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PubMed1996

Interactions between recovery in aphasia, emotional and psychosocial factors in subjects with aphasia, their significant others and speech pathologists.

Associations between clinical and functional aphasia recovery and perceptions of emotional and psychosocial adjustment accompanying aphasia were examined in five subjects at 3 and 9 months post-onset of stroke using a range of objective and subjective measures. The subjective well-being and optimism of significant others of aphasic patients was also examined, and speech pathologists completed measures of optimism. Unique patterns of individual emotional and psychosocial adjustment were found over time in patients and their significant others, even in patients with similar aphasia type and severity. Individual variability in emotional and psychosocial adjustment and their impact on recovery from aphasia are discussed.

Adaptation, Psychological↗
PubMed1984

Transcortical motor aphasia: one or two aphasias?

The name "transcortical motor aphasia" has been used to refer to two different types of language alterations: damage in the left supplementary motor area and Luria's dynamic aphasia. It is proposed that they represent two types of language disturbances different enough to be considered two different forms of aphasia.

Aphasia↗
PubMed1990

Broca's area aphasias: aphasia after lesions including the frontal operculum.

We report 9 cases of aphasia following lesions in the region of the left frontal operculum. It is not possible to capture their variety of clinical manifestations with the simple labels of "Broca's area aphasia." or "Broca's area aphasia." Analysis of the breakdown of various components of speech and language in these cases suggests that the operculum, lower motor cortex, and subjacent subcortical and periventricular white matter contain critical parts of different language systems. These systems can be independently impaired. There are several common language syndromes that follow damage that includes the left frontal operculum. These syndromes reflect the effects of the direction and extent of the lesion in the various language systems.

Adult↗
PubMed1995

Variability in aphasia research: aphasia subject selection in group studies.

Subject selection criteria and descriptive data were compiled from 15 consecutive aphasia group studies published in Brain and Language from its inception (1974-1976) and two decades later. While some measures remain constant (aphasia type and lesion site are most commonly used in both periods), additional measures are reported only or more frequently in the recent period (e.g., age, handedness, bilingualism, language spoken, multiple vs. single lesions). Of interest is the decrease in the total number of subjects included in aphasia group studies from the early to the current period.

Aphasia↗
PubMed1997

Adynamic aphasia: a transcortical motor aphasia with defective semantic strategy formation.

Adynamic aphasia is a form of transcortical motor aphasia characterized by sparse but otherwise normal spontaneous speech that may improve when concepts are introduced by external stimuli. Akinesia, impaired concept formation, inertia of concept generation, a defective semantic network, damage or impaired access to the verbal output lexicon, and defective semantic strategy formation have been proposed to account for this disorder. We studied a patient with adynamic aphasia and frontal lobe systems dysfunction due to bilateral striatocapsular infarctions. The patient was not akinetic but did demonstrate inertia of concept generation that could be overcome with prompting. However, prompting did not improve the number of concepts generated. He demonstrated a generally intact verbal lexicon and semantic network and normal lexical priming. However, his ability to sort closely related items into different classes without prior cuing regarding the nature of the classes was defective. Although his verbal memory was normal, he appeared to use a serial rather than a semantic strategy to recall items. Finally, despite normal lexical priming, he was impaired on a letter fluency task. These results most clearly demonstrate a defect in semantic strategy formation but indicate an additional and possibly related deficit in concept formation and a partial deficit in lexical strategy formation. All of these deficits appear to reflect impairment in the hierarchical organization of knowledge specific to the task at hand. This appears to be a key component of executive functions supported by frontal lobe systems.

Aphasia↗
PubMed1982

The thalamus and aphasia, including transcortical aphasia: a review.

Left thalamic lesions can produce motor speech disturbances: disorders of articulation and of phonation. Left thalamic lesions can also produce aphasic disorders: word-emission difficulties; difficulties with comprehension, reading, writing, and arithmetic; and sometimes suppression of conversational propositional speech with preservation of nonpropositional repetitional or automatic speech. The relative preservation of nonpropositional speech justifies the assignment of such cases of thalamic aphasia to the category of transcortical aphasia (TA). Also included in TA are aphasias from dominant hemisphere supplementary motor region (SMR) lesions. In this context the suggestion by Penfield and Roberts that the thalamus and the SMR interact via the pedunculus thalami superior is noted.

