احمدرضا خاتون آبادی

Recent years have seen the development of voice indices for multi-parametric objective voice evaluation. The current study aims to review these indices and examine their efficiency through the literature.

The study design is a literature review. The five databases of ‘PubMed’, ‘Scopus’, ‘Google Scholar’, ‘Science Direct’, and ‘Web of Science’ were searched using the keywords ‘voice index’, ‘acoustic’, ‘voice assessment’, and ‘acoustic analysis’. Attempts were made to include only the acoustic indices that have been validated and are fairly user-friendly.

Five voice indices were found that met the inclusion criteria: Dysphonia Severity Index (DSI), Acoustic Voice Quality Index (AVQI), Cepstral Spectral Index of Dysphonia (CSID), The Acoustic Breathiness Index (ABI), and Acoustic Psychometric Severity Index of Dysphonia (APSID).

The results suggest using AVQI, ABI, DSI, and CSID in the evaluation and treatment of voice disorders. Of course, it is recommend to examine the efficacy of these indices in more languages and also developing new indices by considering more aspects of voice.

Phonemic and semantic fluency tasks are used for verbal fluency (VF) evaluation. The present study aimed to select the most appropriate semantic categories and the most frequent phonemes of Persian as items for the VF test. Then, we determine the test results in differentiation between cognitively intact people and those with Mild Cognitive Impairment (MCI) and Alzheimer Disease (AD).

A cross-sectional study was conducted on 120 people (60 cognitively intact, 30 with AD, and 30 with MCI) in two phases. In phase one, linguists determine the most frequent phonemes at the beginning of Persian words and the most frequent semantic categories based on a survey. In phase two, the verbal fluency test was administered to cognitively intact people and those with cognitive impairment (patients with AD and MCI). One-way ANOVA and multiple linear regression were used for statistical analysis.

The normal subjects scored significantly higher in all phonemic and semantic fluency tasks than the patients with AD and people with MCI (P<0.05). Regarding the phonemic VF task, the phonemes /sh/, /s/, and then /a/ were better in differentiating the MCI and AD groups from the normal group. Regarding the semantic VF task, the animals’ category was better differentiated the MCI and AD groups from the normal group.

Comparing frequent phonemes and semantic categories of Persian across three groups of normal, AD, and MCI showed that some phonemes and semantic categories can be more differentiating in the VF task. However, it is a preliminary validation study, and this topic needs more investigation in the future.

The Aphasia Check List (ACL) is a comprehensive, time-saving tool for language evaluation in aphasia, including a cognitive assessment part. This cross-sectional study aimed to translate ACL into Persian and analyze the psychometric features of the translated version. The original version of the ACL was translated and adapted from German; its psychometric features were then determined. 

Twenty People With Aphasia (PWA) and 50 age- and education-matched, cognitively healthy controls participated in this research. Possible floor and ceiling effects, discriminant validity, test-retest reliability, and internal consistency of the test were analyzed in addition to the evaluation of internal correlations between the test parts (language & cognition).

Regarding the performance of PWAs in the language section and the cognitive subtests assessing attention, memory, and reasoning, there were no floor and ceiling effects. Adequate discriminant validities for the language section of the test [i.e., total score: (Mann-Whitney U= 6.000, P<0.001); diagnostic subtests scores: (Mann-Whitney U= 3.000, P<0.001), and each subtest individually. Besides, the attention subtest of the cognition section (Mann-Whitney U= 16.500, P<0.001) was also observed. There was no difference between the control and patient groups in the subtests of memory (Mann-Whitney U= 497.500, P=0.973) and reasoning (Mann-Whitney U= 3.000, P= 308). The test-retest reliability was acceptable in all subtests (ICC agreement= 0.573-0.984). The ACL-P suggested appropriate internal consistency (Cronbach’s alpha coefficient= 0.761 for test & retest scores). There were also significant correlations between language and cognition in the control and patient groups.

The ACL-P test indicated sufficient reliability and validity for the evaluation of Persian-speaking PWAs and is suggested to be used in studies on this population.

The present study is a case report of a 50-year-old man (SM) with aphasia whose word retrieval was severely impaired. The aim of the study was to compare the effect of a combined treatment program (attention training and language treatment) and a single program (language treatment alone) on the naming picture materials.

