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PubMed2006

Fine grain temporal analysis in aphasia: evidence from auditory gap detection.

Auditory temporal processing was investigated in individuals with acquired aphasia using a task in which they were asked to detect brief silent gaps inserted between noise segments modeled after formants in speech. To examine within-channel gap detection, gaps of 10, 20, 40, and 80ms duration were inserted between an initial segment (IS) and a trailing segment (TS) centered at the same frequency (1kHz). In a between-channel gap detection condition, gaps of 20, 40, 80, and 100ms duration were inserted between an IS that differed in frequency (4kHz) from the TS (1kHz). The effect of gap onset timing was examined in both conditions by systematically varying the duration of the IS by 10, 20, or 40ms. A combined analysis revealed that for both conditions and all gap and IS durations, individuals with aphasia produced fewer correct responses than age-matched neurologically intact controls. Separate condition analyses revealed that when noise segments were centered at the same frequency, individuals with aphasia demonstrated poorer accuracy in detecting 40 and 80ms gaps relative to normal controls (p<0.001). When gaps were inserted between noise segments differing in frequency, on average, aphasic subjects performed less accurately at durations of 40, 80 and 100ms (p<0.025). Detection in both groups decreased with smaller IS durations. The difficulties with gap detection observed in the aphasic group suggest the existence of fundamental problems in processing the temporal form or microstructure of sounds characterized by rapidly changing onset dynamics.

Analysis of Variance↗

PubMed2005

Isolated idiopathic hypomagnesemia presenting as aphasia and seizures.

Isolated hypomagnesemia of the idiopathic form is a rare condition that is known to present as generalized motor seizures in children. This report describes a 4-year-old African-American male who presented with a predominant symptom of sudden onset aphasia and no clear initial motor seizure activity. An evaluation revealed an isolated and severe hypomagnesemia (initial serum magnesium levels <1.0 mg/dL) and inappropriate renal handling of magnesium (fractional excretion of magnesium >40% under conditions of hypomagnesemia). The child had subsequent generalized tonic-clonic seizures that were brought under control with valproic acid therapy and magnesium supplementation. Six months after the diagnosis, he had regained 50-60% of his speech and had no further staring spells or motor seizure activity after the initial episode. Isolated and idiopathic hypomagnesemia caused by defective renal reabsorption of magnesium is a rare familial condition with variable inheritance. Aphasia as the solitary presenting symptom has not been described before. The exact pathophysiology of hypomagnesemic aphasia and seizures is not known but may relate to disinhibition of specific types of glutamate receptors. In the present case, neuronal depolarization may have been localized to language areas in the temporal lobes.

Aphasia↗

PubMed2006

Meynert on Wernicke's aphasia.

This paper examines Meynert's contribution to aphasia, in particular the suggestion that Meynert already had described the syndrome of sensory aphasia. I examine Meynert's own writings on this subject, Wernicke's statements on this issue and biographies of Meynert and Wernicke. I argue that Meynert did not describe sensory aphasia, nor is there convincing evidence that he stimulated Wernicke in this direction. Meynert was primarily interested in the global neuroanatomical organization of the brain and in particular the special role of the frontal lobes.

Aphasia, Wernicke↗

PubMed1992

Tactile agnosia and tactile aphasia: symptomatological and anatomical differences.

Two patients with tactile naming disorders are reported. Case 1 (right hand tactile agnosia due to bilateral cerebral infarction) differentiated tactile qualities of objects normally, but could neither name nor categorize the objects. Case 2 (bilateral tactile aphasia after operation of an epidural left parietal haematoma) had as severe a tactile naming disturbance as Case 1, but could categorize objects normally, demonstrating that tactile recognition was preserved. Case 1 may be the first case of tactile agnosia clearly differentiated from tactile aphasia. CT scans of Case 1 revealed lesions in the left angular gyrus, and in the right parietal, temporal, and occipital lobes. Case 2 had lesions in the left angular gyrus and of posterior callosal radiations. Our findings suggest that tactile agnosia appears when the somatosensory association cortex is disconnected by a subcortical lesion of the angular gyrus from the semantic memory store located in the inferior temporal lobe, while tactile aphasia represents a tactual-verbal disconnection.

Aged↗

PubMed1994

Visual agnosia and optic aphasia: are they anatomically distinct?

