Orientador: Rosana do Carmo Novaes Pinto / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Estudos da Linguagem / Made available in DSpace on 2018-08-21T11:43:18Z (GMT). No. of bitstreams: 1 Mazuchelli_LarissaPicinato_M.pdf: 6512450 bytes, checksum: 12e5034b7c0e50fcb0d9ea53f571bdf4 (MD5) Previous issue date: 2012 / Resumo: Ao retomarmos a história da afasiologia, observamos que a linguagem oral, até o século XIX, era reduzida a um ato motor e a escrita era vista unicamente como simulacro da fala. Essas concepções ainda estão presentes, contudo, na literatura neurolinguística tradicional, que não apenas dicotomiza a relação entre oralidade e escrita, mas baseia-se em características de uma escrita normativa padrão para avaliar a linguagem de sujeitos afásicos - geralmente de forma superficial e com a consequente patologização de fenômenos que caracterizam processos normais. Na contramão dessas tendências, este estudo de caso fundamenta-se na Neurolinguística de orientação enunciativo-discursiva, em que a linguagem é concebida como um fenômeno sócio-histórico, uma atividade humana, lugar de interação e interlocução de sujeitos, indeterminada, incompleta e passível de (re)interpretação, em que tanto o sujeito quanto ela própria se constituem em um movimento dinâmico. Tendo esses princípios como cenário, o objetivo deste trabalho é discutir o impacto dos episódios neurológicos na vida do sujeito AJ que há mais de dez anos dribla as dificuldades impostas por uma afasia progressiva - assim caracterizada uma vez que prevalecem os indícios do agravamento dos sinais (sintomas) reconhecidamente relacionados ao chamado "declínio cognitivo", na literatura neuropsicológica. A reflexão, realizada por meio da análise qualitativa das produções escritas anteriores aos eventos neurológicos de AJ e de suas produções orais e escritas posteriores a eles - nas sessões de atendimento individual e coletivo do Grupo III do CCA (Centro de Convivência de Afásicos) -, trata (i) do efeito das práticas sociais com a linguagem (especialmente com as atividades de leitura e escrita) na (re)organização linguístico-cognitiva, o que possibilita, ainda que sob o impacto da afasia e do severo comprometimento cognitivo, que AJ se mantenha na língua(gem) e nas relações sociais; (ii) da inter-relação entre oralidade e escrita, que tem maior visibilidade em um caso-limite como o de AJ, para quem a escrita é lugar de (re)encontros e ponto de apoio para seu querer-dizer. Assim, buscamos contribuir para o desenvolvimento teórico acerca do funcionamento da linguagem nas patologias e para o acompanhamento terapêutico de sujeitos com comprometimentos linguísticocognitivos / Abstract: Considering the history of aphasiology, we observe that the oral language, up to the 19th century, was reduced to a motor act, while writing was seen as a simulacrum of the speech. Such concepts are still present, however, in the traditional neurolinguistics literature, which not only dichotomizes the relation between orality and writing, but is based on characteristics of a standard normative writing to evaluate the language of aphasic subjects - generally in a superficial way and with the consequent act of considering pathological phenomena that characterize normal processes. Opposing such tendencies, this case study is based on the discursive-enunciative Neurolinguistics, which conceives language as a socio-historic phenomenon, a human activity, locus of interaction and interlocution of subjects, indeterminate, incomplete and capable of (re)interpretation, in which both subject and the language constitute each other in a dynamic movement. Having these principles as scenery, the objective of this work is discuss the impact of the neurologic episodes in AJ's life, who has been struggling, for over ten years, with the difficulties imposed by the so-called progressive aphasia - characterized by the continuous aggravation of the signs (symptoms) and by being closely related to "cognitive decline" in the neuropsychological literature. The research - guided by a qualitative analysis of AJ's writings produced before the neurological events, and of his oral and written productions after the strokes in individual and collective sessions of the Group III of CCA (Centro de Convivência de Afásicos) - discusses (i) the effect of social practices with language (especially with the activities of reading and writing) in the cognitive-linguistic (re)organization, which enables AJ, despite the impact of the aphasia and of the severe cognitive compromising, to dwell in the language and in social relations; (ii) the interrelation between orality and writing, which has higher visibility in a limit-case as AJ's, to whom writing is the locus of (re)encounter and as a keystone to his will of speech. Thus, we aim to contribute to the theoretical development of language functioning in pathologies and to the therapeutic follow-up of subjects with cognitive-linguistic compromising / Mestrado / Linguistica / Mestra em Linguística

