Semantic disorders of auditory language comprehension in right brain-damaged patients

A test of auditory language comprehension was given to 110 right brain-damaged patients and to 94 normal controls in order to check if patients with lesions of the right (nondominant) hemisphere make a significantly higher number of semantic errors than normals. Confirmation of the hypothesis was obtained, but the relationship between semantic errors and lesion of the right hemisphere did not seem a simple and direct one. In fact, most of the lexical-semantic errors were due to associated variables (such as unilateral spatial agnosia and general mental deterioration) and not to the lesion of the right hemisphere per se. These data do not suggest a specific semantic capacity of the nondominant hemisphere but rather stress the fragility of the lexical-semantic organization at the cortical level.This work was assisted by a grant from C.N.R. (Consiglio Nazionale delle Ricerche).     

Deep agraphia

A case of agraphia is documented which resembles in every respect the pattern of results obtained in deep dyslexia. Pronounceable pseudowords could not be written to dictation while concrete nouns were more accurately transcribed than abstract nouns. Verbs and functions words were written very poorly and oral spelling was impaired. In addition, semantic paragraphias were present. In contrast to the deficit observed in writing, no such impairment was found for reading. It is concluded that writing can occur without phoneme-grapheme conversion and that codes generated for reading are functionally distinct from codes generated for writing.     

Pure agraphia and Gerstmann's syndrome as a visuospatial-language dissociation: an experimental case study

A right-handed man suffered a left parieto-occipital cerebral infarction, causing agraphia with Gerstmann's syndrome but without major aphasia, alexia, or apraxia. Oral spelling was superior to written spelling. Experiments were performed involving (1) analysis of errors in writing, (2) tasks of visual imagery, and (3) identifying letters drawn without leaving a visual trace. The results suggest that the agraphia and Gerstmann's syndrome are due to a dissociation of language skills and visuospatial skills caused by a dominant parieto-occipital lesion.     

Multiple component agraphia in a patient with atypical cerebral dominance: an error analysis

A 52-year-old man with atypical cerebral dominance (left-handed for writing but mixed handedness for other tasks) suffered an extensive right hemisphere stroke, resulting in a combination of deficits that has not been previously reported. There were profound visual constructive and visual perceptual disturbances and a spatial agraphia, which were consistent with a nondominant hemisphere lesion. There was also a severe apraxic agraphia, which is typically associated with a dominant hemisphere lesion, but no other signs of dominant hemisphere dysfunction such as linguistic disturbance or limb-motor apraxia were present. This case serves to highlight the functional and anatomical relationship between handwriting and other forms of praxis; the various sources of error in letter formation; the need to be specific in labeling and describing agraphias ; and the role of a detailed analysis of writing errors in delineating the neuropsychological processes involved in handwriting.     

Written spelling agraphia

When a disorder of single word writing is seen in conjunction with preserved oral spelling and intact written grapheme formation ("written spelling agraphia"), the deficit may be presumed to lie somewhere between letter choice and written motor output. Two potential deficits are considered: (1) visual letter codes are not activated properly and (2) the information contained within properly activated visual letter codes fails to reach intact graphic motor patterns. Two patients with written spelling agraphia were each given a series of tests aimed at distinguishing between the two possibilities. Results suggest that the written spelling agraphia seen in these two patients arises from different underlying deficits. The results are discussed in terms of the patients' CT scan lesion sites, which were markedly different.     

An analysis of writing in a case of deep dyslexia

In tests of her ability to produce written and spoken language, this deep dyslexic patient produced semantic, visual, and derivational errors, including functor substitutions, and exhibited part-of-speech and abstractness effects in oral reading, oral and written naming, and writing to dictation, but not in repetition of single words and copying from memory. This patient therefore provides confirmation of the hypothesis presented in Nolan and Caramazza (1982) that the defining symptoms of deep dyslexia will be observed in responses to any task which requires lexical mediation. The patient's written responses in all tasks but direct copying were characterized by spelling errors which included transpositions, omissions, substitutions, and additions of letters. A model of writing is proposed which explains these errors in terms of a disruption of a phoneme-grapheme conversion process which normally functions to prevent decay of information from a Graphemic Buffer.     

Linguistic semantic agraphia: A dissociation of the lexical spelling system from semantics

Two spelling systems have been described. The phonological system transcodes speech sounds to letters and is thought to be useful for spelling regular words and pronounceable nonwords. Although the second system, the lexical-semantic system, is thought to use visual word images and meaning to spell irregular words, it is not known if this system is dependent on semantic knowledge. We used a homophone spelling test to examine the lexical-semantic system in five patients. The patients were asked to spell individual homophones (doe or dough) using the context of a sentence. Semantically incorrect and correct homophones were spelled equally well, whether they were regular or irregular. These results demonstrate that an irregular word may be spelled without knowledge of the word's meaning. Therefore, the lexical system can be dissociated from semantic influence.     

