Enhancing the Efficiency of Confrontation Naming Assessment for Aphasia Using Computer Adaptive Testing.
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SUBMITTER: Fergadiotis G
PROVIDER: S-EPMC6808378 | biostudies-literature | 2019 Jun
REPOSITORIES: biostudies-literature
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Project description:Purpose:The purpose of this study was to examine the relationship between picture naming performance and the ability to communicate the gist, or essential elements, of a story. We also sought to determine if this relationship varied according to Western Aphasia Battery-Revised (WAB-R; Kertesz, 2007) aphasia subtype. Method:Demographic information, test scores, and transcripts of 258 individuals with aphasia completing 3 narrative tasks were retrieved from the AphasiaBank database. Narratives were subjected to a main concept analysis to determine gist production. A correlation analysis was used to investigate the relationship between naming scores and main concept production for the whole group of persons with aphasia and for WAB-R subtypes separately. Results:We found strong correlations between naming test scores and narrative gist production for the large sample of persons with aphasia. However, the strength of the correlations varied by WAB-R subtype. Conclusions:Picture naming may accurately predict gist production for individuals with Broca's and Wernicke's aphasia, but not for other WAB-R subtypes. Given the current reprioritization of outcome measurement, picture naming may not be an appropriate surrogate measure for functional communication for all persons with aphasia. Supplemental Materials:https://doi.org/10.23641/asha.5851848.
| S-EPMC6111489 | biostudies-literature
Project description:BackgroundItem response theory (IRT; Lord & Novick, 1968) is a psychometric framework that can be used to model the likelihood that an individual will respond correctly to an item. Using archival data (Mirman et al., 2010), Fergadiotis, Kellough, and Hula (2015) estimated difficulty parameters for the Philadelphia Naming Test (PNT; Roach, Schwartz, Martin, Grewal, & Brecher, 1996) using the 1-parameter logistic IRT model. Although the use of IRT in test development is advantageous, its reliance on sample sizes exceeding 200 participants make it difficult to implement in aphasiology. Therefore, alternate means of estimating the item difficulty of confrontation naming test items warrant investigation. In a preliminary study aimed at automatic item calibration, Swiderski, Fergadiotis, and Hula (2016) regressed the difficulty parameters from the PNT on word length, age of acquisition (Kuperman et al., 2012), lexical frequency as quantified by the Log10CD index (Brysbaert & New, 2009), and naming latency (Székely et al., 2003). Although this model successfully explained a substantial proportion of variance in the PNT difficulty parameters, a substantial proportion (20%) of the response time data were missing. Further, only 39% of the picture stimuli from Székely and colleagues (2003) were identical to those on the PNT. Given that the IRT sample size requirements limit traditional calibration approaches in aphasiology and that the initial attempts in predicting IRT difficulty parameters in our pilot study were based on incomplete response time data this study has two specific aims.AimsTo estimate naming latencies for the 175 items on the PNT, and assess the utility of psycholinguistic variables and naming latencies for predicting item difficulty.Methods and proceduresUsing a speeded picture naming task we estimated mean naming latencies for the 175 items of the Philadelphia Naming test in 44 cognitively healthy adults. We then re-estimated the model reported by Swiderski et al (2016) with the new naming latency data.ResultsThe predictor variables described above accounted for a substantial proportion of the variance in the item difficulty parameters (Adj. R 2 = .692).ConclusionsIn this study we demonstrated that word length, age of acquisition, lexical frequency, and naming latency from neurotypical young adults usefully predict picture naming item difficulty in people with aphasia. These variables are readily available or easily obtained and the regression model reported may be useful for estimating confrontation naming item difficulty without the need for collection of response data from large samples of people with aphasia.
