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Broca aphasia: pathologic and clinical.

The speech disturbance resulting from infarction limited to the Broca area has been delineated; it differs from the speech disorder called Broca aphasia, which results from damage extending far outside the Broca area. Nor does Broca area infarction cause Broca aphasia. The lesions in 20 cases observed since 1972 were documented by autopsy, computerized tomography, or arteriogram; the autopsy records from the Massachusetts General hospital for the past 20 years and the published cases since 1820 were also reviewed. The findings suggest that infarction affecting the Broca area and its immediate environs, even deep into the brain, causes a mutism that is replaced by rapidly improving dyspraxic and effortful articulation, but that no significant distrubance in language function persists. The more complex syndrome traditionally referred to as Broca aphasia, including Broca's original case, is characterized by protracted mutism, verbal stereotypes, and agrammatism. It is associated with a considerably larger infarct which encompasses the operculum, including the Broca area, insula, and adjacent cerebrum, in the territory supplied by the upper division of the left middle cerebral artery.

Adult

[Japanese-applied melodic intonation therapy for Broca aphasia].

Since Albert et al. (1973) published Melodic Intonation Therapy (MIT), this new technique for Broca type aphasics has won a good reputation because of its remarkable efficiency. Many improved cases have been reported. On the contrary, there seems to be no study on MIT in Japan. This gap may be mainly caused by the great difference between two languages which makes difficult to apply original MIT to Japanese language. Through a comparative study of two languages, we have made some amendments on original MIT, which just fit for Japanese. MIT is designed to generate verbal output by embedding target phrases and sentences in a simple, nonliguistically loaded melody pattern. The pattern is consisted of the melody line, the rhythm, and points of stress. Now let us explain our Japanese version of MIT concerning these three elements. As for melody line, our version has only two pitches; high and low, since Japanese language has a pitch accent which is decided in each word. As a result, the melody line of Japanese version is far more simple than the original one, which has four pitches. The rhythm of English is called "stress-timed rhythm", which means that a part between two syllables that have primary stresses tends to be spoken at regular intervals regardless of the number of syllables between them. Consequently, the tempo of speech varies depending on the number of syllables between them. On the other hand, Japanese has "syllable-timed rhythm", which means isosyllabic.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Phrenological studies of aphasia before Broca: Broca's aphasia or Gall's aphasia?

The history of aphasia is usually taken to begin with Broca's (1861a,b) discovery of the correlation of aphemia with damage to the posterior inferior portion of the frontal lobes and the subsequent relation to left hemisphere. That there were prior, even biblical, references to aphasia is not in dispute, nor that, according to Benton and Joynt (1960), almost all the clinical forms of aphasia had been described prior to 1800. The significance of Broca's case studies, therefore, lies in the association of motor aphasia with focal pathology in the frontal lobe. This paper examines the status of aphasia localization prior to Broca, and, specifically, the extent to which Broca's discovery may have been anticipated by the phrenologists.

Aphasia, Broca

Lesion localization in Broca's aphasia. Implications from Broca's aphasia without hemiparesis.

The recent hypothesis that injury of the left precentral gyrus (PCG) is critical in causing Broca's aphasia implies that right hemiparesis is an inevitable accompaniment of Broca's aphasia and not merely a coincidental neighborhood sign of PCG damage. A right-handed man was evaluated for posttraumatic Broca's aphasia. The absence in this case of limb or central facial weakness strongly suggests that language impairments of Broca's aphasia need not be associated with PCG damage.

Adult

The efficacy of cueing techniques in Broca's aphasia.

Twenty Broca's aphasia patients were stimulated with four cues in a picture-naming task. Among the severe aphasics in the group, presentation of a word to be imitated was the most effective cue and presentation of the initial syllable of the word ranked second. Sentence completion and printed word cues were equally effective and ranked third. Mild aphasic patients responded equally well to all four classes of cues. Reliability measures indicated that the order of potency of cues for the severe group was stable over time. Oral apraxia did not appear to contribute significantly to the severity of Broca's aphasia in any of these subjects. Possible explanations are presented for the effectiveness of cues studied.

Aphasia

[Transient total motor aphasia. A complication of an axillary brachial plexus block].

Hypo- and hypertension, arrhythmias, bradycardia extending to cardiac arrest with circulatory failure, pneumothorax, allergic reactions with or without anaphylactic shock, production of methaemoglobin, vomiting, vertigo, disorientation, acoustic and visual disorders, tinnitus, slurred speech, muscle contractions, unconsciousness, and epileptic seizures are well-known complications associated with local anaesthetics. We have observed an additional central nervous system complication: a case of transient, total motor aphasia (Broca aphasia) in a 50-year-old patient after axillary blockade of the brachial plexus. Possible causes such as type and dosage of local anaesthetic or a transient ischaemic attack in the area of the prerolandic artery are discussed and related to the literature. Ultimately, however, it is still not apparent why this complication could appear although there was no overdosage intravascular injection, or abnormality of the pulse or blood pressure, and why its manifestation was limited to a motor aphasia.

Aphasia, Broca

On-line sensitivity to local and long-distance syntactic dependencies in Broca's aphasia.

Seven agrammatic Broca's aphasics and ten normal control subjects performed a word-monitoring task to determine the degree to which violations of syntax would affect word-monitoring performance. Both local and long-distance dependencies were explored, as well as the effects of additional interceding words. Results indicated that normal subjects' word-monitoring latencies were significantly slower to target words in ungrammatical contexts for both local and long-distance dependencies. Aphasic subjects showed a significant sensitivity to ungrammaticality in the local dependency condition; for the long-distance dependencies, however, no reaction time difference emerged between grammatical and ungrammatical stimuli. Results are discussed in relation to current theories of the nature of agrammatic deficits.

Adult

[Pragmatic elements of the speech of patients with Broca's aphasia: preliminary clinical study].

The author studies three patients with Broca aphasia characterized by the Boston Diagnostic Aphasia Examination, and following A.R. Luria's criterion on the use and comprehension of pragmatic elements of speech--deixis of time, person, place, discourse and social, implicatures of Grice, conventional, generalized and particularized and presupposition. For this, the author works on the development of three hours speech resulted from interviews and also uses specific tests. One of the patients lost the propositional content of speech and internal language, typical of severe dynamic aphasia. The other two showed instability in comprehension and use of time and place deixis only during the tests, not revealing this anomaly at non-artificial conditions. These findings suggest that metalanguage is upset with its specific temporo-spatial elements affected, and it is possible that there is a graduation in the loss of discourse linkage with verbal and nonverbal context in which mediation is made by pragmatic relation in frontal lesions.

Adult

Reconstructive retrieval deficits in Broca's aphasia.

Anterior aphasic patients' ability to utilize the phonemic and/or semantic features of verbal material for retention purposes was investigated. In the first experiment, patients were asked to either detect word repetitions, phoneme repetitions, or rhymes in a list of items. The aphasics performed well on word and phoneme repetition detection but below both normals and amnesic Korsakoffs on rhyme detection. In the second experiment the patients were instructed to analyze either the physical, phonemic, or semantic features of words they were later asked to recognize. Aphasics were differentially affected (as were normals) by these instructions: semantic feature analysis resulted in the best performance, followed by phonemic feature analysis. It was concluded that anterior aphasics can analyze, recirculate, and even store the phonemic features of words, but find difficulty in reconstructing the originally presented item from these features.

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