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  • 1.
    Blom Johansson, Monica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Östberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Sonnander, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    A multiple-case study of a family-oriented intervention practice in the early rehabilitation phase of persons with aphasia2013In: Aphasiology, ISSN 0268-7038, E-ISSN 1464-5041, Vol. 27, no 2, p. 201-226Article in journal (Refereed)
    Abstract [en]

    Background:

    Having a family member with aphasia severely affects the everyday life of the significant others, resulting in their need for support and information. Family-oriented intervention programmes typically consist of support, information, and skill training, such as communication partner training (CPT). However, because of time constraints and perceived lack of skills and routines, such programmes, especially CPT, are not common practice among speech-language pathologists (SLPs).

    Aims:

    To design and evaluate an early family-oriented intervention of persons with stroke-induced moderate to severe aphasia and their significant others in dyads. The intervention was designed to be flexible to meet the needs of each participant, to emotionally support the significant others and supply them with information needed, to include CPT that is easy to learn and conduct for SLPs, and to be able to provide CPT when the persons with aphasia still have access to SLP services.

    Methods & Procedures:

    An evaluative multiple-case study, involving three dyads, was conducted no more than 2 months after the onset of aphasia. The intervention consisted of six sessions: three sessions directed to the significant other (primarily support and information) and three to the dyad (primarily CPT). The intervention was evaluated both qualitatively and quantitatively based on video recordings of conversations and self-assessment questionnaires.

    Outcomes & Results:

    The importance of emotional support as well as information about stroke/aphasia was clearly acknowledged, especially by the significant others. All significant others perceived increased knowledge and understanding of aphasia and related issues.

    Communicative skills (as manifested in the video recordings) showed improvements from pre- to post-intervention.

    Conclusions:

    The results corroborate the need for individualised and flexible family-oriented SLP services that are broad in content. Furthermore, the results support the early initiation of such services with recurrent contact. The usefulness of CPT this early in the rehabilitation process was indicated but is yet to be proved.

  • 2.
    Blom Johansson, Monica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Östberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Sonnander, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Communication changes and SLP-services according to significant others of persons with aphasia2012In: Aphasiology, ISSN 0268-7038, E-ISSN 1464-5041, Vol. 26, no 8, p. 1005-1028Article in journal (Refereed)
    Abstract [en]

    Background: Significant others are important to persons with aphasia. For several reasons they should be involved in speech-language pathology (SLP) services, including acquiring facilitating communicative strategies and receiving support. In order to further adapt SLP services there is a need to know the perceptions and views of the significant others. Little is known about how they perceive changes in communication as well as received SLP services and in what way they want to be involved in these services.

    Aims: The study aimed to investigate which communicative changes significant others of persons with aphasia had experienced after a stroke event and to what extent these changes were experienced. A further aim was to describe the significant others’ experiences of SLP services and their motivation to participate in these services. Finally, the significant others’ experiences were compared in terms of sex, age, type of relationship, time since stroke onset, and type and severity of aphasia.

    Methods & Procedures: An 80-item study-specific questionnaire was answered by 173 significant others of persons with aphasia living throughout Sweden (response rate 69%). Of these, 33% were male and 67% female. Mean age was 64.2 years (range 33–87 years) and 85.5% of the participants were a cohabiting partner to a person with aphasia.

    Outcomes & Results: A total of 64% of participants perceived their conversations as being less stimulating and enjoyable compared with conversations before stroke onset. Aphasia was considered a substantial or very substantial problem by 64%. The participants took on an increased communicative responsibility, and 70% had changed their communicative behaviour in order to facilitate conversations. A total of 75% (n = 130) had met with the SLP of the person with aphasia. Of those, 63% perceived their own support from SLP services to be adequate; 87% considered language ability training as the most important SLP service. Type and severity of aphasia were especially related to the communicative experiences of the participants and their motivation to be involved in SLP services.

    Conclusions: The substantial decrease from pre- to post-stroke regarding enjoyment and meaningfulness of conversations suggests the need to further improve SLP services in order to help the people in question communicate at an optimal level. We suggest that clinicians should put more emphasis on explaining the benefits and availability of different kinds of aphasia rehabilitation services, such as functional communication training and communication partner training in addition to language ability training.

