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PubMed1986

Semantic classification in aphasia: a study of basic, superordinate, and function relations.

Nonfluent and fluent aphasics were given classification tasks that required the aphasics to identify three kinds of relations: same basic level category, same superordinate level category, and same function. The subjects received the items in word and picture form. In addition the aphasics were required to name the items they were asked to classify. The results showed that the ability to classify is more disrupted in fluent aphasia than in nonfluent aphasia. Within fluent aphasia, the degree to which classification is disrupted is dependent upon the type of relation being tested. While the overall performance of the fluent aphasics was depressed in comparison to nonfluent aphasics, it was significantly more depressed on function relations. The ability to name an item had a significant effect on the ability to classify only for basic level items.

Adolescent↗
PubMed1987

Action-naming performance in four syndromes of aphasia.

This study examined the influence of two situational contexts on the action-naming performances of 44 aphasic patients: single-word confrontation naming and naming within the context of connected speech. Subjects were evenly distributed among the syndromes of Broca's. Wernicke's, anomic, and conduction aphasia. The two naming tasks employed each comprised the same 18 target verbs. Naming performance was not systematically influenced by the particular naming task in any of the aphasia groups studied. However, for some individuals, particularly in the group of anomic aphasia, there were substantial performance discrepancies between scores obtained on the two different tasks. Correlations between scores on the confrontation-naming and picture-description tasks were highest for the Wernicke's aphasics, followed by the conduction, Broca's, and anomic aphasics. The extent to which action-naming error types could discriminate between the four groups of aphasics was examined. Results obtained in the present study were compared to results obtained in an earlier study on object-naming (S. Williams & G. Canter, 1982), Brain and Language, 17, 92-106). Discussion focuses on implications for the psycholinguistic processes involved in action versus object-naming.

Adult↗
PubMed1990

Automatic and volitional semantic processing in aphasia.

The present study investigated the status of semantic information in aphasia by comparing the performances of aphasic and nonaphasic subjects on two tasks: an automatic semantic facilitation task and a volitional task of relatedness judgment. Both the aphasic and nonaphasic groups evidenced a semantic facilitation effect, in an on-line task of semantic processing. However, those aphasics with severe comprehension and naming disturbances (termed low comprehension aphasics) demonstrated considerable difficulty in judging the relatedness between a pictured object and members of that object's semantic field, the severity of the impairment being greater for those pictures that the low comprehension aphasics were unable to name. The pattern of results can best be explained by supposing the structural integrity of the store of semantic information in aphasia, and in particular in low comprehension aphasia: information that is retrieved and manipulated in judgment-mediated tasks with considerable difficulty.

Adult↗
PubMed1990

Traumatic aphasia in children and adults: a comparison of clinical features and evolution.

We compared the performance on test of language, apraxia, acalculia and intelligence of 32 children--age 5 to 16 years--and 31 adults, seen at our Aphasia Unit for the sequelae of a brain trauma. Logorrhea was never present among children who had nonfluent aphasia more frequently than adults. Apraxia and acalculia were equally present in the two groups. Twelve children and 15 adults of the first study were retested at variable distance from trauma. No group difference was found in the recovery of auditory comprehension (Token Test) or oral expression (oral confrontation naming and telling-of-an-event). On a battery of verbal and spatial memory tests 6 of the 12 children had pathological scores in one or more tests. Scholastic achievements were compared with those of the nearest kin. We conclude that while aphasia profiles are different in children and adults, the incidence of apraxia and acalculia and the recovery rate do not discriminate the two groups.

Achievement↗
PubMed1981

Syntactic processing deficits in aphasia.

Four aphasic patients were tested in several tasks to determine their ability to use syntactic information. Two patients classified as Broca's aphasics and presenting markedly different levels of severity of aphasia were deficient in their ability to use syntactic information in sentence comprehension and construction. It is argued that the syndrome of Broca's aphasia undermines patients' ability to perform the syntactic analyses that are necessary to understand and to produce sentences in both language modalities. A third patient was a conduction aphasic who presented a pattern of sentence comprehension similar to the Broca patient, but produced no other evidence of syntactic impairment. The argument is advanced that the conduction patient's apparently selective impairment of syntactic processing in comprehension is actually a reflection of a severe auditory-verbal short-term memory deficit. The fourth patient was classified as a mildly-impaired Wernicke's aphasic, who presented no evidence of a selective disturbance of syntactic processing abilities. These results are interpreted as support for the hypothesis that the syndrome of Broca's aphasia results from an impairment to the syntactic component of the language processing system.

