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PubMed1994

An analysis of spontaneous conversational speech fluency in children with acquired aphasia.

We report on an instrumental analysis of spontaneous conversational speech (SCS) fluency in acquired childhood aphasia (ACA). Tape-recorded SCS samples of 25 children with ACA (clinical judgment: 12 nonfluent and 13 fluent), and of 12 dysarthric and 12 nonaphasic and nondysarthric right hemisphere injured children were analysed in order to: (1) investigate whether a more refined analysis can objectively contribute to the differentiation of patients who were labelled as fluent or nonfluent on the basis of a clinical judgment: (2) verify whether an instrumental analysis of phonation duration does confirm the subjective estimation of verbal rate (i.e. the number of words produced in a unit of time) in groups of children with acquired neurogenic speech/language disorders frequently met in clinical practice. The results are: (1) phonation rate (i.e. the vocalization percentage) seems to represent an adequate variable to distinguish clinically diagnosed nonfluent aphasic children from speech/language impaired children belonging to other clinical groups of acquired neurogenic speech/language disorders; (2) the verbal rate is highly correlated to the phonation rate in all investigated groups except the dysarthric one. We suggest the instrumental method discussed here might contribute to the differential diagnosis between dysarthric and aphasic disturbances in the acute stage of the disease. Concerning the study of ACA, the main issue of the present investigation is that an objective fluency measurement has succeeded in identifying aphasic children who obviously do not fit in with the standard doctrine on ACA, which claims that ACA is invariably nonfluent irrespective of lesion location.

Adolescent↗
PubMed1994

Swallowing difficulty in primary progressive aphasia: a case report.

A 71-year-old right handed man showed insidious and progressive decline of language skills, in contrast with relatively preserved performance on tests and ability to be independent in daily living. Three years later, he developed swallowing difficulties. MRI scans showed widening of the left sylvian fissure. A SPECT scan demonstrated focal hypometabolism restricted to the left temporal lobe. Videofluoroesophagography revealed marked hesitation of oral preparation and oral phases, while the reflex phases were unimpaired. The patient failed to perform oral tasks on command and imitation without motor and sensory deficit. We believe that his swallowing difficulty was due to oral apraxia. This case adds to the heterogeneity of patients with primary progressive aphasia.

Aged↗
PubMed1993

Implications from aphasia for the syntax of null-subject sentences: underlying subject slots in Bulgarian.

Evidence for the existence of an underlying sentence-initial subject slot for Bulgarian null-subject personal constructions can be found in two aberrant tendencies by a Bulgarian patient with aphasia. In response to test sentences consisting of personal constructions that contained an object pronominal clitic and no lexical subject, the patient tended either to insert a superfluous sentence-initial pronominal subject, or to place the object pronominal clitic left-adjacent to the verb, in the position that it would have occupied had a sentence-initial overt subject been present.

Aged↗
PubMed1994

Predicting recovery from aphasia with connectionist networks: preliminary comparisons with multiple regression.

We trained a series of simulated neural networks with the raw scores on the Western Aphasia Battery from 91 aphasic patients. Patients were tested at 3 and at 12 months post onset. The most successful network we trained is able to predict AQ for an individual in 12 months from the raw scores at 3 months post-onset to a tolerance of + or -4.5. We then compared the relative success of a small range of trained networks to predict recovery with linear multiple regression. With the small groups of subjects involved in this preliminary study, the networks appeared to be more successful at predicting recovery.

Aged↗
PubMed1975

The problem of repetition: a study of "conduction" aphasia and the "isolation" syndrome.

The classical view of conduction aphasia and the isolation syndrome holds that there is, respectively, preferential damage to, or sparing of, a (repetition) pathway between the posterior and anterior speech areas. This concept is deeply entrenched in neurological thinking, but is supported neither by clinical nor pathological evidence. These two disorders are explained from the standpoint of a more dynamic theory of language organization. This new approach has implications for our understanding of anatomical relationships "between" the speech areas.

Aged↗
PubMed1975

Central (or conduction) aphasia in a Japanese patient.

A case of relatively pure conduction aphasia in a 66 year old woman is reported. A detailed linguistic analysis was performed and the patient's handling of the phonogrammic and ideogrammic aspects of the Japanese language was analysed. The patient showed a comparable pattern of difficultly in the following four operations: (1) naming of pictures (2) reading aloud of Kanji and Kana characters, (3) repetition of words and (4) transcription of heard words into Kanji and Kana characters. Of special note was the patient's superior written transcription of the ideographic symbols and the superior oral reading of the phonogrammic symbols. These results indicate that the patient had a basic defect in expressing the predetermined target word in verbal or writter form. From the analysis of Kana writings it is hypothesized that the in ability to establish a stable and distinct acoustic word image is responsible for this basic expressive difficulty leading to both paraphasic and paragraphic errors.

Aged↗
PubMed1977

Phonemic identification defect in aphasia.

