The impact of graphomotor demands on letter-like shapes recognition: A comparison between hampered and normal handwriting

Recent research suggests that graphic motor programs acquired through writing are part of letter representations and contribute to their recognition. Indeed, learning new letter-like shapes through handwriting gave rise to better recognition than learning through methods suppressing the graphomotor activity (e.g., typing or viewing). The present study aimed at further assessing the role of the graphic motor programs in letter-like shape recognition by disturbing the graphomotor activity during learning. We compared recognition performance following normal handwriting to recognition performance following hampered handwriting. Adult participants learned sets of symbols by copying them either with a standard pen or with a hampering writing tool. Recognition tests were administered immediately after the learning phase and again one week later. The results revealed lower recognition accuracy following hampered handwriting than following normal handwriting suggesting a contribution of graphomotor skills in the construction of letter representation.     

Production of graphic symbol sentences by individuals with aphasia: efficacy of a computer-based augmentative and alternative communication intervention

The study employed a single-subject multiple baseline design to examine the ability of 9 individuals with severe Broca's aphasia or global aphasia to produce graphic symbol sentences of varying syntactical complexity using a software program that turns a computer into a speech output communication device. The sentences ranged in complexity from simple two-word phrases to those with morphological inflections, transformations, and relative clauses. Overall, results indicated that individuals with aphasia are able to access, manipulate, and combine graphic symbols to produce phrases and sentences of varying degrees of syntactical complexity. The findings are discussed in terms of the clinical and public policy implications.     

Nonspeech and speech processing skills in patients with aphasia and apraxia of speech

Nonspeech and speech auditory processing skills as well as internal speech processing skills were assessed among four patients with acquired "pure" apraxia of speech, 10 with acquired aphasia, 10 with aphasia plus apraxia of speech, and 11 neurologically normal adults. Fourteen tasks were administered and performances on 68 variables were examined using both nonparametric and parametric analyses controlling for the effects of advancing age and associated hearing loss. In all cases, the "pure" apractic patients performed as normal subjects. Few differences were noted among the performances of the aphasic and aphasic-apractic subjects. Results led to three major conclusions: (1) apraxia of speech is a disorder distinct from aphasia; (2) aphasic individuals, despite locus of lesion, demonstrate disabilities for processing nonspeech and speech materials presented auditorily and for analytically evaluating speech evoked internally; and (3) aphasic individuals demonstrating similar severity levels of language impairment show similar performance patterns for these types of processing tasks, despite locus of lesion or coexistence of apraxia of speech.     

Amer-Ind versus ASL: recognition and imitation in aphasic subjects

The imitation and recognition ability of brain-damaged and normal subjects was tested for 30 pairs of semantically matched ASL signs and corresponding Amer-Ind gestures. Subjects were rated according to severity and site of lesion. They were 6 nonaphasic, right-hemisphere brain-damaged subjects, 12 aphasic subjects, and 12 non-brain-damaged geriatric subjects. Results indicated that the Amer-Ind gestures were significantly easier to imitate and to recognize than the matched ALS signs. The relationships between these gestural abilities and severity of aphasia, site of lesion, Amer-Ind transparency ratings, and subjects' performance on a standardized aphasia test are outlined. The theoretical implications that concern the neural systems which mediate spoken and limb gestures are discussed.     

Effects of Damage to Right-Hemisphere Brain Structures on Spontaneous Emotional and Social Judgments

Recent work in cognitive and social neuroscience has focused on the neural substrates of social judgment. The present study explores the effects of damage to the right-hemisphere somatosensory cortices (RSS), a region known for its role in emotion recognition. Seven subjects with RSS damage were shown a short movie depicting objects that move in socially suggestive ways, a stimulus that typically elicits spontaneous social and emotional attributions from normal subjects. The spontaneous verbal responses of RSS-damaged subjects to this movie were compared to those of normal subjects as well as brain-damaged control subjects; the data were derived using a word count and categorization computer program. This method measures spontaneous social and emotional judgments rather than the more typical rating and labeling measures used in neuropsychological studies of social judgment. As predicted, relative to brain-damaged and normal controls, subjects with RSS damage reacted to the stimulus movie with fewer words in categories describing emotional and social processes, despite using a similar total number of words (and slightly more words describing movement, a control category). These results provide further evidence for the role of the RSS in social/emotional processing and identify a role for the RSS in automatic representation in ourselves of body states of others to foster emotion recognition and social cognition.     