Aphasia↗
PubMedDate not supplied

Quantitative study of the rate of recovery from aphasia due to ischemic stroke.

The extent of recovery from aphasia following ischemic stroke has been evaluated by a quantitative method. The greatest improvement was observed during the first 3 months following onset. The rate of recovery was similar for expression and for comprehension, but comprehension was usually less disturbed than expression. Final prognosis depends on the type of aphasia (the poorest prognosis was found for total or global aphasia) and on the severity of the initial insult.

Adult↗
PubMed1987

Kepiński's functional structures, Kohonen's topological structures, aphasia and apraxia.

The concept of functional structures was introduced by Kepiński. At the Second Scandinavian Congress on Image Analysis in 1981 Kohonen provided evidence that the map of signals has the same topological order as the map of reactions. These topological concepts can be applied also to logical structures. The same is true also of functional structures described by Kepiński in schizophrenia, which may be created or destroyed, but their topological order remains unaltered. Functional structures change in obscuration and in hallucinogen-induced psychodelic states. Fixed pathological structures characterized by an altered topological order occur in paranoia. In the case of amnestic aphasia single elements of the topological functional structures fall out-these elements represent terms which patient is unable to recall. In motor aphasia, on the other hand, damage concerns the topological functional structures of speech related movements. In sensory aphasia damage concerns topological functional structures in the sensory area. In Goldstein's amnestic apraxia there is a loss of some elements of the topological functional structures governing the movements. In ideational apraxia the damage concerns topological functional structures representing entire sets of motor function and especially their creation. In ideomotor apraxia the respective topological functional structures are retained, albeit inaccessible, due to a disturbance in the motor association. In motor apraxia the damage seems to concern the topological functional structures governing precise movements and located at a lower level, i.e., closer to the effector. Constructive apraxia seems to result from the disturbed creation of the respective functional structures. Similarly the hypermotility of a maniacal type has a smooth and purposeful character, as far as the relation to a particular situation is concerned, which suggests that the respective topological functional structures are preserved. On the other hand, in the hyperkinetic phase of catatonic schizophrenia, in which the patient performs sequences of incoherent aimless movements without any relation to the current situation and environment, these structures are supposedly altered.

Aphasia↗
PubMedDate not supplied

[On a case of aphasia with thalamic lesion (author's transl)].

The possibility of aphasic disorder caused by thalamic lesions has been supported by anatomo-clinical findings, stereotaxic surgery and more recently by radiological investigations with new techniques, i.e. ct and brain scan. A case of thalamic aphasia investigated with these techniques and the Luria's neuropsychological test is reported in this paper. The case concerns a 50 years old woman who developed a sudden right hemiplegia with marked motor aphasia. C.T. and radioisotope brain scan revealed a left capsular haemorrhage with involvement of thalamic structures. Later, when this patient's aphasia decreased, Luria's test showed reduction of spontaneous speech, anomia, paraphasic and disarthric disorder, distractibility without impairment of comprehension and repitition. These findings are similar to those reported by some AA. in left thalamic lesions and similar to aphasic syndromes caused by cortical lesions. Another important observation was the presence of widespread cortical functional disorder involving the left fronto-temporo-parietal region without evidence of cortical anatomical alteration. The above data and those reported in the literature suggest a very close relationship between thalamic structures, other central nuclei and cortical areas particularly in the control of speech.

Anomia↗
PubMed1980

[Kinesthetic aphasia associated with a pseudothalamic syndrome (author's transl)].

Kinesthetic aphasia, as described by Luria, was evoked in a case of aphasia associated with a "pseudothalamic syndrome" of partial superficial Sylvian infarction. A neurolinguistic study of oral utterances enabled qualitative and quantitative analysis of the errors: the disorder is characterized by the high incidence of articulation substitutions. A comparative study differentiated such disorders of oral expression from other aphasic disorders of expression (arthric disorders and phonemic jargon). Kinesthetic aphasia is distinguished by this clinical specificity and by the site of the lesion in the anterior parietal region of the dominant hemisphere.

