Visual-spatial processing in deaf brain-damaged signers

Sign language displays all the complex linguistic structure found in spoken languages, but conveys its syntax in large part by manipulating spatial relations. This study investigated whether deaf signers who rely on a visual-spatial language nonetheless show a principled cortical separation for language and nonlanguage visual-spatial functioning. Four unilaterally brain-damaged deaf signers, fluent in American Sign Language (ASL) before their strokes, served as subjects. Three had damage to the left hemisphere and one had damage to the right hemisphere. They were administered selected tests of nonlanguage visual-spatial processing. The pattern of performance of the four patients across this series of tests suggests that deaf signers show hemispheric specialization for nonlanguage visual-spatial processing that is similar to hearing speaking individuals. The patients with damage to the left hemisphere, in general, appropriately processed visual-spatial relationships, whereas, in contrast, the patient with damage to the right hemisphere showed consistent and severe visual-spatial impairment. The language behavior of these patients was much the opposite, however. Indeed, the most striking separation between linguistic and nonlanguage visual-spatial functions occurred in the left-hemisphere patient who was most severely aphasic for sign language. Her signing was grossly impaired, yet her visual-spatial capacities across the series of tests were surprisingly normal. These data suggest that the two cerebral hemispheres of congenitally deaf signers can develop separate functional specialization for nonlanguage visual-spatial processing and for language processing, even though sign language is conveyed in large part via visual-spatial manipulation.     

Cerebral dominance assessed by object- and color-naming latencies: sex and familial sinistrality effects.

Two vocal RT experiments were conducted. The first required the naming of five lateralized drawings of common objects; the second of five hues of equal brightness and saturation. Tachistoscopic exposure time was 100 msec. Both tasks yielded faster RT to stimuli channeled directly to the left hemisphere, demonstrating that the left hemisphere superiority for naming letters or digits obtained in previous tachistoscopic studies was not dependent on the use of alphanumeric stimuli. Interesting sex differences in object-naming and familial sinistrality differences in color-naming were obtained. Compared with other behavioral tasks for assessing language laterality, color-naming seems highly recommended in terms of freedom from spatial-confounding, good percentage agreement with clinical estimates of the frequency of left hemisphere language dominance in right handers, and sensitivity to familial sinistrality influences.     

Tone production deficits in nonfluent aphasic Chinese speech

Previous studies demonstrating a right hemisphere lateralization of musical, tonal, and intonational stimuli had suggested that in aphasic tone language speakers, the tonal phonemes might be subject to a lesser degree of deficit than consonantal phonemes. Using a word repetition task, this research demonstrates that left-damaged nonfluent aphasic speakers of Chinese experience a tonal production deficit which is both quantitatively and qualitatively equivalent to the deficit experienced by these speakers in the production of consonants. It is suggested that in tone languages, lexical specification of tone contour information results in left hemisphere lateralization of that information, thus making the tonal phonemes vulnerable to left hemisphere damage.     

Ear asymmetries on a selective attentional task

To ascertain whether there are ear-hemisphere asymmetries of selective attention, signal stimuli (tonal sequences) were presented monaurally with and without complex maskers (music and speech). The right ear-left hemisphere was more disrupted by language maskers; the left ear-right hemisphere was more disrupted by music maskers. These results suggest that there are hemispheric asymmetries of selective attention and that the ear hemisphere that usually processes a class of stimuli has greater difficulty filtering out those stimuli than does the nonspecialized hemisphere.     

Limb apraxia and motor performance

This study was desinged to determine if motor deficits in limb apraxia are task specific. Non-brain-damaged patients and apraxic and nonapraxic patients with left hemisphere damage performed language and limb apraxia tests and six motor tasks with the left hand. Contrary to previous data, no significant group differences occurred on a finger tapping task. Although task complexity or sequencing requirements affected group differences, greatest apraxic impairment was noted on a task of precise steadiness, but only when its response inhibition requirements were increased. This pattern of deficits appears to be associated with greater involvement of the premotor area in the apraxic group.     