Differential effects of unilateral lesions on language production in children and adults.

We present the first direct comparison of language production in brain-injured children and adults, using age-corrected z scores for multiple lexical and grammatical measures. Spontaneous speech samples were elicited in a structured biographical interview from 38 children (5-8 years of age), 24 with congenital left-hemisphere damage (LHD) and 14 with congenital right-hemisphere damage (RHD), compared with 38 age- and gender-matched controls, 21 adults with unilateral injuries (14 LHD and 7 RHD), and 12 adult controls. Adults with LHD showed severe and contrasting profiles of impairment across all measures (including classic differences between fluent and nonfluent aphasia). Adults with RHD (and three nonaphasic adults with LHD) showed fluent but disinhibited and sometimes empty speech. None of these qualitative or quantitative deviations were observed in children with unilateral brain injury, who were in the normal range for their age on all measures. There were no significant differences between children with LHD and RHD on any measure. When LHD children were compared directly with LHD adults using age-corrected z scores, the children scored far better than their adult counterparts on structural measures. These results provide the first systematic confirmation of differential free-speech outcomes in children and adults and offer strong evidence for neural and behavioral plasticity following early brain damage.     

Aphasic performance on a lexical decision task: multiple meanings and word frequency

The lexical access of words varying in the number of meanings and frequency of occurrence was examined in fluent and nonfluent aphasic individuals and a control group of non-brain-damaged adults, using a lexical decision task. Fluent aphasic subjects performed similarly to nonfluent aphasic and normal subjects, showing that words with a high number of meanings and with a high frequency of occurrence were recognized as real words faster than words with few meanings or a low frequency of occurrence. While previous research has demonstrated that the number of meanings associated with a word exerts a powerful influence on the internal lexicon of normals, the results of this study suggest that brain damage resulting in aphasia does not disrupt this semantic organization.     

Narrative comprehension in adults with right and left hemisphere brain-damage: theme organization.

The effects of delayed presentation of a central theme on the comprehension and interpretation of narratives were investigated in adults with right and left hemisphere brain-damage and normal individuals. The performance of subgroups of the subjects with right and left hemisphere brain-damage also was examined. Right hemisphere brain-damaged groups with anterior and posterior lesions were significantly less accurate and identified significantly fewer central themes when central theme presentation was delayed until the end of a narrative than when the theme was presented at the beginning. Subjects with anterior right hemisphere brain-damage produced significantly more embellishments and confabulations than subjects with posterior damage and non-brain-damaged controls, regardless of theme condition. The performance of non-brain-damaged subjects and subjects with fluent and nonfluent aphasia was unaffected by the organization of the central theme in the narratives.     

Illiteracy and brain damage. 2. Manifestations of unilateral neglect in testing "auditory comprehension" with iconographic materials

This report concerns the sentence-picture matching behavior of 100 neurologically healthy and 169 brain-damaged subjects, all of whom were unilingual adult right-handers. Within this population, 144 subjects were totally unschooled illiterates and the remaining 125 had received school education and thereafter had retained writing skills and reading habits. Brain-damaged subjects were tested less than 2 months after a first left- or right-hemisphere stroke. All subjects were administered an aphasia screening battery including, among other subtests, a set of six sentence-picture matching stimuli. For each of these six stimuli, subjects heard a sentence uttered by the examiner and were then requested to match this sentence with one of four drawings presented within a single display divided into four quadrants of equal surface. Three sentences were syntactically "simple" (noun subject + verb) and three were relatively more "complex" (noun subject + verb + one or two noun complements). Evidence of unilateral neglect was found in both left- and right-brain-damaged illiterates and literates. Moreover, the right neglect of left-brain-damaged subjects was manifest mostly when target sentences were relatively "complex" whereas the left neglect of right-brain-damaged subjects was manifest irrespective of the syntactic complexity of target sentences. Our data are interpreted as indicative of an interaction between two cognitive disorders resulting from dysfunctions of asymmetrically represented cognitive mechanisms. The implications of these findings with respect to clinical and research aphasia testing are discussed.     

Reaction times of severe Broca's aphasics to monaural verbal stimuli

Reaction times of nine subjects with severe Broca's aphasia were measured to verbal stimuli presented monaurally to their left or right ears. The aphasic subjects showed left-ear advantages in reaction times to verbal stimuli, paralleling dichotic findings among aphasic patients. The results are interpreted as consistent with right-hemisphere language processing.     

Aphasia in left-handers. Comparison of aphasia profiles and language recovery in non-right-handed and matched right-handed patients.

The present retrospective analysis reports two studies. In Study 1, clinical aspects of aphasia are compared in right-handed (RH) and non-right-handed (NRH) patients; in Study 2, recovery from aphasia is compared in RH and NRH aphasic patients with a minimum of 5 months of daily language rehabilitation. From a continuous series of 1200 brain-damaged subjects, 24 NRH patients with a vascular lesion documented by computerized tomography were selected. In 19 cases the lesion was in the left hemisphere and in 5 cases in the right hemisphere. For 14 NRH patients, a RH subject with similar lesion, matched for age, education, length of illness, etiology (ischemic vs. hemorrhagic), and, when possible, sex was found. Presence and type of aphasia were compared in the two patients of the same pair and were found similar except for Pair 14; the RH subject had global aphasia and the NRH had conduction-like aphasia. Fifteen NRH patients were rehabilitated and reexamined at least 5 months after the first examination. Recovery of the 12 patients with a left-hemisphere lesion was compared with recovery of a group of RH subjects and no significant differences were found. Recovery of the three patients with right-hemisphere lesions is described. It is concluded that differences in type of aphasia and recovery between RHs and NRHs have been overemphasized in the past and must be reconsidered.     

The usefulness of the Western Aphasia Battery for differential diagnosis of Alzheimer dementia and focal stroke syndromes: preliminary evidence.

We assessed the usefulness of the Western Aphasia Battery for distinguishing the language disturbances caused by Alzheimer dementia (AD) from those caused by stroke. Using discriminant function analyses, the multiple variable "aphasia quotient--reading quotient--writing quotient" classified 29 (72.5%) of the 40 patients correctly. These 29 patients included 8 of 10 patients with left hemisphere infarction and fluent aphasia; 6 of 10 with AD; 5 of 10 patients with right hemisphere infarction; and all 10 of the neurologically normal control subjects. The patients with AD and those with right hemisphere stroke were the most difficult to classify using the aphasia battery.     

Right hemisphere semantic processing of visual words in an aphasic patient: an fMRI study

This study was designed to identify the neural network supporting the semantic processing of visual words in a patient with large-scale damage to left-hemisphere (LH) language structures. Patient GP, and a control subject, RT, performed semantic and orthographic tasks while brain-activation patterns were recorded using functional magnetic resonance imaging. In RT, the semantic-orthographic comparison activated LH perisylvian and extrasylvian temporal regions comparable to the network of areas activated by non-brain-damaged subjects in other neuroimaging studies of semantic discrimination. In GP, the same comparison activated homologous right-hemisphere regions, demonstrating the ability of the right hemisphere to subserve visual lexicosemantic processes. The results are discussed within the context of the normal right hemisphere's capacity for semantic processing of visual words. Examining results from functional neuroimaging studies on recovery in the context of innate hemispheric abilities may enable reconciliation of disparate claims about mechanisms supporting recovery from aphasia.     

Cerebral laterality for famous proper nouns: visual recognition by normal subjects

Lexical processing has long been associated with left-hemisphere function, especially for infrequently occurring words. Recently, however, persons with severe aphasia, including word-recognition deficits, were observed to recognize familiar proper nouns. Further, some patients suffering right-hemisphere damage were poorer at identifying famous names than left-hemisphere-damaged subjects. These observations point to the possibility that some property of the right hemisphere provides an advantage for the processing of familiar or personally relevant stimuli. To investigate this possibility, we conducted split-visual-field studies in which we manipulated stimulus sets, recognition task, and exposure duration. Greater accuracy in the right visual field was found for common nouns and unknown proper nouns, and famous proper nouns were overall more accurately recognized. Performance for famous nouns in the two visual fields was not significantly different when the task required categorization into famous or nonfamous and when stimuli most highly rated as familiar were used. These findings support our proposals that (1) both hemispheres can process famous proper nouns and (2) the right hemisphere is specialized for personal relevance.     

