AndréRoch Lecours

Longitudinal study of basal cortisol levels in healthy elderly subjects : evidence for subgroups

A group of 51 healthy elderly volunteer subjects participated in a 3- to 6-year longitudinal study of basal cortisol levels. Once per year basal cortisol levels were examined using hourly sampling over a 24-h period. Analyses of three cortisol measures (last measure obtained, mean cortisol levels across years, and the cortisol slope) revealed that the slope of the regression line measuring cortisol levels at each year was the most predictive measure of cortisol secretion over the years in this elderly population. Cortisol levels were shown to increase with years in one subgroup, to decrease in another, and to remain stable in a third. The age of the subjects was not related to either cortisol levels or to the pattern of change in cortisol secretion over years. Free and total cortisol levels were highly correlated and the groups did not differ with regard to plasma corticosteroid binding globulin. No group differences were observed for weight, height, body mass index, pulse, blood pressure and glucose. However, significant group differences were reported for plasma triglycerides levels as well as high density lipoproteins levels. Positive correlations were reported between the obsession/compulsion subscale of the SCL-90 questionnaire and the cortisol slope of subjects. Finally, previously reported group differences in neuropsychological performance are summarized. Thus, there exists considerable variation in hypothalamo-pituitary-adrenal function amongst aged humans. These results are consistent with recent animal studies showing the existence of subpopulations of aged rats which differ in hypothalamo-pituitary-adrenal activity and cognitive efficiency.

The “Pure form” of the phonetic disintegration syndrome (pure anarthria); anatomo-clinical report of a historical case

The relationships of simple aphasia (Baillarger), pure anarthria (Marie), pure motor aphasia (Dejerine), subcortical motor aphasia (Lichteim, Charcot) and phonetic disintegration (Alajouanine, Ombredane, & Durand) are outlined. Alajouanine et al.s pioneering neurolinguistic studies of phonetic disintegration, both in the semiological context of Brocas aphasia and as an isolated clinical entity, are briefly discussed. One of their neurological and linguistic observations is reviewed in detail, including Marguerite Durands comparative phonetic description of a small corpus of French and English segments (bilingual patient). Anatomical examination of the brain, in this case, is reported: It revealed, essentially, a cortico-subcortical softening of the inferior half of the left precentral gyrus, with sparing of Brocas area proper. Comments are made on Durands conclusion about the possibility of a lesser involvement of English vs. French phonetics in this patient. The notion of pure anarthria is redefined, both from a theoretical and from an operational point of view. The phonetic characteristics of the dystonic phase of phonetic disintegration are discussed. The discussion also bears on the concept of anarthria vs. that of aphasia, and on the possible localizations of cerebral lesions leading to pure phonetic disintegration. The localization of the lesion in the reported case is compared to that in Bernheims and Ladames cases, on which Dejerine grounded his theory of motor aphasia.

Illiteracy and brain damage—1. Aphasia testing in culturally contrasted populations (control subjects)

One hundred neurologically healthy adults were tested for their pointing (choosing one of four or six line drawings as the match to an auditorily presented linguistic stimulus), naming (from line drawings), and repetition abilities. All subjects were unilingual adult right-handers. Fifty-seven subjects were totally unschooled illiterates and 43 were fluent readers. Statistically significant differences were found to exist between the scores of the illiterate and literate subpopulations across all tasks. With the focus being placed on these cultural differences, the discussion bears on: (a) the interaction between linguistic and iconographic factors in certain types of naming and pointing tasks currently used in clinical and research aphasiology, (b) some of the linguistic parameters which are apparently at stake in repetition behavior, and (c) the circumstances in which aphasiological research dealing with groups of patients cannot yield reliable data without reference to neurologically healthy controls. It is argued that, when testing brain-damaged patients of different cultural backgrounds, one runs the risk of over- or underestimating the frequency of aphasia if one does not refer to norms which explicitly take educational level into account.

Illiteracy and brain damage. 3: A contribution to the study of speech and language disorders in illiterates with unilateral brain damage (initial testing).

This report bears on the behavior of 188 unilateral stroke subjects when administered an aphasia screening test comprising a short interview as well as naming, repetition, word-picture matching and sentence-picture matching tasks. All subjects were unilingual lusophone adult (40 yr of age or older) right-handers. Furthermore, they were either totally unschooled illiterates or they had received school education and thereafter retained writing skills and reading habits. Subjects were tested less than 2 months after a first unilateral stroke. In all tasks, global error scores were greater among left and right brain-damaged illiterate and literate subjects than among their controls. In repetition and matching, these differences were statistically significant for the left but not for the right-stroke groups, irrespective of the literacy factor. In naming, on the other hand, significant differences were found not only for the two left-stroke groups but also for the right-stroke illiterate group although not for the right-stroke literate one. Likewise, some degree of word-finding difficulty and of reduction in speech output as well as sizeable production of phonemic paraphasias were observed in the interviews of several right-stroke illiterates, clearly less in those of right-stroke literates. These findings lead us to suggest that cerebral representation of language is more ambilateral in illiterates than it is in school educated subjects although left cerebral dominance remains the rule in both.

