| 1. |
- Ali, M, et al.
(författare)
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Protocol for the development of the international population registry for aphasia after stroke (I-PRAISE)
- 2022
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Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 36:4, s. 534-554
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Tidskriftsartikel (refereegranskat)abstract
- Background: We require high-quality information on the current burden, the types of therapy and resources available, methods of delivery, care pathways and long-term outcomes for people with aphasia.Aim: To document and inform international delivery of post-stroke aphasia treatment, to optimise recovery and reintegration of people with aphasia.Methods & Procedures: Multi-centre, prospective, non-randomised, open study, employing blinded outcome assessment, where appropriate, including people with post-stroke aphasia, able to attend for 30 minutes during the initial language assessment, at first contact with a speech and language therapist for assessment of aphasia at participating sites. There is no study-mandated intervention. Assessments will occur at baseline (first contact with a speech and language therapist for aphasia assessment), discharge from Speech and Language Therapy (SLT), 6 and 12-months post-stroke. Our primary outcome is changed from baseline in the Amsterdam Nijmegen Everyday Language Test (ANELT/Scenario Test for participants with severe verbal impairments) at 12-months post-stroke. Secondary outcomes at 6 and 12 months include the Therapy Outcome Measure (TOMS), Subjective Index of Physical and Social Outcome (SIPSO), Aphasia Severity Rating Scale (ASRS), Western Aphasia Battery Aphasia Quotient (WAB-AQ), stroke and aphasia quality of life scale (SAQoL-39), European Quality of Life Scale (EQ-5D), lesion description, General Health Questionnaire (GHQ-12), resource use, and satisfaction with therapy provision and success. We will collect demography, clinical data, and therapy content. Routine neuroimaging and medication administration records will be accessed where possible; imaging will be pseudonymised and transferred to a central reading centre. Data will be collected in a central registry. We will describe demography, stroke and aphasia profiles and therapies available. International individual participant data (IPD) meta-analyses will examine treatment responder rates based on minimal detectable change & clinically important changes from baseline for primary and secondary outcomes at 6 and 12 months. Multivariable meta-analyses will examine associations between demography, therapy, medication use and outcomes, considering service characteristics. Where feasible, costs associated with treatment will be reported. Where available, we will detail brain lesion size and site, and examine correlations with SLT and language outcome at 12 months.Conclusion: International differences in care, resource utilisation and outcomes will highlight avenues for further aphasia research, promote knowledge sharing and optimise aphasia rehabilitation delivery. IPD meta-analyses will enhance and expand understanding, identifying cost-effective and promising approaches to optimise rehabilitation to benefit people with aphasia.
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| 2. |
- Haggstrom, J, et al.
(författare)
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Prognostic Value of a Test of Central Auditory Function in Conversion from Mild Cognitive Impairment to Dementia
- 2020
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Ingår i: Audiology & neuro-otology. - : S. Karger AG. - 1421-9700. ; 25:5, s. 276-282
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background/Objective:</i></b> It has been suggested that central auditory processing dysfunction might precede the development of cognitive decline and Alzheimer’s disease (AD). The Dichotic Digits Test (DDT) has been proposed as a test of central auditory function. Our objective was to evaluate the predictive capacity of the DDT in conversion from mild cognitive impairment (MCI) to dementia. <b><i>Methods:</i></b> A total of 57 participants (26 females) with MCI were tested at baseline with pure tone audiometry, speech in quiet and in noise, and the DDT. The cognitive outcome was retrieved from medical files after 5 years. Groupwise comparisons of the baseline DDT scores were performed and the relative risk was calculated. <b><i>Results:</i></b> Altogether 22 subjects developed any kind of dementia. Of the original 57 individuals within the MCI group, 15 developed AD and 7 developed other types of dementia. There was no significant difference in baseline DDT scores between the participants who converted to AD and those who did not. However, the group who developed other types of dementia (especially frontotemporal dementia) had lower DDT scores in the left ear than those participants who did not develop dementia. With a baseline DDT score below 50% correct responses, the participants diagnosed with MCI had a 2.49-times-higher risk of developing dementia than those with scores of 50% or better. <b><i>Conclusion:</i></b> The DDT as a central auditory test may be suitable when evaluating cognitive decline.
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| 3. |
- Hybbinette, H, et al.
