Confrontation naming impairment in dementia

In tone languages pitch variations (tones) serve to distinguish the lexical meanings of words. This study was conducted to examine the extent and nature of impairment in the perception of tones by aphasic patients who were monolingual speakers of Thai, a tone language which has five contrastive tones (mid, low, falling, high, rising). Six subjects participated in the study: two Broca aphasics, one transcortical motor aphasic, one conduction aphasic, one right brain-damaged nonaphasic, and one normal control. Three sets of stimuli (two real-speech, one synthetic-speech) were presented for identification, each set containing five Thai words minimally distinguished by tone. Results of the perception tests indicated that the performance of all four left brain-damaged aphasics differed significantly from that of the normal control, while the performance of the right brain-damaged nonaphasic did not. The normal performance of the right brain-damaged nonaphasic patient on this tone identification task suggests that deficits in the perception of tone exhibited by left brain-damaged patients can be attributed specifically to pathology in the language dominant hemisphere rather than to a general brain-damage effect. No difference in performance among the left brain-damaged patients could be attributed to a specific type of aphasic syndrome. The pattern of tonal confusions of the aphasics in comparison to that of normals suggests that their deficit is primarily quantitative rather than qualitative. Although two (mid, low) of the five tones accounted for a large percentage of the aphasics' errors, no uniform rank order of tones in terms of identifiability could be established across aphasic subjects, which suggests that their deficit is general to all five tones rather than selective to individual tones.