Iconic reading in a case of alexia without agraphia caused by a brain tumor: a tachistoscopic study

The lack of nonverbal reading comprehension in the clinical disconnection syndrome, alexia without agraphia, has been contradictory to the relative reading comprehension of the right hemisphere in split brains. We report a 39-year-old patient with verbal alexia without agraphia caused by brain tumor. On rapid tachistoscopic presentation of object names, he denied seeing anything but showed nonverbal reading comprehension by pointing to the corresponding objects. He lost this ability when he recovered ability to name individual letters of the object names. Our results suggest that even partial verbal reading such as the naming of single letters makes demonstration of iconic reading impossible and that total functional disconnection from verbalization, as initially noted in this case or in split brain studies, is necessary to show nonverbal reading comprehension.     

Basal ganglia participation in language pathology

Language disturbances were studied in 40 patients with well-demarcated vascular lesions of the speech-dominant hemisphere. Computerized cranial tomography was used for localization of the lesion. Special emphasis was given to the analysis of automatized speech and repetitive verbal phenomena.Subcortical infarctions with basal ganglia involvement led to transient aphasia although long-lasting abnormalities of language could be detected in these patients. Aphasia was more severe if a cortical lesion was combined with a basal ganglia lesion. Automatisms and recurring utterances occurred only with combined cortical and basal ganglia lesions. A lesion of Wernicke's area alone, without involvement of prerolandic structures or subcortical nuclei, was sufficient to produce long-lasting aphasia, whereas lesions of Broca's area alone produced only transient language disturbances. The results are compatible with a recent theory of multiple cerebral representation of function.     

Feature analysis and the token test

In a picture-matching task pictures of objects had to be arranged into pairs by aphasic and nonaphasic patients and normal controls. Aphasic patients were also given the Token Test. Correlation between the rank order of error scores in both tests was highly significant in aphasic patients. The pictures were also given to a normal group for free matching. Overlapping of normal performance on free matching and aphasic performance on bound matching occurred. We hypothesized that aphasic impairment was due to a difficulty in calling up associations, difficulty in feature analysis, and in moving from one concept to another. These findings are discussed in the light of abilities needed for Token Test performance. The results indicate that the traditionally presumed fundamental difference between verbal and nonverbal cognitive tasks is rather unsatisfactory.     

Increased susceptibility of aphasics to a distractor task in the recall of verbal commands

The ability of 15 control, 15 nonaphasic brain-damaged, and 15 aphasic patients to carry out three-word commands on the Token Test was studied under three conditions: no delay, 20-sec unfilled delay, and 20-sec delay filled with a counting task. Only aphasics with mild to moderate comprehension deficit participated in the experiment and their scores in the no-delay condition were not inferior to those of the other two groups. The 20-sec unfilled delay did not bring about a decrement of the performance in any group, while all of them were impaired with 20-sec filled delay. The rate of forgetting was, however, significantly greater in aphasics than in patients without language disorders, even when the scores of the no-delay condition were introduced as covariates in the analysis of the filled-delay condition. The same result was obtained when, in a second experiment, 4 sec elapsed between the end of the command and the beginning of the counting activity. The increased susceptibility of aphasics to the disruptive effect of the distractor task is viewed as following a failure in organizing verbal information, a deficit that may contribute to lowering their comprehension level.     

Dementia in Parkinson disease: A neuropsychological analysis

An extensive set of neuropsychological measures was administered to 60 Parkinson's disease patients and age-, sex-, and education-matched controls in order to investigate the nature and prevalence of the cognitive deficit in the disease. Parkinsonian patients performed significantly poorer on all measures with the exception of tests for apraxia and object recognition, and on a test of vocabulary knowledge. Discriminant analysis of the test data revealed that over 93% of patients are impaired relative to matched controls, but that assigning a prevalence rate for dementia in the disease may be difficult due to the continuous distribution of cognitive deficits.     

Selective deficit of conceptual structures in aphasia: Class versus thematic relations

Conceptual structures in aphasia were investigated by means of a nonverbal test. The understanding of class and thematic relationships was demonstrated to be selectively impaired according to varieties of aphasic deficit. Broca's aphasics showed difficulty evaluating a thematic relationship and did not differ from normal controls as far as class relationships were concerned. The opposite happened for Wernicke's aphasics whose defect seems to be selectively restricted to class relationships.     

Some aspects of phonological impairment in aphasia

The relationships between expressive and receptive phonemic disorders and between disturbances of phoneme processing and general disorders of auditory comprehension were studied in 69 aphasic patients, by means of a phoneme discrimination test and of a standard aphasia battery. A significant but incomplete correlation between disorders of phonemic output and of phoneme analysis was found. The view is put forth that in some patients only phoneme encoding or decoding is disturbed, whereas in others a central level of phoneme processing is impaired. A significant but partial correlation was also found between disorders of phonological analysis and general disorders of auditory comprehension. This supports the view that, besides sequential phonological analysis, other processes operate in auditory comprehension.     

