Reuth Medical Center

Tel Aviv, Israel

Reuth Medical Center

Tel Aviv, Israel
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Gvion A.,Tel Aviv University | Gvion A.,Ono Academic College | Gvion A.,Reuth Medical Center | Friedmann N.,Tel Aviv University
Neuropsychologia | Year: 2010

We report a new type of dysgraphia, which we term dyscravia. The main error type in dyscravia is substitution of the target letter with a letter that differs only with respect to the voicing feature, such as writing " coat" for " goat" , and " vagd" for " fact" Two Hebrew-speaking individuals with acquired dyscravia are reported, TG, a man aged 31, and BG, a woman aged 66. Both had surface dysgraphia in addition to their dyscravia. To describe dyscravia in detail, and to explore the rate and types of errors made in spelling, we administered tests of writing to dictation, written naming, and oral spelling. In writing to dictation, TG made voicing errors on 38% of the words, and BG made 17% voicing errors. Voicing errors also occurred in nonword writing (43% for TG, 56% for BG). The writing performance and the variables that influenced the participants' spelling, as well as the results of the auditory discrimination and repetition tasks indicated that their dyscravia did not result from a deficit in auditory processing, the graphemic buffer, the phonological output lexicon, the phonological output buffer, or the allographic stage. The locus of the deficit is the phoneme-to-grapheme conversion, in a function specialized in the conversion of phonemes' voicing feature into graphemes. Because these participants had surface dysgraphia and were forced to write via the sublexical route, the deficit in voicing was evident in their writing of both words and nonwords. We further examined whether the participants also evinced parallel errors in reading. TG had a selective voicing deficit in writing, and did not show any voicing errors in reading, whereas BG had voicing errors also in the reading of nonwords (i.e., she had dyslegzia in addition to dyscravia). The dissociation TG demonstrated indicated that the voicing feature conversion is separate for reading and writing, and can be impaired selectively in writing. BG's dyslegzia indicates that the grapheme-to-phoneme conversion also includes a function that is sensitive to phonological features such as voicing. Thus the main conclusion of this study is that a separate function of voicing feature conversion exists in the phoneme-to-grapheme conversion route, which may be selectively impaired without deficits in other functions of the conversion route, and without a parallel deficit in reading. © 2010 Elsevier Ltd.


Ohry A.,Reuth Medical Center | Ohry A.,Tel Aviv University
Journal of Medical Biography | Year: 2017

Felicjan Sławoj-Składkowski was a Polish physician, General and politician who served as Polish Minister of Internal Affairs and was the last Prime Minister of Poland before the Second World War. The lack of basic sanitation in many of Poland’s villages caused him to issue a decree that every household in Poland must have a latrine in working order. Wooden sheds were built in the backyards, subsequently named ‘sławojkis’. © 2015, © The Author(s) 2015.


Friedmann N.,Tel Aviv University | Tzailer-Gross L.,Tel Aviv University | Tzailer-Gross L.,Loewenstein Hospital Rehabilitation Center | Gvion A.,Tel Aviv University | And 2 more authors.
Neuropsychologia | Year: 2011

Individuals with text-based neglect dyslexia omit words on the neglected side of the sentence or text, usually on the left side. This study tested whether the syntactic structure of the target sentence affects reading in this type of neglect dyslexia. Because Hebrew is read from right to left, it enables testing whether the beginning of the sentence and its syntactic properties determine if the final, leftmost, constituent is omitted or not. The participants were 7 Hebrew-speaking individuals with acquired left text-based neglect dyslexia, without syntactic impairments. Each participant read 310 sentences, in which we compared 5 types of minimal pairs of sentences that differed in the obligatoriness of the final (left) constituent. Complements were compared with adjuncts, obligatory pronouns were compared with optional resumptive pronouns, and the object of a past tense verb was compared with the object of a present tense verb, which can also be taken to be an adjective, which does not require an object. Questions that require a verb were compared with questions that can appear without a verb, and clauses that serve as sentential complements of a verb were compared with coordinated clauses, which are not required by the verb. In addition, we compared the reading of noun sequences to the reading of meaningful sentences, and assessed the neglect point in reading 2 texts. The results clearly indicated that the syntactic knowledge of the readers with neglect dyslexia modulated their sentence reading. They tended to keep on reading as long as the syntactic and lexical-syntactic requirements of the sentence had not been met. In 4 of the conditions twice as many omissions occurred when the final constituent was optional than when it was obligatory. Text reading was also guided by a search for a "happy end" that does not violate syntactic or semantic requirements. Thus, the syntactic structure of the target sentence modulates reading and neglect errors in text-based neglect dyslexia, suggesting that the best stimuli to diagnose mild text-based neglect dyslexia are sentences in which the leftmost constituent is optional, and not required by syntax. Another finding of this study is dissociation between neglect dyslexia at the text and at the word levels. Two of the participants had neglect dyslexia at the text level, manifested in omissions of words on the left side of text, without neglect dyslexia at the word level (namely, without omissions, substitutions, or additions of letters on the left side of words). © 2011 Elsevier Ltd.