(författare)
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Recovery of Apraxia of Speech and Aphasia in Patients With Hand Motor Impairment After Stroke
- 2021
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Ingår i: Frontiers in neurology. - : Frontiers Media SA. - 1664-2295. ; 12, s. 634065-
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Aphasia and apraxia of speech (AOS) after stroke frequently co-occur with a hand motor impairment but few studies have investigated stroke recovery across motor and speech-language domains. In this study, we set out to test the shared recovery hypothesis. We aimed to (1) describe the prevalence of AOS and aphasia in subacute stroke patients with a hand motor impairment and (2) to compare recovery across speech-language and hand motor domains. In addition, we also explored factors predicting recovery from AOS.Methods: Seventy participants with mild to severe paresis in the upper extremity were assessed; 50% of these (n = 35) had left hemisphere (LH) lesions. Aphasia, AOS and hand motor assessments and magnetic resonance imaging were conducted at 4 weeks (A1) and at 6 months (A2) after stroke onset. Recovery was characterized in 15 participants showing initial aphasia that also had complete follow-up data at 6 months.Results: All participants with AOS and/or aphasia had LH lesions. In LH lesioned, the prevalence of aphasia was 71% and of AOS 57%. All participants with AOS had aphasia; 80% of the participants with aphasia also had AOS. Recovery in aphasia (n = 15) and AOS (n = 12) followed a parallel pattern to that observed in hand motor impairment and recovery correlated positively across speech-language and motor domains. The majority of participants with severe initial aphasia and AOS showed a limited but similar amount of recovery across domains. Lesion volume did not correlate with results from behavioral assessments, nor with recovery. The initial aphasia score was the strongest predictor of AOS recovery.Conclusion: Our findings confirm the common occurrence of AOS and aphasia in left hemisphere stroke patients with a hand motor impairment. Recovery was similar across speech-language and motor domains, even in patients with severe impairment, supporting the shared recovery hypothesis and that similar brain recovery mechanisms are involved in speech-language and motor recovery post stroke. These observations contribute to the knowledge of AOS and its relation to motor and language functions and add information that may serve as a basis for future studies of post stroke recovery. Studies including neuroimaging and/or biological assays are required to gain further knowledge on shared brain recovery mechanisms.
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| 4. |
- Kristensson, Joana, 1972, et al.
(författare)
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Anomia in left hemisphere stroke, multiple sclerosis and Parkinson's disease - a comparative study
- 2023
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Ingår i: Disability and Rehabilitation. - 0963-8288 .- 1464-5165.
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Tidskriftsartikel (refereegranskat)abstract
- PurposeTo explore quantitative and qualitative features of anomia in participants with left-hemisphere stroke, Parkinson's disease, or multiple sclerosis.Materials and methodsThis descriptive cross-sectional study compares signs of anomia within and across participants (n = 87), divided into four groups; moderate to severe anomia after stroke (MSAS, n = 19), mild anomia after stroke (MAS, n = 22), PD (n = 19) and MS (n = 27). Aspects analysed include naming accuracy and speed, the nature of incorrect responses, semantic and phonemic verbal fluency, information content in re-telling, and the relationship between test results and self-reports on word-finding difficulties and communicative participation.ResultsAll groups had impaired verbal fluency, prolonged response times and reduced information content in re-telling. The MSAS group had significantly more signs of anomia than the other groups. Results from the other groups overlapped on a MAS-PD-MS continuum. Both semantically and phonologically incorrect responses were common in the stroke groups, while semantically incorrect ones predominated in the PD and MS groups. All four groups reported a similar negative impact on self-perceived communicative participation. Correlations between self-reports and test results were inconsistent.ConclusionsAnomia features have quantitative and qualitative similarities and differences across neurological conditions.
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| 7. |
- Strombergsson, S, et al.
(författare)
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Towards an Integrated Curriculum in a Speech and Language Pathology Education Programme: Development and Constituents' Initial Responses
- 2020
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Ingår i: Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP). - : S. Karger AG. - 1421-9972. ; 72:1, s. 52-63
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background:</i></b> A traditional curricular structure may challenge integration between foundational and clinical sciences in speech and language pathology (SLP) education. This project aimed to increase curriculum integration at a Swedish SLP education programme. <b><i>Methods:</i></b> Learning outcomes in the existent curriculum were copied from their original courses and re-structured with reference to vertical tracks, in order to address them within and across years of study. A content analysis of interviews with teachers and students was conducted for the evaluation of curricular change. <b><i>Results:</i></b> Among the changes were earlier introduction to clinical science and revisiting of foundational sciences later in the education. Theme concepts were defined to scaffold horizontal integration, whereas revisited use of documented material was formalized to ensure vertical integration. In evaluation interviews, multiple examples were provided of how the new curriculum was perceived as being more integrated, with horizontal themes and vertical tracks providing structure. Concerns raised highlight the importance of appointing clear responsibilities. <b><i>Conclusions:</i></b> The concepts “gaps” and “overlaps” may guide remediation of areas where increased curricular integration is warranted. Serial child observations running through the curriculum may provide a platform for both horizontal and vertical integration. For maintenance of curricular integration, clear responsibilities are needed, stretching across course and semester boundaries.
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