Stroke är en vanlig orsak till att människor drabbas av afasi. Att drabbas av afasi innebär en stor påverkan på det psykiska måendet och det är vanligt att personer med afasi isoleras från omvärlden. Eftersom personer med afasi har svårigheter att själva uttrycka sin vilja är det viktigt att som sjuksköterska ha en insikt i hur de upplever sin situation. Syftet med studien är därför att belysa personers upplevelse av att leva med afasi till följd utav en stroke. Studien genomfördes som en allmän litteraturstudie. Systematiska sökningar utfördes i tre databaser vilket genererade tio vetenskapliga artiklar som var relevanta för syftet. Resultatet presenterades i två huvudkategorier: förändrat levnadssätt och förändrade sociala relationer. I resultatet beskrivs det att personer med afasi värdesatte att känna sig självständiga och delaktiga. De uppskattade även att engagera sig i olika typer av aktiviteter och känna tillhörighet till andra personer med afasi. Det uppmärksammades dock att personerna med afasi ofta upplevde att människor i deras omgivning var oförstående gällande deras kommunikationssvårigheter vilket orsakade en känsla av exkludering. En ytterligare ökad kunskap om upplevelsen av att leva med afasi kan bidra till en förbättrad vård för personer som drabbats av afasi till följd av en stroke. / Stroke is a common cause of people suffering from aphasia. Suffering from aphasia has a major impact on the mental well-being and it is common for persons with aphasia to get isolated from the rest of the world. It is important that nurses has knowlegde about how people with aphasia experience their own sitaution, since they have difficulty expressing it themselves. The aim of this study was to highlight the experience of living with aphasia as a result of a stroke. The study was conducted as a general litterature study. A systematic research was made, which generated ten articles relevant to the study. The result was presented in two categories: a changed way of living and changed social relationships. The result describes that people with aphasia valued the feeling of being independent and involved in things. They also appreciated to engage in different types of activities and having a sense of belonging together with other people suffering from aphasia. However, it was noticed that people with aphasia often experienced that other people were uncomprehending concerning their communication difficulties which caused a feeling of exclusion. Further research of the experience of living with aphasia can contribute to an improved care for people suffering from aphasia due to a stroke.

Considerable interest has been expressed regarding the issue of recovery of language following head injury in childhood. The two questions most frequently addressed are: 1) Do children recover linguistic abilities faster and better than adults after suffering a head Injury? 2) Is the linguistic disorder, if evident, mainly syntactic or lexical in nature? We have examined 8 children from 6;10-17; 0 who suffered traumatic head injury and who are in varying stages of recovery. Each child has been matched with a normal child of the same age. Despite reports of complete recovery from childhood aphasia, our results indicate persistent word finding problems, with otherwise normal language abilities. There was no correlation between severity of deficit and age at injury or length of coma. / Medicine, Faculty of / Audiology and Speech Sciences, School of / Graduate

Language recovery was examined in 108 individuals with aphasia in the chronic phase of recovery who participated in various forms of aphasia treatment over extended periods of time. The Western Aphasia Battery (WAB) was administered at multiple time points and Aphasia Quotient (AQ) scores were used as a measure of language performance over time. As a group, the cohort showed an improvement of +6.52 AQ points, yielding an average rate of change of +4.07 AQ points per year. The rate of change was greatest at earlier times post onset (between three months and two years), and improvement was greatest for individuals with aphasia in the moderate severity range. Age, sex, and fluency did not have a significant effect on recovery. Education level had marginal predictive value in the direction of those with less education showing greater rate of improvement. These results suggest that language recovery continues during the chronic stage for individuals who are involved in some form of rehabilitation activity, especially in individuals with aphasia of moderate severity.

