ITG) was positively correlated with post-treatment accuracy for Untrained Exemplar set 1 Remediation items. Conclusions: These findings suggest that lower volume in the left temporal pole is associated with decline for Untrained items, while lower volume in the left ITG is associated with a lack of improvement for Untrained items. Possible explanations for the different patterns observed across exemplar sets are discussed. [ABSTRACT FROM AUTHOR]

Background:The last two decades have afforded a small but steady rise in the number of studies exposing language dysfunctions in patients with relapsing remitting multiple sclerosis (RRMS), the most common form of multiple sclerosis however, not much is known about word class naming deficits in this group of individuals. Aim:To explore whether individuals with RRMS show word class naming deficits favouring either nouns or verbs, and if verb accuracy is affected by semantic and phonological verb type. Method:A total of 31 adults with RRMS were compared to 28 demographically matched healthy controls on noun and verb production using the Greek Object and Action Test (GOAT), a picture-based assessment developed for this purpose. Different semantic categories of verbs were investigated such as conceptually/semantically “heavy” verbs (i.e., instrumental verbs, e.g., “sweeping”) compared to conceptually/semantically “weaker” verbs (i.e., non-instrumental verbs (NIVs), e.g., “sleeping”) and instrumental verbs that were phonologically related to a noun (i.e., name-related instrumental verbs, e.g., “mopping”). Outcome & results:Verbs were significantly more difficult to retrieve than nouns for the RRMS group on production tasks compared to the demographic and intelligence matched healthy participants. Moreover, there was a significant difference between instrumental and NIV production with instrumental verbs more difficult to retrieve than NIVs. In regard to phonological relatedness, non-name-related instrumental verbs were significantly more difficult to retrieve than name-related instrumental verbs. Multiple regression analyses conducted as a separate model for verbs and nouns indicated that performance on the GOAT could not be explained by any of the predictor variables (demographic, clinical, or neurocognitive performance). Conclusion:Based on the results, the grammatical distinction for Greek verbs and nouns seems to be preserved in this group of individuals with RRMS. The naming deficit is probably in the connection between the semantic lexicon and the phonological lexicon. In the case of verbs, the magnitude of the difficulty was larger because of the effects of word frequency on verb retrieval. Overall, poor performance on verb and noun naming may be a marker of incipient cognitive decline, and typical cognitive-linguistic testing is not sensitive or specific enough to capture this phenomenon. [ABSTRACT FROM PUBLISHER]

Background:Researchers have demonstrated that people with aphasia (PWA) have preserved semantic knowledge. However, some PWA have impaired access to certain types of knowledge more than others. Yet, all these studies used single concepts. It has not been demonstrated whether PWA have difficulty accessing certain types of features within a discourse sample. Aims:The main goals of this study were to determine whether semantic knowledge and two category types were used differently within discourse produced by participants with anomic aphasia and healthy controls. Methods & Procedures:Participants with anomic aphasia (n = 19) and healthy controls (n = 19) told stories that were transcribed and coded for 10 types of semantic knowledge and two category types, living and non-living things. Outcomes & Results:A Poisson regression model was conducted. The results indicated a significant difference between the groups for the semantic knowledge types,soundandinternal state, but no difference was found for category types. Yet the distribution of semantic knowledge and category types produced within the discourse samples were similar between the groups. Conclusions:PWA might have differential access to certain types of semantic knowledge within discourse production, but it does not rise to the level of categorical deficits. These findings extend single-concept research into the realm of discourse. [ABSTRACT FROM AUTHOR]

Background: Although aphasia rehabilitation has been shown to be efficacious, many questions remain regarding how best to deliver treatment to maximise functional gains for persons with aphasia. Treatment-delivery variables, such as intensity and dosage, are likely to influence both behavioural and structural changes during anomia treatment. While numerous protocols have concluded that treatment intensity positively impacts functional outcomes, few studies to date have examined the role that dose plays in patient outcomes for anomia treatment. Aims: This study sought to investigate how manipulating dose of repeated confrontation naming within sessions influences naming in persons with aphasia. Repeated practice of confrontation naming, without feedback, was hypothesised to improve trained but not untrained words, to be persistent after withdrawal, and to be sensitive to the number of trials (i.e., dose) within sessions. Methods and Procedures: A single-subject ABA design, with replication across seven participants with aphasia, was used to investigate the influence of repeated confrontation naming attempts on the acquisition and maintenance of trained pictures relative to untrained pictures. Training involved repeated attempts to name pictures, along with repeated exposure to pictures of objects (nouns) and their names, without feedback. The primary independent variable was within session dose; the dependent variable was naming accuracy. Outcomes and Results: Naming accuracy improved for all participants for trained pictures across both acquisition and maintenance phases per visual inspection; such positive effects were not observed for untrained pictures. Effect-size calculations indicate that three of seven participants demonstrated considerable change for trained items, while one of seven participants demonstrated meaningful change for untrained items. The high-dose condition elicited small effect sizes for one participant, and large effect sizes for two of seven participants, while the low-dose condition elicited small and medium effect sizes for two of seven participants. Conclusions: Participants across a variety of aphasia severity levels responded positively to two doses of repeated confrontation naming practice, without feedback, across phases of this naming protocol. Results are in line with principles of neuroplasticity and demonstrate that repeated practice, without feedback, can produce significant and persistent changes in naming ability for some persons with aphasia. [ABSTRACT FROM AUTHOR]