Eight-four right-handed patients with unilateral hemispheric damage (50 aphasics, 12 non-aphasic left brain-damaged and 22 right brain-damaged patients) and 53 control patients without cerebral lesions were given a test of phoneme identification which examined the S's ability to identify the acoustic boundary between the two phonemes, /d/ and /t/, expressed in terms of voice-onset time (VOT). Phonemic identification defect (PID), defined with reference to the performance of the control group, was found to be virtually limited aphasics; in over 70 per cent of them, the identification of the boundary zone between voiced and voiceless consonants along the VOT continuum was either impossible or abnormal, While neither the fluency - nonfluency dimension of speech nor the level of comprehension seemed to be crucially associated with PID, some evidence pointed to disordered phonemic output as to one dimension of aphasia that is specifically related to it.

Aphasia↗
PubMed1978

Sign comprehension in global aphasia.

Ten global aphasics and eight brain-damaged non-aphasics were given a test of sign comprehension. The test contained natural, animal and human signs. Subjects were matched for etiology, age and residual intellectual functioning. The global aphasics scored significantly lower than the nonaphasics on the test of sign comprehension, indicating that global aphasia might be reconsidered as a disorder of sign comprehension.

Aged↗
PubMed1982

WAIS performance IQ in aphasia as a function of auditory comprehension and constructional apraxia.

This study investigated differences in nonverbal intelligence between diagnostic subgroups of aphasics using the Performance Tests of the Wechsler Adult Intelligence Scale (WAIS). Subjects were 98 right-handed hospitalized males with unilateral left-hemisphere damage who had unambiguous clinical diagnoses of Broca's, Anomic, Conduction, Mixed Non-Fluent, Wernicke's, or Global aphasia. Group differences were examined using the WAIS Performance IQ (PIQ), and subscores for spatial organization (Block Design and Object Assembly) and for verbalizability (Picture Completion and Picture Arrangement). There were significant group differences for each WAIS score, determined by the impaired performance of the Global aphasics. With covariance correction for level of auditory comprehension, group differences were eliminated on the verbalizable subtests, but not on the spatial organization subtests. Covarying for level of constructional apraxia (assessed with drawings, sticks, and blocks), however, eliminated group differences for both subscores. Using demographic, neurological, and linguistic variables, multiple regression analyses confirmed the covariate analysis findings; constructional apraxia was the most predictive variable for both spatial and verbalizability subscores, while auditory comprehension and education level predicted performance on the verbalizable subtests.

Anomia↗
PubMed1982

Sex differences in recovery from aphasia.

The influence of sex on recovery from aphasia was investigated for oral expression and auditory verbal comprehension separately in 264 males and 121 females subdivided according to presence/absence of rehabilitation. The conclusions were that females recover significantly better than males in oral expression, but not in auditory verbal comprehension. These results are discussed with regard to the possible existence of a different cerebral organization in males and females.

Aphasia↗
PubMed1983

CT scan cerebral hemispheric asymmetry measurements in stroke cases with global aphasia: atypical asymmetries associated with improved recovery.

This study was undertaken in order to examine the relationship between CT scan hemispheric asymmetries and recovery in aphasia. The study had two parts. In Part I, hemispheric asymmetries were measured on the CT scans of 60 right-handed male non-aphasic (non-neurological) controls and 89 right-handed male aphasics, using a modification of LeMay's (1977) techniques. Both the non-aphasic control and aphasic data were in agreement with that of LeMay for frontal width, occipital width and occipital length. In Part II, the degree of CT scan hemispheric asymmetry was quantified for 14 right-handed male global aphasics, in whom differences in degree of language recovery were observed in the months following stroke. Atypical occipital asymmetries were significantly associated with certain aspects of language recovery (naming, single-word comprehension and single-word repetition). The authors postulate that increased capacity for right hemisphere contribution to language function might in part explain recovery in the cases exhibiting atypical occipital CT asymmetries.

Adult↗
PubMed1986

Aphasia does not always follow left thalamic hemorrhage: a study of five negative cases.

Five right-handed patients suffering from a recent CT-assessed left posterior thalamic hemorrhage are reported. In all patients a standard language examination performed within one month after stroke onset did not reveal aphasic disturbances. While the present series argues for the role of intrathalamic lesion localization, a review of the literature suggests that lesion site per se does not always account for the presence or absence of aphasia in the individual case. The importance of reduced blood flow and metabolism in cortical areas which appear undamaged on CT scan is briefly discussed.

Aged↗
PubMed1988

Encoding of frequency of occurrence by aphasia patients: attentional or linguistic deficit?

Frequency-encoding performance of aphasic patients and control subjects was studied in order to test Grober's (1984) hypothesis that aphasic patients are not deficient in the encoding of frequency of events. Experiment 1 compared patients and controls on four types of list: spoken words, visual words, images of objects, and abstract figures. Experiment 2 varied semantic and phonological similarity among the words in one list. Both experiments found differences between the groups, and differences between conditions. The deterioration in patients tended to be greater for linguistic than for nonlinguistic material (experiment 1), and was strongly enhanced by semantic similarity (experiment 2). Results are better explained by a linguistic deficit than by an attentional capacity account of aphasia.

