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PubMed1994

Corticonigral degeneration with neuronal achromasia presenting with primary progressive aphasia: ultrastructural and immunocytochemical studies.

We describe a clinico-pathological variant of a degenerative disorder involving Broca's, Wernicke's, and supplementary motor areas, which presented as primary progressive aphasia, dysarthria, bucco-facial apraxia, and hearing loss as initial symptoms, followed by organic personality changes. Postmortem examination revealed severe focal atrophy of the cerebral convolutions in the frontal operculum, superior frontal gyrus, and superior and transverse temporal gyri in addition to diffuse atrophy of the frontal and temporal lobes in both hemispheres. Microscopical examination revealed argyrophilic neuronal inclusions (ANIs) in the neuronal perikarya and presynaptic terminal throughout the central nervous system, as well as neuronal loss and swollen chromatolytic neurons in the affected cortices. Neocortical ANIs showed a positive immunoreaction with an anti-tau antibody but only a weak reaction with an anti-ubiquitin antibody immunohistochemically. Ultrastructurally, neocortical ANIs consisted of 15-nm thick smooth-surfaced tubules and tubules with constrictions at 120-150-nm intervals; thus they were different from the typical paired helical filaments of the 80-nm interval constrictions observed in the subiculum. ANIs were also found in the basal ganglia, brain stem nuclei, and cervical cord. Accordingly, ANIs appear distinct from neurofibrillary tangles (NFTs) of progressive supranuclear palsy, NFTs of Alzheimer-type dementia, and Pick bodies. The authors consider that this case fits the histopathological criteria of corticonigral degeneration with neuronal achromasia except for the unusual extension to the temporal lobes.

Aphasia↗
PubMed1983

Reversal of ear advantage in recovery from aphasia: a case report.

A reversal from a left ear advantage to a right ear advantage on a digit dichotic listening test was observed during the first 3 months post-onset of aphasia in a 52-yr-old male patient. Explanations for this pattern of recovery were discussed under both a "lesion effect" and a "dominance effect" interpretation.

Aphasia↗
PubMed1987

Illiteracy and brain damage--1. Aphasia testing in culturally contrasted populations (control subjects).

One hundred neurologically healthy adults were tested for their pointing (choosing one of four or six line drawings as the match to an auditorily presented linguistic stimulus), naming (from line drawings), and repetition abilities. All subjects were unilingual adult right-handers. Fifty-seven subjects were totally unschooled illiterates and 43 were fluent readers. Statistically significant differences were found to exist between the scores of the illiterate and literate subpopulations across all tasks. With the focus being placed on these cultural differences, the discussion bears on: (a) the interaction between linguistic and iconographic factors in certain types of naming and pointing tasks currently used in clinical and research aphasiology, (b) some of the linguistic parameters which are apparently at stake in repetition behavior, and (c) the circumstances in which aphasiological research dealing with groups of patients cannot yield reliable data without reference to neurologically healthy controls. It is argued that, when testing brain-damaged patients of different cultural backgrounds, one runs the risk of over- or underestimating the frequency of aphasia if one does not refer to norms which explicitly take educational level into account.

Adult↗
PubMed1988

Mixed transcortical aphasia. On relative sparing of phonological short-term store in a case.

A case of Mixed Transcortical Aphasia is reported. The patient showed completely impaired verbal comprehension and speech production, with preservation of automatic speaking and singing; repetition was relatively spared. A detailed study of word and nonword repetition is reported, in order to demonstrate that the patient's residual repetition ability is based on relative sparing of short-term phonological store.

Aged↗
PubMed1994

Selective attention and aphasia in adults: preliminary findings.

Thirteen patients with left-hemisphere stroke and history of aphasia and 13 normal controls were administered the covert orientation of visual attention task (COVAT). This task presents targets to the right or left of a central fixation point after a cue (84% of trials) or with no cue (16% of trials). Left-hemisphere damaged patients also received tests of language function at the time of the study. For targets presented 100 msec after cue onset, normal controls demonstrated equivalent responding for targets to the left and to the right of a central fixation point. Patients with left-hemisphere damage showed slower reaction times when responding to targets on the right as opposed to the left side of space when attention was first cued to the opposite side of space (invalid trials) or when attention was focused on a central fixation point (uncued trials), but they did not show slower reaction times on the right side when attention was first cued to the right (valid trials). For left-sided targets, no differences between valid, invalid, and uncued trials existed. Slower responding to right- as opposed to left-sided targets on invalid and uncued trials was correlated with impaired performance on six of seven language measures for patients with left-hemisphere damage. Implications for the relationship between language and selective attention systems in the left hemisphere are discussed.

Adult↗
PubMed1994

The relationship between comprehension and oral reading in progressive fluent aphasia.

The role played by comprehension in oral reading was investigated in three patients with progressive fluent aphasia. For patients J.L. and G.C., there was evidence of a deficit in semantic memory affecting both word production and comprehension. F.M., although equally anomic, had significantly better single-word comprehension than either J.L. or G.C. It was predicted that, for J.L. and G.C., success or failure in word comprehension should show item-specific correspondence with success or failure in reading exception words, but not regular words. This predicted pattern was obtained between word-picture matching tests and reading. For F.M., with only minimal comprehension impairment for the items used, a smaller trend in the same direction was observed. The results are discussed with respect to Patterson and Hodges' hypothesis (Neuropsychologia 30, 1025-1040, 1992) regarding the consequences of impaired semantic memory for the integrity of representations in the phonological output lexicon.

Aphasia↗
PubMed1996

Semantic and episodic memory in aphasia.

Within the framework of the distinction between episodic and semantic memory, it has been argued that these two memory Systems are organised in a hierarchical way. The hierarchical hypothesis assumes that episodic memory is a specific subsystem of semantic memory and therefore implies that episodic memory cannot exist without semantic memory. If this hypothesis is correct, it should be expected that (episodic) yes/no recognition performance would improve in patients with preserved semantic memory, following semantic encoding. In the present study we investigated the influence of semantic encoding on recognition memory performance in a population of 28 aphasic patients (AA) and 14 normal controls (NC). Experiment 1 considered recognition memory for semantically unrelated items, whereas Experiments 2 and 3 assessed recognition memory for semantically related items. In Experiment 3, but not in Experiment 2, subjects were explicitly instructed to make a semantic association between the items. AA were impaired, compared to NC, only on the recognition memory performance of Experiment 1. The ability to make a semantic association between two items was significantly and positively correlated to the ability to recognise, in a subsequent test, those same items. A further analysis showed that patients who were impaired on the semantic association task did significantly worse on the recognition task of Experiment 3 than NC and than patients who were unimpaired on the semantic association task. These findings are discussed in the context of memory deficits in aphasia and interpreted as giving support to the view that episodic memory for an item is affected by the level of semantic awareness of that same item.

Aphasia↗
PubMed1983

Hemiplegic writing in severe aphasia.

Three patients with severe aphasia and right hemiplegia are described who could write to dictation with the right arm using a limb prosthesis though agraphic with the "intact" left hand. The phenomenon of "hemiplegic writing" is explained as an access to submerged or preprocessing levels in language and action structure, through the use of older proximal motor systems. This interpretation has implications for our understanding of language and brain function, as well as for approaches to the treatment of patients with severe language disorders.

Adult↗
PubMed1983

Aphasia following a right thalamic hemorrhage.

A left-handed patient with a right thalamic hemorrhage and disordered speech is described. Sequential examinations and aphasia testing were done during a 1-year follow-up period and the results are reported. This case supports those authors who have described characteristics they feel are helpful in diagnosing disordered speech associated with thalamic lesions. Paucity of speech, reduced voice volume, anomia, some paraphasia, and severe dysgraphia were present, but comprehension and repetition were relatively preserved. She showed modest improvement with time. This case also confirms that thalamic involvement in speech is a dominant, rather than a specifically left hemispheric function.

Aged↗
PubMed1984

Phonemic imperception in aphasia.

This study investigated characteristics of 14 aphasics with impaired phoneme discrimination identified from a population of 100 patients with left hemisphere lesions. All patients with impaired phoneme discrimination were significantly impaired in aural comprehension, but many showed intact sound recognition and some showed normal reading comprehension. Defects in phoneme discrimination were typically seen in the acute stage of aphasia resulting from stroke; and in most instances, defects in phoneme discrimination were no longer apparent 4 months postonset. All patients who recovered normal phoneme discrimination also made significant improvement in aural comprehension. The findings support the concept that some aural comprehension defects result from a specific disturbance in phoneme discrimination.

Adult↗
PubMed1984

A case of acquired aphasia and convulsive disorder: some linguistic aspects of recovery and breakdown.

Among the cases of acquired aphasia and convulsive disorder several children are reported to have experienced more than one aphasic period. We present such a case in more detail, with emphasis on some characteristics of spontaneous speech. The occurrence of paraphasias, and in particular of neologisms, appeared to be associated with language recovery and breakdown. At the beginning of the period of recovery, a rapid and total disappearance of neologisms was observed, while only literal paraphasias remained. A period of language breakdown was preceded by the return of neologisms. The process was not influenced by drug therapy.