  • 3. Fernaeus, Sven-Erik
    et al.
    Östberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    The AMQ: a four-factor inventory of absentmindedness and memory2009In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 50, no 3, p. 193-202Article in journal (Refereed)
    Abstract [en]

    The Absentmindedness and Memory Questionnaire (AMQ) is a new self-rating scale designed to evaluate everyday memory problems related to absentmindedness. It includes 24 items and is based on studies of different samples (N= 623). Its test-retest reliability is high and it has consistently shown similar factor structure. The AMQ thus measures four weakly correlated factors: Absentmindedness, Persons, Locations and Codes/Addresses. Factor analysis further indicates that Absentmindedness may include two subfactors: momentary attention deficit and prospective forgetfulness or impaired agenda memory. Gender differences were found in Persons (Female+) and Locations (Male+) but not in Absentmindedness or Codes/Addresses. The current version of AMQ has seven interindividually comparable response alternatives for each item in the questionnaire. This makes it useful as a measure of subjective absentmindedness or forgetfulness as well as a complementary measure of subjective memory for persons, locations, and codes/addresses/stories, especially at follow-up examinations.

  • 4. Fernaeus, Sven-Erik
    et al.
    Östberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Hellström, Åke
    Wahlund, Lars-Olof
    Cut the coda: early fluency intervals predict diagnoses2008In: Cortex, ISSN 0010-9452, E-ISSN 1973-8102, Vol. 44, no 2, p. 161-169Article in journal (Refereed)
    Abstract [en]

    The aim of this study was threefold: (i) to clarify whether letter and category fluency tap different cognitive abilities; (ii) to make diagnostic comparisons and predictions using temporally resolved fluency data; (iii) to challenge and test the widely made assumption that 1-min sum scores are the fluency test measure of choice in the diagnosis of dementia. Scores from six 10-sec intervals of letter and category fluency tests were obtained from 240 participants including cognitive levels ranging from mild subjective cognitive complaints to Alzheimer's disease. Factor analysis revealed clearly separate factors corresponding to letter and category fluency. Category fluency was markedly impaired in Alzheimer's disease but not in Mild Cognitive Impairment. Only scores from relatively early intervals predicted Alzheimer's disease and Mild Cognitive Impairment. The conclusions are (i) letter and category fluency are different tests, category fluency being the best diagnostic predictor; (ii) it would be possible to administer category fluency tests only for 30 sec, because after this point the necessary differential diagnostic information about the patient's word fluency capacity has already been gathered.

  • 5. Lindberg, Olof
    et al.
    Walterfang, Mark
    Looi, Jeffrey C. L.
    Malykhin, Nikolai
    Östberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Zandbelt, Bram
    Styner, Martin
    Paniagua, Beatriz
    Velakoulis, Dennis
    Orndahl, Eva
    Wahlund, Lars-Olof
    Hippocampal Shape Analysis in Alzheimer's Disease and Frontotemporal Lobar Degeneration Subtypes2012In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 30, no 2, p. 355-365Article in journal (Refereed)
    Abstract [en]

    Hippocampal pathology is central to Alzheimer's disease (AD) and other forms of dementia such as frontotemporal lobar degeneration (FTLD). Autopsy studies have shown that certain hippocampal subfields are more vulnerable than others to AD and FTLD pathology, in particular the subiculum and cornu ammonis 1 (CA1). We conducted shape analysis of hippocampi segmented from structural T1 MRI images on clinically diagnosed dementia patients and controls. The subjects included 19 AD and 35 FTLD patients [13 frontotemporal dementia (FTD), 13 semantic dementia (SD), and 9 progressive nonfluent aphasia (PNFA)] and 21 controls. Compared to controls, SD displayed severe atrophy of the whole left hippocampus. PNFA and FTD also displayed atrophy on the left side, restricted to the hippocampal head in FTD. Finally, AD displayed most atrophy in left hippocampal body with relative sparing of the hippocampal head. Consistent with neuropathological studies, most atrophic deformation was found in CA1 and subiculum areas in FTLD and AD.

