Characteristics of event-related potential and frequency on working memory of post-stroke aphasia / 中国康复理论与实践

Objective To explore the task-state electroencephalogram(EEG)characteristics of working memory in patients with post-stroke aphasia(PSA). Methods From September,2020 to February,2021,a total of eight patients with PSA(PSA group)and eight healthy adults(HC group)were recruited to collect EEG and memory scale data.The EEG data of working memory task-states were used to analyze the characteristics of the EEG frequency band indicators in time domain event-related potentials(ERP)and frequency;and the correlation with the items in the memory scale. Results Finally,five patients and five controls were included.N1 and P2 components were induced in the frontal area,and P300 components were induced in the parieto-occipital area.Compared with HC group,the activation of N1 and P2 increased in central prefrontal region,while the activity of P300 decreased in the right parieto-occipital re-gion in PSA group(|t|>2.193,P<0.05).The energy of theta band decreased in the right prefrontal region and the central parieto-occipital region,the energy of alpha1 band decreased in the left parieto-occipital region,and the energy of gamma band increased in the left central region(t>2.398,P<0.05).The energy of gamma band correlated with immediate recall(r = 0.914,P = 0.030)and correct recognition(r = 0.931,P = 0.022)of Auditory Verbal Learning Test,and inverting(r = 0.924,P = 0.025)and anterograde(r = 0.889,P = 0.044)of Digit Span Test. Conclusion Visual working memory task can activate the compensatory processing activity of memory related brain re-gions after PSA,which can be used as an objective indication for the evaluation of PSA working memory related research.There is close relationship between language impairment and working memory.

Analysis of the clinical presentation and genetic profile of epilepsy-aphasia spectrum due to GRIN2A gene mutations / 中华神经科杂志

Objective:To explore the clinical phenotypic features and genetic variation characteristics of children with epilepsy-aphasia spectrum due to GRIN2A gene variants confirmed by second-generation sequencing. Methods:The clinical data of 5 children with epilepsy-aphasia spectrum with epileptic onset diagnosed in the Department of Neurology, Children′s Hospital Affiliated to Zhengzhou University, from February 2019 to November 2022 were retrospectively analyzed. Whole-exome genome sequencing of the probands using a second-generation sequencing method confirmed that all 5 cases were children with the GRIN2A gene variant. The characteristics of the GRIN2A gene variants were analyzed. Results:Among the 5 children diagnosed with epileptic aphasia spectrum due to GRIN2A gene variants, the male-to-female ratio was 4∶1, and the age range of onset was 1.5-4.4 years. The clinical phenotype included seizures in all cases, language and intellectual developmental deficits in 4 cases, and attention deficit hyperactivity disorder in 3 cases. The seizures were manifested as focal seizures or secondary generalized seizures, and were effectively controlled with antiepileptic drugs. Among the 5 children, gene variant of case 1 was originated from a paternal heterozygous variant, and cases 2-5 had de novo variants, which were c.2107C>T (p.Gln703 *) nonsense variant, c.2284G>A (p.Gly762Arg) missense variant, c.2197del (p.Ala733Glnfs *3) shifted coding variant, c.2511G>A (p.Trp837 *) nonsense variant, and c.1651+1G>C shear site variant, respectively. None of the 5 loci were reported in the literature. Conclusions:Epilepsy-aphasia spectrum is an epilepsy syndrome with a complex onset, and may have different phenotypes at different genetic variant loci, with focal seizures or secondary generalized seizures, which can be effectively controlled with anti-seizure medication. The GRIN2A gene variant is the genetic etiology of the epileptic aphasia spectrum.

Synaptic vesicle protein 2A positron emission tomography images of semantic variant primary progressive aphasia patient with GRN mutation: a case report / 中华神经科杂志

Synaptic dysfunction plays an important role in the early stage of frontotemporal dementia (FTD), and there are differences in the pattern of synaptic damage in different genotypes. GRN gene mutations are rare in the Chinese population, and there are no reports of synaptic damage patterns in GRN mutations or semantic variant primary progressive aphasia (svPPA). The synaptic injury characteristics of a patient with svPPA harboring GRN gene mutations, which was characterized by decreased synaptic density in the left frontal, temporal, parietal lobe and contralateral cerebellum were reported in this article. The underlying mechanism of synaptic dysfunction involved in the disease process, and potential targets for future clinical interventions were indicated.

The effect of transcranial direct current stimulation on the functional connectivity of language-related brain areas in patients with post-infarction picture-naming dysfunction: a resting state functional magnetic resonance study / 中华物理医学与康复杂志

