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PubMed1989

Effect of restricted cortical lesions on absolute thresholds and aphasia-like deficits in Japanese macaques.

The effect of small bilateral cortical lesions on pure-tone audiograms and on the ability to discriminate between two types of Japanese macaque coo vocalizations was determined in four Japanese macaques (Macaca fuscata). A lesion that included the middle portion of the superior temporal gyrus of both hemispheres, that is, the primary and secondary auditory areas, resulted in a partial hearing loss as well as an inability to discriminate the vocalizations. Lesions that included the ventral portions of the superior temporal gyrus of both hemispheres but spared auditory cortex on one side also resulted in a partial hearing loss but had either a small effect or no effect on the ability to discriminate the vocalizations. Bilateral ablation of the dorsal superior temporal gyrus and adjacent parietal and occipital areas did not appear to result in a hearing loss and had no effect on the ability to discriminate the vocalizations. These results suggest that a hearing loss may be produced by lesions that involve small portions of the ventral two-thirds of the superior temporal gyrus bilaterally although the resulting loss is not as great as that observed with larger lesions. However, the aphasia-like deficit appears to result from a lesion of primary and/or secondary auditory cortex.

Acoustic Stimulation↗
PubMed2000

Superadditive effects of multiple lesions in a connectionist architecture: implications for the neuropsychology of optic aphasia.

Neuropsychological disorders have traditionally been understood in terms of a focal lesion to a single component of a cognitive architecture. Optic aphasia (OA) defies explanation in this way. In OA, naming of visual stimuli is impaired in the absence of general visual agnosia or anomia. OA has been explained by positing multiple semantic systems or multiple functional pathways to visual naming. M. J. Farah (1990) instead sketched a parsimonious account based on multiple lesions--to pathways mapping visual input to semantic and semantics to naming responses--and the assumption that the effects of the lesions are superadditive. The authors demonstrate superadditive effects of damage in a connectionist architecture and model other phenomena associated with OA. Multiple lesions with superadditivity provide a novel class of explanations for neuropsychological deficits that previously seemed to imply the existence of highly specialized processing components.

Aphasia↗
PubMedDate not supplied

Sign language aphasia during left-hemisphere Amytal injection.

Although it has been established that the left cerebral hemisphere subserves spoken language, the nature of brain organization for sign language remains relatively unexplored. The issue is especially important because sign language displays the complex linguistic structure of spoken languages, but conveys it through manipulation of visuo-spatial relations, thereby exhibiting properties for which the hemispheres of hearing individuals show opposing specializations. We had the unique opportunity to study a hearing signer proficient in American sign language (ASL), during the left intracarotid injection of a barbiturate (the Wada test), and before and after a right temporal lobectomy. The subject was a strong right-hander. Neuropsychological and anatomical asymmetries suggested left cerebral dominance for auditory-based language. Emission tomography revealed lateralized activity of left Broca's and Wernicke's regions for spoken language. The Wada test, during which all left language areas were rendered inoperative, caused a marked aphasia in both English and ASL. After partial ablation of the right temporal lobe, the abilities to sign and understand signing were unchanged. These data add further support to the notion that anatomical structures of the left cerebral hemisphere subserve language in a visuo-spatial as well as an auditory mode.

Adult↗
PubMed2005

Working memory in aphasia: theory, measures, and clinical implications.

Recently, researchers have suggested that deficits in working memory capacity contribute to language-processing difficulties observed in individuals with aphasia (e.g., I. Caspari, S. Parkinson, L. LaPointe, & R. Katz, 1998; R. A. Downey et al., 2004; N. Friedmann & A. Gvion, 2003; H. H. Wright, M. Newhoff, R. Downey, & S. Austermann, 2003). A theoretical framework of working memory can aid in our understanding of a disrupted system (e.g., after stroke) and how this relates to language comprehension and production. Additionally, understanding the theoretical basis of working memory is important for the measurement and treatment of working memory. The literature indicates that future investigations of measurement and treatment of working memory are warranted in order to determine the role of working memory in language processing.

Aphasia↗
PubMed2003

The role of syntactic complexity in treatment of sentence deficits in agrammatic aphasia: the complexity account of treatment efficacy (CATE).