Cerebral organization of oral and signed language responses: case study evidence from amytal and cortical stimulation studies

A normally hearing left-handed patient familiar with American Sign Language (ASL) was assessed under sodium amytal conditions and with left cortical stimulation in both oral speech and signed English. Lateralization was mixed but complementary in each language mode: the right hemisphere perfusion severely disrupted motoric aspects of both types of language expression, the left hemisphere perfusion specifically disrupted features of grammatical and semantic usage in each mode of expression. Both semantic and syntactic aspects of oral and signed responses were altered during left posterior temporal-parietal stimulation. Findings are discussed in terms of the neurological organization of ASL and linguistic organization in cases of early left hemisphere damage.     

Shift of visual field preference for English words in native Hebrew speakers.

Lateralization for visual verbal material was tested with Hebrew and English stimuli presented to Israeli adolescents in their second, fourth, and sixth years of study of English as a second language. Seventy-two children, 12 male and 12 female subjects in each class, were tested by means of a target-word recognition task. Laterality scores derived from reaction-time measures resulted in: (1) a left visual field preference for the English stimuli in the youngest group which decreased with increasing age, becoming a right visual field preference in the oldest group, and (2) a significant and equal right visual field preference for Hebrew stimuli for all groups. The data suggest right hemisphere involvement in acquiring the reading skills of a new language.     

Bilateral capacity for speech sound processing in auditory comprehension: evidence from Wada procedures

Data from lesion studies suggest that the ability to perceive speech sounds, as measured by auditory comprehension tasks, is supported by temporal lobe systems in both the left and right hemisphere. For example, patients with left temporal lobe damage and auditory comprehension deficits (i.e., Wernicke's aphasics), nonetheless comprehend isolated words better than one would expect if their speech perception system had been largely destroyed (70-80% accuracy). Further, when comprehension fails in such patients their errors are more often semantically-based, than-phonemically based. The question addressed by the present study is whether this ability of the right hemisphere to process speech sounds is a result of plastic reorganization following chronic left hemisphere damage, or whether the ability exists in undamaged language systems. We sought to test these possibilities by studying auditory comprehension in acute left versus right hemisphere deactivation during Wada procedures. A series of 20 patients undergoing clinically indicated Wada procedures were asked to listen to an auditorily presented stimulus word, and then point to its matching picture on a card that contained the target picture, a semantic foil, a phonemic foil, and an unrelated foil. This task was performed under three conditions, baseline, during left carotid injection of sodium amytal, and during right carotid injection of sodium amytal. Overall, left hemisphere injection led to a significantly higher error rate than right hemisphere injection. However, consistent with lesion work, the majority (75%) of these errors were semantic in nature. These findings suggest that auditory comprehension deficits are predominantly semantic in nature, even following acute left hemisphere disruption. This, in turn, supports the hypothesis that the right hemisphere is capable of speech sound processing in the intact brain.     

Deficits in temporal sequencing of verbal material: The effect of laterality of lesion

Temporal sequencing of verbal materials (digits, words, and geometric forms) presented in two sensory modalities (auditory and visual) to three groups of subjects (Broca's with left anterior lesions, patients with right hemisphere lesions, and normals) was examined. Each subject was asked to point to a set of stimuli in the same sequence as presented by the examiner. Results indicated that patients with left hemisphere lesions were more impaired on all tasks than the right hemisphere lesioned patients who, in turn, were impaired compared to normal controls. Response to auditory presentation was superior to response to visual presentation. Also, digits were the easiest for all groups, and words were easier than geometric forms. Of special interest was the finding which suggested that right hemisphere lesions are associated with impairment of verbal temporal sequencing under either auditory or visual presentation.     

