Papers by Jessica Richardson
Frontiers in Human Neuroscience, Oct 13, 2022
Background: Persistent posttraumatic symptoms (PPS) may manifest after a mild-moderate traumatic ... more Background: Persistent posttraumatic symptoms (PPS) may manifest after a mild-moderate traumatic brain injury (mmTBI) even when standard brain imaging appears normal. Transcranial direct current stimulation (tDCS) represents a promising treatment that may ameliorate pathophysiological processes contributing to PPS. Objective/Hypothesis: We hypothesized that in a mmTBI population, active tDCS combined with training would result in greater improvement in executive functions and post-TBI cognitive symptoms and increased resting state connectivity of the stimulated region, i.e., left dorsolateral prefrontal cortex (DLPFC) compared to control tDCS. Methods: Thirty-four subjects with mmTBI underwent baseline assessments of demographics, symptoms, and cognitive function as well as resting state functional magnetic resonance imaging (rsfMRI) in a subset of patients (n = 24). Primary outcome measures included NIH EXAMINER composite scores, and the Neurobehavioral Symptom Inventory (NSI). All participants received 10 daily sessions of 30 min of executive function training coupled with active or control tDCS (2 mA, anode F3, cathode right deltoid). Imaging and assessments were re-obtained after the final training session, and assessments were repeated after 1 month. Mixed-models linear regression Frontiers in Human Neuroscience 01 frontiersin.org Quinn et al. 10.3389/fnhum.2022.1026639 and repeated measures analyses of variance were calculated for main effects and interactions. Results: Both active and control groups demonstrated improvements in executive function (EXAMINER composite: p < 0.001) and posttraumatic symptoms (NSI cognitive: p = 0.01) from baseline to 1 month. Active anodal tDCS was associated with greater improvements in working memory reaction time compared to control (p = 0.007). Reaction time improvement correlated significantly with the degree of connectivity change between the right DLPFC and the left anterior insula (p = 0.02). Anodal tDCS improved reaction time on an online working memory task in a mmTBI population, and decreased connectivity between executive network and salience network nodes. These findings generate important hypotheses for the mechanism of recovery from PPS after mild-moderate TBI.
Participation in aphasia therapy generally results in positive outcomes. Constraint-induced aphas... more Participation in aphasia therapy generally results in positive outcomes. Constraint-induced aphasia therapy (CIAT) researchers in particular make bold claims about the efficacy of the approach, but pervasive methodological problems throughout the literature detract from the impact of those claims. The study reported in this dissertation was designed to determine the effect of CIAT on standardized measures of language ability, functional communication, and quality of life. In addition, continuous assessment of dependent variables occurred to ensure that improvements in naming and discourse behaviors could be attributed to CIAT and not to other extraneous factors. Six adults with aphasia participated in this modified single-subject, multiplebaseline across individuals design consisting of a baseline, treatment, and maintenance phase. Results provide the new information that the CIAT protocol utilized in this study resulted in a reduction in activity and participation limitations. Furthermore, this study demonstrated the effect of CIAT on naming of trained items and on untrained discourse tasks though the stability criteria used in this study did not prevent the occurrence of accelerating trends in baseline data and therefore reduces the impact of these claims. Results also supply needed information about treatment elements and preliminary information about dosage that will serve as a platform for future research. Suggestions for future research geared towards refining aphasia treatment are provided.
