Explore the vast range of titles available.

In a randomized, sham-controlled trial involving 40 patients, therapeutic lesions on one side in the subthalamic nucleus were produced by focused ultrasound. At 4 months, motor performance was better in the active-treatment group. Twelve patients had neurologic deficits, many of which resolved by 12 months.

Depressive symptoms may increase the risk of progressing from mild cognitive impairment (MCI) to dementia. Consumption of n-3 PUFA may alleviate both cognitive decline and depression. The aim of the present study was to investigate the benefits of supplementing a diet with n-3 PUFA, DHA and EPA, for depressive symptoms, quality of life (QOL) and cognition in elderly people with MCI. We conducted a 6-month double-blind, randomised controlled trial. A total of fifty people aged >65 years with MCI were allocated to receive a supplement rich in EPA (1·67 g EPA+0·16 g DHA/d; n 17), DHA (1·55 g DHA+0·40 g EPA/d; n 18) or the n-6 PUFA linoleic acid (LA; 2·2 g/d; n 15). Treatment allocation was by minimisation based on age, sex and depressive symptoms (Geriatric Depression Scale, GDS). Physiological and cognitive assessments, questionnaires and fatty acid composition of erythrocytes were obtained at baseline and 6 months (completers: n 40; EPA n 13, DHA n 16, LA n 11). Compared with the LA group, GDS scores improved in the EPA (P = 0·04) and DHA (P = 0·01) groups and verbal fluency (Initial Letter Fluency) in the DHA group (P = 0·04). Improved GDS scores were correlated with increased DHA plus EPA (r 0·39, P = 0·02). Improved self-reported physical health was associated with increased DHA. There were no treatment effects on other cognitive or QOL parameters. Increased intakes of DHA and EPA benefited mental health in older people with MCI. Increasing n-3 PUFA intakes may reduce depressive symptoms and the risk of progressing to dementia. This needs to be investigated in larger, depressed samples with MCI.

Anne O'Hare Royal Hospital for Sick Children, Edinburgh, United Kingdom, and University of Edinburgh, United Kingdom Marion Rutherford Royal Hospital for Sick Children Contact author: Susan Peppé, Speech and Hearing Sciences, Queen Margaret University, Clerwood Terrace, Edinburgh EH12 8TS, United Kingdom. E-mail: speppe{at}qmu.ac.uk . Purpose: This study aimed to identify the nature and extent of receptive and expressive prosodic deficits in children with high-functioning autism (HFA). Method: Thirty-one children with HFA, 72 typically developing controls matched on verbal mental age, and 33 adults with normal speech completed the prosody assessment procedure, Profiling Elements of Prosodic Systems in Children. Results: Children with HFA performed significantly less well than controls on 11 of 12 prosody tasks ( p < .005). Receptive prosodic skills showed a strong correlation ( p < .01) with verbal mental age in both groups, and to a lesser extent with expressive prosodic skills. Receptive prosodic scores also correlated with expressive prosody scores, particularly in grammatical prosodic functions. Prosodic development in the HFA group appeared to be delayed in many aspects of prosody and deviant in some. Adults showed near-ceiling scores in all tasks. Conclusions: The study demonstrates that receptive and expressive prosodic skills are closely associated in HFA. Receptive prosodic skills would be an appropriate focus for clinical intervention, and further investigation of prosody and the relationship between prosody and social skills is warranted. KEY WORDS: high-functioning autism, prosody, intonation, language, assessment CiteULike     Connotea     Del.icio.us     Digg     Facebook     Reddit     Technorati     Twitter     What's this?

