Showing papers on "Aphasia published in 1994"
TL;DR: The performance of three patients with impairments of the categories noun and verb suggests that anatomically distinct neural systems in the temporal and frontal lobes of the dominant hemisphere might play a critical role in lexical processing of nouns and verbs, respectively.
399 citations
Book•
01 Jan 1994
TL;DR: Localization and Function: Old Issues Revisited and New Developments, by A. Kertesz, Frontal Lesions and Function and Localization of Lesions in Constructional Impairment.
Abstract: A Kertesz, Localization and Function: Old Issues Revisited and New Developments GA Ojemann, Cortical Stimulation and Recording in Language R Lesser, S Arroyo, J Hart, and B Gordon, Use of Subdural Electrodes for the Study of Language Functions D Swick, M Kutas, and HJ Neville, Localizing the Neural Generators of Event-Related Brain Potentials EJ Metter and WR Hanson, Use of Positron Emission Tomography to Study Aphasia H Chertkow and D Bub, Functional Activation and Cognition: The 15O PET Subtraction Method JR Binder and SM Rao, Human Brain Mapping with Functional Magnetic Resonance Imaging A Kertesz and MA Naeser, Anatomical Asymmetries and Cerebral Lateralization MA Naeser, Neuroimaging and Recovery of Auditory Comprehension and Spontaneous Speech in Aphasia with Some Implications for Treatment in Severe Asphasia SZ Rapcsak and AB Rubens, Localization of Lesions in Transcortical Aphasia SE Black and M Behrmann, Localization in Alexia DP Roeltgen, Localization of Lesions in Agraphia LJ Gonzalez-Rothi, AS Raade, and KM Heilman, Localization of Lesions in Limb and Buccofacial Apraxia J Jankowiak and ML Albert, Lesion Localization in Visual Agnosia J Sergent, Cognitive and Neural Structures in Face Processing KM Heilman, RT Watson, and E Valenstein, Localization of Lesions in Neglect and Related Disorders A Kirk and A Kertesz, Localization of Lesions in Constructional Impairment S Cappa and C-W Wallesch, Subcortical Lesions and Cognitive Deficits A Kertesz, Frontal Lesions and Function TL Jernigan and LS Cermak, Structural Basis of Memory KF Gray and JL Cummings, Neuroimaging in Dementia Index
172 citations
TL;DR: It is claimed that variation in the nature of the variation between more and less disordered systems is tied to the ability of the system to deliver activation to intended units, relative to that of unintended units, within the time required by the task at hand.
132 citations
TL;DR: The role played by comprehension in oral reading was investigated in three patients with progressive fluent aphasia, and it was predicted that, for J.L. and G.C., success or failure in word comprehension should show item-specific correspondence with success or success in reading exception words, but not regular words.
129 citations
TL;DR: This paper used a combination of multiple regression and factorial designs in an effort to establish that age of acquisition, rather than word frequency or imageability, influenced success in speech production tasks.
Abstract: This paper presents a single-case study of an aphasic patient, NP, whose lexical processing was affected by age of acquisition, such that words typically acquired early in life were processed with greater accuracy in spoken naming, written naming, and reading aloud than were later-acquired words. A combination of multiple regression and factorial designs was used in an effort to establish that age of acquisition, rather than word frequency or imageability (both factors with which age of acquisition is highly correlated), influenced success in speech production tasks. In addition to showing effects of age of acquisition on spoken naming, written naming, and reading aloud, NP also showed evidence of both semantic and phonological impairments. On the basis of NP's pattern of impairments and studies of the effects of age of acquisition on lexical processing in normal subjects, we propose that age of acquisition affects the process of retrieving phonological word-forms, with early-acquired phonologica...
111 citations
TL;DR: Similar aphasia profiles in patients with deep frontal and paraventricular white matter lesions suggest that damage to a frontal-caudate functional system underlies a "core" aphasian profile in these patients.
Abstract: There has been disagreement about the precise characteristics of "subcortical aphasia." We evaluated 14 patients with aphasia after subcortical lesions and controlled for duration, general anatomic site of lesions (capsulostriatal only), and etiology. The clinical profiles of the patients were quite similar, varying in severity in rough proportion to lesion size and varying in quality in proportion to anterior paraventricular extent. Large lesions were associated with impaired "executive" and "generative" language functions. Similar aphasia profiles in patients with deep frontal and paraventricular white matter lesions suggest that damage to a frontal-caudate functional system underlies a "core" aphasia profile in these patients.
