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PubMed2006

Simulating single word processing in the classic aphasia syndromes based on the Wernicke-Lichtheim-Geschwind theory.

The Wernicke-Lichtheim-Geschwind (WLG) theory of the neurobiological basis of language is of great historical importance, and it continues to exert a substantial influence on most contemporary theories of language in spite of its widely recognized limitations. Here, we suggest that neurobiologically grounded computational models based on the WLG theory can provide a deeper understanding of which of its features are plausible and where the theory fails. As a first step in this direction, we created a model of the interconnected left and right neocortical areas that are most relevant to the WLG theory, and used it to study visual-confrontation naming, auditory repetition, and auditory comprehension performance. No specific functionality is assigned a priori to model cortical regions, other than that implicitly present due to their locations in the cortical network and a higher learning rate in left hemisphere regions. Following learning, the model successfully simulates confrontation naming and word repetition, and acquires a unique internal representation in parietal regions for each named object. Simulated lesions to the language-dominant cortical regions produce patterns of single word processing impairment reminiscent of those postulated historically in the classic aphasia syndromes. These results indicate that WLG theory, instantiated as a simple interconnected network of model neocortical regions familiar to any neuropsychologist/neurologist, captures several fundamental "low-level" aspects of neurobiological word processing and their impairment in aphasia.

Aphasia↗
PubMed2006

Real-time comprehension of wh- movement in aphasia: evidence from eyetracking while listening.

Sentences with non-canonical wh- movement are often difficult for individuals with agrammatic Broca's aphasia to understand (, inter alia). However, the explanation of this difficulty remains controversial, and little is known about how individuals with aphasia try to understand such sentences in real time. This study uses an eyetracking while listening paradigm to examine agrammatic aphasic individuals' on-line comprehension of movement sentences. Participants' eye-movements were monitored while they listened to brief stories and looked at visual displays depicting elements mentioned in the stories. The stories were followed by comprehension probes involving wh- movement. In line with previous results for young normal listeners [Sussman, R. S., & Sedivy, J. C. (2003). The time-course of processing syntactic dependencies: evidence from eye movements. Language and Cognitive Processes, 18, 143-161], the study finds that both older unimpaired control participants (n=8) and aphasic individuals (n=12) showed visual evidence of successful automatic comprehension of wh- questions (like "Who did the boy kiss that day at school?"). Specifically, both groups fixated on a picture corresponding to the moved element ("who," the person kissed in the story) at the position of the verb. Interestingly, aphasic participants showed qualitatively different fixation patterns for trials eliciting correct and incorrect responses. Aphasic individuals looked first to the moved-element picture and then to a competitor following the verb in the incorrect trials. However, they only showed looks to the moved-element picture for the correct trials, parallel to control participants. Furthermore, aphasic individuals' fixations during movement sentences were just as fast as control participants' fixations. These results are unexpected under slowed-processing accounts of aphasic comprehension deficits, in which the source of failed comprehension should be delayed application of the same processing routines used in successful comprehension. This pattern is also unexpected if aphasic individuals are using qualitatively different strategies than normals to comprehend such sentences, as under impaired-representation accounts of agrammatism. Instead, it suggests that agrammatic aphasic individuals may process wh- questions similarly to unimpaired individuals, but that this process often fails to facilitate off-line comprehension of sentences with wh- movement.

Adult↗
PubMed2005

Treating attention in mild aphasia: evaluation of attention process training-II.

UNLABELLED: This study examined whether attention processing training-II [Sohlberg, M. M., Johnson, L., Paule, L., Raskin, S. A., & Mateer, C. A. (2001). Attention Process Training-II: A program to address attentional deficits for persons with mild cognitive dysfunction (2nd ed.). Wake Forest, NC: Lash & Associates.; APT-II], when applied in the context of a multiple baseline ABA design, would improve the attention abilities of RW, a patient with mild conduction aphasia and concomitant attention and working memory deficits. We also explored whether APT-II training would enhance RW's auditory comprehension, other cognitive abilities such as memory, and his and his spouse's perceptions of his daily attention and communication difficulties. With treatment, RW improved on trained attention tasks and made modest gains on standardized tests and probes that evaluated cognitive skills related to treatment activities. Nominal change in auditory comprehension and untrained attention and memory functions was observed, and neither RW nor his spouse reported noticeable improvements in his daily attention or communication abilities. These and previous findings indicate that structured attention retraining may enhance specific attention skills, but that positive changes in broader attention and untrained functions are less likely. LEARNING OUTCOMES: As a result of reading this article, the participant will be able to: (1) summarize the previous literature regarding attention impairments and treatment approaches for patients with aphasia. (2) describe how Attention Processing Training-II affected the attention, auditory comprehension, and other cognitive abilities of the patient in this study.

