University:
Boston University
Course:
SAR HP 151 | Introduction to Health Professions
Academic year:

2023
Views:

404

Pages:

12
Author:

Juliana Giles

The mul(dimensional nature of aphasia: Using factors beyond language to predict treatment outcomes Background • Variable recovery pa:erns in persons with aphasia (PWA) • General predictors of recovery • Age, lesion size, iniEal severity of language impairment • TradiEonal view of aphasia as a language disorder • Research poinEng to aphasia as a mulEdimensional disorder • PWA demonstrate impairments in • A:enEon • Memory • ExecuEve funcEons Diﬃculty a"ending • CogniEve factors have been shown to predict treatment outcomes • General cogniEon • ExecuEve funcEons/self-monitoring • VisuospaEal memory Diﬃculty recalling Overarching Aims 1) to determine whether baseline language and cogniEve abiliEes and/ or demographic variables predicted paEents’ response to language treatment 2) to ascertain which speciﬁc cogniEve measures predicted a response to anomia treatment. Retrospec(ve Analysis 1 N = 64 PWA (41 M; mean age = 60.1; MPO = 49.3) • Western Aphasia Ba:ery (WAB) Aphasia QuoEent (AQ): M= 66.63, SD = 25.82, range = 10.2-100 • Completed one of four language treatment studies (Des Roches et al., 2016; Gilmore et al., 2017, in prep.; Kiran et al. 2015; Sandberg & Kiran, 2014) • 1 sentence comprehension treatment (N = 27) • 3 word retrieval treatments (N = 37) • Treatment intensity: 2-hour, 2x/week for 10-12 weeks mean PMG = .5464 SD = .3482 range = -.1765-1.00 No diﬀerence in PMG by treatment groups (one-way ANOVA: F(1,62) = .35, P = .56) Language & Cogni7ve Measures Boston Naming Test (BNT) Pyramids and Palm Trees Test (PAPT) Western Aphasia Ba:ery (WAB) • Spontaneous speech • Auditory Verbal Comprehension • RepeEEon • Naming & Word Finding • Reading • WriEng CogniEve LinguisEc Quick Test (CLQT) • A:enEon • Memory • Language • ExecuEve FuncEon • VisuospaEal Skills Principal Components Analysis (PCA) 6 Factor Loadings Measure LANGUAGE WAB Spontaneous Speech WAB Auditory Verbal Comprehension WAB RepeEEon WAB Naming & Word Finding WAB Reading WAB WriEng WAB ConstrucEonal, VisuospaEal, & CalculaEon PAPT .87 .81 .89 .94 .81 .72 .37 .25 BNT CLQT A:enEon CLQT Language .85 CLQT Memory .93 CLQT VisuospaEal Skills0 CLQT ExecuEve FuncEon .17 .94 .12 .24 COGNITIVE .22 .28 .16 .21 .3 .49 .80 .42 .26 .87 .19 .24 .97 .89 Regression: PMG ~ Lang.Comp + Cog.Comp + Age + MPO St. Coeﬀ. Intercept 0.54637 Lang.Comp 0.5773 Cog.Comp 0.3103 Std.Error t 0.03341 16.355 0.03367 5.969 0.03367 3.208 p <2e-16*** .000000132*** 0.00213 ** Residual standard error: 0.2673 on 61 degrees of freedom Mul7ple R-squared: 0.4295, Adjusted R-squared: 0.4108 F-sta7s7c: 22.96 on 2 and 61 DF, p-value: .00000003677 For each 1 standard devia=on increase in Language Component score, PMG increases by .20. For each 1 standard devia=on increase in Cogni=ve Component score, PMG increases .10. 8 Retrospec(ve Analysis 2 • N = 24 PWA (16 M; mean age = 61; MPO = 55) • WAB AQ: M = 58.72, SD = 26.39, range = 11.7 – 95.2 • Completed 12 week semanEc feature analysis-based treatment • Treatment intensity: 2-hour, 2x/week for 12 weeks • Treatment response was posiEve overall Standardized Cogni7ve Measures • • • • • • • • CogniEve LinguisEc Quick Test Raven’s Coloured Progressive Matrices Corsi block-tapping test Wechsler Scales Digit Span Doors and People Test Visual RecogniEon subtest Serial Response Time Test Geometric Control- Form Matching (mental rotaEon) Geometric Control- Inclusion (mental rotaEon) Regression: PMG ~ CLQT Execu=ve Func=ons + Corsi Memory Span + Digit Span Total + Doors & People Test + Serial Response Time Learning + Geometric Control Inclusion + Geometric Control Form Matching Intercept Geometric Form Matching CLQT EF Digit Span Coeﬀ. -1.29365 0.377647 0.518785 0.493945 Std.Error 0.9222 .8528754 .5810616 .4109923 t -1.403 2.285 2.413 3.113 p 0.17981 .03633 .02818 .00669 Residual standard error: 0.2612 on 16 degrees of freedom Mul7ple R-squared: 0.6845, Adjusted R-squared: 0.5465 F-sta7s7c: 4.959 on 7 and 16 DF, p-value: .003843 For each 1 standard devia=on increase in Geometric Control Form Matching, PMG increases by .15. For each 1 standard devia=on increase in CLOT Execu=ve Func=ons, PMG increases by .20. For each 1 unit increase in Digit Span Total, PMG increases by .19. 11 Take home message • CogniEon ma:ers • Brain damage in Lem hemisphere impacts both language AND cogniEon • Speciﬁc cogniEve skills are relevant to anomia treatment outcomes • Verbal short-term memory • VisuospaEal processing • ExecuEve funcEons