Pronoun comprehension in aphasia: a comparison of three languages

The research reported here investigated the effect of phonological and syntactic factors on the processing of pronouns by aphasics. The comprehension of these "closed-class" elements was studied in three different languages: French, Dutch, and German. The cross-linguistic design made it possible to vary phonological status (clitic/nonclitic) and phrasal category (noun phrase/prepositional phrase) as well as grammatical relation (direct/indirect object) while keeping class membership (closed class) and meaning constant. A sentence-picture matching task was given to 20 German-speaking, 16 Dutch-speaking, and 14 French-speaking aphasics, half of each language group being classified as agrammatic Broca's and half as paragrammatic Wernicke's aphasics. The results suggest that Broca's aphasics' limitations in retrieving pronouns, and therefore other closed-class elements, are not a function of either phonological status, phrasal category, or grammatical relation. These subjects' observed high level of performance on pronouns in language comprehension appears due to the kind of semantic and syntactic information they encode. Our findings indicate that a more refined distinction than closed class vs. open class is necessary.     

The noun-verb problem in Chinese aphasia.

Previous studies have shown that Broca's aphasics experience a selective difficulty with action naming inside or outside of a sentence context. Conversely, it has been suggested that Wernicke's aphasics are particularly impaired in object naming. A number of explanations have been offered to account for this double dissociation, including grammatical accounts according to which the main verb problem in agrammatic Broca's aphasics is viewed as a by-product of their syntactic and/or morphological impairment, due perhaps to the greater morphological load carried by verbs (compared with nouns). In the Chinese language, there are no verb conjugations and no declensions. Hence there is no reason to expect a relationship between morphological impairment and deficits in action naming. We examined comprehension and production of object and action names, outside of a sentence context, in a sample of Chinese-speaking Broca's and Wernicke's aphasics. There was an interaction between patient group and object/action naming, but no corresponding interaction on the comprehension task. We conclude that action-naming deficits in Broca's aphasia (and/or the corresponding sparing of action names in Wernicke's aphasia) cannot be attributed to morphological differences between nouns and verbs. We also found a sublexical variant of the noun/verb dissociation applied to the internal structure of compound words made up of a verbal and a nominal element: Broca's aphasics tended to lexicalize the verbal portion of these words more often than the nominal compound, while Wernicke's showed the opposite pattern. These sublexical effects are difficult to explain in syntactic terms nor do they fit the standard lexical view. A modified lexical account is proposed, emphasizing semantic/conceptual effects in a distributed lexicon.     

Production deficits in aphasia: A voice-onset time analysis

An experimental study was conducted to examine phonetic and phonemic deficits in the speech production of aphasics. Subjects included four Broca's aphasics, four Conduction aphasics, five Wernicke's aphasics, one nonaphasic dysarthric patient, and four normal controls. The subjects read a list of words containing word-initial stop consonants which were subsequently measured acoustically for voice-onset time. The results showed that Broca's aphasics exhibit a more severe production disorder than Conduction aphasics who in turn exhibit a more severe disorder than Wernicke's aphasics, in accord with clinical observations. In addition, although Broca's aphasics produced both phonetic and phonemic errors, the results showed that they have a pervasive phonetic disorder which affects their correct target productions as well as the total number of phonetic errors produced. This deficit however seems to be a speech deficit rather than a low-level motor control problem. In contrast, the Wernicke's aphasics show a deficit characterized by isolated phonemic mistargeting errors. Finally, the pattern of productions for the Conduction aphasics indicates that some patients show a predominantly phonetic disorder similar to the Broca's aphasics and others show predominantly a phonemic disorder similar to the Wernicke's aphasics.     

Syntactic effects in sentence completion by Broca's aphasics

A study of six Broca's aphasics is reported. The task was to complete sentence frames with a missing word whose type was systematically varied by syntactic form class (nouns, verbs, prepositions, and particles) and the number of lexical options appropriate to any given instance. The primary aim was to contrast syntactic type (content vs. function words) and level of sentential constraint as ways of determining whether there was a central syntactic component to the language deficit. There was a significant effect for word type and an interaction between word type and level of constraint. These results are discussed as supporting a syntactic interpretation of the deficit.     

Syntactic priming effects in aphasia: an investigation of local syntactic dependencies

This study explored on-line processing of local syntactic dependencies in normal subjects and in Broca's and Wernicke's aphasics using a lexical decision paradigm. In addition, subjects performed a grammatically judgement task on the real word pairs used in the lexical decision tasks. Results of two experiments for normal subjects indicated different syntactic priming effects as a function of the type of local syntactic dependency. Word pairs that formed a single constituent phrase, i.e., a verb phrase, showed both facilitory and inhibitory effects, whereas word pairs that reflected local syntactic dependencies across a phrase boundary, i.e., pronoun verb, showed only inhibitory effects. Broca's aphasics failed to show facilitory effects when presented with word pairs forming a single constituent phrase but, similar to normals, did show inhibition when presented with word pairs that reflected local syntactic dependencies across a phrase boundary. In contrast, Wernicke's aphasics failed to show inhibitory effects in both experiments. The implications of these results for theories of language processing deficits in aphasia are considered.     

Analytical competence and language impairment in aphasia

Matched groups of Broca's and Wernicke's aphasics, brain-damaged patients without aphasia and chronic schizophrenics were tested in a nonverbal matching task where the subject had to indicate which of two pictures was more closely linked to a clue picture. Eight additional verbal and nonverbal reference tasks were administered. Both aphasic groups performed worse than brain-damaged controls when the identification of individual attributes or actions shared by clue and referent was required, but were unimpaired when the two had a set of referential-situational associations in common. Factor analyses resulted for both groups in two factors, one of which represents general Language Impairment. For the Broca's aphasics this factor was closely related to general organic deficit as measured by the Trail Making Test; for the Wernicke's aphasics it was associated with tasks which might be considered illustrative of analytical competence in isolating and comparing individual features of objects or concepts.     

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.     

Syntactic component in language responsible cognitive structure: Neurological evidence

From the results of a broad ranging comprehension test, a hierarchy of difficulty emerged that is shared by the two groups of aphasics (Broca's and Wernicke's aphasics) and by the control group of normal subjects. The parallelism has been interpreted as a confirmation of the hypothesis that syntactic competence is not inaccessible either in Wernicke's or in Broca's aphasia. The Minimal Distance Principle, as a relevant recognition principle, has been studied, and although not confirmed by the scores has been brought to the fore both by the correlations between the variables under study and by the correlations with the concomitant variables of age and level of education.     

Mechanisms underlying writing and speech in aphasia

As a parallel to the dual decoding concept for processing of written language we proposed that phonological encoding does not necessarily occur in writing and that the phonemic and graphemic subsystems can be independent on the one-word level. This hypothesis was tested by comparing oral and written performance in a picture-naming task in Broca's and Wernicke's aphasics. In addition, the residual tacit knowledge of the orthographic properties of the names of the pictures was examined with a multiple-choice recognition task. The principal finding is that Broca's aphasics who were better in written than in oral naming showed more graphemically and semantically motivated errors than aphasics who were better in oral than in written naming, the latter producing more phonemically motivated errors. This result supports the dual encoding concept for writing on the singleword level, implying a direct route from the mental lexicon to the graphemic system in parallel with a route mediated by the phonemic system. Multiple-choice recognition was found to be superior to both oral and written performance in both Broca's and Wernicke's aphasics.     

Nasal consonant production in Broca's and Wernicke's aphasics: speech deficits and neuroanatomical correlates

The present study investigated the articulatory implementation deficits of Broca's and Wernicke's aphasics and their potential neuroanatomical correlates. Five Broca's aphasics, two Wernicke's aphasics, and four age-matched normal speakers produced consonant-vowel-(consonant) real word tokens consisting of [m, n] followed by [i, e, a, o, u]. Three acoustic measures were analyzed corresponding to different properties of articulatory implementation: murmur duration (a measure of timing), amplitude of the first harmonic at consonantal release (a measure of articulatory coordination), and murmur amplitude over time (a measure of laryngeal control). Results showed that Broca's aphasics displayed impairments in all of these parameters, whereas Wernicke's aphasics only exhibited greater variability in the production of two of the parameters. The lesion extent data showed that damage in either Broca's area or the insula cortex was not predictive of the severity of the speech output impairment. Instead, lesions in the upper and lower motor face areas and the supplementary motor area resulted in the most severe implementation impairments. For the Wernicke's aphasics, the posterior areas (superior marginal gyrus, parietal, and sensory) appear to be involved in the retrieval and encoding of lexical forms for speech production, resulting in increased variability in speech production.     

