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PubMed1982

Cognitive impairments of aphasics in picture sorting and matching tasks.

On the basis of earlier experiments showing a differential deficit of aphasics in picture sorting and matching tasks, two experiments were conducted to test the conjecture of a specific deficit of aphasics in the analytical appraisal of individual features. Broca's and Wernicke's aphasics--according to clinical diagnoses and the Aachener Aphasie Test--were compared with patients having right-hemisphere lesions or left-hemisphere lesions without aphasia. Both groups of aphasics differed from the control groups in the sorting task, irrespective of the sorting criterion, but the differences were small. The picture matching task did not discriminate between groups. Obviously, the basic assumption has to be modified with respect to specific conditions of task requirements. The experimental literature is reviewed.

Aphasia↗
PubMed1998

Consonant and vowel production of right hemisphere patients.

Recent reports of subclinical phonetic deficits in posterior and most particularly in Wernicke's aphasics have challenged the traditional dichotomy which characterized speech deficits in aphasia as anterior/phonetic and posterior/phonological. It is unclear whether the basis of the phonetic deficit in posterior aphasics reflects the fact that the speech production system extends to more posterior regions of the left hemisphere than previously thought or alternatively is the result of generalized brain damage effects. The present study explores the latter possibility by investigating the patterns of speech production in right hemisphere brain-damaged, non-aphasic patients with anterior and posterior lesions. Acoustic analyses conducted on a range of consonant and vowel parameters showed differences between the speech patterns of both anterior and posterior right hemisphere patients and that of Wernicke's aphasics. These findings suggest that the subclinical deficit of Wernicke's aphasics can not simply be ascribed to a generalized brain-damage effect and raise the possibility that the right hemisphere also plays some role, if only a minor one, in the phonetic implementation of speech.

Aged↗
PubMedDate not supplied

[The effect of afferent subcortical conduction pathways on speech function status].

The combined analysis of neuropsychologic, electroencephalographic, and neurologic data as well as of the results of computerized and emission-computerized tomography in patients with ischemic stroke during the neurorehabilitation period made it possible to ascertain the correlation between the lesions of subcortical pathways and speech disorders. Besides the intracortical, the cortico-subcortical connections of the left associative cortex were demonstrated. The semantic aphasia was shown to be always associated with the dynamic aphasia; and each of these forms could be either primary or secondary depending on the lesion localization (from the EEG and neurophysiologic data). The incidence of local polymorphous delta and theta waves in the EEG is an unfavorable predictive sign for patients after ischemic stroke.

Adolescent↗
PubMed1995

[Clinical and neuroradiological studies of eclampsia--cerebral vasospasm and relation to the brain edema].

Clinical and neuroradiological studies involving cerebral angiography were conducted in four patients with eclampsia. In three cases (case 1, 2 and 4), neurological focal signs, abnormal low density areas on cranial CT and T2 high intensity areas on cranial MRI disappeared within a month. But in one case (case 3), cerebral infarction occurred and right hemiparesis and aphasia persisted. Cerebral angiography in the acute phase demonstrated vasospasm in all cases and arterial occlusion in the middle cerebral artery due to vasospasm in case 3. Angiography demonstrated several types of spasms, including diffuse, peripheral and multi local. Furthermore, in some cases, diffuse vasospasms were recognized at the siphon and extracranial portions of the internal carotid artery. In one case (Case 4), segmental vasospasms were detected in the bilateral vertebral arteries. Three to four weeks later, follow-up cerebral angiography was performed in three cases. Cerebral vasospasms had partially or completely recovered. Subarachnoid hemorrhage (SAH) was excluded by lumbar puncture and neuroradiological findings in all cases. We concluded that eclampsia itself causes cerebral vasospasm and that the mechanism of vasospasm is different from that of SAH, since cerebral vasospasm occurred in the extracranial cerebral arteries. We suspected that cerebral vasospasm in eclampsia causes cerebral ischemia, which leads to cytotoxic edema and dysfunction of the blood-brain barrier (BBB) and cerebral autoregulation. With this background, brain edema, especially vasogenic edema, may easily occur and clinical symptoms of eclampsia may appear when the blood pressure rapidly increases.

Adolescent↗
PubMed2006

Non-fluent progressive aphasia: cerebral metabolic patterns and brain reserve.

