.An article in Medical News Today, 18 Feb 2022

When ABC journalist Bob Woodruff was injured while reporting in Iraq in 2006, he suffered severe head injuries that caused him to lose his ability to recall and produce common words - a condition called aphasia. Today, Woodruff has recovered most of his language skills thanks to intensive behavioral therapy - reading and repeating words and sounds.

“The standard of care for patients with aphasia has always been and will always be speech/language therapy, but a new area is opening up that looks at what drugs can be used in combination with therapy to enhance recovery from brain damage and help the brain repair itself,” said Gerry Stefanatos, D.Phil., an associate professor of communication sciences and disorders in the College of Health Professions. “We’re looking at the mechanism of how this combination works - it’s underlying effect on patients with aphasia.”

In research presented at the International Neurological Society this month, Stefanatos found that dextroamphetamine (D-AMPH), a drug commonly used to treat attention deficit hyperactivity disorder, improved the processing of speech among those suffering from Broca’s aphasia and the similar Anomic aphasia.

“Improving a patient’s attention and working memory may allow them to better focus and process information during therapy sessions,” said Stefanatos. “Attention is critically important for learning and relearning skills, and could be helpful in forging new neural pathways in the brain.”

The National Aphasia Association estimates some one million people in the United States live with aphasia, which is caused by lesions to the language centers of the brain. These lesions are often due to stroke or brain injury, but can also be the result of a brain tumor or progressive disease such as Parkinson’s or Alzheimer’s. Types of aphasia can range from a patient having difficulty finding and producing a word to a patient having no ability at all to speak or understand language.

Stefanatos’ study looked at the use of D-AMPH in ten aphasia patients. All were also given a placebo for comparison purposes. In each condition, participants were asked to make decisions about different types of speech sounds (vowels, consonant-vowels) and complex tones. Their brain’s electrical response to each was recorded via an electroencephalogram (EEG).

Those who took the D-AMPH had a strong reaction to the sounds - even to consonant-vowel sounds, which are more often difficult for individuals with aphasia to process.

“This tells us that D-AMPH may help the left hemisphere of the brain regain the ability to perform its functions,” said Stefanatos. “Understanding why the drug is having this effect allows us to start to think about how to tailor treatments to make them more effective or explore alternative drugs or drug combinations.”

Stefanatos said he and his team chose to look at this particular drug because in patients with ADHD it has been shown to stimulate the release of dopamine and epinephrine, which help in attention and learning. But he notes that some people aren’t good candidates for this particular drug.

“Now that we have a rudimentary understanding of why the drug may work to enhance the results of therapy, our next step is to look at dose effects and perhaps other drugs with more favorable side effect profiles,” said Stefanatos.

With collaborators from the departments of Radiology and Physical Medicine and Rehabilitation, Stefanatos will next study functional magnetic resonance imaging to explore the effects of D-AMPH on cerebral metabolism and where in the brain of individuals with aphasia it has the greatest effect.

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Article adapted by Medical News Today from original press release.
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Other authors on this study are Andrew DeMarco at Temple University, Robert Segal at McGill University in Quebec, and Arthur Gershoff, M.D. and Y. Ieuji of the Moss Rehab Stroke and Neurological Diseases Program, part of the Albert Einstein Healthcare Network in Philadelphia. This work was funded by grants from the National Institute of Health and the Pennsylvania Department of Health.

EMPOWER

EMPOWER: Living Well with Aphasia. DVD, 5 minutes. This DVD was created by people with aphasia at the SCALE Center in Baltimore, MD to encourage their peers to fully participate in life. The acronym, “EMPOWER” is used to provide seven recommendations for re-engaging community. Great DVD for you support group or program! Order

By Carol Cline Schultz

Carol Schultz suffered an aphasic stroke that left her completely without words. She could neither speak, read nor write, and understood spoken words only with great difficulty. “Crossing the Void” is the story of her courageous journey back.

With the language part of her brain permanently damaged, in a different approach to re-learning speech and writing, Schultz taught herself to picture individual letters to prompt the sounds that would become words. Her book describes the painstaking process that led her from wordlessness to book author. Order .