| S-EPMC6713450 | biostudies-literature
Project description:Picture naming impairments are a typical feature of stroke-induced aphasia. Overall accuracy and rates of different error types are used to make inferences about the severity and nature of damage to the brain's language network. Currently available assessment tools for picture naming accuracy treat it as a unidimensional measure, while assessment tools for error types treat items homogenously, contrary to findings from psycholinguistic investigations of word production. We created and tested a new cognitive psychometric model for assessment of picture naming responses, using cognitive theory to specify latent processing decisions during the production of a naming attempt, and using item response theory to separate the effects of item difficulty and participant ability on these internal processing decisions. The model enables multidimensional assessment of latent picture naming abilities on a common scale, with a relatively large cohort for normative reference. We present the results of 4 experiments testing our interpretation of the model's parameters, as they apply to picture naming predictions, lexical properties of the items, statistical properties of the lexicon, and participants' scores on other tests. We also created a website for researchers and clinicians to analyze item-level data using our model, providing estimates of latent abilities and percentile scores, as well as credible intervals to help gauge the reliability of the estimated model parameters and identify meaningful changes. To the extent that the model is successful, the estimated parameter values may aid in treatment decisions and progress monitoring, or they may help elucidate the functional properties of brain networks. (PsycINFO Database Record
| S-EPMC5980659 | biostudies-literature
Project description:BackgroundImpaired naming is a ubiquitous symptom in all types of aphasia, which often adversely impacts independence, quality of life, and recovery of affected individuals. Previous research has demonstrated that naming can be facilitated by phonological and semantic cueing strategies that are largely incorporated into the treatment of anomic disturbances. Beneficial effects of cueing, whereby naming becomes faster and more accurate, are often attributed to the priming mechanisms occurring within the distributed language network.ObjectiveWe proposed and explored two novel cueing techniques: (1) Silent Visuomotor Cues (SVC), which provided articulatory information of target words presented in the form of silent videos, and (2) Semantic Auditory Cues (SAC), which consisted of acoustic information semantically relevant to target words (ringing for "telephone"). Grounded in neurophysiological evidence, we hypothesized that both SVC and SAC might aid communicative effectiveness possibly by triggering activity in perceptual and semantic language regions, respectively.MethodsTen participants with chronic non-fluent aphasia were recruited for a longitudinal clinical intervention. Participants were split into dyads (i.e., five pairs of two participants) and required to engage in a turn-based peer-to-peer language game using the Rehabilitation Gaming System for aphasia (RGSa). The objective of the RGSa sessions was to practice communicative acts, such as making a request. We administered SVCs and SACs in a pseudorandomized manner at the moment when the active player selected the object to be requested from the interlocutor. For the analysis, we compared the times from selection to the reception of the desired object between cued and non-cued trials.ResultsNaming accuracy, as measured by a standard clinical scale, significantly improved for all stimuli at each evaluation point, including the follow-up. Moreover, the results yielded beneficial effects of both SVC and SAC cues on word naming, especially at the early intervention sessions when the exposure to the target lexicon was infrequent.ConclusionsThis study supports the efficacy of the proposed cueing strategies which could be integrated into the clinic or mobile technology to aid naming even at the chronic stages of aphasia. These findings are consistent with sensorimotor accounts of language processing, suggesting a coupling between language, motor, and semantic brain regions.Trial registrationNCT02928822 . Registered 30 May 2016.
