Search

It is debated whether primary progressive apraxia of speech (PPAOS) and progressive agrammatic aphasia (PAA) belong to the same clinical spectrum, traditionally termed non-fluent/agrammatic variant primary progressive aphasia (nfvPPA), or exist as two completely distinct syndromic entities with specific pathologic/prognostic correlates. We analysed speech, language and disease severity features in a comprehensive cohort of patients with progressive motor speech impairment and/or agrammatism to ascertain evidence of naturally occurring, clinically meaningful non-overlapping syndromic entities (e.g. PPAOS and PAA) in our data. We also assessed if data-driven latent clinical dimensions with aetiologic/prognostic value could be identified. We included 98 participants, 43 of whom had an autopsy-confirmed neuropathological diagnosis. Speech pathologists assessed motor speech features indicative of dysarthria and apraxia of speech (AOS). Quantitative expressive/receptive agrammatism measures were obtained and compared with healthy controls. Baseline and longitudinal disease severity was evaluated using the Clinical Dementia Rating Sum of Boxes (CDR-SB). We investigated the data's clustering tendency and cluster stability to form robust symptom clusters and employed principal component analysis to extract data-driven latent clinical dimensions (LCD). The longitudinal CDR-SB change was estimated using linear mixed-effects models. Of the participants included in this study, 93 conformed to previously reported clinical profiles (75 with AOS and agrammatism, 12 PPAOS and six PAA). The remaining five participants were characterized by non-fluent speech, executive dysfunction and dysarthria without apraxia of speech or frank agrammatism. No baseline clinical features differentiated between frontotemporal lobar degeneration neuropathological subgroups. The Hopkins statistic demonstrated a low cluster tendency in the entire sample (0.45 with values near 0.5 indicating random data). Cluster stability analyses showed that only two robust subgroups (differing in agrammatism, executive dysfunction and overall disease severity) could be identified. Three data-driven components accounted for 71% of the variance [(i) severity-agrammatism; (ii) prominent AOS; and (iii) prominent dysarthria]. None of these data-driven LCDs allowed an accurate prediction of neuropathology. The severity-agrammatism component was an independent predictor of a faster CDR-SB increase in all the participants. Higher dysarthria severity, reduced words per minute and expressive and receptive agrammatism severity at baseline independently predicted accelerated disease progression. Our findings indicate that PPAOS and PAA, rather than exist as completely distinct syndromic entities, constitute a clinical continuum. In our cohort, splitting the nfvPPA spectrum into separate clinical phenotypes did not improve clinical-pathological correlations, stressing the need for new biological markers and consensus regarding updated terminology and clinical classification.

Background: Developmental dyslexia (DD) is a neurodevelopmental disorder that is characterized by difficulties with all aspects of information acquisition in the written word, including slow and inaccurate word recognition. The neural basis behind DD has not been fully elucidated. Method: The study included 22 typically developing (TD) children, 16 children with isolated spelling disorder (SpD), and 20 children with DD. The cortical thickness, folding index, and mean curvature of Broca's area, including the triangular part of the left inferior frontal gyrus (IFGtriang) and the opercular part of the left inferior frontal gyrus, were assessed to explore the differences of surface morphology among the TD, SpD, and DD groups. Furthermore, the structural covariance network (SCN) of the triangular part of the left inferior frontal gyrus was analyzed to explore the changes of structural connectivity in the SpD and DD groups. Results: The DD group showed higher curvature and cortical folding of the left IFGtriang than the TD group and SpD group. In addition, compared with the TD group and the SpD group, the structural connectivity between the left IFGtriang and the left middle-frontal gyrus and the right mid-orbital frontal gyrus was increased in the DD group, and the structural connectivity between the left IFGtriang and the right precuneus and anterior cingulate was decreased in the DD group. Conclusion: DD had atypical structural connectivity in brain regions related to visual attention, memory and which might impact the information input and integration needed for reading and spelling. [ABSTRACT FROM AUTHOR]

