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K M Heilman

Publications and source records attributed to K M Heilman.

At least 127 records · Page 7Linked to original sources
PubMed1996

Pars triangularis asymmetry and language dominance.

The pars triangular is a portion of Broca's area. The convolutions that form the inferior and caudal extent of the pars triangularis include the anterior horizontal and anterior ascending rami of the sylvian fissure, respectively. To learn if there are anatomic asymmetries of the pars triangularis, these convolutions were measured on volumetric magnetic resonance imaging scans of 11 patients who had undergone selective hemispheric anesthesia (Wada testing) to determine hemispheric speech and language lateralization. Of the 10 patients with language lateralized to the left hemisphere, 9 had a leftward asymmetry of the pars triangularis. The 1 patient with language lateralized to the right hemisphere had a significant rightward asymmetry of the pars triangularis. Our data suggest that asymmetries of the pars triangularis may be related to speech-language lateralization.

Adolescent↗
PubMed1996

Understanding emotional prosody activates right hemisphere regions.

BACKGROUND: Defects in expressing or understanding the affective or emotional tone of speech (aprosodias) have been associated with right hemisphere dysfunction, while defects of propositional language have been linked to left hemisphere disease. The brain regions involved in recognition of emotional prosody in healthy subjects is less clear. OBJECTIVES: To investigate the brain regions involved in understanding emotional prosody and to determine whether these differ from those involved in understanding emotion based on propositional content. METHODS: We studied 13 healthy subjects using water labeled with radioactive oxygen 15 and positron emission tomography while they listened to 3 similar sets of spoken English sentences. In different tasks, their responses were based on the emotional propositional content, on the emotional intonation of the sentence (prosody), or on their ability to repeat the second word in the sentence (control). RESULTS: Understanding propositional content activated the prefrontal cortex bilaterally, on the left more than on the right. In contrast, responding to the emotional prosody activated the right prefrontal cortex. CONCLUSION: Neurologically healthy subjects activate right hemisphere regions during emotional prosody recognition.

Adult↗
PubMed1996

Developmental dyslexia: a motor-articulatory feedback hypothesis.

Reading is mediated by parallel and widely distributed modular systems. There are, therefore, multiple loci in these systems where dysfunction may lead to developmental dyslexia. However, most normal children learn to read using the alphabetic system. Learning to use this system requires awareness that words are comprised of a system of speech sounds (phonological awareness) and the knowledge of how to convert letters (graphemes) into these speech sounds (phonemes). Most dyslexic children have deficient phonological awareness and have difficulty converting graphemes into phonemes. Studies of patients with acquired lesions who are unable to convert graph-emes into phonemes, as well as positron emission tomographic studies of normal subjects, suggest that the left inferior frontal lobe is important in phonologic reading. Phonetic gestures are represented in the brain as invariant motor commands that program the articulators. Phonologic reading may activate the left inferior frontal lobe because grapheme-to-phoneme conversion requires activation of these motor-articulatory gestures. Dyslexic children are unaware of the position of their articulators during speech. The inability to associate the position of their articulators with speech sounds may impair the development of phonological awareness and the ability to convert graphemes to phonemes. Unawareness of their articulators may be related to programming or feedback deficits.

Auditory Pathways↗
PubMed1996

The role of visual imagery in spelling.

Current models of spelling posit that information from the orthographic output buffer can be translated into physical letter codes for written output or into name letter codes for spoken output. It is not known, at present, whether or not visualization of these codes is necessary to spell or recognize orally spelled words. We report a 73-year-old woman who could spell words better than she could image them and who demonstrated near flawless recognition of orally spelled words. We conclude that visual imagery is not necessary to either spell or recognize orally spelled words.

Aged↗
PubMed1996

The use of hemi-imagery for studying brain asymmetries in image generation.

To learn if there are brain asymmetries for image generation we asked 50 right-handed normal subjects to image one-half of an object and to report which half (right or left) they saw. We found that these subjects were more likely to image the right half of objects than the left. We also found that right hemi-imagers demonstrated a greater degree of right-handedness than did left hemi-imagers. Our results suggest that in strongly right-handed subjects the left hemisphere is more adept at object image generation than is the right hemisphere.

