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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Persistent depression of mood following stroke and acute psychiatric disturbances in conjunction with infarcts in the right hemisphere has been well reported. Sometimes its psychiatric features were most salient although neurological signs could not be elicited. We treated two patients with infarcts in the right hemisphere. The first developed depression with melancholia, the second a bipolar disorder. We question whether aprosodia or mood neglect may give a melancholic profile of depression following right hemisphere damage.
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PMID:[Mood disorders and right hemisphere infarction]. 269 75

Research interest in the "negative" symptoms of schizophrenia has increased in recent years. Given the clinical similarity between affective deficits in schizophrenic patients and aprosodic deficits in stroke victims, the authors conducted a study testing for aprosodia in eight schizophrenic patients. Seven were found to have aprosodia with motor components. Further study of the aprosodias may provide some insight into affective disturbance in schizophrenia.
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PMID:Aprosodia in eight schizophrenic patients. 377 41

This study investigated two mechanism-based treatments for expressive aprosodia, a disturbance in emotional prosody thought to be governed by the right hemisphere. The 3 participants all suffered right CVA's resulting in expressive aprosodia. Presence of expressive aprosodia was determined by performance on two batteries of emotional communication. A single subject ABAC design was employed in which two treatments, one imitative and one cognitive linguistic, were assigned in random order. All participants in this study were randomly assigned to begin with the cognitive linguistic treatment. Probes of treated and untreated emotions were completed during baseline and therapy phases. Probe items were judged by a reliable, trained rater blind to time of testing. Visual and statistical analyses were completed. These analyses confirmed that both treatments were active. For example, effect size calculations confirmed modest to substantial treatment effects for both treatments in all 3 patients. Replication to increase confidence about treatment effect and enhance understanding of the neuromechanisms underlying aprosodia is underway.
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PMID:Novel treatments for expressive aprosodia: a phase I investigation of cognitive linguistic and imitative interventions. 1532 24

Objectives. Both the number and type of higher cortical function deficits (HCFD) in acute stroke patients are important diagnostically and for gauging the extent of neurological deficits. Methods. The Stroke Data Bank (SDB) provided a large prospective data base for such evaluation. Thirty-one different HCFDs, each defined in the SDB manual, were considered. Results. Of 1,805 patients in the SDB, 641 instances of HCFD in 422 patients were recorded in alert patients at initial examination (within the first 7 to 10 days of ictus). Aphasia (41%) was the most commonly found HCFD, followed by neglect syndrome (27.2%), apraxia (11.7%), and anosognosia (11.1%). Agnosia (3.9%), alexia (3.3%), and aprosodia (1.5%) were less frequently found HCFDs. Cardioembolic infarct was most likely to have associated HCFDs (66%), and lacunar infarction was least likely to be accompanied by HCFDs (6%), with infarction caused by large artery thrombosis (50%) and infarct of undetermined cause (47%) having similar frequencies. The co-occurrence of sensory and motor deficits among the eight major subgroups of HCFD showed that neglect syndrome, apraxia, and anosognosia were most likely to be associated with long tract signs, whereas alexia, aprosodia, and agnosia invariably were not associated with sensorimotor impairment. Approximately half of aphasic patients had associated sensorimotor impairment. Conclusion. Our findings show that higher cortical function deficits are prevalent in the acute phase of stroke, particularly aphasia and neglect syndromes. They are more often associated with nonlacunar stroke and some are less likely to be associated with any sensorimotor deficits.
J Stroke Cerebrovasc Dis
PMID:Higher cortical function deficits among acute stroke patients: The stroke data bank experience. 1789 81

Purpose Limited evidence exists to guide the assessment and treatment of cognitive-communication disorders associated with right hemisphere stroke. The purpose of this study was to obtain information about speech-language pathologists' (SLPs') clinical practices and decision making for this population to understand what practices are being used and identify gaps in clinical practice. Method A survey was distributed via online ASHA Communities for the Special Interest Groups and other social media platforms. Respondents included 143 SLPs from across the United States representing 3-50 years of experience and a wide range of practice settings. Survey questions probed assessment practices including how tests are selected, what tests are used to diagnose specific deficits, and how confident SLPs were in their diagnoses. Treatment decisions were queried for a small set of disorders. Results SLPs routinely assess cognitive disorders using standardized tests. Communication disorders are less likely to be formally assessed. Three core right cerebral hemisphere deficits-anosognosia, aprosodia, and pragmatic deficits-are either not assessed or assessed only through observation by 80% of SLPs. Evidence-based treatments are commonly used for disorders of attention, awareness, and aprosodia. Conclusion Communication disorders are less likely to be formally assessed than cognitive disorders, creating a critical gap in care that cannot be filled by other allied health professionals. Suggestions for free or low-cost resources for evaluating pragmatics, prosody, and awareness are provided to aid SLPs in filling this gap. Supplemental Material https://doi.org/10.23641/asha.12159597.
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PMID:Speech-Language Pathology Practices for Adults With Right Hemisphere Stroke: What Are We Missing? 3233 Mar 89