Dissociation of algorithmic and heuristic processes in language comprehension: Evidence from aphasia

Three groups of aphasic patients, Broca's, Conduction, and Wernicke's, and a nonaphasic patients control group were tested for comprehension of object-relative center-embedded sentences. The sentences were of three types: sentences in which semantic constraints between words allowed the subjects to assign a correct semantic reading of the sentence without decoding the syntax, sentences in which semantic constraints were relaxed and for which a correct reading was only possible with knowledge of syntactic relationships among words, and sentences which described highly improbable events. The subjects' task was to choose which of two pictures captured the meaning expressed in the sentence. Broca's and Conduction aphasics performed near perfectly on sentences where they could use semantic information. Their performance dropped to chance when they had to use syntactic information. These results support a neuropsychological dissociation of heuristic and algorithmic processes based primarily, though not exclusively, on semantic and syntactic information, respectively.     

Deficits in thematic integration processes in Broca's and Wernicke's aphasia

This study investigated how normal subjects and Broca's and Wernicke's aphasics integrate thematic information incrementally using syntax, lexical-semantics, and pragmatics in a simple active declarative sentence. Three priming experiments were conducted using an auditory lexical decision task in which subjects made a lexical decision on a 'target' (the last word of each sentence) preceded by a 'prime' (a subject noun phrase and verb). The presence and magnitude of priming was compared to a baseline condition in which non-words systematically replaced real word primes. Normal subjects showed evidence for combinatorial thematics by exhibiting significant and larger amounts of thematic priming in the condition where two real words were present in the prime than in the conditions in which only one real word was present in the prime. Additionally, normal subjects showed sensitivity to both syntactic structures and pragmatics. In contrast, Broca's patients did not show significant priming for any condition nor did they show a difference in the magnitude of priming among the conditions. Nonetheless, they showed sensitivity to pragmatics. Wernicke's patients showed significant priming for all conditions, but did not show differences in the magnitude of priming among the conditions. However, they showed sensitivity to sentence grammaticality and pragmatics. The distinct patterns of performance of Broca's and Wernicke's aphasics are discussed in terms of the nature of their impairments in the processes of combinatorial thematics.     

Processing of lexical ambiguities in aphasia

Wernicke's and Broca's aphasics performed a lexical decision task wherein they had to decide whether the third word of an auditorily presented triplet series of words was "real" or not. The first and third words of each triplet were related to one, both, or neither meaning of the second word which was semantically ambiguous. The performance pattern of the Wernicke's aphasics was similar to that of normals. They showed selective access to different meanings of the ambiguous words, as demonstrated by the fact that the context provided by the first word affected semantic facilitation on the third word. In contrast, Broca's aphasics showed no semantic facilitation in any priming condition. These results are consistent with previous findings, suggesting that semantic representations may be largely spared in Wernicke's aphasics. The failure of the Broca's aphasics to demonstrate facilitation is consistent with the view that they have a processing deficit in automatically accessing the lexical representation of words.     

Immediate memory span, recognition memory for subspan series of words, and serial position effects in recognition memory for supraspan series of verbal and nonverbal items in Broca's and Wernicke's aphasia

Four Broca's aphasics, four Wernicke's aphasics, and four matched controls were investigated on three verbal and one visual short-term memory tasks. Experiment 1 considered memory span and subspan recognition memory for verbal items and Experiment 2 assessed serial position effects in supraspan verbal recognition memory. The Broca's aphasics demonstrated verbal memory deficits, which could not be attributed to linguistic disturbances, while the verbal memory deficiencies seen with the Wernicke's aphasics could be regarded as secondary to linguistic defects. In Experiment 3, where visual recognition memory was investigated, only the Broca's aphasics showed deficient performance. The wider context of deficient mnemonic performance in aphasia is discussed.     

Processing passive sentences in aphasia: deficits and strategies

Broca's and Wernicke's aphasics' ability to process passive sentences in the absence of semantic cues was investigated in an experiment which varies syntactic complexity and word order. The results indicate that Broca and Wernicke patients use different strategies for sentence comprehension. Wernicke patients use rather general strategies for interpretation, which assign syntactic function according to sequential arrangements of words. Broca's aphasics, by contrast, base their interpretation on specific structural elements of the sentence's surface form, without, however, being able to exploit the full syntactic information of these elements. The different strategies are interpreted to reflect differential underlying deficits.     

Thematic analysis in agrammatic comprehension: syntactic structures and task demands.

