Author: Richard Steele , Ph.D.

Because music engages and integrates contributions from many different cerebral areas, it may hold untapped promise in the rehabilitation of aphasia. Music activates regions in both hemispheres of the brain that are associated with attention, memory, focus, motor planning, action sequencing, auditory processing, pattern recognition, emotional affect and expression, and — when lyrics are involved — underlying competencies and performance of speech and language. Because the focal lesions following stroke are unlikely to compromise entirely this widely distributed bilateral network of cerebral areas , they may be recruited, with the help of music, to help replace the functions of affected regions.

Consider Melodic Intonation Therapy (MIT), which uses music in aphasia rehabilitation. MIT was developed in the early 1970s by Martin Albert and colleagues at the Boston Veterans Administration’s Aphasia Research Center. When successful, MIT improves verbal expression, quantitatively and qualitatively, in persons with left-hemisphere brain damage resulting in Broca’s aphasia. Albert and others observed that persons with Broca’s aphasia often could sing lyrics not otherwise available to them as spoken words for conversation. The technique involves practicing phrases initially as song fragments, then diminishing the prominence of melody and musical rhythm, and moving towards more conversational delivery. Some patients — though not all — have benefited markedly from MIT.

At least two mechanisms appear to be at work when MIT is effective. The first is “intersystem reorganization,” a process by which a spared ability, like song, fosters and supports performance improvements in an impaired ability. In this case, phrases supported by melody and rhythm are exploited to support and foster the eventual production of more normal speech. As practice improves fluency and self-confidence, and as melody and rhythm yield ground over time to more conversational intonations and cadences, the capacity for volitional speech expands.

A second mechanism appears to be the improved regulation of right hemisphere interactions. As Oliver Sacks describes in Musicophilia, areas in the right hemisphere that correspond to the damaged left-hemisphere language areas often become hyperactive when persons with Broca’s aphasia attempt to speak. This hyperactivity — essentially, unregulated and overpowering “noise” — can spill over and interfere with the desired left-hemisphere cerebral activity, hindering competent speech and language performance and producing frustration. Brain scans indicate that MIT quells this contralateral hyperactivity by giving the right hemisphere other, non-interfering tasks to occupy its energies and regulate its activities. The right hemisphere becomes otherwise engaged and hence non-disruptive. The resulting diminution of noise opens a space for the left hemisphere to operate without right-hemisphere interference, promoting improved speech-language performance.

To read more articles from Lingraphica, click on the above link and hit the “Our Research” tab.

________________
For further reading: Oliver Sacks. “Speech and song: aphasia and music therapy.” Chap. 16 in Musicophilia. New York, NY: Alfred A. Knopf. 2007.

Author: National Aphasia Association

The National Aphasia Association announces that Congress has yet AGAIN passed a resolution in the House and Senate to declare June as National Aphasia Awareness Month! The NAA is indebted to Senator Tim Johnson (SD) and Congressman Edward J Markey (MA) for their sponsorship and efforts. A special thanks also goes to NAA Board member, Dr. Paul Rao, for spearheading the project. Read more about it in the National Aphasia Association Newsletter! .

Author: Winston J. Lindsley

Winston J. Lindsely had a stroke four and half years ago after heart surgery, which resulted in him having both aphasia and apraxia. He continues to regain his speech. He and his speech therapist have made a couple of CDs/DVDs which he uses for home practice.

Winston attended RAP at University of Michigan in Ann Arbor and they are now using his CDs with their clients.

In addition, he attended and was given permission to film the presentations at the National Aphasia Conference in Boston in June, 2006.

To find out more about these tools, please contact at the link above and for their order form or contact them via email at WinGOGlobal@gmail.com .

Author: Medical News Today

An important breakthrough in our understanding of how the brain works could help stroke patients to regain their speech.

Action Medical Research has announced the results of the study as a “leap forward in understanding”. The charity adds that patients could benefit from this discovery within the next three to five years.

Up to one quarter of stroke patients suffer from speech impairment of some degree. This can mean difficulty with speaking and understanding what is said to them or even trouble with reading and writing.

