Slave systems in verbal short-term memory

Background: The model of performance in short-term memory (STM) tasks that has been most influential in cognitive neuropsychological work on deficits of STM is the “working memory” model mainly associated with the work of Alan Baddeley and his colleagues.

Aim: This paper reviews the model. We examine the development of this theory in studies that account for STM performances in normal (non-brain-damaged) individuals, and then review the application of this theory to neuropsychological cases and specifications, modifications, and extensions of the theory that have been suggested on the basis of these cases. Our approach is to identify the major phenomena that have been discussed and to examine selected papers dealing with those phenomena in some detail.

Main Contribution: The main contribution is a review of the WM model that includes both normative and neuropsychological data.

Conclusions: We conclude that the WM model has many inconsistencies and empirical inadequacies, and that cognitive neuropsychologists might benefit from considering other models when they attempt to describe and explain patients' performances on STM tasks.     

Book Reviews

Background: Addressing the long-term consequences of stroke is a top 10 research priority, and understanding the views of different stakeholders is essential in designing appropriate patient-centred multidisciplinary rehabilitation.

Aims: This study reports on the perspectives of 38 individuals who live with or work with aphasia: people with aphasia (PWA), family members (FM) and friends, and speech and language therapists (SLTs), about its consequences in the daily lives of PWA.

Method &; Resources: In total, 14 PWA, 14 FM and 10 SLTs participated in the study. All participants were interviewed about the consequences of stroke and aphasia. Small focus groups were used with some participants. In-depth semi-structured interviews were used with other participants. Interviews were carried out in groups or individually in order to accommodate severe aphasic impairments or respondents with fewer years of education. Interviews were video or audio-recorded. Verbal and non-verbal communication was transcribed and analysed qualitatively using content analysis. Data was coded and mapped onto the ICF framework.

Outcomes &; Results: All three groups reported consequences in Body Functions and Body Structures, primarily in Mental Functions (Specific Mental Functions and Global Mental Functions) and Neuromusculoskeletal and Movement-Related Functions. Within Specific Mental Functions, PWA emphasised Expression of Oral Language, whereas FM and SLTs emphasised Emotional Functions. Within Global Mental Functions, PWA and FM emphasised Energy and Drive Functions, whereas SLTs emphasised Temperament and Personality Functions. Some consequences were shared between PWA and SLTs (Sensory Functions and Pain, and Functions of the Digestive, Metabolic and Endocrine Systems), whilst others were specific to SLTs alone (Voice and Speech Functions, and Cardiovascular, Haematological, Immunological and Respiratory Systems). All three groups reported consequences in Activities and Participation in Major Life Areas; Community, Social and Civic Life; Interpersonal Interactions and Relationships; Communication; and Mobility. Some consequences were shared by PWA and FM (Domestic Life), and others by FM and SLT (Self Care). Consequences in General Tasks and Demands were only described by SLTs and in Learning and Applying Knowledge by PWA. Both PWA and FM reported a general Loss of Autonomy.

Conclusions: PWA, FM and SLTs reported a considerable range of stroke and aphasia consequences in the daily life of those who live with it. They were concerned to different degrees with language, physical and emotional changes, and impact on communication, mobility, self-care, relationships, leisure and work. Professionals’ practices in Portugal need to be changed in order to consider these findings.     

应用定量脑电图探讨低频重复经颅磁刺激干预亚急性期运动性失语症机制的研究

目的:通过观察定量脑电图(QEEG)在低频重复经颅磁刺激(r TMS)干预亚急性期运动性失语患者前后的变化,进一步探讨其机制。方法:将30例脑卒中后亚急性期运动性失语患者随机分为r TMS组与假刺激组各15例。两组患者均给予常规药物治疗及言语训练,r TMS组在右侧大脑半球Broca镜像区给予低频r TMS治疗,连续治疗3周。最终两组各脱落2例。于治疗前和治疗3周后(治疗后)行定量脑电图检查,比较各个频段上(δ+θ)/(α+β)值的差异,并采用西方失语成套测验(WAB)评定治疗前后的言语功能。结果:治疗后,两组患者在FP1、F3、F7、T3、C3频段(δ+θ)/(α+β)值下降,差异有显著性意义(P0.01);r TMS组在F3频段(δ+θ)/(α+β)值下降较假刺激组明显,差异有显著性意义(P0.01);r TMS组治疗前后自发言语、复述、命名以及失语商(AQ)分的差值较假刺激组大,差异有显著性意义(P0.05);相关分析显示r TMS组在FP1、F3、F7、T3、C3频段上,治疗前后的(δ+θ)/(α+β)差值与AQ差值呈负相关,差异有显著性意义(P0.05)。结论:低频r TMS刺激右侧大脑半球Broca镜像区能改善亚急性期运动性失语患者的言语功能,定量脑电图的变化提示了低频r TMS能促进左侧大脑皮质神经电活动变化。     

Priorities for Closing the Evidence-Practice Gaps in Poststroke Aphasia Rehabilitation: A Scoping Review

Objective

To identify implementation priorities for poststroke aphasia management relevant to the Australian health care context.

