ABSTRACT
BACKGROUND: Primary progressive aphasia is a degenerative disease of nervous system clinically characterized by the progressive decrease of speech ability and the relatively reserved memory. OBJECTIVE: To investigate the characteristics of speech dysfunction and the clinical features of primary progressive aphasia we by reported onel patient with primary progressive aphasia. DESIGN: A case analysis. SETTING: Department of Neurology, Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences. PARTICIPANT: One male patient of 56 years old with primary progressive aphasia was selected from the Department of Neurology, Beijing Tiantan Hospital in March 2004, he had got education in senior middle school. The patient had been unable to tell the names of daily living objects at the beginning of 2001. Not only his ability of listening comprehension had gradually declined, but his characters had gradually changed except that his memory had not been affected obviously since 2003. Although he was able in self-care now, he could not normally work. METHODS: ① The spoken fluent types of the patient were evaluated with the standards for the fluency of spoken language in Aphasia battery of Chinese. Western battery aphasia was used to assess the type of aphasia of the patient. Boston diagnostic aphasia examination severity grading standard was applied to grade the severity of aphasia. ② The cognitive psychological tests of visual character-figure matching, denomination for figures and oral reading were used to judge whether the patient had verb-noun dissociation. ③The memory of the patient was assessed with clinical memory scale. MAIN OUTCOME MEASURES: ① spoken fluency, the type and grade of aphasia; ② condition of verb-noun dissociation for the patient; ③ memory of the patient. RESULTS: ① Examination of aphasia: The patient presented the spontaneous talking that named the fluent type, there were wrong meanings in his talks so that he was diagnosed as sensory aphasia. The severity of aphasia was separated into grade 3 levels. ② Cognitive psychological test: The correct rates of verbs and nouns in the test of denomination for figures were 15% and 53% respectively, and there was obvious difference (t=0.231, P ＜ 0.05). ③ Clinical memory scale: The memory quotient was 111,and the clinical memory grade was higher than normal. CONCLUSION: The most outstanding clinical characteristics of patients with primary progressive aphasia is speech dysfunction, and there is verb specific injury.
ABSTRACT
OBJECTIVE: About 70% patients with stroke have dysfunction at various degrees in clinic, especially aphasia would affect their social communication and even offer a serious economic load for family and social. This paper aims to summarize the relevant articles on aphasia recovery so as to provide researching evidences in the future. DATA SOURCES: Relevant articles were retrieved from the Medline with the key words of "aphasia, recovery, language, recovery" in English from January 1980 to January 2004. STUDY SELECTION: All articles were selected firstly, those which were related to aphasia recovery were selected, and the non-randomly clinical papers were excluded. The full text of rest was looked up to determine whether they were randomized controlled studies or not. Randomized controlled researches were regarded as inclusion criteria regardless of blind way. DATA EXTRACTION: Among 22 articles on aphasia recovery, 12 were selected according to inclusion criteria and 10 were excluded because of duplicated papers.DATA SYNTHESIS: Recovery of language function was related to sex,age, ducational degrees, characteristics of lesion, range of lesion, duration from episode to language recovery, insight and self redress of language disorder. Therefore, there were various findings and views for previous re searches on mechanism of aphasia recovery. CONCLUSION: There is not uniform conclusion on mechanism of aphasia recovery. Compliance of language function in brain may be a mechanism of aphasia recovery.