Objective:To observe the effects of transcranial direct current stimulation (tDCS) on functional connectivity (FC) in language-related brain regions of patients with picture-naming dysfunction after cerebral infarction by using resting state functional magnetic resonance imaging(rs-fMRI).Methods:Twenty-eight patients with post-infarction picture-naming dysfunction were divided into an acute stage group( n=16) and a recovery stage group( n=12) according to the course of the disease, and 18 middle-aged and elderly volunteers were recruited as the normal control group.The anodic tDCS was applied on the posterior perisylvian region(PPR) of the left sylvian of the patients, 5 days a week for 2 weeks.Before and after the 2 weeks′ treatment, the rs-fMRI and Psycholinguistic Assessment of Chinese Aphasia (PACA)-picture-naming subscale were performed, and FC changes in language-related brain areas were observed. Results:After treatment, the PACA scores of patients in both acute and recovery stage groups were significantly improved after treatment( P<0.05). Compared with normal subjects, FC in multiple brain regions and particularly the Wernicke area was reduced in both cerebral hemispheres among the patient group. It was more severe in the dominant hemisphere.After the tDCS treatment, FC in both frontotemporal lobes and in the Wernicke area was significantly enhanced in both the acute and recovery groups. Further comparison showed that in the acute group FC in both temporo-occipital lobes was significantly enhanced after treatment. In the recovery group, the enhanced FC in the left temporal lobe before the treatment was significantly reduced after treatment. Conclusion:The fMRI technique can evaluate changes in brain connectivity in aphasia patients with picture-naming dysfunction after cerebral infarction accurately and non-invasively.tDCS may improve picture-naming function of stroke patients by enhancing the FC in bilateral language-related brain areas(concentrated in frontotemporal lobes) and Wernicke area.

Application of Main Concept Analysis and Story Narration Assessment in Aphasia Discourse Assessment / 听力学及言语疾病杂志

Objective To compare the application of main concept analysis(MCA)and story narration as-sessment(SNA)in aphasia discourse assessment,and study their clinical applicability.Methods A total of 8 apha-sic and 22 healthy control subjects were recruited.Local sequential picture materials were used to elicit language samples.The differences between groups in the assessment results of the MCA and the SNA were compared,the consistency of the assessment results of the two methods were also analyzed.The inter-rater and the intra-rater reli-ability of the two methods was discussed.Results The results of the MCA showed that the number of accurate and complete(AC)main concepts(P＜0.01),the number of accurate and complete main concepts per minute(AC/min)(P＜0.05)and main concept scores(MC scores)(P＜0.05)of the aphasia group were significantly lower than those of the healthy group.The number of absent(AB)main concepts(P＜0.05)were significantly higher than those of the control group.As for the result of SNA,the score of the content of sub picture description(P＜0.05),the total score of sub picture description(P＜0.05)and the total score of overall description(P＜0.05)in the aphasia group were significantly less than those in the control group(P＜0.05).No significant difference be-tween the standardized scores of the two methods were observed,and inter-rater and the intra-rater reliability were both in a good range.Conclusion The clinical applicability of the two methods is excellent and the evaluation results are conststent.The MCA has outstanding advantages in evaluating the quality and quantity of information,while SNA examines the syntax and content organization,which can reflect the overall discourse performance.

Central auditory processing and aphasia: A scoping review / Processamento auditivo central e afasia: uma revisão de escopo

ABSTRACT Purpose: to report scientific evidence on the impact of aphasia on central auditory processing and map the contribution of auditory training to aphasic individuals. Methods: a scoping review approaching national and international databases (SciELO, LILACS, PubMed, Scopus, and Cochrane Library) and the gray literature (Google Scholar and Open Grey). The inclusion criteria covered articles that addressed the interface between central auditory processing and aphasia, excluding duplicates, literature reviews, and scientific abstracts. Literature Review: the review comprised 13 articles that met the eligibility criteria for this study. Seven of the selected articles assessed central auditory processing, four used electrophysiological examinations (such as auditory brainstem response and long-latency auditory evoked potentials) to assess the auditory pathway, and only one analyzed the intervention in aphasic individuals with auditory training. Conclusion: scientific evidence points to an important change in aphasic people's central auditory processing, with impaired figure-ground, auditory closure, temporal resolution and ordering, and binaural integration. Moreover, it is relevant to assess auditory processing, given the contribution of auditory training in speech-language-hearing therapy for a better prognosis in the rehabilitation of aphasia.

RESUMO Objetivo: reportar as evidências científicas do impacto da afasia no Processamento Auditivo Central e mapear a contribuição do Treinamento Auditivo para a população afásica. Métodos: trata-se de uma revisão de escopo realizada nas bases de dados nacionais e internacionais: Scielo, Lilacs, Pubmed, Scopus, Cochrane Library e com uma busca adicional à literatura cinzenta no Google Scholar e Open Grey. Os critérios de inclusão abrangeram artigos que abordassem a interface do processamento auditivo central e afasia, excluindo-se as duplicações, artigos de revisão da literatura e resumos científicos. Revisão de Literatura: selecionaram-se 13 artigos que cumpriram os critérios de elegibilidade deste estudo. Dos artigos selecionados, sete apresentaram a avaliação do Processamento Auditivo Central, quatro apresentaram os exames eletrofisiológicos - como os exames de Potencial Evocado Auditivo de Tronco Encefálico (PEATE) e Potencial Evocado Auditivo de Longa Latência (PEALL) - para avaliação da via auditiva e apenas um estudo analisou a intervenção dos indivíduos afásicos por meio do treinamento auditivo. Conclusão: as evidências científicas apontam importante alteração no Processamento Auditivo Central dos afásicos, apresentando prejuízos nas habilidades auditivas de figura-fundo, fechamento auditivo, resolução e ordenação temporal e integração binaural. Ainda, demonstra-se como relevante a avaliação do processamento, devido à contribuição do Treinamento Auditivo nas terapias fonoaudiológicas para um melhor prognóstico na reabilitação das afasias.

