Showing papers on "Aphasia published in 1998"

Studying Bilinguals: Methodological and Conceptual Issues.

Abstract: Because the field of bilingualism is still relatively new, studies in the linguistics, psycholinguistics, language development and neurolinguistics of bilingualism have often produced conflicting results. It will be argued in this paper that some of the difficulties encountered by researchers could have been lessened, if not avoided, had close attention been paid to methodological and conceptual issues. Among the issues covered are bilingual participants, language mode, stimuli, tasks as well as models of bilingual representation and processing. Each issue is dealt with in the following way: first it is explained, then the problems it causes are discussed, and, finally, tentative solutions are proposed. Examples are taken from descriptive and experimental studies of normal bilingual adults and children as well as bilinguals suffering from aphasia and dementia.

A Meta-Analysis of Clinical Outcomes in the Treatment of Aphasia

Abstract: An extensive search of aphasia-treatment literature yielded 55 reports of clinical outcomes satisfying the essential criteria for inclusion in a meta-analysis. The results confirmed those of an ear...

Supported conversation for adults with aphasia: methods and resources for training conversation partners

Abstract: (1998). Supported conversation for adults with aphasia: methods and resources for training conversation partners. Aphasiology: Vol. 12, No. 9, pp. 816-830.

Cognitive decline following stroke: A comprehensive study of cognitive decline following stroke.

Abstract: General insight into the frequency and gravity of cognitive dysfunctions following stroke and its influencing factors is still lacking. With an extensive neuropsychological battery 229 patients who had suffered a stroke were assessed. More than 70% of the patients showed a marked slowness of information processing, whereas at least 40% of all patients had difficulty with memory, visuospatial and constructive tasks, language skills, and arithmetic. A significant effect was found for side and type of stroke, gender, and the presence of aphasia. No significant effect was found for cortical versus subcortical lesions, having one versus multiple strokes, having lowered consciousness on admission, the presence of risk factors, a paresis of the hand, or the interval between the stroke and the neuropsychological assessment.

Dynamic aphasia: an inability to select between competing verbal responses?

Abstract: In this study we report a patient (A.N.G.) who, following a malignant left frontal meningioma impinging upon Brodmann area 45, presented a 'pure' dynamic aphasia. Her spontaneous speech was markedly reduced in the absence of any syntactical impairment. Her naming, repetition and reading skills were completely normal. Two experimental investigations were carried out. The first investigation found that A.N.G. had a profound impairment in phrase and sentence generation tasks given a verbal context. However, her verbal generative skills were normal when she was asked to describe pictorial scenes and complex actions. Moreover, it was found that A.N.G. had no difficulty ordering the constituent words of a sentence. Thus, it was concluded that her verbal planning skills were intact. The second investigation tested a hypothesis that dynamic aphasia is due to an inability to select a verbal response option whenever the stimulus activates many competing verbal responses. Predictions based upon this hypothesis were confirmed on three different verbal generation tasks. It was found that our patient's grave verbal generative impairment was present for tasks involving stimuli which activate many potential responses. However, it was absent for tasks involving stimuli which activate few or only a single 'prepotent' response. The findings are discussed with reference to traditional interpretations of dynamic aphasia and more general interpretations of prefrontal cortex functioning. On the basis of a computational model of prefrontal cortex functioning, we propose that pure dynamic aphasia may be caused by damage to a 'context' module containing units responsible for selection of verbal response options. Moreover, it is suggested that our findings support the view that Brodmann area 45 is involved in verbal response generation to stimuli which activate many potential response options.