Functional imaging studies suggest that brain reserve allows patients with Alzheimer's disease with more years of schooling to cope better with brain damage. No studies exist on patients with non-fluent progressive aphasia (NFPA). We aimed to explore metabolic patterns of patients with NFPA and to provide evidence for brain reserve in NFPA. 11 right-handed patients with NFPA and 16 age-matched controls underwent (18)F-FDG PET imaging. Scans of patients and controls were compared in SPM2. A linear regression analysis with glucose metabolism as dependent variable and years of schooling as the independent variable, adjusted for age, gender, and a total score of the CERAD neuropsychological battery was conducted. The NFPA group showed a hypometabolism of the left hemisphere including the middle frontal, and inferior temporal and angular gyri, and the bilateral caudate nuclei and thalami (p(corr)<0.05). The regression analysis revealed a significant inverse association between education and glucose metabolism in the left inferior temporal, parahippocampal, and supramarginal gyri (p(corr)<0.05). We conclude that brain reserve is also present in NFPA.

Age Distribution↗
PubMedDate not supplied

Syntactic representations in agrammatic aphasia: the case of prepositions.

The focus of this paper is the syntactic deficit in agrammatic aphasia. The specific issue is the extent to which prepositions are impaired in this syndrome. This category is of particular interest because of the unique role its members play in the grammar. This is the organization of the paper: First, several descriptive generalizations are examined critically, and arguments against them are advanced. Then, a new hypothesis is formulated, stated in terms of current linguistic theory. This hypothesis views the deficit as being partial from a syntactic point of view. The relevant notion to account for the data (i.e., partitioning the impaired from preserved prepositions) is Government, a structural relation that must hold between the preposition at issue and the verb. The consequences of this hypothesis are derived, and an experiment that was conducted to test them is reported. The findings of this experiment not only support the hypothesis, but also suggest that the impairment is unique to agrammatic aphasic patients, since the performance of a control group of fluent aphasics was different. Finally, several theoretical issues are discussed in light of the findings and of the proposed description of the agrammatic deficit.

Aged↗
PubMedDate not supplied

Progressing stroke with neurological deterioration in a group of Israeli elderly.

Progressing stroke with neurological deterioration (PSND), i.e., neurological deterioration of patients during the first days following a stroke, although not an infrequent event, has hitherto been addressed only by few studies. This is the first investigation conducted in Israel with the aim to determine its prevalence and characteristics. Data regarding 140 patients with first ever stroke were collected prospectively between May 1999 and October 2000. All patients underwent a thorough daily neurological examination over the first 7 days, using the Canadian Neurological Scale. Most (90%), patients had hemiparesis, with dysarthria, aphasia and dysphagia being the most frequent associated neurological deficits. Thirty percent of the patients were on anti-aggregant therapy prior to the stroke. The prevalence of PSND was 23%. The 1-month in-hospital death rate of these PSND patients was 31%. Univariate analysis showed that previous anti-aggregant therapy, Parkinson's disease (PD), obesity, hyperlipidemia, and presence of aphasia were significantly more frequent in the PSND group. In addition, these patients arrived earlier to the emergency room. However, logistic regression analysis showed that only PD and obesity could possibly be considered as predictors for development of PSND. The prevalence as well as the death rate of PSND in this group of Israeli elderly is within the range reported in the literature. However, prior anti-aggregant treatment and PD, are here reported for the first time as associated conditions. Future research will possibly clarify the links between these entities and PSND.

Aged↗
PubMed2001

Implicit word cues facilitate impaired naming performance: evidence from a case of anomia.

Word-finding difficulties observed in some patients with anomia have been attributed to an insufficient activation of phonology by semantics. There are, however, few direct tests of this hypothesis. This paper reports the case of FR, who presented with anomic aphasia following temporal lobe epilepsy and a cavernoma in the left superior temporal lobe. His anomic deficit was characterized by: (1) no apparent associated semantic impairment; (2) item consistency for accuracy and errors across different administrations; (3) accuracy strongly correlated with word frequency; and (4) a partial, albeit weak, knowledge of the gender of unnamed items. We conducted a naming experiment in which target pictures were implicitly primed by briefly presented masked words. Results showed that the prior presentation of the written target name improved accuracy. When compared with unprimed trials, the presence of the primes also increased phonological errors and decreased semantic errors. We argue that automatic phonological activation derived directly from the implicit written primes interacted with the remaining phonological input from the picture's semantic representation leading to increased accuracy and a change in the balance of error types.

Adult↗
PubMed1987

An investigation of Luria's hypothesis on prompting in aphasic naming disturbances.