ObjectiveTo assess the impact of hypothermic neural rescue at birth on health-related quality of life (HRQL) in middle childhood.DesignSix-year to 7-year follow-up of surviving children from the Total Body Hypothermia for Neonatal Encephalopathy (TOBY) Trial.SettingCommunity study including a single parental questionnaire to collect information on children’s HRQL.Patients145 children (70 in the control group, 75 in the hypothermia group) whose parents consented and returned the questionnaire.InterventionsIntensive care with cooling of the body to 33.5°C for 72 hours or intensive care alone.Main outcome measuresHRQL attributes and utility scores using the Health Utilities Index (HUI).ResultsAt 6–7 years, speech appeared disproportionately affected when compared with other aspects of HRQL but levels of normal emotional functioning were similar in both groups. The mean (SE) HUI3 HRQL scores were 0.73 (0.05) in the hypothermia group and 0.62 (0.06) in the control group; mean difference (95% CI) 0.11 (−0.04 to 0.26).ConclusionsFindings of non-significant differences were not unexpected; the study used data from long-term survivors in a neonatal trial and was underpowered. However, results favoured moderate hypothermia and so complement the clinical results of the TOBY Children study. The work provides further insight into the long-term HRQL impact of perinatal asphyxial encephalopathy and provides previously unavailable utility data with which to contemplate the longer term cost-effectiveness of hypothermic neural rescue.Trial registration numberThis study reports on the follow-up of the TOBY clinical trial: ClinicalTrials.gov number NCT01092637.

Objective To determine the effectiveness of a cognitive behaviour language therapy (CBLT) programme to reduce speech anxiety among stuttering school adolescents. Methods This was a group randomized clinical trial that enrolled stuttering school adolescents who had severe speech anxiety. The participants were randomized to either the treatment group or the control group. The Speech Anxiety Thoughts Inventory (SATI) score was recorded before and after a 12-week CBLT programme was delivered in 24 group sessions to the treatment group. The control group did not receive any therapy. Results A total of 92 stuttering school adolescents who met the inclusion criteria were randomized to the treatment group (n = 46; 22 males, 24 females; mean ± SD age, 16.36 ± 2.20 years) or the control group (n = 46; 28 males, 18 females; mean ± SD age, 15.45 ± 2.10 years). Results showed that the CBLT intervention significantly reduced speech anxiety among stuttering school adolescents compared with the control group (post-test SATI assessment, mean ± SD 26.52 ± 1.67 versus 89.92 ± 3.17, respectively). Conclusion These findings suggest that speech educators and therapists in educational institutions and hospitals should follow the principles of CBLT when treating speech anxiety.

Background: Prehospital identification of acute stroke increases the possibility of early treatment and good outcome. To increase identification of stroke, the Face Arm Speech Time (FAST) test was introduced in the Emergency Medical Communication Center (EMCC). This substudy aims to evaluate the implementation of the FAST test in the EMCC and the ambulance service. Methods: The study was conducted in the region of Stockholm, Sweden during 6 months. The study population consisted of all calls to the EMCC concerning patients presenting at least one FAST symptom or a history/finding making the EMCC or ambulance personnel to suspect stroke within 6 h. Positive FAST was compared to diagnosis at discharge. Positive predictive values (PPV) for a stroke diagnosis at discharge were calculated. Results: In all, 900 patients with a median age of 71 years were enrolled, 667 (74%) by the EMCC and 233 (26%) by the ambulances. At discharge, 472 patients (52%) were diagnosed with stroke/transient ischemic attack (TIA), 337 identified by the EMCC (71%) and 135 (29%) by the ambulances. The PPV for a discharge diagnosis of stroke/TIA was 51% (CI 47-54%) in EMCC-enrolled and 58% (CI 52-64%) in ambulance-enrolled patients. With a positive FAST the PPV of a correct stroke/TIA diagnosis increased to 56% (CI 52-61%) and 73% (CI 66-80%) in EMCC- and ambulance-enrolled patients, respectively. Positive FAST from EMCC was also found in 44% of patients with a nonstroke diagnosis at discharge. A stroke/TIA diagnosis at discharge but negative FAST was found in 58 and 27 patients enrolled by the EMCC and ambulances, respectively. Conclusions: The PPV of FAST is higher when used on the scene by ambulance than by EMCC. FAST may be a useful prehospital tool to identify stroke/TIA but has limitations as the test can be negative in true strokes, can be positive in nonstrokes, and FAST symptoms may be present but not identified in the emergency call. For the prehospital care situation better identification tools are needed.

