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.     

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.     

The effects of slowed speech on auditory comprehension in aphasia

The present study investigates the effects of slowed speech on auditory comprehension in aphasia. Specifically, an attempt was made to isolate the effects of added time on comprehension at the language processing stages of auditory perception, by increasing the duration of the vowel segments in each word; word recognition and semantic analysis, by adding silences between words; and syntactic analysis, by adding silences at constituent phrase boundaries. Sentences were also read at a slow rate to see the effects of naturally slowed speech on sentence comprehension. Test sentences consisted of simple active and passive declarative sentences, and complex sentences with embedded medial and final relative clauses. Sentences were either semantically reversible or nonreversible. Thirty-four aphasic patients who varied in both severity and type of aphasia were tested on a picture verification task. Results indicated that slowing facilitated language comprehension significantly only in the syntactic condition. Neither syntactic complexity nor semantic reversibility interacted with slowed speech to facilitate auditory language comprehension. Further, it was only the Wernicke's aphasics who showed significant improvement with time added at constituent boundaries. These results suggest that time alone does not facilitate language comprehension in aphasia, but that rather it is the interaction of time with syntactic processing which improves comprehension.     

Semantic processing in aphasia: Evidence from an auditory lexical decision task

W. Milberg and S. E. Blumstein (1981, Brain and Language 14, 371–385) demonstrated semantic facilitation effects in a visual lexical decision task administered to Wernicke and other aphasics with severe comprehension deficits. In an attempt to explore the generalizability of these findings in a task where the acoustic-phonetic system could not be bypassed to access meaning, Wernicke's, Global, Broca's, and Conduction aphasics were administered a lexical decision task in the auditory modality. The patients were also given a simple semantic judgment task using the word pairs from the lexical decision task. The aphasic patients showed evidence of semantic facilitation whether they were categorized by diagnostic group or comprehension level. Performance of the semantic judgment task correlated with the severity of auditory comprehension deficits, whereas the consistency of the semantic facilitation effect did not. Even patients with severe comprehension deficits showed semantic facilitation. These results decrease the likelihood that auditory comprehension deficits are due to semantic organization per se and increase the likelihood that the deficits lie in one of the many processes involved in access to that information.     

Aphasia in Turkish: speech production in Broca's and Wernicke's patients

Turkish speech production was studied in 7 Broca's and 10 Wernicke's aphasics. Turkish is an agglutinative language, with few free-standing closed-class morphemes. The speech of Broca's patients was not telegraphic; although nonfluent, noun and verb suffixes were used appropriately. The speech of Wernicke's aphasics was fluent, using a wide range of often inappropriate forms. Both groups used appropriate nominal morphology. Broca's patients used a limited set of verb forms in contextually appropriate fashion. Wernicke's patients used a wide range of verb forms, all morphosyntactically correct, but often semantically anomalous. Both groups retained canonical subject-object-verb word order and controlled various types of pragmatically appropriate word order variation. It is proposed that aphasic speech patterns reflect retrieval problems rather than impairment of a portion of the language system.     

A note on temporal relations between language and gestures

The initiation of the spontaneous gestures of Wernicke's aphasics was analyzed in relation to shifts in semantic content between the syntactic boundaries of main clauses and embedded clauses. Gestures proved more likely to arise at the initial boundaries of embedded clauses when these were semantically discontinuous with the main clause than when these were semantically related to the main clause. Spontaneous gestures may signal underlying shifts in semantic intention, thereby reflecting the difficulties encountered by Wernicke's aphasics in maintaining a coherent stream of thought across syntactic boundaries.     

Measuring lexical access during sentence processing

The results from “on-line” investigations of sentence comprehension are often difficult to interpret since it is not always apparent what component processes are reflected in the response measure. The results of two experiments reported here indicate that response latencies from phoneme-triggered lexical decision (PTLD) reflect the time needed for lexical access during sentence processing. Listeners were presented with sentences and were asked to make a word/nonword judgment for items beginning with a particular word-initial target phoneme. Speed of lexical access was manipulated by varying the semantic predictability of the target-bearing word. WORD judgments were faster for words that were preceded by semantically related verbs than were WORD judgments for words that were preceded by neutral verbs. The present results are consistent with other studies showing semantic facilitation of lexical access during the processing of fluent speech. It is argued that the phoneme-triggered lexical-decision task is a more suitable measure of lexical access during sentence processing than phoneme monitoring (Foss, 1969) or word monitoring (Marslen-Wilson & Tyler, 19751. In addition, it is pointed out that the phoneme-triggered lexical-decision task lends itself to modifications which should enable investigators to study various aspects of on-line sentence processing.     

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.     