Dickstein R.,Haifa University | Levy S.,Reuth Medical Center | Shefi S.,Haifa University | Holtzman S.,Haifa University | And 2 more authors.
NeuroRehabilitation | Year: 2014

BACKGROUND: Stroke is the leading cause of adult disability, with walking impairment being a devastating indicator of chronic post-stroke hemiparesis. Limited resources exist for individual treatments; therefore, the delivery of safe group exercise therapy is highly desired. OBJECTIVE: To examine whether the application of group-based motor imagery practice to community-dwelling individuals with chronic hemiparesis improves gait. METHODS: Sixteen individuals with chronic hemiparesis from two community centers participated in the study, with eight from each center. Four participants in each center received five weeks of the experimental intervention, consisting of group-based motor imagery exercises of gait tasks, followed by five weeks of control treatment of motor imagery exercises for the affected upper extremity. Four other subjects in each center received the same treatments in reverse order. Pre- and post intervention measurements included clinical and biomechanical gait parameters. RESULTS: Comparisons within (pre- vs. post) and between treatments (experimental vs. control) indicated no significant change in any gait variable. Nevertheless, the verbal reports of most participants alluded to satisfaction with the experimental intervention and to an increase in self-confidence. CONCLUSIONS: Despite the lack of evidence for the effectiveness of group-based motor imagery practice in improving gait among individuals with chronic hemiparesis, the contrast between the measured outcomes and the positive verbal reports merits further inquiry. © 2014 ? IOS Press and the authors.


Gvion A.,Ono Academic College | Gvion A.,Tel Aviv University | Gvion A.,Reuth Medical Center | Friedmann N.,Tel Aviv University
Cortex | Year: 2010

The article describes AE, a Hebrew-speaking individual with acquired dysgraphia, who makes mainly letter position errors in writing. His dysgraphia resulted from impairment in the graphemic buffer, but unlike previously studied patients, most of his errors related to the position of letters rather than to letter identity: 80% of his errors were letter position errors in writing, and only 7% of his errors were letter omissions, substitutions, and additions. Letter position errors were the main error type across tasks (writing to dictation and written naming), across output modalities (writing and typing), and across stimuli, e.g., migratable words (words in which letter migration forms another word), irregular words, and nonwords. Letter position errors occurred mainly in the middle letters of a word. AE's writing showed a significant length effect, and no lexicality, migratability, or frequency effects. His letter position deficit was manifested selectively in writing; he made no letter position errors in reading, demonstrating the dissociability of letter position encoding in reading and writing. These data support the existence of a letter order function in the graphemic buffer that is separate from the function responsible for activating letter identities. © 2009 Elsevier Srl.


Gvion A.,Ono Academic College | Gvion A.,Tel Aviv University | Gvion A.,Reuth Medical Center | Friedmann N.,Tel Aviv University
Frontiers in Human Neuroscience | Year: 2013

Nissim, a 64 years old Hebrew-speaking man who sustained an ischemic infarct in the left occipital lobe, exhibited an intriguing pattern. He could hold a deep and fluent conversation about abstract and complex issues, such as the social risks in unemployment, but failed to retrieve imageable words such as ball, spoon, carrot, or giraffe. A detailed study of the words he could and could not retrieve, in tasks of picture naming, tactile naming, and naming to definition, indicated that whereas he was able to retrieve abstract words, he had severe difficulties when trying to retrieve imageable words. The same dissociation also applied for proper names-he could retrieve names of people who have no visual image attached to their representation (such as the son of the biblical Abraham), but could not name people who had a visual image (such as his own son, or Barack Obama). When he tried to produce imageable words, he mainly produced perseverations and empty speech, and some semantic paraphasias. He did not produce perseverations when he tried to retrieve abstract words. This suggests that perseverations may occur when the phonological production system produces a word without proper activation in the semantic lexicon. Nissim evinced a similar dissociation in comprehension-he could understand abstract words and sentences but failed to understand sentences with imageable words, and to match spoken imageable words to pictures or to semantically related imageable words. He was able to understand proverbs with imageable literal meaning but abstract figurative meaning. His comprehension was impaired also in tasks of semantic associations of pictures, pointing to a conceptual, rather than lexical source of the deficit. His visual perception as well as his phonological input and output lexicons and buffers (assessed by auditory lexical decision, word and sentence repetition, and writing to dictation) were intact, supporting a selective conceptual system impairment. He was able to retrieve gestures for objects and pictures he saw, indicating that his access to concepts often sufficed for the activation of the motoric information but did not suffice for access to the entry in the semantic lexicon. These results show that imageable concepts can be selectively impaired, and shed light on the organization of conceptual-semantic system. © 2013Gvionand Friedmann.


