Recently interests in aphasic rehabilitation associated with other higher brain function disorders have grown rapidly. However, in Japan a few studies on this issue have been reported. In this paper, higher brain function disorders associated with aphasia were discussed on the basis of findings from three cases with aphasia. The incidences of other higher brain function disorders associated with aphasia were about 30% in our study. However, the degree of improvement in other higher brain function may differ substantially from the degree of aphasia in each period after the onset. In order to develop more effective training methods many studies have to be done.

View full abstract

    Attentional disorders and their rehabilitation were studied in patients with cerebrovascular disease, and the following observations were made. 1) Attentional disorders occur in cerebrovascular desease regardless of whether the left or right side of the brain is damaged. However, rehabilitation is often very difficult in patients with right brain damage and in these cases it is thought that the appearance of attentional disorders together with a variety of non-dominant hemisphere syndromes is a distinctive feature. A therapeutic program for treating the attentional disorders of patients with cerebrovascular desease must be based on this knowledge. 2) In order to detect an impediment in pacing, we designed a figure tracing task which can be applied to either left or right brain damage. The findings suggest that many points emerged in patients with right brain damage. 3) We introduce an actual rehabilitation program for patients with early onset or chronic right brain damage with attentional disorders and then briefly discuss the efficacy of the rehabilitation therapy.

View full abstract

    Two trends in memory rehabilitation were discussed. First, the traditional and pragmatic techniques for supporting amnesic individuals were reviewed. These include external aids and internal mnemonic strategies such as verbal elaboration and a visual imagery method. A pure amnesic patient with herpes encephalitis was reported who demonstrated a significant benefit by verbal elaboration mnemonics, but not by visually-aided cues. Second, the newly developed top-down approaches for memory remediation were reviewed. These interventions including acquisition of domain-specific knowledge and a method of vanishing cues intend to utilize preserved ability of amnesic subjects. By discussing the theoretical importance and limits of the method of vanishing cues in which implicit memory process is implicated, the role of errors was highlighted in amnesic patients' memory rehabilitation. Although the method of vanishing cues is considered to be errorless and effortful intervention, the effect of errors and efforts in learning sessions has not been satisfactorily investigated. To determine the role of errors and efforts, we conducted two training programs. In Training 1, Korsakoff patients learned fictitious face-name associations under each of four study conditions that differed from one another in errors and efforts required to fulfill task demands. Recall performance gradually improved over four training sessions and was affected by the error factor. The paired associate and the vanishing cues methods led to superior recall in comparison with the target selections and the initial letter methods, demonstrating an advantage of errorless learning. In contrast, the effort factor was found to have little effect. In Training 2, the effectiveness of the vanishing cues method was further examined over additional training sessions. The roles of errors and efforts in the memory rehabilitation of amnesic patients were discussed.

View full abstract

    Frontal lobe dysfunction has been believed to be resistive to cognitive rehabilitation training. We introduced three main rehabilitation approaches ; the self-instructional procedure, a problem-solving training, and physical set-changing exercise to 6 patients of frontal lobe dysfunction.
    They were trained with above-mentioned methods for 6 months. In the self-instructional procedure phase and the problem-solving training phase, psychologists guided and trained patients one hour per day twice a week. In the physical set-changing exercise phase, patients were advised to do exercise twice daily for 20 minutes at home, following a video tape. Each training phase lasted for 6 weeks.
    After the 3 rehabilitation program, all patients revealed improvement in activities in the real life setting. The self-instructional procedure and problem-solving training proved to be effective in some executive function tests.

View full abstract

    A 69-year-old, right-handed male patient with left-parietal lobe lesions demonstrated impairments of kinesthetic reading-aloud and kinesthetic written reproduction with intact capacities of visual reading-aloud and visual written reproduction. It is speculated that disconnection phenomenon occurred in which images of characters cannot be retrieved from their kinesthetic stimuli, although kinesthetic, visual and auditory images of characters as well as motor and sensory systems seem to be intact. It is suggested that lesions centered in the left-parietal lobe produce deficits both in unimodal somesthetic association and cross-modal association for characters.

View full abstract

    It is reported that a patient with sensory aphasia who had difficulty in repeating a word correctly. The patient read aloud words correctly, but the uttered ponemes were transformed progressively, then those phoneme reached to nonsense neologisms even when he was presented with a picture of the words simultaneously.
    We investigated the time and the number of word repetition before the transformation began. The noun and verb words which varying from 2 to 6 moras were used in the experiment.
    The results showed that the number of mora had a strong effect on the transformation, but grammatical class of the words did not. It is explained that the mechanism of the symptom was based on insufficient function of the phonological processor and disorders of information feedback between each cognitive module in speech processor.

View full abstract

    SLTA or WAB, and an articulation test were performed on three cases showing aphasia and dysarthria caused by left putaminal lesion, and features of the verbal symptoms of the patients were evaluated. Test results revealed that aphasia of mild degree seen in the acute phase in all three cases, with word recall as its major feature, disappeared in the chronic phase, while dysarthria persisted in all cases. The features of articulation were as follows : 1) There was no sign of abnormality in voice ; 2) Distortion was noted in articulation, and there was no regularity in erred sound ; 3) With respect to prosody, sound and syllables were heard separately, and duration of sounds and syllables was irregular ; 4) No abnormality was present in speech modality ; 5) No sign of abnormality appeared in elongation of vowels ; 6) With diadochokinesis, speech behavior was particularly inferior when repeating trisyllables ; 7) No distinct separation existed between spontaneous speech and repetition or words read aloud. The features of articulation disorder seen in the three cases differed from dysarthria as noted in pseudobulbar palsy, dysarthria caused by spinocerebellar degenerative disease, and also from dysarthria in degenerative disease in bilateral extrapyramidal systems. The dysarthria in these three cases may be caused by lesions on or around the left putamen. The exhibited features differed in detail from anarthria although the symptoms were similar to those of cases of left putaminal lesion reported by Kaneko et al. (1989).

View full abstract