REHABILITATION OF PATIENTS WITH SPEECH DISORDERS OCCURRING FROM POSTERIOR CORTICAL LESIONS

Cover Page


Cite item

Full Text

Abstract

Background: Research data on the compensatory mechanisms in patients with stroke sequelae that have been accumulated within the last years, allows for reconsideration of conventional techniques to restore aphasia.

Aim: To increase efficacy of the logopedic rehabilitation of patients with sequelae of the local posterior cortical lesions of the brain.

Materials and methods: Two hundred and eighty six patients with aphatic speech disorders during the early and late restorative periods of stroke participated in the study. The presence of aphasia caused by suppressed functioning of the posterior cortical areas was confirmed by the results of neurologic and logopedic assessments using the method of speech assessment in aphasia (L.S. Tsvetkova et al., 1981). Depending on the type of aphasia, the patients were divided in the groups as follows: 1) those with acoustic + gnostic aphasia (middle temporal gyrus); 2) those with acoustic + amnestic aphasia (upper temporal gyrus); 3) those with semantic aphasia (parietal – temporal – occipital areas). All patients underwent a course of logopedic rehabilitation aimed at restoration of the speech thinking.

Results: Until now, there was no technique for restoration of acoustic + amnestic and semantic types of aphasia with severe speech impairment. We have developed and implemented modified restoration methods for patients with posterior types of aphasia that increased the efficacy of rehabilitation. An improvement was seen in 61% of patients with severe aphasia, in 68% of those with moderate degree of aphasia and in 90% of patients with mild aphasia.

Conclusion: The clue for achievement of very good results of speech thinking restoration was the consideration of the mechanisms of speech impairment and compensatory processes in patients with the stroke sequelae

About the authors

M. M. Scherbakova

Moscow Regional Research and Clinical Institute (MONIKI)

Author for correspondence.
Email: mmsch@mail.ru

First Category Logopedist

Russian Federation

S. V. Kotov

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru

MD, PhD, Professor; Head of Department of Neurology; Head of Chair of Neurology, Postgraduate Training Faculty