Background:Though treatments for anomia in aphasia typically use accuracy of trained and untrained targets to determine treatment efficacy, researchers have begun to employ error analyses in order to more closely delineate the mechanisms involved in anomia recovery. Aims:The aim of this study was to examine changes in naming errors of 24 individuals with aphasia after phonomotor treatment (14 new individuals and 10 individuals whose word retrieval error data were previously reported in a separate manuscript). Methods & Procedures:Twenty-four individuals with aphasia received phonomotor treatment. Confrontation naming was assessed pre-treatment, immediately post-treatment, and 3 months post-treatment. Responses were scored for accuracy and error type. Paired-samplesttests comparing pre-treatment versus immediately post-treatment and 3 months post-treatment accuracy and error-type proportions were conducted. Additionally, the role of language severity in error-type proportion shifts was examined through analyses of subgroups and correlational analyses between language measures and error-type change scores. Outcomes & Results:Trained and untrained naming accuracy improved significantly immediately post-treatment, and gains were maintained 3 months post-treatment. No significant changes in error-type proportions were noted; however, trends towards decreases in proportions of omissions were noted immediately post-treatment (trained items) and 3 months post-treatment (trained and untrained items). In a post hoc subgroup analysis, a significant decrease in the proportion of omissions on trained items was noted 3 months post-treatment for the subgroup of individuals with lower lexical retrieval ability. Conclusions:Results are indicative of a shift in linguistic processing in which the linguistic network was holistically altered as a result of phonomotor treatment. [ABSTRACT FROM AUTHOR]

Background: The efficacy of telerehabilitation-based treatment for anomia has been demonstrated in post-stroke aphasia, but the efficacy of this method of anomia treatment delivery has not been established within the context of degenerative illness. Aims: The current study evaluated the feasibility and efficacy of a telerehabilitation-based approach to anomia treatment within the three subtypes of primary progressive aphasia (PPA). Methods & Procedures: Each of the three telerehabilitation participants represented a distinct subtype of PPA. Following a baseline evaluation of language and cognition, a phonological treatment and an orthographic treatment were administered to all participants over the course of 6 months. One month after the end of treatment, a post-treatment evaluation began. All treatment sessions and the majority of the evaluation sessions were administered via telerehabilitation. Treatment effects were examined within each subject, and treatment effects were also compared between each telerehabilitation participant and a group of in-person participants who had the same subtype of PPA. Outcomes & Results: All three telerehabilitation participants exhibited positive treatment effects. CGR (nonfluent/agrammatic variant PPA) and WCH (logopenic variant PPA) showed maintenance of naming for prophylaxis items under both treatment conditions, while ACR (semantic variant PPA) demonstrated increased naming of remediation items under the phonological treatment condition. Compared to in-person participants with the same subtype of PPA, each of the telerehabilitation participants typically showed effects that were either within the expected range or larger than expected. Conclusions: Telerehabilitation-based anomia treatment is feasible and effective in all three subtypes of PPA. [ABSTRACT FROM AUTHOR]

Background: Studies of verb anomia therapy in poststroke aphasia are rare, even though verbs are central to speech. In the great majority of studies, a traditional face-to-face setting with phonological, semantic, and/or sensorimotor cues is used to enhance lexical access. Technology-based therapy is expanding rapidly and has the potential to help individuals with aphasia improve verb retrieval abilities. Aims: This study aimed to assess the treatment outcome of and satisfaction with a therapy for verb anomia in chronic poststroke aphasia using a tablet for self-administered treatment at home. Methods & Procedures: Single-case studies were conducted with two participants who presented with chronic poststroke verb anomia. The following four phases were completed: (1) baseline measures; (2) training on the use of the tablet; (3) self-administered therapy with the tablet; and (4) follow-up, generalisation, and rating of the therapy measures. Twenty self-administered sessions were completed. Outcomes & Results: A significant improvement in verb naming was observed for the two participants following therapy. No generalisation was found for untreated verbs or for treated verbs in a novel task. Both participants were very satisfied with the self-administered treatment using a tablet. Conclusions: The use of tablet-based therapy to improve verb naming could be an interesting way to enhance rehabilitation of acquired language deficits. New technologies are promising and further studies are needed to demonstrate their usefulness and determine the pros and cons of using them in clinical settings. [ABSTRACT FROM PUBLISHER]