Background: Parkinson's disease (PD) is a progressive neurodegenerativa disorder where patients exhibit impairments in speech production. Few studies have investigated the influence of music interventions on vocal abilities of individuals with PD. Objectives: To evaluate the influence of a group voice and singing intervention on speech, singing, and depressive symptoms in individuals with PD. Methods: Ten patients diagnosed with PD participated in this one-group, repeated measures design study. Participants received the sixty-minute intervention, in a small group setting once a week for 20 consecutive weeks. Speech and singing quality were acoustically analyzed using a KayPentax Multi-Dimensional Voice Program™, voice ability using the Voice Handicap Index (VHI), and depressive symptoms using the Montgomery and Åsberq Depression rating scale (MADRS), Measures were taken at baseline (Time 1), after 10 weeks of weekly sessions (Time 2). and after 20 weeks of weekly sessions (Time 3). Results: Significant changes were observed for five of the six singing quality outcomes at Time 2 and 3, as well as voice range and the VHI physical subscale at Time 3. No significant changes were found for speaking quality or depressive symptom outcomes; however, there was an absence of decline on speaking quality outcomes over the intervention period. Conclusions: Significant improvements in singing quality and voice range, coupled with the absence of decline in speaking quality support group singing as a promising intervention for persons with PD. A two-group randomized control study is needed to determine whether the intervention contributes to maintenance of speaking quality in persons with PD.

This book provides comprehensive coverage of speech and language disorders arising from pathological processes involving the subcortical structures of the brain. It gives an understanding of these disorders in terms of their neuropathological basis, clinical symptomatology and prognosis. A full discussion of contemporary models and theories of subcortical participation in speech and language processing is given, including discussion of the possible roles of structures such as the basal ganglia, subthalamic nucleus, thalamus and cerebellum. The book covers speech and language disorders associated with a variety of subcortical conditions, ranging from major degenerative conditions such as Parkinsons' Disease, Huntington's chorea and dystonia, through to acquired non-degenerative subcortical lesions arising from, for example, cerebrovascular accidents and sterotactic surgically induced lesions. In addition, a full description of the relevant assessment and treatment procedures currently recommended for use for each of the subcortical communication disorders is given.

The purpose of this study was to compare the efficacy of Melodic Based Communication Therapy (MBCT) to traditional speech and language therapy for eliciting speech in nonverbal children with autism. Participants were 12 nonverbal children with autism ages 5 through 7 randomly assigned to either treatment group. Both groups made significant progress after treatment. The MBCT group progressed significantly in number of verbal attempts after weeks 1 through 4 and number of correct words after weeks 1 and 3, while the traditional group progressed significantly after weeks 4 and 5. No significant differences in number of verbal attempts or number of correct words were noted between groups following treatment. A significant number of new words were heard in the home environment for the MBCT group ( p  = .04). Participants in the MBCT group had more imitative attempts ( p  = .03). MBCT appears to be a valid form of intervention for children with autism.

BackgroundRecent evidence suggests that deep brain stimulation of the subthalamic nucleus (STN-DBS) may have a disease modifying effect in early Parkinson's disease (PD). A randomised, prospective study is underway to determine whether STN-DBS in early PD is safe and tolerable.Objectives/methods15 of 30 early PD patients were randomised to receive STN-DBS implants in an institutional review board approved protocol. Operative technique, location of DBS leads and perioperative adverse events are reported. Active contact used for stimulation in these patients was compared with 47 advanced PD patients undergoing an identical procedure by the same surgeon.Results14 of the 15 patients did not sustain any long term (>3 months) complications from the surgery. One subject suffered a stroke resulting in mild cognitive changes and slight right arm and face weakness. The average optimal contact used in symptomatic treatment of early PD patients was: anterior −1.1±1.7 mm, lateral 10.7±1.7 mm and superior −3.3±2.5 mm (anterior and posterior commissure coordinates). This location is statistically no different (0.77 mm, p>0.05) than the optimal contact used in the treatment of 47 advanced PD patients.ConclusionsThe perioperative adverse events in this trial of subjects with early stage PD are comparable with those reported for STN-DBS in advanced PD. The active contact position used in early PD is not significantly different from that used in late stage disease. This is the first report of the operative experience from a randomised, surgical versus best medical therapy trial for the early treatment of PD.