Qualitative aspects of pantomime recognition defect in aphasia

This study investigated the performance pattern of aphasic patients on a pantomime recognition test in which one of the four response alternatives was an object semantically related to the correct choice. Aphasics with defective pantomime recognition made 71% of their total errors on the semantic foils, and for the majority of such patients, semantic errors represented 80 to 100% of total errors. Only aphasies with objective evidence of confusion failed to make highly frequent semantic errors. The findings suggest that most aphasies who fail pantomime recognition are impaired because of semantically vague understanding of the pantomimes' intended meaning rather than complete lack of understanding of the pantomime.     

Pantomime, praxis, and aphasia.

The production and comprehension of pantomimed movements by asphasic subjects were studied with respect to their relationship to the aphasic deficit on one hand and apraxia on the other. At issue was whether impaired use of pantomime is a manifestation of reduced symbolic capacity or purely a manifestation of an apraxic impairment of purposeful movement or both. Tests of pantomime included a Pantomime Recognition Test, a nonverbal Transitive Pantomime Production Test, and an Intransitive Pantomime Production Test (to oral command). Imitation of Nonmeaningful Movements served as a measure of apraxia, uncontaminated by symbolic or linguistic factors. Imitation of Meaningful Movements taken from the pantomime tasks was also tested. Independent measures of auditory comprehension, picture naming, and reading comprehension were used as indices of language impairment. Intellectual function was measured by the Performance scale of the WAIS. Thirty aphasic subjects were examined. Twenty healthy age-matched normals served to establish scoring standards for the pantomime tests. Multiple regression analysis revealed significant, independent contributions from both auditory comprehension and imitation of Nonmeaningful Movements to all of the tests of pantomime production and pantomime recognition. All measures of pantomime production and pantomime recognition were strongly intercorrelated. While the three language measures were strongly correlated with each other, auditory comprehension was the only one of them that was significantly and consistently related to the pantomime tests. None was related to the imitation of nonmeaningful movement. The results are taken as indicating (1) that pantomime production and imitation share common factors with both praxis and auditory comprehension; (2) apraxia entails impairment of both production and interpretation of purposeful movements. Possible theoretical accounts for these results are offered.     

Pantomime recognition defect in aphasia: implications for the concept of asymbolia

This study investigated the relationship of impaired pantomime recognition to reading comprehension, sound recognition, letter recognition, and nonverbal abstract reasoning among aphasic patients. Defects in pantomime recognition were closely associated with defects in reading comprehension, but some with impaired pantomime recognition performed well on some or all of the remaining tests. Implications of the findings for the theory of asymbolia, and for reading comprehension are discussed.     

Comprehension of symbolic gestures in aphasia

One-hundred-and-twenty-eight patients with unilateral hemispheric damage (53 aphasics, 26 nonaphasic left, and 49 right brain-damaged patients) and 25 normal controls were given a test of symbolic gesture comprehension and other tests of verbal comprehension and of reproduction of symbolic gestures. On the test of symbolic gesture interpretation aphasic patients performed significantly worse than any other group of brain-damaged patients. Within the aphasic patients the inability to understand the meaning of symbolic gestures was highly related to the number of semantic errors obtained at a verbal comprehension test. On the contrary, only a mild relationship was found between comprehension and reproduction of symbolic gestures. Some implications of these findings are discussed.     

Lexical decision and aphasia: Evidence for semantic processing

Wernicke's and Broca's-Conduction aphasics and a Global aphasic were presented with a lexical-decision task in which English words and pronounceable nonwords were preceded by semantically related, unrelated, or nonword primes. The patients were also given a simple semantic-judgment task using the word pairs from the lexical-decision task. Wernicke's aphasics performed similar to normals and Broca's-Conduction aphasics showing significantly shorter latencies in making real-word identifications when preceded by a semantically related word. In addition, both superordinate and coordinate associates showed semantic-priming effects. Performance on the semantic-judgment task showed significantly more impairment in the aphasic group than in the normal controls. These results suggest that aphasics with even severe language impairments retain stored semantic information that may be automatically activated, yet is inaccessible to conscious semantic decision during metalinguistic tasks.     

