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PubMed1984

Prosodic disturbance in aphasia: vowel length in Thai.

The aim of this study is to determine to what extent a phonologically contrastive function of the prosodic feature of length is resistant to impairment in aphasia. The language chosen for investigation is Thai, a language which contrasts short and long vowels. Subjects included two Broca aphasics, one transcortical motor aphasic, one Wernicke aphasic, one conduction aphasic, one nonaphasic right-brain-damaged patient, one nonaphasic cerebellar dysarthric patient, and five normal controls. The subjects read a list of words containing short and long vowels. Vowel durations were measured from spectrograms. The results showed that the timing of vowel duration for signaling the contrast between short and long vowels remains relatively intact in nonfluent as well as fluent aphasic patients. These data are brought to bear on issues concerning the specialization of the left hemisphere for temporal processing, the contribution of the right hemisphere to the processing of nonaffective components of prosody, the nature of prosodic disturbance in Broca's aphasia and cerebellar dysarthria, and the separate disruption of prosodic features.

Adult↗
PubMed1984

Comprehending homographs in aphasia.

This study assessed 13 aphasic subjects' knowledge of the multiple meanings of homographs. The results indicated that the various meanings were less available to aphasic subjects than to normal subjects. In addition, specific meanings became less available as they became less typical although the number of meanings associated with a homograph did not influence performance. Aphasia type also did not influence performance. Performance on the experimental test was significantly correlated with auditory comprehension level and picture naming ability. The results were related to recent findings on semantic organization in aphasia.

Adult↗
PubMed1985

Two syndromes of aphasia occurring with ischemic lesions involving the left basal ganglia.

Seven aphasic patients with circumscribed left basal ganglia infarctions were investigated within the first 15 days after their strokes. Five showed transcortical motor aphasia initially. Two patients suffered from anterior chorioideal artery infarction. As this vessel does not contribute to cortical supply, cortical malfunction probably cannot account for the language deficits. Patients with infarctions in the supply area of anterior lenticulostriate arteries became fluent with frequent phonemic and semantic paraphasias resembling Wernicke's aphasia. Three of four patients showed transiently more pronounced deficits in auditory than in written-language comprehension.

Adolescent↗
PubMed1989

Nonlinguistic auditory capabilities in aphasia.

Nonlinguistic auditory capabilities were assessed through psychophysical tests in 11 left-CVA aphasic, four right-CVA nonaphasic, and eight normal male subjects selected from the same age group. The tests included frequency discrimination, gap detection, gap discrimination, frequency sweep discrimination, assessment of the magnitude of the frequency uncertainty effect in the detectability of tones in noise, and assessment of frequency selectivity through simultaneous masked thresholds. Results of these tests were compared to measures of auditory comprehension obtained from the Boston Diagnostic Aphasia Examination, the Porch Index of Communicative Ability, and the Token Test. Nonlinguistic auditory performance of the three subject groups differed significantly from each other. For the left-CVA subjects, frequency sweep discrimination, frequency discrimination, and the frequency uncertainty effect in tone-in-noise detection were the best predictors of verbal auditory comprehension. The right-CVA subjects displayed marked deficits with regard to all pitch-related tests. The findings stress the importance of considering the presence of nonlinguistic auditory dysfunctions when evaluating linguistic auditory capabilities in aphasia.

Adult↗
PubMed1990

Enhancement of naming in nonfluent aphasia through gesture.

In a number of studies that have examined the gestural disturbance in aphasia and the utility of gestural interventions in aphasia therapy, a variable degree of facilitation of verbalization during gestural activity has been reported. The present study examined the effect of different unilateral gestural movements on simultaneous oral-verbal expression, specifically naming to confrontation. It was hypothesized that activation of the phylogenetically older proximal motor system of the hemiplegic right arm in the execution of a communicative but nonrepresentational pointing gesture would have a facilitatory effect on naming ability. Twenty-four aphasic patients, representing five aphasic subtypes, including Broca's, Transcortical Motor, Anomic, Global, and Wernicke's aphasics were assessed under three gesture/naming conditions. The findings indicated that gestures produced through activation of the proximal (shoulder) musculature of the right paralytic limb differentially facilitated naming performance in the nonfluent subgroup, but not in the Wernicke's aphasics. These findings may be explained on the view that functional activation of the archaic proximal motor system of the hemiplegic limb, in the execution of a communicative gesture, permits access to preliminary stages in the formative process of the anterior action microgeny, which ultimately emerges in vocal articulation.

Aged↗
PubMed1992

On the nature of naming difficulties in aphasia.

