Brain atrophy in primary progressive aphasia involves the cholinergic basal forebrain and Ayala's nucleus

Primary progressive aphasia (PPA) is characterized by left hemispheric frontotemporal cortical atrophy. Evidence from anatomical studies suggests that the nucleus subputaminalis (NSP), a subnucleus of the cholinergic basal forebrain, may be involved in the pathological process of PPA. Therefore, we studied the pattern of cortical and basal forebrain atrophy in 10 patients with a clinical diagnosis of PPA and 18 healthy age-matched controls using high-resolution magnetic resonance imaging (MRI). We determined the cholinergic basal forebrain nuclei according to Mesulam's nomenclature and the NSP in MRI reference space based on histological sections and the MRI scan of a post-mortem brain in cranio. Using voxel-based analysis, we found left hemispheric cortical atrophy in PPA patients compared with controls, including prefrontal, lateral temporal and medial temporal lobe areas. We detected cholinergic basal forebrain atrophy in left predominant localizations of Ch4p, Ch4am, Ch4al, Ch3 and NSP. For the first time, we have described the pattern of basal forebrain atrophy in PPA and confirmed the involvement of NSP that had been predicted based on theoretical considerations. Our findings may enhance understanding of the role of cholinergic degeneration for the regional specificity of the cortical destruction leading to the syndrome of PPA.     

Predicting confrontation naming item difficulty

Background: Item response theory (IRT; Lord & Novick, 1968) is a psychometric framework that can be used to model the likelihood that an individual will respond correctly to an item. Using archival data (Mirman et al., 2010), Fergadiotis, Kellough, and Hula (2015) estimated difficulty parameters for the Philadelphia Naming Test (PNT; Roach, Schwartz, Martin, Grewal, & Brecher, 1996) using the 1-parameter logistic IRT model. Although the use of IRT in test development is advantageous, its reliance on sample sizes exceeding 200 participants make it difficult to implement in aphasiology. Therefore, alternate means of estimating the item difficulty of confrontation naming test items warrant investigation. In a preliminary study aimed at automatic item calibration, Swiderski, Fergadiotis, and Hula (2016) regressed the difficulty parameters from the PNT on word length, age of acquisition (Kuperman, Stadthagen-Gonzalez, & Brysbaert, 2012), lexical frequency as quantified by the Log10CD index (Brysbaert & New, 2009), and naming latency (Székely et al., 2003). Although the model's predictive utility was high, a substantial proportion (20%) of the response time data were missing. Further, only 39% of the picture stimuli from Székely and colleagues (2003) were identical to those on the PNT. Given that the IRT sample size requirements limit traditional calibration approaches in aphasiology and that the initial attempts in predicting IRT difficulty parameters in our pilot study were based on incomplete response time data this study has two specific aims.

Aims: To estimate naming latencies for the 175 items on the PNT, and assess the utility of psycholinguistic variables and naming latencies for predicting item difficulty.

Methods and Procedures: Using a speeded picture naming task we estimated mean naming latencies for the 175 items of the PNT in 44 cognitively healthy adults. We then re-estimated the model reported by Swiderski et al (2016) with the new naming latency data.

Outcomes and Results: The predictor variables described above accounted for a substantial proportion of the variance in the item difficulty parameters (Adj. R² = .692).

Conclusions: In this study we demonstrated that word length, age of acquisition, lexical frequency, and naming latency from neurotypical young adults usefully predict picture naming item difficulty in people with aphasia. These variables are readily available or easily obtained and the regression model reported may be useful for estimating confrontation naming item difficulty without the need for collection of response data from large samples of people with aphasia.     

Language disturbances associated to insular and entorhinal damage: study of a patient affected by herpetic encephalitis

The herpes simplex encephalitis (HSE) patient reported in this study presented a left hemisphere lesion limited to the left insula and to the left anterior parahippocampal region. The patient was followed longitudinally, focusing on the aphasia type, the language recovery, and the integrity of semantic representations. The language deficit was of fluent type, without phonological impairment, and showed a good but incomplete recovery after four months. A semantic impairment was possible at the onset, but recovered quickly and did not present a disproportionate impairment of living categories.     

Weak Satiety Responsiveness Is a Reliable Trait Associated with Hedonic Risk Factors for Overeating among Women

Some individuals exhibit a weak satiety response to food and may be susceptible to overconsumption. The current study identified women showing consistently low or high satiety responses to standardised servings of food across four separate days and compared them on behavioural, psychological and physiological risk factors for overeating and future weight gain. In a crossover design, 30 female participants (age: 28.0 ± 10.6; body mass index (BMI): 23.1 ± 3.0) recorded sensations of hunger in the post-prandial period following four graded energy level breakfasts. Satiety quotients were calculated to compare individuals on satiety responsiveness across conditions. Body composition, resting metabolic rate (RMR), energy intake, food reward and craving, and eating behaviour traits were assessed under controlled laboratory conditions. A distinct low satiety phenotype (LSP) was identified with good consistency across separate study days. These individuals had a higher RMR, greater levels of disinhibition and reported feeling lower control over food cravings. Further, they consumed more energy and exhibited greater wanting for high-fat food. The inverse pattern of characteristics was observed in those exhibiting a consistently high satiety phenotype (HSP). Weak satiety responsiveness is a reliable trait identifiable using the satiety quotient. The LSP was characterised by distinct behavioural and psychological characteristics indicating a risk for overeating, compared to HSP.     

