Klaus Willmes

Background: Creating a holistic picture of children and youth who suffer from acquired aphasia or another (developmental) language disorders is very difficult due to missing diagnostic instruments covering participation. Szenario-Kids is a new diagnostic instrument to measure multimodal communication abilities in everyday life situations of children and youth aged 6 to 16 years. Aims: We aimed to examine feasibility and psychometric properties of the model-based Szenario-Kids in the healthy population, to build the basis for later test evaluation in the language-impaired patient group. Method: Szenario-Kids was administered to n  =  57 children and youth without communication deficits (mean age 9.16 years; German as native language). The diagnostic instrument was presented twice within two weeks, complemented by standardized diagnostic instruments to cover all communication modalities and enable correlation of performance between tests. Results: Data analysis showed good practicability, satisfying parallelism of test versions A and B ( p  =  .098-.845), acceptable to excellent reliability (Cronbach's α  =  .781-.920) and high interrater reliability ( ICC  =  .733-.960), very strong test-retest correlation ( r  =  .736-.893) and moderate to strong concurrent validity ( r  =  -.475-.611; p ≤ .01). Conclusions: The analysis of feasibility and psychometric properties revealed promising results for the group without communication deficits. Neurolinguistic underpinnings can be explained within our Multimodal Communication Model (MCM). Thus, the evaluation of Szenario-Kids in language-impaired children and youth is a next step.

ZusammenfassungHintergrundLaborparameter haben einen hohen Stellenwert in der Differenzialdiagnostik akuter Bewusstseinsstörungen. Zur Unterscheidung zwischen generalisierten tonisch-klonischen Anfällen (GTKA) und Synkopen als Ursache einer akuten Bewusstseinsstörung können Serumlaktat- und Serumkreatinkinase(CK)-Konzentrationen wertvolle Hinweise liefern.MethodikBei Patienten mit klinisch eindeutigen GTKA (n = 30) und klinisch eindeutigen Synkopen (n = 15) wurden die Serumlaktatkonzentrationen bei Aufnahme sowie die CK-Konzentrationen 10–48 h nach der zur Aufnahme führenden Episode verglichen. Zusätzlich wurde deren Sensitivität und Spezifität als diagnostische Indikatoren für die Unterscheidung zwischen einer Synkope und einem GTKA bestimmt.ErgebnisseDie Serumlaktat- und Serum-CK-Konzentrationen waren bei GTKA-Patienten gegenüber Synkopen-Patienten signifikant erhöht (Serumlaktat: p < 0,001; Serum-CK: p < 0,005). In der ROC(„receiver operating characteristic“)-Analyse ergab sich für den Serumlaktatwert als Indikator für einen GTKA eine AUC („area under the curve“) von 0,94 (95 %-Konfidenzintervall [KI]: 0,88–1,0). Für die Serum-CK ergab sich eine AUC von 0,77 (95 %-KI: 0,63–0,9).DiskussionDie Laktatwertbestimmung als Point-of-care-Diagnostik hat eine hohe Relevanz bei der zeitnahen Abklärung unklarer Bewusstseinsstörungen. Die CK ist ebenfalls geeignet, um einen generalisierten tonisch-klonischen Anfall von einer Synkope zu unterscheiden, ist dem Serumlaktatwert jedoch in der Diskriminationsfähigkeit unterlegen.AbstractBackgroundLaboratory parameters can help in the differential diagnostics of acute episodes of transient loss of consciousness. Especially serum lactate and serum creatine kinase (CK) levels may provide valuable hints to distinguish generalized tonic-clonic seizures (GTCS) from syncope.Material and methodsSerum lactate levels at admission and CK levels 10–48 h after the episodes that led to admission were compared between patients with GTCS (n = 30) and those with syncope (n = 15). In addition, sensitivity and specificity of lactate and CK as diagnostic markers for syncope and GTCS were determined.ResultsThe serum lactate and serum CK levels were significantly increased in patients with GTCS as compared to syncope patients (serum lactate: p < 0.001; CK: p < 0.005). The area under the curve (AUC) for serum lactate as an indicator for GTCS was 0.94 (95% confidence interval [CI] 0.88–1.0). For CK the receiver operating characteristics (ROC) analysis produced an AUC of only 0.77 (95% CI: 0.63–0.9).ConclusionThe determination of the lactate value as point-of-care diagnostics appears to be highly relevant in the rapid clarification of unclear episodes with transient loss of consciousness. The CK level at follow-up is also suitable for distinguishing GTCS from syncope but is inferior to the serum lactate value.