Aged↗
PubMed2006

Episodic receptive aphasia in a child with Landau-Kleffner Syndrome: PET correlates.

We report a four-year-old boy with Landau-Kleffner Syndrome (LKS) characterized by episodic receptive aphasia lasting for few weeks followed by gradual recovery of baseline language functions. Neuropsychological evaluation during an episode showed severe impairment in verbal skills and comprehension, but relative preservation of non-verbal skills. Although he could carry on a conversation during remission, neuropsychological evaluation demonstrated findings reflective of receptive language deficits. Prolonged EEG disclosed frequent sharp-wave activity in the left and right temporal regions but no electrographic seizures. Glucose metabolism PET scan during the fourth episode of aphasia revealed intense hypermetabolism in the left temporal neocortex. Awake EEG during the PET tracer uptake period showed 6.0 spikes/min in the left temporal region and 4.0 spikes/min in the right. A repeat PET scan during remission showed hypometabolism in the left temporal cortex. Awake EEG during the FDG uptake period showed 16.0 spikes/min in the right temporal region and 0.3 spikes/min in the left. During his fifth aphasic episode, EEG (without PET) showed 0.16 spikes/min in the right temporal region and none in the left. Intermittent short episodes of predominantly receptive aphasia with near-total recovery between episodes can be one of the clinical presentations of LKS. This case illustrates the dynamic changes of glucose metabolism in the temporal lobe during episodes of aphasia and remission in a case with LKS. The clinical course of our patient with transient EEG and PET findings suggest that glucose metabolism in LKS cannot be attributed solely to interictal epileptiform activities on scalp EEG.

Child, Preschool↗
PubMed2002

[Kurt Goldstein's understanding of amnesic aphasia and its underlying disorder - an early model of the pensée opératoire of the French psychosomatic school?].

Kurt Goldstein's understanding of amnesic aphasia in some regards anticipated the model of the pensée opératoire, a concept developed during the 60's and 70's by the French psychoanalytical school of psychosomatics. Goldstein interpreted amnesic aphasia within the framework of a "basic disorder". Closely following the philosopher Ernst Cassirer, Goldstein described amnesic aphasia as an expression of a general alteration following localized or generalised brain damage. Due to various historical events (world war, fascism, the holocaust) as well as developments during the 20(th) century (dominance of the English language in many areas of science), these connections were forgotten or were no longer recognised as such. Without wanting to determine the extent to which the concept of pensée opératoire possesses validity, one can interpret Goldstein's reflections on aphasia as a heretofore unreceived preliminary model of the psychosomatic concept of the French School.

Anomia↗
PubMed1991

Three cases of anomic aphasia after lesions in and/or around the basal ganglia.

The present paper reports 3 cases of aphasia with small lesions in the region of the basal ganglia to discuss whether neostrial dysfunction can cause aphasic symptoms. The Standard Language Tests of Aphasia (SLTA) was used to assess the type and degree of aphasia. Two patients with infarction either in the left putamen or in the head of the left caudate nucleus showed severe disturbance only in recalling words, especially nouns. The other patient showed the same symptom, in addition to writing disturbance that developed shortly after surgical extirpation of an arteriovenous malformation (AVM) in the left caudate nuclei. The symptoms common to the 3 patients corresponded well to the "anomic aphasia" proposed by Benson. The aphasic symptoms disappeared completely or largely within several months. This easy reversibility suggests that the aphasic disorder in the three patients was caused by damage not to the basal ganglia themselves, but to the affecting axons passing through or by the nuclei.

Aged↗
PubMed1981

Transcortical sensory aphasia with relatively spared spontaneous speech and naming.

Patients with transcortical sensory aphasia have relatively preserved repetition ability but have poor comprehension and naming ability. Their spontaneous speech contains paraphasic errors and lacks content. We describe a patient with a left parietal lesion who had poor comprehension but who was able to repeat. However, unlike previously reported cases of transcortical aphasia, the patient had relatively normal naming and spontaneous speech. We believe that this distinct and previously unreported form of transcortical aphasia is induced by a one-way dissociation between phonemic and semantic processors.

Aphasia↗
PubMed1989

Distributed anatomy of transcortical sensory aphasia.