Adult↗
PubMed1996

Rapidly progressive dementia: a clinicopathologic correlation.

We evaluated a 66-year-old man with a rapidly progressive, akinetic-rigid dementia syndrome. Despite extensive testing, which included magnetic resonance imaging (MRI), we were unable to make the correct antemortem diagnosis. Autopsy demonstrated spontaneous progressive multifocal leukoencephalopathy. This report illustrates that even in the absence of characteristic MRI findings, this uncommon cause of dementia should be considered in the differential diagnosis of rapidly progressive, akinetic-rigid syndromes with dementia.

Aged↗
PubMed1996

Ventral tegmental area injury and frontal lobe disorder.

A patient developed acute behavioral changes implicating frontal-executive dysfunction. His clinical signs suggested mesencephalic injury, and a cranial MRI scan showed an abnormality restricted to a small region of the ventral midbrain. We suggest that the patient's behavioral disorder originated from disruption of the ventral tegmental area or it projections, structures that influence frontal brain processes via the mesocortical dopamine tract.

Behavior↗
PubMed1995

Morphologic cerebral asymmetries and handedness. The pars triangularis and planum temporale.

OBJECTIVE: To explore the relationship between morphologic cerebral asymmetries of the pars triangularis (PTr) and the planum temporale (PT) measured on three-dimensional, gradient-echo, magnetic resonance imaging scans of healthy right- and left-handed subjects. DESIGN: (Blinded) comparison of healthy right- and left-handed subjects who underwent magnetic resonance imaging. SETTING: The Seimens 1-T Magnetom (Seimens, Iselin, NH) at the University of Florida Health Science Center, Gainesville. SUBJECTS: Healthy right-handed (n = 8) and left-handed (n = 8) subjects matched for age, sex, and educational level. MAIN OUTCOME MEASURES: (1) Average length of the PTr (anterior ascending and anterior descending rami), (2) average length of the PT, (3) asymmetry quotients ([left-right]/[(left+right) (0.5)]) of the PTr and PT, and (4) combined asymmetry quotients of the PTr and PT. RESULTS: There was a significant leftward asymmetry of the PTr and PT in the right-handed subjects, but there was no significant asymmetry in the left-handed subjects. When the combined asymmetry quotient of the PTr and PT was calculated, the right-handed subjects had a leftward asymmetry (87.5% [n = 7]) or left was equal to right (12.5% [n = 1]), and the left-handed subjects had a leftward asymmetry (62.5% [n = 5]), left was equal to right (12.5% [n = 1]), or a rightward asymmetry (25% [n = 2]). In the left-handed subjects, writing posture seemed to predict these combined asymmetry quotients, ie, left-handed subjects using an inverted writing posture had a leftward asymmetry and left-handed subjects using a non-inverted writing posture had a rightward asymmetry of the perisylvian speech-language regions. CONCLUSIONS: On three-dimensional, gradient-echo, magnetic resonance imaging scans, we found a significant leftward asymmetry of the PTr and PT. When the groups were divided into right- and left-handed subjects, the former had a significant leftward asymmetry of the PTr and PT, while the latter did not. Measurements of the PTr and PT appear to be important indexes of the known functional asymmetries of the perisylvian speech-language regions.

Adult↗
PubMed1995

Gesture laterality in aphasic and apraxic stroke patients.

Limb preference during conversational gestures may be a reflection of functional hemispheric asymmetries. In right-handers, speech and praxis are usually mediated by the left hemisphere and in conversation, right-handers gesture more with their right than left hand. However, patients with left hemisphere brain damage, who are aphasic and apraxic but not hemiplegic, may use their right hemisphere to compensate for their left. Therefore, we investigated spontaneous lateralized gesture production during conversation in a group of left hemisphere-damaged stroke patients, who were aphasic and apraxic but not hemiparetic, and compared their performance to a group of matched controls. Whereas the control group had a strong right-hand preference, the nonparetic but apraxic and aphasic stroke patients were as likely to produce gestures with the right, left, or both hands.

Aged↗
PubMed1995

Agrammatic sentence production: the use of a temporal--spatial strategy.