Beliefs about beliefs: representation and constraining function of wrong beliefs in young children's understanding of deception

Understanding of another person's wrong belief requires explicit representation of the wrongness of this person's belief in relation to one's own knowledge. Three to nine year old children's understanding of two sketches was tested. In each sketch subjects observed how a protagonist put an object into a location x and then witnessed that in the absence of the protagonist the object was transferred from x to location y. Since this transfer came as a surprise they had to assume that the protagonist still believed that the object was in x. Subjects had to indicate where the protagonist will look for the object at his return. None of the 3–4-year old, 57% of 4–6-year old, and 86% of 6–9-year old children pointed correctly to location x in both sketches. Of the many cases where 4–6-year olds made an error they failed in only about 20% to remember the initial location correctly. As a test of the stability of children's representation of the protagonist's wrong belief the sketches continued with a statement about the protagonist's intention to either deceive an antagonist or truthfully inform a friend about the object's location. Independent of age, of those children who correctly thought that the protagonist would search in x, 85% of the time they also correctly thought that he would direct his antagonist to location y and his friend to location x. This shows that once children can represent a person's beliefs they can constrain their interpretation of this person's stated intentions to the person's beliefs. In a more story-like situation another group of children had to infer a deceptive plan from the depiction of a goal conflict between two story characters and one character's expedient utterance. At the age of 4–5 years children correctly judged this utterance as a lie only 28% of the time while 5–6-year olds did so 94% of the time. These results suggest that around the ages of 4 to 6 years the ability to represent the relationship between two or more person's epistemic states emerges and becomes firmly established.     

Event-related potentials in neuropsychological studies of language

Experiments are described in which event-related potentials (ERPs) are employed to study the specialization of functions between and within the cerebral hemispheres during the performance of language and nonlanguage tasks by normal adults. Similar studies of deaf subjects suggest that the functional organization of the brain may be altered after different early language and sensory experiences. Studies of patients with alexia without agraphia suggest that the ERP may be a valuable tool with which to study cerebral reorganization after brain damage.     

Text comprehension in aphasia

The semantic and pragmatic strategies in the comprehension of spoken texts are investigated in four subgroups of aphasic patients and in normal and brain-damaged controls. Short texts of similar linguistic structure were read to the subjects, who were required to choose the picture, from a multiple choice set of five, that was appropriate to the story. Besides a picture showing the main event of the story, one picture depicted the literal sense of a metaphorical comment, and the others misrepresented semantic functions expressed in the text. With respect to these types of responses, both aphasics and controls exhibited the same pattern of reaction. It is concluded that the redundancy of texts makes up for the difficulties aphasics have in comprehending isolated words and sentences.     

Nonverbal categorization in fluent and nonfluent anomic aphasics

This study aimed to demonstrate that the naming difficulties of a particular group of aphasics, namely, fluent aphasics, are related to an underlying inability to organize feature set information. In order to test this hypothesis, the performance of fluent aphasics, nonfluent aphasics, and a nonaphasic brain-injured control group, was examined on a nonverbal categorization task, which was carefully structured in terms of instance typicality. Scores of visuoperceptual and naming tests were correlated with categorization task errors. As predicted, fluent aphasics showed a significant deficit in performance on the categorization task in comparison with other subjects. Differences in the nature of the errors the fluent aphasics made suggested that their problems were related to difficulties in abstracting the prototype for each category and in sorting category members with reference to these prototypes. For fluent aphasics, but not other subjects, a significant correlation was found between categorization task performance and naming ability.     

Facet theory applied to the construction and validation of the Aachen Aphasia Test

The linguistic performance of 120 aphasic patients of the four standard syndromes assessed by the Aachen Aphasia Test (AAT) is analyzed by a nonmetric (ordinal) multidimensional scaling procedure (Smallest Space Analysis, SSA1). The linguistic structure of the test items is characterized within the framework of L. Guttman's facet theory. Three systematic components (facets) are discerned: linguistic modality, unit, and regularity. Properties of the facets as well as their relations are assessed and tested empirically by analyzing the interrelations among different items or sets of items. The spatial configurations obtained by the scaling procedure fit only partially the expectations derived from the facet-theory model. The modality facet was found to have a strong overriding influence on the aphasic test performance. The facets unit and regularity were only found for the most rigorously designed subtests, Written Language and Comprehension. The results suggest the introduction of a new combined facet linguistic complexity which reflects the dependency of the facets regularity and unit.     

Comprehension disorders in aphasia: a historical review.

This paper reviews the clinical reports and theoretical inferences made by early scientists in regard to the impairment of auditory comprehension so often found in aphasics. It first presents an analysis of the literature on and the interpretation of comprehension disorders in aphasia up to the time of Pierre Marie and Arnold Pick. It then reviews early attempts to assess and quantify receptive impairment. Finally, it discusses the historical origin of some of the questions on comprehension currently under investigation by contemporary researchers.     

