A study of spelling in aphasia

To secure systematic information on spelling abilities following damage to the dominant hemisphere, a test probing performance in three modalities of response was administered to a group of aphasic patients. Except for a predictable deficit among anterior aphasics in oral spelling, anterior and posterior aphasics exhibited comparable performances on the measures of spelling. However, anterior and posterior aphasics differed from one another on the kinds of words they most accurately spelled, the errors they were prone to make, and certain strategies which they characteristically adopted. These results suggest two alternative approaches to spelling: one approach, common in posterior aphasics, entails choosing letter combinations on the basis of their customary sounds; a second approach, common among anterior aphasics, appears to rely on a partially preserved image of the word's appearance.     

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.     

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.     

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.     

Time for auditory processing of object names by aphasics

Ten Wernicke's and ten Broca's aphasics were compared with normal controls and brain-damaged nonaphasics with respect to the time required for the auditory decoding of object names. This value was obtained by using a subtraction method with two reaction time determinations, one of which included an auditory processing phase while the other did not. The overall mean of approximately 200 msec for Broca's aphasics did not differ significantly from the normal, while the mean of 650 msec for the Wernicke aphasics was much slower. All groups responded more quickly to high-frequency than low-frequency words and all but the Wernicke aphasics improved in the second trial block over their performance in the first trial block.     

Verb processing during sentence comprehension in aphasia

This study examines verb processing during on-line sentence comprehension in aphasia. We describe two experiments that explore whether a group of Broca's aphasics, who were agrammatic in comprehension as well as speech, a group of fluent aphasics, and a group of normal controls are sensitive to the argument structure arrangements of verbs. Subjects had to perform a complex secondary task both in the immediate vicinity of the verb and also at a point well past the verb while listening to sentences for meaning. Reaction times to this secondary task show that both normal controls and agrammatic Broca's aphasic subjects activate multiple argument structure possibilities for a verb in the vicinity of the verb, yet at a point downstream from the verb such effects disappear. These data suggest that the problems agrammatic subjects show with verbs in sentence comprehension, and the general lexical access deficit also recently claimed to be part of the agrammatics' problem, may not extend to the real-time processing of verbs and their arguments. Fluent aphasic subjects, on the other hand, do not show sensitivity to the argument structure properties of verbs, suggesting that these patients may have a semantic-like sentence processing deficit.     

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.     

Comparison of the performances of a fluent and a nonfluent aphasic on a pantomimic referential task

The pantomimic performances of a typical Broca's (nonfluent) and Wernicke's (fluent) aphasic were compared with each other and with four normal control subjects on a simple task of nonverbal referential communication. Both aphasic subjects demonstrated only about 50% accuracy in their pantomimic communication. Also, measures were obtained of the motoric fluency of the pantomimes of all subjects and comparisons were made between the fluent and nonfluent aphasics. These measures demonstrated distinct differences in the fluency patterns of the pantomimes of the two aphasic subjects similar to the differences in speech fluency which distinguish and characterize these two types of aphasia; that is, the fluent aphasic pantomimed fluently and like the control subjects and the nonfluent aphasic pantomimed nonfluently. The quantitative and qualitative similarities in the fluency patterns of the speech and the pantomimic behaviors of the aphasic subjects are discussed in terms of their implications for a definition of aphasia.     

Effects of nonlinguistic auditory variations on lexical processing in Broca's aphasics

In a series of experiments, the effect of white noise distortion and talker variation on lexical access in normal and Broca's aphasic participants was examined using an auditory lexical decision paradigm. Masking the prime stimulus in white noise resulted in reduced semantic priming for both groups, indicating that lexical access is degraded by nonlinguistic white noise distortion. However, talker variation within a prime-target pair had no effect upon the performance of either the normal or aphasic individuals. The absence of a talker variation effect suggests that voice-specific information is not encoded in the lexical representations of words. The normal performance of Broca's aphasics under conditions of both white noise and talker variation supports the view that these patients have a lexical processing impairment rather than a more generalized language deficit characterized by limited computational resources.     

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.     

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.     

Sentence comprehension by Broca's aphasics: Effects of some suprasegmental variables

Three subtests of comprehension (one of varying sentential stress, one of shifting juncture, and one of applying emphatic stress to functors) were administered to eight Broca's aphasics and eight controls to determine the effects of stress and juncture on disambiguation of these sentences. Data indicated that the aphasic group performed significantly worse than the normals on all three subtests of comprehension. In addition, there was a strong positive correlation between severity of aphasia and error scores for all three tests. Results are discussed in relation to intact-vs.-disordered comprehension.     

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.     

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.     

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.     

The effects of grammatic class and cue type on cueing responsiveness in aphasia

This study investigated the effects of two types of cues (semantic and phonemic) and two grammatic classes (noun and verb) on cueing responsiveness. Subjects consisted of 10 Broca's, 10 Wernicke's, 8 conduction, and 8 anomic aphasics. Cues were administered following failure to name on confrontation. Responsiveness to the two types of cues was dependent on aphasic type and grammatic class. Broca's and conduction aphasics responded better to phonemic cueing, while anomic aphasics were more responsive to semantic cueing. With regard to grammatic class, aphasics responded better to phonemic cueing on nouns; however, no significant difference between types of cues was demonstrated on verbs. Neuropsychological implications for the cueing and naming processes are discussed.     

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.     

The selective impairment of phonological processing: A case study

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

Reading and listening comprehension in Broca's aphasia: Lexical versus syntactical errors

Ten agrammatic Broca's aphasics were presented with a series of four picture plates together with a spoken or written sentence stimulus. All sentence stimuli were of the structure, the + N + is/are + V + ing + the + N. The four pictures on each stimulus plate represented (a) the correct response, (b) a reversal of the stimulus sentence subject and object, (c) a change in the number of the subject of the stimulus sentence, and (d) a change in one of the major lexical items of the stimulus sentence. Subjects selected the correct picture most often. When they erred, they usually selected a subject-object reversal. Number errors were less frequent, and the patients seldom selected a change in major lexical item. This pattern occurred with both written and spoken sentences. These results were interpreted as reflecting the dependence of agrammatic Broca's aphasics on the semantic interpretation of the lexicon for decoding sentences in the face of deficits in syntactical-grammatical interpretation, irrespective of comprehension modality.