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Rehabilitation of Language Disorders in Adults and Children
Published in Barbara A. Wilson, Jill Winegardner, Caroline M. van Heugten, Tamara Ownsworth, Neuropsychological Rehabilitation, 2017
Anastasia Raymer, Lyn Turkstra
Two forms of non-fluent aphasia fall in the transcortical category in that, despite non-fluent spontaneous verbal expression, repetition abilities are remarkably intact, yielding a parrot-like quality or echolalia when asked to repeat sentences. In transcortical motor aphasia (TCMA), verbal expression is non-fluent and word retrieval difficulty may arise due to impaired initiation of verbal output (Crosson, Ford and Raymer, 2015). Auditory comprehension can be affected for grammatically complex sentences. TCMA has been described acutely with left hemisphere lesions of the mesial frontal cortex (supplementary motor area), dorsolateral frontal cortex, or thalamus (Kreisler et al., 2000). In mixed transcortical aphasia, sometimes referred to as ‘isolation of the speech area’, repetition is relatively spared, whereas other language domains are severely impaired. This infrequent syndrome occurs with damage to left anterior and posterior cortical watershed regions that preserve left perisylvian cortex (Baumgaertner, 2015).
Pharmacotherapy for post-stroke aphasia: what are the options?
Published in Expert Opinion on Pharmacotherapy, 2023
Marcelo L. Berthier, Guadalupe Dávila
A new option for treating PSA is rotigotine (transdermal patches). Rotigotine is a non-ergoline dopamine agonist that binds all receptors (D1-D5) with a special affinity for D3, and it is approved for treating Parkinson’s disease and restless legs syndrome [82]. Rotigotine is safe in stroke patients and improves post-stroke neglect [82] and language function (spontaneous speech, comprehension, and naming) in a patient with severe mixed transcortical aphasia and linguistic anxiety [83] secondary to two extensive hemorrhages involving left frontal and parietal cortices [84]. Future trials can evaluate the role of rotigotine over more traditional ergoline dopaminergic agents, like bromocriptine, because it has good tolerance and adverse event profile [82]. PWA featuring reduced verbal output and motivation would be the best candidates for dopaminergic stimulation [76,85].
The usability of an AAC pain description system for patients with acquired expressive communication disorders
Published in Augmentative and Alternative Communication, 2023
Chen-li Kuo, Tsai-Hsuan Tsai, Shen-Mei Tung, Yueh-E Lin
The PainDiary app used in this study was designed for people whose listening comprehension and basic symbol processing abilities are intact; however, a proportion of patients with global aphasia, mixed transcortical aphasia, Wernicke’s aphasia, or transcortical sensory aphasia are unable to comprehend spoken messages. In addition, it is common for patients treated in neurosurgery wards to have impairments in the cognitive abilities required to use the app effectively, such as attention, memory, and visual retention. In situations where using a high-tech AAC app such as PainDiary independently is not possible, support from communication partners is desirable. A wide range of augmented inputs such as written support, gestures, and images implemented by communication partners could improve communication effectiveness for people with auditory comprehension deficits (Brown & Thiessen, 2018). With appropriate visuographic support, partner involvement is important for people with auditory comprehension difficulty (Dada et al., 2019). In the current study, the participants interacted with PainDiary through a series of questions related to pain assessment. Because there are also images associated with pain, the app has the potential to be used by nurses and other health care professionals to augment conversations about pain with patients who have auditory comprehension challenges.
Diagnosing and managing post-stroke aphasia
Published in Expert Review of Neurotherapeutics, 2021
Shannon M. Sheppard, Rajani Sebastian
Mixed transcortical aphasia is similar to global aphasia, except repetition skills are spared. Lesions are typically large and surround Broca’s and Wernicke’s area (watershed regions). Broca’s and Wernicke’s areas remain intact, but language recognition and production appear to be isolated from intentions generated elsewhere in the brain [20].