Cases reported "Aphasia"

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1/10. writing with voice: an investigation of the use of a voice recognition system as a writing aid for a man with aphasia.

    BACKGROUND: People with aphasia may experience difficulties that prevent them from demonstrating in writing what they know and can produce orally. voice recognition systems that allow the user to speak into a microphone and see their words appear on a computer screen have the potential to assist written communication. AIM: This study investigated whether a man with fluent aphasia could learn to use Dragon NaturallySpeaking to write. methods & PROCEDURES: A single case study of a man with acquired writing difficulties is reported. A detailed account is provided of the stages involved in teaching him to use the software. The therapy tasks carried out to develop his functional use of the system are then described. Outcomes included the percentage of words accurately recognized by the system over time, the quantitative and qualitative changes in written texts produced with and without the use of the speech-recognition system, and the functional benefits the man described. OUTCOMES & RESULTS: The treatment programme was successful and resulted in a marked improvement in the subject's written work. It also had effects in the functional life domain as the subject could use writing for communication purposes. Conclusions: The results suggest that the technology might benefit others with acquired writing difficulties.
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ranking = 1
keywords = voice
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2/10. An unlearned foreign "accent" in a patient with aphasia.

    Rarely, aphasics may develop what appears to be a foreign accent, as noted by Monrad-Krohn whose Norwegian patient sounded German. We describe a right-handed native American who developed a foreign accent following damage to the left premotor region and white matter anterior to the head of the left caudate nucleus. Her aphasia was of the transcortical motor type. Both she and her parents were born in the USA, she never traveled outside the country and never learned a foreign language. Phonetic analysis of her voice taped prior to the stroke revealed normal speech with a midwestern accent. In contrast, analyses of her current spontaneous speech, repetition, and reading reveal shifts in vowels, e.g., /I/   /i/, /ae/   /a/; increased diphthonigization; and tense speech posture. These features, which were especially frequent in spontaneous speech, probably explain her "accent." Acoustic analysis of fundamental frequency contours of sentences read in different emotional tones revealed a restricted range and variability of the peaks and valleys.
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ranking = 0.125
keywords = voice
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3/10. Glomus vagale tumor: the significance of early vocal cord paralysis.

    Glomus body tumors most frequently originate in the middle ear (tympanicum) or on the jugular bulb (jugulare). Tumors that arise from the vagal body account for less than 2.5% of these unique paraganglionic neoplasms. Otologic manifestations of tympanicum and jugulare tumors usually precede or accompany neurologic findings. In reviewing five cases of glomus vagale tumors, the initial symptom of voice change, caused by vocal cord paralysis, preceded the presenting symptoms of hearing loss and tinnitus by an average of 2.5 years. The concept of early cranial nerve involvement by glomus vagale tumors is supported in a literature review. The evaluation of "idiopathic" vocal cord paralysis must include radiographic inspection of the skull base, whereas an accurate, temporal account of presenting symptoms may help distinguish vagal body tumors from other vascular neoplasms of this region.
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ranking = 0.125
keywords = voice
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4/10. face processing and name retrieval in an anomic aphasic: names are stored separately from semantic information about familiar people.

    Recent models of face recognition have proposed that the names of familiar people are accessed from a lexical memory store that is distinct from the semantic memory store that holds information about such things as a familiar person's occupation and personality. names are nevertheless retrieved via the semantic system. If such models are correct, then it should be possible for a patient to have full access to semantic information about familiar people while being unable to name many of them. We report this pattern in an anomic aphasic patient, EST, whose inability to recall the names of familiar people occurred in the context of a general word-finding problem. EST showed a preserved ability to access semantic information from familiar faces, voices, and spoken and written names and to process facial expressions, but he was unable to name many familiar faces. These findings are compatible with current models of face processing and challenge models which propose that names are stored alongside semantic information in a general-purpose long-term memory store.
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ranking = 0.125
keywords = voice
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5/10. Phonagnosia: a dissociation between familiar and unfamiliar voices.