We report the sentence production of a left-handed man with a right-hemisphere infarct. He demonstrated an inability to correctly map grammatical categories (subject, object) onto thematic roles (agent, patient) even for simple active sentences. The patient's performance appears to be the result of selective damage to the functional level (Garrett, 1980) of sentence production. His failure could not be accounted for by theories of agrammatism that implicate memory deficits, phonologic processing impairments, or deficits in processing complex transformations. The patient's performance revealed the consistent application of a temporal-spatial strategy in sentence production, despite adequate lexical-semantic abilities.

Aged↗
PubMed1995

Asyntactic thematic role assignment: the use of a temporal-spatial strategy.

We report syntactic comprehension performance of a left-handed man with a right-hemisphere infarct. He was unable to accurately map grammatical categories (subject, object) onto thematic roles (agent, patient), despite demonstrating intact conceptual knowledge of these thematic roles. He performed poorly on both active and passive reversible sentences. His asyntactic thematic role assignment cannot be accounted for by a short-term memory impairment or any hypothesis that predicts selective vulnerability to passive sentence constructions. Rather than performing randomly, our patient used a temporal or spatial strategy in assigning thematic roles. Because he also had a production-mapping deficit and used the same temporal-spatial strategy in production tasks, we hypothesize that the mapping of thematic roles onto grammatical categories and vice versa may be a specific aspect of sentence processing that is common to sentential production and comprehension. We also raise the possibility that thematic roles have underlying spatial representations prior to being elaborated by grammar.

Aged↗
PubMed1995

Spontaneous gestures following right hemisphere infarct.

Neurobehavioral studies of gesturing have been largely limited to left hemisphere damaged (LHD) patients. We compared spontaneous gesturing in seven right hemisphere damaged (RHD) patients, seven LHD patients, and seven normal controls (NHD) during videotaped interviews. Two judges coded symbolic, expressive, grooming, and fidgeting gestures in 120 10-sec intervals of videotape per patient. We found that RHD patients made significantly more total gestures and grooming gestures with the hand ipsilateral to their lesion than did LHD patients. Furthermore, RHD patients made more total and grooming gestures with their right hand than NHD subjects did with either hand. There were no differences in gesture production between the right and left hands of NHD patients. These results suggest that RHD produces enhanced gesturing, particularly involving grooming behavior.

Aged↗
PubMed1995

Spatial characteristics of thematic role representation.

Humans use language to describe actions by mapping the thematic roles of agent (doer of actions) and patient (recipient of actions) on the grammatical categories of subject and object. The extent to which thematic roles can be conceptualized independent of language is not known. If nonlinguistic conceptualization of thematic roles is possible, then representation of these roles would evidence nonlinguistic characteristics. Motivated by observations in an aphasic man, we wished to learn if thematic roles are conceptualized spatially. Normally subjects were asked to draw stick figures depicting the thematic roles of agent and patient. They demonstrated a systematic spatial bias in locating agents to the left of where they located patients. This bias, somewhat mitigated by ordering effects of motor output and auditory input, was brought into clearest focus when subjects depicted thematic roles in a context stripped of surface sentential form. These data imply that, in their nascent form, the thematic roles of agent and patient are spatially represented prior to being projected on grammar.

Adult↗
PubMed1995

Right-left confusion in Gerstmann's syndrome: a model of body centered spatial orientation.

Gerstmann's syndrome encompasses the tetrad of finger agnosia, agraphia, acalculia and right-left confusion and is associated with lesions of the dominant angular gyrus. The localizing value of this syndrome has been questioned because multiple mechanisms can account for each of the components of the syndrome. We present the case of a man who developed Gerstmann's syndrome following a focal infarct of the left angular gyrus. The patient's right-left confusion could not be accounted for by either an aphasia or a degraded body schema. A series of experiments that investigated the patient's spatial mapping system by progressively restricting the degrees of freedom for spatial rotation revealed an isolated defect in deriving the relative position of an object along the horizontal axis. Defective horizontal mapping can account for the other components of Gerstmann's syndrome because they all share a common dependency on relative horizontal positioning.

Aged↗