Gvion A.,Tel Aviv University | Gvion A.,Reuth Medical Center | Friedmann N.,Tel Aviv University
Aphasiology | Year: 2012

Background: Within cognitive neuropsychological models conduction aphasia has been conceptualised as a phonological buffer deficit. It may affect the output buffer, the input buffer, or both. The phonological output buffer is a short-term storage, responsible for the short-term maintenance of phonological units until their articulation, as well as for phonological and morphological composition. The phonological input buffer holds input strings until they are identified in the input lexicon. Thus the phonological buffers are closely related to phonological short-term memory (pSTM), and hence it is important to assess pSTM in conduction aphasia. Because the input and output buffers play different roles, impairment in each of them predicts different impairments in the patient's ability to understand certain sentences, to learn new words and names, and to remember and recall lists of words and numbers for short time periods.This research was supported by a research grant from the National Institute for Psychobiology in Israel (Friedmann 2004-5-2b), by the Israel Science Foundation (grant no. 1296/06, Friedmann), and by the ARC Centre of Excellence in Cognition and its Disorders (CCD), Macquarie University.Aims: This study explored in detail pSTM in individuals with conduction aphasia, comparing individuals with input and output deficits, recall and recognition tasks, and stimuli of various types. It also tested pSTM in six age groups of healthy individuals, assessing the effect of age on various types of stimuli. This paper presents a new battery of 10 recall and recognition span tests, designed to assess pSTM in aphasia and to measure spans and effects on spans.Methods & Procedures: The participants were 14 Hebrew-speaking individuals with conduction aphasia, 12 with input or input-output phonological buffer deficit, and 2 with only output deficit, and 296 healthy individuals.Outcomes & Results: The analyses of the spans and effects on pSTM in the 10 tests indicated that all the participants with conduction aphasia had limited pSTM, significantly poorer than that of the control participants, and no semantic STM impairment. They had shorter spans, smaller length and similarity effects, and larger sentential effect than the controls. The individuals with conduction aphasia who had an impairment in the phonological input buffer showed deficit in both the recall and recognition span tasks. The individuals with the output conduction aphasia showed impairment only in the recall tasks. The healthy individuals showed age effect on span tasks involving words, but no effect of age on span tasks of nonwords.Conclusions: pSTM is impaired in conduction aphasia, and different pSTM impairments characterise different types of conduction aphasia. Output conduction aphasia causes difficulties only when verbal output is required, whereas input conduction aphasia also causes a deficit when only recognition is required. This suggests that rehearsal can take place without the phonological output buffer. Age differentially affects pSTM for words and nonwords in healthy adults: whereas the encoding of words changes, the ability to remember nonwords is unchanged. © 2012 Copyright 2012 Psychology Press, an imprint of the Taylor & Francis Group, an Informa business.


Gvion A.,Tel Aviv University | Gvion A.,Reuth Medical Center | Friedmann N.,Tel Aviv University
Aphasiology | Year: 2012