An article posted in STROKENET, By David Wasielewski

Many stroke survivors need to deal with changes in their memory following a stroke. These issues can vary widely and may be difficult for the patient and caregiver to understand. Some individuals will experience a specific inability to remember faces. Some may have problems with numbers and calculations. In my personal experience there is often a decrease in the speed at which I can retrieve a certain memory.

In severe cases survivors can experience a complete inability to form any new memories (short term memory deficit). But how do strokes affect the ability to store and access one’s memories? Neurologists are only just beginning to understand the complexities of what are two very different brain functions, 1) The formation of new memories and 2) The storage of those memories once they are created.
Read full article


“Aphasia: The Movie”
Official Selection, 2011 Feel Good Film Festival
August 13th, 2011, 6:30pm

Cal State LA Student Union Theatre
August 15, 2011, 5:30pm

The short narrative film Aphasia, starring Carl McIntyre, has been announced as an Official Selection of the 2011 Feel Good Film Festival (www.fgff.org) in California during the weekend of August 12-14 at the historic Raleigh Studios in Hollywood. Aphasia will screen on Saturday, August 13, 2021 at 6:30 pm. Tickets can be purchased online: http://www.brownpapertickets.com/event/187692.

If you are unable to make the Film Festival, Cal State LA & Cal State Northridge are sponsoring a screening on Monday, August 15th at 5:30pm at Cal State LA’s Student Union Theatre. Tickets are $17 and can be purchased online: http://aphasiamoviescreening.uticketit.com/.

Aphasia was written by Jim Gloster, a Charlotte, NC director, actor and writer. Gloster wanted to capture the story of his friend, actor Carl McIntyre who suffered a massive stroke in 2005 at just 44 years of age. As a result, McIntyre lives with aphasia, an acquired communication disorder that impairs a person’s ability to process language but does not affect intelligence.

Aphasia is a double dose of reality told in narrative form. Carl stars as himself and portrays his life story in a powerful and nuanced performance. Aphasia uses comedy and pathos to raise awareness about aphasia and provide hope and inspiration to anyone working to overcome obstacles in their lives. The film recounts McIntyre’s first person experience during the stroke, his recovery and his struggle with his inability to communicate.

For more information about the movie, visit http://aphasiathemovie.com.

June 26th, 2011
Rehabilitation Institute of Chicago
Chicago, IL

Conference Highlights Suggested Audience
* Special Interest sessions for families and consumers
* Technology Demontrations
* Recreational, Art, Theatre, Reading, Gardening & Music Activities
* Networking & Discussion *People with aphasia & their families
* Aphasia Community Group Leaders
* Rehabilitation professionals; including speech-language pathologists, physicians, psychologists, social workers, and nurses

Snyder Center for Aphasia Life Enhancement (SCALE) members in
Baltimore, MD prepared “EMPOWER” for the Speaking Out
Conference in June 2010. The theme is “Empowering Others to Live
Well with Aphasia”. The acronym “Empower” is used to represent
seven ways that SCALE members live well with aphasia:
1) Engage yourself in everyday activities
2) Make new friends, community & relationships
3) Practice, patience and be positive
4) Other ways of doing things
5) Working on new interests, teaching others
6) Exercise & recreation
7) Religion…Keep the Faith

For more information, please contact the National Aphasia Association
(800) 922-4622
naa@aphasia.org

