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PubMed1981

Language function, foot of the third frontal gyrus, and rolandic operculum.

Two cases with expressive speech disorders were studied neuropsychologically and neurologically; anatomical and histopathological examinations were performed in both cases. In case 1, a small infarction in the foot of the left third frontal gyrus (F3) produced only transient word-finding difficulties that did not recur after a second stroke with lesion of the symmetrical zone in the right hemisphere. A transient, predominantly articulatory difficulty was observed in case 2; this was thought to be associated with a small infarction in the lower motor strip, including the Rolandic operculum. On the basis of the literature and our two cases, it may be concluded that overlapping lesions of these two areas play an important role in the development of persistent Broca's aphasia and that each of these two areas may be responsible for different components of the speech production: work-finding difficulties being associated with lesions of posterior F3 and articulatory disorders with lesions of the Rolandic operculum.

Aphasia, Broca↗
PubMed1993

Neuropsychological patterns and language deficits in 20 consecutive cases of autopsy-confirmed Alzheimer's disease.

A retrospective chart review of clinical symptoms was done for 20 consecutive patients in whom postmortem examination had revealed senile plaques and neurofibrillary tangles in a distribution consistent with Alzheimer's disease. All patients had met clinical diagnostic criteria for probable Alzheimer's disease. On initial examination, 1 to 14 years beyond putative onset of the dementia, all patients displayed at least some memory impairment. In 16 patients, disturbances of attention or recent memory were among the most salient features. In two patients, language disturbances, and in two others, visuospatial deficits, were more prominent than difficulties with memory and attention. On initial examination, 17 of the 20 patients displayed word-finding difficulties, characteristically in the context of a fluent, anomic aphasia. All of the 12 reexamined patients demonstrated progressive, although variable, deterioration. In general, the initial salient deficit remained salient during much of the disease course. Language comprehension was spared in the earlier stages but eventually deteriorated. Severe deficits emerged in all major cognitive domains as the disease reached the terminal stages. Nonfluent aphasias (eg, Broca's aphasia) were not observed even in the advanced stages of the disease.

Aged↗
PubMed2004

Cognition and anatomy in three variants of primary progressive aphasia.

We performed a comprehensive cognitive, neuroimaging, and genetic study of 31 patients with primary progressive aphasia (PPA), a decline in language functions that remains isolated for at least 2 years. Detailed speech and language evaluation was used to identify three different clinical variants: nonfluent progressive aphasia (NFPA; n = 11), semantic dementia (SD; n = 10), and a third variant termed logopenic progressive aphasia (LPA; n = 10). Voxel-based morphometry (VBM) on MRIs showed that, when all 31 PPA patients were analyzed together, the left perisylvian region and the anterior temporal lobes were atrophied. However, when each clinical variant was considered separately, distinctive patterns emerged: (1) NFPA, characterized by apraxia of speech and deficits in processing complex syntax, was associated with left inferior frontal and insular atrophy; (2) SD, characterized by fluent speech and semantic memory deficits, was associated with anterior temporal damage; and (3) LPA, characterized by slow speech and impaired syntactic comprehension and naming, showed atrophy in the left posterior temporal cortex and inferior parietal lobule. Apolipoprotein E epsilon4 haplotype frequency was 20% in NFPA, 0% in SD, and 67% in LPA. Cognitive, genetic, and anatomical features indicate that different PPA clinical variants may correspond to different underlying pathological processes.

Aged↗
PubMed1993

An acoustic analysis of rate of speech effects on vowel production in aphasia.

The present investigation examined the production of tense and lax vowel duration differences at two speaking rates in the speech of 10 nonfluent aphasics, 8 fluent aphasics, and 10 normal control subjects. Subjects produced four repetitions of each of the vowels [i e ae o u I epsilon upsilon --] at each speaking rate. Acoustic analyses revealed that subjects in all three groups were able to manipulate overall rate of speech. In addition, normal controls and fluent aphasic subjects produced vowels under the fast rate condition which were significantly shorter than those under the slow rate condition. Despite a change in overall speaking rate, the nonfluent aphasics did not exhibit a significant difference in vowel duration at the two rates of speech, suggesting a deficit in the implementation of this temporal parameter. Both normal controls and fluent aphasic patients produced nonoverlapping distributions of tense and lax vowels at both speaking rates. In contrast, the nonfluent aphasics demonstrated a great deal of overlap in the distribution of tense and lax vowel durations at the fast rate. Results are discussed in relation to the nature of the speech production deficits in nonfluent and fluent aphasic patients.