Aphasia↗
PubMed1984

Interruption of phonological coding in conduction aphasia.

A case study of conduction aphasia, investigating single word repetition, phonological coding, and short-term memory, is reported. Evidence from intact adults suggests that repetition can occur through either a lexical route or a direct auditory-articulatory link. For this conduction aphasic, E.A., the direct link was impaired, although the lexical route could be used to produce accurate single word repetition. Several experiments demonstrated a significant impairment in the generation and maintenance of an abstract phonological code. The consequences of a disruption of phonological coding on speech perception and on verbal short-term memory are discussed.

Aphasia↗
PubMed1985

A procedural approach to the study of aphasia.

Linguistic models have a fundamental weakness in the study of aphasia in that as models of a single linguistic competence they cannot in principle explain dissociations in language disturbances. Procedural (i.e., computational) models of specific language abilities/tasks are to be preferred in that they can explain dissociation data and they are necessarily very detailed to account for varied patterns of disrupted behavior. A procedural model of sentence production is outlined and the model is applied to account for some aspects of agrammatic speech.

Aphasia↗
PubMed1985

Rapid recovery from aphasia: a detailed language analysis.

The paper presents a daily analysis of the language recovery of a patient who was globally aphasic at the time of her first observation and who had recovered language, as measured by the Western Aphasia Battery, at the time of her discharge 14 days later. The paper emphasizes the relatively regular growth of normal syntactic, lexical, and pragmatic features coupled with similar regular decreases in aphasic features. Observations of both phenomena are necessary to describe language recovery.

Adult↗
PubMed1986

An unlearned foreign "accent" in a patient with aphasia.

Rarely, aphasics may develop what appears to be a foreign accent, as noted by Monrad-Kröhn whose Norwegian patient sounded German. We describe a right-handed native American who developed a foreign accent following damage to the left premotor region and white matter anterior to the head of the left caudate nucleus. Her aphasia was of the transcortical motor type. Both she and her parents were born in the USA, she never traveled outside the country and never learned a foreign language. Phonetic analysis of her voice taped prior to the stroke revealed normal speech with a midwestern accent. In contrast, analyses of her current spontaneous speech, repetition, and reading reveal shifts in vowels, e.g., /I/----/i/, /ae/----/a/; increased diphthonigization; and tense speech posture. These features, which were especially frequent in spontaneous speech, probably explain her "accent." Acoustic analysis of fundamental frequency contours of sentences read in different emotional tones revealed a restricted range and variability of the peaks and valleys.

Aphasia↗
PubMed1987

Age-related changes in aphasia type and stroke location.

Two-hundred consecutive CT scans of patients with an infarction in the territory of the middle cerebral artery (MCA) were examined for evaluation of a possible relationship between age and stroke location. Two distinct procedures, one evaluating the incidence of four areas within the MCA territory and the other measuring some quantified parameters, were used. Statistical studies failed to show any significant correlation between these parameters and the age of patients. These results lead to refute previous claims that semiological changes in aphasia type with age in stroke patients may be due to a posterior shift of cerebral infarcts with age.

Adult↗
PubMed1988

A long-term follow-up case study of crossed aphasia assessed by single-photon emission tomography (SPECT), language, and neuropsychological testing.

A 65-year-old man with well-defined crossed aphasia secondary to right cerebral infarction 10 years previously was studied for current language and cognitive abilities and regional cerebral blood flow (rCBF) during cognitive activation measured by single-photon emission tomography (SPECT). Reversed hemispheric lateralization was demonstrated by qualitative aspects of the patient's constructional deficits, dominant parietal lobe signs, and absence of the neglect syndrome. Language activation procedures during SPECT produced focal increases in rCBF to both frontal lobes with a phoneme detection task and to right temporal and parietal lobes with a math task. The authors stress the complexities of assessing brain/language mechanisms in vivo and demonstrate variabilities in rCBF during language activation dependent on task selection.

Aged↗
PubMed1989

The systematic misrepresentation of bilingual-crossed aphasia data and its consequences.

The evidence from bilingual-crossed aphasia which has been used to support a bilingualism-right hemisphere effect for language representation and/or processing is critically reevaluated. Data gathered by the case survey method are shown to have been misrepresented in the literature. The argument based on a single group study of right-lesioned subjects is shown to rest upon a fundamental misinterpretation of those data. The consequences of such misrepresentation and misinterpretation as reflected in recent research are discussed.

Anomia↗