This case was affected by a hemorrhagic cerebrovascular accident in the territory of Middle Cerebral Artery branches of the left hemisphere. Two naming treatments, i.e. the single and combined treatments sequentially, were provided for SM; during each of them a 50-item wordlist was practiced (Lists A and B). 12 treatment sessions were implemented for him during each treatment program. These two lists along with another list (List C), left for assessment of generalization of treatments to untrained items, were probed 6 times during and after each program. The whole picture set was normalized in another study described in the text.

Our patient’s naming ability progressed during the treatment programs. However, this progression was more salient in combined treatment program. More specifically, List B had the mean score of 34.25 in combined treatment program that was higher than mean of List A in single treatment program (14.5). The slope of List B scores was also higher than that of List A (3.7 vs 1.2). List C showed more generalization of combined treatment to untrained items than single treatment based on its mean scores (27 vs 18.5).

the observed improvements of naming ability were felt to be the result of combining attention training into the language treatment which is lead to sustained attention, less distraction and more concentration.

Emotion can contribute to the severity of stuttering, although the underlying mechanism is unknown. Event-related Potential (ERP) could be very helpful for assessing emotional processing in persons with stuttering. Our study aimed at the investigation of phonological processing for emotional and neutral words in Children Who Stutter (CWS) by ERP.

Ten CWS were given 120 emotional and neutral words to read. Phonological processing was assessed by aloud reading task, while simultaneously ERP was recorded. The results were analyzed as behavioral (reaction time and accuracy) and electrophysiological (amplitude and topography).

There were significant differences in reaction time and accuracy between positive, negative, and neutral words (P<0.05). The electrophysiological data analysis showed significant differences for a minimum of amplitude in the left frontal area, for a maximum of amplitude in the right temporal area, and peak to peak distance in the left frontal area (P<0.05). Visual inspection suggested that recorded fluctuations have a bigger amplitude range for neutral words in all brain regions, except prefrontal, frontal and right frontal.

Valence would affect behavioral measures. Generally, emotion facilitates word processing by reducing activity in anterior brain areas in phonological processing time.

One of the most challenging decisions is to assess the preterm infant’s transition from tube feeding to oral feeding. Thus, we require a reliable tool for determining the time to start oral feeding. This study aimed to measure the interrater and intrarater reliability of the Preterm Infant Oral Feeding Readiness Assessment scale (PIOFRA).

This study was an observational, cross-sectional study. The study participants were preterm infants who had been hospitalized in the Neonatal Intensive Care Unit of Shariati Hospital affiliated to Tehran University of Medical Sciences, between December 2017 and February 2018. The inclusion criteria were absence of neurological and gastrointestinal disorders or major congenital anomalies, Apgar score 3 or more in the first 1 minute, and 5 or more in the first 5 minutes. The exclusion criteria included family’s unwillingness to participate in the study, infant’s death, or a sudden change that affects neonates’ nutritional status, like cerebral hemorrhage or intestinal problems.

The interrater and intrarater reliability of the total PIOFRA scale was good Intraclass Correlation Coefficients (ICC˃0.75). The interrater and intrarater reliability of most items were good and excellent, with weighted kappa more than 0.50, with the exception of lip posture and especially stress sign, with weighted kappa less than 0.40.

Generally, most items of the PIOFRA scale had acceptable interrater and intrarater reliability. Also, the interrater and intrarater reliabilities of the total POFRAs score was good.

Dysphagia is one of the common symptoms observed in more than 80% of patients with Parkinson disease (PD). Dysphagia is a potentially harmful feature that leads to the reduction of the quality of life, malnutrition, and aspiration pneumonia, which is one of the main causes of death in patients with PD. The current study aimed at reviewing therapeutic approaches to dysphagia treatment in PD.
Evidence Acquisition: MEDLINE literature through PubMed until 2017 was reviewed.

Studies on the dysphagia treatment approaches in PD are very diffuse. These studies include the conventional rehabilitation of dysphagia, as well as behavioral-instrumental and electrophysiological treatments. Despite the usefulness of these treatments, due to the poor quality of such studies, the generalization of their results is limited.

It appears that a combination of treatments provides satisfactory results. Therefore, it is necessary to use new treatment methods in addition to the conventional treatments.