Some people find that, over time, their speech and understanding improves but many more face an uphill struggle and some never recover; even with therapy.

Until now little was known about why some patients make progress and some do not.

However the Action Medical Research study has found that an answer lies in the complex pathways that exist between the speech processing areas on both sides of the brain.

Dr Jane Warren, who is based at Imperial College London, has used specialised brain imaging techniques to identify areas of the brain that are responsible for understanding speech and their connections with each other.

Dr Warren has compared the way that nerve cells function in healthy brains with those in patients who have been affected by stroke.

What she has discovered is that the brains of stroke sufferers may have to ‘relearn’ how to put together different types of information in order to understand speech by using different parts of the brain to compensate for damaged areas.

This may mean using new pathways so that one side of the brain can talk to the other more effectively.

Therefore, the better that these two sides of the brain can co-operate then the better the chance of speech recovery for the patient.

This breakthrough could assist the development of new drug and therapy based treatments to help patients to learn to speak again.

Dr Yolande Harley of Action Medical Research said, “This really is a leap forward in understanding and is likely to be of benefit to patients in the near future.

“Language difficulties can have a devastating, long term effect well after someone has recovered from the shock and immediate physical impact of having a stroke.

“Simple, everyday activities that we take for granted; making a phone call, doing the shopping or simply holding a conversation can become an ordeal.

“We all have those moments where a word is on the tip of our tongue and know that frustration; imagine constantly feeling as if you are struggling to find a word and that you cannot get across exactly what you want to say.

“Then you may get a sense of the distress that a stroke patient feels.”

Dr Warren explains, “We’ve known for a long time that different parts of the brain do different things; but one aspect of the brain that we knew little about is how the brain creates and uses language systems.

“During the course of my work I have been able to find out what is happening within the brain as stroke sufferers recover their speech.

“Researchers already know that the front left hand side of the temporal lobe seems to be concerned with finding meaning whilst the right hand side is more concerned with inflection or pitch.

“When a stroke occurs, the blood supply to part of the brain is blocked and, as a result, it doesn’t get any oxygen or nutrients and dies.

“My work has shown that the brain has a remarkable range of alternative strategies to bypass these dead areas and resume normal service.

“There are several circuits that link different parts of the brain together. Whether or not these circuits are damaged by a stroke is likely to be a big factor in determining how well a stroke sufferer recovers language.

“If we can find ways to get the left and right sides of the brain co-operating with one another better after a stroke, we could improve the chances of recovery.

“It’s a very exciting result.”

To view this article in its entirety, please Click Here .

Author: By Amanda Gardner, Health Day Reporter

SUNDAY, Jan. 7 (HealthDay News) — Scientists on Sunday reported the discovery of a new source of human stem cells that have the capability to develop into many different types of cells, including muscle, bone, fat, blood vessel, nerve and liver cells.

These stem cells, found in amniotic fluid, could one day lead to a readily available supply of stem cells that don’t come with the ethical problems surrounding embryonic stem cells.

“These cells are easier to get, and from acceptable medical procedures [for example, amniocentesis] that are done on a routine basis,” said study senior author Dr. Anthony Atala, director of the Institute for Regenerative Medicine at Wake Forest University School of Medicine.

“This is another source of multi-potential cells,” added Paul Sanberg, director of the University of South Florida Center for Aging and Brain Repair, in Tampa. “Because the cells can be accessed either post-birth or through amniocentesis, it’s possible that people could store those cells. If the cell lines that are created were available, then people could do some research on a non-embryonic source, which eliminates all the ethical and political issues.”

The discovery of the cells, known as amniotic fluid-derived stem (AFS) cells, is reported in the Jan. 7 issue of Nature Biotechnology.

The hope is that stem cells, which have the potential to develop into many different cell types in the body, may one day yield treatments or cures for diseases such as diabetes, liver failure, spinal injury, stroke, Alzheimer’s disease and heart disease.

But embryonic stem cell research in the United States has been severely hampered since Aug. 9, 2001, when President Bush placed limits on federal funding of the field. As of that date, federal funds could only be used to study stem cell lines derived from embryos that had been destroyed before that date.

