A systematic review of verb production training in agrammatic Broca's aphasia

Year 2025, Volume: 7 Issue: 4, 478 - 484, 28.07.2025

Zeynep Başer

https://doi.org/10.38053/acmj.1708276

Abstract

Aims: This systematic review investigates the effectiveness of verb production training in individuals with agrammatic Broca’s aphasia. It highlights verb retrieval and verb inflection treatments, evaluating their impact on naming accuracy, sentence production, and generalization. The ultimate goal of the present study is to systematically review and evaluate the effectiveness of verb production training methods—including both verb retrieval and verb inflection interventions—for improving communication outcomes in patients with agrammatic Broca’s aphasia.
Methods: This review followed the PRISMA 2020 guidelines. Four databases (PubMed, Medline/EBSCOhost, Web of Science, and Google Scholar) were searched using PICO-based terms. Inclusion criteria consisted of peer-reviewed articles in English which exclusively focused on verb production training in agrammatic Broca’s aphasia with measurable outcomes. Exclusion criteria included studies on other aphasia types, non-intervention papers, and non-English or unavailable full texts. After removing duplicates and screening 1461 records, ten studies met the eligibility criteria.
Results: Of the ten studies included, six focused on verb retrieval treatments and four on verb inflection treatment. Interventions varied widely, including semantic, gestural, and repetition-based methods for verb retrieval and morphosemantic and morphophonological treatments for verb inflection. While verb retrieval treatments improved naming of trained verbs, generalization to untrained items was inconsistent. Morphosemantic approaches to verb inflection outperformed morphophonological treatments and had broader generalization and improvements in narrative tasks, particularly with regular verb training. Overall, participant response varied depending on the nature of the impairment and treatment modality.
Conclusion: Verb production training is effective in improving targeted linguistic abilities in agrammatic Broca’s aphasia, particularly when approaches are tailored to individual deficits. Morphosemantic and multimodal interventions demonstrate promising results. However, limited generalization to untrained contexts remains a key challenge, highlighting the need for future therapies that integrate semantic, syntactic, and real-life communicative components.

Keywords

Broca’s aphasia , verb production , the PRISMA 2020 , language disorders , aphasia treatment

Ethical Statement

The study was carried out without involvement of any animate beings. Hence, an ethics committee approval was not required. All steps were carried out in conformity with the ethical guidelines and principles outlined in the Declaration of Helsinki.

Agramatik Broca afazisinde fiil üretimi eğitiminin sistematik bir incelemesi

Abstract

Aims: This systematic review investigates the effectiveness of verb production training in individuals with agrammatic Broca’s aphasia. It highlights verb retrieval and verb inflection treatments, evaluating their impact on naming accuracy, sentence production, and generalization. The ultimate goal of the present study is to systematically review and evaluate the effectiveness of verb production training methods—including both verb retrieval and verb inflection interventions—for improving communication outcomes in patients with agrammatic Broca’s aphasia.
Methods: This review followed the PRISMA 2020 guidelines. Four databases (PubMed, Medline/EBSCOhost, Web of Science, and Google Scholar) were searched using PICO-based terms. Inclusion criteria consisted of peer-reviewed articles in English which exclusively focused on verb production training in agrammatic Broca’s aphasia with measurable outcomes. Exclusion criteria included studies on other aphasia types, non-intervention papers, and non-English or unavailable full texts. After removing duplicates and screening 1461 records, ten studies met the eligibility criteria.
Results: Of the ten studies included, six focused on verb retrieval treatments and four on verb inflection treatment. Interventions varied widely, including semantic, gestural, and repetition-based methods for verb retrieval and morphosemantic and morphophonological treatments for verb inflection. While verb retrieval treatments improved naming of trained verbs, generalization to untrained items was inconsistent. Morphosemantic approaches to verb inflection outperformed morphophonological treatments and had broader generalization and improvements in narrative tasks, particularly with regular verb training. Overall, participant response varied depending on the nature of the impairment and treatment modality.
Conclusion: Verb production training is effective in improving targeted linguistic abilities in agrammatic Broca’s aphasia, particularly when approaches are tailored to individual deficits. Morphosemantic and multimodal interventions demonstrate promising results. However, limited generalization to untrained contexts remains a key challenge, highlighting the need for future therapies that integrate semantic, syntactic, and real-life communicative components.

Keywords

Broca’s aphasia , verb production , the PRISMA 2020 , language disorders , aphasia treatment

