Publications by authors named "Eleni Peristeri"

15 Publications

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Editorial for Special Issue "Genetic Basis and Epidemiology of Myopathies".

Int J Mol Sci 2021 Feb 22;22(4). Epub 2021 Feb 22.

Department of Neurology, Faculty of Medicine, University of Thessaly, 41100 Larissa, Greece.

We are pleased to announce a Special Issue on the Genetic Basis and Epidemiology of Myopathies. This Special Issue is collecting papers pertaining to various lines of research focusing on the genetic basis and the epidemiology of myopathies. The Guest Editors' note combines the contributing authors' reviews and findings of relevant research, and we hope that future studies on myopathies will attempt to confirm these findings and, additionally, evaluate supplementary phenotypic and histological expressions of myopathies, as well as genetic factors in their pathogenesis.
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http://dx.doi.org/10.3390/ijms22042152DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7926838PMC
February 2021

Interference Resolution in Nonfluent Variant Primary Progressive Aphasia: Evidence From a Picture-Word Interference Task.

Cogn Behav Neurol 2021 Mar 3;34(1):11-25. Epub 2021 Mar 3.

Faculty of Medicine, University of Thessaly, Thessaly, Greece.

Background: Picture-word interference tasks have been used to investigate (a) the time course of lexical access in individuals with primary progressive aphasia (PPA) and (b) how these individuals resolve competition during lexical selection.

Objective: To investigate the time course of Greek-speaking individuals with PPA to produce grammatical gender-marked determiner phrases by examining their picture-naming latencies in the context of distractor words.

Method: Eight individuals with nonfluent variant PPA (nfv-PPA; M age = 62.8 years) and eight cognitively intact controls (M age = 61.1 years) participated in our study. In a picture-word interference task, the study participants named depicted objects by producing determiner + noun sequences. Interference was generated by manipulating the grammatical gender of the depicted objects and distractor words. Two stimulus onset asynchronies were used: +200 ms and +400 ms.

Results: The individuals with nfv-PPA exhibited longer picture-naming latencies than the controls (P = 0.003). The controls exhibited interference from incongruent distractors at both asynchronies (P < 0.001); the individuals with PPA exhibited interference from incongruent distractors only at the +400-ms interval (P = 0.002). The gender-congruency effect was stronger for the individuals with PPA than for the controls at the +400-ms interval (P = 0.05); the opposite pattern was observed at the +200-ms interval (P = 0.024).

Conclusion: Gender interference resolution was abnormal in the individuals with nfv-PPA. The results point to deficits in lexicosyntactic networks that compromised the time course of picture-naming production.
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http://dx.doi.org/10.1097/WNN.0000000000000255DOI Listing
March 2021

Transcranial magnetic stimulation (TMS) and repetitive TMS in multiple sclerosis.

Rev Neurosci 2021 Feb 25. Epub 2021 Feb 25.

Department of Neurology,Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Biopolis, Mezourlo Hill, 41100Larissa, Greece.

Multiple sclerosis (MS) is the most well-known autoimmune disorder of the central nervous system, and constitutes a major cause of disability, especially in young individuals. A wide array of pharmacological treatments is available, but they have often been proven to be ineffective in ameliorating disease symptomatology or slowing disease progress. As such, non-invasive and non-pharmacological techniques have been gaining more ground. Transcranial magnetic stimulation (TMS) utilizes the electric field generated by a magnetic coil to stimulate neurons and has been applied, usually paired with electroencephalography, to study the underlying pathophysiology of MS, and in repetitive trains, in the form of repetitive transcranial magnetic stimulation (rTMS), to induce long-lasting changes in neuronal circuits. In this review, we present the available literature on the application of TMS and rTMS in the context of MS, with an emphasis on its therapeutic potential on various clinical aspects, while also naming the ongoing trials, whose results are anticipated in the future.
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http://dx.doi.org/10.1515/revneuro-2020-0140DOI Listing
February 2021

Effects of executive attention on sentence processing in aphasia.

