Verbal Neuropsychological Functions in Aphasia: An Integrative Model

Abstract

A theoretical framework which considers the verbal functions of the brain under a multivariate and comprehensive cognitive model was statistically analyzed. A confirmatory factor analysis was performed to verify whether some recognized aphasia constructs can be hierarchically integrated as latent factors from a homogenously verbal test. The Brief Aphasia Evaluation was used. A sample of 65 patients with left cerebral lesions, and two supplementary samples comprising 35 patients with right cerebral lesions and 30 healthy participants were studied. A model encompassing an all inclusive verbal organizer and two successive organizers was validated. The two last organizers were: three factors of comprehension, expression and a "complementary" verbal factor which included praxia, attention, and memory; followed by the individual (and correlated) factors of auditory comprehension, repetition, naming, speech, reading, writing, and the "complementary" factor. By following this approach all the patients fall inside the classification system; consequently, theoretical improvement is guaranteed.

Relación entre el informe del cuidador sobre el habla espontánea del paciente y la Evaluación Breve de la Afasia

“…None of the patients had any associated neurological disease (prior or simultaneous). The patients who were excluded were those who suffered from visual agnosia, who were unable to identify objects or cards, or who did not have a minimal and clear comprehension and expression of affirmative and negative responses, whether verbal or nonverbal (7,10) .…”

“…For that characterization it was also taken into account that, according to a previous BAE study (10) , there were no significant differences between patients with right hemisphere injury and healthy participants in any of the BAE factors.…”

“…Although it is necessary (and methodologically correct) to verify the properties of both approaches, only the second approach has been more widely spread. Nevertheless, there are some studies which verify the relevance of the first approach, with good results (6)(7)(8)(9)(10) . The premise guiding the first approach would be: if simple measures with very few items per function can prove validity as representatives of more extensive functions, it increases the probability of constructing multivariate or multifunctional instruments (also characterized for their efficiency) composed of a variety of these simpler measures.…”

“…Following such model, this study intends to analyze the relevance or concurrent validity of a single item of the caregiver's interview, consisting of four questions and four final categories of evaluation referred to the verbal function of the patient, through its relationship with multiple reliable and valid measurements of aphasia. These measurements were represented by the Brief Aphasia Evaluation (BAE) (6,7,10) .…”

“…Explicitly, the main objective of the present study was: to study the relationship between the caregiver's perception of the patient's spontaneous speech impairment, as expressed in an interview item consisting of four questions, and the patient's performance in the BAE both in its spontaneous speech item and in the main factors of the scale (6,10) . The complementary objective of the present study was to analyze the accuracy (sensitivity-specificity) of the caregiver's perception of the patient's spontaneous speech, regarding the presence or absence of disorder according to the professional in the BAE spontaneous speech item.…”