Orientador: Regina Yu Shon Chun. / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-24T11:42:06Z (GMT). No. of bitstreams: 1 Ramos_RenatadeLima_M.pdf: 4849030 bytes, checksum: 8e3cb46260c390ad0bb76dda595f50e7 (MD5) Previous issue date: 2013 / Resumo: O reconhecimento rápido e precoce da afasia após o Acidente Vascular Cerebral (AVC) pode ser difícil em alguns casos. A partir da necessidade de uma detecção mais eficaz para assistência no pós-AVC surgem os screenings tests, testes rápidos, que detectam a presença ou a ausência da afasia e favorecem a reabilitação da pessoa com essa alteração de linguagem. O The Language Screening Test ¿ LAST foi validado na França e traduzido para o inglês, é um teste rápido para a detecção da afasia que pode ser utilizado em diferentes contextos de saúde. A carência de instrumentos com esse caráter no Brasil justifica sua tradução, adaptação cultural e validação para o português do Brasil. Objetivos: Adaptação cultural e validação do "The Language Screening Test" (LAST) para o português do Brasil. Sujeitos e métodos: A pesquisa segue os preceitos éticos, tendo sido aprovada sob número 140.230 Foi realizada no Hospital das Clínicas da UNICAMP (HC/UNICAMP, Campinas, São Paulo, Brasil). Trata-se de pesquisa metodológica caracterizada pelos processos de avaliação de instrumentos. O processo de adaptação cultural do instrumento seguiu cinco estágios: tradução, síntese, retro-tradução, revisão por um comitê de juízes especialistas e o pré-teste. Participaram dessa pesquisa 130 sujeitos distribuídos em três etapas diferentes: provas de linguagem para adaptação semântica, idiomática, conceitual e cultural; aplicação do LAST adaptado ¿ versões A e B e aplicação do teste de Boston Diagnóstico para Afasia (provas de expressão oral, compreensão auditiva e nomeação). Resultados: O Comitê de Juízes ratificou poucas mudanças na versão traduzida do teste conforme as respostas do primeiro grupo de participantes além de sugerir outras, sendo que ao todo foram trocadas apenas duas palavras/figuras alvo e quatro sentenças foram adaptadas, o que gerou o documento adaptado a cultura brasileira próximo a versão original francesa. Na aplicação do pré-teste em pessoas sem alterações de linguagem, 90% obteve score máximo, resultando em baixa freqüência de erro no teste. Na população com afasia os resultados apresentaram forte correlação em todos os campos correspondentes do LAST ¿ versões A e B e o Teste de Boston, com nível de significância de 5%. A confiabilidade medida através de forma paralela ou alternada apresentou equivalência entre as versões A e B do LAST adaptado. Conclusão: Os resultados mostram validade de construto e confiabilidade entre os testes aplicados, indicando que o screening test LAST em suas versões A e B após tradução, adaptação cultural e validação para o português são aptos para utilização no Brasil / Abstract: The rapid and early diagnosis of aphasia after stroke can be difficult in some cases. From the need for more effective detection to better assist in post-stroke, the screenings tests - rapid tests, which detect the presence or absence of aphasia and favor the rehabilitation of people with this language disorder - arise. "The Language Screening Test - LAST" was validated in France and translated into English. It is a rapid test for the detection of aphasia that can be used in different health contexts. The lack of instruments of this nature in Brazil justifies its translation, cultural adaptation and validation into Brazilian Portuguese. Objectives: Cultural adaptation and validation of "The Language Screening Test " ( LAST) for the Brazilian Portuguese. Subjects and methods: The research follows the ethical principles, having been approved under number 140.230. It was performed at the Hospital of UNICAMP (HC/ UNICAMP, Campinas, São Paulo, Brazil). It is about methodological research characterized by processes of instruments validation. The process of cultural adaptation of the instrument followed five stages: translation, synthesis, back - translation, revision by a committee of expert judges and the pre-test. 130 users participated in this study divided into three different steps: answered the language testes, pre-testing with adapted LAST - versions A and B and application of Boston Diagnostic Aphasia Test (oral expression, listening comprehension and naming test). Results: The Judges Committee ratified a few changes in the translated version of the test according to the responses of the first group of participants, besides they suggested other changes, and in the end there were only two exchanges of words/pictures-target and four sentences