Aphasiology 2020 31;34(8):943-969. Epub 2019 May 31.

Johns Hopkins University, USA.

Background: In the recent years there has been increasing interest in the effects of attentional control on syntactic comprehension, as measured in garden path sentence resolution. Persons with aphasia (PWA) experience greater penalties in garden path sentences compared to language-unimpaired adults but the origin of this deficit remains a controversial issue. One of the possible deficits has been claimed to be disambiguation of lexical cues in the sentence. However, in languages such as English with little morphological variation this connection is hard to establish. To test this hypothesis we used garden path sentences in a morphologically rich language, Greek, where morphological cues may resolve garden path at the lexical level. We further tested whether domain-general attentional control abilities and in particular shifts in attentional control predict garden path resolution in PWA and age- and education-matched controls.

Aim: This study aimed to determine whether PWA were able to integrate disambiguating morphological (Case) cues while processing garden path sentences. In addition, we tested whether domain-general attentional control and in particular attentional shift from global to local and local to global information (as defined by Navon, 1977) correlates directly with garden path resolution in PWA and healthy controls.

Methods & Procedure: Fifteen participants with non-fluent/agrammatic aphasia along with fifteen age- and education-matched language-unimpaired adults performed an online self-paced reading and grammaticality judgment task that included object/subject ambiguous sentences. Syntactic ambiguity was created by the optional transitivity of verbs, while the garden path effect was resolved by morphological Case. The individuals' executive attention skills were tested through an online non-verbal global-local attention shifting task that measured costs stemming from shifting attention from the global to the local level, and vice versa.

Outcomes & Results: PWA were slower and more erroneous than controls in integrating Case cues to disambiguate garden path sentences as manifested in the self-paced reading and grammaticality judgment task. In the global local task, PWA exhibited greater global-to-local (vs. local-to-global) attention shifting costs, while controls did not exhibit dissociation. In the regression analysis, garden path resolution in PWA was significantly predicted by global-to-local attention shifting costs, while controls' garden path resolution was significantly predicted by local-to-global attention shift costs.

Conclusions: The present study showed for the first time that morphological cues can shed light in sentence comprehension deficits exhibited by PWA. Furthermore, domain-general attentional control abilities were significantly associated with sentence comprehension abilities in both healthy controls and PWA.
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http://dx.doi.org/10.1080/02687038.2019.1622647DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7500515PMC
May 2019

SLC2A3 rs12842 polymorphism and risk for Alzheimer's disease.

Neurol Res 2020 Oct 4;42(10):853-861. Epub 2020 Jul 4.

Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa , Larissa, Greece.

Background: Many studies support the hypothesis that brain glucose dysregulation contributes to neurodegeneration and disease progression. The SLC2A3 gene encodes the Neuronal Glucose Transporter 3 (GLUT3), a critical molecule for glucose transport into the neuron. The GLUT3 rs12842 polymorphism has been associated with an increased risk for attention-deficit/hyperactivity disorder (ADHD). Epidemiological and genetic studies have reported a link between antecedent ADHD and Alzheimer's disease (AD), as both share a dysregulation of brain glucose.

Aim: This study aimed to explore the possible correlation of the SLC2A3 rs12842 polymorphism with susceptibility towards AD.

Methods: We genotyped 327 patients with AD and 327 controls for the GLUT3 rs12842. : Rs12842 was associated with a decreased risk of developing AD in the co-dominant [Odds Ratio (OR) (95% confidence interval (CI) = 0.67 (0.45-0.99)), p = 0.039], dominant [OR (95% CI) = 0.64 (0.44-0.93), p = 0.019] and log-additive modes [OR (95% CI) = 0.65 (0.46-0.91), p = 0.012].

Conclusions: Our results suggest a significant, inverse association between SLC2A3 rs12842 and the risk of AD.
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http://dx.doi.org/10.1080/01616412.2020.1786973DOI Listing
October 2020

Cognitive Deficits in Myopathies.