The selective impairment of phonological processing: A case study

A case study is reported of an aphasic patient with fluent speech and markedly superior comprehension of written vs. spoken words. Results of extensive testing supported the hypothesis that the patient suffers from a phonological processing deficit that affects performance in all tasks that require the generation of a phonological code. This selective deficit is interpreted as the underlying cause of diverse symptoms such as asyntactic comprehension of written sentences, the commission of spelling errors in writing, and the production of literal paraphasias and neologisms in spontaneous speech. Alternative possibilities for the classification of this patient are discussed.     

Dissociations of language function in dementia: A case study

In this report we describe and attempt to characterize the deterioration in semantic knowledge occurring in a victim of a progressive dementing disease. The subject was unable to match even highly familiar naming words with their actual or pictured referents; instead, she consistently overextended verbal labels to closely associated distractors. The alteration in scope of referential meanings suggested by this overextension effect was apparently related to a breakdown in the structure of underlying categories. On a nonverbal match-to-sample procedure, for example, dogs were treated as exemplars of the cat family. Evidence for the breakdown of semantic knowledge was not limited to picture labeling paradigms. Thus, we found that the subject was unable to utilize semantic context in the written disambiguation of spoken homophones but could, at the same time, use even minimal syntactic cues as the basis for proper lexical selection. This last result was consistent with other lines of evidence pointing to the relative preservation of syntactic operations, in marked contrast to the semantic loss. The importance of this dissociation of function in organic pathology is considered from a number of perspectives, including its relevance to models of language organization in the brain.     

On the role of the anterior cingulate cortex in phonation: A case report

A 41-year-old male patient is presented with a lesion in the anterior cingulate cortex, medial orbital cortex, and rostral striatum bilaterally and supplementary motor area on the left side. The patient first exhibited a state of akinetic mutism which lasted about 6 weeks. During this state, no volitional vocal utterances were made; there were, however, occasional groans of pain. During recovery, the mute phase was replaced by a state in which the patient could whisper but not phonate verbal utterances. About 10 weeks after the accident, phonation was restored. The speech was characterized, however, by monotonous intonation and a very low frequency of spontaneous utterances. While the frequency of spontaneous speech improved noticeably during the following months, emotional intonation remained permanently defective. A comparison of the present case with other cases from the literature as well as experimental monkey data suggest that the anterior cingulate cortex is involved in the volitional control of emotional vocal utterances.     

The effect of anxiety,reinforcement, and intelligence on the learning of a difficult task

The effects of anxiety, reinforcement, and intelligence were studied on the learning of a difficult task (paired associates with 1% association values) in 252 subjects studying in class IX in Chandigarh schools (mean age, 14.7 years). A 2 × 3 × 3 factorial design was used with two anxiety groups (high and low), three reinforcement conditions (praise, reproof, and praise + reproof), and three levels of intelligence (high, middle, and low). In general, the results were in line with the Sarasonian theoretical framework that anxiety shows its debilitating effects under certain conditions, but not all. At upper levels of intelligence, neither anxiety nor reinforcement was found significant. At lower levels of intelligence, anxiety was found to interfere with learning under all the reinforcement conditions. It was found further that the most affected group was the middle intelligencehigh anxiety group. This group performed better under praise than under praise + reproof and reproof alone.     

Selective semantic-lexical impairment of language comprehension in right-brain-damaged patients

Fifty right-brain-damaged patients and thirty-nine normal controls were given two tests of semantic-lexical discrimination (auditory language comprehension and reading comprehension) and a test of phoneme discrimination. The aims of the research consisted in checking: (A) if right-brain-damaged patients are significantly more impaired than normal controls on the tasks of semantic discrimination even when the influence of associated variables (such as unilateral spatial neglect or general mental impairment) is ruled out; and (B) if semantic-lexical disorders of right-brain-damaged patients are selective or if they are associated with disorders of phoneme discrimination. Results have shown that right hemispheric lesions consistently impair semantic-lexical discrimination but do not hamper phoneme discrimination. Some implications of these results are discussed.     

Developmental changes in assigning agent relations in Hebrew: The interaction between word order and structural cues

Developmental changes in the interaction between word order and structural cues was investigated by having Hebrew-speaking children between 4 and 10 years of age interpret NVN utterances that balanced the complementary and contradictory effects of work order and two types of morphological cues, inflections that mark subject-verb gender agreement and an object particle. In Hebrew, gender inflections are highly complex and irregular while the object particle is highly regular and distinctive. Both word order and structural cues affected interpretations by subjects of all age groups, though the role of structural cues increased with age. For all groups, the objec particle was a dominant cue. The likelihood of assigning the agent relation to the first or second noun systematically varied with the relative weights of cues that supported and opposed each assignment. Comparisons were made between processing of Hebrew and processing of Serbo-Croatian and Turkish.