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Background: Castilian-Spanish, Catalan, Galician, and European Portuguese are the most widely spoken languages of the Ibero-Romance group. An increasing number of authors have addressed the impact of aphasia on the morphosyntax of these varieties. However, accurate linguistic characterisations are scarce and the different sources of data have not been yet compiled.Aims: To stimulate state-of-the-art research, we provided a comprehensive summary of morphosyntactic aspects of Ibero-Romance and a review of how these are affected in non-fluent aphasia. The topics we dealt with are the use of verb argument structure and morphology, sentential negation and word order, definite articles, personal and reflexive pronouns, passives, topicalised constructions, questions, and relative clauses.Methods & Procedures: An exhaustive fieldwork and search of PubMed, Web of Science, and Medline records were performed to retrieve studies focused on morphosyntactic issues concerning the Ibero-Romance varieties. A total of 27 studies produced by 46 authors of varying background emerged. We did not review studies of category-specific deficits and aspects related to bilingual aphasia, although we assume that most speakers of Galician and Catalan are bilingual. Studies of spontaneous speech were included when no controlled experimental tasks were available.Outcomes & Results: The morphosyntactic commonalities of Ibero-Romance have been tackled from different theoretical perspectives. There exist asymmetries in findings which we explain with the use of different tasks (and task complexity) and individual differences between participants.Conclusions: Discourse-linking factors as well as deviations from the canonical pattern are recurrent answers to these asymmetries. A comprehensive theory of impairments in non-fluent aphasia integrating relevant aspects of both structural and processing accounts seems necessary.
Depression is the most prevalent psychiatric disorder in the general population. Despite a large demand for efficient treatment options, the majority of older depressed adults does not receive adequate treatment: Additional low-threshold treatments are needed for this age group. Over the past two decades, a growing number of randomized controlled trials (RCT) have been conducted, testing the efficacy of physical exercise in the alleviation of depression in older adults. This meta-analysis systematically reviews and evaluates these studies; some subanalyses testing specific effects of different types of exercise and settings are also performed. In order to be included, exercise programs of the RCTs had to fulfill the criteria of exercise according to the American College of Sports Medicine, including a sample mean age of 60 or above and an increased level of depressive symptoms. Eighteen trials with 1,063 participants fulfilled our inclusion criteria. A comparison of the posttreatment depression scores between the exercise and control groups revealed a moderate effect size in favor of the exercise groups (standardized mean difference (SMD) of –0.68, p < .001). The effect was comparable to the results achieved when only the eleven trials with low risk of bias were included (SMD = –0.63, p < .001). The subanalyses showed significant effects for all types of exercise and for supervised interventions. The results of this meta-analysis suggest that physical exercise may serve as a feasible, additional intervention to fight depression in older adults. However, because of small sample sizes of the majority of individual trials and high statistical heterogeneity, results must be interpreted carefully.
Continuous treatment with antidementia drugs in Germany 2003-2013: a retrospective database analysis
(2015)
Background: Continuous treatment is an important indicator of medication adherence in dementia. However, long-term studies in larger clinical settings are lacking, and little is known about moderating effects of patient and service characteristics.
Methods: Data from 12,910 outpatients with dementia (mean age 79.2 years; SD = 7.6 years) treated between January 2003 and December 2013 in Germany were included. Continuous treatment was analysed using Kaplan-Meier curves and log-rank tests. In addition, multivariate Cox regression models were fitted with continuous treatment as dependent variable and the predictors antidementia agent, age, gender, medical comorbidities, physician specialty, and health insurance status.
Results: After one year of follow-up, nearly 60% of patients continued drug treatment. Donezepil (HR: 0.88; 95% CI: 0.82-0.95) and memantine (HR: 0.85; 0.79-0.91) patients were less likely to be discontinued treatment as compared to rivastigmine users. Patients were less likely to be discontinued if they were treated by specialist physicians as compared to general practitioners (HR: 0.44; 0.41-0.48). Younger male patients and patients who had private health insurance had a lower discontinuation risk. Regarding comorbidity, patients were more likely to be continuously treated with the index substance if a diagnosis of heart failure or hypertension had been diagnosed at baseline.
Conclusions: Our results imply that besides type of antidementia agent, involvement of a specialist in the complex process of prescribing antidementia drugs can provide meaningful benefits to patients, in terms of more disease-specific and continuous treatment.
Background: Interoceptive awareness, the awareness of stimuli originating inside the body, plays an important role in human emotions and psychopathology. The insula is particularly involved in neural processes underlying iA. However, iA-related neural activity in the insula during the acute state of major depressive disorder (MDD) and in remission from depression has not been explored.
Methods: A well-established fMRI paradigm for studying interoceptive awareness (iA; heartbeat counting) and exteroceptive awareness (eA; tone counting) was used. Study participants formed three independent groups: patients suffering from MDD, patients in remission from MDD or healthy controls. Task-induced neural activity in three functional subdivisions of the insula was compared between these groups.