have been adapted, which generated the document adapted to Brazilian culture close to the original French version. In applying the pre-test in people with no language alteration, 90 % obtained the maximum score, resulting in low frequency of error in the test. In the population with aphasia, the results showed a strong correlation in all the corresponding fields of the LAST - versions A and B and the Test of Boston, with a significance level of 5 %. The reliability measured via parallel and alternate form showed equivalence between A and B LAST adapted versions. Conclusion: The results show construct validity and reliability between the tests applied, indicating that the screening test LAST in its versions A and B after translation, cultural adaptation and validation for Portuguese are suitable for use in Brazil / Mestrado / Interdisciplinaridade e Reabilitação / Mestra em Saúde, Interdisciplinaridade e Reabilitação

Orientador: Maria Irma Hadler Coudry / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Estudos da Linguagem / Made available in DSpace on 2018-08-14T10:14:25Z (GMT). No. of bitstreams: 1 Labigalini_AnaPaulaVila_M.pdf: 4323017 bytes, checksum: bfd92a47db1ca0aaa7f6845685441608 (MD5) Previous issue date: 2009 / Resumo: Esta dissertação objetivou refletir sobre a formação do fonoaudiólogo no Brasil e como ela habilita a atuação clínica desse profissional; e também objetivou investigar as razões pelas quais a prática fonoaudiológica parece desconsiderar os aspectos interacionais de sujeitos afásicos atendidos. A partir de dados e depoimentos de um sujeito afásico (F), pretendeu-se realizar uma reflexão teórica sobre as duas abordagens terapêuticas fonoaudiológicas a que foi submetido, suas formas de avaliação, de terapia, e as atividades utilizadas. Inicialmente o acompanhamento longitudinal do sujeito F, realizado com base em uma abordagem discursiva da afasia, evidenciou a negação do sujeito pelo atendimento fonoaudiológico recebido anteriormente, o qual se embasava em uma concepção médico-biologicista. Esta abordagem auxiliou na demonstração da heterogeneidade do fenômeno afásico e as contribuições de um processo terapêutico que não exclui o sujeito. Foi possível dar visibilidade à formação do fonoaudiólogo no Brasil, já que ainda podemos visualizar um distanciamento com os sujeitos e, consequentemente, com a linguagem. E também há uma necessidade teórico-prática de rompimento entre a Fonoaudiologia e o modelo médico, para assim poder (re)criar seu lugar de ação. E, conseqüentemente, valorizar seu papel de locutor/interlocutor, durante as atividades discursivas, contextualizadas de acordo com as condições histórico-culturais de cada sujeito. Avaliações e terapias fonoaudiológicas descontextualizadas continuam existindo, multiplicando-se e excluindo os sujeitos afásicos de suas práticas históricas e sociais, pois o número de profissionais com este tipo de formação ainda é muito grande no país. A partir dessas questões teórico-práticas, mostrou-se importante pensar sobre o exercício da linguagem abordado pela Fonoaudiologia Tradicional e a ausência da Lingüística nesta graduação. / Abstract: This dissertation aimed at reflecting upon the education of the speech pathologist in Brazil, and the way this formation enables the clinical performance of this professional. Another objective was to investigate the reasons why the speech phatology practice seem to discard interactional aspects of the assisted aphasic subjects. Based on data and depositions of an aphasic subject (F), it was intended to do a theoretical reflection upon two therapeutic approaches of the speech therapy, applied to the subject, the way of evaluation, the therapy, as well as the activities realized with the subject. At first, the longitudinal follow up of the subject F, based on a discursive approach of the aphasia highlighted the negation of the subject through the previously received assistance, which based itself on a medical-biologist conception. This approach helped in the demonstration of the heterogeneity of the aphasic phenomenon and the contribution of a therapeutic process that does not exclude the subject. It was possible it give visibility to the education of the speech pathologist in Brazil, since we still can visualize an certain distance regarded the subjects, and consequently a distance with language. There is also a theoretical-practice necessity of rupture between speech therapy and the medical model in order to (re)create its place of action, thou valorizing its role of interlocutor during the discursive activities, contextualized according to the historic-cultural condition of each subject. Evaluations and speech therapy therapies not contextualized are still on practice, multiplying and excluding the aphasic subjects of their own historic and social practices, since the quantity of professionals with this kind of orientation is still high in the country. Based on these theoretical-practice issues, it was important to tackle upon the language exercise approached by the Traditional Speech Therapy and the absence of Linguistics in the graduation courses. / Mestrado / Linguistica / Mestre em Linguística

