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PubMed1975

[Mental disorders in patients with vascular aphasia].

The author conducted a study of some personality traits in 30 patients with different forms of vascular aphasia with the aid of a polar profile test. The questionnaire had 16 polar qualities. According to each of these criteria 2 scales were formed: prior to and following the disease. Two main types of personality changes wered noted: pseudoneutrotic disorders of a different degree (in patients with articular motor and sensory aphasia) and moderately or slightly expressed symptoms of apatho-abulia (in patient with expressed motor and mixed motor-sensory aphasia).

Aphasia↗
PubMed2006

Primary progressive aphasia in a bilingual woman.

Multilingual aphasias are common because most people in the world know more than one language, but little is known of these syndromes except in patients who have had a stroke. We present a 76-year-old right-handed woman, fluent in English and Chinese, who developed anomia at age 70 and then progressed to aphasia. Functional neuroimaging disclosed mild left temporoparietal hypometabolism. Neurolinguistic testing was performed in both English and Chinese, representing a unique contribution to the literature. Results revealed conduction-like aphasia that was comparable in the two languages, although English was slightly better preserved. Primary progressive aphasia has disrupted 2 languages in a similar manner, suggesting their close neuroanatomic relationship in this case.

Aged↗
PubMed2004

Comprehension of sentences with stylistic inversion by French aphasic patients.

Three French-speaking agrammatic aphasics and three French-speaking Conduction aphasics were tested for comprehension of Active, Passive, Cleft-Subject, Cleft-Object, and Cleft-Object sentences with Stylistic Inversion using an object manipulation test. The agrammatic patients consistently reversed thematic roles in the latter sentence type, and the Conduction aphasics performed at chance. The results are discussed in relationship to existing models of aphasic impairments in assigning syntactic structures and using them to determine thematic roles in sentences. We conclude that the results for the agrammatic patients demonstrate the importance of compensatory mechanisms underlying aphasic comprehension and the results in the Conduction aphasics indicate the importance of working memory deficits in determining such deficits. The results are also relevant to models of normal syntactic structure.

Aged↗
PubMed1980

Emotional and psychotic reactions induced by aphasia.

A systematic study of the emotional and psychotic reactions induced by aphasia was conducted on 63 aphasic patients. 'Indifference reaction' was found in 19 cases and 'depressive reaction' in 36 cases. In 3 aphasics, we observed 'Goldstein's catastrophic reaction' and in 3 other patients, a state of 'euphoric unrestrained excitement'. Finally, in 2 aphasics 'psychotic reaction' was found, characterized by a state of psychomotor catatonic excitement. The hypothesis is advanced that the catatonic phenomenology of these subjects may be interpreted as 'Bonhoeffer's acute exogenous reaction' with catatonic symptoms.

Affective Symptoms↗
PubMed1991

Double infarction in one cerebral hemisphere.

Thirty-two patients whose first stroke was due to double infarct in one cerebral hemisphere were identified among 1,911 consecutive patients from the Lausanne Stroke Registry. The double infarct involved territories of the superficial middle cerebral artery, superficial posterior cerebral artery, lenticulostriate, anterior choroidal artery, or borderzone. The most common combination involved territories of the anterior middle cerebral artery plus the posterior middle cerebral artery. In the patients with the double infarct, the prevalence of potential cardiac sources of embolism (19%) was similar to that found in the registry in general, but the double infarct was closely associated with tight (greater than or equal to 90% of the lumen diameter) stenosis or occlusion (75%) of the internal carotid artery. The most common neurological picture mimicked large infarction in the middle cerebral artery territory, but nearly half of the patients with double infarct in one cerebral hemisphere had a specific clinical syndrome, which was not found in the 1,879 remaining patients from the registry, including hemianopia-hemiplegia (in 6), acute conduction aphasia-hemiparesis (in 2), and acute transcortical mixed aphasia (in 6), in relation to characteristic combinations of infarcts. These unique clinical and etiological correlates warrant the recognition of double infarct in one cerebral hemisphere from other acute ischemic strokes.

Adult↗
PubMed2005

The rises and falls of disconnection syndromes.