ObjectiveBroca's aphasia is a syndrome of impaired fluency with retained comprehension. The authors used an unbiased algorithm to examine which neuroanatomical areas are most likely to result in Broca's aphasia following surgical lesions.MethodsPatients were prospectively evaluated with standardized language batteries before and after surgery. Broca's area was defined anatomically as the pars opercularis and triangularis of the inferior frontal gyrus. Broca's aphasia was defined by the Western Aphasia Battery language assessment. Resections were outlined from MRI scans to construct 3D volumes of interest. These were aligned using a nonlinear transformation to Montreal Neurological Institute brain space. A voxel-based lesion-symptom mapping (VLSM) algorithm was used to test for areas statistically associated with Broca's aphasia when incorporated into a resection, as well as areas associated with deficits in fluency independent of Western Aphasia Battery classification. Postoperative MRI scans were reviewed in blinded fashion to estimate the percentage resection of Broca's area compared to areas identified using the VLSM algorithm.ResultsA total of 289 patients had early language evaluations, of whom 19 had postoperative Broca's aphasia. VLSM analysis revealed an area that was highly correlated (p < 0.001) with Broca's aphasia, spanning ventral sensorimotor cortex and supramarginal gyri, as well as extending into subcortical white matter tracts. Reduced fluency scores were significantly associated with an overlapping region of interest. The fluency score was negatively correlated with fraction of resected precentral, postcentral, and supramarginal components of the VLSM area.ConclusionsBroca's aphasia does not typically arise from neurosurgical resections in Broca's area. When Broca's aphasia does occur after surgery, it is typically in the early postoperative period, improves by 1 month, and is associated with resections of ventral sensorimotor cortex and supramarginal gyri.

Introduction: Broca’s aphasia, a non-fluent aphasia, is a frustrating condition with extensive psychological, familial, and social impact. The reports of people who have already recovered or can express themselves are essential to increasing knowledge about the experience of living with Broca’s aphasia. A-FROM is a framework designed to organize thinking about the impact of living with aphasia and includes four key domains: Communication and language environment; Language and related impairments; Personal identity, attitudes and feelings, and Participation in life situations. Nursing intervention is central to optimizing recovery and positively influencing the experience of successfully living with this clinical condition. Objective: To map scientific evidence about the experience of people who lived through a period of Broca’s aphasia. Methods: A Scoping Review was performed following the Joanna Briggs Institute methodology. The review was based on the research question, "How does the person report the experience of having lived through a period of Broca’s aphasia?", formulated according to the PCC strategy. The search was carried out in MEDLINE®, CINAHL®, Psychology and Behavioral Sciences Collection, and Scopus electronic databases in November 2022. Articles were selected based on the eligibility criteria. The review followed the PRISMA-ScR EQUATOR checklist. Results: Seventeen articles published between 1961 and 2022 were included. Data obtained were grouped according to the key domains of the A-FROM tool. Information related to Personal identity, attitudes and feelings, and Participation in life situations were the most cited, followed by Language and related impairments and Communication and language environment. Conclusion: It was identified that health professionals, therapeutic interventions, spirituality, hope, context, interactions, and psychosocial factors influence the experience of Broca’s aphasia. It is essential to continue investigating how people report the experience of having lived through a period of Broca’s aphasia to improve the quality of care and people's quality of life.

This work examines, in addition to Paul Pierre Broca’s psycholinguistic contributions, his adherence and contribution to Basque linguistics. Three areas have been analyzed: neurolinguistics, anthropology and Basque linguistics. Thus, critical interpretations of neurological discoveries are exposed. We have examined the paper «Sur l’origine et la répartition de la langue basque. Basques français et basques espagnols» (Broca, 1875), in order to present the main hypotheses and reflections that appear in it, referring to the geographical drift of the Basque language and the sociolinguistic situation of the 19th century, among other areas.

Introduction Broca's aphasia, a non-fluent aphasia, is a frustrating condition with extensive psychological, familial, and social impact. The reports of people who have already recovered or can express themselves are essential to increasing knowledge about the experience of living with Broca's aphasia. A-FROM is a framework designed to organize thinking about the impact of living with aphasia and includes four key domains: Communication and language environment; Language and related impairments; Personal identity, attitudes and feelings, and Participation in life situations. Nursing intervention is central to optimizing recovery and positively influencing the experience of successfully living with this clinical condition. Objective To map scientific evidence about the experience of people who lived through a period of Broca's aphasia. Methods A Scoping Review was performed following the Joanna Briggs Institute methodology. The review was based on the research question, "How does the person report the experience of having lived through a period of Broca's aphasia?", formulated according to the PCC strategy. The search was carried out in MEDLINE®, CINAHL®, Psychology and Behavioral Sciences Collection, and Scopus electronic databases in November 2022. Articles were selected based on the eligibility criteria. The review followed the PRISMA-ScR EQUATOR checklist. Results Seventeen articles published between 1961 and 2022 were included. Data obtained were grouped according to the key domains of the A-FROM tool. Information related to Personal identity, attitudes and feelings, and Participation in life situations were the most cited, followed by Language and related impairments and Communication and language environment. Conclusion It was identified that health professionals, therapeutic interventions, spirituality, hope, context, interactions, and psychosocial factors influence the experience of Broca's aphasia. It is essential to continue investigating how people report the experience of having lived through a period of Broca's aphasia to improve the quality of care and people's quality of life. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Health & Life Sciences / Sağlık ve Yaşam Bilimleri Dergisi is the property of Istanbul Kultur University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Of all the nineteenth-century physicians whose names still resonate today, Armand Trousseau is perhaps the one most familiar, for his description of carpal spasm as a sign of hypocalcemia (Trousseau's sign) and his description of the hypercoagulable state associated with cancer (Trousseau's syndrome). In the last three years of his life, Trousseau turned his attention to aphasia, which he included in his 1864 and 1865 lectures given at Hôtel-Dieu Hospital in Paris and which he discussed in an address to the Imperial Academy of Medicine in 1865. Trousseau preceded Wernicke in describing aphasia as a symptom complex, in which he included Broca's aphemia, receptive aphasia, the inability to read with and without the inability to write (alexia with and without agraphia), the inability to name common objects (amnesic aphasia or anomia) and to recognize numbers (acalculia), and the inability to draw. Trousseau concluded that such a varied symptomatology could not arise from a single area, and he proposed that lesions of the posterior inferior frontal convolution identified by Broca, of the insula and corpus striatum and of the temporal and parietal lobes, could give rise to aphasia. The role of the posterior temporal lobe in receptive aphasia was confirmed by Wernicke in 1874, and the role of the inferior parietal lobule in agraphia and alexia was confirmed by Dejerine in 1891. Trousseau thought that aphasia resulted from the loss of the memory for words and for the synergistic actions of the movements of articulations learned in early childhood. Trousseau added inattention, lack of comprehension, and cognitive decline to amnesia as contributing factors to the verbal and nonverbal expression of thought. Trousseau constructed a comprehensive theory of aphasia that unified its semiology, localization, and pathophysiology. This construct had the virtue of being predictive and falsifiable by the clinico-pathological method. Through insight born of observation, Trousseau identified the issues that dominated aphasiology into the twenty-first century. [ABSTRACT FROM AUTHOR]