Aphasia, Wernicke↗
PubMed2006

The effect of a therapy dog on the communication skills of an adult with aphasia.

UNLABELLED: Little evidence-based research has been published within the field of communication disorders on the role of dogs as catalysts for human communication. This single participant study, a point of entry into this realm of research, explores the effects of a therapy dog on the communication skills of a patient with aphasia receiving intensive speech and language therapy within a rehabilitation setting. The researchers conclude that the presence of the dog does have the potential to stimulate both overt social-verbal and social-nonverbal communication. LEARNING OUTCOMES: As a result of this activity the reader will be able to (1) describe the beneficial role of dogs to serve as catalysts for human communication (2) describe ways in which a person with aphasia may be assisted by a therapy dog and (3) become familiar with an animal-assisted therapy (AAT) program set-up for patients with communication disorders within a rehabilitation setting.

Affect↗
PubMed2006

Ubiquitin-positive frontotemporal lobar degeneration presenting with progressive Gogi (word-meaning) aphasia. A neuropsychological, radiological and pathological evaluation of a Japanese semantic dementia patient.

A patient with progressive anomia and alexia with agraphia for kanji (Japanese morphograms) is described. The patient showed a deficit in single-word comprehension and on-reading (a type of reading that conveys phonetic value) dominance in kanji reading, i.e. on-preceding (pronouncing first with on-reading, irrespective of its preferred reading) and kun-deletion (inability to recall and recognize kun-reading [another type of reading that conveys meaning]) when reading a single-character kanji. These features were due to loss of lexico-semantic information and thus the patient was regarded as having progressive Gogi (word-meaning) aphasia by Imura, a Japanese manifestation of semantic dementia. Macroscopically, neuropathological examination disclosed atrophy of the left frontotemporal lobe with accentuation in the anterior portion of the temporal lobe. Histologically, there was neuronal loss in the cerebral cortex, hippocampus, parahippocampal gyrus, amygdala, caudate nucleus, and putamen. Ubiquitin-immunoreactive neuronal inclusions were present in the hippocampal dentate granular cells. This case demonstrates that progressive Gogi aphasia is semiologically identical to semantic dementia, and our patient clinicopathologically resembled those of Rossor et al. [Rossor, M.N., Revesz, T., Lantos, P.L., Warrington, E.K. Semantic dementia with ubiquitin-positive tau-negative inclusion bodies. Brain 2000; 123: 267-76.] and Hodges et al. [Hodges, J.R., Davies, R.R., Xuereb, J.H., Casey, B., Broe, M., Bak, T.H., et al. Clinicopathological correlates in frontotemporal dementia. Ann Neurol 2004; 56: 399-406.].

Aged↗
PubMed2004

Spatiotemporal patterns of language-specific brain activity in patients with chronic aphasia after stroke using magnetoencephalography.

Six participants with chronic aphasia secondary to first-ever ischemic stroke within the middle cerebral artery (MCA) distribution of the left hemisphere and six neurologically intact controls of similar age were given a running recognition memory task for words while the magnetic flux normal to the scalp surface was measured with a whole-head neuromagnetometer. This task had been previously shown to be valid for the localization and lateralization of brain activity specific to receptive language function. As expected, patients exhibited relatively decreased activation in areas known to be involved in receptive language function, including superior temporal gyrus (STG) in the left hemisphere, as well as increased activation of areas outside of the left STG that might potentially support language function. Decreased activation within left STG was associated with a reduction in receptive language in patients, as was increased activation outside of left STG. Results support hypotheses suggesting that peri-lesional areas outside premorbid language areas may assume receptive language function after aphasia secondary to stroke, but that better recovery occurs when putative premorbid language areas are able to normalize.

Aged↗
PubMed2004

A method for studying the evolution of naming error types in the recovery of acute aphasia: a single-patient and single-stimulus approach.

In this study, we present a method for analysing the evolution of picture naming errors in the follow-up of single patients affected by acute aphasia. In particular, we have based our analysis on the presence of response type inconsistency, as patients often fail to give the same type of response to the same stimulus at a task repetition attempted after a short time. Due to the uncertain definition of the type of response associated to a given stimulus for each stage of the clinical course, the investigation of the factors underlying the transition between different types of response is a serious methodological challenge. The solution presented here is based on a multiple presentation of the same naming battery at different stages of the clinical course, on the estimation of the probability associated with each response type at each stage, and on the estimation of the transition probability between different response types from one clinical stage to another. The basic idea was to use the set of probabilities referred to above as single stimuli weights in the study of linear models; these permit to compare different types of responses and different types of transitions. We present the application of this method to the study of a single case, a woman affected by fluent aphasia examined twice in the first 2 weeks following stroke. Besides discussing empirical findings, we comment on the usefulness of this method for wider fields of inquiry.

Aged↗
PubMed2005

Audio-visual matching of speech and non-speech oral gestures in patients with aphasia and apraxia of speech.

BACKGROUND: Audio-visual speech perception mechanisms provide evidence for a supra-modal nature of phonological representations, and a link of these mechanisms to motor representations of speech has been postulated. This leads to the question if aphasic patients and patients with apraxia of speech are able to exploit the visual signal in speech perception and if implicit knowledge of audio-visual relationships is preserved in these patients. Moreover, it is unknown if the audio-visual processing of mouth movements has a specific organisation in the speech as compared to the non-speech domain. METHODS: A discrimination task with speech and non-speech stimuli was applied in four presentation modes: auditory, visual, bimodal and cross-modal. We investigated 14 healthy persons and 14 patients with aphasia and/or apraxia of speech. RESULTS: Patients made substantially more errors than normal subjects on both the speech and the non-speech stimuli, in all presentation modalities. Normal controls made only few errors on the speech stimuli, regardless of the presentation mode, but had a high between-subject variability in the cross-modal matching of non-speech stimuli. The patients' cross-modal processing of non-speech stimuli was mainly predicted by lower face apraxia scores, while their audio-visual matching of syllables was predicted by word repetition abilities and the presence of apraxia of speech. CONCLUSIONS: (1) Impaired speech perception in aphasia is located at a supra-modal representational level. (2) Audio-visual processing is different for speech and non-speech oral gestures. (3) Audio-visual matching abilities in patients with left-hemisphere lesions depend on their speech and non-speech motor abilities.

Adult↗
PubMed2006

False recognition of incidentally learned pictures and words in primary progressive aphasia.

Recognition memory was tested in patients with primary progressive aphasia (PPA), a language based dementia with relative preservation of memory for at least the first 2 years. The goal of the study was two-fold: (1) to compare true and false recognition rates for words versus pictures in patients with PPA and cognitively intact controls and (2) to determine if the semantic relatedness of distracters-to-targets influences recognition memory performance. Overall, performance of PPA patients was worse for words than pictures. PPA patients and healthy elderly controls showed similar recognition rates for studied items. However, the patients had significantly more false alarms than controls, particularly to semantically related items. This suggests that the aphasia in PPA patients contributes to their difficulty in selecting among items within a semantic class.

Aged↗
PubMed2006

Thematic role assignment in patients with Broca's aphasia: sentence-picture matching electrified.

An event-related brain potential experiment was carried out to investigate on-line thematic role assignment during sentence-picture matching in patients with Broca's aphasia. Subjects were presented with a picture that was followed by an auditory sentence. The sentence either matched the picture or mismatched the visual information depicted. Sentences differed in complexity, and ranged from simple active semantically irreversible sentences to passive semantically reversible sentences. ERPs were recorded while subjects were engaged in sentence-picture matching. In addition, reaction time and accuracy were measured. Three groups of subjects were tested: Broca patients (N=10), non-aphasic patients with a right hemisphere (RH) lesion (N=8), and healthy aged-matched controls (N=15). The results of this study showed that, in neurologically unimpaired individuals, thematic role assignment in the context of visual information was an immediate process. This in contrast to patients with Broca's aphasia who demonstrated no signs of on-line sensitivity to the picture-sentence mismatches. The syntactic contribution to the thematic role assignment process seemed to be diminished given the reduction and even absence of P600 effects. Nevertheless, Broca patients showed some off-line behavioral sensitivity to the sentence-picture mismatches. The long response latencies of Broca's aphasics make it likely that off-line response strategies were used.

