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Aphasia in brain-damaged adult patients refers "to the more or less complete loss of the ability to use language" resulting from acquired brain damage, typically of the left hemisphere. The defective spoken output of persons with aphasia (PWA) has anomia as a main clinical manifestation. Improving anomia is a main goal of any language treatment.
The present randomized controlled study assessed the effectiveness of a novel, two-week, rehabilitation protocol (PHOLEXSEM), focused on PHonological, SEmantic, and LExical deficits, aiming at improving lexical retrieval, and, generally, spoken output.
The effects of the PHOLEXSEM treatment were compared to those of a control treatment, i.e., a Promoting Aphasics Communicative Effectiveness (PACE) protocol.
Finally, we studied the effects of age, education, disease duration, brain lesion volume, and functional independence (Functional Idependence Measure, FIM) on the treatment-induced linguistic improvements.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PHOLEXSEM | Experimental | Each session lasted 30 minutes, and comprised three sections, each lasting 10 minutes: Repetition, Semantic Feature Analysis (SFA), and Lexical retrieval. Repetition: 50 items for different kind of stimuli including: syllables, 2-syllable words and non-words; 2-syllable words and non-words with one consonant cluster; 3-syllable words and non-words; 3-syllable words and non-words with one consonant cluster, nuclear phrases. SFA: stimuli were 46 pictures of nouns, including living and non-living objects, controlled for frequency of use. Lexical retrieval phase: the patient was given three fluency tasks: a) 4 min of phonemic recall, b) 4 min of semantic recall, and c) 2 min of verb recall. |
|
| PACE | Active Comparator | Three decks of cards - diversified by frequency of use - depicting nouns, were presented in sets of 4 cards each. In an exchange modality, the task consisted in understanding the noun chosen by the patient and, in turn, by the rehabilitator. Any communicative modality (oral, gestural, verbal, graphic) was allowed. Word difficulty was graded based on the frequency of use and semantic proximity or distance between target and distractors. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PHOLEXSEM | Behavioral | Phonological, Lexical, and Semantic training |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in the Neuropsychological Examination of Language (ENPA) | A test for aphasia assessment in the Italian population | At baseline and immediately after the intervention. |
| Change from baseline in phonemic fluency | To assess lexical retrieval based on a letter | At baseline and immediately after the intervention. |
| Change from baseline in semantic fluency | To assess lexical retrieval based on a semantic category | At baseline and immediately after the intervention. |
| Change from baseline in syntagma repetition | The syntagma repetition test from the Aachner Aphasie Test (AAT) | At baseline and immediately after the intervention. |
| Change from baseline in the auditory digit span | To assess auditory verbal short-term memory | At baseline and immediately after the intervention. |
| Change from baseline in the word repetition span | To assess auditory verbal short-term memory, with words stimuli | At baseline and immediately after the intervention. |
| Change from baseline in the Token Test | To assess auditory language comprehension | At baseline and immediately after the intervention. |
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Inclusion Criteria:
Exclusion Criteria:
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Data will be made available on Zenodo upon request.
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| ID | Term |
|---|---|
| D001037 | Aphasia |
| D020521 | Stroke |
| D000849 | Anomia |
| ID | Term |
|---|---|
| D013064 | Speech Disorders |
| D007806 | Language Disorders |
| D003147 | Communication Disorders |
| D019954 | Neurobehavioral Manifestations |
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| PACE |
| Behavioral |
See arm description |
|
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |