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At least 19 recordsLinked to original sources
PubMed1978

Lesion localization in aphasia with cranial computed tomography and the Boston Diagnostic Aphasia Exam.

Nineteen stable left-hemisphere stroke patients with aphasia were evaluated by the Boston Diagnostic Aphasia Examination (BDAE) and the Token Test (TT), and by cranial computed tomography (CT). The types of aphasia included Broca (three patients), Wernicke (four patients), conduction (four patients), transcortical motor (four patients), and global (four patients). The lesions, as localized by CT scan, were superimposed onto five composite lesion localization maps for these five aphasia syndromes. There was good correlation between BDAE aphasia type and lesion localization. On CT scans, the locations of cortical language areas lie in a specific relationship to parts of the ventricular system.

Aged↗
PubMed1979

[Crossed aphasia with jargon aphasia in two right-handed patients (author's transl)].

Two cases of crossed aphasia in right-handed patients are reported. The oral language of these two patients was characterized by a reduction in its lexical and grammatical content. Their written language, however, was a veritable jargon with anosognosia. The jargon aphasia of the first patient consisted mainly of neologisms. The written language of the second patient was slightly less disorganized and corresponded to an asemantic jargon. The existence of this jargon aphasia gives these two observations an exceptional character in relation to other cases of crossed aphasia in right-handed patients. It supplies new information which can be the basis for discussion on the relations between cerebral laterlization of language functions and manual preference.

Aged↗
PubMed1979

[Computed tomography in crossed aphasia (author's transl)].

Crossed aphasia, first described by Bramwell, is aphasia due to the hemispheric damage on the side of handedness. Crossed aphasia in a dextral is rare, and in Japan, there have not been more than ten cases in which the lesion is localized clearly. The cases reported till now have been verified mainly by necropsy. However, the time lag between the appearance of aphasia and the necropsy may affect the conclusion subtly. We consider that computed tomography (CT) can obtain almost the same findings as that by necropsy. However, at present there have been few cases diagnosed by CT except two cases reported by April et al. and Wechsler. We have reported a 47-year-old man in a dextral, who shows left hemiparesis and Broca's aphasia. His lesion is diagnosed by cerebral angiography and CT as the right hemisphere infarction due to right middle cerebral artery occlusion. CT localizes the lesion on the right hemisphere mainly sited deep region and sited wedge shaped cortical area of the fronto-parietal region. On the other hand, it localizes no lesion on the left hemisphere. CT in aphasia has been already reported by Hayward et al. In their report they concluded that correlation of lesion located by CT with aphasia type supported Geschwind's concept of aphasia. In this report we have discussed CT in crossed aphasia analysing our case and the two cases by April et al. and Wechsler. Three cases including our case are all Broca's aphasia, and we compare the lesion location of these three cases with Hayward's lesion located on Broca's aphasia. As the result of this, we can draw the conclusion that the lesion location by CT of these three cases and that of Hayward's report are almost symmetric.

Aphasia↗
PubMed1979

Localisation of lesions in aphasia: clinical-CT scan correlations in stroke patients.

Ninety right-handed patients with present or past evidence of aphasia following a stroke were given a standard language battery and a CT scan examination. Presence and type of aphasia were correlated with the location and extent of the CT scan lesion. Most of the findings were compatible with the traditional views about the localisation of lesions in aphasia (e.g., anterior lesions in nonfluent aphasias with good comprehension, posterior lesions in fluent aphasia, etc.). The possible explanations for some unexpected findings (e.g., purely anterior lesions in global aphasia, or purely deep lesions in Broca's aphasia) are discussed. It is stressed that in establishing clinico-CT scan correlation, careful consideration must be given to the fact that both aphasia and the underlying lesion evolve with time.

Acute Disease↗
PubMed1979

The resolving stroke and aphasia. A case study with computerized tomography.

A 39-year-old man suffered an intracerebral hemorrhage in the region of the left internal capsule deep to Wernicke's area. The location of the lesion was confirmed by computerized tomography (CT) performed two days postictally. Two weeks after admission, the Boston Diagnostic Aphasia Examination (BDAE) diclosed Wernicke's aphasia. We hypothesize that the hematoma exerted pressure on Wernicke's cortical area, thus causing the resulting Wernicke's aphasia at that time. A CT scan three months later showed absorption of the hematoma, with a residual low-density lesion deep to Wernicke's area, in the region of the arcuate fasciculus. At that time, BDAE testing disclosed a mild conduction aphasia. Serial CT scanning combined with discriminating clinical evaluation of aphasia provides a valuable opportunity for study of the processes underlying stroke resolution and aphasia.

Adult↗
PubMed1979

Differential aphasia in tow bilingual individuals.

Moderate nonfluent aphasia following a left parietotemporal lesion was found in the native language of one bilingual patient, in contrast to less severe, fluent aphasia in the patient's secondary language. Conversely, mild anomia was found in the native language of a second patient, while global aphasia was found in the secondary language. His lesion was located in the left posterior frontal area. These examples of differential aphasia were assessed by standard aphasia tests and by language inventory translated into the appropriate languages. We propose that differential aphasia resulting from a single hemispheric lesion is related to the disruption of different basic cognitive functions, which participate to varying degrees in the performance of the languages affected. In terms of neurolinguistic theory, the findings in these patients support the observation that most frequently used language is the first to recover. They refute the notion that the native language recovers first.

Adult↗
PubMed1979

A translation of Finkelnburg's (1870) lecture on aphasia as "asymbolia" with commentary.

On March 21, 1870, Dr. D.C. Finkelnburg addressed the Society of the Lower Rhine in Bonn on the popular topic of aphasia. He challenged the prevailing view that aphasia was a disorder of speech only and the emphasis that had been given to the issue of cerebral localization. The disorder, he pointed out, not only extended beyond the speech modality to include verbal comprehension, reading, and writing but also included many extraverbal disturbances of symbolic usage. In support of his argument, he presented five detailed case studies of aphasics (two with autopsy data) who demonstrated a variety of verbal and extraverbal deficits. Because the term aphasia referred specifically to speech disturbance and inadequately signified the full extent of the disorder, Finkelnburg proposed the more generic term asymbolia as a more accurate representation of the nature of the disorder. This translation makes available a previously inaccessible but historically important and still viable contribution to the study of the nature of aphasia.

Aphasia↗
PubMed1978

[Broca's aphasia. The clinical picture and a consideration of the neurolinguistic structure (author's transl)].

Broca's aphasia is characterized by disorders on the phonemic, syntactic and lexical level of linguistic description. It is not only the patient's speech which is impaired; abilities to comprehend, read and write are likewise impaired. Articulatory disorders (dysarthria) which are due to an impaired innervation of the phonatory and articulatory musculature may exist. However these disorders do not account for all the linguistic deficits found in cases of Broca's aphasia. The characteristic feature enabling a differential diagnosis of Broca's aphasia is agrammatism.

Adult↗
PubMed1979

"Transcortical" features of aphasia following left thalamic hemorrhage.

In a series of 14 thalamic hemorrhage documented by Computerized Axial Tomography (CT) scans, aphasia was present in seven out of eight patients with left lesions while it was absent in the six patients with right lesions. In three cases where detailed language testing was performed, aphasia was characterized by reduction of spontaneous speech with semantic paraphasias, preserved repetition and partially defective auditory verbal comprehension. The language disturbance was persistent in two patients, while it recovered spontaneously within four weeks in one patient. The clinical picture in these patients is similar to the classical "transcortical" aphasias, which are usually due to damage of the marginal language areas. It is suggested that the left thalamus contributes to the semantic level of verbal behavior, which is possibly subserved by these areas.

Aged↗
PubMed1979

Prognostic value of EEG in acute vascular aphasia: a long term clinical-EEG study of 53 patients.

A group of 53 patients rendered acutely aphasic by occlusive cerebrovascular disease were studied by serial EEG's, repeated neurologic examinations and speech evaluations (Porch Index of Communicative Ability) over a period of eight to twenty-four months, in order to correlate EEG findings with the degree of language disorder and prognosis for language recovery. Normal and mildly abnormal EEG's, posterior slow foci, focal slowing of semirhythmic type and higher alpha frequencies over the intact hemisphere correlated with good language recovery. In the majority of the patients, the curves of "EEG Improvement" and "Language Recovery" closely paralleled each other. These data indicate that the EEG is of prognostic value as to recovery from aphasia in patients suffering from acute occlusive cerebrovascular disease. Despite the advent of newer diagnostic tests, such as CAT scan, which has established its value in evaluation of the anatomy of aphasia, (9) EEG remains to be useful as a tool that could predict the outcome of aphasia in stroke patients.

Adult↗
PubMed1978

Broca aphasia: pathologic and clinical.

The speech disturbance resulting from infarction limited to the Broca area has been delineated; it differs from the speech disorder called Broca aphasia, which results from damage extending far outside the Broca area. Nor does Broca area infarction cause Broca aphasia. The lesions in 20 cases observed since 1972 were documented by autopsy, computerized tomography, or arteriogram; the autopsy records from the Massachusetts General hospital for the past 20 years and the published cases since 1820 were also reviewed. The findings suggest that infarction affecting the Broca area and its immediate environs, even deep into the brain, causes a mutism that is replaced by rapidly improving dyspraxic and effortful articulation, but that no significant distrubance in language function persists. The more complex syndrome traditionally referred to as Broca aphasia, including Broca's original case, is characterized by protracted mutism, verbal stereotypes, and agrammatism. It is associated with a considerably larger infarct which encompasses the operculum, including the Broca area, insula, and adjacent cerebrum, in the territory supplied by the upper division of the left middle cerebral artery.

Adult↗
PubMed1979

Common dimensions of visual and auditory agnosia and an explanation of the auditory recognition deficit in aphasia.

An experimental analysis of auditory recognition disturbances was performed; 81 patients with localized cerebral lesions were examined with a recognition test for meaningful sounds and with a nonverbal intelligence test (Block Design). Sensory stimulation was 5 or 15 sec for each sound. Nonverbal intelligence accounted for a considerable and significant amount of variance in recognition performance. The aphasic group was more impaired in auditory recognition than were both the other groups, i.e., patients with right or left hemispheric lesions without aphasia. The auditory recognition disturbance in the aphasic group depended to a significant extent on stimulus duration, which means a slowing down of the recognition process in aphasia. The analogies to studies on visual agnosia are striking. In both modalities, recognition depends on intellectual functioning, sensory disturbances or reduced sensory input, and the presence of aphasia.

Adult↗
PubMed1977

On the occurrence and prognosis of aphasia in patients with cerebral infarction.

Of 338 consecutive patients with cerebral infarction, aphasia in the acute phase was found in 96. Of these, 18 had totally recovered from aphasic speech disturbances when leaving the hospital. The patients were examined 2-8, in average 6 years after the onset of the illness. 39% of them had died, 27% still suffered from aphasic speech disturbances, while 32% were recovered from aphasia. In addition, disturbances in writing, reading, and/or calculation were observed in more than the half of the survivors. Of patients over 65 years of age 56% were dead compared with 32% of younger patients. Aphasia was observed relatively more in geriatric patients, and the recovery of them was poorer.

Adolescent↗
PubMed1979

The relationships between conceptual and semantic-lexical disorders in aphasia.