Int J Mol Sci 2020 May 27;21(11). Epub 2020 May 27.

Department of Neurology, Laboratory of Neurogenetics, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, 41110 Larissa, Greece.

Myopathies represent a wide spectrum of heterogeneous diseases mainly characterized by the abnormal structure or functioning of skeletal muscle. The current paper provides a comprehensive overview of cognitive deficits observed in various myopathies by consulting the main libraries (Pubmed, Scopus and Google Scholar). This review focuses on the causal classification of myopathies and concomitant cognitive deficits. In most studies, cognitive deficits have been found after clinical observations while lesions were also present in brain imaging. Most studies refer to hereditary myopathies, mainly Duchenne muscular dystrophy (DMD), and myotonic dystrophies (MDs); therefore, most of the overview will focus on these subtypes of myopathies. Most recent bibliographical sources have been preferred.
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http://dx.doi.org/10.3390/ijms21113795DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7312055PMC
May 2020

Clinically reliable cognitive decline in relapsing remitting multiple sclerosis: Is it the tip of the iceberg?

Neurol Res 2020 Jul 19;42(7):575-586. Epub 2020 May 19.

Department of Neurology, Laboratory of Neurogenetics, Faculty of Medicine, University of Thessaly, University Hospital of Larissa , Larissa, Greece.

Objectives: Cognitive impairment is common in multiple sclerosis, but the brain MRI correlates in relapsing remitting multiple sclerosis remain controversial. The current study aimed to investigate whether cognitive decline can be predicted by global and/or regional brain atrophy.

Methods: Sixty-three patients with relapsing remitting multiple sclerosis (36 men, mean age 39.9 ± 9.4 years old, mean EDSS 1.4 ± 1.2, mean disease duration 4.9 ± 4.3 years) and 46 healthy controls (21 men, mean age 37.5 ± 10.8 years old) were included. Demographic data were obtained, and a longitudinal neuropsychological and global and regional MRI brain volume assessment was performed.

Results: The patients performed worse than controls in most neuropsychological tests at baseline. The percentage of patients with clinically meaningful cognitive decline ranged from only 0% to 7.9%. Statistically significant volume reduction was found for all MRI measures except for the left accumbens nucleus. Whole or regional brain atrophy ranged from -0.02% to -0.25%, with subcortical structures showing the largest atrophy rates. A total of 22.2% to 93.7% patients showed atrophy across the brain structures assessed volumetrically.

Discussion: It was regional rather than whole-brain changes that significantly predicted cognitive decline for the patients in the tasks that tested processing speed, visuo-spatial and inhibition skills. The overall data suggest that the progression of cognitive impairment in relapsing remitting multiple sclerosis as captured by conventional neuropsychological testing is the tip of the iceberg of neurodegenerative sequelae in the disease. Also, regional volumetric changes are better than whole-brain atrophy at predicting cognitive dysfunction.
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http://dx.doi.org/10.1080/01616412.2020.1761175DOI Listing
July 2020

The impact of bilingualism on the narrative ability and the executive functions of children with autism spectrum disorders.

J Commun Disord 2020 May - Jun;85:105999. Epub 2020 May 3.

Department of Theoretical and Applied Linguistics, University of Cambridge, English Faculty Building, Room TR-11, 9 West Road, CB3 9DP, Cambridge, United Kingdom. Electronic address:

While there is ample evidence that monolingual children with Autism Spectrum Disorders (ASD) face difficulties with narrative story-telling and executive functions (EF), there is considerable uncertainty about how bilingualism impacts these skills in autism. The current study explores the effect of bilingualism on the narrative and EF skills of forty 7-to-12-year-old bilingual and monolingual children with ASD, as well as forty age-matched bilingual and monolingual children of typical development (TD). Narrative production data were elicited using the Edmonton Narrative Norms Instrument (ENNI; Schneider et al., 2005), which was developed to measure narrative production at a microstructural and macrostructural level. The same children were administered two EF tasks, namely, a global-local visual attention task and a 2-back working memory task. In story-telling, bilingual children with ASD achieved higher scores than monolingual children with ASD on story structure complexity and use of adverbial clauses, and they tended to use significantly fewer ambiguous referential forms than their monolingual peers with ASD. In the global-local task, bilingual children with ASD were faster and more accurate in global trials than monolingual children with ASD, who tended to be more susceptible to interference from locally presented information than the other experimental groups. Higher accuracy and faster response times were also observed for bilingual children with ASD in the 2-back task. Further correlation analyses between the story-telling and EF tasks revealed that bilingual children with ASD drew on a broader range of EF in narrative production than their monolingual peers. The overall findings reveal that bilingual children with ASD outperformed their monolingual peers with ASD in both the microstructure and macrostructure of their narrative production, as well as in their visual attention and working memory skills.
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http://dx.doi.org/10.1016/j.jcomdis.2020.105999DOI Listing
May 2020

Symbol Digit Modalities Test: Greek Normative Data for the Oral and Written Version and Discriminative Validity in Patients with Multiple Sclerosis.

Arch Clin Neuropsychol 2021 Jan;36(1):117-125

University of Patras Medical School, Patras, Greece.

Objectives: The purpose of this study was to generate normative data on the Symbol Digits Modalities Test (SDMT) for the written and oral versions in the Greek adult population. We also investigated the test's validity in discriminating the performance of healthy adults from two groups of adults diagnosed with relapsing remitting (RRMS) and secondary progressive (SPMS) multiple sclerosis.

Method: The sample consisted of 609 healthy men and women between the ages of 18 and 65. All participants were monolingual native Greek adult speakers. Each healthy participant was administered either the written (n = 460) or oral (n = 149) versions of the SDMT. Discriminant validity was examined by comparing 35 healthy participants who had completed the oral version of the SDMT to 35 age - and education-matched RRMS and SPMS patients.

Results: Linear regression models explained between 36% and 55% of the variance in the SDMT oral and written version scores. Age was the strongest predictor of difference in SDMT written and oral version performance, followed by education that also accounted for a further proportion of the SDMT variance. On the contrary, gender was found not to contribute significantly to the variance in the SDMT for either the written or the oral versions. As a result, age- and education-adjusted norms were generated. Regarding the tests discriminative validity, we found that both MS patient groups scored significantly lower than the healthy group.

Conclusions: This is the first study to provide comprehensive normative data for the SDMT in the adult population in Greece, impacting the future practice of neuropsychological assessment in this country.
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http://dx.doi.org/10.1093/arclin/acaa028DOI Listing
January 2021

Pesticides, cognitive functions and dementia: A review.

Toxicol Lett 2020 Jun 4;326:31-51. Epub 2020 Mar 4.

Department of Neurology, Laboratory of Neurogenetics, University Hospital of Larissa, Greece; Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece. Electronic address:

Pesticides are widely-used chemicals commonly applied in agriculture for the protection of crops from pests. Depending on the class of pesticides, the specific substances may have a specific set of adverse effects on humans, especially in cases of acute poisoning. In past years, evidence regarding sequelae of chronic, low-level exposure has been accumulating. Cognitive impairment and dementia heavily affect a person's quality of life and scientific data has been hinting towards an association between them and antecedent chronic pesticide exposure. Here, we reviewed animal and human studies exploring the association between pesticide exposure, cognition and dementia. Additionally, we present potential mechanisms through which pesticides may act neurotoxically and lead to neurodegeneration. Study designs rarely presented homogeneity and the estimation of the exposure to pesticides has been most frequently performed without measuring the synergic effects and the possible interactions between the toxicants within mixtures, and also overlooking low exposures to environmental toxicants. It is possible that a Real-Life Risk Simulation approach would represent a robust alternative for future studies, so that the safe exposure limits and the net risk that pesticides confer to impaired cognitive function can be examined. Previous studies that evaluated the effect of low dose chronic exposure to mixtures of pesticides and other chemicals intending to simulate real life exposure scenarios showed that hormetic neurobehavioral effects can appear after mixture exposure at doses considered safe for individual compounds and these effects can be exacerbated by a coexistence with specific conditions such as vitamin deficiency. However, there is an overall indication, derived from both epidemiologic and laboratory evidence, supporting an association between exposure to neurotoxic pesticides and cognitive dysfunction, dementia and Alzheimer's disease.
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http://dx.doi.org/10.1016/j.toxlet.2020.03.005DOI Listing
June 2020