Lateral specialization and social-verbal development in preschool children

Forty-two 2 1/2- to 5 1/2-year-old children's social and verbal behaviors were observed during free play in a preschool. A test measuring lateral specialization of verbal function and a standardized psychometric test of verbal ability were also administered. Analysis of variance indicated that the right ear (left hemisphere) is predominant in processing verbal stimuli in children as young as 2 1/2. Multiple regression analyses revealed significant relations between the right ear accuracy score for dichotically presented verbal stimuli and both psychometrically measured verbal ability and a social-verbal factor score derived from play behavior. After the increase related to age was statistically partialled out from both verbal ability and social-verbal scores, verbal expression, length of verbal utterances, time spent in conversation, and peer social interactions increased and parallel play decreased as a function of right ear (left hemisphere) accuracy for verbal stimuli. The relationship between left ear (right hemisphere) accuracy scores for verbal stimuli and social-verbal behavior, however, was not linear. Very high and very low levels of left ear recall predicted an increase in the frequency of parallel play and low social-verbal behavior while moderate levels of left ear accuracy scores predicted the reverse.     

Right hemisphere language ability: 1. Clinical evidence

Evidence from a variety of clinical sources concerning the nature of language processing ability within the right cerebral hemisphere (RH) is reviewed. It appears that the RH is severely deficient with respect to the expressive functions of speech and writing, but it may possess a significant ability to comprehend language. It has been suggested that the ability of the RH in this respect may be extensive, but the generality of conclusions drawn seems to be suspect. Evidence from patients with left hemisphere damage suggests that in some circumstances the RH may ‘take over’ the performance of language functions from its inoperative partner. Further work should help clarify the conditions under which this takes place. The theory that reading in deep dyslexia is mediated by the RH is also reviewed. The idea that the RH is able to encode print stimuli into semantic but not phonological representations, and the possibility that it is selectively able to process imageable nouns, are two aspects of this theory that are consistent with other sources of evidence concerning RH language ability. However, support for the theory is far from unanimous, and the contradictory evidence is noted.     

From the left to the right: How the brain compensates progressive loss of language function

In normal right-handed subjects language production usually is a function oft the left brain hemisphere. Patients with aphasia following brain damage to the left hemisphere have a considerable potential to compensate for the loss of this function. Sometimes, but not always, areas of the right hemisphere which are homologous to language areas of the left hemisphere in normal subjects are successfully employed for compensation but this integration process may need time to develop. We investigated right-handed patients with left hemisphere brain tumors as a model of continuously progressive brain damage to left hemisphere language areas using functional neuroimaging and transcranial magnetic stimulation (TMS) to identify factors which determine successful compensation of lost language function. Only patients with slowly progressing brain lesions recovered right-sided language function as detected by TMS. In patients with rapidly progressive lesions no right-sided language function was found and language performance was linearly correlated with the lateralization of language related brain activation to the left hemisphere. It can thus be concluded that time is the factor which determines successful integration of the right hemisphere into the language network for compensation of lost left hemisphere language function.     

Bilateral language: Is the left hemisphere still dominant?

A 13-year-old left-handed boy with a left fronto-parietal vascular malformation evidenced bilateral symmetrical language representation at intracarotid amytal testing. Surgical resection of the parietal motor and frontal premotor area (sparing classical perisylvian language regions) for seizure control resulted in an acute aphasia. Language deficits were still apparent 3 months and to a lesser degree 1 year after surgery. This suggests that when language is bilateral and symmetrical, the left hemisphere may still be dominant or both hemispheres may be necessary to sustain full language competence. Explanations for atypical language localization within the left hemisphere are also discussed.     

Neuropsychological analysis of a case of crossed dysphasia verified at postmortem

A case is reported of crossed dysphasia in a right-handed monolingual patient, where neuropathological verification of the unilateral site of the lesion was obtained within a year of detailed neuropsychological assessment. The patient's pattern of language impairment was characterized by agrammatic speech and relatively preserved naming ability. In addition, the patient had good repetition, poor comprehension, and marked impairment on visuospatial tasks. Neuropathological investigations showed a large area of infarction affecting cortex, white matter, and subcortical structures in the right hemisphere. The possibility is discussed of a distinction between two types of crossed dysphasia with either dissociated or simultaneous language and visuospatial deficits due to reversed representation of hemispheric specific functions or transfer of most cognitive functions to the right hemisphere.     