Divided attention is impaired in the early stages of Alzheimer’s disease (AD). The influence of divided attention on people with AD has been considered from different perspectives, such as motor ability, cortical responses, performance in divided attention evaluation tasks, and comparison of divided attention and directed and focused attention. The purpose of the current study was to investigate divided attention in AD patients from these different perspectives.

 An electronic search was performed in January and February 2016 in PubMed, Science Direct, Medline, Scopus, Google Scholar, and Ovid databases to obtain relevant articles published from 1980 to 2015. The keywords used included “Alzheimer’s disease”, “attention”, and “divided attention”. The articles obtained were studied using the following standard protocol for inclusion criteria written in the English language, the focus of studies was on divided attention in AD, and no other types of cognitive ability. From the 60 articles found, 10 articles that were adhered to the inclusion criteria were selected for consideration.

The 10 studies reviewed considered divided attention in AD from different domains. These domains showed that AD patients had impaired performance in tasks that required divided attention and showed deficits in motor tasks stemming from the negative effects of impaired divided attention on motor ability. Different types of brain deficits have been observed in neuroimaging techniques in individuals with AD during divided attention tasks. Those with AD showed greater impairment for divided attention than for directed and focused attention.

Divided attention influences the lives of those with AD from several perspectives. These include the inability to focus on two or several relevant stimuli simultaneously that require divided attention rather than directed and focused attention and a deficit in the performance of motor tasks such as gait and other problems in daily life, such as falling. In addition, depression also had a negative effect on divided attention. Depressed AD patients had more difficulty in daily activities than AD patients without depression. The areas of the brain involved in divided attention in individuals with AD differ from those involved in unaffected people.

Aphasia is a language disorder caused by left hemisphere damage. For treatment of aphasia, in some of therapeutic approaches, the right hemisphere (RH) abilities, such as, emotional perception, is used for stimulation of the language process in the left hemisphere. The aim of this study is to investigate emotional word repetition in aphasia after a stroke, in Persian language patients.

Fifteen aphasic patients (eleven male and four female) between 45 and 65 (58/4 ± 7/8) years of age, participated in this cross-sectional study. A list of 20 emotional words and a list of 20 neutral words as stimuli were prepared and the patients were asked to repeat each word after five seconds; if a patient needed to repeat a word again, it was repeated for him/her again, and the total score for each subject was calculated. The paired t-test was used to test group mean differences and the significant level was 0.05.

The mean and standard deviation for emotional word repetitions were 6.93 ± 1.72 and for non-emotional word repetition was 7.10 ± 2.23, and the P value = 0.892, thus, no significant difference between emotional and non-emotional word repetitions was noticed. The mean and standard deviation for the positive emotional word repetitions were 3.53 ± 3.29 and for negative word repetitions were 3.40 ± 3.56, (P = 0.751), with no significant difference between positive and negative emotional word repetitions.

Despite the main hypothesis that the right hemisphere is involved in the processing of emotions, it can be stated that both hemispheres are involved in the processing of emotional words, albeit in a different and probably complementary manner.

Naming is a simple and basic skill of the language which involves semantic, lexical, and phonological levels. There are many different factors affecting the speed and convenience of naming. One of these factors is the word Age of Acquisition (AoA) and since language processing occurs at an extremely fast rate, psycholinguistics needs a method that has very good temporal resolution. The Event-related Brain Potentials (ERP) method is almost ideal among the imaging techniques of studying a language.

The current study aimed to investigate the electroencephalograph signals related to the time period of phonological encoding during immediate picture naming through the analysis of AoA effect.

In this cross-sectional study 15 male, native Farsi speakers, aged 18 - 25 years participated. The test involved naming 80 pictures including 40 early-acquired words and 40 late-acquired words, presented by a monitor screen. EEG (electroencephalogram) was recorded continuously from 64 electrodes mounted on an electrode cap. The waves related to early and late-acquired groups were investigated in terms of amplitude, latency, and scalp distribution within a 300 millisecond time range linked to phonological encoding process.

The results showed that the pictures of the early-acquired words were named 40 millisecond faster than those of late-acquired words (P = 0.022). The difference between the two groups was significant on the latency and scalp distribution, but not significant on amplitude.

According to the results of the study, AoA modulated response latencies (early acquired words were produced faster than late-acquired ones), indicating increased processing time-cost for late acquired words, which happens during the phonological encoding period (phonological code retrieval and syllabification). Furthermore, the results seem to support a phonological encoding locus for the main AoA effects