Russian Federation

References

  1. Котов СВ. Основы клинической неврологии. Клиническая нейроанатомия, клиническая нейрофизиология, топическая диагностик заболеваний нервной системы: руководство для врачей. М.: ГЭОТАР-Медиа; 2011. 672 с. Kotov SV. Osnovy klinicheskoy nevrologii. Klinicheskaya neyroanatomiya, klinicheskaya neyrofiziologiya, topicheskaya diagnostika zabolevaniy nervnoy sistemy: rukovodstvo dlya vrachey [Basics of clinical neurology. Clinical neuroanatomy, clinical neurophysiology, topical diagnostics of disorders of the nervous system: a manual for doctors]. Moscow: GEOTAR-Media; 2011. 672 p. (in Russian).
  2. Лурия АР. Высшие корковые функции человека. СПб.: Питер; 2008. 624 с. Luriya AR. Vysshie korkovye funktsii cheloveka [High cortical functions in humans]. Saint Petersburg: Piter; 2008. 624 p. (in Russian).
  3. Зайдель Э. Лексическая организация и правое полушарие. В: Хомская ЕД, ред. Хрестоматия по нейропсихологии. М.: МПСИ; 2004. с. 542–4. Zaydel' E. Leksicheskaya organizatsiya i pravoe polusharie [Lexical organization and the right hemisphere]. In: Khomskaya ED, editor. Khrestomatiya po neyropsikhologii [A reading book on neuropsychology]. Moscow: MPSI; 2004. p. 542–4 (in Russian).
  4. Манвелов ЛС, Кадыков АС. Инсульт. М.: В. Секачев, Институт общегуманитарных исследований; 2004. 192 с. Manvelov LS, Kadykov AS.
  5. Insul't [Stroke]. Moscow: V. Sekachev, Institut obshchegumanitarnykh issledovaniy; 2004. 192 p. (in Russian).
  6. Маршинин БА. Перцептивные и мыслительные процессы, их мозговое обеспечение. М.: Логос; 2007. 196 с. Marshinin BA. Pertseptivnye i myslitel'nye protsessy, ikh mozgovoe obespechenie [Perceptive and thinking processes and their brain resourcing]. Moscow: Logos; 2007. 196 p. (in Russian).
  7. Price CJ. The anatomy of language: contributions from functional neuroimaging. J Anat. 2000;197 Pt 3:335–59.
  8. Shaywitz BA, Pugh KR, Constable T, Shaywitz SE, Bronen RA, Fulbright RK, Shankweiler DP, Katz L, Fletcher JM, Skudlarski P, Gore JC. Localization of semantic processing using functional magnetic resonance imaging. Hum Brain Mapp.1995;2(3):149–58.
  9. Jobard G, Crivello F, Tzourio-Mazoyer N. Evaluation of the dual route theory of reading: a metanalysis of 35 neuroimaging studies. Neuroimage. 2003;20(2):693–712.
  10. Booth JR, Burman DD, Meyer JR, Gitelman DR, Parrish TB, Mesulman MM. Functional anatomy of intra- and cross-modal lexical tasks. Neuroimage. 2002;16(1):7–22.
  11. Johnson JS, Newport EL. Critical period effects in second language learning: the influence of maturational state on the acquisition of English as a second language. Cogn Psychol. 1989;21(1):60–99.
  12. Posner M, Sandson J, Dhawan M, Shulman S. Is word recognition automatic? A cognitiveanatomical approach. Cogn Neurosci. 1989;1(1):50–60.
  13. Halgren E, Dhond RP, Christensen N, Van PC, Marinkovic K, Lewine JD, Dale AM. N400- like magnetoencephalography responses modulated by semantic context, word frequency, and lexical class in sentences. Neuroimage. 2002;17(3):1001–116.
  14. Fredericu AD, Ruschemeyer SA, Hahne A, Fielach CJ. The role of left inferior frontal and superior temporal cortex in sentence
  15. comprehension: localizing syntactic and semantic processes. Cereb Cortex. 2003;13(2): 170–7.
  16. Demonet JF, Thierry G, Cardebat D. Renewal of the neurophysiology of language: functional neuroimaging. Physiol Rev. 2005;85(1):49–95.
  17. Щербакова ММ, Ларина ОД. Сборник зада- ний для восстановления речи у больных с акустико-мнестической афазией. М.: В. Се- качев; 2012. 62 с. Shcherbakova MM, Larina OD. Sbornik zadaniy dlya vosstanovleniya rechi u bol'nykh s akustiko- mnesticheskoy afaziey [Collection of tasks to restore the speech in patients with acoustic + amnestic aphasia]. Moscow: V. Sekachev; 2012. 62 p. (in Russian).
  18. Щербакова ММ, Ларина ОД. Сборник заданий для восстановления речи у больных с семантической афазией. М.: В. Секачев; 2013. 80 с. Shcherbakova MM, Larina OD. Sbornik zadaniy dlya vosstanovleniya rechi u bol'nykh s semanticheskoy afaziey [Collection of tasks to restore the speech in patients with semantic aphasia]. Moscow: V. Sekachev; 2013. 80 p. (in Russian).