Scientists have thus been on a quest to find new, less controversial sources of stem cells.

It’s been known for decades that the placenta and amniotic fluid contain a large number of cells shed from the developing embryo. “These cells could be harvested, grown outside the body and used,” Atala said.

Unlike “true” stem cells, however, these cells were predestined to grow into only one type of cell, or a limited type of other cells.

“We wanted to see if there was a true stem cell population within this fluid, pluripotent stem cells which could give rise to multiple cell types,” Atala explained. Pluripotent cells are capable of differentiating into many different types of cells.

After seven years of digging, Atala’s team found that 1 percent of the amniotic fluid cells were pluripotent. The newly discovered cells seem to possess characteristics that rest halfway between embryonic stem cells and adult stem cells. Like other stem cells, they can self-renew and double in number every 36 hours. But unlike other stem cells, they do not produce tumors.

The stem cells could be harvested any time from the beginning of pregnancy until just after a baby is born, Atala said.

When nerve cells created from AFS cells were implanted into mice with a degenerative brain disease, the cells re-populated the diseased areas of the brain. Bone cells were also successfully grown into bony tissue in mice, and liver cells were grown that could secrete urea.

But it will be some time before any human benefit from these cells is seen — if it is seen at all, the researchers said.

“It’s a very nice paper, very good science,” said Dr. Darwin Prockop, director of the Center for Gene Therapy at Tulane University Health Sciences Center in New Orleans. “But I can’t quite put a circle around the potential of the cells. They may be useful for some kinds of therapy but I don’t quite know where it’s going to go.”

Theoretically speaking, Atala said, a bank of 100,000 specimens could potentially supply 99 percent of the U.S. population with a perfect genetic match for transplantation.

But human studies haven’t even begun yet.

“We don’t know what the extent of therapy will be with these cells,” Atala said. “Time will tell.”

More information

The U.S. National Institutes of Health has more on stem cells, including current official policy.

SOURCES: Anthony Atala, M.D., director, Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, N.C.; Paul Sanberg, Ph.D., D.Sc., distinguished professor, neurosurgery, and director, University of South Florida Center for Aging and Brain Repair, Tampa; Darwin Prockop, M.D., Ph.D., professor, biochemistry, and director, Center for Gene Therapy, Tulane University Health Sciences Center, New Orleans; Jan. 7, 2007, Nature Biotechnology

Here.

Author: National Stroke Association

May is National Stroke Awareness Month , a time to educate the nation and spread awareness about stroke prevention, symptom recognition and recovery. In recent years stroke deaths have declined by 10,000 Americans. This year, National Stroke Association hopes to continue to reduce stroke deaths by educating the public to recognize stroke symptoms, and to Act F.A.S.T. and “Save a Life.”
• For every minute that brain cells are deprived of oxygen during stroke, the likelihood of brain damage increases. Act F.A.S.T.
• Treatment can be more effective if given early on. Act F.A.S.T.
• TIA (transient ischemic attack) is a risk factor of stroke and a call to action to prevent a stroke. Act F.A.S.T.
For the six million stroke survivors in the United States, Acting F.A.S.T. is even more critical because they are at risk for a recurrent stroke. But stroke prevention is only one part of the stroke recovery journey. For stroke survivors, the other integral component is National Stroke Association’s message of HOPE: Stroke is a Lifelong Journey. Because hope is such an important part of a successful stroke recovery.

For more information and to get Involved with Stroke Awareness Month and/or Shop for Stroke Awareness Items at www.stroke.org .

Author: Charlene Laino for WebMD Medical News

Reviewed By Louise Chang, MD

Latest Heart News
Macular Degeneration Doubles Heart Attack Risk
Hyperglycemia in Heart Patients Needs Addressing
Adult Stem Cells Help Those With Immune Disorders
Curry Spice May Thwart Heart Failure
Many Patients Don’t Take Drugs After Heart Attack

Feb. 21, 2008 (New Orleans) — A new drug that packs a wallop of caffeine and alcohol may be the latest weapon in the war on stroke.
In a small study, 60% of stroke patients who were given the drug, called caffeinol, had no or minimal disability when they were discharged from the hospital.
In contrast, only 26% of stroke survivors given standard therapy with tissue plasminogen activator, or tPA, fared that well, says researcher Sheryl Martin-Schild, MD, PhD, a neurovascular fellow of the University of Texas Health Science Center in Houston.