Find out more about the conference and register by clicking on Speaking Out

An article posted in The New York Times on May 2, 2021
By JANE E. BRODY

Steve Riedner of Schaumburg, Ill., was a 55-year-old tool-and-die maker, a job that involves difficult mental calculations, and a frequent speaker at community meetings when he found himself increasingly at a loss for words and unable to remember numbers. He even began to have difficulty reading his own written comments.
The neurologist he consulted thought Mr. Riedner had suffered a stroke and for three years treated him with cholesterol-lowering medication. But instead of his language ability stabilizing or improving, as should happen following a stroke, it got worse.
A second neurologist concluded after further testing that Mr. Riedner might have a condition called primary progressive aphasia, or P.P.A., a form of dementia affecting the brain’s language center.
Having seen only one other case in his career, the neurologist referred Mr. Riedner and his wife, Mary Beth, to the Cognitive Neurology and Alzheimer’s Disease Center at Northwestern University, whose director, Dr. M. Marsel Mesulam, is perhaps the world’s leading expert on this relatively rare disorder.
P.P.A. is a clinical syndrome, one of several forms of brain disease lost in the medical shadow of their much better known relative Alzheimer’s disease. While hardly as common as Alzheimer’s, P.P.A. is often misdiagnosed, and many patients like Mr. Riedner lose valuable time trying inappropriate and ineffective treatments. Though there is no cure, patients and families can learn ways to minimize the disabilities it causes.
Unlike Alzheimer’s, P.P.A. does not affect memory, at least not initially. It also tends to occur at younger ages, often in the late 50s, and affects twice as many men as women. While symptoms of Alzheimer’s are readily recognized by friends and relatives but not those affected, people with P.P.A. are painfully aware of their struggle to communicate, often long before it is apparent to others.
“Early symptoms are usually very subtle, and patients may be the only ones aware of the problem because they have to work harder to communicate, even though they may not make obvious errors,” said Joseph R. Duffy, head of speech pathology at the Mayo Clinic in Rochester, Minn. “Initially, their communicative errors are like those we all make and may be written off as due to chronic fatigue. But gradually the errors of speech occur with increasing frequency.”
‘Like Being a Parent Again’
The disorder is also commonly misdiagnosed, usually as Alzheimer’s disease or a result of depression or anxiety, Dr. Duffy said in an interview. But while a definitive diagnosis can be made only at autopsy, the results of neuropsychological testing and the patient’s progressive difficulty with communication despite a normal memory can pinpoint P.P.A. as the problem.
As the condition worsens, cognitive difficulties may become apparent. Now seven years into the disorder, Mr. Riedner is having increasing problems performing the tasks of daily living.
“He can no longer punch in the numbers to operate the garage door or the microwave or the remote for the TV,” Mrs. Riedner, his wife of 38 years, said in an interview. “He might open the car window, then not know how to close it. We bought him an iPad, but he can’t learn how to use it.”
New ways of communicating have to be learned, like using gestures or making lists of things to say or do or eat, so that the person can point to them when needed. Unfortunately, sign language doesn’t work because it, too, depends on the region of the brain that is diseased.
“In some ways it’s like being a parent again. He acts in childlike ways sometimes, but he still wants to be himself, an independent adult,” Mrs. Riedner said. “Coping with the problem takes an immense amount of patience on both our parts.”
Mrs. Riedner said the center at Northwestern has been “a lifesaver for us,” a source of support, speech therapy and rehabilitation, help with practical matters like applying for Social Security disability insurance, and tips on how to minimize the inevitable frustrations that can accompany lost language skills.
Dr. Mesulam was the first in modern times to recognize the distinction between P.P.A. and other forms of dementia.
In 1975, as a newly minted neurologist at Beth Israel Hospital in Boston, he became puzzled by a group of patients who seemed to know what they wanted to say but couldn’t string words together in an intelligible sequence. Their communicative problems got progressively worse, although there were no lesions apparent in their brains.
His report in 1982 on six such cases stimulated modern interest in P.P.A. As Dr. Mesulam explained in a retrospective article in the journal Alzheimer Disease and Associated Disorders in the fall of 2007, “The aphasia can interfere with word-finding, object naming, syntax, phonology, morphology, spelling or word comprehension. The progression occurs in the course of years rather than months, and the primary nature of the aphasia is demonstrated by showing that memory for recent events, recognition of familiar faces and objects, reasoning, and basic aspects of comportment are relatively preserved at the initial stages.”
Focus on What Remains
With no therapy available to treat the underlying disease, treatment involves determining which aspects of language are strongest, then providing speech therapy that emphasizes those areas and avoids areas in which patients are weakest, Dr. Mesulam said.
Dr. Duffy said that early intervention is important and should focus on alternative approaches to communication like using a computer, picture icons, or iPhones or iPads that have apps that can talk for a person. Family members are taught how to aid comprehension by communicating simply and clearly: telling patients only one thing at a time, reducing noise and other distractions, and avoiding multitasking.
Family members are also taught coping skills and helped to prepare for the future as the disease progresses, said Darby Morhardt, a social worker at the Northwestern center. “There’s inevitably a grieving process as patients change right before their eyes, but at the same time families want to grasp as much as possible of what remains.”
Patients often are encouraged to develop new hobbies and skills that don’t rely on communication, like woodworking, gardening, fishing, sculpting or painting. Among Northwestern’s patients is one who began breeding pigeons and another who started judging dog races.
Unfortunately, if patients live long enough, other deficits — including those involving memory and cognitive abilities, and motor problems resembling symptoms of Parkinson’s disease — often become apparent, as is now happening to Mr. Riedner.
Like Alzheimer’s disease, P.P.A. shortens life expectancy: The average age of death is 67. Ms. Morhardt said it’s important for patients and their families not to delay getting financial matters in order. Many would be wise to consult a lawyer who specializes in elder law, she said.
This article has been revised to reflect the following correction:
Correction: May 5, 2021
The Personal Health column on Tuesday, about primary progressive aphasia, a type of dementia that affects the brain’s language center, misspelled the hometown of Steve Riedner, who struggled with symptoms for years before the disease was correctly diagnosed. It is Schaumburg, Ill., not Schaumberg.
Read full article by The New York Times

