Crossed aphasia refers to language disturbance induced by unilateral right hemisphere (non-language dominant) injury in right-handed people who had no previous history of brain damage. Crossed aphasia occurs in less than 2 percent who developed a aphasia. We report a case of a 49-year-old right handed man with language disturbance after right middle cerebral infarction. He showed nonfluent crossed aphasia with Gerstman syndrome such as right-left disorientation, finger agnosia, acalculia and agraphia, but not with apraxia and neglect. At 7 weeks after onset, language function indicated improvement in spontaneous speech and at 19 weeks after onset, improvement in spontaneous speech, comprehension, repetition, naming and reading.
Agnosia ; Agraphia ; Aphasia* ; Apraxias ; Brain ; Cerebral Infarction ; Comprehension ; Dyscalculia ; Hand ; Humans ; Infarction, Middle Cerebral Artery* ; Middle Aged

Digital therapeutics is an evidence-based intervention using high-quality software, with the sole purpose of treatment. As many healthcare systems are encountering high demands of quality outcomes, the need for digital therapeutics is gradually increasing in the clinical field. We conducted review of the implications of digital therapeutics in the treatment of neurological deficits for stroke patients. The implications of digital therapeutics have been discussed in four domains: cognition, speech and aphasia, motor, and vision. It was evident that different forms of digital therapeutics such as online platforms, virtual reality trainings, and iPad applications have been investigated in many trials to test its feasibility in clinical use. Although digital therapeutics may deliver high-quality solutions to healthcare services, the medicalization of digital therapeutics is accompanied with many limitations. Clinically validated digital therapeutics should be developed to prove its efficacy in stroke rehabilitation.
Aphasia ; Aphasia, Broca ; Cognition ; Delivery of Health Care ; Hemianopsia ; Hemiplegia ; Humans ; Medicalization ; Neurologic Manifestations ; Rehabilitation ; Stroke

BACKGROUND: The term "transcortical aphasia" is applied to primary lesions not involving the receptive and expressive language areas, but rather the areas connected to the association cortex. By definition, patients with transcortical aphasia can repeat what they have heard, but they have difficulty producing spontaneous speech or understanding speech. This paper reports the clinical features of stroke patients with transcortical aphasia to delineate the language profiles of its subtypes. METHODS: Eighty patients with stroke were divided into three subtypes of transcortical aphasia: transcortical sensory aphasia, transcortical motor aphasia, and mixed transcortical aphasia. A Korean version of the Western Aphasia Battery was used to compare the subdomains of language ability among the three groups. RESULTS: The patients showed a relatively preserved repetition ability, but the performances in repetition and generative naming, and the aphasia quotient were highest in the transcortical sensory aphasic group, followed by the transcortical motor aphasic and mixed transcortical aphasic groups. CONCLUSIONS: The present study provides detailed information on the language profiles of the three subtypes of transcortical aphasia, which can be differentiated based on the aphasia quotient and generative naming scores.
Aphasia ; Aphasia, Broca ; Aphasia, Wernicke ; Humans ; Language ; Stroke

Variant angina pectoris (VAP) is a special type of unstable angina with coronary artery spasm as the main pathogenesis, characterized by resting chest pain, and transient ST segment dynamic changes. The development of acute myocardial infarction is not uncommon. We report a case of a 49-year-old female patient diagnosed with VAP at 2 years before who suddenly suffered severe chest pain. Troponin-I was elevated. Immediate coronary angiography showed near-total occlusion in the proximal left anterior descending artery, which was not fully dilated despite use of intracoronary nitroglycerin. Intravascular ultrasound showed focal significant stenosis with a large amount of plaque at the site of spasm and the lesion was successfully treated with drug-eluting stent placement. Intravascular imaging may be instrumental in high-risk patients with VAP who suffer recurrent chest pain despite intensive anti-spasm medications.
Angina Pectoris, Variant ; Angina, Unstable ; Arteries ; Atherosclerosis* ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Drug-Eluting Stents ; Female ; Humans ; Middle Aged ; Myocardial Infarction* ; Nitroglycerin ; Spasm* ; Troponin I ; Ultrasonics ; Ultrasonography

Speech and language are uniquely human-specific traits that have contributed to humans becoming the predominant species on earth from an evolutionary perspective. Disruptions in human speech and language function may result in diverse disorders, including stuttering, aphasia, articulation disorder, spasmodic dysphonia, verbal dyspraxia, dyslexia, and specific language impairment (SLI). These disorders often cluster within a family, and this clustering strongly supports the hypothesis that genes are involved in human speech and language functions. For several decades, multiple genetic studies, including linkage analysis and genomewide association studies, were performed in an effort to link a causative gene to each of these disorders, and several genetic studies revealed associations between mutations in specific genes and disorders such as stuttering, verbal dyspraxia, and SLI. One notable genetic discovery came from studies on stuttering in consanguineous Pakistani families; these studies suggested that mutations in lysosomal enzyme-targeting pathway genes (GNPTAB, GNPTG, and NAPGA) are associated with non-syndromic persistent stuttering. Another successful study identified FOXP2 in a Caucasian family affected by verbal dyspraxia. Furthermore, an abnormal ultrasonic vocalization pattern (USV) was observed in knock-in (KI) and humanized mouse models carrying mutations in the FOXP2 gene. Although studies have increased our understanding of the genetic causes of speech and language disorders, these genes can only explain a small fraction of all disorders in patients. In this paper, we summarize recent advances and future challenges in an effort to reveal the genetic causes of speech and language disorders in animal models.
Animals ; Aphasia ; Apraxias ; Articulation Disorders ; Dyslexia ; Dysphonia ; Humans ; Language Disorders* ; Mice ; Models, Animal ; Stuttering ; Ultrasonics