Aphasics' ability to assign thematic roles during sentence comprehension was investigated. The study was motivated by the hypothesis that capacity limitations, e.g., due to slowed processing operations, interact systematically with certain aspects of structural analysis more than with others. Experiments using a sentence-picture matching paradigm were conducted with several agrammatic Broca's and paragrammatic Wernicke's patients. Experiment 1 tested comprehension of various syntatic structures. The astoundingly good performance in Experiment 1 for both patient groups was attributed to the low task demands of the experiment. Raising the task demands, by delaying presentation of the relevant picture set in Experiment 2, resulted in a significant decrement of comprehension performance for agrammatic Broca's aphasics, but not for Wernicke's aphasics. Putting the main verb in the sentence-final position, as in Experiment 3, affected Wernicke's aphasics', but not Broca's aphasics' performance. In principle, one explanation for the performance differences between Experiments 1 and 2 for Broca's patient might be a deficit in these patients' verbal memory capacity. Therefore, verbal memory span on different word categories was tested in an additional experiment. No difference, however, was found between the Broca's patients' and the Wernicke's patients' capacity for verbal memory despite their different sentence comprehension profiles. The present data are taken to support the view that Broca's aphasics' comprehension behavior is due to the processing demands imposed by structural inference chains and not to a general reduction in verbal memory.     

Sensitivity to inflectional morphology in aphasia: A real-time processing perspective

The present study investigates Broca's aphasics' sensitivity to morphological information in an on-line task. German is used as the test language because it is highly inflected. Results from two word monitoring experiments show first that Broca's patients like normal controls are sensitive to the presence of a contextually incorrect inflection. Contrary to normals, they are, however, not sensitive to the absence of an obligatory inflection even when its presence is syntactically highly constrained. Second, they reveal that Broca's aphasics are only sensitive to the presence of an incorrect inflection when it functions as a marker of lexical category (noun vs. verb) and not when it functions as a diacritical marker (second person singular vs. third person singular). The results are taken as evidence for the claim that Broca's aphasics are impaired in the ability to process the full syntactic information encoded in closed class elements in a fast, automatic, and obligatory way.     

The relation between gesture and language in aphasic communication

Effective communication in aphasia depends not only on use of preserved linguistic capacities but also (and perhaps primarily) on the capacity to exploit alternative modalities of communication, such as gesture. To ascertain the capacity of aphasic patients to use gesture in their spontaneous communication, informally structured interviews were conducted with two Wernicke's aphasics and two Broca's aphasics, as well as with four normal controls. The performances of the patient groups were compared on the physical parameters of gesture, the points in the communication where gestures occurred, and several facets of the semantics and pragmatics of gesture. Generally speaking, the gestures of the aphasics closely paralleled their speech output: on most indices, the performance of the Wernicke's aphasics more closely resembled that of the normal controls. Wernicke's aphasics differed from normals in the clarity of their language and gestures: While individual linguistic units were often clear, the relation among units was not. In contrast, the Broca's aphasics equaled or surpassed the normal controls in the clarity of their communications. The results offer little support for the view that aphasic patients spontaneously enhance their communicative efficacy through the use of gesture; these findings can, however, be interpreted as evidence in favor of a “central organizer” which controls critical features of communication, irrespective of the modality of expression.     

The mapping from sound structure to the lexicon in aphasia: evidence from rhyme and repetition priming

Two studies were conducted to explore the hypothesis that Broca's and Wernicke's aphasics have deficits arising from the processes involved in activating the lexicon from phonological form. The first study explored whether phonologically similar lexical entries differing only in their initial consonants show "rhyme priming." Results revealed that Broca's aphasics failed to show facilitation when the target was identical to the prime (i.e. identity priming) and they showed significant inhibition when targets were preceded by rhyming words. Wernicke's aphasics showed a pattern of results similar to that of normal subjects, i.e., identity priming and rhyme priming as well as significantly slower reaction-times in the rhyming condition compared to the identity condition. The second study investigated form-based repetition priming in aphasic patients at a number of intervals including when no other stimuli intervened between repeated stimuli (0 lag) or when 4, 8, or 12 stimuli intervened. Results showed that, unlike old normal subjects who showed repetition priming for both words and nonwords, both Broca's and Wernicke's aphasics showed repetition priming for word targets only. Moreover, in contrast to old normal subjects who showed a greater magnitude of priming at 0 lag for word targets, neither Broca's aphasics or Wernicke's aphasics showed priming at 0 lag. Implications of these findings are considered with respect to the hypotheses that Broca's and Wernicke's aphasics have deficits in the nature of the activation patterns within the lexicon itself and in auditory (working) memory.