M. Kerschensteiner

Text comprehension in aphasia.

Abstract 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.

The Fluency-Non Fluency Dimension in the Classification of Aphasic Speech

Summary In this study, we have investigated whether the fluency-non fluency dimension of spontaneous aphasic speech can be confirmed by mathematical analysis. The speech production of 47 unselected aphasic patients was rated according to criteria similar to those proposed by Benson (1967). A cluster analysis in two-dimensional as well as in ten-dimensional space yielded two distinct groups, corresponding to the clinical syndromes of fluent and non fluent aphasia. Thus, it was demonstrated that this classification of spontaneous aphasic speech reflects naturally occurring differences in language behavior. A tentative rank order of variables according to their discriminating power was computed.

Visuo-cognitive performances in patients with unilateral hemispheric lesions

SummaryThree factorial reference tests for Speed of Visual Closure (Cs), Flexibility of Visual Closure (Cf) and Perceptual Speed (P) were given to 41 patients with unilateral retro-rolandic brain lesions. The tests were: the Street Test (for Cs), the Gottschaldt Test (for Cf) and the test Form Perception from the GATB (for P). By means of analyses of variance the influence of hemispheric side and intrahemispheric locus of lesion, of aphasia and of visual field defect (VFD) was studied.Aphasia was related only to impairment in Gottschaldts test. In none of the experimental tests an independent main effect of side or intrahemispheric locus of lesion or of VFD was found. However, in Streets test as well as in Form Perception, patients with right-sided lesion plus VFD were more impaired than any other subgroup. It could be demonstrated that neither VFD per se nor hemispheric side of lesion alone could account for this finding. It is suggested that the presence of VFD in the patients with right-sided lesions does not act on test performance as a defect in visual function but stands for a critical localization of lesion.ZusammenfassungEine Gruppe von 41 Patienten mit einseitigen retrorolandischen Großhirnläsionen wurde mit drei faktoriellen Referenztests für „Speed of Visual Closure“ (Cs), „Flexibility of Visual Closure“ (Cf) und „Perceptual Speed“ (P) untersucht. Es wurden verwendet: der Street-Test (für Cs), der Gottschaldt-Test (für Cf) und der Test „Form Perception“ aus der GATB (für P). Mittels Varianzanalysen wurden die Auswirkungen von Seitigkeit und intrahemisphärischer Lokalisation sowie von Aphasie und Gesichtsfelddefekten auf die Testleistungen geprüft.Aphasie beeinflußte nur die Leistung im Gottschaldt-Test. Selbständige Haupteffekte für Seitigkeit und intrahemisphärische Lokalisation der Läsionen sowie für Gesichtsfelddefekte wurden nicht gefunden. Sowohl im Street-Test als auch im Test Form Perception waren jedoch Patienten mit rechtsseitigen Läsionen, die zugleich Gesichtsfelddefekte hatten, signifikant schlechter als jede andere Untergruppe. Es konnte gezeigt werden, daß weder der Gesichtsfelddefekt für sich noch die rechtsseitige Hirnschädigung allein dieses Ergebnis erklären. Nach diesen Befunden muß man annehmen, daß bei den rechtsseitig geschädigten Patienten die Gesichtsfeld-einschränkung nicht unmittelbar die Testleistungen beeinflußt, sondern vielmehr eine für diese Leistungen kritische Lokalisation der Hirnläsion anzeigt.

Die Wernicke-Aphasie

SummaryDespite the variability of its behavioral manifestations Wernickes aphasia is considered to be a unitary syndrome. According to the criteria of intelligibility, phonemic and semantic paraphasias in spontaneous speech, 4 forms of Wernickes aphasia are differentiated: 1) with predominantly semantic paraphasias, 2) with semantic jargon, 3) with predominantly phonemic paraphasias and 4) with phonemic jargon. A severe deficit in language understanding is common to all 4 forms. In addition to phonemic and semantic paraphasias paragrammatism is an outstanding feature of the language production in Wernickes aphasia. After a survey of views about the localization of the lesion and of earlier descriptive models a neurolinguistic explanation of the characteristic symptoms of Wernickes aphasia is suggested.ZusammenfassungDie Wernicke-Aphasie ist bei aller Variabilität des Sprach-verhaltens als einheitliches Syndrom zu beschreiben. Nach den Kriterien: Verständlichkeit, phonematische und semantische Paraphasien in der Spontansprache lassen sich 4 Erscheinungsformen unterscheiden:Wernicke-Aphasie mit vorwiegend semantischen Paraphasien,Wernicke-Aphasie mit semantischem Jargon,Wernicke-Aphasie mit vorwiegend phonematischen Paraphasien,Wernicke-Aphasie mit phonematischem Jargon.Allen 4 Formen sind schwere Störungen im Sprachverständnis gemeinsam. In der Sprachproduktion tritt neben den phonematischen und semantischen Paraphasien als wesentliches Merkmal der Paragrammatismus auf. Nach einem Überblick über die Lokalisation der Schädigung und frühere Beschreibungsmodelle werden für die charakteristischen Symptome der Wernicke-Aphasie neurolinguistische Erklärungen vorgeschlagen.Despite the variability of its behavioral manifestations Wernickes aphasia is considered to be a unitary syndrome. According to the criteria of intelligibility, phonemic and semantic paraphasias in spontaneous speech, 4 forms of Wernickes aphasia are differentiated: 1) with predominantly semantic paraphasias, 2) with semantic jargon, 3) with predominantly phonemic paraphasias and 4) with phonemic jargon. A severe deficit in language understanding is common to all 4 forms. In addition to phonemic and semantic paraphasias paragrammatism is an outstanding feature of the language production in Wernickes aphasia. After a survey of views about the localization of the lesion and of earlier descriptive models a neurolinguistic explantation of the characteristic symptoms of Wernickes aphasia is suggested.