This study investigated Luria's hypothesis that aphasic subgroups would respond differentially to phonemic prompts. Responsiveness to initial-sound cues was examined in 40 aphasics--10 Broca's, conduction, Wernicke's, and anomic aphasics who had naming difficulties. Results, with the exception of the anomic aphasic group, supported Luria's predictions. Broca's aphasics were responsive to phonemic cueing, while Wernicke's aphasics were not. Conduction aphasics tended to respond in a fashion similar to the Wernicke's group. The relationship of cueing responsiveness to underlying naming mechanisms is discussed.

Adult↗
PubMed1991

Analysis of the spontaneous writing errors of normal and aphasic writers.

Samples of spontaneous writing were collected from 150 normal subjects, 13 Broca's aphasics, 23 Wernicke's aphasics and 14 conduction aphasics. The errors obtained were classified using a system derived from investigations of slips of the pen in normal subjects. All three aphasic groups made a higher proportion of word-level errors than did the normal writers. Word-level errors tended to be selection errors (substitutions, blends, neologisms, and omissions) rather than movement errors (anticipations, perseverations and reversals). Conduction aphasics showed proportionately more letter movement and fewer letter selection errors than normal writers while Wernicke's and Broca's aphasics showed similar proportions. Graphic and phonetic similarity was no more important a determinant of letter errors in aphasics than in normals. The span of movement errors was particularly restricted in the Broca's and conduction aphasics. Asking patients to write connected text yields insight into the nature of the underlying disorder that could not be obtained from studying the writing of single words.

Agraphia↗
PubMed2006

Attentional disorder in vascular dementia.

Clinical trials in vascular cognitive impairment are in their infancy. The current narrow definitions of vascular dementia (VaD) should be broadened. VaD is characterised by a specific cognitive profile involving preserved memory with impairments in attentional and executive functioning. The present study aimed at a) Investigating whether VaD/pts showed the marked decrease in selective attentional functioning different from the healthy ageing population; b) Determining norms for the Digit Symbol Coding (DSC) task performance for the Georgian elderly population. Case-control study of selective attentional performance was conducted by forming groups of 15 VaD/pts (mean age M=65,6; SD=8,64), 64 young (aged 17-25 years with M=20,69; SD=2.97) and 64 healthy old subjects (aged 50-75 years with M=59,77; SD=7,13). Severity levels of dementia determined by MMSE. VaD/pts were administered the qualitative assessment procedure of aphasia for excluding the cases with aphasia. The selective attentional functioning was studies by the DSC task. A statistically significant difference was detected on the DSC task for the three study groups F(2,62)=87,030, p<.0001 using one-way ANOVA. Norms for the selective attention functioning were prepared for the Georgian elderly population. The study results showed that attentional disorder is a prominent characteristic of VaD. The DSC task reveals ageing effect and differentiates performance of VaD/pts from the performance of normal elderly participants.

Adolescent↗
PubMed1988

Language learning and retention in young language-disordered children.

Simultaneous sign and spoken language training was conducted with young, language-disordered children under standardized training and follow-up conditions with a stringent learning criterion to determine if language learned was stable over time. Twenty-one children between 36 and 86 months with no or nonfunctional language participated in the study. Diagnoses included autism, mental retardation, combined autism and mental retardation, and developmental aphasia. Children completed a mean of 74 signed speech training sessions. Sessions were twice daily, 5 days a week. Follow-up evaluations were made approximately 6 months after training. Of the 21 children, 17 learned at least one word and 7 children learned multiple-word phrases during the training. Most language learned in training was found to be retained at follow-up approximately 6 months later. Gestural imitation, play style, language age, developmental age, and fine motor skills had strong correlations with language learning and retention.

Aphasia↗
PubMed1995

Reality orientation therapy in Alzheimer disease: useful or not? A controlled study.

The aim of this controlled study was to evaluate the effects of a long-term program of formal didactic group therapy [class reality orientation therapy (ROT)] in Alzheimer disease. The study was conducted in the day hospital of an Alzheimer Dementia Research and Care Unit (Brescia, Italy), a multidisciplinary care center providing diagnostic evaluation and treatment for elderly patients with cognitive impairment. The criteria for the inclusion of patients in the study were mild to moderate cognitive impairment [Mini Mental Status Examination (MMSE) between 11 and 24/30] and absence of major aphasia, blindness, and overt behavioral disturbances such as wandering or agitation. Sixteen patients constituted the experimental group and 12 the control group. The last cognitive, functional, and affective evaluation in the experimental and control group was performed 8.2 and 8.5 months after baseline assessment, respectively. The experimental group had repeated cycles of 1-month ROT classes, and 5-7 weeks was allowed between each cycle. Differential change for MMSE score between the two groups was significant. In the experimental group, there was mild improvement in MMSE score (0.68 point) at the last assessment, whereas the control group declined (-2.58 points). This treatment effect on MMSE score (3.27 points) was controlled for potential confounders in a multiple regression analysis. Adjusted treatment effect, including age, education, baseline MMSE, disease duration, disease severity, number of diseases other than Alzheimer, and time elapsing from baseline to last assessment, was very slightly lower: 3.12. In the experimental group, treatment effect was evaluated by comparing ROT cycle changes and resting period changes. A clearly significant treatment effect was found for MMSE and verbal fluency.