Background: Phonological priming has been shown to facilitate naming in individuals with aphasia, as well as healthy speakers, resulting in faster naming latencies. However, the mechanisms of phonological facilitation (PF) in aphasia remain unclear. Aims: Within discrete vs. interactive models of lexical access, this study examined whether PF occurs via the sub-lexical or lexical route during noun and verb naming in agrammatic and anomic aphasia. Methods & Procedures: Thirteen participants with agrammatic aphasia and 10 participants with anomic aphasia and their young and age-matched controls (n = 20/each) were tested. Experiment 1 examined noun and verb naming deficit patterns in an off-line confrontation naming task. Experiment 2 examined PF effects on naming both word categories using eyetracking priming paradigm. Outcomes &Results: Results of Experiment 1 showed greater naming difficulty for verbs than for nouns in the agrammatic group, with no difference between the two word categories in the anomic group. For both participant groups, errors were dominated by semantic paraphasias, indicating impaired lexical selection. In the phonological priming task (Experiment 2), young and age-matched control groups showed PF in both noun and verb naming. Interestingly, the agrammatic group showed PF when naming verbs, but not nouns, whereas the anomic group showed PF for nouns only. Conclusions: Consistent with lexically mediated PF in interactive models of lexical access, selective PF for different word categories in our agrammatic and anomic groups suggest that phonological primes facilitate lexical selection via feedback activation, resulting in greater PF for more difficult (i.e., verbs in agrammatic and possibly nouns in anomic group) lexical items. [ABSTRACT FROM AUTHOR]

Background: Treatment studies for anomia in primary progressive aphasia (PPA) have rarely compared multiple treatments in the same individual, and few anomia treatment studies have included participants with the logopenic variant of PPA (lvPPA). Aims: The goals of this study were to evaluate two types of treatment for anomia in a bilingual participant (ND) with lvPPA, and to examine possible cross-language transfer of treatment effects. Methods & Procedures: ND is a Norwegian-English bilingual woman with lvPPA who began this study at the age of 69. In the phonological treatment, ND listened to a word while viewing a corresponding picture, and she repeated the word. In the orthographic treatment, ND read a word out loud while viewing the corresponding picture, and she then copied the word. Both treatments were conducted in English, and accuracy for three tasks (oral naming, written naming, and naming to definition) was assessed in English and Norwegian. The treatment occurred over a one-year period, with eight sessions at the laboratory during the first month, followed by monthly laboratory sessions and thrice-weekly home practice sessions during the subsequent 11 months. Post-treatment assessments were conducted at 1 week, 8 months, 1 year, 20 months, and 3 years. Outcomes & Results: Compared to untrained items, the orthographic treatment resulted in greater English written naming accuracy. This treatment also resulted in cross-language transfer: greater Norwegian oral naming and naming to definition accuracy. The phonological treatment resulted in marginally greater English oral naming accuracy, but it did not have a significant effect on naming accuracy in Norwegian. Conclusions: These findings suggest that the orthographic treatment was effective in strengthening the orthographic representations of the treated items, which facilitated ND’s written naming performance. The pattern of cross-language transfer suggests that the orthographic treatment also strengthened the language-independent semantic representations of the treated items, thereby facilitating access to their Norwegian phonological representations. [ABSTRACT FROM AUTHOR]

Background: Semantic priming in individuals with anomic aphasia has never been the primary focus of an investigation. To date, one study investigated the effects of semantic priming in individuals with fluent aphasia (including anomic aphasia), revealing an inconsistency in semantic priming in the anomic group. Parallels from Broca’s aphasia and Wernicke’s aphasia literature may be drawn. However, due to the heterogeneity of anomic aphasia, a focused investigation was necessary. Aims: Semantic priming effects were investigated using a cross-modal pairwise paradigm. It was hypothesised that participants with anomic aphasia would demonstrate priming patterns at a stimulus onset asynchrony (SOA) of 500 ms with slower overall reaction times (RTs) than the control participants. It was further hypothesised that the participants with anomic aphasia might show less inhibition effects than the control participants. Methods & Procedures: Participants with anomic aphasia (n = 11) and healthy control participants (n = 16) completed a lexical decision task where prime–target pairs were present in equal proportions (related, unrelated, and nonwords). A neutral prime condition was also incorporated. Using a cross-modal pairwise paradigm, participants heard a spoken word 500 ms later, a written word appeared on screen (for 4000 ms). Participants were required to make a decision as to whether the written word was real, and RTs were recorded. Outcomes & Results: Linear mixed model analysis was undertaken and revealed no significant two-way interaction effect, indicating both groups showed priming patterns. A main effect of group was evident, showing faster RTs by the control participant group, confirming our hypothesis that people with anomic aphasia primed at an SOA of 500 ms in a similar manner to the control participants, with slower RTs. Conclusions: Semantic priming effects were present in anomic aphasia at relatively short SOAs and may be contributed to by automatic processes. Several parameters are proposed that should be adopted for further investigation into semantic priming in anomic aphasia including electrophysiological measures and manipulation of SOAs and relatedness proportions (RPs) to more precisely measure the effects of controlled versus automatic processes. Such investigation has the potential to inform new assessment and management techniques. [ABSTRACT FROM AUTHOR]

