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.     

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.     

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.     

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.     

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.     

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.     

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.     

Lexical decision in sentences: Effects of syntactic structure

A lexical decision paradigm was used to examine syntactic influence on word recognition in sentences. Initial fragments of sentences were presented visually (CRT display) one word at a time (at reading speeds), from left to right. The string terminated with the appearance of a lexical decision target. The grammatical structure of the incomplete sentence affected lexical decision reaction time (RT). In Experiment 1, modal verb contexts followed by main verb targets and preposition contexts followed by noun targets produced lower RTs than did the opposite pairings (i.e., modal/noun and preposition/verb). In Experiment 2, transitive verb contexts followed by noun targets and subject noun phrase contexts followed by verb targets yielded lower RTs than did the opposite pairings. Similar contrasts for adjective targets did not yield comparable effects in Experiment 2, but did when the adjective was the head of a predictable phrase (Experiment 4). In Experiment 3, noun targets yielded lower RTs than did verb targets after contexts of a transitive verb followed by a prepositional phrase. An account of these effects is offered in terms of parsing constraints on phrasal categories.     

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.     

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.     

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.     

Summation priming in aphasia: evidence for alterations in semantic integration and activation

The present study used a lexical decision paradigm to study the summation of priming effects in normal and aphasic participants. The amount of priming produced by pairs of definitionally converging associative words was compared to the amount of priming produced by pairs of single associative words and non-words in two experiments in which the ISI between primes and targets varied from 200 ms (Experiment 1) to 600 ms (Experiment 2). Control subjects showed a pattern of additive summation priming at the short ISI and overadditive summation priming at the longer ISI. Broca's aphasics showed overadditive priming at the short ISI and no significant priming at the longer ISI; Wernicke's aphasics showed no significant priming at the short ISI and additive priming at the longer ISI. These results suggest that aphasics differ from normals in their ability to integrate the activation derived from multiple linguistic associations and may provide an account of some of the clinical phenomenology of these patients.     

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 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.     

The role of lexical competition and acoustic-phonetic structure in lexical processing: evidence from normal subjects and aphasic patients

This study examined the effects that the acoustic-phonetic structure of a stimulus exerts on the processes by which lexical candidates compete for activation. An auditory lexical decision paradigm was used to investigate whether shortening the VOT of an initial voiceless stop consonant in a real word results in the activation of the lexical-semantic network of its voiced competitor, i.e., does acoustically modified time prime penny via dime. Results for normal subjects showed semantic priming for related pairs and mediated priming for voiced competitors, consistent with cascade models of language processing allowing for interaction between phonological and semantic levels of processing. Although Broca's aphasics showed semantic priming (dime primed penny), they failed to show priming in the context of a lexical competitor. These results are consistent with the hypothesis that these patients have a lexical processing deficit characterized by an overall reduction in lexical activation.     

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.     

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.     

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.     

Effect of lexical cues on the production of active and passive sentences in Broca's and Wernicke's aphasia

This study compared the sentence production abilities of individuals with Broca's and Wernicke's aphasia in an attempt to explore the extent to which impaired lexical retrieval impedes sentence production. The ability to produce active and passive reversible and non-reversible sentences was examined when varying amounts of lexical information was provided. The results showed that both Wernicke's and Broca's aphasic individuals were impaired in passive sentence production and that these difficulties were not overcome when lexical cues (the relevant nouns and uninflected verb) were provided. However when auxiliary and past tense morphemes were provided along with the verb stem, production of passive sentences improved drastically for both groups. Analysis of error patterns, however, revealed differences between the two groups, suggesting that Broca's aphasic subjects may find passive sentences difficult due to problems with retrieving the relevant grammatical morphemes. Subjects with Wernicke's aphasia may have been unable to automatically access the passive sentence structure.