The transcoding processes in patients with agraphia to dictation

The main purpose of the present study is to prove that the mechanism of transcoding, that is, of transposition of certain units of a sign system into the corresponding ones of another sign system, is an independent mechanism. We attempted to demonstrate this thesis with reference to certain transcoding processes within the verbal function of writing to dictation, in particular, by examining the agraphic disturbances in aphasics on this form of writing. We found that this type of agraphia in patients with an intact input stage (i.e., intact auditory and visual word perception) but with a blocked shift from the phonetic to the graphemic level (even in cases with intact auditory and visual word perception), or in those with a blocked shift to the grapho-motor one (even in cases with intact copying), is due to disturbed mechanisms of transcoding. The fact that in patients with pure writing-to-dictation disability copied writing is not disturbed proves that the transcoding process is selectively blocked. Transcoding processes in copying and total agraphia are discussed by comparison.     

Numerical taxonomy of aphasia

Two hundred consecutively seen aphasics, 142 of them with infarcts, were examined by tests of fluency, comprehension, repetition, naming, and information content. The language scores were subjected to a minimum variance clustering algorithm separately for the total and for the infarct groups. The latter generated 10 clusters on a dendrogram. Attribute analysis of each cluster provided a clinically meaningful profile of language performance for these groups. The degree of correlation of most computer generated clusters with clinically recognized groups was high, and the homogeneity of some of the clusters is striking. An exception appears to be “conduction aphasia,” which is bimodally distributed. One of these clusters, with high fluency and low comprehension scores, was renamed “afferent conduction” aphasia, and the other, with lower fluency and higher comprehension, was renamed “efferent conduction” aphasia. The Principal Components Analysis was used to evaluate the discriminatory value of language characteristics, and the Nearest Neighbor Network Analysis was used to evaluate the significance of clustering. The dendrogram for all aphasics showed a less specific and less homogenous six clusters.     

Perception of nonlinguistic auditory rhythms by the speech hemisphere

Two groups of right-handed young adults were tested on a series of handedness measures and on dichotic nonverbal rhythmic sequences. Cross-validated multiple regression analysis revealed that all of the cerebral-lateralization/manual-praxis measures were positively related to the degree of left-hemisphere perceptual asymmetry for nonverbal rhythms (Crawford peg, scissor, handwriting, Crawford screws, tracing, total R = .67). Seventeen of the 52 subjects manifested significant (p < .05) left-hemisphere laterality coefficients for the dichotic stimuli. More complex rhythms elicited greater left-hemisphere perceptual preference. The results are discussed in reference to the concept of cerebral lateralization.     

The processing of fundamental frequency in a dichotic matching task

The temporal characteristics of auditory memory were investigated using a reaction time paradigm. The study attempted to determine whether or not there are functionally distinct left and right hemisphere components of auditory memory with different capacities for the retention of nonlinguistic information, such as fundamental frequency, over the course of several seconds. The results indicated that fundamental frequency information in auditory memory remains substantially unchanged over the course of 2 sec. No evidence was found for the existence of separate left and right hemisphere components of auditory memory with different temporal characteristics. The implications of this finding for the organization of auditory memory in the brain are discussed.     

Brain perfusion and neuropsychological test scores: A correlation study in aphasics

In 26 patients suffering from the pure types of aphasias (11 total, 6 motoric, 5 sensory, and 5 amnesic), hemispheric and regional cerebral blood flow were measured and the flow values were correlated with psychological test scores including Wechsler Adult Intelligence Scale (WAIS), Token Test, Benton Test, and word fluency tests. With respect to the flow values, an overall difference between the groups of aphasics was proved by analysis of variance [regional cerebral blood flow (rCBF): F(3,22) = 13.77, p < .001]. The location of mainly impaired brain perfusion was not always confined to the centers within the speech area expected in view of the clinical disturbance, but most patients had neurologic deficits in addition to their aphasia. High correlations were found between the rCBF values within ischemic foci and WAIS subtests, as well as Token Test and word fluency tests. The correlation coefficients calculated between hemispheric flow and the psychological data indicated, in many instances, the same dependency, but did not attain the high statistical significance obtained with the regional values. The results show dependencies of several aspects of mental function upon cerebral perfusion and provide information for possible mechanisms responsible for the disturbance of nonverbal intelligence in aphasics.     

Aphasia in a polyglot

A Greek-born aphasic who had been able to speak four languages (Romanian, Russian, Greek, German) was tested quantitatively for verbal expression (standard interview indexes) and verbal reception (fifth part of the Token Test). The form of aphasia (qualitative aspect) was found to be identical for all four languages. Quantitatively, his performance in the four languages was different, with the languages used most during the past 20 years (Romanian and Russian) being less impaired. Nevertheless, verbal reception was equally impaired quantitatively in all four languages. Treatment with semantic-syntagmatic methods performed in Romanian had a beneficial effect on speech in the other languages as well. The authors feel that the expressive disturbance noted in aphasia reflects involvement of deep as well as of surface structures of language, but the receptive disturbance reflects involvement of the deep structures only. This may account for quantitative discrepancies in expression without discrepancy in reception among the four languages, as well as the qualitatively identical features of the disturbance in verbal expression and reception.     

Text comprehension in aphasia

The semantic and pragmatic strategies in the comprehension of spoken texts are investigated in four subgroups of aphasic patients and in normal and brain-damaged controls. Short texts of similar linguistic structure were read to the subjects, who were required to choose the picture, from a multiple choice set of five, that was appropriate to the story. Besides a picture showing the main event of the story, one picture depicted the literal sense of a metaphorical comment, and the others misrepresented semantic functions expressed in the text. With respect to these types of responses, both aphasics and controls exhibited the same pattern of reaction. It is concluded that the redundancy of texts makes up for the difficulties aphasics have in comprehending isolated words and sentences.     

Listening to speech while retaining music: What happens to the right-ear advantage?

On each trial, subjects were played a dichotic pair of syllables differing in the consonant (/ba/, /da/, /ga/) or in the vowel (/ba/, /b?/, /bi/). The pair of syllables was preceded by a melody, or a sentence, and followed by the same or a different melody, or sentence. Subjects either had to retain the first piece of additional material or were free to ignore it. The different combinations of phonemic contrast, additional material, and instruction concerning the additional material were used in different sessions. In each case, the main task of the subjects was to respond to the presence or the absence of the target /ba/ on the ear previously indicated. There was no effect of context on relative ear accuracy, but the right-ear advantage observed for consonants in response latency when subjects retained a sentence gave way to a small nonsignificant left-ear advantage when subjects retained a melody. Right-ear advantage in response latencies was also observed for vowels in the verbal context, but the contextual effect, although in the same direction as for consonants, was very slight. The implications of contextual effects for a theory of the determinants of the auditory laterality effects are discussed.     

A different form of agraphia: Syntactic writing errors in patients with motor speech and movement disorders

Three patients are described who displayed syntactic writing errors in combination with a motor speech disturbance and impaired motor limb function. Two of the patients had bulbar amyotrophic lateral sclerosis (ALS). Agraphia appeared when verbal communication was no longer possible. Autopsy in one patient disclosed only lesions consistent with ALS. The third patient had palilalia and chorea and, although not aphasic, his written language showed persistent syntactic errors. We hypothesize that the agraphia in these patients occurred because of the combination of disordered feedback from the motor speech apparatus and limbs.