Adult↗
PubMed1987

The incidence of aphasia and global aphasia in left brain-damaged patients.

Two hundred and twenty three right-handed patients consecutively admitted to the wards in a 21-month period for a left-sided cerebrovascular disease were examined 15 to 30 days after the stroke for the presence of aphasia. Twenty-seven of them could not be assessed. Of the remaining 196, 108 (55.1%) were aphasic. The incidence of global aphasia (43%) in the latter group was higher than in previous studies. Based on CT-scan data it was associated in 32% of patients with a deep lesion and only in 53% with an antero-posterior cortical-subcortical lesion, contrary to what is traditionally assumed. There was no sex difference in the incidence and distribution of aphasia.

Acute Disease↗
PubMed2002

Crossed aphasia: an analysis of the symptoms, their frequency, and a comparison with left-hemisphere aphasia symptomatology.

This study presents a thorough analysis of published crossed aphasia (CA) cases, including for the first time the cases published in Japanese. The frequency of specific symptoms was determined, and symptomatology differences based on gender, familial sinistrality, and CA subtype were investigated. Results suggested that the CA population is comparable to the left-hemisphere patient population. However, male were significantly more likely than female CA subjects to show a positive history of familial sinistrality. Typical right-hemisphere (i.e., nonlanguage-dominant) symptoms were frequent but rarely carefully reported or assessed. Results are compared with previous CA reviews and left-hemisphere aphasia. Suggestions for a more systematic assessment of the CA symptomatology are presented.

Adult↗
PubMed1993

Nonoptic aphasia: aphasia with preserved confrontation naming in Alzheimer's disease.

Patients with Alzheimer's disease (AD) frequently exhibit anomia early in the course of the disease. Current theories of naming describe lexical retrieval in visual confrontation naming as requiring processing through the semantic system before lexical access. We report on three patients with AD who demonstrated severely impoverished spontaneous speech, impaired list generation, but preserved visual confrontation naming. Extensive investigation of one of these patients revealed an impairment of semantic knowledge. Our results support previous theories that there are two routes to visual naming, one via the semantic system and one directly from the internal visual representation to the lexicon. We labeled this aphasia resulting from an impaired semantic system but a preserved direct route to the lexical system as "nonoptic aphasia" and suggest that it is the earliest language deficit in some patients with AD.

Aged↗
PubMed1987

The Frenchay Aphasia Screening Test: a short, simple test for aphasia appropriate for non-specialists.

This paper describes preliminary studies on a screening test for aphasia which takes 3-10 minutes to complete and which is suitable for use by general practitioners, junior medical staff and other non-specialists. Data are presented to show that it is a reliable, valid assessment. Using cut-off values derived from normal people, the test is sensitive, but its specificity is limited by such associated factors as hemianopia. Using cut-off values derived from patients known to have aphasia, its specificity is improved. An abnormal result needs to be interpreted in the light of all available clinical information. The test should help identify patients with linguistic disturbance.

Aphasia↗
PubMed1993

Ideomotor apraxia without aphasia and aphasia without apraxia: the anatomical support for a double dissociation.

This study aimed to verify the existence of a double aphasia/apraxia dissociation. Apraxic patients without aphasia and aphasic patients without apraxia were included in a consecutive series of patients with cortical or subcortical CT documented vascular lesions in the left hemisphere. Of 699 patients, 10 were found to be apraxic but not aphasic and 149 aphasic but not apraxic. These findings indicate an aphasia/apraxia double dissociation. This suggests that praxis and language make use of two different, partly overlapping networks.

Aged↗
PubMed1998

[Difference between transcortical sensory aphasia following the left frontal lesion and transcortical sensory aphasia following the left posterior lesion].