Schizophasia and jargonaphasia ☆: A comparative description with comments on Chaika's and Fromkin's respective looks at “schizophrenic” language

Abstract Different varieties of deviant spoken language segments (phonemic, morphemic, verbal, and syntagmic paraphasias and telescopages, neologisms) and different forms of deviant spoken language behaviors (thematic production, dyssyntaxia, glossolalia, and glossomania) are defined and exemplified. Their production is shown to be rule-governed at phonetic and phonological levels; it is shown to be rule-governed or rule-deviant at morphological and/or syntactic levels. Their qualitative and quantitative attributes in normal discourse in the jargonaphasias and in schizophasia are compared. It is underlined that the latter is a behavior episodically observed in only a small proportion of subjects considered to be schizophrenics. Awareness of, and deliberateness in, deviant language production are discussed. A distinction is made between deviations testifying to diminished ability, which betray the speakers intention, and deviations testifying to singular but rigorous use of ability, which are adapted to the speakers intentions. The former are contended to be common in the jargonaphasias and occasional in standard discourse and schizophasia, the latter to be characteristic of schizophasia and of various forms of “literary” language, but incompatible with aphasia. In lapidary terms, this implies that ordinary speakers think and talk standard, that (most) jargonaphasic speakers think standard but talk deviant, that schizophasic speakers think quaint and talk accordingly. It is further suggested that the differential diagnosis of jargonaphasia and schizophasia, when made on the sole basis of tape recorded samples of discursive language, resorts mainly to quantitative appraisal of different types of deviant segments on one hand, and, on the other, to the listeners interpretations of the speakers mode of ideation. Within the realm of pathological language production, nearly exclusive and important production of phonemic transformations is said to be characteristic of conduction aphasia; combined production of numerous phonemic and verbal transformations, and of neologisms, is said to be characteristic of Wernickes aphasia proper; nearly exclusive and important production of verbal transformations is said to be possible in so-called transcortical sensory aphasia; and predominant production of morphemic transformations and of glossomaniac utterances is said to be characteristic of schizophasia. Linguistic definitions of the “disturbances” behind schizophasic utterances are reviewed. Indications are given concerning the evolution of language behavior in jargonaphasia and schizophasia.

Linguistic and other psychological aspects of paroxysmal aphasia

Abstract A case of paroxysmal aphasia is reported. Aphasic spells occurred, in this patient, without modification in consciousness and without involvement of behaviors others than those related to oral and written speech and language. Longer spells successively recapitulated the clinical pictures of global, Wernickes, conduction, and amnestic aphasia. Besides aphasiological evaluations, neurological, psychometrical, electroencephalographical, and CT-scan documents were obtained. The discussion bears on four main points: the linguistic characteristics of paroxysmal aphasia as compared to those of aphasias of other etiologies; Pierre Maries oneness doctrine of aphasia; the mutual relationships of language and thought (in aphasia); the affective experience lived by one with severe aphasia, with special reference to the notion of anosognosia.

Sequences of phonemic approximations in aphasia

The trends of sequences of phonemic approximations to a single target were studied in three types of aphasia (Brocas, conduction, and Wernickes), as gathered in five tasks (spontaneous speech, repetition of meaningful words, repetition of nonsense words, reading aloud, and automatized sequences). A phonemic error ratio was defined in order to quantify the distance between each approximation of a given sequence and its target. The results of a computer analysis based on this ratio were analyzed according to three parameters. A study of three types of patients revealed that conduction aphasics exhibited the most regular trend toward the target in sequences of phonemic approximations; the analysis of the various tasks indicated that sequences produced in repetition by conduction aphasics form an exception to the regularity of this trend, and an examination of the various lengths of sequences indicated that longer sequences showed a less decisive trend toward the target than shorter sequences. The discussion bears on some theoretical aspects of the phonological production mechanism and its control: the initial strength and permanence of the internal representation of the target emerge as important factors required for the good functioning of this mechanism.

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.

Language in right-handers with right-hemisphere lesions: A preliminary study including anatomical, genetic, and social factors ☆

A comprehensive test battery was devised to study the effects of right hemisphere lesions on the speech and language of nonaphasic dextrals. Data were thus obtained for 62 subjects, 20 of them neurologically healthy and 42 with a focal right hemisphere lesion resulting from a cerebro-vascular accident. A preliminary global analysis of these data is reported. Anomalies were observed in 33 brain-damaged subjects. Although discreet in all cases, these anomalies were shown to have various degrees of severity. Given the population submitted to this study, the subject most likely to show such anomalies was defined, genetically, as a right-handed adult with a family history of ambidextrality or left-handedness and, socially, as one with a relatively limited education. The implications of these findings are discussed together with the problem of the anatomo-clinical correlations of language disorders resulting from right hemisphere lesions in nonaphasic dextrals.

Visual neglect and left-sided context effects

Patients with visual neglect generally fail to respond to an item placed on the left of a target location, even when both stimuli are situated in the right visual field. Little is known, however, about the level of processing for the unattended items. Two patients with left visual neglect served as subjects in several experiments measuring passive contextual effects of a left-sided item on responses to a focal target. The results reveal that a neglected item may influence the speed of responding. The findings are interpreted relative to the loci of context effects in normal subjects.