The aims of this project were to accurately measure and describe speech characteristics of profes... more The aims of this project were to accurately measure and describe speech characteristics of professional fighters; and to analyze the future potential of using speech characteristics as biomarkers for acquired neurogenic decline or chronic traumatic encephalopathy (CTE). The Professional Fighters Brain Health Study (PFBHS) is a longitudinal project investigating the effect of repeated head trauma in professional combatants. The PFBHS provided recorded speech samples for this project. This study measured accurate speech characteristics of 102 professional boxers and mixed martial artists and compared these results to a group of 27 age-matched healthy controls. Analysis revealed a significant difference in articulation rate between fighters and controls. Additionally, fighters produced more frequent interruptions in the forward flow of speech such as pauses and disfluencies. Clinical implications of this project include a better understanding of the speech symptoms associated with acquired neurogenic decline, or CTE. v TABLE OF CONTENTS CHAPTER 1: INTRODUCTION ………………………………………………………… 1 Motor speech features in boxers ……………………………………………………… 2 Motor speech disorders associated with RHI lesion sites …………………………… 3 Description and focus of this project …………………………………………………. 4 CHAPTER 2: PARTICIPANTS AND PROCEDURES ………………………….…….. Participants ……………………………………………………………………………. Stimuli ………………………………………………………………………………….. Acoustic Measures …………………………………………………………………….. Reliability ……………………………………………………………………………… Statistical Analyses …………………………………………………………………….
Journal of Speech Language and Hearing Research, Mar 14, 2023
Purpose: During motor speech examinations for suspected apraxia of speech (AOS), clients are rout... more Purpose: During motor speech examinations for suspected apraxia of speech (AOS), clients are routinely asked to repeat words several times sequentially. The purpose of this study was to understand the task in terms of the relationship among consecutive attempts. We asked to what extent phonemic accuracy changes across trials and whether the change is predicted by AOS diagnosis and sound production severity. Method: One hundred thirty-three participants were assigned to four diagnostic groups based on quantitative metrics (aphasia plus AOS, aphasia-only, and aphasia with two borderline speech profiles). Each participant produced four multisyllabic words 5 times consecutively. These productions were audio-recorded and transcribed phonetically and then summarized as the proportion of target phonemes that was produced accurately. Nonparametric statistics were used to analyze percent change in accuracy from the first to the last production based on diagnostic group and a broad measure of speech sound accuracy. Results: Accuracy on the repeated words deteriorated across trials for all groups, showing reduced accuracy from the first to the last repetition for 62% of participants. Although diagnostic groups differed on the broad measure of speech sound accuracy, severity classification based on this measure did not determine degree of deterioration on the repeated words task. Discussion: Responding to a request to say multisyllabic words 5 times sequentially is challenging for people with aphasia with and without AOS, and as such, performance is prone to errors even with mild impairment. For most, the task does not encourage self-correction. Instead, it promotes errors, regardless of diagnosis, and is, therefore, useful for screening purposes.
Stroke, Mar 1, 2011
Background and Purpose-Previous evidence suggests that anodal transcranial direct current stimula... more Background and Purpose-Previous evidence suggests that anodal transcranial direct current stimulation (A-tDCS) applied to the left hemisphere can improve aphasic participants' ability to name common objects. The current study further examined this issue in a more tightly controlled experiment in participants with fluent aphasia. Methods-We examined the effect of A-tDCS on reaction time during overt picture naming in 8 chronic stroke participants. Anode electrode placement targeted perilesional brain regions that showed the greatest activation on a pretreatment functional MRI scan administered during overt picture naming with the reference cathode electrode placed on the contralateral forehead. A-tDCS (1 mA; 20-minute) was compared with sham tDCS (S-tDCS) in a crossover design. Participants received 10 sessions of computerized anomia treatment; 5 sessions included A-tDCS and 5 included S-tDCS. Results-Coupling A-tDCS with behavioral language treatment reduced reaction time during naming of trained items immediately posttreatment (Zϭ1.96, Pϭ0.025) and at subsequent testing 3 weeks later (Zϭ2.52, Pϭ0.006). Conclusions-A-tDCS administered during language treatment decreased processing time during picture naming by fluent aphasic participants. Additional studies combining A-tDCS, an inexpensive method with no reported serious side effects, with behavioral language therapy are recommended. (Stroke. 2011;42:819-821.
