Effects of acupuncture plus language training on language function and cerebral blood flow in patients with motor aphasia after ischemic stroke / 针灸推拿医学（英文版）

Objective: To observe the effects of acupuncture at the Governor Vessel acupoints plus language training on the language function and cerebral blood flow in patients with motor aphasia after ischemic stroke. Methods: Eighty-six patients were randomized into a control group and an observation group, with 43 cases in each group. Conventional symptomatic treatment was offered to both groups. Besides, the control group received language training, while the observation group received language training plus additional acupuncture at the Governor Vessel acupoints. Before and after treatment, the aphasia battery of Chinese (ABC) and Chinese functional communication profile (CFCP) were tested, and the mean velocity (Vm) and resistance index (RI) of the left middle cerebral artery (MCA) were detected. Results: The total effective rate was higher in the observation group than in the control group (P<0.05). After treatment, the observation group gained higher scores in oral expression, comprehension, repeating, naming objects, reading, and writing, as well as the general score of ABC (all P<0.05), higher than those in the control group (all P<0.05). The CFCP score increased in both groups after intervention, showing significant intra-group differences (both P<0.05), and the CFCP score was higher in the observation group than in the control group (P<0.05). After treatment, Vm of the left side MCA increased in the control group (P<0.05), while no significant change was observed in RI (P>0.05); in the observation group, Vm of the left side MCA increased and RI decreased significantly compared with the baseline (both P<0.05), and were markedly different from those in the control group (both P<0.05). Conclusion: Acupuncture at the Governor Vessel acupoints plus language training can produce valid efficacy in treating motor aphasia after ischemic stroke; it can notably improve the language function, everyday oral communication ability, and increase cerebral perfusion of the patients.

Terapia de produção audiovisual associada a estimulação por corrente contínua melhora nomeação em paciente com afasia de Broca e doença de Parkinson / Audiovisual production therapy associated with transcranial current stimulation improves naming in a patient with Broca's aphasia and Parkinson's disease

RESUMO A doença de Parkinson (DP) é uma doença neurodegenerativa, caracterizada por disfunções motoras e não motoras. Pacientes com DP também podem apresentar problemas de linguagem, incluindo deficit em tarefas de nomeação. Dificuldade em tarefas de nomeação é uma característica importante da afasia de Broca, transtorno de linguagem associado a lesões pós-acidente vascular cerebral (AVC) no córtex pré-frontal inferior esquerdo (área de Broca). Aqui, apresenta-se o caso de um paciente de 79 anos diagnosticado com DP (estágio 4 na escala de Hoehn e Yahr) e afasia crônica não fluente pós-AVC, com deficit de nomeação severos. O paciente foi tratado com uma nova combinação de terapia audiovisual de produção e estimulação transcraniana por corrente contínua (ETCC), técnica neuromodulatória não invasiva, que tem sido cada vez mais adotada para potencializar terapias fonoaudiológicas. ETCC anodal (2 mA) foi aplicada sobre o córtex pré-frontal inferior esquerdo (F7 no sistema 10/20), durante nove sessões de 20 minutos, ao longo de duas semanas, enquanto o paciente tentava nomear imagens de objetos comuns com o auxílio de vídeos curtos mostrando uma boca articulando os sons do nome do objeto (pista audiovisual). Observou-se aumento significativo nos escores de nomeação entre o pré e o pós-tratamento, tanto para imagens treinadas, quanto para não treinadas, mas fonemicamente similares (generalização). Os resultados apresentaram indícios iniciais de que terapia audiovisual de produção associada à ETCC anodal sobre a área de Broca pode representar uma alternativa viável para pacientes com deficits de nomeação severos.