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BACKGROUND: Most studies believed that lesion sites are decisive to the attack and types of aphasia, which is also in disputation.OBJECTIVE: To classify and evaluate aphasia with CT and MRI examinations, so as to reveal the association between aphasia types and lesion sites.DESIGN: A cross-sectional study.SETTING: Department of Neurology, Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences.PARTICIPANTS: The lesion sites were selected from 1 198 patients with cerebral infarction, who were hospitalized in the stroke unit of the Department of Neurology, Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences between February 2002 and February 2005, the diagnosis accorded with the diagnostic standard of cerebral infarctionset by National Meeting for Cerebrovascular Disease, and the patients with cerebral infarction were caused by lesions of left cerebral hemisphere ry school and above, the intellect was normal before attack, and there was score of Western battery aphasia was ＞ 93.8. Totally 221 males and 104 females were enrolled, and the average age was (68.72±4.56) years.and received MRI examination within 1 week after admission. The data collection and treatment were finished with the Siemens Trio 2003T magaphasia of the patients was classified and evaluated with the Western battery aphasia by professional language therapist within 2 weeks after adtic aphasia examination severity grading standard by the same language therapist on the same day of Western battery aphasia. There were 6 grades, grade 0 was taken as meaningless language or auditory understanding ability, and grade 5 as extremely few differentiable language disorders, the patients could feel some difficulties subjectively, but the hearer was uncertain to obviously detect.MAIN OUTCOME MEASURES: Association between aphasia types and lesion sites; Grading of aphasia severity. Aphasia not caused by the involvement of language centers: Of the 1 198 patients with cerebral infarction, the Broca area in 5 cases and Wernicke area in 4 cases were involved, and did not cause aphasia syndrome in the Western battery aphasia showed that 83 cases had Broca aphasia, 48 cases Wernicke aphasia, 58 cases complete aphasia, 12 cases conduction aphasia, 36 cases transcortical motor aphasia, 17 cases transcortical sensory aphasia, 19 cases transcortical mixed aphasia and 52 cases nominal aphasia. The lesions located at typical language center in 240 cases and at nonaphasia examination severity grading standard: It was grade 0 in 84 cases, grade 1 in 79 cases, grade 2 in 77 cases, grade 3 in 63 cases and grade 4 in 22 cases, and the typical language centers were involved in most of the patients of grade 0 and grade 1.CONCLUSION: The association between types and lesion sites of most aphasia are in accordance with the typical aphasia mode, but it was not completely accordant in a few aphasias, the lesion of non-language centers can also cause aphasia, and the aphasia is greatly severe in the patients with the lesion site of language centers.
ABSTRACT
BACKGROUND: Chinese character is the only non-alphabetic system of writing, the patterns of semantic symbol, phonetic symbol and sign in the cognition of Chinese characters, it is the combination of form, sound and meaning, and its cognitive pattern, pathway, analytical judgement of semantic and storage are different from those of western alphabetic system of writing, and the processing of Chinese characters maydifferent from that of alphabetic system of writing.OBJECTIVE: To localize the motor language center of the healthy volunteers whose native language is Chinese by means of the equivalent current dipole (ECD) and synthetic aperture magnetometry (SAM) of magnetoen cephalography (MEG).DESIGN: A single-sample univariate analysis.SETTING: Department of Neurology, Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences.PARTICIPANTS: Ten healthy volunteers whose native language is Chinese were selected from the postgraduates and training participants in the Department of Neurology, Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences between July 2003 and April 2005, they were all right handedness and had no speech disorders and cognitive impairments, and all accepted training of language task.METHODS: All the healthy subjects were given the language task stimulation of reading words and pseudowords silently, the number of the silently read nouns, appearing time for each noun and the interval between two tasks were strictly matched, ① Words were the common high-frequency characters, accorded to the law of Chinese characters components, and had 4-13 strokes. ② Pseudowords, composed by Chinese characters made-up software, accorded to the made-up law of Chinese character, but could not compose the stroke assemble of the character, and had 4-13 strokes. The evoked magnetic field produced after the stimulation was recorded with MEG, the collected data were overlapped with MRI to obtain the localization of language functional areas.RESULTS: All the 10 volunteers finished the test and entered the analysis of results. Both words and pseudowords evoked obvious late magnetic reaction waves in bilateral cerebral hemispheres, the motor language centers both located at posterior inferior frontal gyrus.CONCLUSION: The motor and classic motor language centers are general concordant in the normal people whose native language is Chinese, that was to say, the motor language center localizes at posterior inferior frontal gyrus of normal people whose native language is Chinese.