Neurolinguistics evidence of oral discourse in schizophrenic patients. Comparative analysis with Wernicke's aphasia

Introduction: In schizophrenia, the presence of a digressive oral discourse is very frequent, plenty of paraphasias and neologisms, provoked by the alterations of thought, which is common in thisillness. This form of empty oral discourse, full of paraphasias and neologisms, is one of the characteristic clinical manifestations of Wernicke's aphasia; with the difference that, in thesepatients, the symptomatology is linguistic, not secondary to alterations of thought. What cognitive mechanisms lead to similar verbal behaviors in both groups of patients? Objective: The purpose of this research was to obtain empirical evidence about cognitive mechanisms that underlie the alterations of verbal communication in both types of patients, from the comparative analysis of their execution in neurocognitive and neurolinguistic tests. Method: The study was implemented in a population of 70 patients organized into two groups: 35 aphasics and 35 schizophrenics. Both groups were subjected to the tests of Semantic Matching of Images, Identification of Homonymous Images and Oral Denomination of Images and Comics. Data processing involved descriptive statistics and Student's t-test for comparative analysis between groups. Results: Indicate that there are no significant differences between groups in semantic processing. In the formation of lexical concepts, schizophrenics show worse performance; while aphasics perform worse on neurolinguistic examination tests. Conclusions: Empirical evidence shows that the oral discourse of both groups of patients is markedly digressive and empty, with paraphasias and neologisms, but linguistically different.

Introducción: En la esquizofrenia es muy frecuente la presencia de un discurso oral digresivo, lleno de parafasias y neologismos, provocado por las alteraciones del pensamiento común en esta enfermedad.Esta forma de discurso oral vacío, lleno de parafasias y neologismos, es una de las manifestaciones clínicas características de la afasia de Wernicke,con la diferencia de que en estos pacientes la sintomatología es lingüística, no secundaria a alteraciones del pensamiento.¿Qué mecanismos cognitivos conducen a conductas verbales similares en ambos grupos de pacientes? Objetivo: Obtener evidencia empírica sobre los mecanismos cognitivos que subyacen a las alteraciones de la comunicación verbal en ambos tipos de pacientes, a partir del análisis comparativo de su ejecución en pruebas neurocognitivas y neurolingüísticas. Método: El estudio se implementó en una población de 70 pacientes organizados en dos grupos: 35 afásicos y 35 esquizofrénicos.Ambos grupos fueron sometidos a las pruebas de Coincidencia Semántica de Imágenes, Identificación de Imágenes Homónimas y Denominación Oral de Imágenes y Cómics.El procesamiento de datos involucró estadística descriptiva y prueba t de Student para análisis comparativo entre grupos. Resultados: Indican que no existen diferencias significativas entre grupos en el procesamiento semántico.En la formación de conceptos léxicos, los esquizofrénicos muestran peor desempeño;mientras que los afásicos obtienen peores resultados en las pruebas de examen neurolingüístico. Conclusiones: La evidencia empírica muestra que el discurso oral de ambos grupos de pacientes es marcadamente digresivo y vacío, con parafasias y neologismos, pero lingüísticamente diferentes.

Introdução: Na esquizofrenia é muito frequente a presença de um discurso oral digressivo, repleto de parafasias e neologismos, provocados pelas alterações de pensamento comuns nesta doença.Essa forma de discurso oral vazio, repleto de parafasias e neologismos, é uma das manifestações clínicas características da afasia de Wernicke,com a diferença de que, nesses pacientes, a sintomatologia é linguística e não secundária a alterações do pensamento.Que mecanismos cognitivos levam a comportamentos verbais semelhantes em ambos os grupos de pacientes? Objetivos: Obter evidências empíricas sobre os mecanismos cognitivos subjacentes às alterações da comunicação verbal em ambos os tipos de pacientes, a partir da análise comparativa da sua execução em testes neurocognitivos e neurolinguísticos. Métodos: O estudo foi implementado numa população de 70 pacientes organizados em dois grupos: 35 afásicos e 35 esquizofrênicos.Ambos os grupos foram submetidos aos testes de Emparelhamento Semântico de Imagens, Identificação de Imagens Homônimas e Denominação Oral de Imagens e Quadrinhos.O processamento dos dados envolveu estatística descritiva e teste t de Student para análise comparativa entre grupos. Resultados: Indicam que não há diferenças significativas entre os grupos no processamento semântico.Na formação de conceitos lexicais, os esquizofrênicos apresentam pior desempenho;enquanto os afásicos apresentam pior desempenho nos testes de exame neurolinguístico.Conclusões:a evidência empírica mostra que o discurso oral de ambos os grupos de pacientes é marcadamente digressivo e vazio, com parafasias e neologismos, mas linguisticamente diferente.