A patient with left infero-medial occipital-temporal infarct suffered a visual agnosia that, by a minor change of the task, could be manipulated to optic aphasia. Tools in actual use and pantomimes of tool use were better named than stationary tools, a dissociation that suggests differences in the ability of stimuli to evoke associations over multiple modalities. Based on this case and analysis of previous reports we suggest that optic aphasia differs from visual agnosia primarily in the degree of callosal disconnection and that the preserved demonstration of tools use and semantic classification of optic aphasia reflect right hemisphere contribution to visual processing.

Aged↗

PubMed1976

Personality factors in jargon aphasia.

The personality background of 20 patients with jargon aphasia was compared to that of a standard aphasia group with particular reference to features of the so called anosognosic personality; denial or marked overt fear of illness and strong work orientation. Such attitudes toward illness were found in 19 of 20 jargon subjects, and seven of the comparison group. Nineteen of the jargon patients and eleven of the non-jargon asphasics were described as highly work oriented. The premorbid personality was also significantly related to the type of denial of the speech deficit, and to related aspects of behavior. Patients with strong premorbid denial explicitly and completely denied their asphasic deficits, and were affable, bland or unconcerned. Patients with a history of overt fear of illness had implicit or mixed forms of denial, and showed disturbed, agitated, paranoid and often psychotic behavior. The type of denial is thus related not only to premorbid personality, but to observable behavior in hospital. The observations are regarded as providing additional evidence for the view that jargon may be regarded as "anosognosic aphasia," and represents not only a linguistic deficit, but an adaptation to the deficit.

Adult↗

PubMed1978

Delayed auditory feedback and aphasia.

The effect of Delayed Auditory Feedback (DAF) was evaluated in three groups of subjects: 10 normal controls, 10 non-fluent aphasics, and 10 fluent aphasics. Speec production tasks consisted of (1) repeating sound and words; (2) naming objects; (3) producing sentences from given stimulus words; (4) answering questions; (5) reciting nursery rhymes; and (6) reading. Two delays were used, 180 and 360 msec. Two independent judges rated patients' responses for changes in intensity, duration, and quality of speech. Inter-judge reliability was considered satisfactory. Contrary to some previous reports, all subjects, including all the fluent aphasics, showed some DAF effect. Fluent aphasics, however, showed a significantly smaller DAF effect than non-fluent aphasics. Patient with conduction aphasia appeared to be the least impaired. Overall DAF effect was greater with 180 msec. than with 360 msec. The largest DAF effect occurred during answering question, followed by repeating, reading, nursery rhymes, sentence production, and naming, in that order. Repetition of a complex word produced a greater DAF effect than repetition of a simple sound. Finally, we found a differential effect of DAF on the three measures used in the study. We hypothesize that DAF effects result from changes in two separate monitoring systems. One systems is related to changes in the intensity of speech and does not appear to be affected by aphasia. The other is responsible for duration and qualitative changes in speech and is differentially affected in relation to pathology producing aphasia.

Adult↗

PubMed1979

"Transcortical" features of aphasia following left thalamic hemorrhage.

In a series of 14 thalamic hemorrhage documented by Computerized Axial Tomography (CT) scans, aphasia was present in seven out of eight patients with left lesions while it was absent in the six patients with right lesions. In three cases where detailed language testing was performed, aphasia was characterized by reduction of spontaneous speech with semantic paraphasias, preserved repetition and partially defective auditory verbal comprehension. The language disturbance was persistent in two patients, while it recovered spontaneously within four weeks in one patient. The clinical picture in these patients is similar to the classical "transcortical" aphasias, which are usually due to damage of the marginal language areas. It is suggested that the left thalamus contributes to the semantic level of verbal behavior, which is possibly subserved by these areas.

Aged↗

PubMed1982

[Analysis and quantitative study of language disorders in lesions of the left thalamus: thalamic aphasia].

We have studied 5 patients having a language disturbance associated with a left thalamic lesion documented by computerized tomography. These patients were submitted to a french adaptation of the Boston Diagnostic Aphasia Examination, originally designed by Goodglass and Kaplan. A quantitative analysis of these language disturbances has shown that they are characterized by reduction of fluency, resembling that of dynamic aphasia, with impaired volume, tone and articulation of speech. There is also a difficulty at finding word categories. Perseverations are frequent while paraphasias are scarce, being then mostly incoherences. Comprehension is impaired, but only at a complex level. Reading and writing are inconsistently affected. This symptom-complex is coherent enough from case to case to be considered as a recognizable type of aphasia, and specially since it is invariably associated with a left thalamic lesion.