Handbook of Neurolinguistics

Abstract: Prologue: G. Gainotti, Category-Specific Disorders for Nouns and Verbs: A Very Old and Very New Problem. H. Goodglass, Advances in Neurolinguistic Research. A.R. Lecours and M. Simard, Cerebral Substrate of Language: Ontogenesis, Senescence, Aphasia, and Recoveries. History of Neurolinguistics: H.A. Whitaker, Neurolinguistics from the Middle Ages to the Pre-Modern Era: Historical Vignettes. Clinical and Experimental Methods in Neurolinguistics: K. Willmes, Methodological and Statistical Considerations in Cognitive Neurolinguistics. J. Neils-Strunjas, Clinical Assessment Strategies: Evaluation of Language Comprehension and Production by Formal Test Batteries. C. Westbury, Research Strategies: Psychological and Psycholinguistic Methods in Neurolinguistics. S.J. Segalowitz and H. Chevalier, Event-Related Potential (ERP) Research in Neurolinguistics: Part I: Techniques and Applications to Lexical Access. S.J. Segalowitz and H. Chevalier, Event-Related Potential (ERP) Research in Neurolinguistics: Part II: Language Processing and Acquisition. H.A. Whitaker, Electrical Stimulation Mapping of Language Cortex. J-F. Demonet, Tomographic Brain Imaging of Language Functions: Prospects for a New Brain/Language Model. A.C. Papanicolaou, P.G. Simos, and L.F.H. Basile, Applications of Magnetoencephalography to Neurolinguistic Research. P. Luu and D.M. Tucker, Vertical Integration of Neurolinguistic Mechanisms. N.F. Dronkers and C.A. Ludy, Brain Lesion Analysis in Clinical Research. J.A. Fields and A.I. Troster, The Sodium Amytal (Wada) Test: Procedural and Interpretative Considerations. Experimental Neurolinguistics: A. Levels of Language Representation and Processing: Linguistic and Psychological Aspects: J.T. Gandour, Phonetics and Phonology. G. Jarema, The Breakdown of Morphology in Aphasia: A Cross-Language Perspective. P. Hagoort, The Shadows of Lexical Meaning in Patients with Semantic Impairments. H. Kolk, Disorders of Syntax in Aphasia: Linguistic-Descriptive and Processing Approaches. Y. Chantraine, Y. Joanette, and D. Cardebat, Impairments of Discourse-Level Representations and Processes. Z. Eviatar, Attention as a Psychological Entity and Its Effects on Language and Communication. M. Van der Linden and M. Poncelet, The Role of Working Memory in Language and Communication Disorders. D. Van Lancker and N.A. Pachana, The Influence of Emotion on Language and Communication Disorders. D. Corina, The Processing of Sign Language: Evidence from Aphasia. S. Dehaene and L. Cohen, Levels of Representation in Number Processing. A.E. Harris and S.L. Small, Computational Models of Normal and Impaired Language in the Brain. B. Lateralization of Language and communication: M. Hiscock, Brain Lateralization across the Life Span. E. Zaidel, Language in the Right Hemisphere Following Callosal Disconnection. M. Kinsbourne, The Right Hemisphere and Recovery from Aphasia. F. Aboitiz and A. Ide, Anatomical Asymmetries in Language-Related Cortex and Their Relation to Callosal Function. J.B. Hellige, Unity of Language and Communication: Interhemispheric Interaction in the Lateralized Brain. Part IV: Clinical Neurolinguistics: A. Language and Communication in Special Populations and in Various Disease Processes M. Paradis, Language and Communication in Multilinguals. B. Crosson and S.E. Nadeau, The Role of Subcortical Structures in Linguistic Processes: Recent Developments. M.M. Cherrier, M.F. Mendez, J.L. Cummings, and D.F. Benson, Language and Communication in Non-Alzheimer's Dementias. P. Caramelli, L.L. Mansur, and R. Nitrini, Language and Communication Disorders in Dementia of the Alzheimer Type. H. Cohen, Language Impairment in Parkinson's Disease. S. McDonald, Communication and Language Disturbances Following Traumatic Brain Injury. J.I. Tracy, Language Abnormalities in Psychosis: Evidence for the Interaction between Cognitive and Linguistic Mechanisms. B. Language and Communication in Developmental Disorders: G. Denes, Landau-Kleffner Syndrome: Clinical and Linguistic Aspects. S. Sarkari, A.A. Tan, and D.L. Molfese, The Development of Language in Some Neurological Diseases. F. Happe, Language and Communication Disorders in Autism and Asperger's Syndrome. C. Recovery from and Rehabilitation of Language and Communication Disorders: S.F. Cappa, Spontaneous Recovery from Aphasia. L. Blomert, Recovery from Language Disorders: Interactions between Brain and Rehabilitation. N. Martin, Recovery and Treatment of Acquired Reading and Spelling Disorders. P.H.K. Seymour, Neurolinguistic Issues in the Treatment of Childhood Literacy Disorders. V.M. Roth and R.C. Katz, The Role of Computers in Aphasia Rehabilitation. Resources in Clinical and Experimental Neurolinguistics and Related Fields: B. MacWhinney, Computational Transcript Analysis and Language Disorders. B. Stemmer and B. Gahl, Neurolinguistic and Related Assessment and Rehabilitation Software: A Listing. B. Stemmer and S. Lacher, Neurolinguistic and Related Journal and Book Resources: A Listing. B. Stemmer and M. Hild, Neurolinguistic and Related Resources on the Internet: A Listing. References. Index.