Expressive amusia and aphasia: the story of Maurice Ravel / Amusia e afasia expressiva: a história de Maurice Ravel

ABSTRACT The French composer, Maurice Ravel, at the peak of his career, showed signs of a progressive disorder that affected his ability to function with verbal and musical language, as noted by the neurologist Théophile Alajouanine. The worsening of the disease led to a craniotomy, performed in 1937, which failed to reveal the cause of his illness, and he died shortly thereafter. A lack of post-mortem neuropathological evidence precluded a definitive diagnosis of the illness, which remained enigmatic. Speculations about the precise diagnosis of Ravel's neurological disease have been largely based on Alajouanine's observations, which included aphasia and amusia, mostly expressive, and ideomotor apraxia, while musical judgement, taste, and memory remained relatively intact, implying different neuroanatomical substrates. A possible subform of frontotemporal lobar degeneration complex was the diagnostic suggestion of many authors. His untimely death deprived the world of this remarkable musician, and the music that remained trapped in his mind.

RESUMO O compositor francês Maurice Ravel, no ápice de sua carreira, mostrou sinais de uma desordem progressiva que afetou sua capacidade de funcionar com linguagem verbal e musical, como notado pelo neurologista Théophile Alajouanine. O agravamento de sua condição levou a uma craniotomia, efetuada em 1937, que deixou de revelar a causa de sua doença, tendo ele falecido pouco depois. A ausência de evidência neuropatológica pós-morte impediu o diagnóstico definitivo da doença, que permaneceu enigmático. Especulações sobre o diagnóstico preciso da doença neurológica de Ravel foram baseadas sobretudo nas observações de Alajouanine, que compreendiam afasia e amusia, predominantemente expressiva, e também apraxia, enquanto o julgamento, gosto e memória musicais permaneceram relativamente intactos, implicando diferentes substratos neuroanatômicos. A possibilidade de uma subforma do complexo da degenearação lobar frontotemporal foi a sugestão diagnóstica de muitos autores. A sua morte prematura privou o mundo desse notável músico e da música que permaneceu presa em sua mente.

Conhecimento dos profissionais da saúde de um hospital público em relação à afasia / Knowledge on aphasia held by health professionals of a public hospital / Conocimiento de los profesionales sanitarios de un hospital público sobre la afasia

Introdução: A compreensão da afasia é fundamental para os profissionais de saúde que prestam assistência a pacientes com AVC. No entanto, a informação disponível sobre a afasia ainda é limitada e insuficiente para uma abordagem eficaz. É de suma importância identificar o conhecimento dos profissionais de saúde a respeito da afasia, a fim de planejar o atendimento aos pacientes e suas famílias.Objetivo: Avaliar o nível de conhecimento dos profissionais de saúde de um hospital público em relação à afasia e analisar como eles lidam com pacientes com afasia durante o período de hospitalização. Método: Realizamos uma pesquisa com profissionais de saúde por meio de um questionário online para avaliar seu conhecimento sobre a afasia e suas estratégias de atendimento. Resultados: Os resultados indicam que profissionais de saúde com níveis de educação mais elevados tendem a possuir um entendimento mais sólido da afasia. No entanto, persistem lacunas de conhecimento em diversos aspectos da afasia. Embora a maioria dos profissionais se sinta adequadamente preparado para lidar com pacientes com afasia, eles reconhecem os desafios envolvidos e expressam o desejo de receber orientações para aprimorar suas habilidades de comunicação. Conclusão: Este estudo ressalta a necessidade de uma formação mais abrangente para os profissionais de saúde no que diz respeito à afasia e suas estratégias de comunicação. É fundamental o desenvolvimento de programas de treinamento e a elaboração de diretrizes específicas para os profissionais que atuam com esses pacientes, visando proporcionar um atendimento de alta qualidade. (AU)

Introduction: Understanding aphasia is crucial for healthcare professionals providing care to stroke patients. However, there is a need to enhance and refine the information available about aphasia for practical application. It is imperative to assess the knowledge of healthcare professionals regarding aphasia to facilitate effective care planning for patients and their families. Objective: This study aims to evaluate the level of knowledge among healthcare professionals in a public hospital concerning aphasia and their approach to patients with aphasia during their hospitalization. Method: An online questionnaire was administered to healthcare professionals to assess their understanding of aphasia and their caregiving strategies. Results: The findings indicate that healthcare professionals with higher education levels tend to have a better understanding of aphasia. Nevertheless, knowledge gaps persist in various aspects of aphasia. While most professionals feel adequately prepared to interact with patients experiencing aphasia, they acknowledge the challenges involved and express a desire for guidance to enhance their communication skills. Conclusion: This study underscores the necessity for comprehensive training of healthcare professionals in the realm of aphasia and effective communication strategies. The development of training programs and guidelines is crucial to better serve patients with aphasia, ensuring the provision of high-quality care. (AU)