An extensive naming battery was administered to ten patients representing classical aphasia syndromes. The battery included traditional performance measures and error scoring, phonological cuing, multiple-choice tasks tapping semantic and phonological knowledge, and word repetition tests. Differences in the patients' performance profiles were interpreted as reflecting lexical-phonological, phoneme assembly or multiple deficits. The results suggest that the hypothesized naming deficits have complex relationships to classical aphasia syndromes.

Adult↗
PubMed1981

Facets of analytical processing in aphasia: a picture ordering task.

Aphasics, especially those diagnosed as Broca's, have more difficulties than patients will right hemisphere lesions when required to order six pictures on the basis of a single feature delineated by the extremes of the rank-order. Additional analyses indicate that they tend also to perform worse than patients with diffuse injuries and than patients with left hemispheric lesions without aphasia. Differences are more pronounced when the critical features have to be inferred from the depicted objects (e.g. age of persons) than when they can be seen directly in the drawings (e.g. girth of persons). The performance of the aphasics correlated significantly with word comprehension scores but negligible with the Token Test. Results are discussed with respect to analytical functions differentially impaired in aphasia.

Adult↗
PubMed1984

Nonlinguistic memory in aphasia.

Two experiments were carried out to assess nonlinguistic memory in aphasia. In the first experiment, subjects had to make judgments about the frequency with which words in a study list were repeated, and, in the second, they had to recall the spatial location in which a pictured object had been presented originally. Aphasics were very accurate in both tasks and did not differ from normal controls. It is suggested that a comprehensive account of memory in aphasia requires that we look beyond their omnipresent language deficit to more general processing factors such as attentional capacity.

Adult↗
PubMed1986

Unexpected CT-scan findings in global aphasia.

The clinical-CT scan correlation was studied in 37 stroke patients with global aphasia. The time between stroke and language examination was between 21 and 60 days; the time between stroke and CT scan was equal to or longer than 21 days. It was found that while 22 patients harboured the expected large lesions including Broca's and Wernicke's areas, 8 had anterior lesions sparing Wernicke's area, 3 had posterior lesions sparing Broca's area, and 4 had deep lesions centered on the insula and lenticular nucleus. These findings suggest that global aphasia, albeit apparently simple from the semeiological viewpoint (also due to its severity), does in fact include different clinical entities. However, no clear-cut correlation was found between either subtype of speech production or severity, and locus of the lesion (except that deep lesions were associated with somewhat milder forms). An interesting finding, i.e. that all 8 patients with anterior lesions were females, while the 3 posterior ones were male, is briefly discussed in terms of possible differential organization of language functions in the two sexes.

Adult↗
PubMed1988

Grammatical morphology in aphasia: a case of errata or reader misinterpretations?

As convincing as the discussion presented by Elizabeth Bates, Angela Friederici and Beverly Wulfeck on grammatical morphology in aphasia in three languages may seem, we were at loss when trying to reconstruct the quantitative basis of their argumentation (see Bates et al., 1987, Grammatical morphology in aphasia: Evidence from three languages. Cortex, 23: 545-575). With the present notice we would like to lessen the possibility of reader misinterpretations that may easily confuse the thread of the argument of this article in the form in which it was originally presented.

Aphasia↗
PubMed1981

Analysis and remediation of aphasia in the U.S.S.R: the contribution of A. R. Luria.

This paper surveys the contribution of A. R. Luria to aphasiology, emphasising the unique extent to which he integrated theory and therapeutic practice. The influence exerted by two prominent Russian figures, Pavlov and Vygotskii, is discussed. Luria's view of the primary defects underlying the main forms of aphasia is summarised; this is followed by a brief account of his application of certain notions of structural linguistics, including Jakobson's interpretations of the breakdown of language following brain damage. Examples are given of the wide range of simple tests included in Luria's neuropsychological investigations. The factual part of the article culminates in some examples of his methods of restoring higher cortical functions, in particular, verbal skills. The summary criticises certain aspects of Luria's analysis as being too mechanistic and simplistic, and cites criticisms of details from other workers, but considers many of his insights and the total coherence of his view of cortical functioning and cortical disturbance to be still of the utmost importance for clinicians undertaking aphasia therapy. The need for therapists everywhere to develop language rehabilitation with as systematic a basis as Luria's is stressed.

Aphasia↗
PubMed1989

Differentiating Alzheimer's patients from the normal elderly and stroke patients with aphasia.