语义距离半球效应的ERP研究

以通过视觉通路呈现的汉语双字词为实验材料,操纵启动词与目标词的语义距离。在词汇决定实验中记录ERP,发现：（1）除N300外,P240亦对语义距离敏感,它可能是一种与语义加工有关的新的ERP成分;（2）P240在头皮中央偏左的部位较早出现,但在头皮右侧波幅较大;（3）N300和P240都不存在语义距离的半球效应,该结果没有证实右脑更专擅远距离语义加工的假设,表明使用汉语与使用拼音文字的脑机制存在差异。     

Apractic agraphia in a patient with normal praxis

Most right-handed crossed aphasics are not apractic. They usually have agraphia characterized by misspellings but retain the ability to write well-formed graphemes. We describe a right-handed patient with a right parietal lesion who was aphasic and not apractic. He was unable to write any formed graphemes despite a relatively preserved ability to spell aloud. We postulate that praxis and writing are dissociated in this patient because the motor engrams for praxis were located in his left hemisphere and the engrams for writing were in his right hemisphere. In addition, he comprehended commands for limb motor activities (praxis) far better than he comprehended other speech. This suggests that in this patient the areas used to comprehend limb motor commands may be anatomically distinct from areas important in comprehending other aspects of speech.     

Developmental dysgraphias

Two cases of developmental dysgraphia are presented. These ten-year-old children are of at least average intelligence and vocabulary, with normal speech and no known neurological abnormality. Psycholinguistic investigations reveal that although performance for the two cases is quantitatively similar, there are marked qualitative differences: The majority of R.B.'s spelling errors are phonologically plausible, and she is better at spelling regular than irregular words. Non-word spelling is as good as word spelling. The pattern of spelling deficit is consistent with the label surface dysgraphia. A phonological route to spelling has developed in relative isolation from a lexical-semantic route to spelling. A.H.'s spelling contrasts in a number of ways with R.B.'s. Fewer than 1/5 of his spelling errors are phonologically plausible, and the spelling of regular words is no better than the spelling of irregular words. A.H. may have impaired development of the segmentation component of the phonological route and therefore be overreliant on an, albeit imperfect, lexical-semantic spelling route. Normal children at the same spelling level display patterns of performance similar to R.B. but differ quantitatively from A.H.     

Dissociations of writing and praxis: Two cases in point

For normal writing it is essential that both motoric and linguistic competence be present; disruption of one or the other of these faculties may result in qualitatively different types of agraphia. Two right-handed patients became agraphic after left hemisphere lesions; pure apraxic agraphia in the absence of limb apraxia developed in one patient and pure linguistic agraphia in association with severe ideomotor limb apraxia in the other. The performance of these patients not only serves to illustrate the dissociation between the motoric and linguistic faculties that underlie writing but also confirms that ideomotor limb apraxia and apraxic agraphia are distinct and dissociable entities.     

Ideogram writing in a disconnection syndrome

A case of disconnection-type agraphia coupled with alexia was reported. The patient showed several asymmetrical manual capacities between the two hands, i.e., dissociated difficulty of Kanji (ideogram) writing between the two hands, left unilateral difficulty of Kana (phonogram) writing, right unilateral dyscopia of letters as well as geometrical figures, and right unilateral difficulty in drawing without a model. Anatomically, lesions involved most of the corpus callosum in its posterior portion including the splenium and the left medial occipital lobe. From these data, a possible liguistic capacity of the right hemisphere was suggested.     

Developmental phonological and lexical agraphia in adults

Many cases of agraphia from acquired cerebral lesions may be divided into two groups, phonological and lexical, suggesting two dissociable spelling systems. Studies of developmental agraphia have described some children who have spelling patterns similar to acquired phonological or lexical agraphia. This study analyzed spelling results from 22 adolescent and adult subjects with developmental agraphia (DA) and compared them to those from control subjects and subjects with acquired agraphia (AA). On the basis of spelling ability, subjects with DA could be divided into two groups. Analysis of the profile of spelling abilities indicated that the two groups of subjects with DA were almost indistinguishable from the two groups of subjects with AA, phonological and lexical. This supports the contention that DA in adults may be divided into phonological and lexical groups and further supports the two-system hypothesis for linguistic agraphia.     

Disruption of semantic influence on writing following a left prefrontal lesion

We report a patient with impaired spontaneous writing, written naming, and homophone spelling, consistent with a disruption of semantic influence on writing. However, writing to dictation by both the phonological and lexical spelling systems was intact. In addition, general semantic abilities were spared, as indicated by preserved auditory and reading comprehension. We propose that our patient could not incorporate meaning into writing because of a disruption of both direct and indirect connections between semantics and the orthographic output lexicon. The writing dysfunction was accompanied by a similar impairment of speech output, suggesting that it was part of a more general disturbance of semantic influence on language production following left prefrontal damage.     

Priming nouns and verbs: differential influences of semantic and grammatical cues in the two cerebral hemispheres

The current experiment investigated how sentential form-class expectancies influenced lexical-semantic priming within each hemisphere. Sentences were presented that led readers to expect a noun or a verb and the sentence-final target word was presented to one visual field/hemisphere for a lexical decision response. Noun and verb targets in the semantically related condition were compared to an unrelated prime condition, which also predicted part of speech but did not contain any lexical-semantic associates of the target word. The semantic priming effect was strongly modulated by form-class expectancy for RVF/LH targets, for both nouns and verbs. In the LVF/RH, semantic priming was obtained in all conditions, regardless of whether the form-class expectancy was violated. However, the nouns that were preceded by a noun-predicting sentence showed an extremely high priming value in the LVF/RH, suggesting that the RH may have some sensitivity to grammatical predictions for nouns. Comparisons of LVF/RH priming to calculations derived from the LSA model of language representation, which does not utilize word order, suggested that the RH might derive message-level meaning primarily from lexical-semantic relatedness.     

Effects of spelling errors on the perception of writers

The authors investigated the perceived relationship between spelling errors and cognitive abilities in a series of 3 experiments. Specifically, they examined whether college students' ratings of an author's intellectual ability, logical ability, and writing ability were affected by the presence of spelling errors. In the 1st experiment, the presence of 4 spelling errors in a short essay did not significantly affect the ratings. The spelling ability of college students, as measured by a standard oral dictation spelling test, was moderately conelated with a brief test of intelligence. In a 2nd experiment, college students rated the author of a short essay as having lower ability when there was a large number of spelling errors. The effect was more pronounced on the ratings of writing ability than it was on the ratings of logical ability or intellectual ability. This finding was replicated in a 3rd experiment, in which the essay contained misspellings actually made by writers. The results suggest that spelling errors can affect how people perceive writers, particularly when there are many spelling errors. College students appear to attribute spelling errors more to writing ability than they do to general cognitive abilities such as intelligence and logical ability.     

The Continuum of Deep/Surface Dyslexia

A right-handed male sustained traumatic brain injury which resulted in anomia, dyslexia, and agraphia. The most severe CT (computed tomography)-identified brain damage was located in the right parieto-temporal lobe. In the first months following the injury, the pattern of reading errors was similar to that associated with deep dyslexia. However, nonlexical derivation of phonology from print was not abolished. As the patient's ability to associate letter patterns with sounds improved, oral reading also improved. Although he no longer produced semantic errors in oral reading, he continued to produce oral reading errors that were visually and phonologically related to the targets. Four months after the injury, the error pattern observed in the patient's oral reading was consistent with very mild surface dyslexia. The significance of these observations to dual-deficit models of acquired dyslexia is discussed, as are their implications for rehabilitation.     

Pure agraphia in Romaji after left inferior frontal gyrus infarction: A case of selective deficit in syllable-to-grapheme conversion in Japanese

The Japanese writing system employs two distinct categories of characters: Kana and Kanji. The difference between Kana and Kanji writing corresponds roughly to that between phonological and lexical systems in Western languages. When typing, most Japanese use alphabetical characters based purely on phonological rules. In particular, the Romaji system is used, in which a syllable consists of a single vowel, a consonant–vowel compound (e.g., ka, ki), or a sequence of consonant–y(semivowel)–vowel (e.g., kya, kyu). We describe a right-handed Japanese patient who developed pure agraphia that affected Romaji writing but preserved Kana and Kanji writing and who had a lesion in the left pars opercularis of the inferior frontal gyrus that extended to the anterior precentral gyrus. The patient demonstrated literal paragraphia in spelling Romaji across modalities. Our findings suggested that the patient’s agraphia in Romaji after a confined left frontal infarction was manifested by a selective impairment in syllable-to-grapheme conversion.     

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.