    A dissociation between facial recognition and facial discrimination is well known, but investigations of "phonagnosia" (impairment of voice recognition and discrimination) have not been pursued. Using familiar and unfamiliar voices as stimuli, a marked difference between the ability to recognize familiar voice and the ability to discriminate between unfamiliar voices was identified in five patients, and a sixth showed a severe impairment in both tasks. Clinical and radiologic findings in these cases suggest that recognition of familiar voices is impaired by damage to inferior and lateral parietal regions of the right hemisphere, whereas impairment of voice discrimination abilities is associated with temporal lobe damage of either hemisphere. This dissociation of recognition and discrimination of the human voice suggests that these two functions are mediated by different brain structures and may contribute differentially clinical syndromes.
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ranking = 1.375
keywords = voice
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6/10. Cerebral blood flow in thalamic aphasia.

    A 59-year-old man is reported, who became aphasic after left thalamic infarction, shown by CT. His speech was fluent, with reduced voice volume, impaired auditory and reading comprehension, verbal paraphasias but intact repetition skills. A single photon emission computed tomography (SPECT) scan to measure regional cerebral flow (rCBF) showed a reduction of flow in the parietotemporal areas of the left hemisphere. It is suggested that thalamic aphasia could result from structural subcortical damage with a homolateral functional cortical deficit leading to the specific aphasic disturbance.
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ranking = 0.125
keywords = voice
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7/10. aphasia following right thalamic hemorrhage in a dextral.

    A 74-year-old, right-handed woman with a right thalamic hemorrhage and aphasia is described. Sequential neurologic examinations and aphasia testing were carried out during a 1-year period and the results are reported. The patient exhibited a language deficit resembling a transcortical aphasia in the acute stage. Reduced spontaneous speech, fading voice volume, fluent verbal output with paraphasia, anomia, and a mild comprehension difficulty were present. Repetition was good. At 1 year postonset, the primary language problem exhibited by the patient was in object naming, all other components of the original language deficit having shown good recovery. This is the first reported case of right thalamic involvement in speech/language in the absence of personal and familial sinistrality.
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ranking = 0.125
keywords = voice
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8/10. aphasia following a right thalamic hemorrhage.

    A left-handed patient with a right thalamic hemorrhage and disordered speech is described. Sequential examinations and aphasia testing were done during a 1-year follow-up period and the results are reported. This case supports those authors who have described characteristics they feel are helpful in diagnosing disordered speech associated with thalamic lesions. Paucity of speech, reduced voice volume, anomia, some paraphasia, and severe dysgraphia were present, but comprehension and repetition were relatively preserved. She showed modest improvement with time. This case also confirms that thalamic involvement in speech is a dominant, rather than a specifically left hemispheric function.
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ranking = 0.125
keywords = voice
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9/10. aphasia after left thalamic infarction.

    We examined a 70-year-old woman who became aphasic after a left thalamic infarction. Computed tomographic scan showed injury that was largely limited to the ventral anterior and rostral ventral lateral thalamic nuclei. speech was characterized by reduced voice volume, impaired auditory and reading comprehension, perseverations, intermittent use of jargon, fluctuations in the ability to perform confrontation naming, extraneous intrusions, verbal paraphasia, intact repetition skills, and fluent speech that was laconic but grammatically correct. We propose that the deficits after left thalamic injury can be grouped into the following four large clusters: extrapyramidal deficits (decreased or fading voice volume), deficits in lexical access (anomia, verbal paraphasia), deficits in vigilance (neologisms, intrusions, fluctuating performance, jargon, perseverations), and comprehension defects.
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ranking = 0.25
keywords = voice
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10/10. Lack of error awareness in an aphasic patient with relatively preserved auditory comprehension.

    The neuropsychological mechanisms underlying unawareness of speech/language deficits are unknown, but four possibilities have been suggested: impaired lexical-semantic representations associated with impaired speech comprehension, a failure of feedback, reduced attentional capacity, and psychological denial. We studied a patient who was unaware of his jargon aphasia despite only a mild auditory comprehension disturbance. Delaying auditory feedback altered his speech patterns. He recognized more of his errors in a recording of his voice than he did while speaking. He also recognized more errors in a recording of the examiner making errors than he did when listening to the recordings of his own speech. Based on these results, we suggest that none of the proposed mechanisms can exclusively account for this man's performance and that each may contribute to his failure to detect and correct errors in speech production.
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ranking = 0.125
keywords = voice
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