Adult↗
PubMed1993

Rate of speech effects in aphasia: voice onset time.

This study investigated the ability to produce appropriate voice onset time (VOT) contrasts under conditions of rate modulation in groups of nonfluent aphasic subjects, fluent aphasic subjects, and nonneurological controls. Acoustic analyses of the consonants [b d g p t k] produced in the context of the vowels [i e a o u] at two different rates of speech revealed that normal subjects' VOTs were significantly shorter at the fast rate of speech relative to the slow/normal rate, as expected. In addition, the rate change had a significantly greater effect on voiceless stops as compared to voiced and on velar consonants as compared to labials and alveolars. The nonfluent aphasic patients exhibited a similar pattern except that no differences in magnitude of rate-related changes were found across place of articulation. Further, similar to previous studies, the nonfluent aphasic patients produced voice and voiceless consonants with somewhat overlapping VOT distributions, indicating an impairment in temporal integration in these subjects. Finally, the fluent aphasic patients demonstrated a surprisingly aberrant pattern of results, with VOTs under th fast condition shorter than under the slow, but no differences in magnitude of change across place of articulation or voicing categories. The results are discussed in relation to the nature of speech production deficits in both nonfluent and fluent aphasic patients. Implications for remediation are considered.

Adult↗
PubMed1993

Intraword timing relations in Thai after unilateral brain damage.

The present study examined temporal characteristics of monosyllabic, bisyallabic, and trisyllabic words in Thai to evaluate timing control at the word level in brain-damaged patients. Subjects included young and old normal adults, right hemisphere patients, and left hemisphere nonfluent and fluent aphasic patients. Utterances were produced at a conversational speaking rate. Results indicated that, on an absolute or relative measurement scale, magnitude of the shortening effect on nonfinal syllables in polysyllabic words was significantly smaller in left nonfluent aphasics than in other groups. In trisyllabic words, duration of the penultimate syllable for left fluent aphasics was also significantly longer than that of normals. Left nonfluent and fluent aphasics were significantly more variable than other speakers in their production of bisyllabic and trisyllabic words. Findings are discussed in relation to issues pertaining to the nature of timing deficits in nonfluent and fluent aphasic patients.

Adult↗
PubMed1995

Syntactic processing in agrammatic aphasia by speakers of a Slavic language.

It is widely believed that agrammatic aphasics have lost the ability to assign complete syntactic representations. This view stems from indications that agrammatics often fail to comprehend complex syntactic structures, as for example, some types of relative clauses. The present study presents an alternative account. Comprehension by Serbo-Croatian-speaking agrammatic aphasics was tested on four types of relative clause structures and on conjoined clauses. The relative clauses varied in type of embedding (embedded vs. nonembedded) and in the location of the gap (subject position vs. object position). There were two control groups: Wernicke-type aphasics and normal subjects. The findings from a sentence-picture matching task indicated that agrammatic aphasics were able to process complex syntactic structures, as evidenced by their well-above chance performances. The success rate varied across different types of relative clauses, with object-gap relatives yielding more errors than subject-gap relatives in all groups. Each group showed the same pattern of errors: agrammatic subjects were distinguished from Wernicke subjects and normal subjects only in quantity of errors. These findings are incompatible with the view that the agrammatics are missing portions of the syntax. Instead, their comprehension deficits reflect varying degrees of processing impairment in the context of spared syntactic knowledge.

Adult↗
PubMed1995

Lexical properties, prosody, and syntax: implications for normal and disordered language.

This paper is primarily about sentence processing in neurologically intact subjects--but carries with it the underlying message that though both grammatical and on-line analyses of agrammatism have borne considerable fruit, there is much about the efforts from normal psycholinguistics that has yet to find its way into investigations of aphasia. We describe some of our psycholinguistic work and show how it has influenced our work in aphasia. This work involves three different kinds of information that the human sentence processing system appears to exploit: (1) lexical properties, particularly those having to do with verbs; (2) syntactic operations that connect one position in the sentence to another, nonadjacent position; and (3) prosody, which is often overlooked but which may turn out to be crucial to accounts of both normal and disordered sentence processing. Finally, we suggest that lexical properties interact with prosody to help the parser in its initial analysis.

Aphasia, Broca↗
PubMed1995

The elusive character of agrammatism.

Traditionally, agrammatism was viewed as a restricted disorder of speech production which was associated with Broca's aphasia. This view has been replaced by a more complex picture which involves a range of linguistic impairments in both language production and comprehension. These disorders have been variously characterized as deficits, in the representation of linguistic structures and deficits in the on-line computation of sentence structures and their interpretations. A variety of analyses of production and comprehension in agrammatism, invoking both representational and computational analyses, are reviewed. Each has inadequacies, but, at the same time, it is argued that each also advances the understanding of agrammatism.