Carolina Digital Repository (University of North Carolina at Chapel Hill), 2017
Purpose: We sought to characterize articulatory distortions in apraxia of speech and aphasia with... more Purpose: We sought to characterize articulatory distortions in apraxia of speech and aphasia with phonemic paraphasia and to evaluate the diagnostic validity of error frequency of distortion and distorted substitution in differentiating between these disorders. Method: Study participants were 66 people with speech sound production difficulties after left-hemisphere stroke or trauma. They were divided into 2 groups on the basis of word syllable duration, which served as an external criterion for speaking rate in multisyllabic words and an index of likely speech diagnosis. Narrow phonetic transcriptions were completed for audio-recorded clinical motor speech evaluations, using 29 diacritic marks. Results: Partial voicing and altered vowel tongue placement were common in both groups, and changes in consonant manner and place were also observed. The group with longer word syllable duration produced significantly more distortion and distorted-substitution errors than did the group with shorter word syllable duration, but variations were distributed on a performance continuum that overlapped substantially between groups. Conclusions: Segment distortions in focal left-hemisphere lesions can be captured with a customized set of diacritic marks. Frequencies of distortions and distorted substitutions are valid diagnostic criteria for apraxia of speech, but further development of quantitative criteria and dynamic performance profiles is necessary for clinical utility.
Brain Stimulation, 2017
Background: A 2006 trial in healthy students found that anodal tDCS delivered bi-frontally during... more Background: A 2006 trial in healthy students found that anodal tDCS delivered bi-frontally during slow wave sleep enhanced declarative memory. Although there have been supporting animal studies and similar findings in pathological groups, this study has not been replicated in the intervening years. We therefore tested these earlier results for replication using similar methods with the exception of current waveform. Methods: Twelve healthy students underwent either active or sham tDCS. Active stimulation consisted of oscillating square wave tDCS delivered during early Non-Rapid Eye Movement (NREM) sleep. Anodes placed bi-frontally at F3/F4 EEG positions, and cathodes placed at mastoids. Current density was 0.517 mA/CM2, stimulation frequency was 0.75 Hz. Stimulation occurred during five, fiveminute blocks with one-minute inter-stimulation intervals. The primary outcomes were both declarative memory consolidation measured by a paired word association test (PWA), and non-declarative memory, measured by a non-dominant finger-tapping test (FTT). We also recorded and analyzed sleep EEG. Results: There was no difference in the number of paired word associations remembered after sleep [(active = 3.1 ± 3.0SD increase; sham = 3.8 ± 3.1S.D increase)]. Finger tapping improved mathematically but not significantly more following active stimulation (3.6 ± 2.7 S.D.) than sham stimulation (2.3 ± 2.2 S.D.). Conclusion: This study failed to find improvements in declarative or performance memory and could not replicate an earlier study using nearly identical settings. Specifically there was no beneficial effect on either overnight declarative or non-declarative memory consolidation via square-wave oscillating tDCS intervention applied bi-frontally during early NREM sleep. This suggests waveform may be critical to memory related improvements.
Currently there is a gap in the literature in understanding the relationship between the newly ca... more Currently there is a gap in the literature in understanding the relationship between the newly categorized primary outcome measure of discourse and secondary outcomes related to psychosocial impact, such as participation, psychological impact, social well-being, or mood. In a large sample of persons with stroke-induced aphasia (N=115), this study analyzed discourse samples using main concept analysis to determine how discourse performance correlates with the secondary outcome measures ALA, CCRSA, GDS, and CIQ. As a secondary research question, the differences in these relationships dependent on severity was also explored. Results showed statistically significant positive correlations between main concepts (MCs) and ALA (overall), CCRSA, and CIQ (overall), with effect sizes ranging from weak to moderate strength. This study provides novel insights into the relationship between the newly categorized primary outcome measure of discourse and secondary outcomes related to psychosocial im...
Brain Stimulation, 2019
produced deeper activation that was more symmetric with reversal of coil orientation. Conclusion:... more produced deeper activation that was more symmetric with reversal of coil orientation. Conclusion: These results suggest PA and AP stimulation activate different neuronal populations, which may explain differences in motor thresholds, as well as in latencies of motor-evoked potentials recorded in hand muscles. By combining realistic models of neuronal dynamics and E-field distributions, our model allows quantification of the effects of various pulse waveforms, coil or electrode configurations, and individual head anatomies on the neural response to TMS.