“Caffeinol contains about as much caffeine as five to seven cups of good, strong New Orleans coffee and the equivalent of two shots of alcohol,” she tells WebMD.
The research was presented at the American Stroke Association’s International Stroke Conference 2008.

How Caffeinol Works: Read More .

Author: Source: Concentric Medical, Inc

MOUNTAIN VIEW, Calif., Feb. 22 /PRNewswire/ — Concentric Medical, Inc., the global leader in devices for clot removal in ischemic stroke patients, today announced that results from the use of its Merci Retrieval System(TM) were featured and discussed in seventeen separate presentations at the International Stroke Conference held in New Orleans, Louisiana, February 20-22, 2008.

Positive clinical and economic results from the use of the Merci Retrieval System in patients suffering from acute ischemic stroke were discussed during five main podium presentations and more than 12 poster sessions over the three-day conference, which had more than 3,500 people in attendance.

And for the first time, a study performed at the University of California, San Francisco Medical Center confirmed the positive economic impact of successfully restoring blood flow with the Merci Retriever®. According to the American Stroke Association, stroke is estimated to cost the U.S. health care system in excess of $63 billion per year.

“The prevalence of the Merci Retrieval System at important scientific meetings like the International Stroke Conference is very gratifying,” said Gary Curtis, President and CEO of Concentric Medical. “It underscores the progress Concentric has made in making the Merci Retrieval System a front-line approach to revascularizing patients with acute ischemic stroke.”

As the first device cleared by the U.S. Food and Drug Administration for retrieval of clot in patients suffering from acute ischemic stroke, the Merci Retrieval System has been used on over 7,000 patients worldwide, making the Merci Retrieval System the most clinically accepted device of its kind.

About Concentric Medical
Concentric Medical is located in Mountain View, California, and was founded in August 1999. The company manufactures and markets the Merci Retrieval System, which is available in over 250 leading stroke centers around the world.

Author: Life Line Screening

A stroke, also known as a “brain attack”, is ranked as the third leading killer in the world, and the second among women. Through preventive screenings, the risk of having a stroke can be greatly reduced.

Through screenings and education about the disease and its risk factors, the possibility of avoiding a major occurrence can be minimized. According to the National Stroke Association, “Every year, approximately 750,000 Americans have a new or recurrent stroke.” Although most stroke victims never show any symptoms, companies such as Life Line Screening have taken the initiative to do their part in helping to lessen the ever-growing number.

Life Line Screening was established in 1993, and has since become the nation’s leading provider of vascular screenings. One of the four screenings offered focuses on the risk for stroke in the carotid artery. This particular type of stroke is related to a build-up of a plaque-like substance, and can be identified in a matter of 10 minutes. Registered and registry eligible sonographers utilize ultrasound technology to determine whether there is an abnormally low amount of blood flow through the arteries, therefore increasing the risk for stroke.

All results are read by board certified physicians, and returned to the customer within 21 days. Should there be any abnormality detected, individuals are encouraged to take the information to their primary physician for follow-up care.

Over 1 million people have been screened since the company’s inception, and the goal remains to screen another 1 million in the next two years. The results of these screenings are staggering. Of the customers screened, 8-10 percent showed some type of abnormality, while 2-3 percent were rated in the severe category and encouraged to follow-up with their doctor on the same day as the screening.

“My mother was initially found to have a 95 percent blockage of her left carotid artery, which was found during one of your screenings. Surgery was performed and her prognosis is excellent. I expect her quality of life will continue to be wonderful as a sure and certain stroke was prevented. She still remains asymptomatic. Thank you again for offering this important preventive service to clients. It was the best money she ever spent!” Marsha Dewitt RN, BSN, CCRC for Billie Swinney, Bartlesville, Okla. (Carotid)

Screenings are fast, painless and low cost. They involve the use of ultrasound technology, and scan for potential health problems related to: blocked arteries which can lead to a stroke, aortic aneurysms which can lead to a ruptured aorta, and hardening of the arteries in the legs, which are a strong predictor of heart disease. Also offered for men and women, is a bone density screening to assess their risk for osteoporosis.