  • 6. Lindberg, Olof
    et al.
    Östberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Zandbelt, Bram
    Öberg, Johanna
    Zhang, Y
    Andersen, Christian
    Looi, Jeffrey Chee Leong
    Bogdanovic, Nenad
    Wahlund, Lars-Olof
    Cortical morphometric subclassification of frontotemporal lobar degeneration2009In: American Journal of Neuroradiology, ISSN 0195-6108, E-ISSN 1936-959X, Vol. 30, no 6, p. 1233-1239Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND PURPOSE: Frontotemporal lobar degeneration (FTLD) is a primary neurodegenerative disease comprising 3 clinical subtypes: frontotemporal dementia (FTD), semantic dementia (SD), and progressive nonfluent aphasia (PNFA). The subdivision is primarily based on the characteristic clinical symptoms displayed by each subtype. We hypothesized that these symptoms would be correlated to characteristic patterns of brain atrophy, which could be indentified and used for subclassification of subjects with FTLD.

    MATERIALS AND METHODS: Volumes of 9 cortical regions were manually parcellated and measured on both hemispheres on 27 controls, 12 patients with FTD, 9 patients with PNFA, and 13 patients with SD. The volumetric data were analyzed by traditional t tests and by a multivariate discriminant analysis (partial least squares discriminant analysis).

    RESULTS: The ensemble or pattern of atrophy was a good discriminator in pair-wise comparison between the subtypes: FTD compared with SD (sensitivity 100% [12/12], specificity 100% [13/13]); FTD compared with PNFA (sensitivity 92% [11/12], specificity 89% [8/9]); and SD compared with PNFA (sensitivity 86% [11/13], specificity 100% [9/9]). Temporal-versus-frontal atrophy was the most important pattern for discriminating SD from the other 2 subtypes. Right-sided versus left-sided atrophy was the most important pattern for discriminating between subjects with FTD and PNFA.

    CONCLUSIONS: FTLD subtypes generally display a characteristic pattern of atrophy, which may be considered in diagnosing patients with FTLD.

  • 7. Looi Chee Leong, Jeffrey
    et al.
    Lindberg, Olof
    Zandbelt, Bram
    Östberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Andersen, Christian
    Botes, Lisa
    Svensson, Leif
    Wahlund, Lars-Olof
    Caudate nucleus volumes in frontotemporal lobar degeneration: differential atrophy in subtypes2008In: American Journal of Neuroradiology, ISSN 0195-6108, E-ISSN 1936-959X, Vol. 29, no 8, p. 1537-1543Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND PURPOSE: Frontostriatal circuits involving the caudate nucleus have been implicated in frontotemporal lobar degeneration (FTLD). We assessed caudate nucleus volumetrics in FTLD and subtypes: frontotemporal dementia (FTD, n = 12), semantic dementia (SD, n = 13), and progressive nonfluent aphasia (PNFA, n = 9) in comparison with healthy controls (n = 27) and subjects with Alzheimer disease (AD, n = 19).

    MATERIALS AND METHODS: Diagnoses were based on accepted clinical criteria. Manual volume measurement of the head and body of the caudate, excluding the tail, was conducted on T1-weighted brain MR imaging scans, using a published protocol, by a single analyst blinded to the diagnosis.

    RESULTS: Paired t tests (P < .05) showed that the right caudate nucleus volume was significantly larger than the left in controls and PNFA. No hemispheric asymmetry was found in AD, ETD, and SD. Across the groups, there was a positive partial correlation between the left caudate nucleus volume and Mini-Mental State Examination (MMSE) scores (r = 0.393, n = 76, P = .001) with higher left caudate volumes associated with higher MMSE scores. Multivariate analysis of covariance was used to assess the statistical significance between the subject groups (AD, ETD, SD, PNFA, and controls) as independent variables and raw right/left caudate volumes at the within-subject level (covariates: age and intracranial volume; P < .05). Control volume was largest, followed by AD (93% of control volume), SD (92%), PNFA (79%), and ETD (75%).

    CONCLUSIONS: Volume of the head and body of the caudate nucleus differs in subtypes of FTLD, due to differential frontostriatal dysfunction in subtypes being reflected in structural change in the caudate, and is correlated with cognition