An article By Randy Stark published in the Stroke Network May Newsletter

Have you ever wondered why some golfers stare at the ball for so long before they actually swing? Or why some basketball players seem to zone out just before shooting a free throw? And some track and field athletes seem to be in a trance right before they line up to race? Chances are, these athletes are tapping into the amazing potential of the human mind.

No, there’s nothing supernatural or weird going on at that free throw line. I’m not suggesting that he’s trying to mentally levitate the ball toward the hoop. (Although that probably couldn’t hurt Shaquille O’Neal’s free-throw percentage!) I’m talking about the use of mental practice….also known as visualization, or imagery.

For many years, great athletes have used mental training as well as physical training to achieve their maximum performance. When performing mental practice, a person visualizes the entire task or skill they are trying to improve, imagining every specific movement of that activity. From start to finish, the athlete will mentally rehearse the movement or skill, and can actually improve his/her physical performance of that movement or skill through mental practice.

In his book “Mental Training for Peak Performance,” Steven Ungerleider, PhD, reports of a study conducted on Olympic track and field athletes regarding mental practice. Out of 633 athletes surveyed, 83 percent reported using mental practice as part of their training. Some mentally practice their performance right before the sport or event, but others set aside time for mental practice as part of their daily training regimen.

Obviously I didn’t write this article to encourage you in your golf game, or prepare you for the next summer Olympics. Mental practice is a not just a widely used training technique for athletes, but also a valuable treatment option in stroke recovery.

Consider the research below on the effectiveness of mental practice in stroke rehab.

Read More

FOR IMMEDIATE RELEASE

Lingraphica Welcomes Jaleel Shujath as Director of Sales and Marketing

Princeton, NJ. – February 21, 2022 - Lingrapghica, Inc., one of the nation’s leading medical devices companies serving persons affected by aphasia, announced today it has hired Jaleel Shujath to the position of Director, Sales and Marketing.

In this role, Mr. Shujath will lead the effort to increase awareness of Lingraphica’s innovative augmentative and alternative communication (AAC) devices among stroke victims and speech language pathologists. He brings several years of experience marketing technology solutions to life sciences researchers, while at Cellomics, GE Healthcare, and PBL InterferonSource.

Located at Lingraphica’s Princeton, New Jersey office, he reports to the CEO Andrew Gomory. “Jaleel’s extensive marketing experience international background, impressive track record at PBL and GE, and his enthusiasm for business challenges and team-based success, will serve him well at Lingraphica,” said Mr. Gomory.

Mr. Shujath is a member of the American Marketing Association. He earned a Bachelor of Science in Biology from Tufts University and an MBA in Marketing from the University of New Haven School of Business
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About Lingraphica, Inc.
Lingraphica-The Aphasia Company™ is the leading provider of speech-generating devices for people whose ability to speak or understand words has been impaired by a stroke or brain injury. With the Lingraphica they can communicate with picture icons that speak words and phrases in a natural human voice, or they can practice speech using videos and language exercises. The Lingraphica is Medicare reimbursable. It is available for a no-obligation trial. For more information call toll-free 1-888-APHASIA (1-888-274-2742) or visit www.aphasia.com.
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Published 10/17/10

WASHINGTON, D. C. When her stroke hit, Edna Wooten somehow stopped her car. Then her grown daughter ignored her slurred protests and raced her to the hospital - in time for a drug to dissolve the blood clot causing her stroke.