A nonverbal test of conceptual thinking was administered to 55 normal controls and to 203 patients with monohemispheric brain lesions (74 aphasics and 129 nonaphasic brain-damaged patients), in order to study the relationships between conceptual impairment of aphasic patients and breakdown of the semantic-lexical level of integration of language. A very high number of aphasic patients (54 out of 74) and a limited number of nonaphasic brain-damaged subjects (31 out of 129) obtained a pathological score on the test of conceptual thinking, but only some components of the aphasic symptomatology seemed closely linked to the conceptual disorder. In fact a non-significant relationship was found between conceptual impairment and: ("fluent" or "non-fluent") clinical type of aphasia; severity of aphasic disturbance. On the contrary, a strong relationship was found between conceptual disorder and impairment of the semantic-lexical level of integration of language. These findings seem to show that conceptual disturbance and semantic-lexical troubles are closely linked in aphasia.

Aphasia↗
PubMed1979

Language deficits after apparent clinical recovery from childhood aphasia.

Twenty-seven children with childhood injury to the left hemisphere were tested for language function and compared with appropriate controls. Eleven children had incurred their lesions before the age of 1 year, 16 afterward. The group with perinatal injury to the left hemisphere did not show a specific aphasic deficit even though they were mildly cognitively impaired. The group of children with later injury to the left hemisphere showed aphasic deficits if the original injury had caused a language defect; otherwise the left hemisphere injury was not associated with specific disturbances in language function. The average age at time of lesion in those children who had recovered from aphasia was 4.7 years. We conclude that even when childhood aphasia results from a unilateral nonprogressive lesion, recovery of language is less complete than has been generally supposed.

Adolescent↗
PubMed1979

Motivational factors in aphasia therapy: research suggestions.

Following Wepman (1953), the process of recovery from aphasia is seen as involving stimulation, motivation, and facilitation. The most adequate studies of aphasia therapy outcome focus on facilitation to the virtual exclusion of stimulation and motivation, although clinical experience suggests their importance. Motivation includes both the subjective and experiential aspects of the patient's response to aphasic disablement (anxiety, feelings of inadequacy) and the quality of the speech-therapist/patient alliance during the treatment. Retrospective studies utilizing sufficiently improved aphasics and ratings of the patient-therapist alliance are suggested as preliminary means of defining "motivation" in this context more accurately. Research approaches are also outlined which would assess the importance of and interaction between the three factors implicated in recovery for therapeutic outcome.

Aphasia↗
PubMed2026

Modulating sentence comprehension in people with aphasia through anodal tDCS: A double-blind randomized cross-over study.

This double-blind randomized cross-over study investigated the effects of perilesional anodal transcranial direct current stimulation (AtDCS) combined with speech-language therapy on sentence comprehension in eight individuals with chronic nonfluent agrammatic aphasia. The behavioral therapy consisted of an intensive comprehension treatment including drilling in sentence-to-picture matching and Mapping Therapy. Each participant underwent both the anodal tDCS and sham stimulation conditions (five received sham first followed by real stimulation, and the remaining three the reverse sequence), with each condition paired with the same behavioral treatment and separated by a four-month washout period. Stimulation was applied over the perilesional area (left BA6) for 20 min during daily 40-min therapy sessions over four consecutive weeks. Sentence comprehension was assessed with the RiComprendo battery and functional communication with the Communicative Effectiveness Index (CETI). Data were analyzed using paired t-tests, Bayesian analyses, and linear mixed-effects models to control for baseline performance and individual variability. Both stimulation conditions produced significant pre-to-post improvements in sentence comprehension, particularly for syntactically complex structures such as passives and center-embedded object relatives. However, gains were overall greater following AtDCS, as reflected in larger effect sizes, stronger Bayes factors, and a significant treatment effect in the mixed-effects models. Only the AtDCS condition yielded significant improvements in self-perceived comprehension abilities on the CETI. These findings suggest that AtDCS over perilesional cortical areas may boost the effects of traditional language therapy on sentence comprehension, supporting its feasibility and potential as an adjuvant intervention in post-stroke aphasia rehabilitation.

Humans↗