Background: Anomia, a persistent and frequent symptom of aphasia after stroke, obstructs the transfer of information in conversation, which can have serious consequences for participation in everyday social interaction with significant others and in society. Aims: This study aimed to replicate the findings of Coelho and his colleagues, as well as Boyle, and Wambaugh and Ferguson regarding the use of semantic feature analysis (SFA) for individuals with aphasia after stroke. Its main purpose was to explore whether intervention could (1) increase the ability to participate in conversation and (2) lead to positive changes in functional communication as perceived by the participants themselves and their significant others. Methods & Procedures: In this multiple-baseline across-subjects-design study, three participants with chronic aphasia were treated with intensive training using SFA. Treatment outcome was assessed with repeated measures of confrontation naming of actions and objects and with quantitative ratings of the quality of speech as well as communicative participation in conversation. The ratings were made by independent assessors blinded as to what phase of the study the data were obtained from. In addition, a questionnaire measuring perceived functional communication as reported by the participants and their significant others was administered before and after the training as well as at a follow-up session 10–12 weeks after the training was completed. Outcome & Results: Only minor treatment outcomes were apparent in this study. Visual inspection of the results showed a slight increase in the ability to participate in conversation for two of the three participants as well as a fall in the number of complex paraphasias for one of them and an increase in self-corrections for two. There was no improvement in the participants’ confrontation-naming ability. Two of the three participants rated their own functional communication skills higher at follow-up than before training while the third participant reported no change. As regards the ratings by significant others at follow-up versus before training, there was one slight decrease, one slight increase, and one considerable increase. Conclusions: Treatment with SFA might improve communicative skills and increase participation in everyday conversation despite not having a measurable effect on confrontation-naming ability in a formal assessment situation. Further research is needed to identify the individuals with aphasia who can benefit from treatment with SFA and to determine the nature of its impact on communicative participation. [ABSTRACT FROM AUTHOR]

Background: Anomia, difficulty producing words, is a pervasive symptom of many individuals with aphasia. We have developed a treatment for naming deficits—the Phonological Components Analysis (PCA) protocol—that has proven efficacious in improving word-finding abilities for individuals with post-stroke aphasia. Aims: The aim of this investigation is to present preliminary findings exploring the potential influence of choice—that is the active engagement of a participant in therapy—on our PCA treatment. Methods & Procedures: Five individuals with aphasia were treated in one of two conditions—Choice or No Choice. Potential changes in neural activation as a function of the treatment were also investigated. Two individuals (one from each condition) underwent functional MRI (fMRI) pre- and post-therapy. Outcomes & Results: All the individuals demonstrated a significant treatment effect immediately post-treatment and at a 4-week follow-up and four of the five participants at an 8-week follow-up. Three also demonstrated generalisation to untrained items. Unfortunately, no clear-cut patterns emerged to allow us to make claims about the influence of choice, per se, on the behavioural manifestations of improved naming. Interestingly, the participant from the Choice condition showed neural activation changes post-treatment in frontal and parietal regions that were not evident for the participant in the No Choice condition. Moreover, these changes were accompanied by a larger treatment effect for that individual and generalisation to a novel naming task. Conclusion: The efficacy of PCA treatment for naming deficits is further supported. In addition, the neuroimaging data suggest the possibility that active engagement of an individual in his/her therapy (in this case choosing phonological attributes of a target word) may exercise executive functions important for success in treating anomia. Also, continued exploration of task factors that may promote even better treatment effects using this protocol is warranted, as is continued investigation of the neural underpinnings associated with treatment effects. [ABSTRACT FROM AUTHOR]

The article focuses on relationship of executive control to aphasia treatment outcomes. Topics discussed include predicting the outcome of anomia therapy for people with aphasia post cerebrovascular accident; improving patients quality of life; and maintenance and generalization, following a structured naming therapy protocol.