ABSTRACT Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor and nonmotor symptoms. PD patients may present language problems, including deficits in confrontation naming. Naming deficits are also an important feature of Broca's aphasia, a condition associated with post-stroke damage to the left inferior prefrontal cortex (Broca's area). We present the case of a 79-year old, male patient diagnosed with both PD (stage 4 in Hoehn and Yahr's scale) and chronic post-stroke, non-fluent aphasia. The patient, with particularly severe naming deficits, was treated with a novel combination of audiovisual production therapy and transcranial direct current stimulation (tDCS), a noninvasive neuromodulatory technique that has been increasingly used to potentiate speech therapy. Anodal tDCS (2 mA) was applied to the left inferior prefrontal cortex (F7 in the 10/20 system) in nine 20-min sessions over two weeks while the patient tried to name pictures of common objects aided by short videos of an articulating mouth (audiovisual cue). We found significant pre- to post-training naming improvement for treated items and for untreated, phonemically similar items (generalization). The results provide initial indication that audiovisual production therapy combined with anodal tDCS over Broca's area may represent a viable treatment alternative for patients with severe naming deficits.

Familial Creutzfeldt-Jakob Disease with V180I Mutation Presented with Broca's Aphasia

Familial Creutzfeldt-Jakob Disease (fCJD) is characteristic with older age onset, relatively low occurrence rate, slower progression and lower possibility of developing myoclonus, cerebellar, pyramidal signs and visual disturbance compared with classical sporadic CJD. We report a case of 75-year-old male patient presented with sudden onset of right side weakness with Broca's aphasia who has been diagnosed with fCJD with V180I mutation. This case indicates that fCJD with V180I mutation can have stroke-like initial presentation.

Application of the continuous language rehabilitation nursing in the motor aphasia patients with abrain stroke / 中国实用护理杂志

Objective To investigate the clinical effect of continuous language rehabilitation nursing on the language function in patients with stroke motor aphasia. Methods A total of 60 motor aphasia patients with a brain stroke were recruited and divided into experimental group and control group with 30 cases each by random digits table method. The control group was treated with the routine stroke care in traditional Chinese medicine, while the experimental group with the continuing language rehabilitation nursing base on the routine stroke care. The language function of both groups were detected by the Chinese Rehabilitation Research Center Standard Aphasia Examination before and after 3 months treatment, and a survey of nursing satisfaction of patients when discharged was conducted. Results The right rate of hear and understand, retelling, say, read aloud, reading comprehension, transcription, description, dictation, calculation in the Chinese Rehabilitation Research Center Standard Aphasia Examination was (44.35 ± 18.69), (32.37 ± 22.25), (21.49 ± 14.91), (27.63 ± 12.54), (46.87 ± 15.30), (14.25 ± 6.11), (7.33±3.23), (11.63±4.82), (18.93±6.82)%before the treatment and (62.14±10.81), (55.36±19.53), (41.42 ± 13.75), (59.16 ± 11.05), (55.57 ± 13.90), (32.39 ± 7.12), (9.73 ± 3.92), (27.45 ± 4.71), (37.46 ± 6.91)%after the treatment in the experimental group, except for description, the differences were significant ( t=2.096-14.540, P<0.01 or 0.05). The right rate of hear and understand, retelling, say, read aloud, reading comprehension, transcription, description, dictation, calculation in the Chinese Rehabilitation Research Center Standard Aphasia Examination was (43.86±15.89), (34.28±20.27), (22.84±15.40), (28.63±12.45), (47.23±11.30), (13.40±6.24), (7.27±3.70), (11.10±4.73), (19.50±6.80)%before the treatment and (49.46± 14.27), (42.36±20.58), (30.33±13.36), (40.31±11.88), (49.97±10.13), (15.37±5.59), (8.50±3.74), (12.83± 4.36), (21.47 ± 7.74)% after the treatment in the control group, the differences of hear and understand, retelling, say, read aloud were significant (t=2.263-3.991, P<0.05 or 0.01). There were significant differences in hear and understand, retelling, say, read aloud, transcription, dictation, calculation after the treatment between two groups (t=2.510-10.298, all P<0.05). The score of satisfaction was (94.36 ± 5.55) in the experimental group and (88.25 ± 5.46) points in the control group, and there was significant difference (t=4.299, P<0.01). Conclusions Continuing language rehabilitation nursing can improve the recovery of the language function of the motor aphasia patients with a brain stroke.