Adult↗

PubMed1988

Crossed aphasia: functional studies with single photon emission computerized tomography.

The correlation between clinical picture, CT scan and regional cerebral blood flow (rCBF) assessed by single photon emission computerized tomography (SPECT) was investigated in two patients with crossed aphasia. The presence and degree or right hemisphere dysfunction, beyond the areas affected by CT, closely paralleled the time course of language disturbances in both patients: transient aphasia in case 1 was associated with temporary reduction of perfusion in the right hemisphere, while in case 2 persistent aphasia and apraxia were found along with severe right hemisphere hypoperfusion three year after the onset of stroke.

Aged↗

PubMed1989

Dynamic aphasia: the selective impairment of verbal planning.

A single case study of a patient, ROH, who had a space occupying lesion in the left frontal lobe is reported. His selective speech disorder had all the hallmarks of a dynamic aphasia. Tests of sentence completion, phrase generation and sentence generation were administered. His ability to generate sentences was significantly better given a pictorial context than a verbal context. Although he could order a sequence of pictures, he had the greatest difficulty in ordering the constituent words of a sentence. Luria's hypothesis that dynamic aphasia is due to an impairment of inner speech which provides "the linear scheme of a sentence" is discussed. It is concluded that dynamic aphasia does not reflect a deficit of language processing but rather the selective impairment of verbal planning.

Adult↗

PubMedDate not supplied

Test-retest reliability of three aphasia tests: performance of non-brain-damaged older adults.

This study was designed to assess the test-retest reliability of three aphasia tests. The Auditory Comprehension Test for Sentences (ACTS), the Boston Naming Test (BNT), and the Reading Comprehension Battery for Aphasia (RCBA) were administered on two separate occasions to 31 non-brain-damaged adults aged 50 to 76 years. The results showed acceptable score stability for all three aphasia tests. Sixty-eight percent of the time, older non-brain-damaged adults would be expected to score within 4.0% or less of the total number of test items on repeated testing.

Aged↗

PubMed2001

Corticobasal degeneration presenting with nonfluent primary progressive aphasia: a clinicopathological study.

A 62-year-old woman initially presented with slowly progressive nonfluent aphasia with minimal intellectual involvement. Echolalia and personality change were prominent whereas parkinsonian features and signs suggesting parietal lobe dysfunctions were not present. The patient's language deficit was consistent with transcortical motor aphasia. She did not manifest extrapyramidal signs. The patient was diagnosed as having Pick's disease or frontal lobe dementia. She died at age 65, 2 years and 9 months following disease onset. Neuropathological findings including cytoskeletal abnormalities, however, were clearly distinct from those of classical Pick's disease and were consistent with those reported in corticobasal degeneration (CBD). The distribution of her cortical lesions was accentuated in the frontal language-related area. The clinical manifestations in CBD are diverse, and primary progressive nonfluent aphasia should be considered as an initial symptom of CBD. Neuropathological examination of such patients should include cytoskeletal abnormality studies.

Aphasia, Primary Progressive↗

PubMed1998

Mechanism of short-term memory and repetition in conduction aphasia and related cognitive disorders: a neuropsychological, audiological and neuroimaging study.

To evaluate the role of the sub-cortical white matter and cortical areas of the supramarginal gyrus in short-term memory impairment (shortened digit or letter span) and repetition difficulty, four patients with conduction aphasia and impaired short-term memory and two patients with only short-term memory impairment were given digit span, letter span, speech audiometry and dichotic listening tests. The results showed that in most of the patients letter span was inferior to digit span and that bilateral ear suppression in the dichotic listening test was observed in two patients with a lesion in the inferior part of the supramarginal gyrus, suggesting that what was affected was phonological information and that the supramarginal gyrus was the storage site. The overlapped lesion of conduction aphasia patients with short-term memory impairment was the periventricular white matter at the upper to middle part of the trigone, while patients with only short-term memory impairment had a lesion in the inferior supramarginal gyrus in common. Thus, damage to the periventricular white matter at the trigone may yield the phonemic paraphasia characteristic of conduction aphasia, while damage to the inferior part of the supramarginal gyrus may result in the impairment of short-term memory. We believe that as a part of the mechanisms of short-term memory and repetition, phonological information is processed in the primary auditory cortex and goes through the periventricular white matter to the inferior part of the supramarginal gyrus and is temporarily stored there.