Background: The nature of the relation between phonological working memory and sentence comprehension is still an open question. This question has theoretical implications with respect to the existence of various working memory resources and their involvement in sentence processing. It also bears clinical implications for the language impairment of patients with phonological working memory limitation, such as individuals with conduction aphasia.Aims: This study explored whether limited phonological working memory impairs sentence comprehension in conduction aphasia.Methods & Procedures: The participants were 12 Hebrew-speaking individuals with conduction aphasia who, according to 10 recall and recognition span tasks, had limited phonological short-term memory in comparison to 296 control participants. Experiments 1 and 2 tested their comprehension of relative clauses, which require semantic-syntactic reactivation, using sentence-picture matching and plausibility judgement tasks. Experiments 3 and 4 tested phonological reactivation, using two tasks: a paraphrasing task for sentences containing an ambiguous word in which disambiguation requires re-accessing the word form of the ambiguous word, and rhyme judgement within sentences. In each task the distance between a word and its reactivation was manipulated by adding words/syllables, intervening arguments, or intervening embeddings.Outcomes & Results: Although their phonological short-term memory, and hence their phonological working memory, was very impaired, the individuals with conduction aphasia comprehended relative clauses well, even in sentences with a long distance between the antecedent and the gap. They failed to understand sentences that required phonological reactivation when the phonological distance was long.Conclusions: The theoretical implication of this study is that phonological working memory is not involved when only semantic-syntactic reactivation is required. Phonological working memory does support comprehension in very specific conditions: when phonological reactivation is required after a long phonological distance. The clinical implication of these results is that because most of the sentences in daily language input can be understood without phonological reactivation, individuals with phonological working memory impairment, such as individuals with conduction aphasia, are expected to understand sentences well, as long as they understand the meaning of the sentences and do not attempt to repeat them or encode them phonologically. © 2012 Copyright 2012 Psychology Press, an imprint of the Taylor & Francis Group, an Informa business.


Rosenbaum T.,Inner Stability Ltd. | Aloni R.,Tel Aviv University | Heruti R.,Tel Aviv University | Heruti R.,Reuth Medical Center
Journal of Sexual Medicine | Year: 2014

Introduction: Surrogate partner therapy (SPT) is a controversial and often misunderstood practice. Aim: The aim of this study was to review the history and evidence-based literature regarding SPT, describe and provide a model for ethical SPT practice, and present two case examples illustrating ethical concerns. Methods: Literature review and report of clinical experience were the methods used. Main Outcome Measure: Results of literature review and clinical experience were assessed for this study. Results: Sex therapy pioneers Masters and Johnson introduced surrogacy in sex therapy; however, there is a lack of published evidence supporting treatment efficacy and ethico-legal questions have limited the practice from becoming a common intervention. SPT can be an effective intervention that may enhance sexual medicine practice. However, SPT must be offered according to legal, professional, and ethical standards. Conclusions: Sexual medicine practitioners should consider SPT based on the ethical paradigms offered, and sex therapy practices utilizing SPT should collect and publish outcome data. Rosenbaum T, Aloni R, and Heruti R. Surrogate partner therapy: Ethical considerations in sexual medicine. © 2013 International Society for Sexual Medicine.


Zerach G.,Ariel University | Anat B.,Haifa University | Solomon Z.,Tel Aviv University | Heruti R.,Reuth Medical Center
Journal of Sexual Medicine | Year: 2010

Introduction. The aversive impact of combat and combat-induced posttraumatic stress disorder (PTSD) on marital intimacy and sexual satisfaction has been examined in several studies. Nevertheless, the toll of war captivity on marital intimacy in relation to dyadic adjustment and sexual satisfaction remains unknown. In particular, the mediating role of marital intimacy in the relationship between PTSD symptoms and dyadic adjustment and between PTSD symptoms and sexual satisfaction has not yet been systematically explored thus far. Aims: This study aimed to examine the interrelationships of PTSD symptoms, dyadic adjustment, sexual satisfaction, and marital intimacy among ex-prisoners of war (ex-POWs). Methods. A sample of Israeli veterans ex-POWs (ex-POWs: N = 105) from the 1973 Yom Kippur War and a matched comparison group of veterans who participated in the same war but were not held captive (control: N = 94) were compared in the study variables. Main Outcome Measures: The PTSD inventory, dyadic adjustment scale, index of sexual satisfaction, and capacity for intimacy questionnaire. Results. Findings revealed that ex-POWs reported higher levels of PTSD symptoms and lower levels of dyadic adjustment and sexual satisfaction than comparable controls. There were also differences between the groups in the pattern of relations between PTSD symptoms, dyadic adjustment, sexual satisfaction, and marital intimacy. Finally, for ex-POWs, marital intimacy partially mediated the relationships between PTSD symptoms and dyadic adjustment and sexual satisfaction outcome measures. Conclusions. PTSD symptoms are implicated in marital problems of ex-POWs. A significant relationship was found between the traumatized ex-POW's capacity for intimacy and both their sexual satisfaction and dyadic adjustment. Zerach G, Anat B-D, Solomon Z, and Heruti R. Posttraumatic symptoms, marital intimacy, dyadic adjustment, and sexual satisfaction among ex-prisoners of war. © 2010 International Society for Sexual Medicine.

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