Lynn J. Speedie

Comprehension of affective and nonaffective prosody

We studied patients with damage of either the right (RHD) or left hemisphere (LHD) and control subjects to determine whether the RHD patients had a global or limited prosodic defect. Compared with LHD patients and controls, RHD subjects had decreased comprehension of emotional prosody. Both LHD and RHD groups had more impaired comprehension of propositional prosody than controls, but the RHD and LHD groups did not differ. The right hemisphere, therefore, seems to be dominant for comprehending emotional prosody but not propositional prosody.

Olfactory Recognition: Differential Impairments in Early and Late Huntington's and Alzheimer's Diseases

Forty-two patients with senile dementia of the Alzheimer type (SDAT), 38 patients with Huntingtons disease (HD) and matched normal controls were administered tests of olfactory, verbal, and visual recognition after being screened for normal olfactory discrimination. Early-affected Huntingtons patients (EHD) with minimal chorea or cognitive deficit displayed marked deficits in olfactory recognition despite normal verbal and visual performance, even after correction for task difficulty, suggesting involvement of olfactory brain regions early in the disease process. In the early Alzheimers group (EAD), marked deficits were seen on all recognition modalities indicating more global impairment. Both overall (early plus late) patient groups were impaired relative to controls on all recognition tasks, with the olfactory paradigm being most affected.

Comprehension of emotional prosody following unilateral hemispheric lesions: Processing defect versus distraction defect ☆

Two studies were conducted in order to determine whether the poor performance of RHD patients on emotional prosody tasks could be attributed to a defect in perceiving/categorizing emotional prosody (processing defect) or to a problem in being distracted by the semantic content of affectively intoned sentences (distraction defect). In one study, patients with RHD, LHD or NHD listened to affectively intoned sentences in which the semantic content was congruent or incongruent with the emotional prosody. In a second study, the patients listened to affectively intoned sentences that had been speech filtered or unfiltered. Findings from these studies indicate that both processing and distraction defects are present in RHD patients.

Disruption of automatic speech following a right basal ganglia lesion

Following a right basal ganglia lesion, a right-handed man, age 75, was unable to recite familiar verses. Serial automatic speech, singing, recitation of rhymes, and swearing were impaired, and only idioms and social greetings were preserved. Speech no longer contained overused phrases and he could comprehend automatic speech. In contrast, propositional speech was preserved in both French and Hebrew. Right basal ganglia lesions may impair production but not comprehension of automatic speech.

Cognitive impairment in adult-onset adrenoleukodystrophy.

Adrenoleukodystrophy (ALD) is a progressive X-linked disorder that produces pathological changes, mainly in the adrenal cortex and the white matter of the central nervous system. The main biochemical abnormality is the accumulation of saturated unbranched fatty acids with a chain length of 24 or more, referred to as very-long-chain fatty acids (VLCFA). Affected children develop large zones of demyelination associated with perivascular lymphoctyic infiltrations resembling those seen in multiple sclerosis. Adults show a more chronic form of the disease, referred to as adrenomyeloneuropathy (AMN). AMN mainly involves the spinal cord ad peripheral nerves, although the cerebral hemispheres may also be affected. Approximately 15% of female carriers have nervous-system involvement that resembles AMN. It is well known that ALD may initially appear as a psychiatric disorder. In the present study, we have assessed the prevalence of cognitive impairment in a group of AMN patients and neurologically symptomatic ALD heterozygotes initially presenting primarily physical complaints. Sixty percent of these patients demonstrated significant neuropsychological impairment, most commonly a pattern of spared and impaired functions typical of a subcortical dementia. We suggest that this progressive cognitive impairment may underlie other behavioral deficits, affirming the significance of the psychological features of this genetically determined disorder.

Reading Direction and Spatial Neglect

Many American and European investigators have reported that hemispatial neglect is more frequent and more severe after right than left hemisphere lesions. This hemispheric asymmetry may be due to biological asymmetries, learned behavior, or both. Readers of European languages, unlike readers of Semitic languages, scan from left to right. Learned rightward scanning may increase the unilateral neglect associated with right hemisphere lesions and reduce the severity of neglect associated with left hemisphere lesions. To learn if hemispheric asymmetries of neglect are influenced by learned scanning behavior, we used line bisection and cancellation tasks to study patients with unilateral stroke who read only a Semitic or European language before the age of fifteen. We found that independent of reading direction, unilateral neglect was more commonly associated with right than left hemisphere lesions. After right hemisphere damage right to left readers bisected lines closer to center than left to right readers, but on the cancellation test readers of European languages did not perform differently than readers of Semitic languages. These findings suggest that whereas learned scan direction may influence the severity of neglect when measured by line bisection, these learned directional scans cannot fully account for the observed hemisphere asymmetries of neglect. They also suggest that the line bisection test is more influenced by the direction of scanning than is the cancellation test.

Phonologic agraphia in a left‐handed patient after a right‐hemisphere lesion

Oral and written spelling were evaluated in a left-handed patient with a right-hemisphere infarct and right-hemisphere language representation. Spelling was intact for different classes of words, but there was severe difficulty in both oral and written spelling of nonwords. This pattern was consistent with phonologic agraphia. There was selective disruption of the segmentation component, with intact phoneme-to-grapheme conversion supporting the Roeltgen and Heilman hypothesis of two-system spelling after lesions in the left supramarginal gyrus. This is the first case of phonologic agraphia after right supramarginal gyrus damage in a left-handed patient.

Language performance deficits in elderly depressed patients

Abstract Elderly depressed patients are thought to have memory, orientation and judgement difficulties but are not thought to have language performance deficits. Recently, naming difficulties were reported in patients with cognitive impairment resulting from depression. We examined language performance of elderly depressed patients with long histories of major affective disorder. We compared language functions of these patients with those of normal elderly subjects of two educational levels. The depressed patients were significantly impaired relative to both normal groups in confrontation naming, reading non-words and in the quality of their written language. Further exploration of language performance of elderly depressed patients is needed.