Bilingual deep dysphasia

We report B.R.B., a bilingual Turkish–English speaker with deep dysphasia. B.R.B. shows the typical pattern of semantic errors in repetition with effects of lexicality and imageability on performance in both languages. The question we asked is whether language type (Turkish or English) or language status—that is, first acquired (L1) or second acquired (L2)—has a greater impact on performance. Results showed that repetition in L1 (Turkish) was better than that in L2 (English). We also observed effects of language status on oral reading, writing to dictation, and naming (spoken and written) with greater impairment to repetition than other tasks in both languages. An additional finding was that spoken-word translation in both directions was worse than written-word translation, and word class had an effect on translation from L1 to L2. We argue that interactive activation models of deep dysphasia could explain deep dysphasia in bilingual speakers and interactions between task and language, if the weighted connections that support language processing in L2 are assumed to be weaker, thus causing rapid phonological decay to have more impact on task performance in L2. Implications of the results for models of bilingual language processing are also considered.     

Short-term memory,working memory,and syntactic comprehension in aphasia

Sixty-one people with aphasia were tested on 10 tests of short-term memory (STM) and for the ability to use syntactic structure to determine the meanings of 11 types of sentences in three tasks—object manipulation, picture matching, and picture matching with self-paced listening. Multilevel models showed relationships between measures of the ability to retain and manipulate item and order information in STM and accuracy and reaction time (RT), and a greater relationship between these STM measures and accuracy and RT for several more complex sentence types in individual tasks. There were no effects of measures of STM that reflect the use of phonological codes or rehearsal on comprehension. There was only one effect of STM measures on self-paced listening times. There were double dissociations between performance on STM and individual comprehension tasks, indicating that normal STM is not necessary to perform normally on these tasks. The results are most easily related to the view that STM plays a facilitatory role in supporting the use of the products of the comprehension process to accomplish operations related to tasks.     

Participants’ perceptions of an aphasia-friendly occupational therapy home program

Background: Upper extremity impairments post-stroke impact participation in valued occupations. Home programs are used to extend the frequency and amount of upper extremity practice for people post-stroke, but novel ways of increasing adherence to these programs is needed to ensure intense repetitive practice.

Objectives: The purpose of this process evaluation, was to examine the perceptions of people with aphasia as it relates to modifications to home programs that could influence participation, specifically listening to music and aphasia-friendly adaptations of written materials.

Methods: Seven people with chronic aphasia completed an upper extremity home program that included the use of music and aphasia-friendly modified materials (ClinicalTrials.gov ID:2016/06/18). After the home program, participants completed semi-structured interviews to understand their perceptions of the program and the modifications.

Results: Five themes were identified including (1) music, (2) activities, (3) instructions, (4) logistics, and (5) progress. Most participants perceived music as helpful, but a few reported it being distracting. Participants found the variety of activities helpful as well as specific characteristics of the instructions such as photographs and images. Some participants expressed elements of the home program to be barriers to practice such as using the activity monitors and logbook, which required assistance at times. Finally, participants noted their own progress resulting from the program and liked that they could adjust the intensity of the program as they progressed.

Conclusions: Overall participants in this study with aphasia perceived the modifications to home programs including aphasia friendly written instructions and music to facilitate successful home practice.     

Semantic contributions to immediate serial recall: Evidence from two contrasting aphasic individuals

This paper examines the effect of semantic variables on serial recall in two contrasting aphasic cases and a group of controls. Experiment 1 manipulates word imageability and Experiment 2 manipulates semantic similarity. Controls not only showed better recall of imageable/semantically grouped lists, but under some conditions they also produced proportionately fewer phonological errors. These findings suggest that increasing the effectiveness of lexical/semantic support reduces reliance on phonological support. Consistent with this proposal, case TV, whose phonological impairment should increase his reliance on lexical/semantic support, produced abnormally low rates of phonological errors under some conditions. Conversely, case NP, who had a lexical/semantic impairment, produced abnormally high rates of phonological errors under some conditions. Analysis of serial recall curves in both aphasics and controls support the hypothesis that phonological processes are particularly critical for the recall of list-final items. However, there was no evidence that semantic support is especially crucial for list-initial recall. Controls did not exhibit stronger effects of semantic variables at list-initial position. Case NP (lexical/semantic impairment) performed disproportionately poorly on these items, but only under certain conditions.     

Verbal memory and sentence comprehension in aphasia: A case series

ABSTRACT

This case series explores the relationship between verbal memory capacity and sentence comprehension in four patients with aphasia. Two sentence comprehension tasks showed that two patients, P1 and P2, had impaired syntactic comprehension, whereas P3 and P4’s sentence comprehension was intact. The memory assessment tasks showed that P1 and P2 had severely impaired short-term memory, whereas P3 and P4 performed within the normal range in the short-term memory tasks. This finding suggests an association between short-term memory deficit and sentence comprehension difficulties. P1 and P3 exhibited impaired comparable working memory deficits, suggesting a dissociation between working memory and sentence comprehension.