  • 8. Looi, JC
    et al.
    Svensson, L
    Lindberg, O
    Zandbelt, BB
    Östberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Örndahl, E
    Wahlund, L-O
    Putaminal volume in frontotemporal lobar degeneration and Alzheimer disease: differential volumes in dementia subtypes and controls2009In: American Journal of Neuroradiology, ISSN 0195-6108, E-ISSN 1936-959X, Vol. 30, no 8, p. 1552-1560Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND PURPOSE: Frontostriatal (including the putamen) circuit-mediated cognitive dysfunction has been implicated in frontotemporal lobar degeneration (FTLD), but not in Alzheimer disease (AD) or healthy aging. We sought to assess putaminal volume as a measure of the structural basis of relative frontostriatal dysfunction in these groups. MATERIALS AND METHODS: We measured putaminal volume in FTLD subtypes: frontotemporal dementia (FTD, n = 12), semantic dementia (SD, n = 13), and progressive nonfluent aphasia (PNFA, n = 9) in comparison with healthy controls (n = 25) and patients with AD (n = 18). Diagnoses were based on accepted clinical criteria. We conducted manual volume measurement of the putamen blinded to the diagnosis on T1 brain MR imaging by using a standardized protocol. RESULTS: Paired t tests (P < .05) showed that the left putaminal volume was significantly larger than the right in all groups combined. Multivariate analysis of covariance with a Bonferroni correction was used to assess statistical significance among the subject groups (AD, FTD, SD, PNFA, and controls) as independent variables and right/left putaminal volumes as dependent variables (covariates, age and intracranial volume; P < .05). The right putamen in FTD was significantly smaller than in AD and controls; whereas in SD, it was smaller compared with controls with a trend toward being smaller than in AD. There was also a trend toward the putamen in the PNFA being smaller than that in controls and in patients with AD. Across the groups, there was a positive partial correlation between putaminal volume and Mini-Mental State Examination (MMSE). CONCLUSIONS: Right putaminal volume was significantly smaller in FTD, the FTLD subtype with the greatest expected frontostriatal dysfunction; whereas in SD and PNFA, it showed a trend towards being smaller, consistent with expectation, compared to controls and AD; and in SD, compared with AD and controls. Putaminal volume weakly correlated with MMSE.

  • 9. Looi, Jefferey Chee Leong
    et al.
    Walterfang, Mark
    Styner, Martin
    Svensson, Leif
    Lindberg, Olof
    Karolinska institutet.
    Östberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Botes, Lisa
    Örndahl, Eeva
    Chua, Phyllis
    Kumar, Rajeev
    Velakoulis, Dennis
    Wahlund, Lars-Olof
    Shape analysis of the neostriatum in frontotemporal lobar degeneration, Alzheimer's disease, and controls2010In: NeuroImage, ISSN 1053-8119, E-ISSN 1095-9572, Vol. 51, no 3, p. 970-986Article in journal (Refereed)
    Abstract [en]

    Background and purpose: Frontostriatal circuit mediated cognitive dysfunction has been implicated in frontotemporal lobar degeneration (FTLD), but not Alzheimer's disease, or healthy aging. We measured the neostriatum (caudate nucleus and putamen) volume in FTLD (n=34), in comparison with controls (n=27) and Alzheimer's disease (AD, n=19) subjects.

    Methods: Diagnoses were based on international consensus criteria. Manual bilateral segmentation of the caudate nucleus and putamen was conducted blind to diagnosis by a single analyst, on MRI scans using a standardized protocol. Intra-cranial volume was calculated via a stereological point counting technique and was used for scaling the shape analysis. The manual segmentation binaries were analyzed using UNC Shape Analysis tools (University of North Carolina) to perform comparisons among FTLD, AD, and controls for global shape, local p-value significance maps, and mean magnitude of shape displacement.

    Results: Shape analysis revealed that there was significant shape difference between FTLD, AD, and controls, consistent with the predicted frontostriatal dysfunction and of significant magnitude, as measured by displacement maps. There was a lateralized difference in shape for the left caudate for FTLD compared to AD; non-specific global atrophy in AD compared to controls; while FTLD showed a more specific pattern in regions relaying fronto- and corticostriatal circuits.

    Conclusions: Shape analysis shows regional specificity of atrophy, manifest as shape deflation, with implications for frontostriatal and corticostriatal motoric circuits, in FTLD, AD, and controls.