93 citations
TL;DR: The findings are interpreted to suggest that Broca's suffer from a pathological limitation in parsing capacity, giving rise to a faster than normal decay of syntactic information.
92 citations
TL;DR: This paper investigated the influence of aphasia, familiarity and activity on conversational repair in interactions between nine aphasic individuals and 18 normal subjects (nine of whom lived with the aphasics, and nine of whom were visiting the theaphasic subjects).
Abstract: This study investigated the influence of aphasia, familiarity and activity on conversational repair in interactions between nine aphasic individuals and 18 normal subjects (nine of whom lived with the aphasic subjects, and nine of whom were visiting the aphasic subjects). Data were collected in the homes of the aphasic subjects, and comprised unstructured conversation, semi-structured interaction involving retelling the events witnessed in a mock car accident, and structured testing. Conversation Analysis investigated the frequency of interactive trouble-indicating behaviour (metalinguistic comment and hypothesis forming per minute), and the nature of repair pattern (proportional pattern of repair trajectories used). Normal subjects increased their frequency of interactive trouble-indicating behaviour, and used more interactive repair patterns when conversing with aphasic partners as compared with when conversing with normal partners. The difference in familiarity between subjects did not appear ...
89 citations
TL;DR: Although gender differences were small, the infarct lesions producing aphasia in men were more posteriorly placed and the infArct lesions in women were more anteriorly placed, suggesting possible gender differences in the positioning of the language zone in the brain.
83 citations
TL;DR: PET is able to evaluate the functional disturbances associated with expanding arachnoid cysts, and to follow the neurological improvement after drainage, according to a case of epileptic aphasia associated with a left sylvian arachNoid cyst.
Abstract: Regional brain glucose utilisation was investigated with PET and fluorodeoxyglucose (FDG) in a case of epileptic aphasia (Landau-Kleffner syndrome) associated with a left sylvian arachnoid cyst. CT and MRI had failed to disclose any mass effect of the cyst on surrounding brain structures. Sequential metabolic measurements showed a comparable pronounced hypometabolism in cortical regions around the cyst, involving speech areas, and suggested mild but chronic compression of the developing brain. After placement of a cyst-peritoneal shunt system, significant metabolic improvement occurred in all cortical regions, especially the inferior frontal gyrus and the perisylvian area, with predominant residual deficit in the left superior temporal gyrus. These findings were correlated with a pronounced increase in word fluency and slower progress in verbal auditory comprehension. This report suggests that PET is able to evaluate the functional disturbances associated with expanding arachnoid cysts, and to follow the neurological improvement after drainage.
83 citations
TL;DR: An improvement in aphasia in patients undergoing rehabilitation after a stroke after 12 weeks' treatment with piracetam is shown, but an effect on tests of activities of daily living is unable to be demonstrated and the effect on perceptual deficit is not confirmed.
Abstract: The nootropic agent piracetam has been shown to improve learning and memory, and it may, by this means, facilitate recovery and rehabilitation after a stroke. We report the results of a pilot study exploring its effects in patients undergoing rehabilitation after acute cerebral infarction in the carotid artery territory. We compared piracetam and placebo, each given for 12 weeks, in a multicenter, double-blind, randomized trial of parallel-group design; testing was performed at baseline (6-9 weeks poststroke), weeks 5 and 12, and, in fewer patients, 12 weeks after termination of treatment. Standardized tests of activities of daily living (Barthel Index, Kuriansky Test), aphasia (Aachen Aphasia Test), and perception (Rivermead Perception Assessment Battery) were the primary efficacy variables. Of 158 patients, 137 (81 males, 56 females) were studied after treatment and 88 at 24-week follow-up. Thirty patients on piracetam (45%) and 37 on placebo (53%) were aphasic on entry. Both groups, including the subgroups with aphasia, were well matched at baseline for demographic data, stroke sequelae, type and severity of aphasia, and prognostic parameters. Multivariate analysis of Aachen Aphasia subtest scores showed a significant overall improvement relative to baseline in favor of piracetam (p = 0.02) at 12 weeks. This was not seen at 24 weeks when, however, fewer patients were available for evaluation so that we could neither confirm nor deny whether improvement was maintained after cessation of piracetam. We were unable to demonstrate an effect on tests of activities of daily living and could neither confirm nor exclude an effect on perceptual deficit. We have shown an improvement in aphasia in patients undergoing rehabilitation after a stroke after 12 weeks' treatment with piracetam that requires confirmation in further studies.
TL;DR: While drug therapy is unlikely to revolutionize the treatment of aphasia, it nonetheless holds promise as an adjunct to behavioral speech and language therapy to decrease performance variability and consequently to improve mean performance in patients with mild to moderate language dysfunction.