  19. Ахутина ТВ, Цветкова ЛС, Пылаева НМ. Методика оценки речи при афазии. М.: Изд-во МГУ; 1981. 67 с. Akhutina TV, Tsvetkova LS, Pylaeva NM. Metodika otsenki rechi pri afazii [The technique for speech assessment in aphasia]. Moscow: MSU; 1981. 67 p.
  20. Дорофеева СА. Реабилитация больных с речеслуховой агнозией. В: Храковская МГ, ред. Проблемы патологии развития и распада речевой функции: Методические материалы научно-практической конференции «Центральные механизмы речи», посвященной памяти проф. Н.Н. Трауготт. СПб.: Изд-во Санкт-Петербургского университета; 2001. с. 112–5. Dorofeeva SA. Reabilitatsiya bol'nykh s recheslukhovoy agnoziey [Rehabilitation of patients with speech and auditory aphasia]. In: Khrakovskaya MG, editor. Problemy patologii razvitiya i raspada rechevoy funktsii: Metodicheskie materialy nauchno-prakticheskoy konferentsii “Tsentral'nye mekhanizmy rechi”, posvyashchennoy pamyati prof. N.N. Traugott [The problems of abnormalities in development and destruction of the speech functioning: methodological materials and the research and practical conference “The Central Speech Mechanisms” in memoriam Prof. N.N. Traugott]. Saint Petersburg: SPbU; 2001. p. 112–5 (in Russian).
  21. Иваницкая ЛИ, Ополинский ЭС, Шкловский ВМ. Электрофизиологические исследования механизмов акустической информации у больных с сенсорной афазией. Дефектология. 1988;(5):10–6. Ivanitskaya LI, Opolinskiy ES, Shklovskiy VM. Elektrofiziologicheskie issledovaniya mekhanizmov akusticheskoy informatsii u bol'nykh s sensornoy afaziey [Electrophysiological assessments of the mechanisms of acoustic information in patients with sensory aphasia]. Defektologiya. 1988;(5):10–6.
  22. Храковская МГ. Резервные способы восстановления высших психических функций у больных с афазией. В: Хомская ЕД, Ахутина ТВ, ред. I Международная конференция памяти А.Р. Лурия: сборник докладов. М.: Факультет психологии МГУ; 1998. с. 241–4. Доступно на: http://transyoga.ru/assets/files/ books/psychology/homsk_confpam.pdf. Khrakovskaya MG. Rezervnye sposoby vosstanovleniya vysshikh psikhicheskikh funktsiy u bol'nykh s afaziey [Stand-by methods of restoration of higher mental functions in patients with aphasia]. In: Khomskaya ED, Akhutina TV, editors. I Mezhdunarodnaya konferentsiya pamyati A.R. Luriya: sbornik dokladov [1st International Conference in memoriam A.P. Luriya: a collection of reports]. Moscow: MSU, Faculty of Psychology; 1998. p. 241–4. Available from: http://transyoga.ru/assets/files/books/psychology/ homsk_confpam.pdf (in Russian).
  23. Щербакова ММ, Котов СВ. Реабилитация больных с афазией по модифицированным методикам восстановления. Альманах клинической медицины. 2014;(31):56–60. bol'nykh s afaziey po modifitsirovannym metodikam vosstanovleniya [Rehabilitation of patients with aphasia according to modified restoration techniques]. Al'manakh klinicheskoy meditsiny. 2014;(31):56–60 (in Russian).
  24. Щербакова ММ. Методики восстановления речи у больных с акустико-мнестической и семантической афазиями грубых степе- ней тяжести. Справочник поликлиническо- го врача. 2013;(1):38–45. Shcherbakova MM. Metodiki vosstanovleniya rechi u bol'nykh s akustiko-mnesticheskoy i semanticheskoy afaziyami grubykh stepeney tyazhesti [Techniques for speech restoration in patients with severe acoustic + amnestic and semantic aphasia]. Spravochnik poliklinicheskogo vracha. 2013;(1):38–45 (in Russian).
  25. Щербакова ММ, Котов СВ. Семантическая афазия. Обследование и реабилитация больных. Русский медицинский журнал. 2014;(10):792–4. Shcherbakova MM, Kotov SV. Semanticheskaya afaziya. Obsledovanie i reabilitatsiya bol'nykh [Semantic aphasia. Patient assessment and rehabilitation]. Russian Medical Journal. 2014;(10):792–4 (in Russian).

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2015 Scherbakova M.M., Kotov S.V.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies