Föreläsningar och seminarier Predisputationsseminarium: Helena Hybbinette
Diagnosis and Recovery Patterns in Patients with Apraxia of Speech after Stroke
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Doktorand Helena Hybbinette
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Despite a large amount of research, our knowledge of the exact nature and neurobiological mechanisms of apraxia of speech (AOS) is still limited. Few studies have investigated AOS in early stroke patients as well as its resolution longitudinally, and factors predicting recovery are largely unknown. While the effects of focal brain lesions induced by stroke have been frequently studied, less is known about alterations in network connectivity in patients with AOS. Despite a close relationship between speech-language and hand motor function, only few studies have addressed the issue of recovery in these multiple behavioral domains. In clinical settings, there is a lack of valid and reliable assessment instruments for AOS diagnosis that are applicable at all severity levels.
The overall aim of this thesis project was to address these questions and to gain more knowledge on the diagnosis, severity, and recovery patterns of AOS in individuals in an early phase after stroke. The specific aims for the four studies were:
Study I: To study the intra- and interrater reliability of the Apraxia of Speech Rating Scale (ASRS), an assessment instrument for AOS diagnosis created for research purposes, in a group of clinically active SLPs in assessment of individuals with speech and language impairments in an early phase after stroke. An additional aim was to investigate the applicability of the ASRS in clinical assessment of individuals with severe speech and language impairments.
Study II: To describe and evaluate preliminary measures of reliability and validity of a clinical assessment protocol for AOS diagnosis, developed as part of a clinical study with the aims to be applicable in clinical settings and to be valid in the assessment of individuals with speech and language impairments at all severity levels.
Study III: To investigate the prevalence of AOS and aphasia in individuals with an upper limb impairment in a subacute phase after stroke, and to compare recovery across speech-language and hand motor domains.
Study IV: To investigate longitudinal changes in functional connectivity (FC) in individuals with AOS after stroke, from the subacute to the chronic phase, to identify predictors of AOS recovery. Additional aims were to study the relation between FC and degree of severity in AOS and to compare FC strength in patients with AOS after a left hemisphere stroke to that in left hemisphere lesioned stroke patients without speech-language impairment.