Introducción: La comprensión de la afasia es importante para los profesionales de la salud que atienden a pacientes con ACV. Sin embargo, la información sobre la afasia sigue siendo limitada e insuficiente para un enfoque efectivo. Es importante identificar el conocimiento de los profesionales de la salud sobre la afasia para planificar la atención a los pacientes y sus familias. Objetivo: Evaluar el conocimiento de los profesionales de la salud de un hospital público sobre la afasia y cómo manejan a los pacientes con afasia durante el período de hospitalización. Método: Se realizó una encuesta a profesionales de la salud a través de un cuestionario en línea para evaluar su conocimiento sobre la afasia y sus tácticas de atención. Resultados: Se señala un mayor conocimiento sobre la afasia entre los profesionales de nivel superior, pero aún existen lagunas de conocimiento en varios aspectos de la afasia. La mayoría de los profesionales se sienten preparados para manejar a pacientes con afasia, pero reconocen que la atención es desafiante y les gustaría recibir orientación para mejorar sus habilidades de comunicación. Conclusión:Este estudio destaca la necesidad de una formación más amplia y completa para los profesionales de la salud sobre la afasia y su comunicación. Es fundamental desarrollar programas de capacitación y guías para atender mejor a estos pacientes y garantizar una atención de calidad. (AU)

Afasia primaria progresiva variante no fluente/agramática / Non-fluent/agrammatic variant of primary progressive aphasia

Introducción: Entre las enfermedades neurodegenerativas se encuentra un grupo de patologías que se caracterizan por un compromiso prominente del lenguaje, denominadas usualmente afasias primarias progresivas, las cuales se subdividen en 3 tipos: variante logopénica, variante semántica y variante no fluente o agramática. Presentación del caso: Paciente con cuadro clínico que inicia a los 65 años, con disminución en la interacción social. Un par de meses después, la esposa nota que el lenguaje del paciente se torna poco fluido, habla con palabras o frases cortas, no logra decir oraciones completas, además de presentar cambios en la entonación de las palabras y alteraciones del lenguaje escrito. El paciente manifiesta que su principal limitación en el momento es el no poder expresar lo que quiere decir, y por este motivo consulta. Discusión: En el caso de este paciente, se describe inicialmente un cambio en su personalidad que no compromete su funcionalidad, sin embargo, al poco tiempo se presenta compromiso del lenguaje como síntoma prominente y que genera mayor compromiso en su calidad de vida, con pruebas neuropsicológicas y hallazgos de neuroimagen que apoyan el diagnóstico de afasia primaria progresiva (APP) variante no fluente o agramatical, con síntomas comportamentales y motores asociados. Conclusión: Las APP son un grupo de trastornos neurocognitivos cuya característica primordial es el compromiso en el lenguaje, cada variante de APP tiene unas características clínicas y criterios diagnósticos específicos que se deben conocer para lograr sospechar el diagnóstico y hacer un abordaje apropiado en el paciente.

Introduction: In the group of neurodegenerative diseases, there is a group of pathologies that are characterized by a prominent compromise of language, normally called primary progressive aphasias, these are subdivided into 3 types: logopenic variant, semantic variant and non-fluent or agrammatic variant. Case presentation: Patient with a clinical picture that begins at age 65, with decreased social interaction, a couple of months later his wife notices that his language becomes not fluent, speaks in short words or phrases, cannot say complete sentences, in addition to changes in the intonation of words and alterations in written language, the patient states that his main limitation at the moment is not being able to express what he wants to say and for this reason they consult. Discussion: In the case of this patient, a change in his personality is initially described that does not compromise his functionality, however soon after a language involvement is presented as the main symptom and the one that generates a compromise in his quality of life, with neuropsychological tests and findings on neuroimaging that supports the diagnosis of primary progressive aphasia (PPA) non-fluent or agrammatical variant, with associated behavioral and motor symptoms. Conclusion: APPs are a group of neurocognitive disorders whose primary characteristic is language impairment. Each APP variant has specific clinical characteristics and diagnostic criteria that must be known in order to suspect the diagnosis and make an appropriate approach to the patient.

Kaiqiao Jieyin acupuncture combined with repetitive transcranial magnetic stimulation for post-stroke aphasia: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of Kaiqiao Jieyin acupuncture (acupuncture for opening orifices and relieving aphasia) combined with repetitive transcranial magnetic stimulation (rTMS) on language ability and daily life communication ability in patients with post-stroke aphasia (PSA).@*METHODS@#Fifty-six patients with PSA were randomly divided into an observation group and a control group, 28 cases in each group. Both groups received routine symptomatic treatment. The control group was treated with speech rehabilitation training and rTMS. On the basis of the treatment in the control group, the observation group was treated with Kaiqiao Jieyin acupuncture at the speech area Ⅰ, Fengchi (GB 20), Tongli (HT 5), Lianquan (CV 23), Panglianquan (Extra), etc. Panglianquan (Extra) on both sides were connected to electroacupuncture, with intermittent wave, 2 Hz in frequency. The above treatment was performed once a day for 5 consecutive days, followed by 2 days of rest for 2 weeks. The scores of western aphasia battery (WAB, including scores of spontaneous speech, auditory comprehension, repetition, naming and score of aphasia quotient [AQ]) and communication abilities in daily living (CADL) in the two groups were compared before and after treatment.@*RESULTS@#After treatment, the spontaneous speech, auditory comprehension, repetition, naming scores and AQ scores in both groups were higher than those before treatment (P<0.05), and the increase in the observation group was greater than the control group (P<0.05). The CADL scores of the two groups were higher than those before treatment (P<0.05).@*CONCLUSION@#Kaiqiao Jieyin acupuncture combined with rTMS can improve the language ability and daily life communication ability of PSA patients.