In a brain composed of localized but connected specialized areas, disconnection leads to dysfunction. This simple formulation underlay a range of 19th century neurological disorders, referred to collectively as disconnection syndromes. Although disconnectionism fell out of favour with the move against localized brain theories in the early 20th century, in 1965, an American neurologist brought disconnection to the fore once more in a paper entitled, 'Disconnexion syndromes in animals and man'. In what was to become the manifesto of behavioural neurology, Norman Geschwind outlined a pure disconnectionist framework which revolutionized both clinical neurology and the neurosciences in general. For him, disconnection syndromes were higher function deficits that resulted from white matter lesions or lesions of the association cortices, the latter acting as relay stations between primary motor, sensory and limbic areas. From a clinical perspective, the work reawakened interest in single case studies by providing a useful framework for correlating lesion locations with clinical deficits. In the neurosciences, it helped develop contemporary distributed network and connectionist theories of brain function. Geschwind's general disconnectionist paradigm ruled clinical neurology for 20 years but in the late 1980s, with the re-emergence of specialized functional roles for association cortex, the orbit of its remit began to diminish and it became incorporated into more general models of higher dysfunction. By the 1990s, textbooks of neurology were devoting only a few pages to classical disconnection theory. Today, new techniques to study connections in the living human brain allow us, for the first time, to test the classical formulation directly and broaden it beyond disconnections to include disorders of hyperconnectivity. In this review, on the 40th anniversary of Geschwind's publication, we describe the changing fortunes of disconnection theory and adapt the general framework that evolved from it to encompass the entire spectrum of higher function disorders in neurology and psychiatry.

Agnosia↗
PubMed1997

The relevance of patient individuality in the evaluation and treatment of aphasia. Case report.

The usual approach to language disorders relies on standardised evaluations in which pattern-tests characterise the subject's status according to the classical aphasiological typology. Those data are then analysed to support a traditional prevalent criterion for the distinction between "normal" and "pathological" linguistic performance, which is strictly focused on a quantitative approach. In the present study a method for evaluation and treatment of aphasia is proposed in which socio-cultural conditions are emphasised, in order to expand this conventional criterion as to encompass a qualitative (individualised) one. Although the methodology draws the attention, the results here obtained also point to the importance of re-evaluating what is presently considered as the most appropriate criterion for "normal" cognitive processes, particularly those related to language.

Aphasia, Conduction↗
PubMed1981

Three studies of deficits in pantomimic expression and pantomimic recognition in aphasia.

Studies were conducted to investigate aphasic deficits in pantomimic behaviors. Three groups of subjects were used: 47 aphasics; 27 right-hemisphere-damaged; and 11 controls. Study I replicates a previous study of pantomimic recognition deficits (Duffy, Duffy, & Pearson, 1975) and essentially duplicates the previous findings of significant deficits of pantomimic recognition in aphasic subjects that are highly correlated with their verbal deficits. Study II examines the relationship between deficits in pantomimic recognition and expression; and the relationships between these two nonverbal behaviors and aphasic verbal deficits. Zero order correlations, partial correlations, and multiple regression analyses are presented. The results show that aphasics exhibit significant deficits in both pantomimic expression and recognition; and, that both of these are highly correlated with aphasic verbal deficits. Study III is an investigation of four causal theories of aphasic deficits in pantomimic expression. Zero order correlations, partial correlations, and multiple regression analyses are presented. It is concluded that aphasic pantomimic expressive deficits are not caused by general intellectual deficit or limb apraxia; but, they are associated with a central symbolic disorder or a verbal mediation deficit. The implications of these studies for an understanding of the nature of aphasia as a syndrome which includes both verbal and nonverbal impairments are discussed.

Aphasia↗
PubMed1986

Acute computerized tomographic scans: their value in the localization of lesions and as prognostic indicators in aphasia.

Twenty three patients with past or present evidence of aphasia following either stroke (n = 19) or head trauma (n = 4) were given the Boston Diagnostic Aphasia Examination in order to classify their aphasia type and determine their language deficit at least three months postonset of their neurological disorder. The location and extent of brain lesions identified from computerized tomographic (C.T.) scans taken in the acute stage and, wherever possible, in the chronic stage (n = 7) were correlated with the type of aphasia. Lesions associated with global, Wernicke's, Broca's, conduction, and anomic aphasia are described and discussed in relation to the findings of previously reported clinico-C.T. scan correlation studies. The value of the acute stage C.T. scan as a predictor of long-term language deficits is discussed.

Adult↗
PubMed1998

On-line processing of filler-gap construction in aphasia.

Two experiments were conducted exploring on-line processing of filler-gap construction in aphasia. An auditory-auditory lexical decision paradigm was used to investigate whether Broca's and Wernicke's aphasic patients show, as do normals, reactivation of the filler at the gap site. Experiment I investigated the processing of a number of filler-gap constructions including wh-questions, relative clauses as subject, relative clauses as object, and embedded wh-questions. Broca's aphasics showed reactivation of the filler at the gap site, whereas Wernicke's aphasics did not. Experiment II examined object relative clauses and their processing by Broca's aphasics. In addition, we investigated whether the presence (or absence) of the relative pronoun played any role in on-line processing. Broca's aphasics performed as did normals. In addition, their performance was unaffected by the presence or absence of the relative pronoun. The results of these experiments suggest that Broca's aphasics do not have an impairment in processing or representing thematic relationships of NP arguments to predicates or relating traces to their antecedents.

Aged↗
PubMed1989

A signal processing component to Broca's aphasia functor deficits.

