Results of VNeST Therapy in Transcortical Sensory Aphasia: A Case Study

Amaç: Afazi alt tiplerinin en nadir görülen formları arasında olan transkortikal sensöriyel afazi ağırlıklı olarak adlandırma ve işitsel anlama becerilerinin etkilendiği nörolojik bir sendromdur. Bu çalışmanın amacı, transkortikal sensöriyel afazi bulgularını işaret eden, anadili Türkçe olan bir olguya uygulanan VNeST terapi yönteminin dil, biliş ve yaşam kalitesi üzerindeki sonuçlarını incelemektir. Yöntem: Olguya 10 hafta boyunca haftada 3-3,5 saat olmak üzere VNeST terapi yöntemi uygulanmıştır. Olgunun terapi öncesi ve terapi sonrası dil becerileri Afazi Dil Değerlendirme Testi (ADD); bilişsel becerileri Montreal Bilişsel Değerlendirme Ölçeği (MoCA); yaşam kalitesi İnme ve Afazi Yaşam Kalitesi Ölçeği (SAQOL-39) aracılığı ile değerlendirilmiştir. Bulgular: Olguya uygulanan VNeST terapi yöntemi sonrasında terapi öncesindeki değerlendirme sonuçlarına kıyasla ADD testinin tüm alt alanlarında özellikle de konuşma akıcılığı, işitsel anlama, adlandırma ve okuma becerilerinde artış olduğu görülmüştür. MoCA’da genel puan artışı olmakla birlikte soyut düşünme ve gecikmeli hatırlama bölümlerinde etkilenimin devam ettiği saptanmıştır. VNeST terapi yönteminin kavramsal çerçevesi ile bağdaştığı düşünülerek araştırılan yaşam kalitesinde, özellikle de iletişim alt alanında artış olduğu görülmüştür. Sonuç: Transkortikal sensöriyel afazide VNeST terapi yönteminin dil, biliş ve yaşam kalitesi bulguları üzerinde olumlu etkiler gösterdiği saptanmıştır. Bu çalışma, bir olgu üzerinde uygulanan VNeST’in Türkçe’de uygulamasını göstermekle birlikte bu terapi yönteminin diğer dillerde de uygulanabileceğini desteklemektedir.

Purpose: Transcortical sensory aphasia (TSA) is neurological syndrome which is among the rarest forms of aphasia subtypes. In TSA, naming and auditory comprehension skills are predominantly affected. It is reported in the literatüre that therapy methods aiming to improve word recall skills that focus on picture-word naming may not be successful in the generalization phase. The Verb Network Strengthening Treatment (VNeST) was proposed based on previous studies reporting using VNeST that there is an increase in the lexical output of individuals with aphasia with limited verbal performances, and the semantic network of fluent individuals with aphasia is stronger compared to their previous performances. Following this treatment, it is suggested that the individuals produce sentences, make use of the discourse, and convey what they would like to express in a clearer way. The purpose of this study was to examine the results of VNeST on language, cognition and quality of life, which was implemented on o 45-year old male academician and architect whose native language is Turkish and who showed symptoms of transcortical sensory aphasia. Method: The VNeST therapy method was implemented for 3-3.5 hours per week for 10 weeks. The following tests were utilized: “Language Assessment Test for Aphasia” (ADD) was used to assess language skills. “Montreal Cognitive Assessment Test” (MoCA) was used to evaluate cognitive abilities of the case. “The Stroke and Aphasia Quality of Life Scale-39” (SAQOL-39) was finally administered to evaluate the quality of life of the case. Results: At the end of therapy, it was observed that there was an increase in the performance of the case in the all the sub-tests of the ADD Test, especially in the fluency in speech, auditory comprehension, naming, and reading skills subtests. This increase was observed as the scores of ADD obtained following the VNeST was compared to those of the evaluation carried out prior to conducting the therapy sessions. There was an increase in the general score belonging to MoCA, even though the case still experienced challenges related to the sections entitled abstraction and delayed recall. Considering the theoretical framework of VNeST therapy method, there was an increase in the quality of life of the case, especially in the communication sub-test scores that pertained to the SAQOL-39. Conclusion: Based on the findings of this case study, it was seen that the VNeST therapy method had positive impact on a set of parameters including language, cognition, and quality of life within a case with TSA. In prospective studies, it might be suggested that the VNeST be supported with discouse analysis. Also, the long-term efficiency of VNeST could be examined. This efficiency could also be extended to individuals with other types of aphasia including Wernicke, conduction aphasia and others.