Wooten was lucky: Too few stroke sufferers get that clot-busting treatment, especially black and Hispanic patients who are at highest risk of having a stroke and also may be particularly hesitant to seek fast care.
New research is targeting those underserved populations to better spread the word that “time is brain” - the faster you move the more brain you save.

“We basically scare people so much about stroke, it motivates them to denial,” says Dr. Lewis Morganstern of the University of Michigan, an expert on stroke disparities. “What we haven’t done a good job of is telling people there is an effective treatment, that people are in control of their own destiny.”

That was the message stroke educator Shauna St. Clair of Georgetown University took to a senior center in a predominantly black neighborhood in the nation’s capital last week, part of a project funded by the National Institutes of Health.

Most strokes are like a clogged pipe, St. Clair explained: Break up the clog and blood can resume feeding starving brain cells on the other side, which is what happened when Wooten, 61, was treated at a nearby hospital.

“Damaged brain cells we can fix. That’s why we want you to get treatment as soon as possible,” St. Clair told the rapt group. “If they stay damaged, they die.”

About 795,000 Americans have a stroke every year. It is the nation’s leading cause of disability and the No. 3 killer. Symptoms include: sudden numbness or weakness in the face, arm or leg, especially on one side; sudden trouble speaking or understanding speech, seeing or walking; a sudden super-severe headache.
While some strokes are caused by bleeding in the brain, the vast majority are ischemic strokes, the clot kind that the drug TPA can help treat — but only if it’s given within a few hours of the first symptom.
Yet 14 years after TPA hit the market, overall only about 5 percent of U.S. patients get it. That’s partly due to problems within the health care system — but also partly because only about a third of stroke sufferers get to the hospital in time for testing to tell if they’re a good candidate.

Everyone needs to know to act fast if they experience or witness stroke symptoms. The new research comes because African-Americans have strokes at twice the rate of whites and are more likely to die. Hispanics are at increased risk of stroke as well. Worse, both populations tend to have strokes at much younger ages than whites.

Georgetown researchers tracked ischemic strokes for a year in Washington, and found black patients received TPA less often than whites in part because of slower hospital arrival — despite community surveys that found widespread knowledge about stroke symptoms.

“No, you can’t wait to see if your symptoms go away,” says Dr. Chelsea Kidwell, a Georgetown neurologist who heads the project. “No, you should not call your relative or friend. … You’ve got to call 911.”
The findings echo a major study that Morganstern leads in Corpus Christi, Texas, where Mexican-Americans were 40 percent less likely than whites to call 911 for a stroke.

The disconnect isn’t surprising, says Dr. Walter Koroshetz, deputy director of the NIH’s National Institute of Neurological Disorders and Stroke. The most common mistake among all populations when feeling a stroke symptom is to go rest.

Adding to the confusion are so-called ministrokes, a TIA or “transient ischemic attack” where an artery is blocked for a few minutes, leaving no permanent damage. But it’s a warning sign that a major stroke may be imminent, something prompt care to treat risk factors like high blood pressure might avert. Other studies have found half of people who have a TIA never tell a health provider.

It takes community-specific research to learn what act-fast messages work, Morgenstern says. His Corpus Christi project recently taught middle-school students to call 911 if they witness someone having stroke symptoms, with homework assignments to teach their parents, too — thus reaching a hard-to-target population. Next, the project is designing ways that local Catholic churches can help with stroke education.
In Washington, Kidwell is working with ambulances to bypass the closest hospital for one of three certified “stroke centers” — hospitals with 24-hour special capabilities to give TPA. The community education won’t just target seniors but younger people who may witness a stroke, like the woman who told St. Clair she’d noticed her mother leaving church looking drunk — a loss of balance caused by a stroke. And it will stress happy endings like Wooten’s. She slept off a TIA two weeks earlier, and credits her daughter’s love of TV hospital shows for recognizing the major stroke. About an hour after getting the clot-buster, “it was like it never happened,” says Wooten, who says her only lingering problem is a slight shake when her right hand holds something heavy. “I’m driving my car, I’m messing with my grandkids. Thank God I’m doing OK.” ___ EDITOR’S NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
For this complete article, Click on www.hometownannapolis.com or
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