Abstract: Communication problems are a common sequela of cerebrovascular disease and other central nervous system disorders. Behavioral treatment of these disorders aims to harness uninjured parts of the brain to improve the communicative life of the individual. While pharmacotherapy has held promise for the treatment of aphasia for over 50 years, it has not fulfilled this promise. This article reviews both the promise and the disappointment of aphasia pharmacotherapy.Diverse theories of the underlying neurological deficits in aphasia have led to different pharmacologic rationales for therapy. Animal studies have demonstrated decreased levels of brain catecholamines after cortical stroke and more rapid stroke recovery with therapy aimed at augmenting brain norepinephrine and dopamine. These studies have led to recent attempts to hasten or extend language and sensorimotor rehabilitation after human stroke by administration of catecholaminergic drugs. When used as an adjunct to behavioral therapy, such pharmacotherap...
Book•
11 Nov 1994
TL;DR: Kirshner et al. as discussed by the authors analyzed CT/MRI scan lesion sites to predict potential for long-term recovery in Aphasia, and showed that the lesion site can be used to predict the likelihood of long term recovery in aphasia.
Abstract: Introduction to Aphasia, Howard S. Kirshner Motor Speech Disorders, Russell J. Love Apraxia of Speech, Howard S. Kirshner Classical Aphasia Syndromes, Howard S. Kirshner How to Analyze CT/MRI Scan Lesion Sites to Predict Potential for Long-Term Recovery in Aphasia, Margaret A. Naeser and Carole L. Palumbo Conduction Aphasia: A Syndrome of Language Network Disruption, D. Frank Benson and Alfredo Ardila Naming and Naming Disorders, Victor W. Henderson PET in Aphasia and Language, E. Jeffrey Metter Insights into Language Mechanisms Derived from the Evaluation of Epilepsy, Bassel Abou-Khalil Alexias, Howard S. Kirshner Disorders of Writing and Spelling, Marjorie Perlman Lorsch Language, Communication, and the Right Hemisphere, Hiram Brownell, Howard Gardner, Penny Prather, and Gail Martino Language in Aging and Dementia, Kathryn A. Bayles Primary Progressive Aphasia Syndrome, Howard S. Kirshner Language Impairment in Closed Head Injury, Sandra Bond Chapman, Harvey S. Levin, and Kathleen A. Culhane Acquired Childhood Aphasia, Bryan T. Woods Language Batteries in Aphasia, Wanda G. Webb Aphasia Therapy, Audrey L. Holland and Pelagie M. Beeson Toward a Pharmacotherapy for Aphasia, Masaru Mimura, Martin L. Albert, and Patrick McNamara Neuropsychiatric Aspects of Aphasia, Ann H. Craig and Jeffrey L. Cummings Neurobehavioral Deficits Associated with Aphasia, Howard S. Kirshner
TL;DR: Overall, omission rates of grammatical morphemes went down and substitution rates tended to go up in picture description as compared to free conversation, which indicates task-dependent changes in the character of agrammatic speech.
TL;DR: In this paper, a single-subject study of a patient with moderately severe mixed aphasia and anomia was undertaken, where the patient had received regular therapy and 10 months had elapsed since the cerebrovascular accident (CVA).
Abstract: Facilitation techniques deemed ‘semantic’ in nature appear to be superior to other techniques in the remediation of anomia (Howard et al. 1985a). In such techniques, however, information about the spoken or written form of the picture name is provided, i.e. the word is presented either in writing or auditorily, and is embedded in a task requiring semantic treatment of the stimulus. The objective of this study is to determine the relative contribution of information about the spoken or written form of the picture name to the facilitative effect of semantic techniques. A single-subject study of a patient with moderately severe mixed aphasia and anomia was undertaken. The patient had received regular therapy and 10 months had elapsed since the cerebrovascular accident (CVA) at the beginning of the experiment. An alternating treatment design compared the effects on naming of a formal-Semantic facilitation technique (including the spoken or written word form in a semantic comprehension task) to a pure...
TL;DR: In this article, a qualitative study investigates the ways in which 20 aphasic people, and in some cases their partners, are coping with mild aphasia, assessed through the use of a rating of level of satisfaction with life.
Abstract: This qualitative study investigates the ways in which 20 aphasic people, and in some cases their partners, are coping with mild aphasia. The investigation considers two aspects of coping. Firstly, coping is defined as the maintenance of an overall sense of meaning and value. This is assessed through the use of a rating of level of satisfaction with life. Secondly, the use of particular coping strategies and styles is delineated. Although the majority of people interviewed report a deterioration in levels of life satisfaction since the onset of aphasia, some report an improvement. Factors perceived as the cause of deterioration and improvement are varied and multifaceted. The informants demonstrate and report idiosyncratic combinations of coping strategies. It is argued that systematic investigation of coping is a necessary precursor to functional therapy, as particular styles and strategies may not combine well with goals defined without this understanding. As many of the processes of adapting to...
TL;DR: Utilization of simple fast previously validated tests of limb impairment, memory, language and language in patients with primary brain tumours will add sensitivity and objectivity to evaluation of neurological response in clinical trials and can be performed quickly by non medical staff.
Abstract: The criteria for clinical response to treatment in cerebral glioma remain poorly defined, but could be made more objective if simple measures of neurological impairments were included in the definitions. We assessed the utility of simple fast previously validated tests of limb impairment (Timed nine hole peg test and 10 meter walk), memory (Williams delayed recall test) and language (Boston Aphasia Severity Rating Scale) in fifty patients with primary brain tumours to see if they could act as a surrogate for neurological impairment. The tests were compared with established measures of physical disability (Barthel Disability Index [BDI]) and handicap. Timed tests of hand function and gait were sensitive to minor impairments and were abnormal in patients with physical disability on BDI. Timed tests correlated well with handicap (rank correlation 0.734). Short term memory was impaired more commonly with tumours involving the left hemisphere (p < 0.01). Dysphasia limited testing of memory in 8%. Depression was associated with problems in limb function (p < 0.01), memory (p < 0.001), language (p < 0.001), BDI (p < 0.001) and handicap (p < 0.001). The number of abnormal fast tests also correlated with the severity of handicap (rank correlation 0.786) indicating that memory impairment and aphasia contribute to handicap and should be assessed. Median time to complete all assessments was 7 minutes 20 seconds. Utilization of these simple tests will add sensitivity and objectivity to evaluation of neurological response in clinical trials and can be performed quickly by non medical staff.
TL;DR: An adapted neuropsychologic profile battery proved to be practical and objective for the follow-up of patients with acquired epileptic aphasia, and no patient with persisting electroencephalographic abnormalities recovered normal or near normal language.
TL;DR: The neuroanatomical areas to be examined on CT scan are discussed, in order to predict which stroke patients are not likely to recover meaningful speech, even for as long as 10 years following stroke onset.
Abstract: SummaryThis article reviews the use of a chronic computed tomography (CT) scan (performed after 2 or 3 months following stroke onset) in assessing a patient's potential for recovery of speech and comprehension in the long term (after 6–12 months following stroke onset). Not all aphasia patients reco
TL;DR: A patient who was unaware of his jargon aphasia despite only a mild auditory comprehension disturbance was studied, and it was suggested that each of the proposed mechanisms may contribute to his failure to detect and correct errors in speech production.
Book•
01 Mar 1994
TL;DR: Aphasia and related disorders. Speech Sound Disorders. Head and Neck Cancer. Disordered Swallowing. Stuttering. Speech and Language Assessment: as mentioned in this paper The Clinical History.
Abstract: Preface. List of Contributors. Perspectives on Diagnosis. Multicultural Issues in Speech and Language Assessment. The Clinical History. The Exit Conference. The Oral Mechanism. Language Disorders. Speech Sound Disorders. Stuttering. Voice Disorders. Assessing Language in the Classroom and Curriculum. Aphasia and Related Disorders. Motor Speech Disorders. Head and Neck Cancer. Cleft Palate. Disordered Swallowing. Adults with Mental Retardation. Children Who Are Hard of Hearing. The Child Who Has Severe or Profound Hearing Loss. Index.
TL;DR: The clinicoanatomic correlation is compatible with the view that crossed aphasia is a "mirror" representation of that seen in cases of uncrossed aphasIA, and the course of recovery suggests complete lateralization of language to the right hemisphere with bilateral or crossed representation of nonverbal skills.