The related factors of post-stroke depression and nursing intervention in patients with motor aphasia / 中国实用护理杂志

Objective To explore the related factors and nursing interventional methods of depression in patients with motor aphasia after stroke. Methods The Stroke Aphasic Depression Questionnaire-Hospital version (SADQ-H) was used to diagnose depression of 271 patients with motor aphasia after stroke. The association of post-stroke depression with social factors, vascular risk factors and stroke features were analyzed. The relationship between depression severity and aphasia severity were analyzed. A total of 166 patients with depression were divided into the control group and the observation group to carry out different nursing interventional methods. Results The incidence of post-stroke depression in patients with motor aphasia was 61.3%(166/271). The occurrence of post-stroke depression was correlated with female (χ2=5.580, P=0.02) , age less than 60 years old (χ2=4.390, P=0.04) , living alone (χ2=5.400, P=0.02) , recent negative events (χ2=4.420, P=0.04). The multi-factor Logistic regression analysis showed that the occurrence of post-stroke depression was independently associated with female (OR=2.58, 95%CI 2.12-3.86, P<0.01), age less than 60 years old(OR=2.62, 95%CI 2.16-3.94, P<0.01), living alone(OR=2.59, 95%CI 2.13-3.92, P<0.01). After 4 weeks of nursing intervention, there were significant differences in SADQ-H scores (t=2.94, P=0.002) and distribution of Boston Diagnostic Aphasia Examination (BDAE) (χ2=14.045,P=0.000) between the control group and the observation group. Conclusions Female, ages less than 60 years old, living alone are independent risk factors of post-stroke depression in motor aphasia patients. The degree of depression is associated with aphasia severity. The early nursing intervention can improve the depression status and promote recovery of the language function of patients with motor aphasia after stroke.

Expressive aphasia as the manifestation of hyperglycemic crisis in type 2 diabetes

No abstract available.

Therapeutic effect of music therapy and speech language therapy on post-stroke patients with non-fluent aphasia / 中华神经科杂志

Objective Estimating the therapeutic effect of music therapy and speech language therapy on post-stroke patients with non-fluent aphasia.Methods Eighty-four post-stroke patients diagnosed with non-fluent aphasia who came from the First Affiliated Hospital of Medical College of Shihezi University were collected between June 2012 and May 2014,then they were randomly divided into music therapy group (n =42) and speech language therapy group (n =42;including chronic (n =46) and acute groups (n =38)) based on table of random numbers.On the basis of conventionally using neurological drugs,music therapy and speech language therapy were given to the patients for one month,respectively.And language function was assessed by partial items of Chinese Version-Western Aphasia Battery before and after therapy.Results No significant changes were found in spontaneous speech,comprehension,repetition,naming and aphasia quotient in chronic and acute group patients through the music therapy and speech language therapy.Significant improvements were revealed in repetition (32.00 (15.00,53.75) vs 48.50(24.50,72.00),Z =2.147,P =0.032;33.00(14.50,49.25) vs 48.50(18.50,63.75),Z =2.018,P=0.038),naming (20.00 (8.50,34.75) vs 37.5(12.50,64.75),Z =2.298,P =0.022;19.50 (7.00,31.25) vs 34.50 (15.00,52.75),Z =2.039,P =0.041) and aphasia quotient (24.50 (10.50,37.50) vs 43.00 (18.00,64.75),Z =2.432,P =0.015;22.50 (10.00,34.50) vs 36.00 (14.00,54.00),Z =2.027,P =0.043) through music therapy and speech language therapy in chronic group patients.Comprehension was significantly improved through music therapy in chronic group patients.Repetition (24.50 (11.00,38.75) vs 46.50 (24.50,67.75),Z =2.038,P =0.043;26.50 (9.50,36.25) vs 42.50(19.00,64.25),Z =1.972,P =0.048) was significantly improved through music therapy and speech language therapy in acute group patients.And spontaneous speech (2.00 (1.00,3.75) vs 8.00 (4.00,12.75),Z =2.012,P =0.036),comprehension (51.00 (17.50,73.75) vs 85.00 (48.00,101.00),Z =2.298,P =0.022),naming (17.50(6.00,29.00) vs 37.50(16.00,58.75),Z =2.161,P =0.031) and aphasia quotient (18.00 (7.50,31.25) vs 42.50 (20.50,63.75),Z =2.256,P =0.024) were significantly improved through music therapy in acute group patients.However,no significant improvements were found in the speech language therapy group of acute patients.Conclusion The two therapies are effective in the chronic patients with non-fluent aphasia,and music therapy is also effective in acute patients with non-fluent aphasia.