The aim of the present study was to examine the interplay of morphological configuration switching and language switching. The morphological configuration is present in word-formation whenever a word contains more than one free morpheme. The morphological configuration is variable both within and between languages for example in two-digit number names (is the decade named first as in twenty-one or the unit named first as in seventeen) and in compound words (is the modifier or the head named first). In the present experiments, participants had to switch between morphological configurations and between languages (German, English, and Spanish). Language-switch cost was measured as the performance difference between language-switch trials and language-repetition trials. In Experiments 1 and 2, participants performed language-comprehension tasks on two-digit numbers and a language-production task on compound words in Experiment 3. All three experiments revealed an under-additive switch cost pattern in which a larger language-switch cost occurred in morphological configuration-repetition trials than in morphological configuration-switch trials. Thus, the present data indicate integration of the morphological configuration and language into one language-related schema-irrespective of the language task (comprehension vs. production) and the type of stimuli (number words vs. compound nouns). (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The aim of this study was to examine language switching in a two-digit number naming task. In contrast to single digits, two-digit numbers have a composition rule (i.e., morphological configuration) that may differ between languages. For example, the Arabic number 21 is read with an inverted composition rule in German (unit before decade) and a non-inverted composition rule in English (decade before unit). In the present experiment, one group of German native speakers and one group of Spanish native speakers had to name two-digit numbers in German, English, or Spanish. The results demonstrate a language-switch cost, revealing better performance in language repetition than in language-switch trials. This switch cost was further modulated by repeating or switching the composition rule, since the language repetition benefit (i.e., the switch cost) was reduced in trials with composition-rule switches compared with trials with composition-rule repetitions. This finding indicates that the...

Apraxia of speech is a motor speech disorder that occurs after lesions to the left cerebral hemisphere, most often concomitant with aphasia. It requires specific approaches in the study of its physiological and neuroanatomical basis and special expertise in clinical care. Knowing its prevalence in patients with aphasia after stroke is therefore relevant for planning specific resources in clinical research and in health care provision. Systematic studies of the frequency of this condition are lacking. We examined the frequency of apraxia of speech in a representative sample of 156 patients with chronic post-stroke aphasia. Three experts classified the patients' speech by best-practice auditory-perceptual methods. Bayesian hierarchical models were fitted to obtain probability distributions for prevalence estimates. A prior distribution was calculated in two steps, including Bayesian models for published frequency data (step 1) and prevalence estimates from experienced clinicians (step 2). Separate models were fitted for different severity ranges. Overall, a prevalence rate of .44 [.30, .58] was obtained. When only moderate and severe cases were taken into account, the rate was .35 [.23, .49]. After a further restriction to only severe impairment, prevalence dropped to .22 [.12, .34]. Patients identified with apraxia of speech had suffered more severe strokes according to clinical criteria and had more severe aphasias. The presence of apraxia of speech was predicted by the articulation/prosody and syntax rating scales of the Aachen Aphasia Test. Lower prevalence estimates published earlier are probably biased by low sensitivity of assessment instruments for mild speech impairment.

In a previous functional magnetic resonance imaging (fMRI) study with normal subjects, we demonstrated regions related to conceptual-semantic word processing around the first frontal sulcus (BA 9) and the posterior parietal lobe (BA 7/40) in agreement with several previous reports. We had the possibility, using the same fMRI paradigm, to study two consecutive cases with left middle cerebral artery (MCA) infarction (RC and HP) and lesions affecting either solely the pre-frontal (HP) or both the pre-frontal and posterior parietal part of the network activated in normal subjects (RC). Both patients showed transcortical sensory aphasia (TSA) on acute assessment. This contradicts classical disconnection accounts of the syndrome stating intact conceptual representations in TSA. Their recovery of language comprehension was associated with activation of a left hemispheric network. Mainly activations of left perilesional pre-frontal regions (RC), left Wernicke's area (RC and HP) or the left posterior middle and inferior temporal cortex (HP) were demonstrated in the TSA patients. The latter findings suggest that in our cases of TSA functional take-over has occurred in regions with related functions ('redundancy recovery') rather than in previously unrelated areas ('vicarious functioning'). Our data support distributed models of conceptual-semantic word processing and multiple left hemispheric representations of closely related functions.

