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PubMed1994

Developmental changes in narrative and non-narrative discourse in children with and without brain injury.

This study presents a set of narrative and non-narrative tasks and analytic procedures for examining the discourse development of children with perinatal brain injury and typically developing children. Three oral discourse genres were collected at ages 5, 6, and 7: script, picture description, and replica play narration. Genre performances were assessed for the presence of hypothesized genre features. Results suggest these tasks and procedures are able to characterize development in discourse abilities for both a normative group and for children with perinatal brain injury. The group of children with brain injury produced shorter discourse performance with more off-task talk. This group also showed difficulty in fully differentiating the various genre types and in creating integrated discourse performances. However, most of these children demonstrated considerable growth in control of genre features over this time period. The possible utility of these tasks and procedures for clinical assessment is discussed.

Brain Injuries↗

PubMed1994

Classifying communicative acts in children's interactions.

Describing speakers' repertoires of communicative intents and rules for expressing those intents is crucial to any complete description of the language capacity. Many different systems for classifying speakers' communicative intents have been developed and used in research analyzing both the acquisition of speech acts and the nature of the communicative deficits shown by various language-impaired populations. We argue, though, that these systems have typically been limited in scope, in applicability across the full developmental range, or in their theoretical foundations. The criteria for an adequate system for analyzing communicative intents are discussed, and a system proposed which meets those criteria.

Child↗

PubMed1986

Cholinesterases in cerebrospinal fluid. Correlations with clinical measures in Alzheimer's disease.

Acetylcholinesterase and butyrylcholinesterase activities in cerebrospinal fluid were measured in 17 patients with Alzheimer's disease and 6 control patients, as potential clinical measures of impaired cholinergic neurotransmission in Alzheimer's disease. The activity of butyrylcholinesterase was decreased in patients with Alzheimer's disease compared to that observed in control patients, but there was overlap between values in the 2 groups. Low butyrylcholinesterase activity was correlated with severity of dementia, memory impairment, and language disorder. Acetylcholinesterase activity was significantly correlated with visual contrast sensitivity, but not with dementia severity, and did not differentiate patients with Alzheimer's disease from control cases. These results suggest that cholinesterases in cerebrospinal fluid are related to brain cholinesterases, and indicate that the activities of acetylcholinesterase and butyrylcholinesterase should be distinguished in studies of cerebrospinal fluid.

Acetylcholinesterase↗

PubMed1995

Serum anti-brain endothelium antibodies and cognitive assessment in patients with Binswanger's encephalopathy.

The pathogenic mechanism underlying the vascular changes in Binswanger's encephalopathy (BE) is unknown. To test whether alterations of the humoral immunity may lead to endothelium damage, we analyzed serum levels of anti-brain endothelium antibodies (ABEA) (IgG and IgM) in 16 BE patients, 19 subjects with ischemic vascular disease without mental deterioration and 18 normal healthy subjects. ABEA IgM were found elevated in 1/16 (6%) BE patients and in 4/19 (21%) patients with cerebrovascular diseases; an increase in ABEA IgG was found in 6/16 (38%) BE patients and in 7/19 (37%) cerebrovascular patients. Association with anti-cardiolipin antibodies (IgG and/or IgM) was found in 50% of BE patients with elevated ABEA and only 10% of those with no increase, whereas high titres of anti-neurofilament antibodies (1:10,000) were detected in 40% and 71% respectively. In BE, ABEA IgG but not IgM showed a trend, although not significant, towards a correlation with the duration of the disease (rs = 0.47; p = 0.07) and significantly correlated with the cognitive function as assessed by the Mini mental state (MMS) score (rs = 0.56; p = 0.02). Higher mean values of the MMS score were found in BE patients with elevated ABEA than in those without (p = 0.04). This difference was not due to language disorders neither to an association with stroke risk factors or anti-neurofilament antibodies. However, there were no significant differences in MMS scores between cerebrovascular patients with ABEA and those without. A "neuro-protective" role is hypothesized for the ABEA in the development of dementia in BE.

Aged↗

PubMed1983

Acquired aphasia in children: revisited.

Observations of acquired aphasia in a more numerous series of children with cortical lesions modifies somewhat the conclusions of an earlier study. Aphasic syndromes in these children seem to result almost exclusively from left hemispheric lesions in right-handers. Aphasia is more frequent, at least among the youngest children, than in adults. The factors most responsible for language disorders in these children are lesion localization and etiology.

Adolescent↗

PubMed1993

A material-control single-case study of the efficacy of treatment for written and oral naming difficulties.

Twenty-two right-handed aphasics with written and/or oral naming difficulties were treated with a traditional language therapy: copying and repetition of words. The efficacy and maintainability of the treatment were evaluated using a variation of the single-case design, which was termed the material-control single-case design. Effectiveness of the treatment for written naming difficulty was demonstrated for 9 of 21 subjects in a first treatment and 3 of 14 subjects in a second treatment. Three of the 14 subjects benefitted overall from both treatments in written naming. In oral naming, 2 of 18 subjects responded well to the first treatment while 2 of 16 responded well to the second treatment. One of the 16 subjects showed benefits from both the first and second treatments in oral naming. Although written and oral naming disturbances were difficult to improve using ordinary language treatment, a small proportion of subjects clearly showed effectiveness of the therapy. Maintenance of the effects of treatment was observed in all of the improvers.

Adult↗

PubMed1995

The efficacy of kinesthetic reading treatment for pure alexia.

This paper presents an effective treatment for pure alexia by a type of single-case design, which we termed a "material-control single-case design" [Sugishita et al., Neuropsychologia, Vol. 31, 559-569, 1993]. Two patients with pure alexia were treated using kinesthetic reading (reading by tracing or copying the outline of each letter with the patient's finger). The results clearly demonstrated that both patients significantly improved their reading and copying performances. Their recovery of reading performance arose from improvement in copying. The results of tachistoscopic reading tests suggested that the patient obtained the ability to read without kinesthetic movements.

Adult↗

PubMed1996

A category-specific naming impairment after temporal lobectomy.

Unilateral temporal lobectomy patients and normal control subjects were tested in a speeded naming task with pictures of living and nonliving things that were equated for name frequency, familiarity, and visual complexity. Although right temporal lobectomy patients and normal subjects performed equally well with the living relative to nonliving things, left temporal lobectomy patients were disproportionately impaired at naming nonliving things. This result has several implications: First, it supports the existence of category-specific naming impairments. In particular, it undermines the proposal that living-nonliving dissociations are artifactual, resulting from the greater difficulty of living things. Second, it demonstrates an asymmetry in the neural representation of nonliving things, in favor of the left hemisphere. Third, it casts doubt on the hypothesis that the anterior temporal cortices are convergence zones that are particularly necessary for the naming of living things.

Adolescent↗

PubMed1995

Aphasic naming: what matters?

This paper investigates the factors which affect naming performance for two groups of aphasic subjects. The effects of word age-of-acquisition, operativity, frequency, familiarity, imageability, concreteness, length and the visual complexity of the stimulus picture were examined. In contrast to previous studies, we found remarkably small effects of word frequency on naming performance; these studies, we argue, have failed to control sufficiently for the effects of variables which intercorrelate with frequency. However, many patients were significantly affected by age-of-acquisition even when any effects of frequency and familiarity had been accounted for. Operativity, imageability and word length were also predictive of naming performance for some of the patients investigated, unlike visual complexity. The applicability of conclusions drawn from groups of aphasics is again thrown into doubt, as these two groups showed different patterns of predictor variables, and the variables affecting the performance of individuals could be different from those affecting the group.

Adult↗

PubMed1996

Evaluation of outcome after intracranial aneurysm surgery: the neuropsychiatric approach.

BACKGROUND: With the reduction of mortality and gross neurologic morbidity of patients undergoing intracranial aneurysm surgery, the interest in outcome is shifting towards more subtle aspects such as cognitive deficits and psychosocial adjustment. METHODS: We discuss two different ways of measuring outcome in a sample of 20 patients who had intracranial aneurysm surgery. Patients were evaluated at discharge using the Karnofsky Scale and the Glasgow Outcome Scale. Six months after discharge we conducted a neuropsychiatric evaluation including cognitive, behavioral, and mood status assessment. RESULTS: Although 13 of out patients had a "good recovery, " 18 had some neuropsychiatric impairment. Comparing patients with "good recovery" with the remainder, patients with poorer outcomes tended to have a left pterional approach, a poorer "drive", and language disorders (p < 0.05). There was no correlation between out cognitive, mood, and behavioral assessment and the results of the Karnofsky and Glasgow Outcome Scales ( p > 0.05). CONCLUSIONS: we conclude that neuropsychiatric deficits are common after intracranial aneurysm surgery and that for our study the Karnofsky Scale and Glasgow Outcome Scale were not sensitive enough to detect residual impairment. therefore, it is important to develop brief tests and scales able to identify these problems and to complement the standard clinical neurological examination.

Adult↗

PubMed1983

Hemiplegic writing in severe aphasia.

Three patients with severe aphasia and right hemiplegia are described who could write to dictation with the right arm using a limb prosthesis though agraphic with the "intact" left hand. The phenomenon of "hemiplegic writing" is explained as an access to submerged or preprocessing levels in language and action structure, through the use of older proximal motor systems. This interpretation has implications for our understanding of language and brain function, as well as for approaches to the treatment of patients with severe language disorders.

Adult↗

PubMed1985

Purdue pegboard performance of disabled and normal readers: unimanual versus bimanual differences.

Differences between dyslexics and controls in the unimanual and bimanual conditions of the peg placement section of the Purdue Pegboard Test were examined. Twenty-three disabled and twenty-three normal readers were studied. The groups were carefully screened on a neuropsychological battery. The disabled readers were comprised of a relatively homogeneous language-disordered subgroup exhibiting deficits in naming. Significant Group X Condition interactions were obtained for both raw and percentile scores and indicated that disabled readers performed worse than controls in the unimanual compared to bimanual conditions. The dyslexics performed particularly poorly compared with controls on the left hand condition. The implications of these data for hypotheses which argue for left hemisphere dysfunction, as well as those which posit interhemispheric transfer deficits in reading disabled children, are discussed.