Speech and language are uniquely human-specific traits, which contributed to humans becoming the predominant species on earth. Disruptions in the human speech and language function may result in diverse disorders. These include stuttering, aphasia, articulation disorder, spasmodic dysphonia, verbal dyspraxia, dyslexia and specific language impairment. Among these disorders, stuttering is the most common speech disorder characterized by disruptions in the normal flow of speech. Twin, adoption, and family studies have suggested that genetic factors are involved in susceptibility to stuttering. For several decades, multiple genetic studies including linkage analysis were performed to connect causative gene to stuttering, and several genetic studies have revealed the association of specific gene mutation with stuttering. One notable genetic discovery came from the genetic studies in the consanguineous Pakistani families. These studies suggested that mutations in the lysosomal enzyme-targeting pathway genes (GNPTAB, GNPTG and NAPGA) are associated with non-syndromic persistent stuttering. Although these studies have revealed some clues in understanding the genetic causes of stuttering, only a small fraction of patients are affected by these genes. In this study, we summarize recent advances and future challenges in an effort to understand genetic causes underlying stuttering.
Aphasia ; Apraxias ; Articulation Disorders ; Dyslexia ; Dysphonia ; Genetic Linkage ; Humans ; Lysosomes ; Stuttering*

Transient global amnesia (TGA) is characterized by abrupt onset temporary dysfunction of anterograde and retrograde amnesia without other neurologic deficits. We encountered a 53-year-old man who developed recurrent TGA while working in a hot and humid machinery room (33degrees C and 64% relative humidity). Heat exposure and physical exertion may facilitate the leakage of cytokines into the systemic circulation so as to cause a cerebral endothelial insult. Functional insufficiency of the hippocampus and its connections caused by physical and environmental factors may be related to recurrent attacks.
Amnesia, Retrograde ; Amnesia, Transient Global* ; Cytokines ; Hippocampus ; Hot Temperature ; Humans ; Middle Aged ; Neurologic Manifestations ; Physical Exertion

Transient global amnesia is characterized by a sudden inability to form new memories (anterograde amnesia) that usually last for minutes to several hours but never longer than 24 hours. and there are no other focal neurologic signs or symptoms. Retrograde amnesia from a few hours to many years may also be associated with this condition. We report a case of a 56-year-old female patient who experienced transient global amnesia in the recovery room after general anesthesia. She repeated the same queries several times to persons nearby and appeared perplexed. A detailed neurologic examination was otherwise entirely normal. Her symptoms resolved completely the next day.
Amnesia, Retrograde ; Amnesia, Transient Global* ; Anesthesia, General* ; Female ; Humans ; Middle Aged ; Neurologic Examination ; Neurologic Manifestations ; Recovery Room*

Optic aphasia is a rare syndrome in which patients are unable to name visually presented objects but have no difficulty in naming those objects on tactile or verbal presentation. We report a 79-year-old man who exhibited anomic aphasia after a left posterior cerebral artery territory infarction. His naming ability was intact on tactile and verbal semantic presentation. The results of the systematic assessment of visual processing of objects and letters indicated that he had optic aphasia with mixed features of visual associative agnosia. Interestingly, although he had difficulty reading Hanja (an ideogram), he could point to Hanja letters on verbal description of their meaning, suggesting that the processes of recognizing objects and Hanja share a common mechanism.
Aged ; Agnosia ; Anomia ; Aphasia* ; Dyslexia ; Humans ; Infarction ; Posterior Cerebral Artery ; Semantics

OBJECTIVE: To investigate whether suppression of right inferior frontal gyrus (Broca's homologue) by 1 Hz repetitive transcranial magnetic stimulation (rTMS) can improve speech recovery. METHOD: We applied low frequency rTMS on right Broca's homologue twice a week for 6 weeks in eight subcortical aphasia patients who were 3 months to 3 years poststroke onset. They were tested with Korean Version-Western Aphasia Battery before and after procedure. Also, they were tested with Parallel Short Forms for the Korean-BostonNaming Test and Animal Naming Test serially for outcome measure. rTMS was performed with intensity of 80% of motor threshold for 10 min (600 pulses) at 1 Hz frequency. RESULTS: Significant improvement was observed in picture naming at post-rTMS only in nonfluent aphasia patients but not in fluent aphasia patients. CONCLUSION: rTMS may provide a novel treatment for aphasia by possibly modulating the distributed, bi-hemispheric language network.
Animals ; Aphasia* ; Aphasia, Broca ; Aphasia, Wernicke ; Humans ; Outcome Assessment (Health Care) ; Transcranial Magnetic Stimulation*