Psychometric and CT scan measurements in a case of crossed aphasia in a dextral

A case of crossed aphasia with lesion deep to the right supramarginal gyrus was studied to determine (1) if this patient behaved similar to patients with the same lesion site in the left hemisphere, (2) if visuospatial deficits were present, and (3) if the CT scan asymmetries were similar to those of other right-handers. Speech and language skills were similar to those patients with similar lesions in the left hemisphere. Visuospatial and arithmetic deficits were similar to those described after right-hemisphere and left-hemisphere damage. CT scan asymmetries were atypical. These results provide behavioral and neuroradiological confirmation of atypical hemispheric dominance.     

Hemispheric predominance assessment of phonology and semantics: a divided visual field experiment

The aim of the present behavioural experiment was to evaluate the most lateralized among two phonological (phoneme vs. rhyme detection) and the most lateralized among two semantic ("living" vs. "edible" categorization) tasks, within the dominant hemisphere for language. The reason of addressing this question was a practical one: to evaluate the degree of the hemispheric lateralization for several language tasks, by using the divided visual presentation of stimuli, and then choose the most lateralized semantic and phonological for mapping language in patients by using fMRI in future studies. During the divided visual field experiment by using words (semantic tasks) and pseudo-words (phonological tasks) as stimuli, thirty-nine right-handed participants were examined. Our results have shown that all tasks were significantly left hemisphere lateralized. Furthermore, the rhyme was significantly more lateralized than phoneme detection and "living" was significantly more lateralized than "edible" categorization. The rhyme decision and "living" categorization will be used in future fMRI studies for assessing hemispheric predominance and cerebral substrate for semantics and phonology in patients. Our results also suggest that the characteristics of stimuli could influence the degree of the hemispheric lateralization (i.e., the emotional charge of stimuli for words and the position of the phoneme to be detected, for pseudo-words).     

Hemispheric lateralization in 47,XXY Klinefelter's syndrome boys

Thirty-two boys with a 47,XXY karyotype were compared with chromosomally normal male controls in their performance on six tasks of hemispheric specialization. The results revealed that the 47,XXY subjects had smaller asymmetries on left hemisphere tasks and larger asymmetries on right hemisphere tasks than controls. Analyses of individual right and left side scores revealed that the atypical lateral asymmetries of the 47,XXYs were due to a shift toward greater right hemisphere involvement on four of the six measures. It was postulated that the slower fetal growth rates of the extra X chromosome group might contribute to their atypical hemispheric specialization and the failure of their left hemisphere to gain dominance over their right in language processing.     

Cerebral mechanisms for understanding emotional prosody in speech

Hemispheric contributions to the processing of emotional speech prosody were investigated by comparing adults with a focal lesion involving the right (n = 9) or left (n = 11) hemisphere and adults without brain damage (n = 12). Participants listened to semantically anomalous utterances in three conditions (discrimination, identification, and rating) which assessed their recognition of five prosodic emotions under the influence of different task- and response-selection demands. Findings revealed that right- and left-hemispheric lesions were associated with impaired comprehension of prosody, although possibly for distinct reasons: right-hemisphere compromise produced a more pervasive insensitivity to emotive features of prosodic stimuli, whereas left-hemisphere damage yielded greater difficulties interpreting prosodic representations as a code embedded with language content.     

Stimulus categorization by brain-damaged patients

Patients with localized insult to the right hemisphere, or to either the anterior or the posterior portion of the left hemisphere, as well as neurologically intact controls, evaluated stimuli on a seven-point rating scale for their degree of category membership. The stimuli were taken from one of two continua, one composed of fruit and vegetable items, and the other of items differing in hue and shape. Different subsets of stimuli provided different contexts for the judgments of category membership. The two left-hemisphere groups showed anomalies in categorizing the fruit and vegetable items but not the perceptual items, while the reverse was true for the right-hemisphere patients. Moreover, both left-hemisphere groups demonstrated context effects in their judgments of the representativeness of the fruit and vegetable items, but differed in the way in which they responded to changing contexts. Left posterior patients demonstrated weak category boundaries and even reclassified items. In contrast, patients with left anterior damage showed highly categorical responses and less differentiation of items within a category. All groups showed striking context effects in judgments of perceptual items in terms of changes in representativeness ratings and the location of a category boundary. Alternative interpretations of the results are offered.