We examined four patients with transcortical sensory aphasia and eight with milder language disturbances but with similar thalamic and/or temporo-occipital lesions. Specific attention was paid to differentiation of the computed tomographic lesion site of the milder cases from the transcortical sensory aphasia cases. The critical lesion for transcortical sensory aphasia in these patients involved pathways in the posterior periventricular white matter adjacent to the posterior temporal isthmus, pathways that are probably converging on the inferolateral temporo-occipital cortex. Analysis of the language function of these patients, of the influence of sensory modalities on language function, and of the interaction between semantic memory and semantic lexical functions suggests the existence of a specific brain system for semantic functions. This semantic system has a particular distributed anatomy. We propose that damage to this system may have a variety of clinical manifestations in language and in memory, depending on the exact lesion configuration.

Aged↗
PubMed2004

Cognition and anatomy in three variants of primary progressive aphasia.

We performed a comprehensive cognitive, neuroimaging, and genetic study of 31 patients with primary progressive aphasia (PPA), a decline in language functions that remains isolated for at least 2 years. Detailed speech and language evaluation was used to identify three different clinical variants: nonfluent progressive aphasia (NFPA; n = 11), semantic dementia (SD; n = 10), and a third variant termed logopenic progressive aphasia (LPA; n = 10). Voxel-based morphometry (VBM) on MRIs showed that, when all 31 PPA patients were analyzed together, the left perisylvian region and the anterior temporal lobes were atrophied. However, when each clinical variant was considered separately, distinctive patterns emerged: (1) NFPA, characterized by apraxia of speech and deficits in processing complex syntax, was associated with left inferior frontal and insular atrophy; (2) SD, characterized by fluent speech and semantic memory deficits, was associated with anterior temporal damage; and (3) LPA, characterized by slow speech and impaired syntactic comprehension and naming, showed atrophy in the left posterior temporal cortex and inferior parietal lobule. Apolipoprotein E epsilon4 haplotype frequency was 20% in NFPA, 0% in SD, and 67% in LPA. Cognitive, genetic, and anatomical features indicate that different PPA clinical variants may correspond to different underlying pathological processes.

Aged↗
PubMed1981

FDG positron emission computed tomography in a study of aphasia.

Positron emission computed tomography (PECT) using 18F-2-fluoro-2-deoxy-D-glucose (FDG) was used to investigate the correlations between clinical status, anatomy (as described by CT), and metabolism in five patients with stable aphasia resulting from ischemic cerebral infarction. Local cerebral metabolic activity was diminished in an area larger than the area of infarction demonstrated by CT. In one patient, FDG PECT revealed a metabolic lesion that probably caused the aphasic syndrome and was not apparent by CT. The data suggest that reliance on CT in delineating the extent of the brain lesion in aphasia or other neuropsychological defects can be misleading; FDG PECT may provide important additional information. Two patients with similar metabolic lesions had very different clinical syndromes, showing that even when currently available methods are combined, major gaps remain in clinicoanatomical correlations in aphasia.

Aged↗
PubMed1993

An on-line analysis of syntactic processing in Broca's and Wernicke's aphasia.

This paper is about syntactic processing in aphasia. Specifically, we present data concerning the ability of Broca's and Wernicke's aphasic patients to link moved constituents and empty elements in real time. We show that Wernicke's aphasic patients carry out this syntactic analysis in a normal fashion, but that Broca's aphasic patients do not. We discuss these data in the context of some current grammar-based theories of comprehension limitations in aphasia and in terms of the different functional commitments of the brain regions implicated in Broca's and Wernicke's aphasia, respectively.

Acoustic Stimulation↗
PubMed1985

Communicative effectiveness in Broca's aphasia.

The purpose of this study was to investigate communicative effectiveness in aphasia. Five patients with Broca's aphasia and five neurologically normal subjects participated in referential communication and spontaneous conversation tasks. Performance on the referential tasks was used to derive measures of communication success, learning, and efficiency. A representative sample of utterances from the referential tasks and 100 utterances from the spontaneous conversation task also were analyzed to determine the frequency of operationally defined errors in speech, lexical access, grammar, content, discourse, and use. Results suggest that patients with Broca's aphasia retain communicative effectiveness in the presence of significant speech and language deficits and experimentally imposed constraints on the use of visual and gestural communication modalities.

Adult↗