Aphasia, Broca↗
PubMed1995

Processing of number and gender inflections by French-speaking aphasics.

This study investigates French-speaking aphasics' sensitivity to gender (of human nouns) and number marking in a sentential context. Using a forced picture choice task, we tested sentences in which grammatical marking surfaced either on a function word or on a content word, within or outside a noun phrase (NP) whose gender or number was required to be identified. Ten fluent and 10 nonfluent aphasics together with 20 adults without neurological history were tested. Results showed that neither group of aphasics presented an across-the-board deficit. Nonfluent patients were strongly impaired when marking surfaced on a content word outside NP (verbs and adjectives), but their sensitivity to grammatical marking was relatively well preserved in the within NP condition (determiners and nouns) and for function words in the outside NP condition (the copula). Fluent patients showed a specific impairment in dealing with semantic gender (as opposed to number information); and their difficulty was exacerbated when the information conveyed by the suffix of a content word must be integrated into an higher order semantic representation, as in the outside NP condition (adjectives). These results are consistent with the view that for both nonfluent and fluent aphasics, the functional locus of their impairment lies on a reduction in the computational resources available to the language processor, which is more severe in the former than in the latter group.

Adult↗
PubMed1995

Coherence violations and propositional usage in the narratives of fluent aphasics.

Aphasic patients have been generally assumed to produce coherent narratives, despite their numerous surface structure deficits. The current study is designed to analyze three types of coherence violations (i.e., information gaps, repetitions of propositions, and irrelevant propositions) in the narratives of mildly impaired conduction, anomic, and Wernicke's aphasics. Results reveal that the three aphasic groups produce qualitatively different patterns of coherence violations. It is hypothesized that these coherence violations reflect adaptive strategies used by the aphasic patients to compensate for their underlying impairments. While the anomic and conduction aphasics appear to compensate for surface structure deficits, the Wernicke's aphasics seem to have an underlying coherence deficit.

Adult↗
PubMed1997

Subcortical aphasia(s): a controversial and promising topic.

Many aspects of subcortical aphasias are not accounted for by a unique pathophysiological mechanism; rather the diversity of the observed symptoms suggests that many functional ensembles, more or less related, to language functions may be disturbed by subcortical lesions. However, such disorders are only moderate in intensity and subcortical aphasias certainly constitute an interesting model for studying the dynamics of recovery of language functions and related neural systems, combining neurolinguistic concepts with advanced functional imaging techniques.

Aphasia, Broca↗
PubMed1997

Subcortical aphasia and the problem of attributing functional responsibility to parts of distributed brain processes.

N&C's discussion is, in places, an exemplar of the sort of rigor and attention to detail that will bring us closer to an understanding of the functional organization of the brain. Indeed, it is this level of work that pushes us to reflect on the assumptions that undergird our research efforts. Our criticisms have developed four main points. First, the level of rigor applied to the consideration of basal ganglionic aphasia should extend to each application of the CPC method (thalamic aphasia included). Second, in our haste to identify specific brain systems with distinct cognitive functions we should not neglect the more basic question of the causal mechanisms by which the brain organizes behavior. Questions of "direct" versus "indirect" involvement of a particular organ in a cognitive function are only likely to distract our attention from this more basic and less inferentially perilous issue. Third, pure cases should no longer be considered touchstones against which all behavioral disturbances are measured. Reifying such ideals is more likely to shroud than reveal the brain's true complexity. Finally, the functions that we enshrine in particular brain regions should explain the particular character of the symptoms observed when they are damaged and should admit of independent verification.

Aphasia, Broca↗
PubMed1998

The interaction of preserved pragmatics and impaired syntax in Japanese and English aphasic speech.

Elicited narrative studies have shown that the underlying pragmatic factor of empathy is relatively preserved in aphasic speakers of Japanese and English (7 Japanese and 14 English-speaking aphasics of varied diagnostic types). Occasional "reversal errors" can be explained in terms of a conflict between the normal encoding of the empathic characteristics of an event and the syntactic limitations imposed by impaired production processes. To account for these findings, we propose a production model following Levelt (1989) for making pragmatic choices among syntactic forms. We also suggest that preferential access to "canonical form" might be a matter of surface morphosyntax, rather than involving semantics or more abstracts levels of syntax.

Adolescent↗