Over 45 ultrasound teams are on staff to travel to your local community, bringing the screenings to you. These non-invasive, inexpensive and painless, ultrasound tests help people identify their risk for stroke, vascular diseases or osteoporosis early enough for their physician to begin preventive procedures.

For more information regarding the screenings or to schedule an appointment,
call 1-800-643-6188. Preregistration is required.

For more information, click on the link above or email: pmotolik@llsa.com

or contact Paula Motolik
Phone: (216) 518-8456

Author: By Marjorie Nicholas, PhD

This is an article that appeared in the April newsletter of the National Aphasia Association.

Individuals with aphasia, family members and therapists all agree that the world needs to be a more “aphasia-friendly” place. One step toward that end is to give speech-language pathology graduate students an understanding of how they can be instrumental in creating an aphasia-friendly environment in the community. In this article, we present highlights of the stimulating and creative advocacy projects developed by our students over the past several years.*

As part of their beginning graduate work, all students in the Communication Sciences and Disorders Program at the MGH Institute of Health Professions (IHP) are required to take a course on aphasia assessment and rehabilitation. One of the assigned projects was to design an Aphasia Advocacy Project that addressed two of the core values of the Life Participation Approach to Aphasia (LPAA).** One core value is that an explicit goal of intervention should be the
“enhancement of life participation.” Another value states that “both personal and environmental factors are targets of intervention.”

Students were instructed to follow these guidelines:
– To get started, think of a place or a situation that poses barriers to people with aphasia. Then think of a solution to get rid of those barriers.
–The project, if implemented successfully, should result in a more “aphasia-friendly” environment.
– Describe the project with enough detail so that another group or individual reading about it project would be able to implement it.
– Give the project a title and create a handout describing it.
– Be creative! This is an opportunity to really think about what you’ve learned about aphasia and use it in the real world

Students worked in groups to develop their projects and presented them to the class at the end of the semester. Four of the projects are described here.

“Aphasia Night at Fenway”
This project outlined an aphasia awareness evening at Fenway Park, home of the Boston Red Sox baseball team. There would be activities to promote public awareness about aphasia, such as student-manned booths under the grandstand where brochures about aphasia and baseball-specific communication boards would be available. To help individuals with aphasia themselves, students suggested creating small foldable communication boards that had graphic images of the playing field, the current roster of players, baseball-specific phrases, as well as pictures of refreshments. The project also envisioned an announcement about aphasia night on the Jumbotron screen in the park, and enlisting the help of a Red Sox player to “adopt the cause” of aphasia. The final component would involve contacting aphasia groups in the community and arranging transportation so that people with aphasia could attend the game.

The Mall for All and Stop the Communication Breakdown: Aphasia Awareness at the Mall
Two groups of students planned activities to make shopping at a mall more pleasant for individuals with aphasia. Their ideas included:
– creating a picture-based store directory of the mall using store logos rather than simply text-based names of stores that would be available at information booths.
– providing in-service training to mall employees about aphasia and aphasia-friendly service using a short presentation and an instructional video. The groups’ presentation to the class included a video showing interactions between a person with aphasia and a sales clerk in a clothing store. The “before aphasia-awareness training” video showed how frustrating an experience shopping could be for an individual with a severe aphasia. The “after-training” video showed how simple measures on the part of the sales clerk resulted in a much more successful shopping outing for the person with aphasia.
– having the mall schedule special “aphasia” shopping days to allow people with aphasia to receive discounts in participating stores.

