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This study examined discourse characteristics of individuals with aphasia who scored at or above the 93.8 cutoff on the Aphasia Quotient subtests of the Western Aphasia Battery-Revised (WAB-R; Kertesz, 2007). They were compared with participants without aphasia and those with anomic aphasia. Participants were from the AphasiaBank database and included 28 participants who were not aphasic by WAB-R score (NABW), 92 participants with anomic aphasia, and 177 controls. Cinderella narratives were analyzed using the Computerized Language Analysis programs (MacWhinney, 2000). Outcome measures were words per minute, percent word errors, lexical diversity using the moving average type-token ratio (Covington, 2007b), main concept production, number of utterances, mean length of utterance, and proposition density. Results showed that the NABW group was significantly different from the controls on all measures except MLU and proposition density. These individuals were compared to participants without aphasia and those with anomic aphasia. Individuals with aphasia who score above the WAB-R Aphasia Quotient cutoff demonstrate discourse impairments that warrant both treatment and special attention in the research literature.

Anomia, a word-finding difficulty, is a frequent consequence of poststroke linguistic disturbance, associated with fluent and nonfluent aphasia that needs long-term specific and intensive speech rehabilitation. The present study explored the feasibility of telerehabilitation as compared to a conventional face-to-face treatment of naming, in patients with poststroke anomia. Five aphasic chronic patients participated in this study characterized by: strictly controlled crossover design; well-balanced lists of words in picture-naming tasks where progressive phonological cues were provided; same kind of the treatment in the two ways of administration. ANOVA was used to compare naming accuracy in the two types of treatment, at three time points: baseline, after treatment, and followup. The results revealed no main effect of treatment type (P=0.844) indicating that face-to-face and tele-treatment yielded comparable results. Moreover, there was a significant main effect of time (P=0.0004) due to a better performance immediately after treatment and in the followup when comparing them to baseline. These preliminary results show the feasibility of teletreatment applied to lexical deficits in chronic stroke patients, extending previous work on telerehabilitation and opening new vistas for future studies on teletreatment of language functions.

Proper name anomia is a common experience that can become unpleasantly amplified in people with dementia (PWD). The Gotcha! app aims to provide practice-based therapy for PWD enabling them to spontaneously retrieve the names of key people in their lives. Gotcha! is a digital confrontation naming therapy app. PWD supply images and names of the people they want to be able to name and train on one face per day for six weeks. We employed a single-case experimental design with weekly testing of free-naming in both six-week blocks (pre therapy and during therapy). A novel speech verifier was used to provide real-time feedback (Barbera et al. 2020). PWD also had an MEG scan before and after the therapy block where they attempt to name pictures of familiar (trained) and famous (untrained) faces. We interrogated the behavioural data in two ways: 1) a within-subject non-parametric analysis using Tau-U metric (Parker et al. 2011); 2) a parametric group analysis using an ANOVA. MEG data were analysed in SPM. We measured source localised gamma-band (30-80 Hz) power 0-1000 ms after the onset of a face. We ran a group-based 2x2 factorial analysis on the resultant images (familiar vs. famous; pre- vs. post-therapy) using a repeated-measures ANOVA to look for changes in power. The trial is ongoing (target = 45 PWD). Results from the first 20 PWD to complete the trial demonstrate: 1) Tau-U. 80% showed a positive trend with better naming during the training phase with 8/20 reaching statistical significance. 2) ANOVA showed a significant effect at the group level of training>baseline phase, F (1,19)=13.18, p = 0.01 Results from the MEG analysis of 14 PWD: We identified a large cluster of 813 voxels situated in the left ventral temporal lobe (MNI: -50 -28 -26, F = 9.19, p = 0.004) where gamma reduction was associated with training (pre-post) of familiar faces, but not (untrained) famous faces. Gotcha! app-based therapy for proper name anomia works for the majority of PWD in our trial thus far. This is the first study to demonstrate that the left ventral temporal lobe region supports practice-based retrieval of familiar face-name associations in PWD.

