Aphasia

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aphasia

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an acquired, multimodal language impairment due to central nervous system damage. there can be no other cognitive impairment that is greater or may explain symptoms

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pyramidal/UMN/ Direct route

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corticospinal and corticobulbar tracts; directly innervate motor neurons of spinal cord and brainstem

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lower motor neuron/ PNS

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cranial and spinal nerves; centers around modulation and regulation of anterior horn cells

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ACH

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excitatory (Alzheimers, dementia)

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dopamine

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inhibitory (BG, PD)

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seratonin

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inhibits pain input (sleep, pain, aggression)

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gamma aminobutyric acid

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GABA; inhibitory

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diaschisis

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temporary suspension of functions that depend on structures remote from an infarct

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penumbra

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an area near the infarction where blood flow is reduced but tissue is intact

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hemorrhage

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bursting artery causing blood to flow onto brain's surface or invade brain tissue and compresses adjacent structures

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edema

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accumulation of fluid in intercellular spaces

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aneurysm

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dilated blood vessel

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ischemic stroke

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80% of strokes; occulsion of an artery usually caused by thrombosis or embolism

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hemorrhage

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bursting artery causing blood to flow onto brain's surface or invade brain tissue

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praxis

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skilled movement

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limb apraxia

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disorder of skilled movement

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agnosia

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impairment of ability to recognize a stimulus even when sensory channels are intact

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prosopagnosia

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face-blindness

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what is a test for limb apraxia?

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Limb Apraxia Test (LAT); device for assessing praxis; relies on imitation; 8 subtests (movement w/ and w/out objects, etc)

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what is a test for oral and limb apraxia?

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Test of Oral and Limb Apraxia (TOLA); evaluates movement differently than the LAT; oral- nonrespiratory movements;

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name 2 nonverbal communication tests

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Assessment of Nonverbal Communication and Boston Nonvocal Communication Scale

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name functional status tests

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Barthel Index, Functional Independence Measure (FIM); Functional Communication Profile (FCP); Burden of Stroke Scale ( BOSS); Communication Activities of Daily Living (CADL-2); Functional Assessment of Communication Skills (ASHA-FACS); Communication Effectiveness Index (CETI)

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test assessing life participation

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WHO Quality of Life Questionnaire

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bedside tests/ screening tests

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Bedside Evaluation Screening Test (BEST-2); informal (yes/no, poinging, naming and describing, automatic); Aphasia Diagnostic Profiles (ADP); Aphasia Language Performance Scales (ALPS) Acute Aphasia Screening Protocol (AASP); Frenchay Aphasia Screening Test (FAST); Quick Assessment for Aphasia; Mississippi Aphasia Screening Test (MAST)

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standardizeds tests of aphasia

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Boston Diagnostic Aphasia Examination (BDAE); Porch Index of Communicative Ability (PICA); Western Aphasia Battery (WAB); Psycholinguistic Assessment of Language Processing in Aphasia (PALPA); Minnesota Test for Differential Diagnosis of Aphasia (MTDDA)

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MTDDA

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Minnesota Test for Differential Diagnosis of Aphasia; lengthy; widely administered in 60s and 70s

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PICA

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Porch Index of Communicative Ability; pros: 18 subtests of 4 language modalities; con: complex scoring; used more for research

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BDAE

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Boston Diagnostic Aphasia Examination; 4 major sections (including Auditory and spoken modalities, reading and writing, etc.) pros: classification of aphasias into syndromes according to symptom patterns; there is a short form; cons: globby, long

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WAB

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Western Aphasia Battery; content and administration similar to Boston; pros: 6 subtests (spontaneous speech, auditory verbal comprehension, repetition, naming, reading, writing); cons: globby, long

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PALPA

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Psycholinguistic Assessment of Language Processing in Aphasia; relates to a cognitive theory of language; emphasis on word level; flexible administration; id of impaired cognition; 60 subtests (not designed to be given in entirety); limitations: does not address sentence production, language use, and discourse level and no measures of reliability or validity

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BEST-2

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Bedside Evaluation Screening TEst; 20 mins; 7 subtests for conversation, spoken production, auditory comprehension and a little reading; no section for writing

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token tests

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used to identify and measure subtle comprehension deficits; Revised Token Test (RTT); Five-item RTT

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BASA

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Boston Assessment of Severe Aphasia; 61 items to assess auditory comprehension, oral and limb apraxia, gesture recognition, oral and gestural expression, reading comprehension, and visuospatial functions

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reading tests

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REading Comprehension Battery for Aphasia (RCBA); 10 subtests from word to paragraph level; ;assesses functional tasks (e.g. reading street signs); letter discrim and recognition

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naming test

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Boston Naming Test; used to detect mild word-finding impairments; line drawings; goes from easy to hard; incorporated into the BDAE-3