Adolescent↗

PubMed1987

Linguistic abilities in patients with prefrontal damage.

The language abilities of 21 patients with prefrontal lesions (11 right and 10 left) and 15 matched normal subjects were analyzed, using a linguistic ability test designed to evaluate performance in six areas: automatic language, language production, verbal memory, syntax, derivative words, and comprehension of logical grammatical structures. Significant differences in the obtained scores of all groups were found. In spite of formal conservation of language in patients with frontal damage, their complex and conceptual verbal abilities were severely compromised.

Adolescent↗

PubMed1988

Phonetically inaccurate spelling among learning-disabled, head-injured, and nondisabled young adults.

We applied the Boder and Jarrico (1982, The Boder Test of Reading-Spelling Patterns, New York: Grune & Stratton) criteria to the WRAT spelling list and examined the phonetically inaccurate spelling error patterns of learning-disabled (LD), head-injured (HI), and nondisabled young adults. Phonetically inaccurate (PI) errors were reliably rated (interrater r = .94) and were correlated significantly more strongly with dysphasic errors (r = .33) than with dyscopia (r = .16). ANOVA showed that LD and HI, which did not differ, made significantly more PI errors than both nondisabled and HI. These results indicate that PI errors reflect an underlying language disorder. The results also suggest that PI errors are more frequent in brain-related disorders. Finally, when group differences in cognitive ability are statistically controlled, PI errors are more common only among LD persons.

Achievement↗

PubMed1991

Understanding of relational time terms before and after in Parkinsonian patients.

The role of the relational time terms before and after in language comprehension was investigated using patients with Parkinson's disease (PD) and normal controls (NC) in Greek. Results lead to the following four conclusions: (a) Comprehension by PD patients of before and after constructions displaying syntactic, semantic, and cognitive constraints equivalent to those of English is significantly different from that of NC matched on chronological age, sex, education, and socioeconomic status. (b) Before is better understood than after. (c) Syntactic variables, when semantic effects are partialed out, do not affect performance. The same is true of semantic effects when syntactic variables are partialed out. (d) Order of mention of events is a predominant source of errors when syntax and semantics are controlled. The data are discussed in relation both to findings with aphasics and to developmental results on the same time terms.

Aged↗

PubMed1992

Narrative discourse after closed head injury in children and adolescents.

This study examined narrative discourse in 20 children and adolescents at least 1 year after sustaining a head injury. Narratives were analyzed along the dimensions of language structure, information structure, and flow of information. Severity of impaired consciousness was associated with a significant reduction in the amount of language and information. The most important finding which emerged was the disruption in information structure. This pattern confirms the impression of disorganized discourse in severely injured children. Explanations for the disruption in information structure are explored in terms of the role of vocabulary, memory, and localization of lesion according to magnetic resonance imaging. In view of recent evidence that frontal lobe damage is associated with discourse formulation deficits in adults and is the most common site of focal lesion in closed head injury, we examined discourse patterns in individual patients with frontal lobe lesions. Preliminary data from our single-case studies suggest discourse patterns similar to those reported for adults with frontal lobe injuries.

Adolescent↗

PubMed1992

The processing of negative sentences in fluent aphasics: semantic and pragmatic aspects.

This paper examines the processing of negative sentences with respect to their truth value in fluent aphasic subjects. Three groups of 25 subjects each (men and women) were studied: the first group consisted of fluent aphasics, the second consisted of right temporal lobe-damaged subjects, and the third of normal subjects. An experiment of sentence verification was carried out. A quantitative study of reaction time (RT) and a qualitative study of the types of answers were carried out. The results show that the fluent aphasics were impaired in their logical-semantic processing of negative sentences and showed a predilection for the affirmative in answering strategies. The right temporal lobe-damaged subjects showed differences only in respect to the normal subjects in the RT, but not in answering strategies. The results suggest that in Wernicke's Aphasics there is a tendency to substitute a type of contextual-pragmatic processing for the logical-semantic processing.

Adult↗

PubMed1992

Impairment of inflectional morphology and lexical storage.

The present study investigates the repetition, comprehension, and production abilities of three French-speaking agrammatic aphasics on stimuli that require attention to the inflectional markers of number, gender, and tense. Two sets of experiments were conducted within a Strong Lexicalist framework. The results suggest that morphological deficits can manifest themselves at distinct levels of grammar, the lexical and the postlexical. The internal morphological structure and idiosyncracies of lexical items were found to have an effect on aphasic performance. A proposal of a differentially organized lexical storage reflecting the particularities of the French verbal system is put forth. The storage hypothesis suggested for verbs is extended to other lexical items.

Aphasia, Broca↗