We reported a case of “Broca's aphasia” without apraxia of speech. The subject was a 41-year-old right-handed man who suffered from a cerebral infarction causing aphasia and right hemiparesis. His MRI revealed a lesion involving subcortical white matter of the Broca's area with posterior extension to the cortical and subcortical areas of the lower part of the post-central gyrus and supramarginal gyrus as well as the superior temporal gyrus, but sparing the lower cortex of the precentral gyrus. He presented neuropsychological symptoms consistent with those of Broca's aphasia as defined by Benson (1979) except for the absence of apraxia of speech. On the other hand, he revealed phonological and syntactic impairments compatible with those of contiguity and sequence, by which Jakobson (1963) characterized Broca's aphasia. His syntactic impairments were also congruent with Berndt et al. (1980) 's definition of Broca's aphasia. The existence of this case of “Broca's aphasia” without apraxia of speech, coupled with the existence of cases with pure apraxia of speech, demonstrates a double dissociation of speech output deficit and linguistic deficit, which are components of so-called Broca's aphasia.

View full abstract

    A 69-year-old right-handed man with a seven-year history of slowly progressive non-fluent aphasia characterized by marked anarthria and mild spelling dysgraphia is described. His naming ability has remained at an exceptionally high level and there has been no impairment of auditory comprehension or reading.
    Non-verbal skills and memory function have also been largely preserved. MR images showed focal atrophy of the left inferior frontal gyrus and the pre-and postcentral gyri, mild dilatation of the left parietal sulci, and sparing of the temporal lobe. SPECT scans demonstrated hypoperfusion in the pars opercularis frontalis. We argue that the selective language deficits in this patient and protracted course are characteristic of aphemia and are considered typical of primary progressive aphasia (PPA) as described by Mesulam. The importance of clinical distinction between PPA and other cases of progressive aphasia preceding global dementia was emphasized.

View full abstract

    Two expressively restricted aphasic patients were trained to use drawing as an alternative communication mode. Although each subject improved his drawing ability through treatment,their drawing abilities were limited respectively.
    Case l became able to draw single objects both at the training room and at home. But in practice with intransitive action pictures, his drawing did not improve beyond copying. As he did not present visuo-spatial or visual-memory problems, his difficulty in learning action pictures was suggested to originate in a deficit of symbolic function for organizing multiple components—agent and objects.
    Case 2 came to draw action pictures in the task, and its effect was generalized to include untrained items. Although he often drew action pictures in PACE-format therapy, he could hardly draw action pictures in natural settings. His difficulty in using action pictures in daily situations was suggested to originate in a defect of awareness and using acquired novel communication modes in natural contexts.
    It was indicated that further elaborating studies which focus on criteria of therapeutic adaptation and utility in daily life are necessary to estimate the potentiality of drawing as an alternative communication mode for severely impaired aphasic patients.

View full abstract

    We report types of aphasia and recovery processes of four Korean-Japanese bilingual aphasics on the basis of their performances on Standard Language Test of Aphasia (SLTA) administered to them. In Japanese, they exhibited Broca's aphasia, mixed aphasia, jargon aphasia and Wernicke's aphasia, respectively. In Korean aphasic disorder of each case was found to be similar to what was exhibited in Japanese and each case was thought to exhibit the same type of aphasia as in Japanese. All cases were also found to follow the same pattern, a synergistic pattern, of recovery, of which three were parallel and one differential. The case with a differential pattern was inferred to have mastered Japanese better than Korean before onset and speech therapy in Japanese was considered to have had a good effect on him.

View full abstract

    We reported a 40-year-old right-handed woman with multiple sclerosis (MS) Who presented right hemiparesis, ideomotor apraxia, crossed optic ataxia of the left hand, and disturbance of speech prosody. MR imaging showed focal lesions in the bilateral posterior limbs of the internal capsule, the left thalamus and curus cerebri, and subcortical white matter in the left anterior lobe, genu and posterior half of the corpus callosum. The ideomotor apraxia and crossed optic ataxia of the left hand were attributed to the lesions of the posterior half of the corpus callosum. Disturbance of speech prosody was thought to have derived from the genu of the corpus callosum.
    Neuropsychological symptoms, for example, aphasia, apraxia and agnosia, are rare in MS. In particular interhemispheric disconnection syndrome is very rare in MS (there have been only two case reports). The corpus callosum, however, is a common site of cerebral lesions in MS. In the literature there has been 4 ˜ 20 % callosal distribution of cerebral plaques in MS in pathological studies, and neuroradiological studies (MR imaging) show focal callosal lesions in 30 % of MS cases who have cerebral lesions. The abnormality of the corpus callosum is seen in almost every case in MS (100 % in pathological, 55 ˜ 93 % in neuroradiological studies).
    The interhemispheric disconnection syndrome in MS may be overlooked because of its transiency compared with cerebral vascular disease.

View full abstract

    In a previous study, we administered a task to forty Japanese aphasic patients in which they were to choose the particles for various combinations of nouns and verbs, and analyzed the strategies involved in their choices, mainly from the standpoint of noun-particle combination (Kojima et al. 1995). The results reported at that time showed that difficulty in choosing the correct particle was influenced by the frequency of conjunction of the noun and particle, as well as by the nature of the argument (essential or optional). Furthermore, difficulty was also influenced by the severity of the comprehension disorder.
    In this current study, we reported a further analysis with regard to the strategies in aphasic patients' particle choice from the standpoint of particle-verb combination. The subjects, the data-base and the form of the task were the same as in the previous study, namely, forty chronic aphasic patients (fourteen Wernicke's aphasia, nine Broca's aphasia, three mixed aphasia, four conduction aphasia and ten amnestic aphasia), a data-base consisting of 494,956 words from the speech of normal Japanese, and 233 two-phrase sentences in which spaces for particles were left blank to permit the respondent to fill in each blank with one among a choice of five particles. Results showed that, with regard to the role of the verb in choosing the correct particle, the frequency of particle-verb conjunction itself did not affect the difficulty of the task, while the conjunction of the noun and particle did have some influence on it, as we reported in the previous study. According to these results, we assume that the viewpoint of the frequency of conjunction of the noun and particle and the nature of the argument (essential or optional) could be parameters to consider when administering syntactic training to aphasic patients.

View full abstract