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Neurology in Documentaries
Published in Eelco F. M. Wijdicks, Neurocinema—The Sequel, 2022
Various types of aphasia, not all of which are depicted in this film, present different severity levels. The additional challenge with receptive (or fluent) aphasia is that it often includes considerable deficits in comprehension, which complicate any effort to engage in meaningful dialogue. Dr. Marjorie Nicholas, Professor of Communication Sciences at the MGH Institute of Health Professions, provides an insightful description. Speech-language pathologists are interviewed in this film, notably those in the team led by Jerome Kaplan, founder of the Aphasia Community Group, one of the oldest groups of its kind in the country. They emphasize that patients with aphasia should be treated differently. Spouses (as well as other family members and caregivers) must figure out what their loved one is attempting to communicate. Some patients mention that perseveration associated with severe expressive aphasia can be exhausting, and it shows. The filmmaker Vincent Straggas recalls, “There is a struggle for them to communicate, and what one usually experiences is a more meaningful and thoughtful conversation. They are real and to the point, and don’t waste time with idle chitchat.”
Stroke
Published in Henry J. Woodford, Essential Geriatrics, 2022
Trials have demonstrated a small benefit of speech and language therapy (SLT) for the treatment of aphasia after stroke (SMD 0.28; 95% CI 0.06–0.49).103 A trial of intensive therapy for aphasia suggested that more than two hours of SLT per day added no additional benefit, but extending the duration of therapy, perhaps up to six weeks, may be worthwhile.104 People with expressive aphasia may be helped by the provision of communication aids. These include simple boards containing pictures or letters to which the person points. More complex computerised speech-generation devices are also available.
Methods for assigning impairment
Published in Ramar Sabapathi Vinayagam, Integrated Evaluation of Disability, 2019
In expressive aphasia, the person understands the questions projected to him/her but unable to express or speak an even single word. In expressive dysphasia, the person understands the questions, struggles to speak a full sentence, and answers in telegraphic style like “yes” or “no” for questions: Is it your name? Is it your age? Are you married? Do you have children? Are you working? Expressive aphasia derives an impairment of 25% and expressive dysphasia 15%.
A preliminary study of atypical cortical change ability of dynamic whole-brain functional connectivity in autism spectrum disorder
Published in International Journal of Neuroscience, 2022
Brodmann area 45 (BA45)is the pars triangularis of the IFG.Together with BA44 andBA46, the BA45 comprises Broca’s area, which is active in semantic tasks (remains controversial).Furthermore, pars triangularis have a role in cognitive control of memory. Lesions of the BA45 may lead to the characteristic findings of expressive aphasia. Greater GMV in the IFG.Lis associated with reduced ASD symptoms severity [66]. Hypo-activation of the IFG during the perception of facial expressions has been reported as the evidence fora deficit of the mirror neuron system in children with ASD [67]. Mirror neuron system may have a role in imitation, empathy, theory of mind and language. Meanwhile, cortical thinning of the mirror neuron system was correlated with ASD symptom severity [68]. Cortical thinning was also observed in the areas involved in emotion recognition and social cognition.
Diagnosing and managing post-stroke aphasia
Published in Expert Review of Neurotherapeutics, 2021
Shannon M. Sheppard, Rajani Sebastian
Depending on the clinical setting, speech language pathologists are often not expected to classify syndromes according to the Boston classification system. Some other common classifications include distinguishing between nonfluent and fluent aphasia. Patients may also be described as having receptive aphasia vs. expressive aphasia. Receptive aphasia refers to difficulty with language (auditory or written) comprehension, while expressive aphasia refers to difficulty with language production. Sometimes speech language pathologists will describe the relative severity of receptive and/or expressive deficits as either mild, moderate, or severe. For example, a patient may be described as having aphasia with mild receptive deficits and moderate-severe expressive deficits. However, this is not best practice as classifying receptive vs. expressive deficits does not provide any information about the type of receptive or expressive deficits. For example, we would expect all patients with aphasia to have expressive language deficits on some level (e.g., word finding difficulty, non-fluent speech, etc.). Thus, stating a patient has mild expressive deficits does not provide information about whether the deficits are due to word finding difficulties, or non-fluent speech or another type of deficit.
One size does not fit all – Stroke survivor’s views on group self-management interventions
Published in Disability and Rehabilitation, 2018
Ella Clark, Kate Bennett, Nick Ward, Fiona Jones
Fourteen participants were interviewed (see Table 1). The interviews lasted from 12 to 54 min, with a mean average of 30 min. The mean age of participants was 58 (with a range of 47–78). The mean time since stroke was 30 months and ranged from 4 months to 174 months. Eight of the interviewees were female, and six were male. Similarly, in the UK, three out of five strokes are in women [37]. Eleven of the interviewees were white British, one was Chinese and one was white Irish. In the UK, people of black and south Asian origin are at a higher risk of stroke compared to white people [38]. The limited ethnic diversity of this research should be considered in terms of transferability of the data. Four of the interviewees were unemployed, three were retired, three were employed (one of the three was self-employed), which is similar to the national statistics which show 69% of stroke survivors were unable to return to work [38]. One participant (8) had mild expressive aphasia. Residuals symptoms reported included: Aphasia, motor impairment, motor weakness, fatigue, low mood, and poor balance. No one else was present at participant interviews 1–12 apart from EC and the participant. Participant 13 brought her husband to the interview, as did participant 14. Five stroke survivors who were approached declined to take part in the study, three as they were too unwell, two as they were too busy.