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      Multisensory cueing facilitates naming in aphasia

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          Abstract

          Background

          Impaired 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.

          Objective

          We 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.

          Methods

          Ten 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.

          Results

          Naming 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.

          Conclusions

          This 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 registration

          NCT02928822. Registered 30 May 2016.

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          Most cited references44

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          Active perception: sensorimotor circuits as a cortical basis for language.

          Action and perception are functionally linked in the brain, but a hotly debated question is whether perception and comprehension of stimuli depend on motor circuits. Brain language mechanisms are ideal for addressing this question. Neuroimaging investigations have found specific motor activations when subjects understand speech sounds, word meanings and sentence structures. Moreover, studies involving transcranial magnetic stimulation and patients with lesions affecting inferior frontal regions of the brain have shown contributions of motor circuits to the comprehension of phonemes, semantic categories and grammar. These data show that language comprehension benefits from frontocentral action systems, indicating that action and perception circuits are interdependent.
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            Conceptual representations in mind and brain: theoretical developments, current evidence and future directions.

            Conceptual representations in long-term memory crucially contribute to perception and action, language and thought. However, the precise nature of these conceptual memory traces is discussed controversially. In particular, the grounding of concepts in the sensory and motor brain systems is the focus of a current debate. Here, we review theoretical accounts of the structure and neural basis of conceptual memory and evaluate them in light of recent empirical evidence. Models of conceptual processing can be distinguished along four dimensions: (i) amodal versus modality-specific, (ii) localist versus distributed, (iii) innate versus experience-dependent, and (iv) stable versus flexible. A systematic review of behavioral and neuroimaging studies in healthy participants along with brain-damaged patients will then be used to evaluate the competing theoretical approaches to conceptual representations. These findings indicate that concepts are flexible, distributed representations comprised of modality-specific conceptual features. Conceptual features are stored in distinct sensory and motor brain areas depending on specific sensory and motor experiences during concept acquisition. Three important controversial issues are highlighted, which require further clarification in future research: the existence of an amodal conceptual representation in the anterior temporal lobe, the causal role of sensory and motor activation for conceptual processing and the grounding of abstract concepts in perception and action. We argue that an embodiment view of conceptual representations realized as distributed sensory and motor cell assemblies that are complemented by supramodal integration brain circuits may serve as a theoretical framework to guide future research on concrete and abstract concepts. Copyright © 2011 Elsevier Srl. All rights reserved.
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              Cortical language localization in left, dominant hemisphere. An electrical stimulation mapping investigation in 117 patients.

              The localization of cortical sites essential for language was assessed by stimulation mapping in the left, dominant hemispheres of 117 patients. Sites were related to language when stimulation at a current below the threshold for afterdischarge evoked repeated statistically significant errors in object naming. The language center was highly localized in many patients to form several mosaics of 1 to 2 sq cm, usually one in the frontal and one or more in the temporoparietal lobe. The area of individual mosaics, and the total area related to language was usually much smaller than the traditional Broca-Wernicke areas. There was substantial individual variability in the exact location of language function, some of which correlated with the patient's sex and verbal intelligence. These features were present for patients as young as 4 years and as old as 80 years, and for those with lesions acquired in early life or adulthood. These findings indicate a need for revision of the classical model of language localization. The combination of discrete localization in individual patients but substantial individual variability between patients also has major clinical implications for cortical resections of the dominant hemisphere, for it means that language cannot be reliably localized on anatomic criteria alone. A maximal resection with minimal risk of postoperative aphasia requires individual localization of language with a technique like stimulation mapping.
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                Author and article information

                Contributors
                paul.verschure@specs-lab.com
                Journal
                J Neuroeng Rehabil
                J Neuroeng Rehabil
                Journal of NeuroEngineering and Rehabilitation
                BioMed Central (London )
                1743-0003
                9 September 2020
                9 September 2020
                2020
                : 17
                : 122
                Affiliations
                [1 ]GRID grid.424736.0, ISNI 0000 0004 0536 2369, Institute for Bioengineering of Catalonia (IBEC), ; Av. d’Eduard Maristany 16, 08019 Barcelona, Spain
                [2 ]Servei de Medicina Física i Rehabilitació de l’Hospital Univ. de Tarragona, 43-005 Tarragona, Spain
                [3 ]GRID grid.6363.0, ISNI 0000 0001 2218 4662, Charite Universitätsmedizin Berlin, ; 10-117 Berlin, Germany
                [4 ]GRID grid.14095.39, ISNI 0000 0000 9116 4836, Freie University Berlin, Brain Language Laboratory, DPH, WE4, ; 14-195 Berlin, Germany
                [5 ]GRID grid.7468.d, ISNI 0000 0001 2248 7639, Humboldt Universität, BSMB, ; 10-099 Berlin, Germany
                [6 ]Einstein Center for Neurosciences, 10-117 Berlin, Germany
                [7 ]GRID grid.425902.8, ISNI 0000 0000 9601 989X, Institució Catalana de Recerca i Estudis Avançats, ; 08-010 Barcelona, Spain
                Author information
                http://orcid.org/0000-0002-4954-1372
                Article
                751
                10.1186/s12984-020-00751-w
                7487671
                73f6694d-dab5-44ff-8932-ce8419d04bdc
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 12 May 2020
                : 27 August 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100010663, H2020 European Research Council;
                Award ID: 341196
                Funded by: FundRef http://dx.doi.org/10.13039/501100007136, Secretaría de Estado de Investigación, Desarrollo e Innovación;
                Award ID: SANAR
                Funded by: FundRef http://dx.doi.org/10.13039/501100003329, Ministerio de Economía y Competitividad;
                Award ID: BES2014068791
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/100014419, EIT Health;
                Award ID: ID19277
                Categories
                Research
                Custom metadata
                © The Author(s) 2020

                Neurosciences
                stroke,aphasia,lexical access,word-finding,multisensory cueing,neurorehabilitation
                Neurosciences
                stroke, aphasia, lexical access, word-finding, multisensory cueing, neurorehabilitation

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