Aged↗
PubMed1999

When traditional care falls short. Caring for people with atypical presentations of cortical dementia.

1 People with chronic dementias receive care and support with programs designed for people with Alzheimer's disease, meaning a significant minority of patients will not benefit as a result of atypical or unusual presentations of cortical decline. 2 When patients have atypical presentations of dementia, nurses must recognize the unusual symptoms, assess care needs, and develop appropriate management strategies. 3 For patients with chronic dementia, individualized care planning includes knowledge of: 1) the patient's culture; 2) their past habits, activities, and preferences; 3) their remaining abilities; 4) the regions of the brain affected, histopathology, and size of the affected area; 5) the usual trajectory for the disease type; and 6) external demands. 4 Conducting research on assessment and care of people with atypical presentations of dementia is very difficult because of their rare nature and lack of recognition by health practitioners who may diagnose the patients with Alzheimer's disease.

Aged↗
PubMed2001

Cerebral laterality for famous proper nouns: visual recognition by normal subjects.

Lexical processing has long been associated with left-hemisphere function, especially for infrequently occurring words. Recently, however, persons with severe aphasia, including word-recognition deficits, were observed to recognize familiar proper nouns. Further, some patients suffering right-hemisphere damage were poorer at identifying famous names than left-hemisphere-damaged subjects. These observations point to the possibility that some property of the right hemisphere provides an advantage for the processing of familiar or personally relevant stimuli. To investigate this possibility, we conducted split-visual-field studies in which we manipulated stimulus sets, recognition task, and exposure duration. Greater accuracy in the right visual field was found for common nouns and unknown proper nouns, and famous proper nouns were overall more accurately recognized. Performance for famous nouns in the two visual fields was not significantly different when the task required categorization into famous or nonfamous and when stimuli most highly rated as familiar were used. These findings support our proposals that (1) both hemispheres can process famous proper nouns and (2) the right hemisphere is specialized for personal relevance.

Adolescent↗
PubMed1988

The efficacy of PACE in the remediation of naming deficits.

This study compared the effects of PACE and traditional stimulation therapy in the remediation of naming deficits. The subject was a 66-year-old conduction aphasic. An ABCBC time-series design was employed. Greater gains were evidenced during the PACE phases of treatment on two types of probes--confrontation naming and picture description tasks.

Aged↗
PubMed1976

The recovery process of a bilingual aphasic.

The recovery process during the first year poststroke in an English-Japanese bilingual aphasic is analyzed with special emphasis on the effect of language therapy. The patient initially manifested equally severe impairment in both English and Japanese involving all language modalities with moderate impairment of reading and auditory comprehension and severe impairment of oral production and writing. Language therapy was conducted in English in a community where Japanese was the only language in the environment. In the course of language therapy, auditory and reading comprehension improved almost simultaneously in both English and Japanese. In contrast, oral language production and writing abilities improved markedly only for the treated language (English). The results are discussed in terms of their implication for the effect of language therapy on aphasia.

Aged↗
PubMed2005

Primary intracranial dural lymphoma of mucosa-associated lymphoid tissue (MALT) type: report of one case and review of the literature.

Primary indolent leptomeningeal lymphoma is a rare entity, and corresponds in most cases to mucosa-associated lymphoid tissue (MALT) type lymphoma. We are reporting a case of a 75 years old woman, who presented with a 2-year history of behavioral disorder, progressive memory loss and aphasia. Neuroimaging showed a mass infiltrating the frontal circumvolutions and the roof of the orbit. The biopsy revealed an infiltration of the dura by an indolent lymphoma, characteristic of a MALT-type lymphoma. Complete staging work-up did not show any evidence of systemic involvement. A treatment with systemic methotrexate, combined with intrathecal chemotherapy and followed by radiotherapy (30,6 Gy) of the primary site, was conducted. The 3-year follow-up confirms the persistent remission, the patient remaining well and free of symptoms. The review of the literature highlights the importance to recognize the indolent PLML as a distinct clinical entity, which exhibits a rather good prognosis following a relatively non-toxic therapy.

Aged↗