Walter Huber

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.

Linguistic and nonlinguistic processing of narratives in aphasia.

Abstract A scrambled Story Test was given to four subgroups of aphasic patients and to one group each of right-hemisphere-damaged patients and of normal controls. Subjects were asked to construct narratives from an unordered set of pictures and from unordered sets of corresponding sentences. Two verbal versions were distinguished, one with high and one with low linguistic cohesion among sentences. As expected, we found interactions between aphasic and nonaphasic behavior, such that aphasic patients made relatively more errors on the verbal versions and right-hemisphere patients on the pictorial version. High versus low linguistic cohesion, however, had no differential impact. It is concluded that brain-damaged patients when processing texts generally rely on macro- rather than on microstructure information. Furthermore, two control tests were administered: the Token Test and a sentence-to-picture matching task with either descriptive or nondescriptive stimulus sentences. Various patterns of correlation between these control tests and the Scrambled Story Test were found. The findings are interpreted in terms of a differential involvement of descriptive versus pragmatic processing strategies.

Piracetam as an adjuvant to language therapy for aphasia: a randomized double-blind placebo-controlled pilot study.

OBJECTIVEnTo determine whether piracetam 4.8 g/day together with intensive language therapy improved language function more than language therapy alone.nnnDESIGNnDouble-blind, placebo-controlled parallel group study.nnnSETTINGnReferral speech and language clinic of a university department of neurology.nnnPATIENTSnSixty-six inpatients with aphasia present between 4 weeks and 36 months.nnnINTERVENTIONSnIntensive language therapy for 6 weeks in all patients. Thirty-two patients received piracetam 4.8 g daily and 34 patients received placebo.nnnMAIN OUTCOME MEASUREnThe Aachen Aphasia Test (AAT), a standardized procedure for evaluating the severity of aphasia, was performed at baseline and after 6 weeks treatment.nnnRESULTSnIn 50 patients evaluated for efficacy, a trend toward improvement in the active group was observed in all subtests of the AAT. This trend was statistically significant for absolute differences in recovery of written language and profile level.nnnCONCLUSIONnPiracetam appears to have a positive adjuvant effect on the recovery of aphasia in patients receiving intensive language therapy.

Prepairs and repairs: different monitoring functions in aphasic language production.

Picture descriptions of aphasic patients and nonaphasic controls were analyzed with respect to type and amount of linguistic repairs and searching phenomena (prepairs). Repairs occurred far less frequently than prepairs, which indicates impaired postarticulatory as opposed to intact prearticulatory monitoring. Prepairs were found to be most frequent in patients with relatively good comprehension, in patients with poor production, and in those who had both good comprehension and poor production. Contrary to expectation, there was no reliable difference in the distribution of prepairs and repairs between patients with Wernickes and Brocas aphasia, although these two groups differed in performance. Possible mechanisms of linguistic monitoring are discussed.

Abnormal eye movement behaviour during text reading in neglect syndrome: A case study

The eye movement behaviour of a patient suffering from a right basal ganglia infarction with a left-sided hemineglect but without any visual field defects was investigated during reading. The eye movements were registered by means of an i.r. light technique (pupil-corneal reflection method). The main findings were abnormal return sweeps. Whereas in normal readers the end of one line of text is linked to the beginning of the new line by a long leftward saccade, the return sweeps of the hemineglect patient stereotypically ended in the middle of the next line. They were followed by sequences of short saccades indicating silent backward reading until a linguistically plausible continuation of sentences from the previous line was found, irrespective of the actual beginning of text. The shortened return sweeps could not be attributed to a general oculomotor disturbance. The spatial border for the occurrence of the patients abnormal scanning pattern (left half of texts) clearly did not depend on a retinal coordinate frame of reference but rather has to be attributed to a different body-centred reference system.

Facet theory applied to the construction and validation of the Aachen Aphasia Test

The linguistic performance of 120 aphasic patients of the four standard syndromes assessed by the Aachen Aphasia Test (AAT) is analyzed by a nonmetric (ordinal) multidimensional scaling procedure (Smallest Space Analysis, SSA1). The linguistic structure of the test items is characterized within the framework of L. Guttmans facet theory. Three systematic components (facets) are discerned: linguistic modality, unit, and regularity. Properties of the facets as well as their relations are assessed and tested empirically by analyzing the interrelations among different items or sets of items. The spatial configurations obtained by the scaling procedure fit only partially the expectations derived from the facet-theory model. The modality facet was found to have a strong overriding influence on the aphasic test performance. The facets unit and regularity were only found for the most rigorously designed subtests. Written Language and Comprehension. The results suggest the introduction of a new combined facet linguistic complexity which reflects the dependency of the facets regularity and unit.

Approaches to Aphasia Therapy in Aachen

Our experience with aphasia therapy has developed in the Neurology Department of the Technical University in Aachen under the direction of Klaus Poeck. Aphasia therapy is provided for both in- and outpatients. Inpatients stay either on acute wards, including intensive care, or on a special aphasia ward. Outpatients are seen either for extensive neurolinguistic and neuropsychological diagnosis at the neurological clinic or for aphasia therapy administered at the school of logopedics. The aphasia therapists cooperate with an interdisciplinary group of researchers including linguists, psychologists, and neurologists. Research on therapy has developed from clinical, diagnostic, and theoretical interests. In the past, we have made several attempts to combine different approaches to a comprehensive treatment regimen (cf. Huber, 1988; Huber, 1991, 1992; Huber, Poeck, & Springer, 1991; Huber & Springer, 1989; Poeck, 1982; Poeck, Huber, Stachowiak, & Weniger, 1977; Springer, 1986; Springer & Weniger, 1980; Weniger,Huber, Stachowiak, & Poeck, 1980; Weniger & Springer, 1989). Furthermore, we have been concerned with methodological issues of therapy research using either single case or group designs (Willmes, 1985, 1990).

Neurofunctional modulation of brain regions by distinct forms of motor cognition and movement features

Extrastriate, parietal, and frontal brain regions are differentially involved in distinct kinds of body movements and motor cognition. Using functional magnetic resonance imaging, we investigated the neural mechanisms underlying the observation and mental imagery of meaningful face and limb movements with or without objects. The supplementary motor area was differentially recruited by the mental imagery of movements while there were differential responses of the extrastriate body area (EBA) during the observation conditions. Contrary to most previous reports, the EBA responded to face movements, albeit to a lesser degree than to limb movements. The medial wall of the intraparietal sulcus and adjacent intraparietal cortex was selectively recruited by the processing of meaningful upper limb movements, irrespective of whether these were object‐related or not. Besides reach and grasp movements, the intraparietal sulcus may thus be involved in limb gesture processing, that is, in an important aspect of human social communication. We conclude that subregions of a frontal–parietal network differentially interact during the cognitive processing of body movements according to the specific motor‐related task at hand and the particular movement features involved. Hum Brain Mapp, 2009.