Advantage of semantic language therapy in chronic aphasia: a study of three cases

The aim of this study was to determine the effects of semantically and of phonologically oriented therapies on word-finding recovery in chronic aphasic patients, more than 3 years after their stroke. For this purpose, three patients were selected who differed in their residual difficulties in language processing: the first patient (JHN) showed problems in both semantic and phonological processing, the second patient (GE) showed difficulties predominantly in semantic functions, and the third patient (EG) suffered mainly from difficulties in phonological processing. All three patients underwent two intensive multimodal therapies, one semantically and the other phonologically oriented. Both types of therapy were applied for 1 month, with a break of 2 months between them. Patient JHN, with both semantic and phonological residual difficulties after his left franto-temporo-insular stroke, showed a significant improvement in his naming abilities after semantically-oriented therapy only. Patient GE with semantic residual difficulties after a left capsulo-lenticular stroke responded significantly better to semantic than to phonological therapy. Patient EG, with phonological residual difficulties after a left sylvian anterior stroke did not respond to any therapy. Moreover, after the total therapy sessions, which consisted of both semantic and phonological therapy, the overall improvement in the naming tasks was significant for JHN and GE but not for EG. These results support the view that, in chronic aphasic patients, improvement of language, and specifically of naming abilities, is still possible several years after the stroke. This progress in word finding seems to be more related to improvements in semantic than in phonological abilities, a finding that might be due to the participation of the right hemisphere specific linguistic abilities in language recovery.