Effect of low frequency or high frequency repetitive transcranial magnetic stimulation on stroke patients with nonfluent aphasia / 中国康复理论与实践

ObjectiveTo explore the effect of low frequency or high frequency repetitive transcranial magnetic stimulation (rTMS) on right Broca's homologue in stroke patients with nonfluent aphasia. MethodsFrom January, 2019 to August, 2022, 80 inpatients in Beijing Bo'ai Hospital were randomly divided into control group (n = 20), sham stimulation group (n = 20), low-frequency (1 Hz) rTMS (LF-rTMS) group (n = 20) and high-frequency (10 Hz) rTMS (HF-rTMS) group (n = 20). All the patients received routine language therapy. LF-rTMS group and HF-rTMS group received ten days of rTMS (1 Hz or 10 Hz), and the sham group received ten days of sham rTMS. The Western Aphasia Battery (WAB) was used to evaluate the language function before, after treatment, and two months after treatment. ResultsBefore treatment, there was no significant difference in the scores of WAB among four groups (P > 0.05). All the scores improved in the four groups immediately after treatment and two months after treatment (P < 0.05). Compared with immediately after treatment, all the scores of WAB improved in LF-rTMS group (P < 0.05), and the scores of recall, name and aphasia quotient (AQ) improved in HF-rTMS group (P < 0.05) two months after treatment. Immediately after treatment, the scores of content and fluency, auditory comprehension and AQ were higher in LF-rTMS group than in HF-rTMS group (P < 0.05). Two months after treatment, the scores of content and fluency were higher in LF-rTMS group than in HF-rTMS group (P < 0.05). ConclusionBoth 1 Hz and 10 Hz rTMS could improve the language function of stroke patients with nonfluent aphasia, especially 1 Hz.

Assessments of Aphasia: Practices and Challenges faced by Malaysian SpeechLanguage Therapists (Penilaian Aphasia: Amalan dan Cabaran yang dihadapi oleh Jurupulih Pertuturan-Bahasa Malaysia) / Jurnal Sains Kesihatan Malaysia

@#Aphasia assessment is crucial in diagnosing aphasia, determining the extent of language impairment, and identifying factors that may support or restrict aphasia recovery to design an appropriate plan of care for people with aphasia. Speech-language therapists (SLTs) play a major role in conducting aphasia assessments. Little is known about the practices of SLTs in assessing aphasia in low-resource regions. The present study aims to identify aphasia assessment practices among Malaysian SLTs and related challenges, as well as strategies for improving aphasia assessments from SLTs’ perspectives. A total of 32 SLT participants who have been practicing in Malaysia completed an online survey to gather their background information, data pertaining to practices and challenges in conducting aphasia assessments, and suggestions for improving aphasia assessments. Descriptive analyses were conducted for all numerical data. Suggestions for improving aphasia assessment practices were analysed qualitatively using the thematic content analysis approach. SLT practices in aphasia assessment were found to be consistent in certain aspects, but not all. Two major challenges were identified: (a) linguistic barriers between clinicians and clients/caregivers, and (b) a lack of standardized assessment tools for aphasia evaluations. Participants suggested “Internal Strategies” and “External Strategies” for improving aphasia assessment practices.

Verbal and nonverbal cognitive function of aphasia after stroke based on Web of Science database: a visualized analysis / 中国康复理论与实践

ObjectiveTo visualize the research trends of verbal and nonverbal cognitive functions in patients with post-stroke aphasia (PSA). MethodsPapers about verbal and nonverbal cognitive functions after stroke were extracted from Web of Science Core Collection from establishment to August, 2022, and a bibliometric analysis was conducted on the distribution of articles published by year, author, journal, institution, and country. Author cooperation, author co-citation, journal co-citation, country/institution cooperation, dynamic evolution, keyword hotspots, and trends were visually analyzed by using VOSviewer software. ResultsA total of 1 630 publications were identified for final analysis. The first article related to the topic was retrieved in 2004. After that, the number of published papers showed an increasing trend year by year, with some fluctuations after 2019. Matthew A. Lambon Ralph and Elizabeth Jefferies were the authors who produced the most, were cited the most, and were the most influential. Neuropsychologia was a highly productive and well-cited publication. The University of Manchester in the United Kingdom and Johns Hopkins University in the United States were the nations/institutions with high yield and high centrality. Although China had a high yield and was in the top five, the centrality was insufficient. The dynamic emergence of keywords revealed that the research had gone through the following stages: evaluating the mechanism of language and nonverbal cognitive function impairment based on neuroimage, exploring the role of nonverbal cognitive dysfunction in pathology and recovery mechanisms of patients with PSA, examining the therapeutic mechanism of non-invasive brain stimulation and electronic tele-rehabilitation equipment, and revealing not only the frontal and temporal areas but also brain network supporting nonverbal cognition. ConclusionIn recent years, some achievements have been made in the researches on verbal and nonverbal cognitive function, particularly in the studies of the neuroimaging-based mechanisms of common damage and the intervention effects of synergistic therapy. In the future, academic cooperation between different regions and different teams needs to be strengthened. Further exploration should be focused on refining the cognitive neuropsychology and exploring new technologies to improve the therapeutic effect of PSA.