This experiment examined the hypothesis that training production of syntactically complex sentences results in generalization to less complex sentences that have processes in common with treated structures. Using a single subject experimental design, 4 individuals with agrammatic aphasia were trained to comprehend and produce filler-gap sentences with wh-movement, including, from least to most complex, object-extracted who-questions, object clefts, and sentences with object-relative clausal embedding. Two participants received treatment first on the least complex structure (who-questions), and 2 received treatment first on the most complex form (object-relative constructions), while untrained sentences and narrative language samples were tested for generalization. When generalization did not occur across structures, each was successively entered into treatment. Results showed no generalization across sentence types when who-questions were trained; however, as predicted, object-relative training resulted in robust generalization to both object clefts and who-questions. These findings support those derived from previous work, indicating not only that generalization occurs across structures that are linguistically related, but also that generalization is enhanced when the direction of treatment is from more complex to less complex constructions. This latter finding supports the authors' newly coined "complexity account of treatment efficacy" (CATE).

Aphasia, Broca↗
PubMed2006

Effect of semantic naming treatment on crosslinguistic generalization in bilingual aphasia.

PURPOSE: The effect of semantic naming treatment on crosslinguistic generalization was investigated in 3 participants with English-Spanish bilingual aphasia. METHOD: A single-subject experimental designed was used. Participants received semantic treatment to improve naming of English or Spanish items, while generalization was tested to untrained semantically related items in the trained language and translations of the trained and untrained items in the untrained language. RESULTS: Results demonstrated a within- and across-languages effect on generalization related to premorbid language proficiencies. Participant 1 (P1; equal premorbid proficiency across languages) showed within-language generalization in the trained language (Spanish) as well as crosslinguistic generalization to the untrained language (English). Participant 2 (P2) and Participant (P3) were more proficient premorbidly in English. With treatment in English, P2 showed within-language generalization to semantically related items, but no crosslinguistic generalization. With treatment in Spanish, both P2 and P3 exhibited no within-language generalization, but crosslinguistic generalization to English (dominant language) occurred. Error analyses indicated an evolution of errors as a consequence of treatment. CONCLUSIONS: These results are preliminary because all participants were not treated in both languages. However, the results suggest that training the less dominant language may be more beneficial in facilitating crosslinguistic generalization than training the more proficient language in an unbalanced bilingual individual.

Aphasia↗
PubMed1977

Aphasia testing: a second look at the Porch Index of Communicative Ability.

It has been claimed that the Porch Index of Communicative Ability (PICA), through its multidimensional scoring system, corrects for lacks in other tests for aphasia. Specifically, the PICA is said to specify the details of the response and indicate the nature of the response; detect and describe small changes in the patient's responses; indicate the patient's level of communicative ability; and eliminate the subjectivity and bias present in descriptive methods of scoring. It is argued here that the PICA does none of these things and that the multidimensional scoring system as applied in the PICA is invalid.

Aphasia↗
PubMed1981

Response of an agrammatic patient to a syntax stimulation program for aphasia.

A Syntax Stimulation Program (SSP) based on the findings of neurolinguistic studies of agrammatic aphasic patients was used to treat one patient with a three year history of severe agrammatism. The SSP is designed to elicit eight different sentence constructions at two levels of difficulty using a story completion technique. The patient received pre-, mid- and post-treatment testing with the Northwestern Syntax Screening Test (NSST) and the cookie theft picture description of the Boston Diagnostic Aphasia Examination (BDAE). With 10 1/2 weeks of treatment, the patient's NSST expressive scores improved from 0 to 21, and his BDAE picture description showed increased phrase length and use of grammatical constructions. In addition, with this special treatment, the patient was able to produce grammatical speech in spontaneous conversation. Thus, the SSP appears to have therapeutic merit in training syntactic skills in presumably stable agrammatic patients.

Adult↗
PubMed1987

Children with a history of acquired aphasia: residual language and academic impairments.

Fifteen children and adolescents with a history of acquired aphasia were administered a battery of language and academic tests, 1-10 years postonset. As a group, these children performed significantly more poorly than non-brain-injured subjects on the language measures, with deficits in word, sentence, and paragraph comprehension; naming; oral production of complex syntactic constructions; and word fluency. One particular language deficit or cluster of deficits did not characterize the group as a whole. For individual brain-injured subjects, language deficits ranged from no or only mild impairment to significant language deficits. All brain-injured subjects were functional verbal communicators at the time of the study; that is, all were oral and primarily used grammatical sentences as their means of communication. Academic difficulties were characteristic of this population. Two thirds of the brain-injured group were receiving academic assistance of some kind at the time of the study. Poor performance on arithmetic calculations was typical. The brain-injured group was heterogeneous with regard to age at onset, etiology, extent of damage, length of recovery, and outcome profiles. Careful and comprehensive assessment of a range of language and academic abilities is essential to adequately identify needs and appropriate intervention strategies for this population.

