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PubMed2002

[A case of left thalamic infarction with aphasia and dysgraphia in Kanji].

We reported an 11-year-old girl with left thalamic infarction causing aphasia and dysgraphia. The lesion corresponded to the perfusion area of the tuberothalamic and paramedian arteries. Confrontation naming and word finding were impaired, but phonological cuing was very helpful despite the absence of amnesia. Dysgraphia was observed only in Kanji (morphogram) writing, and was also improved by visual cuings. These findings suggested difficulty in memory retrieval, in which the left thalamus might have some role.

Agraphia↗
PubMed2001

Speech re-education in patient with motor aphasia in collaboration with family.

The presented paper is an example of family education in managing the patient with motor aphasia following the stroke. The neurological diagnosis confirmed a medium hemiparesis on the right side. During the third week following the stroke, the re-education of speech was taken up basing on the new style of working with patient, i.e. biopsychosocial model of illness and treatment. In this aspect patient is the subject and the therapy is addressed to the patient taking into account his system of values with reference to the illness. The aim of the study--speech therapy--was achieving a maximum integration with the society by solving the problem situation of a patient, i.e. the lack of verbal contact. Speech therapy was performed for 8 weeks and it applied pedagogic and neurolinguistic methods of therapy. The sessions were held every day of maximum 25 minutes. At the final stage of speech re-education the patient had a good verbal contact with the environment.

Aphasia, Broca↗
PubMedDate not supplied

Sentence context effects and the timecourse of lexical ambiguity resolution in nonfluent aphasia.

In the current neurolinguistic literature, two proposals have been put forth to account for the deficit in ambiguous word processing observed in nonfluent aphasic patients. One proposal maintains that these individuals are impaired in the selective access of ambiguous word meanings, while the other argues that they are impaired in the process of contextual selection. In the present study, nonfluent aphasic patients and elderly control subjects participated in a semantic priming experiment, in which ambiguous words were presented in different biasing contexts at both a 0- and 750-ms ISI. At both ISIs, control subjects showed context-selective access, in that only contextually appropriate meanings were activated. In contrast, at the 0-ms ISI, the nonfluent aphasic patients showed activation of both meanings of the ambiguous word regardless of context. Only at the 750-ms ISI did they exhibit context-selective access. These results are consistent with the proposal that left hemisphere damage causing nonfluent aphasia results in an impairment in rapidly integrating lexical-semantic information into context.

Aphasia, Broca↗
PubMed1975

[A new observation of crossed aphasia in a right-handed man].

The observation of a crossed aphasia is presented in a right handed man. These troubles of the language appeared, following an anterior right temporal lobectomy for ablation of an oligodendroglioma. They are in accordance with the classic data of the litterature as much as by their clinical features than by their evolution.

Adult↗
PubMed1975

Aphasia and the expert medical witness.

Psychiatrists have recently been criticized from within and outside the profession for rendering professional opinion in instances where their qualifications are inadequate. In forensic psychiatry, the problem of predicting dangerousness is a notable example. The forensic psychiatrist may also be called to testify as to the present or future competency of the aphasic patient. It therefore behooves the medical expert to be fully aware of the new developments within the field of aphasiology so that in cases involving aphasia the best combined expert testimony can be rendered the court.

Aphasia↗
PubMed2002

[Frontal lobe hematoma associated with transcortical motor aphasia: case report].

An 81-year-old woman with left medial frontal lobe hematoma, which involved the supplementary motor area, is reported. She was right-handed and was initially mute for several hours after the onset. On admission, she exhibited mild paresis of the right lower extremity. Her spontaneous speech was sparse and not fluent, but her articulation and auditory comprehension were normal and repetition was good. She exhibited excellent performance in the confrontation naming task, but showed difficulty in recalling words from a given category during the word fluency task. On the basis of these clinical features, she was diagnosed as having transcortical motor aphasia. Our case may corroborate previous findings that the left medial frontal lobe is important in word fluency but not in confrontation naming.

Aged↗
PubMed1976

Wegener granulomatosis with aphasia.

Wegener granulomatosis, a necrotizing granulomatous vasculitis that characteristically involves the respiratory tract and the kidneys, may affect the nervous system. Despite the relative frequency of neurologic manifestations, there has not been a single report of Wegener granulomatosis manifesting as a cerebral vascular accident. Our patient had limited Wegener granulomatosis with aphasia as the symptom that was observed first. A dramatic recovery occurred after corticosteriod and cytotoxic therapy.

Aphasia↗
PubMed2002

[A case of slowly progressive aphasia accompanied with auditory agnosia].

A 68-year-old right-handed woman was admitted to our hospital because of difficulty to speak and understand conversation over 10 years. She was able to make herself by writing. No change in her personality or behavioral abnormality was observed so that she could live without help. Although her WAIS score and auditory brain stem response were normal, she could not understand the speech or distinguish the sound. She also spoke plenty of words fluently, resulting in undifferentiated jargon. She did not make any effort in speaking. Her speech was, however, unclear and hard to understand. Brain MRI scan disclosed a moderate atrophy of bilateral temporal lobe and enlargement of Sylvius fissure. A three-dimension reconstructed brain surface image showed enlargement of the perisylvian fissure, and atrophy of the gyrus frontalis inferior, operculum, gyrus temporal superior, bilaterally. Reduced cerebral blood flow was demonstrated on 99mTc-ECD SPECT in the left thalamus and bilateral fronto-temporal lobe. A diagnosis of slowly progressive aphasia with auditory agnosia was made. Our case suggests that bilateral disturbance of neuronal network between the primary auditory area and the secondary auditory area is responsible to the consequence of auditory agnosia.

Aged↗
PubMed2003

Evidence of bilateral temporal lobe involvement in primary progressive aphasia: a SPECT study.

UNLABELLED: Primary progressive aphasia (PPA) is rare. Only limited series have been reported with SPECT or PET. Moreover, in the majority of studies, the left-to-right asymmetry ratio was used, leading to difficulties in right hemisphere analyzes. METHODS: Twenty-nine patients with clinical criteria of PPA (Mesulam and Weintraub) were included and compared with 12 control subjects. Complete language examination was performed in all patients. SPECT was performed on a double-head gamma camera after intravenous injection of hexamethylpropyleneamine oxime (22 patients and 12 control subjects) or ethylcysteinate dimer (7 patients). Nineteen regions of interest (ROIs) were drawn on each hemisphere in all patients using the Talairach atlas. The perfusion index (PI = cortex-to-cerebellum ratio) was calculated for each ROI. Atrophy was quantified on MRI by consensus of 3 observers in 16 cortical ROIs. ANOVAs were used to compare the PI between (a). patients and control subjects, (b). patients with (n = 15) or without (n = 14) lexicosemantic abnormalities (LS+ vs. LS-) and patients with (n = 19) or without (n = 10) arthric disorders (A+ vs. A-), and (c). patients with or without atrophy. RESULTS: In the 29 patients, the PI was significantly lower in the left temporopolar, left lateral temporal, left Wernicke, left parietal, and right lateral temporal cortex when compared with control subjects (P < 0.001). In LS+ patients versus control subjects, the PI significantly decreased in the left temporal cortex (lateral temporal; medial temporal; temporopolar; Wernicke), left Broca, left parietal, and right lateral temporal cortex (P < 0.001). In addition, LS+ versus LS- comparison showed a significant decrease in the left lateral, left medial temporal, and left Broca cortex (P < 0.001). In comparison with control subjects, the PI was not significantly different in A+ patients, whereas in A- patients the PI was significantly decreased in the left and right lateral temporal cortex, left Wernicke, and left parietal cortex. Moreover, the PI significantly decreased in the left lateral temporal region in A+ patients compared with A- patients. Finally, in patients without atrophy, the PI significantly decreased in the right and left lateral temporal cortex and the left parietal cortex (P < 0.01). CONCLUSION: Our study demonstrates that right-handed patients with PPA present a decreased perfusion in the bilateral temporal cortex. Moreover, in these regions, morphologic abnormalities are preceded by perfusion abnormalities. Finally, our results show that large left temporal dysfunction occurs in patients with LS disorders.

Aged↗
PubMedDate not supplied

[Kurt Goldstein: from aphasia to linguistics].

The authors try to take into account Kurt Goldstein's contribution on the subject of aphasia. They introduce the significance of the phenomenological approach of the language leading them toward the structuralist theme.

Aphasia↗
PubMed1992

Training and generalization of expressive syntax in nonfluent aphasia.

Generalization of treatment effects remains a consistent goal of clinicians who treat aphasic adults. Specifically, various types of stimulus/response generalization designs are available, depending on the level of generalization desired. We have reviewed training matrices designed to elicit gestural subject-plus-verb targets and treatment studies designed to answer more global questions regarding treatment efficacy. As Kearns (1989) so eloquently states, "clinical accountability cannot, in fact, be fully achieved without documentation of communication skills trained in the clinic generalized to other settings and situations." Although the studies cited and data reviewed in this article did not meet this standard specifically, an attempt was made to provide a brief prelude to the data now emerging in the aphasiology literature. Additionally, with an increasing data base in the literature specific to generalization, more efficacious treatment paradigms will be made available. Clinicians treating aphasic adults thus should have the opportunity to choose the treatments shown to be most effective for a specific type and severity of aphasia.

Aged↗
PubMed1992

[A case of apraxia and global aphasia without apraxia for axial body movement].

The case of a right handed 58 year old woman is presented who suffered an ischemic stroke after angiography following a vasospasm in the left internal carotid artery. The neuropsychological examination revealed global aphasia and severe apraxia for movements of the face and the extremities. However, the patient was able to carry out adequately axial movements to imitation and also to verbal command. These particular findings are discussed and explained within the context of the existing literature.

Aphasia↗
PubMed1992

[Atypical verbal behavior in a 30 year follow-up of an acquired aphasia-epilepsy syndrome].

Detailed study of the communication of one of the patients followed-up by Deonna et al. (1989) who has been suffering since age seven of an atypical acquired aphasia-epilepsia syndrome. Seizures as well as peculiar verbal productions persist at adult age. After a thirty year follow-up, only a small lexicon has been acquired, mostly made of onomatopeia and idiosyncrasies. We describe this lexicon and discuss the quality of the communication in a real-life ecological situation. We then compare it to the jargon and the aphasic productions of the standard neuropsychological examination.

Adult↗
PubMed2003

[Routine clinical diagnosis of primary progressive non-fluent aphasia].

It may be difficult to distinguish between a primary progressive aphasia at a very mild stage from the beginning of Alzheimer's disease (AD). However, this may be achieved by carrying out simple neuro-psychological tests. Nine non-fluent PPA (NFPPA) and 76 AD patients with comparable MMSE as well as 58 control subjects were evaluated using simple tests: MMSE, fluency, apraxia, naming, digital span, story memory, 5 words memory test. NFPPA patients had significantly impaired functions during the semantic category fluency and naming tests as compared to AD patients, whereas they showed a better delayed recall of the 5 words and story memory tests. As compared to AD, MMSE of NFPPA patients was also better in the time orientation and word recall sub-tests, although inferior in words repetition and language items. Thus, with comparable MMSE, NFPPA patients have more lexico-semantic difficulties, but a better delayed verbal memory than AD patients. These simple tests easily confirm the language impairment of NFPPA patients as opposed to the mnestic difficulties of AD, even at very early stages of these pathologies.

Adult↗
PubMed2004

Cortical language activation in aphasia: a functional MRI study.

BACKGROUND: Functional neuroimaging has been used in neurolinguistic research on normal subjects and on patients with brain damage. This study was designed to investigate the differences of the neural basis underlying language processing between normal subjects and aphasics. METHODS: Functional magnetic resonance imaging (fMRI) was used to map the language network in 6 normal subjects and 3 patients with aphasia who were in the stage of recovery from acute stroke. The participants performed a word generation task during multi-slice functional scanning for the measurement of signal change associated with regional neural activity induced by the task. RESULTS: In normal subjects, a distributed language network was activated. Activations were present in the frontal, temporal, parietal and occipital regions. In the patient group, however, no activation was detected in the left inferior frontal gyrus whether the patient had a lesion in the left frontal lobe or not. Two patients showed activations in some right hemisphere regions where no activation appeared in normal subjects. CONCLUSIONS: fMRI with word generation task is feasible for evaluating language function in aphasic patients. Remote effect of focal lesion and functional redistribution or reorganisation can be found in aphasic patients.

Adult↗
PubMed2004

A longitudinal study of behavior in frontotemporal dementia and primary progressive aphasia.

OBJECTIVE: To evaluate the construct validity of the Frontal Behavioral Inventory (FBI) and to describe the evolution of the behavioral abnormalities of the behavioral and aphasic presentations of frontotemporal dementia (FTD) by means of a 3-year longitudinal study. BACKGROUND: The FBI is a standardized behavioral questionnaire useful in the diagnosis and quantification of the personality and behavior disorder FTD. METHOD: Patients who had three consecutive yearly assessments with the FBI were selected, 12 with the behavioral variant of FTD (FTD-bv) and 14 with Primary Progressive Aphasia (PPA). RESULTS: FBI scores rose as the disease progressed in both the FTD-bv and PPA groups over the 3 years of testing. Initial mean FBI scores of the FTD-bv group were above the cutoff for FTD as established for this diagnosis with previous standardization. By the third year, the mean FBI score of PPA patients was also above the established cutoff for FTD. CONCLUSIONS: The outcome of the study demonstrates that the FBI is sensitive to changes in behavior and personality in both variants of FTD. The FBI can be used to describe the evolution of symptoms and the course of the illness of Pick complex patients who present initially with FTD-bv or who present with PPA and subsequently develop the behavioral disorder.

Aged↗
PubMed2006

[Mixed aphasia as a dominating symptom of encephalitis].

Encephalitis has typically a severe course, with psychotic disorders, consciousness disorders, epileptic seizures and meningal signs. The author describes a case of a young male, in whom dominant symptoms of encephalities were aphasia and headache. These symptoms were accompanied by considerable inflammatory changes in cerebral fluid. The outcome of illness was favourable.

Adult↗