Biología del lenguaje desde la afasia post ataque cerebrovascular: reporte de tres casos y revisión de tema / Biology of Language in Post-Stroke Aphasia: Report of Three Cases and Topical Review / Biologia da linguagem desde a afasia pós ataque cerebrovascular: reporte de três casos e revisão do assunto

El lenguaje, capacidad propia del ser humano para comunicarse e interactuar con sus pares, se encuentra determinado por un complejo conjunto de redes neuronales inicialmente descritas de orden únicamente cortical y, en la actualidad, descritas de orden cortico-subcortical relacionadas entre sí. Su funcionalidad se ve afectada, a menudo, por múltiples etiologías. La principal causa de afasia adquirida es el ataque cerebrovascular. El objetivo es documentar y describir los circuitos cortico-subcorticales del lenguaje alterados en pacientes con afasia post ACV, mediante el reporte de tres casos y revisión de tema sobre las redes neurológicas del lenguaje. Tres pacientes post ACV de áreas irrigadas por la arteria cerebral media del hemisferio izquierdo, con lesión de varias estructuras corticales y subcorticales. En todos se encontró daño en áreas diferentes a Broca y Wernicke y predominan alteraciones en estructuras de la red dorsal del lenguaje. En los pacientes reportados el daño vascular se centró en estructuras de la red dorsal del lenguaje en el hemisferio dominante, se comprometen estructuras corticales y subcorticales simultáneamente, aspecto que se relaciona con la complejidad de estructuras, redes y mecanismos involucrados en el lenguaje humano. Son estructuras del lenguaje: ínsula, núcleo caudado, región mesial temporal, adicional a las clásicas áreas perisilvianas izquierdas que, de manera global e interconectadas a partir de corrientes de procesamiento cortical, producen el lenguaje.

Language, a person's ability to communicate and interact with his or her peers, is determined by a complex set of neural networks initially described as being only of cortical order, and currently described as being of cortical-subcortical order, which are interrelated. Its functionality is often affected by multiple etiologies. The main cause of acquired aphasia is stroke. The objective was to document and describe altered language cortical-subcortical circuits in patients with post-stroke aphasia using the report of three cases and a topical review on neurological language networks. All three studied patients suffered a stroke in areas irrigated by the left middle cerebral artery, with injury of several cortical and subcortical structures. In all patients, damage was found in areas other than Broca and Wernicke, where predominant alterations occurred in the dorsal language network. Patients reported vascular damage focused on the dorsal language network in the dominant hemisphere, compromising cortical and subcortical structures simultaneously, which is related to the complexity of structures, networks, and mechanisms involved in human language. The language structures include the insula, caudate, mesial temporal region, in addition to the classic left perisylvian areas, which produce language in a global and interconnected manner through cortical processing networks.

A linguagem, capacidade própria do ser humano de comunicar-se e interagir com seus pares, encontra-se determinado por um complexo conjunto de redes neuronais inicialmente descritas de ordem unicamente cortical, e na atualidade descritas de ordem cortico-subcortical relacionadas entre si. Sua funcionalidade se vê afetada com frequência por múltiplas etiologias. A principal causa de afasia adquirida é o ataque cerebrovascular. É objetivo documentar e descrever os circuitos cortico-subcorticais da linguagem alterados em pacientes com afasia pós ACV, mediante o reporte de três casos e revisão de tema sobre as redes neurológicas da linguagem. Três pacientes pós ACV de áreas irrigadas pela artéria cerebral média do hemisfério esquerdo, com lesão de várias estruturas corticais e subcorticais. Em todos se encontrou dano em áreas diferentes a Broca e Wernicke predominando alterações em estruturas da rede dorsal da linguagem. Nos pacientes reportados o dano vascular se centrou em estruturas da rede dorsal da linguagem no hemisfério dominante, comprometendo estruturas corticais e subcorticais simultaneamente, aspecto que se relaciona com a complexidade de estruturas, redes e mecanismos envolvidos na linguagem humana. São estruturas da linguagem: ínsula, núcleo caudado, região mesial temporal, adicional às clássicas áreas perisilvianas esquerda, que de maneira global e interconectadas a partir de correntes de processamento cortical, produzem a linguagem.