The present study evaluated the effectiveness of transcranial alternating current stimulation (tACS) treating patients with post-stroke anomia using a picture-naming task and a Single-Case Experimental Design (SCED). A right-handed 38-year-old woman with a left-hemisphere stroke and a left-handed 54-year-old man with a right-hemisphere stroke underwent an eight-week treatment program. Specifically, they participated in a picture-naming task three times a week, alternating between sessions with and without tACS stimulation every two weeks. Electroencephalography (EEG) measurements were taken at the end of each two-week period, and behavioral data were collected before, during and after the treatment. EEG and behavioral assessments were also conducted at one- and three-month follow-ups. Picture-naming performance was significantly faster during tACS sessions compared to sessions without tACS. By the end of the intervention, both participants demonstrated improved accuracy and speed, with positive effects also observed in behavioral measures. EEG analysis showed that post-treatment brain activity resembled that of healthy individuals performing similar tasks. Patients’ improvements in picture-naming and behavioral tests showed that the positive effects remained stable even after three months. Thus, preliminary data suggest that tACS might be a promising intervention for anomia, with lasting effects. Large-scale studies are needed to confirm these findings.

Purpose: The relationship between cognitive abilities and aphasia rehabilitation outcomes is complex and remains poorly understood. This study investigated the influence of language and cognitive abilities on anomia therapy outcomes in adults with aphasia. Method: Thirty-four adults with chronic aphasia participated in Aphasia Language Impairment and Functioning Therapy. A language and cognitive assessment battery, including 3 baseline naming probes, was administered prior to therapy. Naming accuracy for 30 treated and 30 untreated items was collected at posttherapy and 1-month follow-up. Multiple regression models were computed to evaluate the relationship between language and cognitive abilities at baseline and anomia therapy outcomes. Results: Both language and cognitive variables significantly influenced anomia therapy gains. Verbal short-term memory ability significantly predicted naming gains for treated items at posttherapy (ß = -0.551, p = 0.002) and for untreated items at posttherapy (ß = 0.456, p = 0.014) and 1-month follow-up (ß = 0.455, p = 0.021). Furthermore, lexical-semantic processing significantly predicted naming gains for treated items at posttherapy (ß = -0.496, p = 0.004) and 1-month follow-up (ß = 0.545, p = 0.012). Conclusions: Our findings suggest that individuals' cognitive ability, specifically verbal short-term memory, affects anomia treatment success. Further research into the relationship between cognitive ability and anomia therapy outcomes may help to optimize treatment techniques.

Anomia, or difficulty with naming and word finding, is a pervasive deficit among individuals with aphasia. There is an extensive literature on the mechanisms underlying anomia and on approaches to treatment, but very little is known about the subjective experience of anomia during day-to-day life. As part of a larger testing battery, 53 adults with poststroke aphasia took part in a novel, structured interview that included an open-ended question about the general experience of anomia: \"Do you ever know what you want to say, but you can't say it out loud? Please describe that feeling.\" Video-recorded interview responses were transcribed and analyzed using thematic analysis, an iterative, data-driven process that categorizes interview data into common themes. Five main themes emerged among the data from 37 participants who produced adequate responses for use in thematic analysis: strategies to cope with or compensate for anomia, comments on awareness of the level of breakdown (e.g., \"I have an idea, but can't get the right words\"), negative emotions, impact on relationships, and changes in frequency over time. Participants showed strong awareness of anomia and its implications, demonstrating an ability to describe their language breakdown, identify relevant strategies to compensate and/or cope, and acknowledge the impact of anomia on their emotions and social interactions. This patient perspective may serve as a valuable supplement to information typically gained via objective language assessments. Clinicians and researchers may wish to consider incorporating similar subjective measures during assessment and treatment planning. Supplemental Material https://doi.org/10.23641/asha.15032643.

Purpose: The ultimate goal of anomia treatment should be to achieve gains in exemplars trained in the therapy session, as well as generalization to untrained exemplars and contexts. The purpose of this study was to test the efficacy of phonomotor treatment, a treatment focusing on enhancement of phonological sequence knowledge, against semantic feature analysis (SFA), a lexical-semantic therapy that focuses on enhancement of semantic knowledge and is well known and commonly used to treat anomia in aphasia. Method: In a between-groups randomized controlled trial, 58 persons with aphasia characterized by anomia and phonological dysfunction were randomized to receive 56-60 hr of intensively delivered treatment over 6 weeks with testing pretreatment, posttreatment, and 3 months posttreatment termination. Results: There was no significant between-groups difference on the primary outcome measure (untrained nouns phonologically and semantically unrelated to each treatment) at 3 months posttreatment. Significant within-group immediately posttreatment acquisition effects for confrontation naming and response latency were observed for both groups. Treatment-specific generalization effects for confrontation naming were observed for both groups immediately and 3 months posttreatment; a significant decrease in response latency was observed at both time points for the SFA group only. Finally, significant within-group differences on the Comprehensive Aphasia Test--Disability Questionnaire (Swinburn, Porter, & Howard, 2004) were observed both immediately and 3 months posttreatment for the SFA group, and significant within-group differences on the Functional Outcome Questionnaire (Glueckauf et al., 2003) were found for both treatment groups 3 months posttreatment. Discussion: Our results are consistent with those of prior studies that have shown that SFA treatment and phonomotor treatment generalize to untrained words that share features (semantic or phonological sequence, respectively) with the training set. However, they show that there is no significant generalization to untrained words that do not share semantic features or phonological sequence features.