A four year prospective study of age-related cognitive change in adults with Down's syndrome

Abstract: Background. While neuropathological studies indicate a high risk for Alzheimer's disease in adults with Down's syndrome, neuropsychological studies suggest a lower prevalence of dementia. In this study, cognitive deterioration in adults with Down's syndrome was examined prospectively over 4 years to establish rates and profiles of cognitive deterioration. Methods. Fifty-seven people with Down's syndrome aged 30 years or older were assessed using a battery of neuropsychological tests on five occasions across 50 months. Assessments of domains of cognitive function known to change with the onset of Alzheimer related dementia were employed. These included tests of learning, memory, orientation, agnosia, apraxia and aphasia. The individual growth trajectory methodology was used to analyse change over time. Results. Severe cognitive deterioration, such as acquired, apraxia and agnosia, was evident in 28·3% of those aged over 30 and a higher prevalence of these impairments was associated with older age. The rate of cognitive deterioration also increased with age and degree of pre-existing cognitive impairment. Additionally, deterioration in memory, learning and orientation preceded the acquisition of aphasia, agnosia and apraxia. Conclusions. The prevalence of cognitive impairments consistent with the presence of Alzheimer's disease is lower than that suggested by neuropathological studies. The pattern of the acquisition of cognitive impairments in adults with Down's syndrome is similar to that seen in individuals with Alzheimer's disease who do not have Down's syndrome.

Prospective and retrospective studies of recovery in aphasia. Changes in cerebral blood flow and language functions.

Abstract: Prospective and retrospective language evaluations and single photon emission computed tomography (SPECT) scans were performed in order to study the relationship between post-stroke recovery from aphasia and changes in cerebral blood flow (CBF) in groups of patients who had made a good recovery and those who had not. For the prospective study, 20 right-handed patients with aphasia secondary to an acute cerebrovascular accident (CVA) in the left middle cerebral artery territory received language evaluations with a Japanese Standard Language Test of Aphasia (SLTA), and SPECT scans performed twice, at a mean of 3.2 and a mean of 9.2 months post-onset. Only one slice of SPECT data was analysed. A significant correlation was observed between the severity of the initial language deficit and initial CBF on the left side, but not the right. Initial CBF was not a predictor for future language recovery in either hemisphere. There was a correlation between the change in the left mean hemispheric CBF (but not the right) and the change in the overall SLTA severity rating from 3 to 9 months post-stroke. In the retrospective study, 16 right-handed patients with residual aphasia secondary to CVA in the left middle cerebral artery territory received SLTA and SPECT at a mean of 82.8 months post-onset. The patients had also received initial language evaluation with SLTA at a mean of 6.5 months post-onset. In contrast to the prospective study, the results demonstrated that the mean left hemispheric CBF at approximately 7 years post-onset did not differ between good and poor recovery groups. However, the mean right hemispheric CBF of the good recovery group was higher than that of the poor recovery group in the frontal and the thalamic regions, and also in the left frontal region. The results of these complementary studies suggest that the initial language recovery within the first year post-onset may be linked primarily to functional recovery in the dominant hemisphere, where an increase in CBF was observed at 9 months post-onset. The increased perfusion adjacent to the lesion may be crucial for early recovery in aphasia. Subsequent language recovery and the long-term recovery in aphasia may be related to slow and gradual compensatory functions in the contralateral hemisphere, specifically in the homotopic frontal and thalamic areas.

Dementia and aphasia in motor neuron disease: an underrecognised association?

Abstract: OBJECTIVES—To determine the prevalence and nature of global cognitive dysfunction and language deficits in an unselected population based cohort of patients with motor neuron disease (MND). METHODS——A battery of neuropsychological and language tests was administered to patients presenting consecutively over a 3 year period to a regional neurology service with a new diagnosis of sporadic motor neuron disease. RESULTS—The 18 patients could be divided on the basis of their performance into three groups: Three patients were demented and had impaired language function (group 1); two non-demented patients had an aphasic syndrome characterised by word finding difficulties and anomia (group 2). Major cognitive deficits were therefore found in five of the 18 patients (28%). The remaining 13 performed normally on the test battery apart from decreased verbal fluency (group 3). CONCLUSIONS—The prevalence of cognitive impairment in MND in this population based study of an unselected cohort was higher than has been previously reported. Language deficits, especially anomia, may be relatively frequent in the MND population. Aphasia in MND may be masked by dysarthria and missed if not specifically examined.

Spoken Language of Individuals With Mild Fluent Aphasia Under Focused and Divided-Attention Conditions

Abstract: The spoken language of individuals with mild aphasia and age-matched control subjects was studied under conditions of isolation, focused attention, and divided attention. A picture-description task...

Language and the brain

Abstract: Preface 1. Neurolinguistics 2. The brain 3. How we know what we know about brain organization for language 4. Aphasia: classification of the syndromes 5. Aphasia: what underlies the syndromes 6. Childhood aphasia and other language disorders 7. Right-brain-damage 8. Dementia 9. Disorders of the written word: dyslexia and dysgraphia 10. Bilingualism 11. Language organisation 12. The future of neurolinguistic study Glossary Notes and further reading Index.

Models, theories and heuristics in apraxia of speech

Abstract: This paper presents an examination of efforts to explain acquired apraxia of speech. The history of the disorder is sketched, its relation to other forms of apraxia and aphasia is discussed, and th...

Effects of treatment for sound errors in apraxia of speech and aphasia.

Abstract: This investigation was designed to examine the acquisition, generalization, and maintenance effects of a treatment for sound errors in speakers with co-occurring apraxia of speech and aphasia. Three speakers with chronic apraxia of speech and aphasia were studied in the context of a multiple baseline design across speakers and behaviors. Treatment combined the use of minimal contrast pairs with traditional sound production training techniques such as integral stimulation and articulatory placement cueing and was applied sequentially to sounds that were determined to be consistently in error before training. Results revealed increased correct sound productions for all speakers in trained and untrained words. Response generalization effects across sounds and stimulus generalization effects varied, but appeared to be limited for most speakers. Although positive maintenance effects were evidenced, some loss of treatment gains was noted following cessation of treatment.

Evaluating the use of TalksBac, a predictive communication device for nonfluent adults with aphasia

Abstract: This paper describes the design and evaluation of a computer-based communication system called 'TalksBac' with four nonfluent adults with aphasia. Despite the increased availability of computer-based augmentative and alternative communication (AAC) devices, their use with adults with aphasia is limited as few devices have been designed for this population. The TalksBac system was designed specifically for nonfluent adults with aphasia and was used by four nonfluent aphasic individuals for a period of 9 months. The TalksBac system is word-based and exploits the ability of some nonfluent individuals with aphasia to recognize familiar words and short sentences. The system consists of two programs. Personal sentences and stories are entered into the TalksBac database by use of a 'carer program'. The 'user program' assists the nonfluent aphasic user to retrieve these prestored conversational items by offering probable items based on previous use of the system. The database has a hierarchical structure, but the...

Frontal lobe degeneration of non-Alzheimer type. II. Clinical picture and differential diagnosis

Abstract: In a longitudinal prospective study of dementia, 158 patients were investigated post mortem. Sixteen patients were classified as frontal lobe dementia (FLD) of non-Alzheimer type and four cases as Pick's disease. Positive heredity for dementia was reported in 50% of these cases compared to 30% in a reference group of patients with Alzheimer's disease (AD). The typical clinical picture in FLD and Pick's disease was that of a slowly progressive dementia, at an early stage dominated by personality change, lack of insight, disinhibition, and later on stereotypy and increased apathy. There was also a progressive dynamic aphasia ending in mutism and amimia. Memory and spatial functions were comparatively spared. Disinhibition, oral/dietary hyperactivity, and echolalia were more consistently found in Pick's disease compared to FLD. The differential diagnosis against AD, cerebrovascular dementia, and other degenerative dementias and against affective disorders and psychotic reactions are discussed.