Does the CD33 rs3865444 Polymorphism Confer Susceptibility to Alzheimer's Disease?

J Mol Neurosci 2020 Jun 22;70(6):851-860. Epub 2020 Feb 22.

Department of Neurology, Laboratory of Neurogenetics, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, Biopolis, Mezourlo Hill, 41100, Larissa, Greece.

Alzheimer's disease (AD) is a complex genetic disorder. To date, published data have reported conflicting results on the role of CD33 rs3865444 polymorphism in AD. The present study aimed at evaluating the effect of rs3865444 on AD in a large cohort of Greek native patients with AD. We also conducted a meta-analysis by pooling information from different studies on the same topic. Patients with AD (n = 327) and healthy controls (n = 327) were analyzed and genotyped for rs3865444. Single locus analyses were run to explore possible associations between CD33 rs3865444 polymorphism and AD. Our analysis yielded no significant interaction between AD and the CD33 rs3865444 polymorphism. The lack of interaction between the two variables persisted even after a pooled meta-analysis of 8 studies (with 13 datasets), with 4015 AD cases and 7981 controls. The overall results do not support the hypothesis that CD33 rs3865444 polymorphism increases the risk of AD. The results also suggest that the identification of functional variants in CD33 that are indisputably correlated with AD may be an important factor to investigate in future genetic screening studies.
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http://dx.doi.org/10.1007/s12031-020-01507-wDOI Listing
June 2020

Beneficial effect of computer-based multidomain cognitive training in patients with mild cognitive impairment.

Appl Neuropsychol Adult 2019 Dec 29:1-10. Epub 2019 Dec 29.

Department of Neurology, University Hospital of Larissa, Larissa, Greece.

The purpose of the present study was to explore the effects of computer-based multidomain cognitive training program on Greek patients with Mild Cognitive Impairment (MCI). Forty-six patients with MCI were randomly divided into two groups; (a) the training group, which received a computer-based multidomain cognitive training program with the use of the RehaCom software and (b) the control group, which underwent standard-clinical care. The duration of the computer-based training program was 15 weeks, administered twice a week for approximately one hour per session. Analysis of the baseline versus endpoint performance of each group demonstrated that in the control group delayed memory and executive function had deteriorated over the observation period of 15 weeks, while improvement was observed in the training group's performance on delayed memory, word recognition, Boston Naming Test (BNT), Clock Drawing Test (CDT), Semantic Fluency (SF), Trail Making Test-A (TMT-A) and Trail Making Test-B (TMT-B). Comparison between the two groups presented asignificant effect of the intervention for most cognitive domains. These findings are promising for the development of training methods designed to delay cognitive decline in patients with MCI, which is considered to be the prodromal stage of Alzheimer's Disease (AD).
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http://dx.doi.org/10.1080/23279095.2019.1692842DOI Listing
December 2019

Brain volume dynamics in multiple sclerosis. A case-control study.

Neurol Res 2019 Oct 6;41(10):936-942. Epub 2019 Jul 6.

Department of Neurology, Laboratory of Neurogenetics, University Hospital of Larissa, University of Thessaly , Larissa , Greece.