Orientador: Rosana do Carmo Novaes Pinto / Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Estudos da Linguagem / Made available in DSpace on 2018-08-27T16:51:07Z (GMT). No. of bitstreams: 1 Oliveira_MarcusViniciusBorges_D.pdf: 3972176 bytes, checksum: 084ce4231fd2c7ed5511c492a548777e (MD5) Previous issue date: 2015 / Resumo: Conhecido na literatura da área como "tip of the tongue", doravante TOT, este fenômeno se refere ao momento em que um sujeito procura uma palavra, acompanhado da sensação de que esta já vai surgir ou que já lhe escapou, o que justifica o uso da metáfora de que a palavra se encontra na "ponta-da-língua". O objetivo principal desta tese é caracterizar os TOTs, ancorados pelos princípios teóricos-metodológicos da abordagem histórico-cultural, que caracterizam a Neurolinguística de orientação enunciativo-discursiva. Este objetivo central se relaciona a outros, mais específicos, tais como (i) discutir e dar visibilidade à relação constitutiva das funções superiores, sobretudo à relação entre linguagem-memória; (ii) contribuir para o desenvolvimento de uma metodologia qualitativa dos TOTs; e, por fim, (iii) compreender as estratégias de busca da palavra desejada, contribuindo não só para entender aspectos do funcionamento lexical envolvido nos TOTs, mas também para subsidiar o trabalho desenvolvido no contexto clínico-terapêutico com sujeitos afásicos. Para atingir estes objetivos, dialogamos com as ideias de diversos autores, dentre os quais: i) Luria e Vygotsky, principalmente com relação ao que juntos desenvolvem no campo da Neuropsicologia, ii) Bakhtin e seu Círculo, no campo da Filosofia da Linguagem, e iii) Jakobson, na Linguística, além dos autores que se dedicam mais especificamente ao campo da Neurolinguística. A maior parte dos estudos descritos na literatura sobre os TOTs partem de expedientes empíricos, cujo resultados são analisados quantitativamente. Nesta tese, contrapomos tais estudos às primeiras reflexões sobre o tema, com destaque para aquelas de Willian James, Robert Woodworth e Sigmund Freud. Também propomos formas alternativas de estudar os TOTs, desenvolvendo diferentes procedimentos qualitativos, que, ao nosso ver, nos permitem avançar na caracterização dos TOTs como eventos enunciativos e dialógicos. Para isso, nos dedicamos às reflexões que relacionam os TOTs às funções psicológicas superiores, trazendo questões acerca dos signos e de sua natureza dialógica, assim como questões que relacionam linguagem e ideologia. Para finalizar, articulamos os principais pontos desta tese à dimensão ética implicada no trabalho terapêutico no campo da linguagem, indicando as possíveis estratégias que podem ser desenvolvidas no cotidiano clínico, visando minimizar os sofrimentos dos sujeitos afásicos quando se deparam com impossibilidade de seu querer-dizer / Abstract: Known in the field literature as "tip of the tongue", herein after "TOT", this phenomenon refers to the state when someone searches for a word, accompanied by the feeling that it will soon come or that it has already gone, which explains the use of the metaphor that the word is on "the tip of the tongue". The main goal of this thesis is to characterize the TOT phenomenon on the basis of theoretical-methodological principles of the historical-cultural approach, which underlie enunciative-discursive Neurolinguistics. This core task relates to other more specific ones, including: (1) to discuss and give visibility to the constitutive relationship among the higher functions, especially that between language and memory; (ii) to contribute to the development of a qualitative methodology of TOTs; and, finally, (iii) to understand the search strategies of the target word, contributing not only to understand aspects of lexical processes involved in TOTs, but also to support the work in the clinical and therapeutic context with aphasic subjects. To achieve these goals, we dialogue with the ideas of several authors, among whom: i) Luria and Vygotsky, particularly regarding the work they have developed together in the field of Neuropsychology; ii) Bakhtin and his Circle, in the field of