Adult↗
PubMed1989

The role of individual difference in determining the nature of comprehension defects in aphasia.

This study was concerned with the relationship between locus of lesion and subtypes of language comprehension defect in aphasia. Previous studies had indicated that performance in sound recognition identified two subtypes of aural comprehension deficit and that performance in pantomime recognition identified two subtypes of reading comprehension defect. Defects in sound recognition and pantomime recognition were found in association with a variety of lesion loci. However, comprehension defective aphasics with normal sound recognition or pantomime recognition had lesions closely similar in location and size to those of aphasics who performed poorly on these tests. Findings suggest that whether an aphasic with a language comprehension defect is impaired in sound recognition or pantomime recognition depends, at least in part, on individually variable predisposing factors. It would appear possible that this phenomenon reflects a separate dimension of hemispheric cerebral dominance.

Adult↗
PubMed1989

Verb finding in aphasia.

Word finding for nouns and verbs was examined in a heterogeneous group of aphasics (N = 9) by comparing the ability to generate synonyms and sentences for the same set of 20 nouns and 20 verbs. Synonym Generation performance resembled that of an age-matched group of normal control subjects (n = 9): In both groups, some subjects produced comparable numbers of synonyms for nouns and verbs while other subjects produced significantly fewer synonyms for verbs. Essentially the same two patterns were displayed on Sentence Generation using the frequency of "empty" nouns (e.g., 'it', 'man') and "empty" verbs (e.g., 'is', 'do') as an index of word-finding difficulty: In both groups, some subjects produced comparable numbers of empty nouns and verbs, while other subjects produced significantly more empty verbs. However, the Sentence Generation performance of one aphasic subject stood out overall by her tendency to avoid empty verbs and produce incomplete sentences. This pattern of performance was interpreted as a breakdown in an early stage of sentence planning that may be directly related to her diagnosis of transcortical motor aphasia.

Aphasia↗
PubMedDate not supplied

A case study of gesturally cued naming in aphasia: dominant versus nondominant hand training.

Gestural plus verbal facilitation of naming was investigated in an aphasic right handed adult with apraxia and hemisensory deficit but no hemiplegia secondary to a left hemisphere lesion. An alternating treatments design was followed in combined gesture/speech training of picture naming to compare speech facilitation with dominant vs. nondominant hand iconic gesturing. A small but consistent facilitation effect was observed for naming associated with verbal plus left hand gestural training over naming of items trained in association with verbal plus right hand gesturing. This same pattern of gestural facilitation was replicated with a second set of lexical targets, those for which only verbal training was initially provided. Overall gains were retained over a six-month follow-up period for trained stimuli. Although findings are limited to the performance of a single subject, results of this study may provide data relevant to understanding mechanisms of facilitation in gesture-cued naming in aphasia.

Aged↗
PubMedDate not supplied

Conversational discourse analysis as a method for evaluating progress in aphasia: a case report.

The gains made by a woman with Broca's aphasia as documented by traditional measures were paralleled by changes in conversation, including increased verbal output and efficiency, and changes in conversation repair patterns. Her conversational partner decreased her verbal output, as predicted. The progress documented with conversational discourse analysis was not observable from other test measures. Clinical and theoretical implications are discussed.

Aphasia, Broca↗
PubMed1996

Cerebellar induced aphasia: case report of cerebellar induced prefrontal aphasic language phenomena supported by SPECT findings.

A 73-year-old right-handed man with ischemic infarction in the vascular territory of the right arteria cerebellaris superior is described. In the acute phase he presented with cerebellar and brainstem symptoms, followed within a few days by a paresis of the right arm and unexpected language disturbances of aphasic origin. The core features of the aphasic syndrome corresponded to a diagnosis of Luria's dynamic aphasia, complicated by expressive and receptive agrammatism. During one year follow-up the ataxia and paretic symptoms disappeared but the slightly ameliorated aphasic syndrome and the sensory disturbances in the left hemicorpus persisted. In the absence of any neuroradiological evidence for a structural lesion in the left frontal language areas, the hypothetical causative role of the right cerebellar lesion on the contralateral prefrontal aphasic symptomatology is advocated and supported by positive 99mTc-hexamethylpropyleneamine oxime single-photon emission-computed tomography findings, revealing a focal hypoperfusion in the clinically suspected areas. In our case, this phenomenon of so-called 'crossed cerebello-cerebral diaschisis', reflecting the distant functional impact of the right cerebellum on the contralateral prefrontal cortical areas, is for the first time associated with an aphasiologic substrate. The co-occurrence of a right cerebellar lesion and an aphasic syndrome forms the first clinical illustration of the pathophysiological hypothesis of a deactivation of prefrontal left hemisphere language functions due to the loss of excitatory impulses through cerebello-ponto-thalamo-cortical pathways.

Aged↗