  • 10. Looi, Jeffrey Chee Leong
    et al.
    Walterfang, Mark
    Styner, Martin
    Niethammer, Marc
    Svensson, Leif Anders
    Lindberg, Olof
    Östberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Botes, Lisa
    Örndahl, Eva
    Chua, Phyllis
    Velakoulis, Dennis
    Wahlund, Lars-Olof
    Shape analysis of the neostriatum in subtypes of frontotemporal lobar degeneration: neuroanatomically significant regional morphologic change2011In: Psychiatry Research: Neuroimaging, ISSN 0925-4927, E-ISSN 1872-7506, Vol. 191, no 2, p. 98-111Article in journal (Refereed)
    Abstract [en]

    Frontostriatal circuit mediated cognitive dysfunction has been implicated in frontotemporal lobar degeneration (FTLD) and may differ across subtypes of FTLD. We manually segmented the neostriatum (caudate nucleus and putamen) in FTLD subtypes: behavioral variant frontotemporal dementia, FTD, n=12; semantic dementia, SD, n=13; and progressive non-fluent aphasia, PNFA, n=9); in comparison with controls (n=27). Diagnoses were based on international consensus criteria. Manual bilateral segmentation of the caudate nucleus and putamen was conducted blind to diagnosis by a single analyst, on MRI scans using a standardized protocol. Intracranial volume was calculated via a stereological point counting technique and was used for normalizing the shape analysis. Segmented binaries were analyzed using the Spherical Harmonic (SPHARM) Shape Analysis tools (University of North Carolina) to perform comparisons between FTLD subtypes and controls for global shape difference, local significance maps and mean magnitude maps of shape displacement. Shape analysis revealed that there was significant shape difference between FTLD subtypes and controls, consistent with the predicted frontostriatal dysfunction and of significant magnitude, as measured by displacement maps. These differences were not significant for SD compared to controls; lesser for PNFA compared to controls; whilst FTD showed a more specific pattern in regions relaying fronto- and corticostriatal circuits. Shape analysis shows regional specificity of atrophy, manifest as shape deflation, with a differential between FTLD subtypes, compared to controls.

  • 11. Tallberg, Ing-Mari
    et al.
    Ivachova, Ekaterina
    Jones Tinghag, Karin
    Östberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Swedish norms for word fluency tests: FAS, animals and verbs2008In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 49, no 5, p. 479-485Article in journal (Refereed)
    Abstract [en]

    Verbal fluency tests are useful measures of acquired language impairment and cognitive decline of various etiologies. The aim of this study was to provide normative data for the Swedish population on the three verbal fluency tests, FAS, Animals and Verbs. A group of 165 healthy participants ranging from 16 to 89 years of age were assessed with the verbal fluency tests and tests of level of intellectual functioning. The sample was stratified by education, age and gender. Level of education had a substantial influence on the performance on verbal fluency, most clearly so in FAS and Verbs. Intellectual level had a positive and significant correlation with all measures of word fluency. Moreover, there was an interaction between age and gender such that women aged between 30 and 64 years outperformed elderly men on FAS and Verbs. Guidelines for instructions and scoring in Swedish are given in the article.

  • 12.
    Östberg, Per
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Bogdanovic, Nenad
    Semantic dementia with lower motor neuron disease showing FTLD-TDP type 3 pathology (sensu Mackenzie)2011In: Neuropathology (Kyoto. 1993), ISSN 0919-6544, E-ISSN 1440-1789, Vol. 31, no 3, p. 271-279Article in journal (Refereed)
    Abstract [en]

    We describe a case of frontotemporal lobar degeneration with semantic dementia and lower motor neuron disease. A 63-year-old man presented with the full clinical picture of semantic dementia, including semantic anomia, surface alexia, lexical agraphia, associative agnosia, prosopagnosia and phonagnosia. Flaccid dysarthria, bulbar dysphagia and fasciculations developed 7 years after onset, followed by death within a year. The neuropathological examination showed heavy neuronal loss in the anterior temporal lobe cortex, dorsal vagal and hypoglossal nuclei and anterior horns of the spinal cord. Ubiquitin- and TDP-43-positive cytoplasmic inclusions were abundant in layer II of affected cortices and in granular cells of the hippocampal dentate gyrus, whereas dystrophic neurites were sparse and intranuclear inclusions absent. It is concluded that FTLD-TDP type 3 can be associated with semantic dementia and lower motor neuron disease in combination.