The rules of acupoint selection of acupuncture and moxibustion for aphasia based on data mining / 中国针灸

OBJECTIVE@#To explore the rules of acupoint selection for aphasia treated with acupuncture and moxibustion using data mining technology.@*METHODS@#From January 1, 2000 to April 1, 2022, the articles for clinical researches of acupuncture and moxibustion for aphasia published in CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase were searched. Using Microsoft Excel 2021, the database was set up to analyze the use frequency of acupoint, meridian tropism, acupoint distribution and the use of specific points. SPSS26.0 was adopted for factor analysis, SPSS Modeler 18.0 was for association rule analysis of prescriptions, and Gephi 0.9.5 was to plot the co-occurrence network diagrams of acupoints and meridians.@*RESULTS@#A total of 140 articles were collated, including 146 acupuncture and moxibustion prescriptions and 189 acupoints. The total use frequency of these acupoints was 1 211. Lianquan (CV 23), Jinjin (EX-HN 12), Yuye (EX-HN 13), Baihui (GV 20) and Yamen (GV 15) were the top 5 acupoints of the high use frequency for aphasia treated with acupuncture and moxibustion. Among 189 acupoints collected, the extra points and empirical points were mostly selected. The top 3 involved meridians were the governor vessel, the gallbladder meridian of foot-shaoyang and the conception vessel. These acupoints were mostly distributed on the head, face and neck region. The use frequency of five-shu points was the highest among the specific points. The acupoint combinations of high frequency referred to Yuye (EX-HN 13)-Jinjin (EX-HN 12), Yuye (EX-HN 13)-Lianquan (CV 23)-Jinjin (EX-HN 12), and Fengchi (GB 20)-Yuye (EX-HN 13)-Jinjin (EX-HN 12). Factor analysis extracted 10 common factors for acupoint compatibility in treatment of aphasia with acupuncture and moxibustion.@*CONCLUSION@#In clinical treatment of aphasia with acupuncture and moxibustion, the local acupoints are preferred. The core acupoints include Lianquan (CV 23), Jinjin (EX-HN 12), Yuye (EX-HN 13), Baihui (GV 20) and Yamen (GV 15). The acupoint prescription is modified flexibly according to syndrome differentiation to enhance the therapeutic effect.

Analysis of changes in connectivity of resting brain functional network before and after acupuncture combined with language rehabilitation training in patients with basal ganglia aphasia after stroke / 中国医师杂志

Objective:To use the resting state functional network connectivity (FNC) method based on independent component analysis (ICA) to analyze the characteristics of FNC changes in patients with basal ganglia aphasia (BGA) after stroke, and to explore its occurrence and recovery mechanism under the intervention of acupuncture combined with language rehabilitation training.Methods:Using a prospective observational research method, 16 right-handed BGA patients who were treated at Beijing Hospital of Traditional Chinese Medicine, Capital Medical University from July 2021 to December 2022, as well as 14 healthy subjects matched in age, gender, education level, and handedness, were included. The resting state functional magnetic resonance imaging, demographic information, and Western Aphasia Examination data of healthy subjects and BGA patients before and after intervention were collected. The GIFT toolbox based on MATLAB platform was applied for ICA and resting state brain network FNC analysis. The FNC differences between BGA patients and healthy subjects were compared horizontally, and the FNC changes in BGA patients before and after intervention were compared vertically.Results:Compared with healthy subjects, post-stroke BGA patients showed decreased connectivity between the basal ganglia network, default network, and visual network before intervention, while increased connectivity between the auditory network, right frontoparietal network, and anterior cuneiform network; After the intervention of acupuncture combined with language rehabilitation training, the connectivity between the basal ganglia network, visual network, and anterior cuneiform network decreased, while the connectivity between the anterior convex network and bilateral frontoparietal network decreased, while the connectivity between the default network, auditory network, right frontoparietal network, and visual network increased. The BGA patient group showed enhanced connectivity between the basal ganglia network and the left frontoparietal network before and after intervention.Conclusions:The FNC changes between the basal ganglia network and other brain networks are key to reflecting the mechanism of BGA occurrence and language function recovery. Acupuncture combined with language rehabilitation training may improve language function by enhancing the connectivity between the basal ganglia network and the left frontoparietal network, and the redistribution of attention resources may also be one of the reasons for promoting language function recovery in BGA patients.

Imaging characteristics of early-onset Alzheimer's disease / 中风与神经疾病杂志

@#Alzheimer's disease (AD) is a progressive irreversible neurodegenerative disease,and its prevalence rate is increasing rapidly as the population ages. Most patients with AD are diagnosed after the age of 65 years,and compared with late-onset Alzheimer's disease (LOAD),approximately 5%~10% of patients with AD develop cognitive impairment before the age of 65 years and are defined as early-onset Alzheimer's disease (EOAD). Although LOAD,typical amnestic EOAD,and atypical EOAD share the same molecular pathology of the accumulation of β-amyloid and tau,they tend to have heterogeneous clinical manifestations. EOAD is frequently misdiagnosed or delayed due to atypical clinical manifestations,and it often has rapid progression and a short survival time;therefore,it is crucial to understand the characteristics of EOAD for early diagnosis and treatment. Different clinical phenotypes of AD appear to have selective vulnerability in certain brain regions,which may help to explain such heterogeneity. This review analyzes the recent research advances in the structural,functional,and molecular imaging of typical amnestic EOAD and atypical EOAD and investigates the feasibility and effectiveness of imaging indicators as a noninvasive marker,so as to provide new ideas for the diagnosis of EOAD.