We conducted a modified replication of K. M. Heilman and R. J. Scholes [Cortex 12, 258-265, 1976] test of functor comprehension in aphasia, controlling the acoustic dimensions of the key function words: 9 Broca patients heard 4 sentence pairs differing only in the post-verb placement of the. They made forced choices between 4 line drawings: one which depicted the correct action, one which depicted the action of the other member in the pair, and two which contained depictions of different figures and actions altogether. Each of the 8 sentences was played in 2 conditions: one with NORMAL intonation, and another with an acoustically more SALIENT post-verbal the. Both of Heilman and Scholes' principal results were successfully replicated, and a SALIENT effect was also discovered, supporting a signal processing component to the Broca syndrome functor deficit.

Aphasia↗
PubMed1976

Classification of aphasic phenomena.

A brief but comprehensive survey of classifying aphasia reveals that most investigators describe at least four major groups, conveniently labelled Broca's, Wernicke's, anomic and global. Conduction and transcortical aphasias are less generally described and modality specific syndromes rarely, if ever, exist purely. The controversy between unifiers and splitters continues but objective numerical taxonomy may solve some of the problems of classification.

Aphasia↗
PubMed1977

Recovery patterns and prognosis in aphasia.

Ninety-three aphasics were studied with repeated language assessment by a scorable test (the Western Aphasia Battery). Recovery rates were determined by measuring language performance (Aphasia Quotient) at nought to forty-five days post-onset, and three, six and twelve months and yearly after. Recovery rates were higher in post-traumatic than in cerebrovascular cases. When the stable infarcts were separately studied, the greatest recovery was seen in "Broca's" aphasics, followed by the "conduction" group. Anomic aphasia appeared to be a common end-stage of evolution. Long-term follow-up (twelve months or more) demonstrated that global aphasics have a poor prognosis, while Broca's and Wernicke's have an intermediate one. Complete recovery occurred frequently among anomic, conduction and transcortical aphasics and in more than half of the traumatic cases. Initial severity and outcome correlated significantly. Age and rate of initial recovery showed a trend of negative correlation; younger patients recovered better, but there were frequent exceptions, depending on other factors, such as the initial severity of aphasia. Although some cases recovered exceptionally well while under therapy, there was no significant difference between the treated and untreated groups, where such a comparison was possible.

Adolescent↗
PubMedDate not supplied

Drawing together: evaluation of a therapy programme for severe aphasia.

This paper reports a therapy study that aims to promote communicative drawing in a group of seven people with severe and long-standing aphasia. Therapy was conducted on individual and group bases over 12 weeks and entailed a range of techniques which are described in some detail. Treatment was evaluated using a novel generative drawing assessment in which subjects were required to draw absent items in response to photographic and conversational cues. Pre- and post-therapy assessments of untreated skills, such as comprehension, naming and gesture, were also conducted. The results indicated that, as a group, the subjects' drawing improved. Unchanged performance on the other assessments indicated that the gains were specific to the content of therapy and could not be attributed to spontaneous recovery. Pre- and post-therapy interviews with carers (i.e. relatives and close friends of the individuals) suggested that the effects of therapy were also being felt in the home. These results have important implications for therapy with people with severe aphasia.

Aged↗
PubMed1998

Expressive aphasia in glioblastoma multiforme patients: an application of content methodology.

Approximately one-third of patients with glioblastoma multiforme experience aphasia (Kraemer & Bullard, 1994). This loss of language abilities can be a major source of frustration for patients. Their quality of life is affected by the inability to interact with others. In this paper, an examination of the phenomenon of expressive aphasia will be conducted through the application of the content methodology process. Content methodology is a process for developing nursing knowledge, which strives to bridge the gap between theory, research and practice (Dawson & Wells, 1992). This process will guide in the development of substantive content for practice. An assessment tool and intervention plan will be presented.

Aphasia, Broca↗
PubMed1993

Language deviations in aphasia: a frequency analysis.

Thirty right-handed left hemisphere-damaged patients were taken and divided into five groups (transcortical motor, Broca, conduction, Wernicke, and anomic aphasia). Language deviations were scored and analyzed for the Picture Description (Plate No. 1, The Cookie Theft), Repetition (Words, High and Low Probability Sentences), and Naming (Responsive Naming, Confrontation, and Body-part naming) subtests of the Boston Diagnostic Aphasia Examination--Spanish version (Goodglass & Kaplan, 1979). A classification of paraphasias is proposed. Language deviations were scores for the following groups: Literal paraphasias (phoneme omissions, additions, displacements, and substitutions), verbal paraphasias (formal, morphologic, semantic, and unrelated), syntagmatic paraphasias, circumlocutions (object description and instrumental function), indefinite anaphors, and neologisms. Frequency of different types of language deviations is presented in the five aphasia groups. It was found that some paraphasic errors appeared in several aphasia groups; others were characteristics of specific aphasic syndromes.

Adolescent↗