A cross-validation study on the token test

Abstract The cut-off score of 11 errors on the Token Test, proposed by O RGASS and P OECK (1966), was applied to a larger sample of brain damaged patients. Whilst 93% of aphasics were correctly identified, 22 per cent of non-aphasic patients were misclassified. Therefore, this cut-off score proved to be unsatisfactory. The discriminating power of the TT, however, was again confirmed: Applying the cut-off score optimal for this sample (23 errors), 91 per cent of aphasics were correctly classified and only 5% of the non-aphasics were misclassified. A moderate influence of age and PIQ on the TT-scores was found. The implication of this results is discussed.

A Quantitative Study on Language Understanding in Fluent and Nonfluent Aphasia

Summary Language understanding, as tested by the Token Test, was compared in two groups of non-fluent (N = 13) and fluent (N = 21) aphasics. No difference between the distribution for the two sub-groups was found. The mean scores were not significantly different for each part of the test and for the total score. Thus, language understanding is impaired to an equal extent in non-fluent and fluent aphasics. The theoretical implications of this finding are discussed.

Impairment in visual recognition of geometric figures in patients with circumscribed retrorolandic brain lesions.

Abstract Twenty patients with left-sided and 21 patients with right-sided circumscribed retrorolandic brain lesion were given Gottschaldts Test, Bentons Visual Retention Test and several tests for pertinent control variables. Analyses of variance demonstrated, that aphasic patients were inferior to left-sided patients without aphasia. There was no difference in the performance of aphasic and right brain damaged patients. Visou-spatial disturbance was associated with lesions of either hemisphere. The impairment of the aphasic patients was not due to language disturbance per se , nor to severity of brain lesion. Rather, presence of aphasia indicated a locus of lesion critical for the performances tested.

A qualitative study on token test performance in aphasic and non-aphasic brain damaged patients

Abstract The performance of 100 aphasic and 100 non-aphasic brain damaged patients in part V of the TT was subjected to a qualitative analysis. The items were ranked according to the frequency of errors occurring in each of the subgroups. The distribution of rank order of errors was compared across aphasic and non-aphasic patients. An attempt was made to determine whether the items most critical for either group were the same as those identified by Whitaker and Noll [9] in a study of normal children. Finally, the linguistic or psychological properties determining the ease or difficulty of a given item for either group were considered. The performance characteristics of aphasic adults and normal children on the Token Test were different. In the aphasic subgroup, the Whitaker and Noll items were, in fact, clustered in the lower half of the rank-ordered distribution. However they accounted for only 37 per cent of the total errors. Therefore, the linguistic hypothesis suggested by Whitaker and Noll did only partly explain the aphasic patients failure.

Die globale Aphasie

SummaryGlobal aphasia is described as a unitary syndrome which is characterized by a severe impairment of all linguistic capabilities. Speech production is extremely limited and consists of stereotyped phrases, recurring utterances or a few isolated words which are usually neologistically distorted. The patients are unable to express their thoughts in a situationally adequate manner. Language comprehension is restricted to simple questions and commands. A clinical description of the syndrome is given and the neurolinguistic structure of the disorders is discussed.ZusammenfassungDie globale Aphasie wird als einheitliches Syndrom beschrieben, das durch eine schwere Beeinträchtigung aller sprachlichen Fähigkeiten charakterisiert ist. Die geringe Sprachproduktion besteht aus Floskeln, Automatismen (recurring utterances) oder aus wenigen, meist neologistisch entstellten Einzelwörtern. Die Patienten sind außerstande, ihre Gedanken der Situation angemessen jeweils neu zu formulieren. Das Sprachverständnis ist nur für die einfachsten Fragen und Aufforderungen erhalten. Zusammen mit der klinischen Beschreibung wird die neurolinguistische Struktur der Störungen im einzelnen erörtert.

Grammatical Impairment in Developmental Aphasia

The language production of a 23 year old patient with developmental aphasia caused by birth injury was analyzed in detail within the framework of Chomskys generative grammar. It was shown that different stages of grammatical development occur simultaneously, without the predominance of those grammatical forms which are identical with or close to adult grammar. Thus the language of this patient with developmental aphasia is quite comparable to the language of children from 3 to 6, and shares many features with grammatical impairment well known from agrammatism and paragrammatism in adult aphasia. It was suggested that in developmental aphasia incomplete linguistic generalizations are related to an incomplete maturation of inhibitory functions during language acquisition, whereas in adult aphasia comparable forms of less advanced grammars are set free by dissolution of function.