Este trabajo pretende analizar los parámetros temporales de las consonantes oclusivas sordas [p, t, k] en el habla espontánea de un hablante con afasia de Broca y apraxia del habla en tres momentos diferentes de su enfermedad, a fin de determinar el nivel de deterioro respecto a su producción sin patología, así como su evolución tras veintidós meses de terapia logopédica. Las principales variables estudiadas han sido la duración consonántica, de la fase de silencio y del VOT. Los resultados estadísticos indican que los parámetros temporales presentan valores mayores a los observados en hablantes sin patología y que estos van en descenso a lo largo de la rehabilitación, especialmente para la realización bilabial. Las variaciones en la duración dependen, fundamentalmente, del punto de articulación y de los procesos de mantenimiento o debilitamiento de la sonoridad. Además, se ha advertido que las principales mejoras se han producido durante el periodo de recuperación espontánea y que las características acústicas de la realización bilabial se diferencian de las de las consonantes dental y velar, siendo la primera la que presenta los valores de duración más altos, así como los patrones de mejora más significativos.

Introduction Broca's aphasia, non-fluent aphasia, encompasses articulation disorders, paraphasia, agrammatism, anomie, and discrete language comprehension disorders.1 It is a frustrating condition with extensive psychological, familial, and social impact.2 The reports of people who have already recovered or can express themselves are essential to understanding and increasing knowledge about the experience of living with Broca's aphasia,3 what promotes a better adjustment and optimization of the care.. Living with Aphasia: a framework for Outcome Measurement (A-FROM)4 is a framework that allows organize thinking about the impact of living with aphasia and includes four key domains: Communication and language environment; Language and related impairments; Personal identity, attitudes and feelings, and Participation in life situations.4 Nursing intervention is central to optimizing recovery and positively influencing the experience of successfully living with this clinical condition.5 Objectives To map and identify the scientific evidence about the experience of people who lived through a period of Broca's aphasia, according to their perspective. Method A Scoping Review was performed following the Joanna Briggs Institute methodology. The review was based on the research question "How does the person report the experience of having lived through a period of Broca's aphasia?", formulated according to the PCC strategy: P=Population (adults who experienced Broca's aphasia); C=Concept (report of Broca's aphasia experience); C=Context (ambulatory and hospital). The search was carried out in the electronic databases MEDLINE®, CINAHL®, Psychology and Behavioral Sciences Collection, and Scopus in April 2020. The selection of articles was performed based on the inclusion and exclusion criteria. Primary studies, theoretical articles, literature reviews, and reports about Broca's aphasia experiences in English, Spanish and Portuguese, were included, with no time limit. The review followed the PRISMA-ScR EQUATOR checklist. Results and Discussion 15 articles published between 1961 and 2020 were included. Data obtained on Broca's aphasia experience were grouped according to the key domains of the A-FROM tool4. Information related to Personal identity, attitudes and feelings, and Participation in life situations were the most cited in the literature, followed by Language and related impairments and Communication and language environment. Conclusions and implications for knowledge development This review highlighted the influence that health professionals, therapeutic interventions, spirituality, hope, context, interactions, and psychosocial factors have on experiencing this clinical condition. It is essential to continue investigating how people report the experience of having lived through a period of Broca's aphasia to improve the quality of care provided to people with this clinical condition and consequently optimize their well-being and quality of life. [ABSTRACT FROM AUTHOR]

