Regaining Language in Aphasia Patients

 The outcome of aphasiac brain damage can seem debilitating to patients as their range of communication abilities is reduced. Depending on the extent of damage, and the area affected, there are treatments that can be employed to restore language abilities, either partially or completely.

The most commonly employed treatment process is speech and language therapy (SLT) and involves the patient working with a therapist on a series of exercises specially tailored to the type of aphasia damage. For patients who struggle to understand the meaning of words, activities, such as pairing words to pictures, or sorting words into groups based on their meaning, may be suggested, to redevelop word association knowledge and definition memory. If the trouble stems from a difficulty in expressing oneself coherently, a therapist may employ tasks in which the patient must name what they see in a picture, or judge whether or not words rhyme with one another. On top of working in one-on-one sessions with a speech therapist, often specially-designed computer programmes are used, alongside group speech sessions in order to improve conversational abilities.

Under circumstances where speech abilities are not restored to a functional level, speech therapists may work with the patient to develop alternative methods of communication. These may be in the form of gestural language, drawing or writing, or communication charts, where the patient has a grid of words or letters and can point to them to convey what they want to say.

While SLT is the most common form of therapy, research is also ongoing into medications and brain stimulation therapies. Certain drugs are being analyzed for their affects on aphasia symptoms, such as bifemelane, which has been noted for its abilities to increase circulation of blood in the brain, while others are being tested for increasing the brain's ability to recover and repair itself, and to help raise levels of depleted chemicals in the brain. Transcranial magnetic stimulation also holds promise, a technique that involves placing an electromagnet on the scalp and briefly sending an electromagnetic current through it to affected areas of the brain to re-stimulate activity in them.

Many of these alternative theories are still in the trial phase and so, currently, SLT is the most effective and widely used treatment. The prognosis of aphasia treatments can be difficult to predict, as it is heavily influenced by how severe the damage was, and also how healthy the brain was pre-injury. Recovery attempts are more likely to be successful in younger patients and are more effective the sooner they are started. Improvements in language and communication are most prominent in the first six months after the injury, however, this does not mean that recovery is impossible after this stage, with improvements still possible after several years in some cases.  

How does insomnia affect the body?

 Anyone who has had a sleepless night can attest to the fact that they don't feel 100% the next day. However, could lack of sleep be having more effect on the body than just leaving a feeling of tiredness?

The brain is the part of the body that is more dramatically affected by insomnia, and many of its everyday functions are inhibited by insufficient rest. While tests have shown that short-term memory on the whole is unaffected by insomnia, those who suffer from it may have a less active working memory, the part of short-term memory involved with processing and storing information and applying it to a task. fMRI scans showed that those with insomnia had lower activity levels in brain regions involved with this working memory compared with control subjects. As well as impacting everyday thinking, lack of sleep can also result in a slowing of mental processes, reduced concentration and, in cases of extreme sleep deprivation, can restrict the transformation of short-term term memories into long-term memory. As well as reducing the efficienct of the brain, a state of prolonged wakefulness means that activity levels of the emotion-processing part of the brain, the amygdala, rise. This increased activity can cause insomniacs to experience higher levels of frustration and anger throughout the day

Over time sleep deprivation can begin to affect hormonal processes, which can further impact sleep quality. Secretions of the stress hormone cortisol rise, resulting in higher levels of anxiety and a faster heart rate. During normal sleep, a hormone is secreted which suppresses feelings of hunger. When sleep is reduced there is more time for the body to produce ghrelin, the hunger hormone, meaning insomnia patients experience heightened appetite. In order to quickly boost energy levels, the body craves foods with a high sugar or salt content, resulting in an observed link between insomnia and obesity.

As sleep cycles become irregular the body's circadian rhythm is affected, meaning that those suffering from too little sleep are likely to experience more erratic peaks and troughs in their energy levels. It is normal to experience a period of lethargy during the day, however, for insomniacs this period is prolonged, making it harder for them to stay awake in the afternoon. At the other extreme, insomniacs may experience stretches of feeling excessively alert, as they become focussed on the pressures of the day and heart rate and adrenaline levels are maintained at a high level.

In the long term, long periods of limited sleep can have drastic effects on the body and a person's performance during activities. If insomnia persists it is important to see a doctor, who can provide advice or medicinal aid for returning to a normal sleeping pattern, giving the body time to repair and relax.

Sleep Science – The Mechanisms Behind Insomnia

 Everyone is prone to a sleepless night or two, brought on by excitement or stress. However, for some, lack of sleep can last for weeks, sometimes months. Sustained sleep-deprivation is something that is estimated to affect between 20% and 50% of adults. Much work has gone into researching not only how to cure insomnia but also what the mechanisms are that cause it.