Verbal self-correction behaviors of fluent and nonfluent aphasic subjects

This investigation examined the use of six explicitly defined verbal self-correction behaviors by fluent and nonfluent aphasic subjects of high and low verbal ability, and by subjects further classified into six groups according to type of aphasia (Broca's, Anomic, Wernicke's etc.). Aphasic groups, on the average, generated some type of verbal self-correction effort on more than half of their initially erroneous responses, and the proportions of these efforts did not differ between aphasic patient groups. Significant differences in self-correction success were found, however, between groups classified according to fluency and severity, as well as among the six groups based on type of aphasia. In the former case, distinctions in self-correction skill favored high-verbal-ability groups regardless of fluency classification. In the latter instance, the subgroups typically formed by less severely impaired patients (Anomic and Broca's) had significantly higher proportions of successful self-correction behaviors than those comprised of individuals with more severe involvement (Wernicke's and Broca's plus severely limiting apraxia of speech). Between-group differences for specific types of self-correction behaviors occurred rarely, but those which were found could be related to characteristics of the particular aphasic groups under consideration. Verbal self-correction behavior is discussed as a behavioral reaction to an erroneous response or dissatisfaction with the quality of an intended response. These behaviors are viewed as indicators of the intactness of an aphasic individual's self-monitoring system, and of his tolerance for responses that are qualitatively limited by his verbal deficits.     

Reversible Verbal Memory Integration Deficits in Obstructive Sleep Apnoea

When presented with novel but semantically related elements after learning verbal material, healthy participants tend to endorse these items as previously learned. This reflects the normal integration and association of novel verbal information into long-term memory. How obstructive sleep apnoea (OSA) negatively impacts verbal memory performance, and whether deficits are reversible following positive airway pressure (PAP) treatment, remain elusive. We investigated immediate and delayed OSA- and PAP treatment-related effects on verbal memory integration, using a false memory paradigm. Twenty-three patients with OSA learned lists of words semantically related to target non-presented words (1) at baseline after a polysomnography diagnosis night, (2) after a consecutive polysomnography night under PAP titration, and (3) after three months of compliant PAP treatment. At each session, participants learned 10 different lists of words, each list comprising 15 semantically related items. They had then to recognize 15 minutes later (after an intermediate vigilance task) previously learned words within a list including studied words (learned), unstudied but semantically related items (lures), and non-related unstudied items (controls). Sleep quality and fatigue questionnaires, and psychomotor vigilance tests (PVT) were administered at each session. PAP treatment led to OSA remission and improvement in objective and subjective sleep quality. Crucially, recognition of learned and lure words increased after the first night under treatment and remained stable three months later, suggesting successful memory integration and restoration of semantic processes. No treatment-related outcome was found on PVT performance. OSA exerts a detrimental but PAP-reversible effect on verbal learning and semantic memory integration mechanisms underlying the acquisition of novel memory representations.     

Gestural impairment and gestural ability in aphasia: A review

Studies of gestural ability in aphasic subjects have found impairment of gestural expression and comprehension, with a close relationship between severity of aphasia and degree of gestural impairment. A few investigators have correlated gestural ability with specific language functions or subcategories of aphasia. Reading appears to correlate better with gestural recognition than does auditory comprehension. Despite the general findings of gestural impairment in aphasia, successes have been reported with gestural training including artificial language techniques, pantomime, Amerind, and American Sign Language. Future studies of gestural therapy in aphasia should examine specific language deficits in order to identify those aphasic individuals who can benefit from gestural training.     

Body image and comprehension of body part names

The relation between awareness of body topology and auditory comprehension of body part names was studied in 22 aphasic subjects. Two nonverbal tasks—human figure drawing and placement of individual body parts in relation to a drawn face—were compared with two auditory tests of body part comprehension. The two nonverbal and the two verbal tasks were closely correlated with each other, but there was no relation involving either of the verbal tests with either of the nonverbal tests. Selection errors in the auditory comprehension tasks were predominantly semantically based and equally distributed between functionally analogous parts and parts related by location on the body.Dr. Benedet's effort in this study was supported by a grant from the Hispano-North American Joint Committee for Cultural and Educational Cooperation.     