Adult↗
PubMed2026

Modulating sentence comprehension in people with aphasia through anodal tDCS: A double-blind randomized cross-over study.

This double-blind randomized cross-over study investigated the effects of perilesional anodal transcranial direct current stimulation (AtDCS) combined with speech-language therapy on sentence comprehension in eight individuals with chronic nonfluent agrammatic aphasia. The behavioral therapy consisted of an intensive comprehension treatment including drilling in sentence-to-picture matching and Mapping Therapy. Each participant underwent both the anodal tDCS and sham stimulation conditions (five received sham first followed by real stimulation, and the remaining three the reverse sequence), with each condition paired with the same behavioral treatment and separated by a four-month washout period. Stimulation was applied over the perilesional area (left BA6) for 20 min during daily 40-min therapy sessions over four consecutive weeks. Sentence comprehension was assessed with the RiComprendo battery and functional communication with the Communicative Effectiveness Index (CETI). Data were analyzed using paired t-tests, Bayesian analyses, and linear mixed-effects models to control for baseline performance and individual variability. Both stimulation conditions produced significant pre-to-post improvements in sentence comprehension, particularly for syntactically complex structures such as passives and center-embedded object relatives. However, gains were overall greater following AtDCS, as reflected in larger effect sizes, stronger Bayes factors, and a significant treatment effect in the mixed-effects models. Only the AtDCS condition yielded significant improvements in self-perceived comprehension abilities on the CETI. These findings suggest that AtDCS over perilesional cortical areas may boost the effects of traditional language therapy on sentence comprehension, supporting its feasibility and potential as an adjuvant intervention in post-stroke aphasia rehabilitation.

Humans↗
PubMed2006

Re-visiting "semantic facilitation" of word retrieval for people with aphasia: facilitation yes but semantic no.

Previous research has shown that word-to-picture matching for targets that cannot be named at pre-test results in improved naming relative to untreated control items for people with aphasia. This paper replicates and extends this finding and investigates its source. Is the effect a result of priming of semantic representations, or of post-semantic mechanisms in word retrieval? The first experiment shows that word-to-picture matching with unrelated distractors improves naming at short (2-3 minutes) and long (up to 25 minute) lags. There was no effect of being made aware of the relationship between word-to-picture matching and picture naming. People who have a semantic impairment improve only with a short lag between word-to-picture matching and naming. Participants with less semantic impairment show larger priming effects that are equal at short and long lags between word-to-picture matching and naming. The second experiment shows that the facilitation effect is just as large for word-to-picture matching with unrelated distractors as with semantically-related distractors. Furthermore, overall there was no difference between matching with coordinate items and with associated items. The results of these experiments show that facilitation of naming by word-to-picture matching in people with aphasia cannot be a result of the priming of semantic representations. Instead they are consistent with two effects: word-to-picture matching results in priming at a lemma level for aphasic people with a semantic impairment that is only found with a short lag between word-to-picture matching and naming. Word-to-picture matching causes priming of the lemma to output lexicon entry mapping that benefits participants with less semantic impairment that is evident at both a short and long lag between word-to-picture matching and naming. These findings fit well with previous research on repetition priming of naming with normal subjects.

Aphasia↗
PubMed1991

Primary progressive non-fluent aphasia: a case study.

A case study of a 65 year old man is described with an eight-year history of progressive primary non-fluent aphasia accompanied by agrammatism, phonemic paraphasias and mild spelling dysgraphia. His naming ability, however, has remained at an exceptionally high level and there has been no evidence of impairment of word or sentence comprehension. Non-verbal skills and memory functions have also been preserved within the range of his very high premorbid level of abilities. Single photon emission computed tomography was consistent with bifrontal hypoperfusion. We argue that the selective language deficits in this patient are characteristic of dynamic aphasia and of other speech disturbances which are also known to be associated with left frontal lesions. The possible underlying pathology is discussed in the context of known degenerative disorders.