Achievement↗
PubMed1989

The communicative effectiveness index: development and psychometric evaluation of a functional communication measure for adult aphasia.

Groups of aphasic patients and their spouses generated a series of communication situations that they felt were important in their day-to-day life. Using criteria to ensure that the situations were generalizable across people, times, and places, we reduced the number of situations to 36 and constructed an index that allowed the significant others of 11 recovering and 11 stable aphasic individuals to rate their partners' performance in the situations on two occasions 6 weeks apart. These data were then used to evaluate the psychometric properties of the Communicative Effectiveness Index (CETI) as a measure of change in functional communication ability. Further application of a generalization criterion reduced the final index to 16 situations. Results showed the CETI to be internally consistent and to have acceptable test-retest and interrater reliability. It was valid as a measure of functional communication according to the pattern of correlations found with other measures (Western Aphasia Battery, Speech Questionnaire, and global ratings). Finally, it was responsive to functionally important performance change between testings. Further research with the CETI and its usefulness for clinicians and researchers are discussed.

Aged↗
PubMed1977

Effect of auditory prestimulation on naming in aphasia.

In five aphasic subjects, picture naming alone was compared with picture naming in the presence of four different auditory cues. Eighty words represented by pictures were associated with the following auditory cues: the first phoneme of the target word; an open-ended sentence designed to elicit the target word; three words, one of which was the target word; three words, all semantically related to the target word. Three conditions--the phonetic cue, the open-ended sentence, and the set of three words containing the target word--facilitated naming significantly. The condition making use of semantically related words resulted in a significant decrease in naming performance. Implications of these findings for theories of verbal recall, impairment of verbal recall in aphasia, and language therapy are discussed.

Acoustic Stimulation↗
PubMed1978

Presentation by order of difficulty of test tasks to persons with aphasia.

To determine the effects of arranging test tasks by order of difficulty, two test forms were administered to each of 20 patients with aphasia. The two test forms were split halves of the Porch Index of Communicative Ability. One of the test forms, Form EH, was presented to each patient with the subtests arranged for the individual subject in an order from easy to hard. The other test form, Form HE, was administered to each subject in the hard-to-easy order. There was no significant difference between the performance of the subjects on the Form EH and their performance on Form HE.

Adult↗
PubMed1980

Statistical prediction of change in aphasia.

We reviewed speech, language, and biographical data on 144 asphasic patients who had suffered left hemisphere cerebral vascular accidents. Using a step-wise multiple regression procedure, we attempted to predict change in severity of aphasia at three, six, and 12 months postonset based on performance at one, three, and six months postonset. Our results suggest statistical prediction of change is feasible. Multiple correlation coefficients ranged from 0.74 to 0.94.

Adolescent↗
PubMed1981

Three studies of deficits in pantomimic expression and pantomimic recognition in aphasia.

Studies were conducted to investigate aphasic deficits in pantomimic behaviors. Three groups of subjects were used: 47 aphasics; 27 right-hemisphere-damaged; and 11 controls. Study I replicates a previous study of pantomimic recognition deficits (Duffy, Duffy, & Pearson, 1975) and essentially duplicates the previous findings of significant deficits of pantomimic recognition in aphasic subjects that are highly correlated with their verbal deficits. Study II examines the relationship between deficits in pantomimic recognition and expression; and the relationships between these two nonverbal behaviors and aphasic verbal deficits. Zero order correlations, partial correlations, and multiple regression analyses are presented. The results show that aphasics exhibit significant deficits in both pantomimic expression and recognition; and, that both of these are highly correlated with aphasic verbal deficits. Study III is an investigation of four causal theories of aphasic deficits in pantomimic expression. Zero order correlations, partial correlations, and multiple regression analyses are presented. It is concluded that aphasic pantomimic expressive deficits are not caused by general intellectual deficit or limb apraxia; but, they are associated with a central symbolic disorder or a verbal mediation deficit. The implications of these studies for an understanding of the nature of aphasia as a syndrome which includes both verbal and nonverbal impairments are discussed.