Cognitive dysfunction and impaired organization of complex motility in degenerative Parkinsonian syndromes

Abstract: Background A frontostriatal pattern of cognitive decline, consisting of a frontal lobe–like syndrome without genuine cortical defects such as amnesia, apraxia, aphasia, or agnosia, is well established in basal ganglial diseases. Recent pathological investigations, however, have again noted cortical damage in progressive supranuclear palsy (PSP), suggesting that cortical defects could be present. Objectives To delineate the pattern of cognitive impairment and to detect higher-order motor impairments (including ideomotor apraxia) in parkinsonian syndromes. Patients and Methods We assessed ideomotor apraxia, and simple and sequential tapping in patients with Parkinson disease, multiple system atrophy, and PSP with similar disease severity, age range, and education. We also administered a comprehensive battery of neuropsychological tests to examine general intelligence, memory, executive functions, attention, and visuospatial orientation. The results were compared between groups and with a matched normal control group. Results Sequential tapping and the imitation of sequences of gestures were impaired in all patient groups, with patients with PSP performing worse than the other groups. Based on ideomotor apraxia scores and a qualitative analysis of errors, 3 patients with PSP and 2 with multiple system atrophy were considered apraxic. General intelligence and executive functions were compromised in all patient groups. The impairment of patients with PSP was more pervasive than that of the other groups, and included compromise of visuospatial functions, attention, and memory. Discriminant analysis of all cognitive and motor tests showed that the tapping and ideomotor apraxia tests best identified the patients vs control subjects. Conclusions The presence of cortical as well as subcortical damage in patients with PSP and those with multiple system atrophy is indicated by the presence of pervasive cognitive and motor disturbances in the former, substantial motor disorganization in the latter, and the finding of ideomotor apraxia in some patients with these diseases. Furthermore, the discovery that tests of motor and gesture best identified all patients vs control subjects is consistent with the existence of a common motor disorganization in these parkinsonian syndromes, in agreement with the known damage to the corticostriatal pathways in these conditions.

Therapy using conversation analysis: Helping couples adapt to aphasia in conversation

Abstract: This study focuses on the assessment and treatment of the conversations of a couple where one partner has aphasia. The assessment and treatment, informed by conversation analysis, are described, and some implications for the relation between language and psychosocial issues discussed.

Slowly progressive pure word deafness

Abstract: Among the reports of primary progressive aphasia, there are few about patients who exhibited progressive pure word deafness with detailed auditory and radiological examination as well as neuropsychological assessment. We describe a 67-year-old right-handed man who exhibited slowly progressive pure word deafness over a period of 9 years without exhibiting any other cognitive or mental deterioration. Magnetic resonance imaging of his brain revealed generalized cortical atrophy, particularly in the left superior temporal region. Auditory examination revealed severe disability in discriminating each syllable or mora of Japanese words despite adequate auditory acuity. He also showed impairment in temporal auditory discrimination assessed by the click fusion test and the click counting test. His ability to discriminate meaningful environmental sounds was mildly impaired. We discuss the pathophysiology of slowly progressive pure word deafness over a period of many years which was not complicated by other language or cognitive dysfunctions.

Joint productions as a conversational strategy in aphasia.

Abstract: To address the longstanding question of the conversational ability of persons with aphasia, this study investigated the spontaneous occurrence of a specific type of conversational collaboration, joint production, that is known to occur in the conversation of ordinary speakers. A person with aphasia and his wife videorecorded eight of their naturally occurring conversations. These conversations were analysed and three types of joint productions were identified: word search, turn completion and appendor production. Additional sequential analysis revealed the linguistic, paralinguistic and contextual resources available to the interactants in designing their joint production. Results showed that, despite the presence of aphasia, this couple was able to successfully employ joint production as an interactive technique leading to conversational success. Implications of this study are discussed relative to the understanding of communicative ability of persons with aphasia and how aphasia is diagnostically and therapeutically approached.