| S-EPMC7487671 | biostudies-literature
Project description:BACKGROUND: Previous work indicates that single word intelligibility tests developed for dysarthria are sensitive to segmental production errors in aphasic individuals with and without apraxia of speech. However, potential listener learning effects and difficulties adapting elicitation procedures to coexisting language impairments limit their applicability to left hemisphere stroke survivors. AIMS: The main purpose of this study was to examine basic psychometric properties for a new monosyllabic intelligibility test developed for individuals with aphasia and/or AOS. A related purpose was to examine clinical feasibility and potential to standardize a computer-mediated administration approach. METHODS #ENTITYSTARTX00026; PROCEDURES: A 600-item monosyllabic single word intelligibility test was constructed by assembling sets of phonetically similar words. Custom software was used to select 50 target words from this test in a pseudo-random fashion and to elicit and record production of these words by 23 speakers with aphasia and 20 neurologically healthy participants. To evaluate test-retest reliability, two identical sets of 50-word lists were elicited by requesting repetition after a live speaker model. To examine the effect of a different word set and auditory model, an additional set of 50 different words was elicited with a pre-recorded model. The recorded words were presented to normal-hearing listeners for identification via orthographic and multiple-choice response formats. To examine construct validity, production accuracy for each speaker was estimated via phonetic transcription and rating of overall articulation. OUTCOMES #ENTITYSTARTX00026; RESULTS: Recording and listening tasks were completed in less than six minutes for all speakers and listeners. Aphasic speakers were significantly less intelligible than neurologically healthy speakers and displayed a wide range of intelligibility scores. Test-retest and inter-listener reliability estimates were strong. No significant difference was found in scores based on recordings from a live model versus a pre-recorded model, but some individual speakers favored the live model. Intelligibility test scores correlated highly with segmental accuracy derived from broad phonetic transcription of the same speech sample and a motor speech evaluation. Scores correlated moderately with rated articulation difficulty. CONCLUSIONS: We describe a computerized, single-word intelligibility test that yields clinically feasible, reliable, and valid measures of segmental speech production in adults with aphasia. This tool can be used in clinical research to facilitate appropriate participant selection and to establish matching across comparison groups. For a majority of speakers, elicitation procedures can be standardized by using a pre-recorded auditory model for repetition. This assessment tool has potential utility for both clinical assessment and outcomes research.
| S-EPMC3246841 | biostudies-literature
Project description:Using diffusion tensor imaging (DTI), we assessed the relationship of white matter integrity and performance on the Boston Naming Test (BNT) in a group of retired professional football players and a control group. We examined correlations between fractional anisotropy (FA) and mean diffusivity (MD) with BNT T-scores in an unbiased voxelwise analysis processed with tract-based spatial statistics (TBSS). We also analyzed the DTI data by grouping voxels together as white matter tracts and testing each tract's association with BNT T-scores. Significant voxelwise correlations between FA and BNT performance were only seen in the retired football players (p?<?0.02). Two tracts had mean FA values that significantly correlated with BNT performance: forceps minor and forceps major. White matter integrity is important for distributed cognitive processes, and disruption correlates with diminished performance in athletes exposed to concussive and subconcussive brain injuries, but not in controls without such exposure.
| S-EPMC5220576 | biostudies-literature
Project description:Primary progressive aphasia (PPA), a selective neurodegeneration of the language network, frequently causes object naming impairments. We examined the N400 event-related potential (ERP) to explore interactions between object recognition and word processing in 20 PPA patients and 15 controls. Participants viewed photographs of objects, each followed by a word that was either a match to the object, a semantically related mismatch, or an unrelated mismatch. Patients judged whether word-object pairs matched with high accuracy (94% PPA group; 98% control group), but they failed to exhibit the normal N400 category effect (N400c), defined as a larger N400 to unrelated versus related mismatch words. In contrast, the N400 mismatch effect (N400m), defined as a larger N400 to mismatch than match words, was observed in both groups. N400m magnitude was positively correlated with neuropsychological measures of word comprehension but not fluency or grammatical competence, and therefore reflected the semantic component of naming. After ERP testing, patients were asked to name the same set of objects aloud. Trials with objects that could not be named were found to lack an N400m, although the name had been correctly recognized at the matching stage. Even accurate overt naming did not necessarily imply normal semantic processing, as shown by the absent N400c. The N400m was preserved in one patient with postsemantic anomia, who could write the names of objects she could not verbalize. N400 analyses can thus help dissect the multiple cognitive mechanisms that contribute to object naming failures in PPA.
