On the evening of December 16, 1997, about 700 children across Japan were hospitalized because of convulsive seizures or vomiting experienced while watching a popular animated TV program that included blue and red stimuli that alternated at 12 flashes per second. In one case, an 11-year-old girl developed a hallucination in the right visual field and a subsequent cramp on the right side of her face, with aphasic speech arrest. She had no history of seizures. Her electroencephalogram (EEG) showed normal background activity and no epileptiform discharges. Intermittent photic stimulation provoked a photoparoxysmal response. Her main clinical manifestation was a TV-induced left occipital lobe seizure spreading toward the left inferior frontal lobe. This suggested a functional link from the occipital lobe to the frontal operculum. 相似文献
The objectives of this study were to investigate the efficacy of bromocriptine (BR) combined with speech therapy (ST) to
improve a late recovery in non-fluent aphasic stroke patients. We performed a double-blind study with high dosage of BR, prescribed
according to a dose-escalating protocol, comprehensive of clinical data, relatives' impression, and language evaluations.
The study was divided into the following phases: t-0, inclusion; t-30, language re-test to evaluate the stability of aphasia;
t-90, placebo (PL) and ST; t-150, BR and ST; t-210, BR; t-270, wash-out. With respect to the baseline assessment, a significant
improvement was observed in the following tests: dictation (F, 4.8; p < .004), reading-comprehension (F, 8.1; p < .0003), repetition (F, 3.8; p < .01) and verbal latency (F, 4.9; p < .01). High dosage of BR promoted a late recovery in stable chronic non-fluent aphasia and this improvement was enhanced
by combination with ST.
Received: 13 July 1999 / Accepted in revised form: 16 November 1999 相似文献
Background: The relationship between spontaneous speech and formal language testing in people with brain tumors (gliomas) has been rarely studied. In clinical practice, formal testing is typically used, while spontaneous speech is less often evaluated quantitatively. However, spontaneous speech is quicker to sample and may be less prone to test/retest effects, making it a potential candidate for assessing language impairments when there is restricted time or when the patient is unable to undertake prolonged testing.Aim: To assess whether quantitative spontaneous speech analysis and formal testing detect comparable language impairments in people with gliomas. Specifically, we addressed (a) whether both measures detected comparable language impairments in our patient sample; and (b) which language levels, assessment times, and spontaneous speech variables were more often impaired in this subject group.Method: Five people with left perisylvian gliomas performed a spontaneous speech task and a formal language assessment. Tests were administered before surgery, within a week after surgery, and seven months after surgery. Performance on spontaneous speech was compared with that of 15 healthy speakers.Results: Language impairments were detected more often with both measures than with either measure independently. Lexical–semantic impairments were more common than phonological and grammatical impairments, and performance was equally impaired across assessment time points. Incomplete sentences and phonological paraphasias were the most common error types.Conclusions: In our sample both spontaneous speech analysis and formal testing detected comparable language impairments. Currently, we suggest that formal testing remains overall the better option, except for cases in which there are restrictions on testing time or the patient is too tired to undergo formal testing. In these cases, spontaneous speech may provide a viable alternative, particularly if automated analysis of spontaneous speech becomes more readily available in the future. These results await replication in a bigger sample and/or other populations. 相似文献
Background: Humans adapt to constantly changing internal and external conditions to meet survival needs. Persons with aphasia (PWA) are faced with changes in their physiological, cognitive, and affective state. They usually have physiological impairments in the frontal or temporal areas, which can lead to cognitive problems such as limited working memory, inefficient executive function, and lapse of attention. These problems have negative impacts on their language. Most PWA also experience long-term social anxiety, pressure, and other negative feelings caused by their illness. According to adaptation theory, symptoms such as omission and disfluency are not caused by deficits in language knowledge but by adaptive behaviours that PWA produce because of certain communicative purposes or the severity of aphasia.
Aims: The purpose of this paper is to review the theories and facts concerning the adaptive language behaviours of PWA and to attempt to account for the features, motivations, and principles of their strategic, adaptive language.
Main Contribution: To adapt to the heterogeneous concomitant cognitive and psychological impairment induced by aphasia, PWA must maximise their expression by efficiently exploiting their resources (i.e., performing normal communication in the most effortless way) following the principle of economy, which is a basic human cognitive principle. PWA employ several strategies to maintain crucial information and avoid effortful, less necessary language elements. They sometimes seek non-verbal strategies to compensate for what cannot be expressed. In this way, PWA are able to transmit information and simultaneously avoid embarrassment caused by erroneous language.
Conclusions: This type of economic language use can be observed in phonology, morphology, syntax, and other levels of language. PWA’s adaptation should be taken into consideration when considering their language, so that it can be differentiated from language disorders caused by other cognitive impairments or competence loss. Sometimes language deficits are only symptoms of adaption rather than the result of impairments. Psychosocial interventions should be included in recovery programmes so that PWA can adapt in a more positive way and make full use of their language potential. 相似文献
There is a lack of clarity in the field regarding how to best predict which naming treatment will be most beneficial for a particular individual with aphasia. The purpose of this study was to elucidate whether or not semantic or phonological therapy differentially impacts on outcomes for people with a range of different aphasic profiles when given both therapies. A single-participant design, with multiple repeated baselines for naming, replicated across four participants, was used. Participants were provided with a counterbalanced order of Semantic Feature Analysis (SFA) and Phonological Components Analysis (PCA) treatment. Findings demonstrated differential effects across participants. This seemed to be influenced by factors such as severity of anomia, order of treatment presentation, and capacity limits. Clinical implications of these findings highlight the importance of expanding our picture of a participant’s behaviours to consider what other important factors can inform intervention decisions. 相似文献
Background: Gestures can provide an excellent natural alternative to verbal communication in people with aphasia (PWA). However, despite numerous studies focusing on gesture production in aphasia, it is still a matter of debate whether the gesture system remains intact after language impairment and how PWA use gestures to improve communication. A likely source for the contradicting results is that many studies were conducted on individual cases or in heterogeneous groups of individuals with additional cognitive deficits such as conceptual impairment and comorbid conditions such as limb apraxia.
Aims: The goal of the current study was to evaluate the integrity and function of gestures in PWA in light of cognitive theories of language–gesture relationship. Since all such theories presuppose the integrity of the conceptual system, and the absence of comorbid conditions that selectively impair gesturing (i.e., limb apraxia), our sample was selected to fulfill these assumptions.
Methods & Procedures: We examined gesture production in eight PWA with preserved auditory comprehension, no comorbidities, and various degrees of expressive deficit, as well as 11 age- and education-matched controls, while they described events in 20 normed video clips. Both speech and gesture data were coded for quantitative measures of informativeness, and gestures were grouped into several functional categories (matching, complementary, compensatory, social cueing, and facilitating lexical retrieval) based on correspondence to the accompanying speech. Using rigorous group analyses, individual-case analyses, and analyses of individual differences, we provide converging evidence for the integrity and type of function(s) served by gesturing in PWA.
Outcomes & Results: Our results indicate that the gesture system can remain functional even when language production is severely impaired. Our PWA heavily relied on iconic gestures to compensate for their language impairment, and the degree of such compensation was correlated with the extent of language impairment. In addition, we found evidence that producing iconic gestures was related to higher success rates in resolving lexical retrieval difficulties.
Conclusions: When comprehension and comorbidities are controlled for, impairment of language and gesture systems is dissociable. In PWA with good comprehension, gesturing can provide an excellent means to both compensate for the impaired language and act as a retrieval cue. Implications for cognitive theories of language–gesture relationship and therapy are discussed. 相似文献