Cortex function and neuropsychological changing of non fluent aphasia type-frontal temple dementia / 中华神经科杂志

Objective To analyse the neuropsychological changing of nonfluent aphasia frontotemporal dementia (nf-FTD) with the FDG-PET, MRI and fMRI. Methods The language and other cognitive function were dynamically estimated by standard neuropsychological assessment which modified by Chinese. Compared with FDG-PET and fMRI, the relationship between the neuropsychologieal changing and the cortex function was studied. Results All the 5 patients met the criteria of nf-FTD by Association for Frontotemporal Dementias, with core syndrome and other supptted syndrome. And still they had the good word reading, calculation by pen, and the un-speechmemory. And they also had the related well living ability. They all had the related cortext metabolism support. Conclusions nf-FTD patients preserve the word reading, visuapacial ability and calculation by pen. These can help us to give the effective advise about the patients training and caring and to give them the chance to show their real social skill.

An effect of cerebral blood flow on Broca aphasia patient of cerebrovascular disease by early rehabilitative intervention / 中国基层医药

Objective To observe the effect of cerebral blood flow on Broca aphasia patient of cerebrovascular disease by early rehabilitative intervention, to evaluate the result of early rehabilitative intervention, to ques the marker evaluating early effect. Methods 41 Broca aphasia patients were divided to rehabilitation groups (23 patients) and control groups(18 patients) according to the sequence of hospitalization, and meanwhile 37 patients of health examination were chosen as health control groups, the patients of rehabilitation groups were treated with drug and rehabilitative intervention but the patients of control group were treated only with drug, the average cerebral blood flow of left middle cerebral artery of both groups and health control group was examined with transcranium doppler before and after treatment. Results The average cerebral blood flow of left middle cerebral artery of rehabilitation group and control group was not different before treatment, the rehabilitation group and control group was less than health control group; the average cerebral blood flow of left middle cerebral artery of rehabilitation group and control group was increased obviously after treatment than that before treatment; the average cerebral blood flow of left middle cerebral artery was not different between rehabilitation group and health control group after treatment, it was different between control group and health control group; the average cerebral blood flow of left middle cerebral artery was increased obviously on rehabilitation group than that on control group after treatment. Conclusions the early rehabilitative intervention can increase the average cerebral blood flow of left middle cerebral artery of Broca aphasia patient accelerate the functional restoration; TCD can be regarded as an early marker to evaluate early effect.

Investigation of Pathologic Mechanism of Motor Aphasia: An Analysis of 25 fMRI Cases / 中国康复理论与实践

@#ObjectiveTo investigate the pathologic mechanism of motor aphasia.Methods25 patients with cerebral infarction and motor aphasia were examined by magnetic resonance spectroscopy (MRS) and perfusion weighted imaging (PWI) at Broca's areas, the results were compared with that of the mirror side.ResultsMRS showed that the N-acetyl aspartate, choline in Broca's areas reduced than that of the mirror side ( P<0.05); while PWI showed that the regional cerebral blood volume and regional cerebral blood flow of damaged Broca's areas decreased significantly than that of the right hemisphere ( P<0.01). Mean transit time and time to peak of damaged Broca's areas prolonged than that of mirror side ( P<0.05).ConclusionHypoperfusion and hypometabolism revealed in Broca's areas of patients with motor aphasia may be one of the mechanisms of motor aphasia.

Mechanism of Chinese processing in patients with Broca aphasia / 中国病理生理杂志

0.05).CONCLUSION:The patient with Broca aphasia is independent in the course of the orthographic input,and the ability to retrieve semantic information from orthographic activation word may not affected by phonological lexicon.