Aphasia↗
PubMed1986

An application of exploratory statistical methods to language pathology: analysis of the Western Aphasia Battery's Cortical Quotient in acute stroke patients. Research note.

Two simple exploratory statistical techniques, stem and leaf displays and box plots, are described and applied to the analysis of Western Aphasia Battery Cortical Quotient scores for 111 acute stroke patients. A stem and leaf display highlights the shape of a distribution of data and is useful for quickly ordering and displaying data in the form of a frequency distribution; box plots focus special attention on the tails of a distribution and are valuable for summarizing, analyzing, and comparing group data. These methods were used to determine an internal Cortical Quotient cutoff score to distinguish between normal and cognitively impaired patients. The utility of this Cortical Quotient cutoff score and the relevance of these statistical techniques to other research in communicative disorders are discussed.

Adult↗
PubMed1993

A system for quantifying the informativeness and efficiency of the connected speech of adults with aphasia.

A standardized rule-based scoring system, the Correct Information Unit (CIU) analysis, was used to evaluate the informativeness and efficiency of the connected speech of 20 non-brain-damaged adults and 20 adults with aphasia in response to 10 elicitation stimuli. The interjudge reliability of the scoring system proved to be high, as did the session-to-session stability of performance on measures. There was a significant difference between the non-brain-damaged and aphasic speakers on each of the five measures derived from CIU and word counts. However, the three calculated measures (words per minute, percent CIUs, and CIUs per minute) more dependably separated aphasic from non-brain-damaged speakers on an individual basis than the two counts (number of words and number of CIUs).

Aged↗
PubMed1994

Speech sample size and test-retest stability of connected speech measures for adults with aphasia.

The effect of speech sample size on the test-retest stability of two measures of connected speech--words per minute (WPM) and percent of words that are correct information units (Percent CIUs)--was evaluated. A standard set of 10 stimuli was used to elicit connected speech from 20 non-brain-damaged adults and 20 adults with aphasia. Each subject's responses to the 10 stimuli were transcribed and scored for WPM and Percent CIUs. Then each subject's responses to the 10 stimuli were randomly divided to produce smaller speech samples representing his or her responses to 1, 2, 3, 4, 5, and 7 stimuli. The test-retest stability of the WPM and Percent CIUs measures was then evaluated for each of the smaller sample sizes and for the complete 10-stimulus sample. For both groups, the test-retest stability of the two measures increased as sample size increased, with the greatest increases occurring as samples increased in size from those representing 1 stimulus to those representing 4 or 5 stimuli, with smaller increases in stability thereafter. In general, these results suggest that the best balance between high test-retest stability and the time and effort required to transcribe and score speech samples can be achieved with samples representing 4 or 5 stimuli (an average of 300 to 400 words for aphasic subjects), although this will vary across individuals.

Aged↗
PubMed1997

Training and generalized production of wh- and NP-movement structures in agrammatic aphasia.

The present research examines production of "complex" sentences, which involve movement of noun phrases (NPs), in 2 agrammatic aphasic subjects. According to linguistic theory (Chomsky, 1991, 1993), such sentences are derived using one of two movement operations, either wh- or NP-movement, subsumed under the general rule "move alpha." In this experiment recovery of both wh- and NP-movement derived sentences was investigated using a treatment research paradigm. Subjects were sequentially trained to produce either wh-movement (i.e., who questions, object clefts) or NP-movement (i.e., passives, subject-raising structures) derived sentences. Throughout training, generalization to untrained sentences relying on both types of movement was tested. The influence of training on aspects of narrative discourse also was examined. Results showed generalization patterns constrained to type of movement. Training wh-movement structures resulted in generalized production of untrained wh-movement structures without influencing production of NP-movement structures. Similarly, training of NP-movement structures resulted in generalization only to other sentence types also relying on NP-movement. Aspects of sentence production in narrative contexts also was improved with treatment. These data indicate that movement to an argument (A) position as in NP-movement is distinct from movement to a non-argument (A-bar) position, required in wh-movement. The site where movement terminates in the s-structure of noncanonical sentences appears to influence sentence production. These findings show that linguistic properties of sentences influence sentence production breakdown and recovery in aphasia.

Aphasia, Broca↗