References

• Harris JD, Quatman CE, Manring MM, Siston RA, Flanigan DC. How to write a systematic review. Am J Sports Med. 2014;42(11):2761-2768. doi:10.1177/0363546513497567
• Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. doi:10.1371/journal.pmed. 1000097
• Rose M, Sussmilch G. The effects of semantic and gesture treatments on verb retrieval and verb use in aphasia. Aphasiology. 2008;22(7-8):691-706. doi:10.1080/02687030701800800
• Links P, Hurkmans J, Bastiaanse R. Training verb and sentence production in agrammatic Broca’s aphasia. Aphasiology. 2010;24(11): 1303-1325. doi:10.1080/02687030903437666
• Faroqi-Shah Y, Friedman L. Production of verb tense in agrammatic aphasia: a meta-analysis and further data. Behav Neurol. 2015;2015(1): 983870. doi:10.1155/2015/983870
• Le H, Lui F, Lui MY. Aphasia. In: StatPearls. StatPearls Publishing; 2025. Accessed May 19, 2025. http://www.ncbi.nlm.nih.gov/books/NBK 559315/
• Hallowell B. Aphasia and other acquired neurogenic language disorders: a guide for clinical excellence [First Edition. Second Edition (2023) Available].; 2017.
• Menn L. Agrammatic aphasia. John Benjamins Publishing Company Accessed January 11, 2025. https://benjamins.com/catalog/z.39
• Saffran EM, Schwartz MF, Marin OSM. The word order problem in agrammatism: II. production. Brain Lang. 1980;10(2):263-280. doi:10. 1016/0093-934X(80)90056-5
• Kim M, Thompson CK. Patterns of comprehension and production of nouns and verbs in agrammatism: implications for lexical organization. Brain Lang. 2000;74(1):1-25. doi:10.1006/brln.2000.2315
• Caramazza A, Capitani E, Rey A, Berndt RS. Agrammatic Broca’s aphasia is not associated with a single pattern of comprehension performance. Brain Lang. 2001;76(2):158-184. doi:10.1006/brln.1999.2275
• Thompson CK, Lee M. Psych verb production and comprehension in agrammatic Broca’s aphasia. J Neurolinguistics. 2009;22(4):354-369. doi: 10.1016/j.jneuroling.2008.11.003
• Bastiaanse R. Production of verbs in base position by Dutch agrammatic speakers: inflection versus finiteness. J Neurolinguistics. 2008;21(2):104-119. doi:10.1016/j.jneuroling.2006.10.006
• Rossi E, Bastiaanse R. Spontaneous speech in Italian agrammatic aphasia: a focus on verb production. Aphasiology. 2008;22(4):347-362. doi:10.1080/02687030701407093
• Milman LH, Dickey MW, Thompson CK. A psychometric analysis of functional category production in English agrammatic narratives. Brain Lang. 2008;105(1):18-31. doi:10.1016/j.bandl.2007.12.008
• Valinejad V, Mehri A, Khatoonabadi A, et al. Treatment of verb tense inflection and sentence production in Persian individuals with agrammatism. Appl Neuropsychol Adult. 2024:1-15. doi:10.1080/23279095. 2023.2297085
• Kurada HZ, Aydın Ö, Köse A. Production of time reference in Turkish Broca’s aphasia: the effect of morphological complexity. Clin Linguist Phon. 2022;36(10):887-903. doi:10.1080/02699206.2021.1963319
• Bastiaanse R, Thompson CK. Verb and auxiliary movement in agrammatic Broca’s aphasia. Brain Lang. 2003;84(2):286-305. doi:10. 1016/s0093-934x(02)00553-9
• Bastiaanse R, Rispens J, Ruigendijk E, Rabadaán OJ, Thompson CK. Verbs: some properties and their consequences for agrammatic Broca’s aphasia. J Neurolinguistics. 2002;15(3-5):239-264. doi:10.1016/S0911-6044(01)00032-X
• Adam H. Verb and noun production in aphasia: evidence from Palestinian Arabic. Int J Brain Cogn Sci. 2014;3(1):1-5.
• Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372: n71. doi:10.1136/bmj.n71
• Hosseini MS, Jahanshahlou F, Akbarzadeh MA, Zarei M, Vaez-Gharamaleki Y. Formulating research questions for evidence-based studies. J Med Surg Public Health. 2024;2:100046. doi:10.1016/j.glmedi. 2023.100046
• Dashti F, Asadi M, Yadegari F. The effect of morphosemantic treatment on verb-tense inflection in persian-speaking patients with agrammatism: a case report. Middle East J Rehabil Health. 2018;In Press (In Press). doi:10.5812/mejrh.80072
• Faroqi-Shah Y. A comparison of two theoretically driven treatments for verb inflection deficits in aphasia. Neuropsychologia. 2008;46(13):3088-3100. doi:10.1016/j.neuropsychologia.2008.06.018
• Bailey DJ, Bunker L, Wambaugh JL. Feasibility of an abstract verb naming treatment for aphasia. Aphasiology. 2024;38(7):1303-1329. doi:10.1080/02687038.2023.2279180
• Kim M, Adingono MF, Revoir JS. Argument structure enhanced verb naming treatment: two case studies. Contemp Issues Commun Sci Disord. 2007;34(Spring):24-36. doi:10.1044/cicsd_34_S_24
• Faroqi-Shah Y, and Graham LE. Treatment of semantic verb classes in aphasia: acquisition and generalization effects. Clin Linguist Phon. 2011; 25(5):399-418. doi:10.3109/02699206.2010.545964
• Boo M, Rose ML. The efficacy of repetition, semantic, and gesture treatments for verb retrieval and use in Broca’s aphasia. Aphasiology. 2011;25(2):154-175. doi:10.1080/02687031003743789
• Rose M. Examining the potency of verb retrieval treatments in aphasia: the components matter-a pilot study. 2010. Accessed May 18, 2025. https://aphasiology.pitt.edu/2098/
• Dashti F, Asadi M, Yadegari F. Morphosemantic treatment of inflection of verb tense in Persian-speaking aphasic patients with agrammatism: a single-subject study. Aphasiology. 2023;37(2):288-306. doi:10.1080/02687038. 2021.2010272
• Faroqi-Shah Y. Selective treatment of regular versus irregular verbs in agrammatic aphasia: efficacy data. Aphasiology. 2013;27(6):678-705. doi: 10.1080/02687038.2012.751577