Taking CAL (Chatter and Listen) to Lunch
The students described a group called Chatter and Listen (CAL), which would be a support group for people with aphasia that organizes social outings such as lunch at a local restaurant. The group would select restaurants that are handicap accessible and have aphasia-friendly menus that are not overly dependent on text. The students planned a lunch for the “group” at Luciano’s Restaurant in Boston. They created an invitation, which included pictorial representations of the restaurant, the date, the money required for the event, and how transportation would be provided. They showed examples of an aphasia-friendly menu that used pictures to supplement text. The plan for the project also involved educating staff at the selected restaurant about what aphasia is and providing tips on how to communicate with people who have aphasia.

Hugs & Smiles: An Aphasia-Friendly Pharmacy
Students described a unique pharmacy that would meet some of the needs of people with aphasia. Components included in-service education to pharmacists on how to effectively communicate with people with aphasia. Many materials given out at the pharmacy could be redesigned to make them less text-dependent. For example, the pharmacy could have a visual aid poster at the counter under plexiglass illustrating frequently asked questions, aphasia-friendly prescription information pamphlets depicting side-effects in pictures, and picture-based visual labels for the prescription bottles. As part of their presentation, the students role-played the communication breakdowns possible in a “regular” pharmacy, and then showed how these could be eliminated or reduced in the “aphasia-friendly” pharmacy.

Other student groups developed plans for aphasia-friendly libraries, high schools, retirement communities, and doctors’ offices. They described community education activities that could be broadcast on TV, as well as available on videotape. In addition, they described fund-raising activities (with names such as EmbRace Aphasia and Walking for Words) for aphasia groups and community awareness events.

Making an Aphasia-Friendly World a Reality
Students presented their projects during the last class of the semester. Because the projects were so interesting and inspiring, we subsequently scheduled a second evening for the student groups to present them to members from MGH IHP’s faculty, clinicians from the community, and clients from our IHP Aphasia Clinic and their families. The presentations were particularly well received by our Aphasia Clinic members and their families.

Some steps have been taken since then to make some of these “dreams” come true. For example, our IHP Aphasia Group has attended a ballgame together at Fenway Park, although not with all the community education events that the students hoped to have as part of the outing.

In addition, with the upcoming NAA “Speaking Out! 2006″ conference in Boston in June, a group of about 16 students from four local speech-language pathology graduate programs (Boston University, Emerson College, MGH Institute of Health Professions, and Northeastern University) will be helping educate both the staff at the conference hotel as well as local merchants about aphasia. This is the first time that students from all four programs have come together to work on a community education effort like this. The group will develop educational materials to leave with hotel staff and local merchants as well as presentations to explain aphasia and suggest ways to maximize effective communication. Local merchants who participate in these educational sessions will be encouraged to offer meal or store discounts to “Speaking Out” attendees with aphasia. Students will also assist the individuals with aphasia who will be introducing the various speakers at the conference. These projects have given the students unique opportunities to learn from each other as they also learn more about what it is like to have aphasia.

As we have found to be the case so often when accommodations are put in place for people with disabilities, all people end up benefiting, not just those with disabilities. For example, sensitivity training about communication difficulties helps non-English-speaking foreign visitors, just as it does those with aphasia. Completing the Aphasia Advocacy projects enabled the students to think beyond the disorder and the impairments they learned about in academic coursework to the reality of an individual living with aphasia in the world. Everyone will benefit if we all can maintain this focus throughout our lives.

___________________
* This article is based on a presentation given by myself and my colleagues Jennifer Mackey and Kevin Kearns at the American Speech-Language-Hearing Association (ASHA) convention in San Diego last fall. We described the results from an aphasia advocacy project that was assigned to students taking a graduate course on aphasia at the MGH Institute of Health Professions (IHP). Our project was inspired by one that Jon Tonkovich had assigned to his graduate students in Michigan a few years ago.

**Chapey, R., Duchan, J.F., Elman, R.J., Garcia, L.J., Kagan, A., Lyon, J.G., & Simmons-
Mackie, N. (2001). Life participation approach to aphasia: A statement of values for the future. In R. Chapey (ed.), Language intervention strategies in aphasia and related neurogenic communication disorders. Philadelphia: Lippincott Williams & Wilkins.

To register for this free email newsletter, please go to the link above.