Philosophy of Language; and iii) Jakobson, in Linguistics, in addition to the authors who have dedicated their studies to the field of Neurolinguistics. Most of the published studies on TOTs are founded on empirical grounds and present results analyzed quantitatively. In this thesis, we confront such studies with pioneer research carried out by William James, Robert Woodworth and Sigmund Freud. We also propose alternative ways of studying TOTs, developing different qualitative procedures which, in our view, allow for advances in the characterization of a TOT as a dialogical event. We aim to relate TOTs to higher psychological functions keeping account of the dialogic nature of signs and of the relation between language and ideology. Finally, we correlate the main points of this thesis to the ethical dimension of therapeutic work in the field of language, indicating possible strategies in the clinical context to minimize the sufferings of aphasic individuals when faced with the impossibility of their speech-will / Doutorado / Linguistica / Doutor em Linguística

Background: Each year, approximately 25,000 are affected by stroke in Sweden. As a result of a stroke, the person may also suffer from various types of disabilities, including aphasia. Aphasia means impairment of communication, where the affected person has difficulties in the spoken or written language. There is a lack of knowledge regarding how people with aphasia experience their condition, both at a community level and in the health care system. Aim: The purpose of the study was to describe patients experiences of aphasia after a stroke. Method: A literature-based study based on an analysis of eight scientific articles. Results: Two main themes emerged: Negative experiences and positive experiences. The results show that people with aphasia often suffer from mental illness related to their condition. Submerged mood and depression where the most common experiences of psychological effect, which can adversely affect patient's social life and daily activities. The results also show that the support from the environment can motivate the patient to want to improve their condition and give the patient an increased well-being. Conclusion: Caregivers need an increased understanding and knowledge of experiences regarding patients with aphasia. This can contribute to preventive actions related to mental illness. The support of the environment is important for patient's recovery and the nurse can, with an increased understanding and knowledge contribute to patient's well-being and rehabilitation. / Afasi är en sekundärskada till följd av en stroke, som innebär en nedsättning av kommunikationsförmågan. Detta sker då vissa delar av hjärnan drabbas av syrebrist, vilket leder till att celler skadas eller dör. Tillståndet kan påverka patienters vardag och detta präglas av patienters upplevelser av deras tillstånd. Negativa upplevelser kan vara frustration, nedstämdhet, ångest och depression, men även upplevelser av att omgivningen är oförstående och saknar insikt i vad afasi innebär. Negativa upplevelser kan leda till att patienter isolerar sig och att de inte fullföljer sin rehabiliteringsplan. Sjuksköterskan behöver mer kunskap angående patienters upplevelser av att leva med afasi – för att kunna förebygga psykisk ohälsa.   Patienter med afasi kan dock erfara positiva upplevelser trots sitt tillstånd. Genom att acceptera sitt tillstånd, samt genom stöd från omgivning och vårdpersonal kan patienter med afasi känna tillhörighet och välbefinnande. Detta kan leda till att patienter som är drabbade av afasi upplever motivation till att fullfölja sin rehabilitering. För att effektivisera återhämtningen kan närstående bjudas in av sjuksköterskan och bli mer delaktiga i patientens kommunikativa rehabilitering, då närståendes stöd och uppmuntran är en viktig aspekt i att patienter upplever motivation till återhämtning.  Patienter med afasi upplever ett sjukdomslidande till följd av att ha insjuknat i en stroke och afasi. Upplevelser av detta leder till ett själsligt lidande för patienten. Sjuksköterskans ansvar är att lindra lidande, samt att återställa och främja hälsa inom ramen för hens kompetensområde – omvårdnad. Sjuksköterskan behöver en ökad kunskap och förståelse för den psykiska påverkan som afasi kan medföra, så att hen kan uppmärksamma symtom på och förebygga psykisk ohälsa hos patienter med afasi. Det här är en litteraturstudie, med avsikt att bidra till evidensbaserad vård med grund i kvalitativ forskning. Resultatet är baserat på kvalitativ analys av åtta vetenskapliga artiklar, som beskriver patienters upplevelser av att leva med afasi.