Agnosia↗
PubMed1975

Aphasia with infarction in the territory of the anterior cerebral artery.

Two right-handed patients with clinical evidence of major infarction in the territory of the left anterior cerebral artery developed a profound but transient aphasia characterized by (1) a striking dissociation between intact repetition and grossly disturbed spontaneous conversational speech, (2) an absence of phonemic paraphasia, (3) a lack of speech inhibition and (4) relative preservation of conformation naming and comprehension. Despite the initially profound motor aphasia, servicable spontaneous conversational speech returned in two to three months. However, more subtle changes in the form of lack of speech initiative and difficulties in narrating stories and describing complex pictures, remained many months after the onset. In these patients the major features of the disturbance could not be explained only on the basis of an interruption of the downgoing pathway from the dominant motor speech area, and in fact, may have been due to damage to the superior and mesial pre-motor area (particularly the supplementary motor region), an area that has been shown to play a role in processes which govern the initiation, continuation and inhibition of speech.

Aged↗
PubMed1977

Factors related to prognosis of acquired aphasia in children.

In a follow up study of 15 children with acquired aphasia, it was found that the persistent presence of concomitant neurological disorders was important for the final outcome. Prognosis seemed to be related to etiology, EEG disturbances and the severity of comprehension deficit at the onset of aphasia.

Age Factors↗
PubMed1978

Alliteration and assonance in neologistic jargon aphasia.

This paper discusses certain aspects of the speech patterns of neologistic jargon aphasic patients, whose syndrome is one form of a more general classification referred to as Wernicke's or cortical sensory aphasia. The classical lesion site is in the posterior superior temporal convolution of the dominant hemisphere. Patients with such lesions typically have difficulties in the comprehension of auditory linguistic stimuli and their speech is often marked with neologistic jargon. A neologism is a phonological form produced by the patient for which one cannot recover with any reasonable degree of certainty some single item in the patient's vocabulary as it presumably existed before the onset of the disease. Specific analysis is focused on those stretches of speech which exhibit perseveration to the point where there is an excessive amount of alliteration and assonance. The data is described in terms of segments, syllables and sequences of syllables and related to both a mechanism underlying the production of this sort of speech and to the more general problems of neologisms in jargon aphasia.

Aphasia↗
PubMed1979

Semantic judgment ability in adult aphasia.

Recent psycholinguistic literature suggests that language usage often involves the ability to make judgments or appraisals about various aspects of language. It was therefore the purpose of the present study to examine the semantic judgment or evaluation abilities of thirty persons with aphasia in comparison to these same behaviors in a group of thirty normal individuals. That is, this study examined subject ability to use knowledge to make comparisons or judgments in reference to specific criteria. Results support the existence of a judgment capacity and indicate that persons with aphasia are impaired in their ability to evaluate semantic material. Therefore, speech pathologists may wish to include semantic judgment tasks in their evaluation procedures and plan therapy directed toward the retrieval of judgment responses.

Aged↗
PubMed1981

Severity of impairment or specific types of aphasia: an empirical investigation.

This study examined empirical means of clustering aphasic patients into relatively homogenous and identifiable groups. The method included: (1) examining the intercorrelations of the subtests of the Neurosensory Comprehensive Examination for Aphasia by the means of factor analysis; (2) allowing the subjects to group themselves in homogenous subgroups by means of hierarchical cluster analysis; and (3) comparing the profiles of these groups on the derived dimensions. Four factors accounting for 79.3% of their total test variance were derived which reflected attention/memory; reading ability; verbal-naming ability; and elementary writing skills. With five groups the hierarchical grouping analysis indicated that only 21.5% of the total variability could be ascribed to within group variability. An analysis of variance of the four factor scores found that 66%, 93%, 81% and 79% of the between group variance of each of the respective factors was associated with group membership and the accuracy of membership prediction was 94.1%. Four groups appeared to be distributed on the basis of a severity model of impairment. One group representing 6.3% of the total sample demonstrated a pattern of specific impairment involving a mild level of impairment on attention/memory tasks, a moderate level of impairment on verbal naming tasks and writing skills, and a profound level of impairment on measures of reading skills. The high inter-factor correlations indicated the general nature of language functioning. The results were discussed in terms of the concept of aphasia as a general cognitive deficit.

Aphasia↗