Background and Purpose-In response to the established notion that improvement of language functions in chronic aphasia only can be achieved through long-term treatment, we examined the efficacy of a short-term, intensive language training, constraint-induced aphasia therapy (CIAT). This program is founded on the learning principles of prevention of compensatory communication (constraint), massed practice, and shaping (induced). Methods-Twenty-seven patients with chronic aphasia received 30 hours of training over 10 days. Twelve patients were trained with the CIAT program. For 15 patients the training included a module of written language and an additional training in everyday communication, which involved the assistance of family members (CIATplus). Outcome measures included standardized neurolinguistic testing and ratings of the quality and the amount of daily communication. Results-Language functions improved significantly after training for both groups and remained stable over a 6-month follow-up period. Single case analyses revealed statistically significant improvements in 85% of the patients. Patients and relatives of both groups rated the quality and amount of communication as improved after therapy. This increase was more pronounced for patients of the group CIATplus in the follow-up. Conclusions-Results confirm that a short-term intense language training, based on learning principles, can lead to substantial and lasting improvements in language functions in chronic aphasia. The use of family and friends in the training provides an additional valuable element. This effective intervention can be successfully used in the rehabilitation of chronic aphasia patients. Additionally, its short-term design makes it economically attractive for service providers.

Background: Recent research suggests the effectiveness of short-term highly intensive treatment approaches in the chronic stage of aphasia. However, the effective elements of such treatment need to be determined. Aims: The present study's aim was to evaluate which factors attribute to the success of aphasia therapy. An intensive (3 hours/day, 10 consecutive days) model-orientated aphasia therapy (MOAT), which considers patients' individual symptoms, was evaluated and therapy effects were compared to those of a similarly intensive training focusing on active speaking elements (constraint-induced aphasia therapy, CIAT) in order to identify the effective elements. Methods & Procedures: 12 patients with chronic aphasia received 30 hours of MOAT over 10 days. Language functions were assessed with a standardised language test (Aachen Aphasia Test) and a naming task prior to therapy, after therapy, and at a 6-month follow-up. In addition, the amount and quality of communication were assessed with questionnaires as an indication of transfer to everyday communication. Results of this treatment group were compared to those of 27 patients who were treated according to principles of CIAT. Outcomes & Results: Language functions improved significantly following treatment relative to the pre-treatment scores, and the improvements remained stable across the follow-up period. Effects were comparable to those of CIAT for most variables, except for written language and perception of everyday communication which improved more

BackgroundFocal clusters of slow wave activity in the delta frequency range (1–4 Hz), as measured by magnetencephalography (MEG), are usually located in the vicinity of structural damage in the brain. Such oscillations are usually considered pathological and indicative of areas incapable of normal functioning owing to deafferentation from relevant input sources. In the present study we investigated the change in Delta Dipole Density in 28 patients with chronic aphasia (>12 months post onset) following cerebrovascular stroke of the left hemisphere before and after intensive speech and language therapy (3 hours/day over 2 weeks).ResultsNeuropsychologically assessed language functions improved significantly after training. Perilesional delta activity decreased after therapy in 16 of the 28 patients, while an increase was evident in 12 patients. The magnitude of change of delta activity in these areas correlated with the amount of change in language functions as measured by standardized language tests.ConclusionsThese results emphasize the significance of perilesional areas in the rehabilitation of aphasia even years after the stroke, and might reflect reorganisation of the language network that provides the basis for improved language functions after intensive training.

Background:The relationship between functional recovery after brain injury and concomitant neuroplastic changes is emphasized in recent research. In the present study we aimed to delineate brain regions essential for language performance in aphasia using functional magnetic resonance imaging and acquisition in a temporal sparse sampling procedure, which allows monitoring of overt verbal responses during scanning.

Beck depression inventory (BDI-1A) is the gold standard screening tool for Parkinson's disease (PD) depression, but as a result of its complexity, it is of limited suitability as a quick and easy screening device. We, therefore, validate the 5-item WHO-Five Well-being Index (WHO-5) as a screening tool for PD depression. Two hundred thirteen of 215 recruited PD patients (99.1%) completed the WHO-5. Receiver operating characteristic plots were used to calculate sensitivity/specificity for all cut-off scores for the detection of depression and combined depression/dysthymia as assessed by an independent investigator using the Mini International Neuropsychiatric Interview (MINI). Internal consistency of the WHO-5 was good (Cronbach's alpha = 0.83). WHO-5 showed high validity with adequate detection of depression without differences in the validity indices compared to BDI-1A (P = 0.234). The optimal cut-off value for detection of depression was 12 of 13 points. WHO-5 is a useful, brief, and easy instrument for identifying PD subjects with depression in daily practice.

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ZusammenfassungHintergrund: Ziel der vorliegenden Studie war, die Aachener Sprachanalyse (ASPA) als ein neues und viele Parameter umfassendes Spontansprachanalysesystem anhand der Testgütekrite-rien Objektivität, Reliabilität und Validität zu evaluieren. Methode: Die Spontansprache von 16 chronischen Aphasikern wurden zu drei Zeitpunkten (zweimal vor und einmal nach zweiwöchi-ger Intensivtherapie) mit ASPA evaluiert. Zudem wurden Transkripte von gesunden Kontrollen mit ASPA ausgewertet. Die Inter-und Intraraterreliabilität wurde für die Transkripterstellung und für die Phraseneinteilung berechnet. Zur Untersuchung der Reliabilität wurden die zwei Messungen vor Therapiebeginn verglichen. Die Validität wurde anhand der Differenzierungsfähig-keit zwischen Aphasikern und Kontrollen sowie der Sensitivität zur Erfassung von Therapieeffekten evaluiert. Ergebnisse: Die Evaluation der Testgütekriterien von ASPA ergab Inter-und Intraraterreliabilitätswerte von über 93 %. Bei den Patienten zeigten sich hohe Korrelationen zwischen den zwei Prä-Messungen. Die Satzbau-und Wortwahlparameter differenzierten signifikant zwischen Aphasikern und Gesunden. In drei der Satzbauparameter zeigten sich signifikante Verbesserungen nach Therapieende. Schlussfolgerungen: Die Ergebnisse der Evaluation von ASPA sprechen für eine gute Objektivität und Reliabilität des Verfahrens. Im Rahmen der Evaluation von Therapieeffekten zeichnen sich die Satzbauparameter durch besondere Sensitivität aus. SchlüsselwörterAphasie´Spontansprache´Aachener Sprachanalyse´Testgüte-kriterien Abstract Background: The proof of the effectiveness of aphasia therapy gains more and more in importance in light of the present financial situation of the public health system and the increasing demand for evidence based medicine. In this context it is expected that improvements are evaluated not only by means of standardised tests or questionnaires but also in communicational situations similar to those in everyday life. The aim of this study was the evaluation of the Aachen Language Analysis (Aachener Sprachanalyse, ASPA). This new analysis system covers many parameters and was evaluated with regard to its objectivity, reliability and validity. Methods: The interraterreliability and the intraraterreliability for the transcript and the division into phrases were evaluated. A comparison of the two pre-therapy measurements was conducted in order to test the reliability of the results. The validity of ASPA was tested by evaluating its ability to differentiate between patients with aphasia and a healthy control group and the sensitivity when evaluating therapy effects. Results: Interraterreliability and intraraterreliability of ASPA were >93 %. High correlations between the two pre-tests were obtained in the patient group. The syntax parameters and wordretrieval parameters differed significantly between patients with aphasia and the healthy controls, whereas no differences were

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