Abstract: Objective: To longitudinaly examine neuropsychological performance in an adult dextral man with crossed aphasia after cerebrovascular accident. Design: Case report using longitudinal neuropsychological, neurological, and radiological examinations performed in close temporal proximity to one another. Setting: The patient was seen on both an inpatient and an outpatient basis by members of the Departments of Neurology and Radiology of the University of Miami (Fla) School of Medicine. Patient: Thirty-four-year-old right-handed monolingual Hispanic man without family history of lefthandedness. Results: Initial neuropsychological testing revealed classic Broca's dysphasia, visual neglect, and visuospatial disturbances. The visuospatial disturbance resolved within 6 months whereas expressive language remained severely impaired. There was a dissociation between praxis and language. Mood was jovial with indifference toward his neurologic and cognitive limitations. Serial magnetic resonance imaging studies unequivocally localized the lesions to the right hemisphere, involving the right frontal, anterior parietal, and subcortical white matter. Conclusions: The clinicoanatomic correlation is compatible with the view that crossed aphasia is a "mirror" representation of that seen in cases of uncrossed aphasia. The course of recovery suggests complete lateralization of language to the right hemisphere with bilateral or crossed representation of nonverbal skills.
TL;DR: It is concluded that nonpropositional speech, to the extent that it is measured by these tasks, is not preserved in aphasics as a group, though some patients may show a fairly consistent non Propositional advantage.
TL;DR: In comparison to earlier findings on timing at segment and word levels, it was found that deficit profiles varied between fluent and nonfluent aphasics as a function of the size of the linguistic unit with nonfluence being affected at the segment, word, and sentence level but fluent aphasic patientsaffected at the sentence level only.
TL;DR: The results strongly suggest that cortical involvement is critical to the extent and severity of neuropsychological changes in patients with lenticulostriate infarcts.
Abstract: According to previous studies, focal capsulostriatal lesions may produce aphasia, hemineglect, gestural apraxia, frontal lobe dysfunction, and memory impairment. A few reports of capsulostriate infarcts secondary to involvement of lenticulostriate arteries have confirmed that aphasia and hemineglect may occur whereas gestural apraxia, anosognosia and frontal-lobe symptoms are rare. Most studies used CT scan assessment and did not exclude possible associated lesions. Neuropsychological changes in 11 patients with lenticulostriate infarcts diagnosed by CT scan were prospectively investigated. MRI in five of the 11 patients showed an associated cortical lesion not seen on CT scan. Patients with pure lenticulostriate infarcts on MRI may exhibit aphasia of mild severity whereas Broca's aphasia, hemineglect, gestural apraxia, and anosognosia were only seen in the subgroup with associated cortical lesions. Aphasia in patients with pure lenticulostriate infarcts was characterised by prominent expressive and lexicosemantic task impairments. The results strongly suggest that cortical involvement is critical to the extent and severity of neuropsychological changes in patients with lenticulostriate infarcts.
TL;DR: This article argued that explanations for the origins of lexical and non-lexical aphasic speech automatisms must take into account: (a) both neurophysiological as well as environmental factors; (b) initial and subsequent productions of the utterance.
TL;DR: Speech perception impairments emerge in nearly all aphasic patients, suggesting that the neural basis for speech perception is broadly distributed in the language hemisphere.
Abstract: The basis of speech production and speech perception deficits in aphasia relates to implementation and access rather than to the underlying representation or knowledge base of the sound structure of language. Speech production deficits occur on the phonological level in which the incorrect phonological form of the word is selected but is implemented correctly, and the phonetic level in which the correct sound segments are selected but articulatory implementation is impaired. Phonological deficits emerge regardless of lesion site, whereas phonetic deficits have a specific localized neuroanatomical substrate. Phonetic deficits are not linguistic but affect particular articulatory movements. Speech perception impairments emerge in nearly all aphasic patients, suggesting that the neural basis for speech perception is broadly distributed in the language hemisphere. The impairment reflects the misperception of phonetic features rather than a deficit in the auditory processing of speech and emerges particularly as the sound properties of speech contact the lexicon.
TL;DR: In this paper, aphasic patients' verbal self correction effort and success were obtained before (pre-treatment) and during (treatment) language therapy and examined in relation to two outcome measures.
Abstract: This study provides objective information on the relationship of verbal self correction and improvement by treated aphasic clients. Measures of aphasic patients' verbal self correction effort and success were obtained before (pre-treatment) and during (treatment) language therapy and examined in relation to two outcome measures. Results revealed that pretreatment verbal-self-correction effort, but not success, was related to changes on the outcome measures. All treatment verbal self-correction measures were significantly correlated with the outcome measures. Patients improving most tended to (1) have higher pre-treatment verbal self-correction effort, (2) have higher auditory comprehension scores and/or improvement markedly on auditory comprehension during treatment, and (3) reflect anomic or conduction aphasia rather than global or Wernicke's aphasia. Findings suggest that verbal self-correction should be considered as one of a cluster of factors in determining the overall severity of the patien...