Only recently the focus in numerical cognition research has considered multi-digit number processing as a relatively new and yet understudied domain in mathematical cognition. In this chapter: (i) we argue that single-digit number processing is not sufficient to understand multi-digit number processing; (ii) provide an overview on which representations and effects have been investigated for multi-digit numbers; (iii) suggest a conceptual distinction between place-identification, place-value activation, and place-value computation; (iv) identify language influences on multi-digit number processing along that conceptual distinction; and (v) argue that for numerical development indices of multi-digit number processing may be more suitable predictors of later arithmetical performance than classical single-digit measure such as the distance effect or non-numerical variables (e.g., working memory). In the final section, we summarize the important issues in multi-digit number processing, outline future directions and try to encourage readers to contribute to a new, exciting, yet understudied domain of numerical cognition.

ABSTRACT Background: Re-learning of lexical entries is fundamental to rehabilitation of the common word finding deficits in language disorders after brain damage. Previous studies examined and compared neural correlates of speech production and word learning in aphasic and healthy speakers, but longitudinal control studies were rarely set out to mimic the lexical confusion and therapeutic remediation in aphasia. Aims: Thus, we aimed to examine functional brain organisation before (familiar word naming), during (learning phase) and after (consolidation phase) standardised training of speech production modulated by aphasia therapy. Methods & Procedures: During the first functional magnetic resonance imaging (fMRI) measurement, participants were asked to name pictures using familiar words; during learning and in the consolidation phase, they were asked to name pictures using newly acquired pseudowords. To examine differential involvement of brain areas dependent on learning and consolidation success, we followed up activations for finally correctly learned (CoL) items between fMRI measurements, and compared activation during naming of CoL versus finally not learned (NoL) items at each measurement. Outcomes & Results: Naming accuracy of participants improved significantly. Although performance increase until the second fMRI measurement was minor, brain activation was present for CoL in comparison to NoL items in right hemisphere homologues of fronto-temporal language-related areas in this phase. Comparing learning with consolidation phases for pseudowords, naming CoL items was accompanied by activation in areas related to monitoring and selection between multiple lexical competitors, and in the right posterior middle temporal gyrus. Conversely, activation specific to the consolidation phase, and also to CoL items in that phase, consisted of a widely distributed network involving areas associated with motor, language and consolidation processes. Activation in right supramarginal and left superior temporal gyrus was related to individual learning success. Conclusions: We were able to demonstrate phase- and performance-dependent activation differences in various areas of the speech production network, which were in part correlated with learning success. The observed similarities to therapy-induced activation changes in aphasia reveal that the novel paradigm is useful in mimicking therapy and may uncover compensatory mechanisms specific to aphasia.

Two implicit generalizations are often made from group-level studies in experimental psychology and their common statistical analysis in the general linear model: (1) Group-level phenomena are assumed to be present in every participant with every variation between participants being random error; (2) phenomena are assumed to be stable over time. In this preregistered study, we investigated the validity of these two generalizations for the SNARC effect (Spatial-Numerical Association of Response Codes, i.e., faster left-/right-sided responses to small/large magnitude numbers, respectively; Dehaene et al., 1993). 10 participants performed the parity judgment task on 30 out of 40 consecutive days. We replicated the group-level SNARC effect when all data were collapsed, suggesting validity of the study. However, the effect was reliably present in only four or five of 10 participants, which reflects the proportions reported in the literature. Crucially, intraindividual variations of the S...

Supplemental material, Contreras_Saavedra,_Willmes,_Koch,_Schuch,_Benini,_and_Philipp._AppendixR3 for Multilingual two-digit number naming: The influence of composition rules on language switching by Carla E Contreras-Saavedra, Klaus Willmes, Iring Koch, Stefanie Schuch, Elena Benini and Andrea M Philipp in Quarterly Journal of Experimental Psychology

The Abbreviated Math Anxiety Scale (AMAS) is one of the most popular instruments measuring math anxiety (MA). It has been validated across several linguistic and cultural contexts. In this study, we investigated the extent of administration method invariance of the AMAS by comparing results (average scores, reliabilities, factorial structure) obtained online with those from paper-and-pencil. We administered the online version of the AMAS to Polish students. Results indicate that psychometric properties of the AMAS do not differ between online and paper-and-pencil administration. Additionally, average scores of the AMAS did not differ considerably between administration forms, contrary to previous results showing that computerized measurement of MA leads to higher scores. Therefore, our results provide evidence for the usefulness of the AMAS as a reliable and valid MA measurement tool for online research and online screening purposes across cultures and also large similarity between ...