Aphasia is one of the most common deficits occurring after stroke that remains, at least in part, even after speech therapy and medication treatment. Non-invasive direct current transcranial stimulation (tDCS) is used to improve brain function by induction of neural plasticity. This study investigated the effect of bi-hemispheric tDCS on verbal function in patients with stroke-induced Broca's aphasia. Thirty patients with Broca's aphasia due to ischemic stroke, referred to an academic hospital in Guilan Province, Iran, in 2019-20, were studied. Patients were divided into two groups receiving seven sessions of either active or sham tDCS. The tDCS sessions began 10–20 days after stroke onset. The severity of aphasia before and after the intervention and a 3-month follow-up were assessed by the Persian version of the Western Battery-1 test (P-WAB-1). T-test, ANOVA, and Repeated Measurement were used for data analyses. The mean P-WAB-1 score was significantly higher in the intervention group both early after tDCS (P ≤ 0.0001) and on the 3-months follow-up (P ≤ 0001). Linear regression analysis indicated that tDCS had a positive effect on verbal performance scores independent of age, sex, and lesion volume (Regression coefficient = −33.3). Bi-hemispheric tDCS effectively improves verbal function in Broca's aphasia in the sub-acute phase of ischemic stroke. • Transcranial direct current stimulation ameliorated post-stroke Broca's aphasia. • Bi-hemispheric tDCS on F3 and F4 zone is effective in improving verbal function. • The verbal expression score increased after 7 sessions of tDCS on dorsolateral prefrontal cortex. [ABSTRACT FROM AUTHOR]

This chapter reviews the history of some of the theoretical models of aphasia, with a focus on the classic Broca-Wernicke model. It sets off in the 19th century when postmortem studies of patients with aphasia led to the first anatomic models of cerebral language representation. I chose to focus on the famous Broca-Wernicke model, not only because it remains influential in daily clinical decision making, but also because of the intriguing fact that the legacy of these physicians differs from their original opinions and theories. The chapter ends in the second half of the 20th century, before the advent of CT and MRI. Over time, there has never been much consensus on the anatomic location of specific language functions, and there remains an ongoing discussion between those who assign language functions to certain anatomic brain regions, and those who advocate that language functions cannot be localized as they are widely distributed across the brain. In retrospect, many historic figures such as Broca, Wernicke, Goldstein, or Luria, actually proposed theories that combined both localist and holist views, already reflecting our modern scientific views on language representation., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Opioid use disorder (OUD) is characterized by the inability to control opioid use despite attempts to stop use and negative consequences to oneself and others. The burden of opioid misuse and OUD is a national crisis in the United States with substantial public health, social, and economic implications. Although medication-assisted treatment (MAT) has demonstrated efficacy in the management of OUD, access to effective counseling and psychosocial support is a limiting factor and a significant problem for many patients and physicians. Digital therapeutics are an innovative class of interventions that help prevent, manage, or treat diseases by delivering therapy using software programs. These applications can circumvent barriers to uptake, improve treatment adherence, and enable broad delivery of evidence-based management strategies to meet service gaps. However, few digital therapeutics specifically targeting OUD are available, and additional options are needed., Objective: To this end, we describe the development of the novel digital therapeutic MODIA., Methods: MODIA was developed by an international, multidisciplinary team that aims to provide effective, accessible, and sustainable management for patients with OUD. Although MODIA is aligned with principles of cognitive behavioral therapy, it was not designed to present any 1 specific treatment and uses a broad range of evidence-based behavior change techniques drawn from cognitive behavioral therapy, mindfulness, acceptance and commitment therapy, and motivational interviewing., Results: MODIA uses proprietary software that dynamically tailors content to the users' responses. The MODIA program comprises 24 modules or "chats" that patients are instructed to work through independently. Patient responses dictate subsequent content, creating a "simulated dialogue" experience between the patient and program. MODIA also includes brief motivational text messages that are sent regularly to prompt patients to use the program and help them transfer therapeutic techniques into their daily routines. Thus, MODIA offers individuals with OUD a custom-tailored, interactive digital psychotherapy intervention that maximizes the personal relevance and emotional impact of the interaction., Conclusions: As part of a clinician-supervised MAT program, MODIA will allow more patients to begin psychotherapy concurrently with opioid maintenance treatment. We expect access to MODIA will improve the OUD management experience and provide sustainable positive outcomes for patients., (©Björn Meyer, Geri-Lynn Utter, Catherine Hillman. Originally published in JMIR Mental Health (https://mental.jmir.org), 08.10.2021.)