: In this study, we aimed to explore the extent and clinical relevance of brain volume dynamics in relapsing remitting multiple sclerosis (RRMS). : Sixty-three patients with RRMS with a disease duration of about 5 years (36 women, mean age 39.9 ± 9.4 years; mean EDSS1.4 ± 1.2, mean relapse rate 0.98 ± 1.17) and 50 healthy control individuals (24 women, mean age 39.1 ± 10.2 years) were recruited and imaged on a MRI scanner by using post-gadolinium high-resolution3D T1W sequences. Cross-sectional and longitudinal volumetric data were obtained by using SIENA(X) and FIRST software. : Patients showed significantly lower subcortical volumes compared to healthy controls. Interestingly, the educational level predicted the rate of right thalamus atrophy. The mean annualized percentage of brain volume change (aPBVC) was -0.92% (±1.64%) and was presented in higher rates during the first five years after MS diagnosis. : Brain atrophy mainly involved subcortical grey matter structures and was more conspicuous during the first years of MS diagnosis. The buffering role of education in atrophy was also corroborated by this study.
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http://dx.doi.org/10.1080/01616412.2019.1637041DOI Listing
October 2019

Syntactic and Story Structure Complexity in the Narratives of High- and Low-Language Ability Children with Autism Spectrum Disorder.

Front Psychol 2017 20;8:2027. Epub 2017 Nov 20.

Department of Theoretical and Applied Linguistics, University of Cambridge, Cambridge, United Kingdom.

Although language impairment is commonly associated with the autism spectrum disorder (ASD), the Diagnostic Statistical Manual no longer includes language impairment as a necessary component of an ASD diagnosis (American Psychiatric Association, 2013). However, children with ASD and no comorbid intellectual disability struggle with some aspects of language whose precise nature is still outstanding. Narratives have been extensively used as a tool to examine lexical and syntactic abilities, as well as pragmatic skills in children with ASD. This study contributes to this literature by investigating the narrative skills of 30 Greek-speaking children with ASD and normal non-verbal IQ, 16 with language skills in the upper end of the normal range (ASD-HL), and 14 in the lower end of the normal range (ASD-LL). The control group consisted of 15 age-matched typically-developing (TD) children. Narrative performance was measured in terms of both microstructural and macrostructural properties. Microstructural properties included lexical and syntactic measures of complexity such as subordinate vs. coordinate clauses and types of subordinate clauses. Macrostructure was measured in terms of the diversity in the use of internal state terms (ISTs) and story structure complexity, i.e., children's ability to produce important units of information that involve the setting, characters, events, and outcomes of the story, as well as the characters' thoughts and feelings. The findings demonstrate that high language ability and syntactic complexity pattern together in ASD children's narrative performance and that language ability compensates for autistic children's pragmatic deficit associated with the production of Theory of Mind-related ISTs. Nevertheless, both groups of children with ASD (high and low language ability) scored lower than the TD controls in the production of Theory of Mind-unrelated ISTs, modifier clauses and story structure complexity.
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http://dx.doi.org/10.3389/fpsyg.2017.02027DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5701940PMC
November 2017

A comparison of the BAT and BDAE-SF batteries in determining the linguistic ability in Greek-speaking patients with Broca's aphasia.

Clin Linguist Phon 2011 Jun 31;25(6-7):464-79. Epub 2011 Mar 31.

School of English, Aristotle University of Thessaloniki, Thessaloniki, Greece.

The aim of this study is to test the validity and reliability of the Bilingual Aphasia Test as a measure of language impairment in a Greek-speaking Broca's aphasic population and to investigate relationships with the same aphasic group's performance on the Greek version of the short form of the Boston Diagnostic Aphasia Examination battery, mainly focusing on a series of subtests which are shared by the two batteries, yet occasionally differ in content. Correlation analyses showed that the two instruments yielded highly comparable results with respect to the measurement of reading and listening comprehension, as well as in the performance-based measurement of the automated sequence capacity of the patients. Nevertheless, the Bilingual Aphasia Test, as a more extensive battery, proved to be more sensitive and objective in characterizing the patients' language abilities in a number of individual language functions, including commands, sentence repetition, naming, verbal fluency and syntactic comprehension.
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http://dx.doi.org/10.3109/02699206.2011.560991DOI Listing
June 2011