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Introduction: Depressive symptoms are a major drawback of aphasia, negatively impacting on functional outcomes. In a previous study, Intensive Language-Action Therapy (ILAT) was effective in improving depression and low mood in persons with chronic non-fluent aphasia. We present a proof-of-concept case-control study that evaluates language and mood outcomes amongst persons with fluent post-stroke aphasia.Participants: Thirteen Spanish speaking persons with fluent aphasia due to chronic stroke lesions in the left hemisphere participated in the study.Intervention: Five participants (intervention group) received ILAT for 3 h/day during two consecutive weeks, for an overall of 30 h, and 8 participants (control group) entered a waiting-list no-treatment arm.Results: The main finding was that participants receiving active treatment showed significant improvements on depression and aphasia severity scores, whereas no significant changes were found in the control group.Conclusions: The implementation of ILAT was efficient in improving clinical language deficits in people with fluent aphasia and contributes to improvement in mood after therapy.Trial registration: EUDRACT (2008-008481-12).

The two forms of obsessive-compulsive disorder (OCD), idiopathic and acquired, have been linked to abnormalities in the fronto-striato-thalamo-cortical circuitry, involving the orbitofrontal cortex, anterior cingulate cortex, thalamus, and striatum. Accumulating evidence indicates that damage to other brain regions (ie, temporal lobes) is also implicated in the pathogenesis of both types of OCD. In addition, some discrete OCD symptoms have received less attention because of their presumed low occurrence and difficultly of categorization. Among these, one intriguing and potentially severe type of obsessive thinking is the so-called "need to know" (NtK), which is a strong urge to access certain information, particularly proper names. In some patients, this monosymptomatic presentation may constitute the major feature of OCD. Here we report the cases of two patients who developed NtK obsessions with tenacious time-consuming, answer-seeking compulsions as the only or more disabling symptomatology in association with malignant tumors involving the right temporal lobe and connected fronto-subcortical circuits.

Changes in ERP (P100 and N400) and root mean square (RMS) were obtained during a silent reading task in 28 patients with chronic post-stroke aphasia in a randomized, double-blind, placebo-controlled trial of both memantine and constraint-induced aphasia therapy (CIAT). Participants received memantine/placebo alone (weeks 0-16), followed by drug treatment combined with CIAT (weeks 16-18), and then memantine/placebo alone (weeks 18-20). ERP/RMS values (week 16) decreased more in the memantine group than in the placebo group. During CIAT application (weeks 16-18), improvements in aphasia severity and ERP/RMS values were amplified by memantine and changes remained stable thereafter (weeks 18-20). Changes in ERP/RMS occurred in left and right hemispheres and correlated with gains in language performance. No changes in ERP/RMS were found in a healthy group in two separated evaluations. Our results show that aphasia recovery induced by both memantine alone and in combination with CIAT is indexed by bilateral cortical potentials.

Patients with semantic dementia (SD) may undergo successful relearning of object names, but these gains are usually restricted to the trained exemplars, demonstrating poor generalization. We hypothesized that generalization could be improved by restoring an item's semantic network through specific strategies that recruit the remaining personal semantic memories (conceptual enrichment therapies). We describe the case of a patient with SD who showed greater generalization of learning following a conceptual enrichment therapy than when learning items in a word-retrieval therapy. Our results suggest that enhancing an item's semantic network connections may result in improved generalization of learning in SD. A learning mechanism in the presence of compromised hippocampi is also discussed.

Background: In the past two decades, single-case studies evaluated the effect of massed repetition training to improve speech production and short-term memory deficits in conduction aphasia (CA). Improvements were reported in treated language and memory domains with modest generalisation of gains to spontaneous speech or auditory comprehension. Although these results are encouraging, sentence repetition training has not been compared with distributed speech-language therapy, and no studies have examined the role of pharmacological interventions to enhance gains promoted by these behavioural interventions in CA.Aims: The effects of massed sentence repetition therapy (MSRT) were compared to those of distributed speech-language therapy (DSLT) in measures of verbal output, short-term memory and repetition in patients with chronic post-stroke CA receiving treatment with the cholinesterase inhibitor donepezil (DP).Methods and Procedures: Three patients with chronic CA aphasia associated to large left perisylvia...

Background: Previous studies looking at relearning and retention of word labels in people with semantic dementia have shown some improvement in naming immediately after the period of learning but this has not usually been maintained. Studies have also shown rigid learning of names, in the order of presentation and to the picture exemplars only, with no generalisation of learning. Aims: This study aimed to explore relearning of a small vocabulary set in a person with semantic dementia (CUB) and to examine her ability to generalise this learning. In addition, it aimed to find out how long the learning persisted after therapy was completed given that semantic dementia is a progressive disorder. Methods & Procedures: A single-case design was used where CUB was asked to learn 28 words while a further 28 were left as controls. A "look and say" method was used daily for 1 month. As well as examining learning of the therapy and control set, CUB was asked to name 168 other exemplars of the learning set to see whether there had been any transfer of her learning from the therapy set. Outcomes & Results: CUB not only relearned a set of picture names but retained these without deliberate practice over a 6-month period. She was also able to generalise this learning to other visually similar exemplars in testing and in daily use. The maintenance of relearning was achieved despite severe deterioration in her semantic memory. Conclusions: Possible reasons are explored as to why CUB was able to relearn and retain these words and why this may differ from all previously reported cases. Differences in amount of time spent relearning, number of items learned, therapy methods, the severity of semantic memory impairment, the degree of atrophy, and the behavioural profiles of people with semantic dementia do not provide adequate explanations for our individual's differential ability to retain her learning over 6 months. The most plausible explanation is that the person with semantic dementia generalised her learning to her everyday speech and this provided the source of maintenance for the relearned names.