Studies of patients with acquired cognitive deficits following brain damage and studies using contemporary neuroimaging techniques form two distinct streams of research on the neural basis of cognition. In this study, we combine high-quality structural neuroimaging analysis techniques and extensive behavioural assessment of patients with persistent acquired language deficits to study the neural basis of language. Our results reveal two major divisions within the language system—meaning versus form and recognition versus production—and their instantiation in the brain. Phonological form deficits are associated with lesions in peri-Sylvian regions, whereas semantic production and recognition deficits are associated with damage to the left anterior temporal lobe and white matter connectivity with frontal cortex, respectively. These findings provide a novel synthesis of traditional and contemporary views of the cognitive and neural architecture of language processing, emphasizing dual routes for speech processing and convergence of white matter tracts for semantic control and/or integration. Contemporary neuroimaging techniques are enabling precise analysis of structure–function relations in the brain. This study combines large-scale structural neuroimaging and behavioural analyses in patients with acquired aphasia to elucidate the neural organization of spoken language processing.

The importance of personalization in script training in aphasia has been assumed but never tested. This study compared acquisition and generalization of personally relevant versus generic words or phrases appearing in the same scripts. Eight individuals (6 men; 2 women) with chronic aphasia received 3 weeks of intensive computer-based script training. For each participant, 2 scripts, a trained and an untrained generalization script, were embedded with 4 personally relevant word choices and 2-4 generic items that were similar across participants. Scripts were probed for accuracy at baseline and posttreatment. Significance testing was conducted on baseline and posttreatment scores, and for gains in personally relevant versus generic items. Effect sizes were computed. Both personally relevant and generic items improved significantly on trained scripts. Improvements on untrained scripts were smaller, with only personally relevant items reaching significance. There was no significant difference on gains made on personalized versus generic items for trained scripts (p = .059), but the effect size was large (d = 0.90). For generalization scripts, this effect was small (d = 0.25) and nonsignificant. Personally relevant words and phrases were acquired, although not generalized, more successfully than generic words and phrases. Data supports the importance of personalization in script training, but the degree of that importance requires further investigation.

Proper name anomia is a common experience that can become unpleasantly amplified in people with dementia (PWD). The Gotcha! app aims to provide practice-based therapy for PWD enabling them to spontaneously retrieve the names of key people in their lives. Gotcha! is a digital confrontation naming therapy app. PWD supply images and names of the people they want to be able to name and train on one face per day for six weeks. We employed a single-case experimental design with weekly testing of free-naming in both six-week blocks (pre therapy and during therapy). A novel speech verifier was used to provide real-time feedback (Barbera et al. 2020). PWD also had an MEG scan before and after the therapy block where they attempt to name pictures of familiar (trained) and famous (untrained) faces. We interrogated the behavioural data in two ways: 1) a within-subject non-parametric analysis using Tau-U metric (Parker et al. 2011); 2) a parametric group analysis using an ANOVA. MEG data were analysed in SPM. We measured source localised gamma-band (30-80 Hz) power 0-1000 ms after the onset of a face. We ran a group-based 2x2 factorial analysis on the resultant images (familiar vs. famous; pre- vs. post-therapy) using a repeated-measures ANOVA to look for changes in power. The trial is ongoing (target = 45 PWD). Results from the first 20 PWD to complete the trial demonstrate: 1) Tau-U. 80% showed a positive trend with better naming during the training phase with 8/20 reaching statistical significance. 2) ANOVA showed a significant effect at the group level of training>baseline phase, F (1,19)=13.18, p = 0.01 Results from the MEG analysis of 14 PWD: We identified a large cluster of 813 voxels situated in the left ventral temporal lobe (MNI: -50 -28 -26, F = 9.19, p = 0.004) where gamma reduction was associated with training (pre-post) of familiar faces, but not (untrained) famous faces. Gotcha! app-based therapy for proper name anomia works for the majority of PWD in our trial thus far. This is the first study to demonstrate that the left ventral temporal lobe region supports practice-based retrieval of familiar face-name associations in PWD.