Background: Primary progressive aphasia (PPA) is a clinical dementia syndrome characterized by impairments in language. The presence of Alzheimer disease (AD) neuropathology has been observed in approximately 40% of PPA cases. Cross-sectional and longitudinal features of cortical atrophy in PPA are emerging but less is known about the integrity of subcortical structures, particularly the thalamus. As a major relay station in the brain, the thalamus is implicated in language functioning given its reciprocal connections with perisylvian regions in the cortex. High-dimensional brain mapping was used to characterize thalamic morphology in individuals with and without non-semantic PPA. Further, shape differences were compared between PPA participants with suspected AD pathology (PPAAβ +) and those without suspected AD pathology (PPAAβ -) as determined by amyloid PET scans. The relationship between shape and specific language deficits were also investigated. Method: Thalamic integrity was examined in 57 PPA participants relative to cognitively healthy controls (N=44) with similar demographics. MR scans were acquired using high-resolution T1-weighted MPRAGE volumes following the ADNI protocol. Thalamic shape features were estimated using Large Deformation Diffeomorphic Metric Mapping. Thalamic nuclei of interest included mediodorsal, pulvinar, and anterior regions. General linear models compared differences in thalamic shape between groups. Pearson models characterized relationships between thalamic nuclei and language function. Results: After controlling for whole brain volume, thalamic volume did not differ between groups [F(1, 99)=0.80, p=0.80]. However, PPA participants exhibited significant bilateral inward shape deformation in dorsal and ventral regions that extended in an anterior to posterior fashion, and unilateral outward deformation in medial and lateral regions only in the left thalamus relative to controls [F(9, 91)=5.75, p<0.001, Wilk's Λ=0.64]. There were no shape differences between PPAAβ + and PPAAβ – groups. Pearson models revealed significant correlations between confrontation naming and shape deformation in the left pulvinar (r=0.59, p<0.01) and left anterior (r=0.55, p<0.01) thalamic nuclei for the PPAAβ + group only, such that lower language scores reflected greater localized volume loss. Conclusions: In the absence of volumetric differences, shape measures were able to capture unique aspects of localized morphologic differences in PPA that corresponded to worse naming performance only in those with suspected AD pathology. Thalamic changes appear to be a contributing and unrecognized component to the presentation and language characterization of PPA.

Background: Working-age adults with aphasia experience difficulties in social participation, specifically the ability to fulfil social roles and reintegrate into communities. Literature regarding social participation of people with aphasia (PWA) is predominantly based on high income countries limiting generalizability of findings. Investigation of PWA’s perspectives on social participation in lower-middle-income countries such as South Africa is warranted. Objective: To describe the perspectives of working-age adults with aphasia regarding social participation within the first two years post-incident. Method: Semi-structured interviews were used to obtain the perspectives of 10 working-age adults (mild to moderate aphasia), using pictorial and written supports, and supported conversation techniques. Data were coded and thematically analysed to identify common themes amongst participants’ perspectives of social participation. Results: Five main themes and two sub-themes were identified. Participants’ perspectives of social participation align with previous qualitative studies regarding perspectives of working-age adults with aphasia, specifically their preference for re-engagement in meaningful activities. Participants described preference for specific 2 communication partners, specifically close friends and family. Reduced social participation was apparent due to difficulties in returning to work. The rehabilitation process was identified as an area of social engagement, specifically participants’ relationships with their speech-language therapist. Faith-related activities were the primary contexts that involved other community members. Conclusion: Successful social participation was dependent on the perceived value and the supportive nature of social activities rather than the quantity of activities. Rehabilitation should facilitate and optimise PWA’s communicative functioning within valued areas of social participation, enhancing person-centred care. Keywords: Social participation; aphasia; mild-moderate aphasia; stroke; lower-middle-income countries; working-age adults; A-FROM; ICF; speech-language therapy; person-centred care. / Dissertation (MA) University of Pretoria 2020. / Speech-Language Pathology and Audiology / MA (Speech-language pathology) / Unrestricted