Application of transcranial direct current stimulation in patients with aphasia after stroke / 国际脑血管病杂志

Post-stroke aphasia (PSA) is a common speech disorder after stroke, involving at least 1/3 of stroke patients, and causing serious adverse effects on their lives and work. The available intervention measures include speech and language rehabilitation therapy, drug therapy, and non-invasive brain stimulation technology. The latter mainly includes transcranial magnetic stimulation and transcranial direct current stimulation (tDCS). tDCS can have a positive impact on PSA by promoting its self-repair, regulating the level of neurotransmitters, and inhibiting inflammation. This article reviews the effect of tDCS on the self-recovery mechanism of PSA and its treatment.

The effects on the language ability and life quality of aphasic stroke survivors of synchronous, long-distance speech rehabilitation training based on Oral Reading for Language with Aphasia / 中华物理医学与康复杂志

Objective:To observe any effect of long-distance application of Oral Reading for Language with Aphasia (ORLA) training on patients with post-stroke aphasia.Methods:A total of 42 stroke survivors with aphasia were randomly divided into an inpatient group, and two online groups, each of 14. All three groups had their routine rehabilitation treatment supplemented with ordinary multimodal language therapy and ORLA. The inpatient group completed the routine in the rehabilitation treatment room, while the online groups completed it at home using Tencent video conferencing software. The conventional multimodal language therapy was conducted once daily, 5 days a week for 4 weeks. For the inpatient group and online group 2 the daily session lasted 30 minutes, while for the online 1 groups the daily length was doubled. The ORLA therapy was also conducted once daily, 5 days a week for 4 weeks, for the inpatient group and online group 2 the daily session lasted 1h, while for the online 1 groups the daily length was 30min.The speech function, reading ability and life quality of the three groups were evaluated before and after the intervention using the Western Aphasia Battery, the Chinese Standard Aphasia Examination Scale and the Chinese version of the Stroke Aphasia Quality of Life Scale.Results:After treatment, the average aphasia quotient (AQ), reading, naming and quality of life scores in all three groups had improved significantly compared with those before treatment. And related language ability scores (such as retelling, fluency, information volume, listening comprehension, etc.) had also improved significantly in all three groups. However, the average AQ, reading, and oral fluency scores of the inpatient group and online group 2 were significantly higher than those of online group 1. Significant improvement was also observed in the reading aloud and life quality of all three groups, but the average improvement in reading aloud was significantly greater in the inpatient group and in online group 2 compared to online group 1. The average life quality of the online groups was significantly superior to that of the inpatient group.Conclusion:Medium- and high-intensity ORLA synchronous remote speech rehabilitation can significantly improve the speech ability, reading ability and life quality of aphasic stroke survivors.

Expression of progranulin in mononuclear cells in the peripheral blood of patients with post-stroke aphasia / 中华物理医学与康复杂志

Objective:To document the expression of aphasia-related progranulin gene (GRN) in mononuclear cells in the peripheral blood (PBMC) of patients with post-stroke aphasia (PSA).Methods:PC12 cells at the logarithmic-growth stage were cultured and divided into a non-specific interference group (the gene control group) and a specific interference group (the gene silencing group) when the cell density reached 30 to 50%. After the expression of GRN was knocked down in the cells, the occurrence of variable splicing events was analyzed using high-throughput transcriptome sequencing (RNA-seq). Meanwhile, 10 PSA patients were selected into a patient group and 10 healthy counterparts were chosen as a control group. Blood was collected from both groups and real-time fluorescence quantitative polymerase chain reactions (RT-qPCR) were employed to determine any changes in GRN mRNA expression and the occurrence of variable splicing events in the nuclear factor related to kappa-B-binding protein (NFRKB) in their PBMCs. The patient group received conventional speech therapy, and immediately after their first and second blood collections their speech functioning was assessed using the Chinese Aphasia Battery (ABC). Pearson correlation coefficients were then computed relating the GRN expression and ABC scores.Results:After knocking down GRN in the PC12 cells, the expression of GRN in the gene knockdown group was significantly different from that in the control group. There were 237 genes with significant differences in variable splicing between the two samples. The number of genes with variable splicing events at the 5′ end was the largest. There were also significant differences between the groups in the average occurrence of NFRKB variable splicing events. And significant diffe-rences were observed in the mRNA expression of GRN between the two blood collections from the patient group, as well as between the first collection from the patient group and the controls. The average oral expression score of the PSA patients improved significantly, particularly the retelling score. The changes in the GRN expression level were positively correlated with the recovery of oral expression ability.Conclusion:GRN can promote the recovery of speech function in PSA patients by regulating the variable splicing of NFRKB.