Aged↗

PubMed2002

The contribution of the right cerebral hemisphere to the recovery from aphasia: a single longitudinal case study.

We examined the role of the right cerebral hemisphere in the recovery from aphasia of HJ, a 50-year-old right-handed and unilingual man who suffered from severe aphasia caused by an extensive left hemisphere (LH) lesion. He was followed-up over 10 months at 4-month intervals, with a lateralized lexical decision task (LDT), an attentional task, and a language battery. Testing started when HJ was 2 months poststroke. In the LDT, words were presented to central vision or lateralized to the left or right visual hemifield. At each test period, we examined the effect of the degree of imageability (high vs. low), and the grammatical class (noun vs. verb) of the targets on HJ's response times and error rates, with left visual field, right visual field, and central vision presentations. The results of the experiment showed that the pattern obtained with the LDT could not be accounted for by fluctuations in attention. There was an interaction of grammatical class with degree of imageability with left visual field displays only. The right hemisphere (RH) was faster with high-imageability words than with low-imageability words, regardless of their grammatical class. There was also an overall RH advantage on response times at 2 and 6 months after onset. This RH predominance coincided with a major recovery of language comprehension and the observation of semantic paralexias, while no major change in language expression was observed at that point. Ten months after onset, the pattern of lateralization changed, and response times for the LDT with either presentation site were equivalent. This LH improvement coincided with some recovery of language expression at the single-word level. The results of this study suggest that, in cases of severe aphasia caused by extensive LH lesions, the RH may play an important role in the recovery process. Furthermore, these results show that the contribution of the two cerebral hemispheres to recovery may vary overtime and affect specific aspects of language.

Aphasia↗

PubMed2003

Object scrambling in Dutch Broca's aphasia.

This study focuses on the production of sentences in which objects have been moved without a change in the order of the thematic roles. In Dutch, the basic word order is subject-adverb-object-verb. The object can be moved over the adverb; this is called object scrambling. The difference between the two word orders is pragmatic in nature: in the basic word order the focus is on the object, in the scrambled order, the focus is on the adverb. The aim of the present study is to evaluate if production of constructions with moved objects is impaired in Broca's aphasia and if so, whether that is for syntactic or pragmatic reasons. The results show that for individuals with Broca's aphasia, sentences with the scrambled word order are more difficult to produce than sentences with the basic word order, even if the scrambled order results in a pragmatically more acceptable sentence. This falsifies several theories of production in Broca's aphasia and shows an interesting parallel to the performance on comprehension tasks.

Aphasia, Broca↗

PubMedDate not supplied

Broca's aphasia, verbs and the mental lexicon.

Verb production is notoriously difficult for individuals with Broca's aphasia, both at the word and at the sentence level. An intriguing question is at which level in the speech production these problems arise. The aim of the present study is to identify the functional locus of the impairment that results in verb production deficits in Broca's aphasia. Levelt's (1989) model is used as a theoretical framework for this study. Two experiments have been conducted, one on verb movement and one on verbs with alternating transitivity. The results suggest that the functional impairment in Broca's aphasia should be located in Levelt's "grammatical encoder."

Aphasia, Broca↗

PubMed2004

Inference revision processing in adults with and without aphasia.

Processing abilities in aphasia, and the nature of processing breakdowns, were the focuses of this investigation. Individuals with either fluent or nonfluent aphasia, plus a control group, participated in a cross-modal lexical priming task designed to elicit priming effects when activation of inference interpretations occurred. Comprehension of inferences was measured by responses to four types of questions that related to the inferences. Results indicated that both the control group, as well as the nonfluent aphasia group, activated the intended meaning of the stimuli whereas the fluent aphasics did not. Comprehension of the inferences was best demonstrated by control participants, nonfluent aphasic participants, and fluent aphasic participants, in that order.

Adult↗