Activation and elaboration effects in recognition and word priming

Two experiments investigated the effect of direct and indirect activation on subsequent accessibility to individual items. In the first experiment, words were semantically processed in the context of either phonologically (rhyming) or conceptually (categorical) related words and tested subsequently for recognition and word completion. On the completion test the initial three letters of a word are presented for completion. The previously presented target word is one of several possible completions. The presence of different contexts had no differential effect either on recognition memory—which persisted at high levels for two days—or on completion—which decayed in the course of about 15 min.

In the second experiment, the contexts were presented but the target words were not. Thus the rhyming and categorical contexts were directly activated but not the actual words that were scored on the subsequent tests. Prior activation of phonologically similar items affected both recognition and completion performance on immediate testing, but not after 10 min. Conceptual activation affected only recognition—an effect that lasted for a period of days. Completion performance demonstrates access to the integration component of recognition. The results were compared with attempts to demonstrate independence of recognition and completion.     

The semantic deficit hypothesis: Perceptual parsing and object classification by aphasic patients

Many aphasic patients are impaired in their ability to provide or to recognize the names of objects, but little is known about the processing deficits that underlie these difficulties. In this report, a model of object naming/name recognition is proposed, and a prediction is tested concerning one possible functional locus of impairment in name-recognition and object-naming disorders. A subgroup of aphasic patients is found to be impaired in the ability to perform perceptual similarity judgments for pairs of stimulus objects, and to be unable to classify the objects into one of two lexical categories. It is concluded that the classification disorder suffered by these patients results from an impairment at the level of the semantically guided perceptual parsing of objects.     

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.     

Pantomime recognition impairment in Alzheimer's disease

This study was designed to examine whether 10 AD patients with diffuse lesions and an early semantic deficit could comprehend the meaning of pantomimes and symbolic gestures. We especially wanted to determine the relationship between pantomime recognition and production. The tasks involved naming or showing an understanding (e.g., circumlocutions) of the pantomimes executed by the examiner and producing pantomimes to verbal command or to imitation. The results showed no significant relationship between pantomime comprehension and pantomime production. However, 60% of AD patients performed poorly compared to controls on the Gesture Recognition task. Gesture comprehension was highly correlated with a measure of global cognitive impairment (3MS). The data are consistent with the proposed separation of comprehension and action production systems in a cognitive model of praxis. Gesture comprehension may be diffusely distributed and thus preserved in the early stages of AD as in circumscribed lesions of the left parietal lobe.     

On obtaining episodic priming in a lexical decision task following paired-associate learning

In four experiments, subjects made lexical (word-nonword) decisions to target letter strings after studying paired associates. In this lexical decision test, word targets previously studied as response terms in the paired associates were preceded at a 150-ms and/or 950-ms stimulus onset asynchrony (SOA) by one of various subsets of the following six types of primes: a neutral (XXX or ready) prime, a semantically unrelated word prime episodically related to the target through its having been previously studied in the same pair, a semantically related word prime previously studied in a pair with some other unrelated word, a semantically unrelated word prime previously studied in a pair with some other unrelated word, a nonstudied semantically related word prime, and a nonstudied semantically unrelated word prime. At the 950-ms SOA, facilitation of lexical decisions produced by the episodically related primes was greater in test lists in which there were no 150-ms SOA trials intermixed, no previously studied semantically related primes, and no studied nonword targets. At the 150-ms SOA, facilitation from episodic priming was greater in test lists in which there were no semantically related primes and all studied word targets and no studied nonword targets. Facilitation effects from semantically related primes were small in magnitude and occurred inconsistently. Discussion focused on the implications these results have for the episodic-semantic memory distinction and the automaticity of episodic and semantic priming effects.     

Phonological, Semantic, and Mediated Priming in Aphasia

An auditory lexical decision task was conducted to examine rhyme, semantic, and mediated priming in nonfluent and fluent aphasic patients and normal controls. Overall, monosyllabic word targets were responded to faster when preceded by rhyming word and nonword primes than unrelated primes. Similarly, semantically related primes facilitated lexical decisions to word targets. No evidence of mediated priming emerged. Results for individual subjects suggest differences in patterns across the subject groups. Implications of the findings for the integrity of lexical access in aphasic patients are considered.     

