Lee B, et al. Ann Rehabil Med. 2014 Dec;38(6):759-765. http://dx.doi.org/10.5535/arm.2014.38.6.759

Few studies have investigated language recovery patterns and the mechanisms of crossed bilingual aphasia following a subcortical stroke. In particular, Korean-Japanese crossed bilingual aphasia has not been reported. A 47-year-old, right-handed man was diagnosed with an extensive right basal ganglia hemorrhage. He was bilingual, fluent in both Korean and Japanese. After his stroke, the patient presented with crossed aphasia. We investigated changes in the Korean (L1) and Japanese (L2) language recovery patterns. Both Korean and Japanese versions of the Western Aphasia Battery (WAB) were completed one month after the stroke, and functional magnetic resonance imaging (fMRI) was performed using picture-naming tasks. The WAB showed a paradoxical pattern of bilingual aphasia, with an aphasia quotient (AQ) of 32 for Korean and 50.6 for Japanese, with Broca’s aphasia. The patient scored better in the Japanese version of all domains of the tests. The fMRI study showed left lateralized activation in both language tasks, especially in the inferior frontal gyrus. After six months of language therapy targeting L1, the Korean-WAB score improved significantly, while the Japanese-WAB score showed slight improvement. In this case, the subcortical lesion contributed to crossed bilingual aphasia more highly affecting L1 due to loss of the cortico-subcortical control mechanism in the dominant hemisphere. The paradoxical pattern of bilingual aphasia disappeared after lengthy language therapy targeting L1, and the therapy effect did not transfer to L2. Language recovery in L1 might have been accomplished by reintegrating language networks, including the contralesional language homologue area in the left hemisphere.

(1) Background: People living with spinal cord injury (SCI) face numerous challenges in their lives in terms of health conditions, everyday activity, and participation in society, which are not fully recognized. To address such issues, a community survey with 125 questions for people living with SCI was conducted and the response rates, population characteristics, health and functioning problems are reported. (2) Methods: The survey questionnaire comprised 125 questions on SCI characteristics, health conditions, activities, participation, and environmental and personal factors. The survey response rates were calculated, and demographics and health and functioning characteristics were analyzed. (3) Results: A total of 890 individuals responded to the survey. The median age of the participants was 48 years (interquartile range (IQR), 39–56), and 76% of the population were males. Paraplegia (60%) and complete injury (58%) were the most common injury type, and the cause was mostly traumatic (92%). More health problems and lower quality of life were more frequent with older age and in patients without paid work. (4) Conclusions: The Ko-InSCI study provides valuable information in terms of health needs and service gaps for people with SCI in the community.

Background/Objectives: People with disabilities face a disproportionately higher disease burden alongside reduced healthcare accessibility, resulting in elevated unmet healthcare needs (UHN). Understanding the factors that drive UHN—and whether these factors differ by disability status—is critical for developing targeted public health interventions. Methods: A secondary cross-sectional analysis was conducted using linked national survey and administrative data—specifically the Korea National Health and Nutrition Examination Survey (KNHANES) cycles VI to VIII (2013–2021) linked with National Health Insurance Service (NHIS) administrative records—to examine determinants of healthcare access and utilization barriers by disability status. Independent variables were selected based on Andersen’s Behavioral Model of Health Services Use for vulnerable populations, encompassing predisposing factors, enabling factors, and need factors (including functional status indicators). Interaction terms between disability status and sex, and between disability status and household income level, were introduced to identify effect modification by disability status. Results: People with registered disabilities had significantly higher UHN compared to those without disabilities. The contributing factors to UHN differed between the two groups, with sex and household income showing statistically significant interaction effects with disability status, indicating that their associations with UHN vary depending on whether an individual has a registered disability. Conclusions: UHN in people with disabilities is shaped by a distinct set of determinants compared to the general population. The overall pattern of contributing factors differed between people with and without disabilities across multiple dimensions. These findings highlight the need for tailored healthcare policies that account for the unique vulnerabilities of people with disabilities, rather than applying uniform strategies across all population groups.