Preserved Semantic Priming Effect in Alexia

BH, a left-handed patient with alexia and nonfluent aphasia, was presented with a lexical-decision task in which words and pronounceable pseudowords were preceded by semantically related or unrelated picture primes (Experiment 1). In Experiment 2, BH was given an explicit reading task using the word lists from Experiment 1. Performance on Experiment 2 disclosed severe reading deficits in both oral reading and semantic matching of the words to pictures. However, in Experiment 1, BH demonstrated a significant semantic priming effect, responding more accurately and more quickly to words preceded by related primes than by unrelated primes. The present results suggest that even in a patient with severe alexia, implicit access to semantic information can be preserved in the absence of explicit identification. The possibility of categorical gradient in implicit activation (living vs. nonliving) in BH was also discussed, which, however, needs to be clarified in the further investigation.     

Lexical creativity during instances of word-finding difficulty: Broca's vs. Wernicke's aphasia

Lexical innovation--the creation of a word by combining existing morphemes in a novel way (e.g. "map ball" for "globe")--was evaluated as a method for circumventing word-finding difficulty in Broca's and Wernicke's aphasia. Aphasic groups were matched for naming performance and compared to a control group of normal adults matched for age and education. Lexical innovations were collected during the administration of a confrontation naming test, and were then analyzed in terms of the correctness of morpheme combination, semantic accuracy, novelty, and communicative effectiveness. An innovation was considered to be communicatively effective when its intended referent was understood by a naive judge. The lexical innovations of the two aphasic groups were diametrically opposed: as compared to both Broca's aphasics and normal adults, Wernicke's aphasics innovated significantly less often, and their innovations were significantly inferior in terms of: semantic precision, the proper construction of morpheme combination, and communicative effectiveness. This pattern suggests that lack of verbal fluency may be compatible with lexical creativity, while empty logorrheic speech may be an impediment to lexical creativity. Similarly, we conclude that the agrammatism of Broca's asphasia does not interfere with lexical innovation, while the paragrammatism of Wernicke's aphasia does interfere with lexical innovation, thus suggesting that paragrammatism affects morpheme combination at the word level as well as the sentence level.     

Phonological processing and lexical access in aphasia

This study explored the relationship between on-line processing of phonological information and lexical access in aphasic patients. A lexical decision paradigm was used in which subjects were presented auditorily with pairs of words or word-like stimuli and were asked to make a lexical decision about the second stimulus in the pair. The initial phonemes of the first word primes, which were semantically related to the real word targets, were systematically changed by one or more than one phonetic feature, e.g., cat-dog, gat-dog, wat-dog. Each of these priming conditions was compared to an unrelated word baseline condition, e.g., nurse-dog. Previous work with normals showed that even a nonword stimulus receives a lexical interpretation if it shares a sufficient number of phonetic features with an actual word in the listener's lexicon. Results indicated a monotonically decreasing degree of facilitation as a function of phonological distortion. In contrast, fluent aphasics showed priming in all phonological distortion conditions relative to the unrelated word baseline. Nonfluent aphasics showed priming only in the undistorted, related word condition relative to the unrelated word baseline. Nevertheless, in a secondary task requiring patients to make a lexical decision on the nonword primes presented singly, all aphasics showed phonological feature sensitivity. These results suggest deficits for aphasic patients in the various processes contributing to lexical access, rather than impairments at the level of lexical organization or phonological organization.     

The effect of pictorial context on sentence memory in Broca's and Wernicke's aphasia

Eighteen aphasic patients (8 Broca's and 10 Wernicke's aphasics), 11 right hemisphere damaged patients and 12 normal subjects were tested to assess the effect of pictorial context on verbal memory with a sentence recognition task. The subjects were read aloud a stimulus sentence describing a simple event and simultaneously shown a picture congruent or incongruent with the sentence. Immediately following or after an interval of 30 sec, the subjects were read aloud a second sentence and asked to judge whether this sentence was the same or different from the stimulus sentence. The results indicated that verbal memory was better retained in supportive situations than in distracting situations, and that this contextual effect was greater in aphasic patients than in any of the other groups. Verbal memory declined rapidly after an interval in aphasic patients, but not in normal subjects. The Broca's and the Wernicke's aphasics demonstrated different performance patterns when semantic analysis of sentences was critical.     

Mapping from Sound to Meaning: Reduced Lexical Activation in Broca''s Aphasics

Recent studies of lexical access in Broca's aphasics suggest that lexical activation levels are reduced in these patients. The present study compared the performance of Broca's aphasics with that of normal subjects in an auditory semantic priming paradigm. Lexical decision times were measured in response to word targets preceded by an intact semantically related prime word ("cat"-"dog"), by a related prime in which one segment was acoustically altered to produce a poorer phonetic exemplar ("c*at"-"dog"), and by a semantically unrelated prime ("ring"-"dog"). The effects of the locus of the acoustic distortion within the prime word (initial or final position) and the presence of potential lexical competitors ("cat" --> /gaet/versus "coat" --> "goat") were examined. In normal subjects, the acoustic manipulations produce a small, short-lived reduction in semantic facilitation irrespective of the position of the distortion in the prime word or the presence of a voiced lexical competitor. In contrast, Broca's aphasics showed a large and lasting reduction in priming in response to word-initial acoustic distortions, but only a weak effect of word-final distortions on priming. In both phonetic positions, the effect of distortion was greater for prime words with a lexical competitor. These findings are compatible with the claim that Broca's aphasics have reduced lexical activation levels, which may result in a disruption of the bottom-up access of words on the basis of acoustic input as well as increased vulnerability to competition between acoustically similar lexical items.     