The performance of individuals with mild and moderate Alzheimer's disease (AD), normal age-matched elderly individuals, and stroke patients with fluent and nonfluent aphasia were compared on a group of neuropsychological tasks. The unique performance profiles associated with each subject group are discussed, and the best tasks for intergroup differentiation specified. Whereas the tasks employed were efficacious for discriminating early- and middle-stage AD patients from normal subjects and aphasic stroke patients, and early- from middle-stage AD patients, they were not efficacious for subtyping aphasia patients according to fluency. Generally, memory measures were best for intergroup differentiation.

Aged↗
PubMed1983

Drawing objects from memory in aphasia.

The ability of aphasic patients to draw from memory objects with a characteristic shape has been investigated. Their capacity to reproduce the form of real objects was studied by showing them for a short time line drawings of simple objects. When the patient had analysed and recognized the figure, the model was hidden from view and the subject was asked to draw the same object from memory. This Drawing from Memory task was administered to 54 aphasics, 67 patients with right hemisphere lesions, 44 nonaphasic left brain-damaged patients and 23 normal controls. The influence of visuoconstructive disabilities was controlled by administering to the same patients a standard test for constructional apraxia (copying 10 geometrical figures). The severity and clinical form of the aphasia and the presence of semantic-lexical impairment at the receptive level were also examined in the aphasic patients. The following results were obtained. (1) Aphasic patients scored significantly less well than the control groups on the Drawing from Memory task and the intergroup differences became greater when the scores from the test for constructional apraxia were included by an analysis of covariance. (2) No significant correlation was detected between the severity and clinical form of the aphasia and the scores obtained on the Drawing from Memory task. (3) There was a significant correlation between impaired drawing from memory and disruption at the semantic-lexical level of language integration.

Aged↗
PubMed1981

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.

Adult↗
PubMed1979

The relationships between conceptual and semantic-lexical disorders in aphasia.

A nonverbal test of conceptual thinking was administered to 55 normal controls and to 203 patients with monohemispheric brain lesions (74 aphasics and 129 nonaphasic brain-damaged patients), in order to study the relationships between conceptual impairment of aphasic patients and breakdown of the semantic-lexical level of integration of language. A very high number of aphasic patients (54 out of 74) and a limited number of nonaphasic brain-damaged subjects (31 out of 129) obtained a pathological score on the test of conceptual thinking, but only some components of the aphasic symptomatology seemed closely linked to the conceptual disorder. In fact a non-significant relationship was found between conceptual impairment and: ("fluent" or "non-fluent") clinical type of aphasia; severity of aphasic disturbance. On the contrary, a strong relationship was found between conceptual disorder and impairment of the semantic-lexical level of integration of language. These findings seem to show that conceptual disturbance and semantic-lexical troubles are closely linked in aphasia.

Aphasia↗
PubMed1992

[The Aachen Aphasia Bedside Test--criteria for validity of psychologic tests].

The Aachen Aphasia Bedside Test (AABT) has been developed in order to examine aphasic patients within the first 4 to 6 weeks after onset of illness. The psychometric properties of the AABT were established by repeated examination of 82 acute stroke patients, ratings by 20 raters on the basis of 10 videotapes, repeated examination of 28 chronic aphasics three times with an interval of 2 days, and parallel examination of 47 chronic aphasic patients with the AABT and the Aachen Aphasia Test (AAT), administered on the same day. Objectivity, reliability and validity of the AABT were highly rated, indicating its usefulness in acute stroke cases. Data on the 82 acute stroke patients showed that an initial prognosis can be made as early as the fourth day after the stroke.

Adult↗
PubMed1985

[Clinical picture and dynamics of sensomotor aphasia in cerebrovascular pathology].

Thirty-seven patients (27 with ischemic and 10 with hemorrhagic strokes) were examined. The patients were followed up for 1 to 5 years. Clinical and neuropsychologic examinations over time and computer-aided tomography of the brain were carried out. The syndrome of sensomotor aphasia was shown to be heterogeneous. Two variants of the syndrome were specified which differed by the clinical manifestations of aphasia, the time-course of recovery of various speech functions, and the localization of affection. The correlation between the recovery of individual speech functions and the cerebral blood supply is discussed.

Adult↗
PubMed1983

CT scan studies of aphasia.

CT scan studies of lesion localization in aphasic patients have in general confirmed the traditional locus of damage within the left hemisphere for the major syndromes. Some interesting exceptions have come to light, such as the possible occurrence of global aphasia with a partial lesion (anterior or posterior) of the language zone. The study of correlations in vivo has underlined the importance of considering time since onset in the evaluation of the clinical picture. Description of atypical aphasias associated with subcortical lesions and correlation of lesion site with specific, partial aspects of linguistic impairment are two areas where CT scan studies are increasing our understanding of the language machinery in the brain.

Agraphia↗