Journal of Speech, Language, and Hearing Research
Purpose: During motor speech examinations for suspected apraxia of speech (AOS), clients are rout... more Purpose: During motor speech examinations for suspected apraxia of speech (AOS), clients are routinely asked to repeat words several times sequentially. The purpose of this study was to understand the task in terms of the relationship among consecutive attempts. We asked to what extent phonemic accuracy changes across trials and whether the change is predicted by AOS diagnosis and sound production severity. Method: One hundred thirty-three participants were assigned to four diagnostic groups based on quantitative metrics (aphasia plus AOS, aphasia-only, and aphasia with two borderline speech profiles). Each participant produced four multisyllabic words 5 times consecutively. These productions were audio-recorded and transcribed phonetically and then summarized as the proportion of target phonemes that was produced accurately. Nonparametric statistics were used to analyze percent change in accuracy from the first to the last production based on diagnostic group and a broad measure of...
Handbook of Clinical Neurology, 2022
This chapter is written for the qualified neurologist or related professional working with person... more This chapter is written for the qualified neurologist or related professional working with persons who have had a stroke or other sudden brain injury. It is critical that the presence of aphasia is detected, no matter how mild the presentation, and to support that assertion, this chapter highlights the plight of persons with latent aphasia. At the individual level, the impact of aphasia is devastating, with overwhelming evidence that aphasia negatively impacts psychosocial outcomes. At the global level, sensitive detection and accurate diagnosis of aphasia are critical for accurate characterization and quantification of the global burden of aphasia. The word "LANGUAGE" is leveraged as an acronym to create a useful and memorable checklist to guide navigation of aphasia screening and assessment: it begins with the definition of language (L), followed by the definition and diagnostic criteria for aphasia (A). Then language abilities and characteristics to be considered in assessment are presented: naming (N); grammar and syntax (G); unintelligible words, jargon, and paraphasias (U); auditory comprehension and repetition (A); graphemic abilities-reading and writing (G); and everyday communication and discourse (E). Recommendations for improving procedural adherence are provided, and a list of potential brief assessment measures are introduced.
Brain Injury, 2019
Primary Objective: To investigate the nature and patterns of narrative discourse impairment in pe... more Primary Objective: To investigate the nature and patterns of narrative discourse impairment in people with severe Traumatic Brain Injury (TBI) during early recovery. Methods and Procedures: A single image picture description task was administered to 42 participants with severe TBI at 3 and 6-months post-injury. The same task was administered to 37 control participants. Discourse samples were analyzed with measures of productivity, informativeness and story organization. The performance of people with TBI was compared with the control group at both 3 and 6 months, and the performance of the participants with TBI was also compared across the two time points. Individual patterns of performance were also examined. Results: Inferential analyses revealed significant differences between the control group and the group with TBI on informativeness at both time points and number of complete episodes at 3 months, but no significant differences for productivity measures. There was no significant change for the group with TBI between 3 and 6 months. However, individual improvement over time was observed. Conclusions: People with TBI have discourse difficulties early post TBI that are also present at 6-months post-injury. In order to understand longer-term discourse recovery, it is necessary to examine participant patterns over further time points on this narrative task.