Altered patterns of word associations in dementia and aphasia

The word associations of 38 demented, 17 aphasic, and 22 normal subjects were studied. Both normal and brain-injured subjects appear to make judgments about the grammatical class of the word stimulus. Certain stimulus words (especially nouns and adjectives) elicit paradigmatic responses whereas other words (especially verbs and adverbs) elicit syntagmatic responses. The mechanism producing syntagmatic responses seems relatively resistant to deterioration in dementia or aphasia. However, in dementia the mechanism that generates paradigmatic responses becomes progressively less efficient (possibly due to a loss of semantic markers) and consequently more random (idiosyncratic) responses emerge. Perseverative responses, inhibited in normal subjects, are more prevalent in dementia. Anomic aphasics show a pattern of word associations similar to that of subjects with mild dementia. Broca's aphasics, while making fewer paradigmatic associations than normals, retain enough self-monitoring mechanisms so that few idiosyncratic and perseverative responses are made while more null responses occur. Wernicke's aphasics show a marked shift away from a paradigmatic word association strategy, possibly due to an inability to access semantic markers or a true loss of these markers. Metalinguistic deficits (i.e., a failure to adopt an appropriate strategy) may also contribute to this shift away from paradigmatic associations. Furthermore, a disruption of self-monitoring mechanisms in Wernicke's aphasia leads to an increase in perseverative and idiosyncratic responses.     

Visual word recognition: reattending to the role of spatial attention

Three experiments examine whether spatial attention and visual word recognition processes operate independently or interactively in a spatially cued lexical-decision task. Participants responded to target strings that had been preceded first by a prime word at fixation and then by an abrupt onset cue either above or below fixation. Targets appeared either in the cued (i.e., valid) or uncued (i.e., invalid) location. The proportion of validly cued trials and the proportion of semantically related prime-target pairs were manipulated independently. It is concluded that spatial attention and visual word recognition processes are best seen as interactive. Spatial attention affects word recognition in 2 distinct ways: (a) it affects the uptake of orthographic information, possibly acting as "glue" to hold letters in their proper places in words, and (b) it (partly) determines whether or not activation from the semantic level feeds down to the lexical level during word recognition.     

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.     

Syntactic and semantic processes in aphasic deficits: The availability of prepositions

The availability of a specific category of closed class items (prepositions) was examined in Broca's and Wernicke's aphasia. The role of prepositions was varied (syntactic/semantic) in two tasks: one requiring production of prepositions and the other acceptability judgments. Overall, it was easier to perform the acceptability task than to produce the target item. In the judgment task, Wernicke's aphasics more accurately determined the acceptability of prepositions in their syntactic role than in their semantic role, but Broca's aphasics showed no such difference. In the production task, Wernicke's aphasics again were more likely to produce prepositions which were in a primarily syntactic role. Broca's aphasics, however, failed to produce such syntactically based prepositions. The results suggest that the availability of a given closed class vocabulary form is not merely a function of its class membership but also of its functional role, and this fact serves to distinguish aspects of Broca's and Wernicke's aphasics' deficit.     

Integrative and semantic relations equally alleviate age-related associative memory deficits

Two experiments compared effects of integrative and semantic relations between pairs of words on lexical and memory processes in old age. Integrative relations occur when two dissimilar and unassociated words are linked together to form a coherent phrase (e.g., horse-doctor). In Experiment 1, older adults completed a lexical-decision task where prime and target words were related either integratively or semantically. The two types of relation both facilitated responses compared to a baseline condition, demonstrating that priming can occur in older adults with minimal preexisting associations between primes and targets. In Experiment 2, young and older adults completed a cued recall task with integrative, semantic, and unrelated word pairs. Both integrative and semantic pairs showed significantly smaller age differences in associative memory compared to unrelated pairs. Integrative relations facilitated older adults' memory to a similar extent as semantic relations despite having few preexisting associations in memory. Integratability of stimuli is therefore a new factor that reduces associative deficits in older adults, most likely by supporting encoding and retrieval mechanisms.     

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.     

The role of syntactic context in word recognition

This study examines the role of syntactic information in word recognition. Subjects made a word-nonword decision regarding a target string that was preceded by a syntactically appropriate word, a semantically related word, or an unrelated word. In Experiment 1, with syntactic and semantic trials assigned to separate blocks, syntactically and semantically appropriate context significantly reduced lexical decision for subsequent target words, compared with unrelated contexts. In Experiment 2, the syntactically and semantically primed trials were either blocked separately or mixed within the same block. Significant syntactic and semantic effects were both observed in the blocked condition, but only the semantic effect was obtained in the mixed condition