Results: Depressed participants showed neural hypo-responses during iA in anterior insula regions, as compared to both healthy and remitted participants. The right dorsal anterior insula showed the strongest response to iA across all participant groups. In depressed participants there was no differentiation between different stimuli types in this region (i.e., between iA, eA and noTask). Healthy and remitted participants in contrast showed clear activity differences.
Conclusions: This is the first study comparing iA and eA-related activity in the insula in depressed participants to that in healthy and remitted individuals. The preliminary results suggest that these groups differ in there being hypo-responses across insula regions in the depressed participants, whilst healthy participants and patients in remission from MDD show the same neural activity during iA in insula subregions implying a possible state marker for MDD. The lack of activity differences between different stimulus types in the depressed group may account for their symptoms of altered external and internal focus.
The processing of nonverbal auditory stimuli has not yet been sufficiently investigated in patients with aphasia. On the basis of a duration discrimination task, we examined whether patients with left-sided cerebrovascular lesions were able to perceive time differences in the scale of approximately 150ms. Further linguistic and memory-related tasks were used to characterize more exactly the relationships in the performances between auditory nonverbal task and selective linguistic or mnemonic disturbances. All examined conduction aphasics showed increased thresholds in the duration discrimination task. The low thresholds on this task were in a strong correlative relation to the reduced performances in repetition and working memory task. This was interpreted as an indication of a pronounced disturbance in integrating auditory verbal information into a long-term window (sampling disturbance) resulting in an additional load of working memory. In order to determine the lesion topography of patients with sampling disturbances, the anatomical and psychophysical data were correlated on the basis of a voxelwise statistical approach. It was found that tissue damage extending through the insula, the posterior superior temporal gyrus, and the supramarginal gyrus causes impairments in sequencing of time-sensitive information.
Finger-based numerical representations have gained increasing research interest. However, their description and assessment often refer to different numerical principles of ordinality, cardinality and 1-to-1 correspondence. Our aim was to investigate similarities and differences between these principles in finger-based numerical representations. Sixty-eight healthy adults performed ordinal finger counting, cardinal finger montring (showing the number of gestures) and finger-to-number mapping with twisted arms and fingers. We found that counting gestures and montring postures were identical for Number 10 but differed to varying degrees for other numbers. Interestingly, there was no systematic relation between finger-to-number mapping and ordinal finger counting habits. These data question the assumption of a unitary embodied finger-based numerical representation, but suggest that different finger-based representations co-exist and can be recruited flexibly depending on the numerical aspects to be conveyed.
Prosody and information status in typological perspective - Introduction to the Special Issue
(2015)
This paper reports the results of a production experiment that explores the prosodic realization of focus in Hungarian, a language that is characterized by obligatory syntactic focus marking. Our study investigates narrow focus in sentences in which focus is unambiguously marked by syntactic means, comparing it to broad focus sentences. Potential independent effects of the salience (textual givenness) of the background of the narrow focus and the contrastiveness of the focus are controlled for and are also examined.
The results show that both continuous phonetic measures and categorical factors such as the distribution of contour types are affected by the focus-related factors, despite the presence of syntactic focus marking. The phonetic effects found are mostly parallel to those of typical prosodic focus marking languages like English. The prosodic prominence required of focus is realized through changes to the scaling and slope of F0 targets and contours. The asymmetric prominence relation between the focus and the background can be expressed not only by the phonetic marking of the prominence of the focused element, but also by the phonetic marking of the reduced prominence of the background. Furthermore, contrastiveness of focus and (textual) givenness of the background show independent phonetic effects, both of them affecting the realization of the background. These results are argued to shed light on alternative approaches to the information structural notion of contrastive focus and the relation between the notions of focus and givenness. (C) 2014 Elsevier B.V. All rights reserved.
Accentual preferences and predictability: An acceptability study on split intransitivity in German
(2015)
The difference in the default prosodic realization of simple sentences with unergative vs. unaccusative/passive verbs (assigning early nuclear accent with unaccusative/passive verbs but late nuclear accent with unergative verbs) is often related to the syntactic distinction of their nominative arguments as starting off in different hierarchical positions. Alternative accounts try to trace this prosodic variation back to asymmetries in the semantic or pragmatic contribution of the verb to an utterance. The present article investigates the interaction of the assignment of default nuclear accent with the predictability of the verb. In an experimental study testing the acceptability of nuclear accent assignment, we confirmed that the predictability of the verb influences accentual preferences (such that highly predictable verbs are preferably not accented). However, the experiment also reveals that the unaccusativity distinction cannot be accounted for by means of pragmatic phenomena of this type: the two verb classes are associated with distinct accentual patterns in the baseline condition, that is, without the predictability manipulation. (C) 2014 Elsevier B.V. All rights reserved.