We assessed the difference between transcortical sensory aphasia (TCSA) following the left frontal lesions (F-TCSA) and TCSA following the left posterior lesions (P-TCSA). All the patients were right-handed and the 7 patients had the lesions in the only frontal lobe and the 10 patients had the lesions only in the left temporo-parieto-occipital regions. We administered pointing tasks, using 90 line drawings representing single nouns. We presented 6 line drawings a pointing board, and we used two kinds of pointing boards: one showed the line drawings each belonging to different categories (random categorized pointing task), the other showed the line drawings each belonging to only either two different categories (two categorized pointing task) and we presented 15 pointing boards each alternatively. The result was that regarding the patients of P-TCSA showed different number of correct answers between the random categorized pointing task and the two categorized pointing task with statistical significance. Regarding the patients of F-TCSA showed no difference between them. The results indicated that disturbance of P-TCSA on the pointing task was the disturbance of semantic process per se. And the disturbance of F-TCSA on the pointing task was that of not only semantic process but also the whole process including comprehending the presented words, searching the line drawings, comparing the line drawings with the presented word and final selection, which demanded persistent multiple memory process consistent with working memory.

Aphasia, Wernicke↗
PubMed1996

Lexical-semantic event-related potential effects in patients with left hemisphere lesions and aphasia, and patients with right hemisphere lesions without aphasia.

Lexical-semantic processing impairments in aphasic patients with left hemisphere lesions and non-aphasic patients with right hemisphere lesions were investigated by recording event-related brain potentials (ERPs) while subjects listened to auditorily presented word pairs. The word pairs consisted of unrelated words, or words that were related in meaning. The related words were either associatively related, e.g. "bread-butter', or were members of the same semantic category without being associatively related, e.g. "church-villa'. The latter relationships are assumed to be more distant than the former ones. The most relevant ERP component in this study is the N400. In elderly control subjects, the N400 amplitude to associatively and semantically related word targets is reduced relative to the N400 elicited by unrelated targets. Compared with this normal N400 effect, the different patient groups showed the following pattern of results: aphasic patients with only minor comprehension deficits (high comprehenders) showed N400 effects of a similar size as the control subjects. In aphasic patients with more severe comprehension deficits (low comprehenders) a clear reduction in the N400 effects was obtained, both for the associative and the semantic word pairs. The patients with right hemisphere lesions showed a normal N400 effect for the associatively related targets, but a trend towards a reduced N400 effect for the semantically related word pairs. A dissociation between the N400 results in the word pair paradigm and P300 results in a classical tone oddball task indicated that the N400 effects were not an aspecific consequence of brain lesion, but were related to the nature of the language comprehension impairment. The conclusions drawn from the ERP results are that comprehension deficits in the aphasic patients are due to an impairment in integrating individual word meanings into an overall meaning representation. Right hemisphere patients are more specifically impaired in the processing of semantically more distant relationships, suggesting the involvement of the right hemisphere in semantically coarse coding.

Adult↗
PubMed1997

Speed of lexical activation in nonfluent Broca's aphasia and fluent Wernicke's aphasia.

Rapid, automatic access to lexical/semantic knowledge is critical in supporting the tight temporal constraints of on-line sentence comprehension. Based on findings of "abnormal" lexical priming in nonfluent aphasics, the question of disrupted automatic lexical activation has been the focus of many recent efforts to understand their impaired sentence comprehension capabilities. The picture that emerges from this literature is, however, unclear. Nonfluent Broca's aphasic patients show inconsistent, not absent, lexical priming, and there is little consensus about the conditions under which they do and do not prime. The most parsimonious explanation for the variable findings from priming studies to date is that the primary disturbance in Broca's lexical activation has something to do with speed of activation. Broca's aphasic patients prime when sufficient time is allowed for activation to spread among associates. To examine this "slowed activation" hypothesis, the time course of lexical activation was examined using a list priming paradigm. Temporal delays between successive words ranged from 300 to 2100 msec. One nonfluent Broca's aphasic patient and one fluent Wernicke's patient were tested. Both patients displayed abnormal priming patterns, though of different sorts. In contrast to elderly subjects, who prime at relatively short interstimulus intervals (ISIs) beginning at 500 msec, the Broca's aphasic subject showed reliable automatic priming but only at a long ISI of 1500 msec. That is, this subject retained the ability to access lexical information automatically if allowed sufficient time to do so, a finding that may help explain disrupted comprehension of normally rapid conversational speech. The Wernicke's aphasic subject, in contrast, showed normally rapid initial activation but continued to show priming over an abnormally long range of delays, from 300 msec through 1100 msec. This protracted priming suggests failure to dampen activation and might explain the semantic confusion exhibited by fluent Wernicke's patients.

Aphasia, Broca↗