<b>Purpose: </b>The purposes of this study are to provide clinicians and researchers ... more <b>Purpose: </b>The purposes of this study are to provide clinicians and researchers with introductory psychometric data for the main concept analysis (MCA), a measure of discourse informativeness, and specifically, to provide descriptive and comparative statistical information about the performance of a large sample of persons not brain injured (PNBIs) and persons with aphasia (PWAs) on AphasiaBank discourse tasks.<b>Method:</b> Transcripts of 5 semi-spontaneous discourse tasks were retrieved from the AphasiaBank database and scored according to detailed checklists and scoring procedures. Transcripts from 145 PNBIs and 238 PWAs were scored; descriptive statistics, median tests, and effect sizes are reported.<b>Results: </b>PWAs demonstrated overall lower informativeness scores and more frequent production of statements that were inaccurate and/or incomplete. Differences between PNBIs and PWAs were observed for all main concept measures and stories. Comparisons of PNBIs and aphasia subtypes revealed significant differences for all groups, although the pattern of differences and strength of effect sizes varied by group and discourse task.<b>Conclusions:</b> These results may improve the investigative and clinical utility of the MCA by providing descriptive and comparative information for PNBIs and PWAs for standardized discourse tasks that can be reliably scored. The results indicate that the MCA is sensitive to differences in discourse as a result of aphasia.<br><b>Supplemental Material S1.</b> Median tests results comparing all persons with aphasia to all controls for the five discourse tasks.<br><b>Supplemental Material S2.</b> Comparison median tests comparing all individuals not aphasic by Western Aphasia Battery (NABW) to all controls for the five discourse tasks.<br><b>Supplemental Material S3. </b>Comparison median tests comparing all individuals with anomic aphasia to all controls for the five discourse tasks.<br><b>Supplemental Material S4. </b>Comparison median tests comparing all individuals with condu [...]
Brain Sciences, 2021
Recently, a multilevel analytic approach called Main Concept, Sequencing, and Story Grammar (MSSG... more Recently, a multilevel analytic approach called Main Concept, Sequencing, and Story Grammar (MSSG) was presented along with preliminary normative information. MSSG analyses leverage the strong psychometrics and rich procedural knowledge of both main concept analysis and story grammar component coding, complementing it with easy-to-obtain sequencing information for a rich understanding of discourse informativeness and macrostructure. This study is the next critical step for demonstrating the clinical usefulness of MSSG’s six variables (main concept composite, sequencing, main concept+sequencing, essential story grammar components, total episodic components, and episodic complexity) for persons with aphasia (PWAs). We present descriptive statistical information for MSSG variables for a large sample of PWAs and compare their performance to a large sample of persons not brain injured (PNBIs). We observed significant differences between PWAs and PNBIs for all MSSG variables. These differ...
American Journal of Speech-Language Pathology, 2020
Purpose Macrostructural narrative analyses are important clinical measures, revealing age-related... more Purpose Macrostructural narrative analyses are important clinical measures, revealing age-related declines and disorder-related impairments in the accuracy, completeness, logical sequencing, and organization of content. The current study aims to provide preliminary data on typical aging and psychometric evidence supporting multilevel Main Concept, Sequencing, and Story Grammar (MSSG) analyses that capture these aspects of narratives. Method Transcripts of Cinderella narratives for 92 healthy control participants stratified across four age brackets from the online database AphasiaBank were coded by Richardson and Dalton (2016) for main concept (MC) analysis. In the current study, MSSG analyses were completed for (a) logical sequencing, independently and in combination with MC accuracy and completeness (MC + sequencing), and (b) story grammar organization (i.e., inclusion of episodic components and complexity of episodes). Interrater agreement (99%–100%) revealed highly reliable scori...
Frontiers in Human Neuroscience, 2021
We investigated spectral resting-state EEG in persons with chronic stroke-induced aphasia to dete... more We investigated spectral resting-state EEG in persons with chronic stroke-induced aphasia to determine its reliability, sensitivity, and relationship to functional behaviors. Resting-state EEG has not yet been characterized in this population and was selected given the demonstrated potential of resting-state investigations using other neuroimaging techniques to guide clinical decision-making. Controls and persons with chronic stroke-induced aphasia completed two EEG recording sessions, separated by approximately 1 month, as well as behavioral assessments of language, sensorimotor, and cognitive domains. Power in the classic frequency bands (delta, theta, alpha, and beta) was examined via spectral analysis of resting-state EEG data. Results suggest that power in the theta, alpha, and beta bands is reliable for use as a repeated measure. Significantly greater theta and lower beta power was observed in persons with aphasia (PWAs) than controls. Finally, in PWAs theta power negatively c...
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Papers by Jessica Richardson