The 3 P's of Insomnia

A popular explanation for this sleep disorder looks at three key factors – predisposition, precipitation, and perpetuation. Advocates of the 3-P Model believe that insomniacs have certain characteristics, such as being naturally anxious or being perfectionists, that make them more susceptible to sleep problems. This predisposition, combined with a precipitating event, such as a death of a loved one or job stress, can affect sleep resulting in a period of acute insomnia (short-term sleep loss). The third facet of this model is that anxiety about, and poor attitudes towards, sleep will perpetuate the symptoms of insomnia. This is because, the more uneasiness a sufferer feels about falling asleep, the more active their brain will be, resulting in them actually staying awake for longer.

The Cognitive Processes of Sleeplessness

This idea of perceptions of how one will sleep feeds into the Cognitive Model of insomnia, an idea put forward over ten years ago. The simple concept is that those suffering from insomnia worry about their sleep and what will happen if they don't get enough. These thoughts actually trigger emotional stress and brain activity which causes the individual to search themselves and their surroundings for factors that could interrupt their sleep, such as noise, light, or discomfort. In the process of focussing on these things they actually bring themselves back into a state of full wakefulness, as the brain isn't allowed to wind down. By actively focussing on the act of falling sleep, insomniacs delay it, by maintaining the brain in a state of awareness.

The Brain Chemistry of Insomniacs

Related to the Cognitive Model, but taking a more in depth stance, the Neurocognitive Model of sleep deprivation explores how brain activity may differ between those with regular sleeping patterns and those without. Scientists have observed that those suffering from acute insomnia actually have higher levels of electrical activity in the brain than those who don't suffer sleep problems. The result of this could be that insomnia sufferers may have higher sensory or information processing activity during times when those with regular sleeping patterns don't. This could have drastic effects on a person's ability to fall asleep, as they are more aware of what is happening around them.

The role physiological factors has been more thoroughly researched, as it has come to be believed that insomniacs may have innate characteristics that affect how easily their sleep is disrupted by both external and psychological factors. Elevated levels of brain metabolism have been observed in studies of insomniacs, making it harder for them to switch off at night. Furthermore, it has been seen that patients with insomnia secrete less melatonin at night, the hormone responsible for making us feel tired. This, combined with the observed increased levels of norepinephrine, a hormone similar to adrenaline, in insomniacs have the debilitating effect of making it much harder to fall asleep.

Thankfully, as insomnia becomes better understood, more techniques and medical interventions are being developed to cure it.

Tips to keep your brain young and healthy

Changes in our brain functions are a very common consequence of ageing and mental decline may be one of the most feared results of getting old. According to research more than 16 million people in the United States suffer from cognitive impairment, which means they have trouble remembering, focusing or even learning new things.

If you are noticing some of the early symptoms of cognitive impairment such as forgetting appointments and recent events or having trouble making sound decisions here are a few tips to keep your brain healthy and young.

Exercise

Physical exercise can help the brain become more efficient and adaptive to change.  According to Harvard Medical School “research shows that using your muscles may also help your mind. (…) Exercise lowers blood pressure, improves cholesterol levels, fights diabetes, and reduces mental stress, all of which can help your brain as well as your heart.” Exercising 3 times per week is a great way to start.

Eat healthy

A healthy diet can help both your body and mind. Eating foods that are low in saturated fat and keeping your calorie intake balanced will keep your brain younger. Also, vitamins B6, B12 and folic acid, which can be found in cereals and grains have proved to reduce homocysteine levels that are linked to cognitive impairment.

Mental Exercise

Engage in activities that challenge and stimulate your brain. Try solving math problems or crosswords, painting, or learning a new craft or language.

Socialize 

By having friends and going out, you are open to new experiences and challenges. They are also a great motivation when it comes to getting involved in several activities.

Avoid tobacco, alcohol and other drugs

Excessive abuse of tobacco, alcohol and other drugs can reduce your ability to remember, focus or execute tasks.

Keep your emotions balanced

Even though extreme anxiety and depression are not linked to cognitive impairment, it is always beneficial for your metal health to keep your emotions balanced.

Maintain social connections

 Constant communication and interaction with others is very important in maintaining social connections. The ability to bond with others over a period of time is associated with lower blood pressure and better mental health.  

Avoid injuries

Head injuries such as concussions can affect your brain’s activity while getting older. Reduce the risk by protecting your head.

These are just some simple tips and tricks to help your brain stay young and healthy. They are easy to incorporate in your everyday life, and will also improve your physical and mental health.