  • 13.
    Östberg, Per
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Bogdanovic, Nenad
    Karolinska institutet.
    Wahlund, Lars-Olof
    Karolinska institutet.
    Articulatory agility in cognitive decline2009In: Folia Phoniatrica et Logopaedica, ISSN 1021-7762, E-ISSN 1421-9972, Vol. 61, no 5, p. 269-274Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Motor speech disorders are believed to be uncommon in early Alzheimer's disease (AD). However, data from maximum performance tests of motor speech function in AD and related disorders are virtually nonexistent. The aim of this study was to make such data available. MATERIALS AND METHODS: Sequential speech motion rate was analyzed in 236 memory clinic patients with different levels of cognitive functioning. RESULTS: Sequential speech motion rate was moderately but significantly decreased in mild dementia in AD. About 10% of AD and mild cognitive impairment cases had markedly decreased rates. Rates were strongly reduced in progressive nonfluent aphasia, whereas semantic dementia did not differ from subjective cognitive impairment. Frontotemporal dementia had lower rates than AD. CONCLUSIONS: A proportion of patients with cognitive decline has markedly reduced articulatory agility. The cause of this reduction in some patients with mild cognitive impairment and mild AD is unknown. Semantic dementia is not associated with impaired articulatory agility.

  • 14.
    Östberg, Per
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Crinelli, Raffaella
    Danielsson, Rimma
    Wahlund, Lars-Olof
    Bogdanovic, Nenad
    Fernaeus, Sven-Erik
    A temporal lobe factor in verb fluency2007In: Cortex, ISSN 0010-9452, E-ISSN 1973-8102, Vol. 43, no 5, p. 607-615Article in journal (Refereed)
    Abstract [en]

    Verb fluency requires self-sustained verb retrieval. The brain correlates of this task are virtually unknown. We investigated the relations between verb and noun (semantic) fluency and regional brain perfusion in subjects with varying degrees of cognitive decline, ranging from very mild subjective impairment to Alzheimer's disease (AD). Data consisted of single-photon emission computed tomography (SPECT) data and temporally resolved verb and noun fluency scores from 93 participants. Impaired verb fluency was predicted by a temporal lobe hypoperfusion factor and low education, whereas high age and low perfusion in the parietotemporal-occipital region predicted impaired noun fluency. Analysis of perfusion within the temporal region indicated primary involvement of the temporal pole and medial temporal lobe in AD. This might reflect pathology of the anterior parahippocampal region, which appears early in neurodegenerative disease. Although temporal lobe structures have not usually been implicated in verb processing, early temporal pathology thus appears to contribute to impaired verb fluency in cognitive decline.

  • 15.
    Östberg, Per
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Fernaeus, Sven-Erik
    Bogdanovic, Nenad
    Wahlund, Lars-Olof
    Word sequence production in cognitive decline: forward ever, backward never2008In: Logopedics, Phoniatrics, Vocology, ISSN 1401-5439, E-ISSN 1651-2022, Vol. 33, no 3, p. 126-135Article in journal (Refereed)
    Abstract [en]

    Backward recall of automatic word sequences involves declarative and working memory abilities known to be impaired in the early stages of cognitive decline. Yet its utility in the diagnosis of mild cognitive impairment and mild dementia has not been studied in detail. We analysed word sequence production in 234 participants drawn from three categories: subjective cognitive impairment, mild cognitive impairment, and mild dementia in Alzheimer's disease. The names of the months were used as a diagnostic target for investigating forward versus backward sequence production. Forward production remained normal across categories. In contrast, backward speed was significantly decreased in mild cognitive impairment. In dementia both speed and accuracy were impaired. Backward production had significant diagnostic classificatory power. We conclude that word sequence production yields data relevant to the diagnosis of dementia with a minimum of time and expense.

  • 16.
    Östberg, Per
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Hansson, Viktoria
    Häägg, Sofia
    Adult norms and test-retest reliability for the Months Backward test: Durational and response accuracy measures2012In: Logopedics, Phoniatrics, Vocology, ISSN 1401-5439, E-ISSN 1651-2022, Vol. 37, no 1, p. 11-17Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to present adult norms and to estimate the test-retest reliability for durational and response accuracy measures on the word sequence production test, Months Backward. A total of 216 neurologically intact adults (aged 18-88) stratified by sex, age, and education took the test at maximum speed. Errors and speech duration were recorded. A retest was conducted with 40 participants after 3 weeks. Altogether 94% of the participants completed the test without error. Errors were associated with slow performance. Duration was predicted by years of education (beta = -0.39) and self-reported dyslexia (beta = 0.19). The test-retest reliability was 0.82 for duration and 0.97 for errors. A regression formula for adjustment of logarithmically transformed duration scores is provided.

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