| S-EPMC2810188 | biostudies-literature
Project description:Transcranial direct current stimulation has been shown to increase the efficiency of language therapy in chronic aphasia; however, to date, an optimal stimulation site has not been identified. We investigated whether neuromodulation of the right cerebellum can improve naming skills in chronic aphasia. Using a randomized, double-blind, sham-controlled, within-subject crossover study design, participants received anodal cerebellar stimulation (n = 12) or cathodal cerebellar stimulation (n = 12) + computerized aphasia therapy then sham + computerized aphasia therapy, or the opposite order. There was no significant effect of treatment (cerebellar stimulation versus sham) for trained naming. However, there was a significant order x treatment interaction, indicating that cerebellar stimulation was more effective than sham immediately post-treatment for participants who received cerebellar stimulation in the first phase. There was a significant effect of treatment (cerebellar stimulation versus sham) for untrained naming immediately post-treatment and the significant improvement in untrained naming was maintained at two months post-treatment. Greater gains in naming (relative to sham) were noted for participants receiving cathodal stimulation for both trained and untrained items. Thus, our study provides evidence that repetitive cerebellar transcranial direct stimulation combined with computerized aphasia treatment can improve picture naming in chronic post-stroke aphasia. These findings suggest that the right cerebellum might be an optimal stimulation site for aphasia rehabilitation and this could be an answer to handle heterogeneous participants who vary in their size and site of left hemisphere lesions.
| S-EPMC7677607 | biostudies-literature
Project description:BackgroundRepetitive transcranial magnetic stimulation (rTMS) has been used experimentally to facilitate naming abilities in individuals with chronic post-stroke aphasia. However, little is known about how rTMS confers clinical improvement, hampering its therapeutic value. The present study investigated the characteristics of naming failure that improve following administration of continuous theta burst stimulation (cTBS)-an inhibitory form of rTMS-to the right pars triangularis (rPTr) in persons with chronic aphasia.MethodsEleven participants with chronic aphasia following left hemisphere stroke named pictures prior to and immediately following cTBS of the rPTr and a control site (vertex) in separate sessions. Prior to stimulation, we obtained two baseline measurements of picture naming ability to determine the extent and type (i.e., phonological vs. semantic) of naming impairment. Items presented for naming during stimulation were those that were named incorrectly in one or both of the baseline sessions (i.e., inconsistent vs. wrong items, respectively). Analyses assessed whether cTBS effects differed depending on the severity and/or type of naming impairment.ResultsRelative to vertex, cTBS of the rPTr improved naming of inconsistent, but not wrong, items for individuals with more severe baseline naming impairment. Critically, baseline phonological but not semantic naming impairment severity marginally correlated with improved accuracy overall, and significantly correlated with decreased phonological errors following rPTr stimulation.ConclusionCTBS of the rPTr enhances naming by facilitating phonological access during word retrieval, indicating that individuals whose naming impairment is localized to this stage of processing may be most likely to benefit from this rTMS approach.
| S-EPMC6503859 | biostudies-literature
Project description:BackgroundPrevious attempts to investigate the effects of semantic tasks on picture naming in both healthy controls and people with aphasia have typically been confounded by inclusion of the phonological word form of the target item. As a result, it is difficult to isolate any facilitatory effects of a semantically-focused task to either lexical-semantic or phonological processing. This functional magnetic resonance imaging (fMRI) study examined the neurological mechanisms underlying short-term (within minutes) and long-term (within days) facilitation of naming from a semantic task that did not include the phonological word form, in both participants with aphasia and age-matched controls.ResultsBehavioral results showed that a semantic task that did not include the phonological word form can successfully facilitate subsequent picture naming in both healthy controls and individuals with aphasia. The whole brain neuroimaging results for control participants identified a repetition enhancement effect in the short-term, with modulation of activity found in regions that have not traditionally been associated with semantic processing, such as the right lingual gyrus (extending to the precuneus) and the left inferior occipital gyrus (extending to the fusiform gyrus). In contrast, the participants with aphasia showed significant differences in activation over both the short- and the long-term for facilitated items, predominantly within either left hemisphere regions linked to semantic processing or their right hemisphere homologues.ConclusionsFor control participants in this study, the short-lived facilitation effects of a prior semantic task that did not include the phonological word form were primarily driven by object priming and episodic memory mechanisms. However, facilitation effects appeared to engage a predominantly semantic network in participants with aphasia over both the short- and the long-term. The findings of the present study also suggest that right hemisphere involvement may be supportive rather than maladaptive, and that a large distributed perisylvian network in both cerebral hemispheres supports the facilitation of naming in individuals with aphasia.
| S-EPMC3477078 | biostudies-literature