Treatment of naming in nonfluent aphasia through manipulation of intention and attention: A phase 1 comparison of two novel treatments B Crosson et al. Journal of the International Neuropsychological Society (2007), 13, 582-594.

Aphasia (language deficits) frequently happen as a result of strokes in the brain’s left hemisphere. Nonfluent aphasia is difficulty initiating and maintaining the flow of spoken output. When word production mechanisms in the left hemisphere are extensively compromised in nonfluent aphasia, evidence indicates the right hemisphere may be more capble than the left in assuming some aspects of word production. BIRC scientists designed an “intention” treatment to better engage right-hemisphere mechanisms in word production. In the intention treatment picture-naming trials were initiated with a complex left-hand movement. The attention treatment involved presenting pictures in left hemispace without complex hand movements during the picture-naming trials. Outcome for the intention treatment was compared to outcome for the attention treatment. In this study thirty-four nonfluent aphasia patients, four or more months post-stroke, were given two picture-naming treatments. Patients were divided into two groups: moderate to severe word-finding impairment (n=23) and profound word-finding impairment (n=11). Both treatments significantly increased naming performance in the moderate to severe word-finding impairment group. Eighty-nine percent (89%) and eighty-four percent (84%) improved significantly during the intention and attention treatments, respectively. Generalization to untrained items was found in both treatments for this group, but more so in the intention treatment. In the profoundly word-finding impaired group 55% and 64% showed significant improvement in the intention and attention treatments, respectively. Patients who improved on either treatment usually showed significant generalization to untrained items. A faster rate of improvement was realized with the intention treatment than with the attention treatment for patients with moderate to severe word finding impairment. Current research endeavors to determine how much the complex left-hand movemnet contributes to relateralization of word production and treatment gains.