An investigation of body part as object (BPO) responses in normal and brain-damaged adults

A test of simple pantomime was administered to three groups of adults and comparisons were made across groups of the incidence of subjects who exhibited body part as object (BPO) responses and of the mean frequency of occurrence of BPO in each group. The three groups were left-hemisphere-damaged aphasics (N = 28), right-hemisphere-damaged (N = 24), and normal controls (N = 28). The results indicated no significant differences among groups on the BPO measures. Also, to test the strength of association between the frequency of occurrence of BPO and measures of limb apraxia and severity of aphasia for the left-hemisphere-damaged aphasic group, correlation coefficients were obtained. The correlations were low and nonsignificant. The results of this investigation do not support the common clinical assumption that the occurrence of BPO during the performance of simple pantomimes is pathognomic for left-hemisphere pathology or associated with limb apraxia.     

Levels-of-processing effects on Chinese character completion: The importance of lexical processing and test cue

The levels of processing (LoP) effect was studied in Chinese character completion tasks. The same stem cue, either graphemically or semantically related to the target character, was used to generate either a perceptual or a conceptual test. Participants received either direct or indirect instructions, so that the same stem cue also produced either an explicit or an implicit test of memory. This allowed us to examine simultaneously the roles of perceptual versus conceptual test and retrieval intentionality in the LoP effect. No LoP effects were found when the memory test was implicit. LoP effects were also not found for stems and characters related graphemically (perceptually), but were found for stems and characters related semantically (conceptually) when the memory test was explicit. The results are discussed in terms of the importance of lexical processing for character completion tests and the importance of reinstatement of the study process during retrieval for explicit memory tests.     

Retention of verbal information by rehearsal in relation to the fluency of verbal output in aphasia

The purpose of the present study was to determine if aphasic subject groups differentiated by the fluency of their verbal output employed rehearsal as a strategy for maintaining verbally coded information in primary memory. A task based upon the Brown-Peterson paradigm was administered to 10 fluent aphasic patients, 10 nonfluent aphasic patients, 10 right-brain-damaged patients, and 10 nonneurological patients. The findings indicate that the nonfluent aphasic patients did not rehearse the verbal information while the fluent aphasic, right-brain-damaged, and nonneurological patients did rehearse. In addition, both fluent and nonfluent aphasic patients encoded significantly less information into the memory system initially and performed worse on the task overall than right-brain-damaged and nonneurological patients.     

Auditory event-related potential probes and behavioral measures of aphasia

This study examined the relationship between an auditory event-related potential probe technique measure of differential hemispheric processing and traditional tests of aphasia in aphasic patients. Subjects were 10 aphasic and 10 normal adult males. The results of the electrophysiological measures indicated that the aphasic subjects responded differently from the normal group particularly when the task required processing of verbal information. During the verbal task the aphasic group showed higher amplitude right hemisphere responses as compared to left. The normal group showed little hemispheric task related asymmetries. The pattern of electrical asymmetry in the aphasic group seems to be an indicator of severity as measured by traditional aphasia examinations.     

Influence of suggestion in the DRM paradigm: what state of consciousness is associated with false memory?

We assessed the effect of suggestion on the Deese–Roediger–McDermott paradigm and associated it with the Remember–Know–Guess paradigm. Undergraduate students were given either lists of semantically related words or texts containing these words. After the recall task, if participants did not produce the critical lure, the experimenter suggested that the word had been present, using either a question (moderate suggestion) or an assertion (strong suggestion); these conditions were compared to a condition without suggestion. Afterwards, participants took a recognition test. The results showed that strong suggestions lead to more false recognitions than other conditions and the state of consciousness associated with false recognitions tends to be a feeling of knowing rather than remembering, regardless of the verbal version (list or text). Therefore moderate suggestions did not lead to more false recognitions compare to no suggestion. We discuss the impact of suggestion on consciousness associated with false memories.