Biomedical subjects
K Willmes
Publications and source records attributed to K Willmes.
[Results of a multicenter study on the spontaneous prognosis of aphasias of vascular etiology].
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[Results of a training program to improve the speed of visual perception and concentration in brain-damaged patients].
A program for the training of perceptual speed and attention with a duration of four weeks was developed and given to thirty brain damaged patients. In order to evaluate a possible generalization effect of the training all subjects were tested three times, i.e. at the beginning of the training, after four and after eight weeks with a series of 16 standardized psychometric tests. These comprised tasks which closely resembled the training procedures as well as tasks testing psychomotor functions in a broader sense and even tasks of reasoning and other intellectual functions. To test the different effects of training, spontaneous recovery and test repetition an experimental design with two groups of patients and two control groups was necessary. Only the groups of patients showed a significant and marked improvement in all tests which could neither be explained by spontaneous recovery nor by test repetition. The training effect proved to be stable after four weeks. The most marked improvement, however, was seen with those tasks most closely resembling the training procedures; in no case the performance level of the control groups was reached.
Ideomotor apraxia and aphasia: an examination of types and manifestations of apraxic symptoms.
Eighty-eight aphasic patients with the four standard syndromes as well as two control groups, 10 right-sided brain damaged patients and 10 patients without brain damage were examined for ideomotor apraxia by means of 200 tasks. The tasks required oral, arm, leg and bimanual movements, both on verbal command and on imitation. The limb movements were half meaningful, half meaningless. Performances were evaluated according to five response categories: correct, fragmentary, augmentative, perseveratory, other errors. The aim of the investigation was to ascertain whether there are apractic syndromes which are either related to the aphasic syndromes or are characterized by certain types of errors or by manifestation on certain parts of the body. The findings were negative in all three respects. The meaning of these findings for the organization of praxis and language is discussed. The performances of the control groups were consistently higher than those of the aphasic patients.
Facet theory applied to the construction and validation of the Aachen Aphasia Test.
The linguistic performance of 120 aphasic patients of the four standard syndromes assessed by the Aachen Aphasia Test (AAT) is analyzed by a nonmetric (ordinal) multidimensional scaling procedure (Smallest Space Analysis, SSA1). The linguistic structure of the test items is characterized within the framework of L. Guttman's facet theory. Three systematic components (facets) are discerned: linguistic modality, unit, and regularity. Properties of the facets as well as their relations are assessed and tested empirically by analyzing the interrelations among different items or sets of items. The spatial configurations obtained by the scaling procedure fit only partially the expectations derived from the facet-theory model. The modality facet was found to have a strong overriding influence on the aphasic test performance. The facets unit and regularity were only found for the most rigorously designed subtests. Written Language and Comprehension. The results suggest the introduction of a new combined facet linguistic complexity which reflects the dependency of the facets regularity and unit.
To what extent are the cognitive performances of Wernicke's aphasics disturbed by their own vocalizations?
The influence of vocalization on performance in the Token Test and arithmetic and memory span tasks was studied in Wernicke's aphasics. Tasks had to be carried out under two conditions: performance with oral repetition of the task commands or oral description of the task stimuli; performance without oral repetition or description of task commands or stimuli. Performance was significantly better in all tasks when no vocalization was required. The results are taken as evidence that in Wernicke's aphasics any activation of impaired language functions leads to interference between the defective linguistic functions and those which are still available to the patients.
Treatment of acquired aphasia: speech therapists and volunteers compared.
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Axial movements in ideomotor apraxia.
Non-symbolic axial movements were examined and compared to oral and limb movements in a group of 60 aphasic patients (15 of each major subgroup) with exclusively left-sided brain damage. The contention in the literature that axial movements are preserved in patients with ideomotor limb apraxia was not confirmed.
A new look at the Token Test using probabilistic test models.
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A refined method to relate morphological and functional aspects of aphasia.
A method is described to relate brain morphology and neuropsychological disturbances such as aphasia. By mapping lesions with computerized tomography onto a grid model of five brain slices, it is possible to compare aphasiological information and lesion site by data processing, allowing the quantitative and qualitative manipulation of a large number of data. The soundness of the method is investigated in a pilot study on the localization of aphasic disturbances. Data processing was performed on a preliminary group of 70 patients with different aphasic syndromes (Broca, Wernicke, and global aphasics with and without recurring utterances). The results confirmed the findings of older studies, with the typical locus of Wernicke's aphasia being Wernicke's area. In conformity to more recent studies, the main lesion for Broca aphasics was found to be in the insular cortex, with a relatively important participation of the frontal white matter. The implications of this refined method for more vigorous aphasiological and neuropsychological research are briefly indicated.
[The Aachen Aphasia Test: reliability and inter-rater agreement (author's transl)].
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[The Aachen Aphasia Test Rationale and construct validity (author's transl)].
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[The Aachen Aphasia Test. Differential validity (author's transl)].
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Command hallucinations: who obeys and who resists when?
The impact of auditory command hallucinations on the behaviour of schizophrenic patients sometimes appears to be unpredictable. In order to tackle this problem, the psychopathological characteristics of command hallucinations in 31 schizophrenic patients were assessed using a 24-item questionnaire. Using binary data and relative risk analysis methods, predictors were determined for obeying or resisting command hallucinations. Characteristics of voices and the attitude toward the voices appear equally important for prediction. A set of three psychopathological characteristics comprising a voice known to the patient, emotional involvement during the hallucinations, and seeing the voice as real provides significant predictivity of behaviour following command hallucinations. These results are interesting for clinical and forensic psychiatrists.