Crossed aphasia: an analysis of the symptoms,their frequency,and a comparison with left-hemisphere aphasia symptomatology

This study presents a thorough analysis of published crossed aphasia (CA) cases, including for the first time the cases published in Japanese. The frequency of specific symptoms was determined, and symptomatology differences based on gender, familial sinistrality, and CA subtype were investigated. Results suggested that the CA population is comparable to the left-hemisphere patient population. However, male were significantly more likely than female CA subjects to show a positive history of familial sinistrality. Typical right-hemisphere (i.e., nonlanguage-dominant) symptoms were frequent but rarely carefully reported or assessed. Results are compared with previous CA reviews and left-hemisphere aphasia. Suggestions for a more systematic assessment of the CA symptomatology are presented.     

Hemispheric asymmetries for complex visual patterns

Three tachistoscopic studies examined the laterality of spatial-form perception in normal adults using randomly generated eight-point and 12-point patterns (Vanderplas & Garvin, 1959) as the lateralized stimuli. In the first study of recognition accuracy, 36 subjects were tested in a partial replication of Fontenot. No laterality effects were found, and over-all recognition was better for the more complex 12-point patterns. In a second similar study with 20 subjects, the lateralized stimulus was followed by a central masking pattern. A left-hemisphere superiority for recognition and better over-all recognition for more complex patterns was obtained. These data do not support Fontenot's report of right-hemisphere superiority in complex visuospatial processing. Given these diverse findings, a reaction time study using mental rotation was conducted using the same patterns to determine whether latency would reflect accuracy of recognition. Twenty-six subjects judged whether a rotated lateralized test pattern was the same or different from a central target pattern. Measures of both latency and accuracy were separately assessed. No main effect of visual field was obtained on either measure. These studies suggest that the nature of hemispheric involvement in spatial form perception is far from resolved.     

Spared access to idiomatic and literal meanings: a single-case approach

The current study examines how patients with aphasia access the meanings of idioms during spoken sentence comprehension. In our experiment, we had 4 subjects whose native language is German: 2 left-hemisphere damaged patients (Wernicke's and global aphasia); 1 right-hemisphere damaged patient; and 1 age-matched healthy speaker. Ambiguous two-element German noun compounds carrying an idiomatic as well as a literal meaning served as target words. While listening to contextually biasing sentences containing the target words, the subjects performed a lexical decision task at the offset of each compound. All the subjects, including the aphasic patients, accessed the compounds' literal and idiomatic meanings simultaneously despite the existence of contextually biasing sentences. The data are discussed by taking account of the findings of recent studies of lexical semantic processing in aphasia.     

Variable solutions to the same problem: aberrant practice effects in object naming by three aphasic patients

Although deficits in confrontation naming are a common consequence of damage to the language areas of the left cerebral hemisphere, some patients with aphasia show relatively good naming ability. We measured effects of repeated practice on naming latencies for a set of pictured objects by three aphasic patients with near-normal naming ability and by neurologically intact young and older adults. While the non-injured participants showed a systematic reduction in overall mean latencies and reduced trial-to-trial latency variability, the aphasic patients did not. Examination of the latency distributions suggests that successful naming by aphasic patients may come about by different underlying operations.     

The effects of speech output technology in the learning of graphic symbols

The effects of auditory stimuli in the form of synthetic speech output on the learning of graphic symbols were evaluated. Three adults with severe to profound mental retardation and communication impairments were taught to point to lexigrams when presented with words under two conditions. In the first condition, participants used a voice output communication aid to receive synthetic speech as antecedent and consequent stimuli. In the second condition, with a nonelectronic communications board, participants did not receive synthetic speech. A parallel treatments design was used to evaluate the effects of the synthetic speech output as an added component of the augmentative and alternative communication system. The 3 participants reached criterion when not provided with the auditory stimuli. Although 2 participants also reached criterion when not provided with the auditory stimuli, the addition of auditory stimuli resulted in more efficient learning and a decreased error rate. Maintenance results, however, indicated no differences between conditions. Finding suggest that auditory stimuli in the form of synthetic speech contribute to the efficient acquisition of graphic communication symbols.     

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.