How clerks understand the requests of people living with aphasia in service encounters

ABSTRACT

Aphasia often restricts participation. People living with aphasia (PLWA) engage in fewer activities, which leads to fewer interactions than before aphasia. Analyses of interactions with non-familiar people in activities of daily life could provide knowledge about how to integrate these situations in rehabilitation and facilitate ongoing PLWA participation post-rehabilitation. This qualitative study is the first to examine how PLWA make their requests understood in service encounters despite aphasia. Six people living with moderate or severe aphasia were video-recorded in situations of service encounters, e.g., pharmacies, specialised shops, restaurants, and others. We identified fifty-nine occurrences with one or several difficulties in the formulation of the request. They were examined, including the clerks’ responses and ensuing interaction using multimodal conversation analysis. Results showed that PLWA used nonverbal communication within the physical environment and the context of the interaction to support verbal production. In the majority of situations, the clerks understood the request promptly. In other situations, they both collaborated to achieve a clear understanding of the request. Moreover, the findings attest to the competence of people living with moderate or severe aphasia in engaging in service encounters and add to the knowledge base about interaction and social participation in aphasia.     

Continuous Measurement of O2 Consumption and CO2 Elimination During a Wakeful Hypometabolic State

Abstract

A previous investigation has demonstrated that the practice of a meditational technique elicits a wakeful, hypometabolic state. Measurement of O₂ consumption and CO₂ elimination was made by sampling techniques; mean values of these parameters were calculated from 6–10 minute samples. The present study extends this investigation, using a recently developed method of continuous measurement of O₂ consumption and CO₂ elimination. Continuous measurement of these parameters permitted the determination of mean values for the entire experimental periods as well as for selected intervals and permitted the examination of the sequence of respiratory changes. The present study reports statistically significant decreases in O₂ consumption of 5 percent and CO₂ elimination of 6 percent for the entire 20 minutes of the meditation period. These are lower than the sample values of 16 percent and 15 percent reported in the previous study. However, when selected intervals of the meditation period are examined, decreases in O₂ consumption and CO₂ elimination are comparable to those previously reported. The results are consistent with the difference between the discontinuous sampling measurement method originally employed and the continuous measurement method of the present investigation.     

Validation of the language component of the Addenbrooke's Cognitive Examination – Revised (ACE‐R) as a screening tool for aphasia in stroke patients

Aim: Several tests are available for aphasia screening following stroke. However, some of them have shortcomings such as need of specialist knowledge, low sensitivity and/or specificity and lengthy administration time. Our study aims to evaluate the language component of the Addenbrooke's Cognitive Examination – Revised (ACE‐R) as a screening tool for aphasia in stroke patients. Methods: The language component of ACE‐R was administered to consecutive patients admitted to a post‐acute stroke unit. Patients who were medically unstable or had a significant history of sensory impairment or mental health issues were excluded. The test was administered by two junior doctors with basic training in ACE‐R administration. Patients recruited were also assessed by an experienced speech and language therapist (SLT). The results of the two assessments were documented by a different member of the team and the SLT results were used as the benchmark to calculate the ACE‐R language component sensitivity and specificity. Results: Fifty‐nine participants were recruited and 27 of them were women. The mean age was 72 (SD 11.9). Thirty‐four participants had left and 11 right hemisphere stroke. Fourteen had bilateral affection. Six participants were left handed. A cut‐off value of 22/26 of ACE‐R language component showed 100% specificity and 83.1% sensitivity, while a cut‐off value of 16/26 had 88.2% specificity and 100% sensitivity. Conclusion: Our results suggest that the language component of ACE‐R has a satisfactory sensitivity and specificity compared with other screening tests used in strokes. It is easy to administer and free to use.     

An Analytical Model / Emotional Intelligence Quotient and QOL in Mothers with Infants in Japan

Objective: The purpose of this study was to examine the relationship between the emotional intelligence quotient and health-related quality of life using structural equation modeling.Methods: A self-administered questionnaire survey was conducted among 1,911 mothers who visited the Health Center for an infant medical examination. A hypothetical model was constructed using variables of the emotional intelligence quotient, social support, coping, parenting stress, and perceived health competence.Result: There were a total of 1,104 valid responses (57.8%). Significant standardized estimates were obtained, confirming the goodness of fit issues with the model. The emotional intelligence quotient had a strong impact on physical and psychological quality of life, and showed the greatest association with coping. This study differed from previous studies in that, due to the inclusion of social support and explanatory variables in coping, an increase in coping strategies was more highly associated with emotional intelligence quotient levels than with social support.Conclusion: An enhanced emotional intelligence quotient should be considered a primary objective to promote the health of mothers with infant children.     

Parallel recovery in a trilingual speaker: the use of the Bilingual Aphasia Test as a diagnostic complement to the Comprehensive Aphasia Test

We illustrate the value of the Bilingual Aphasia Test in the diagnostic assessment of a trilingual speaker post-stroke living in England for whom English was a non-native language. The Comprehensive Aphasia Test is routinely used to assess patients in English, but only in combination with the Bilingual Aphasia Test is it possible and practical to provide a full picture of the language impairment. We describe our test selection and the assessment it allows us to make.