Most of visual agnosic patients have several impaired visual perception, since their occipital lobe or lobes were damaged. In 13patients whom we had reported as visual agnosic visual perceptual functions were investigated. Several disorders of visual perception might be related to a visual agnosic symptom and relationship of perceptual disorders to visual agnosia was discussed.
    1) Many patients with right occipital lesions showed impaired discrimination or learning of unfamiliar faces, whether they had prosopagnosia or not. In our patient prosopagnosic symptom was mild and relatively transient, although disturbed perception of unfamiliar faces was profound and persistent. Some authors supposed a double dissociation between the recognition of familiar and unfamiliar faces.
    2) Our patients with visual object agnosia had several disturbances of perception or copying of simple and overlapping figures. Such disturbances, however, could be observed in almost all patients with medial occipital lesion in either cerebral hemisphere.
    3) In patients with color anomia a kind of visual perceptual distortion was observed. Despite their normal hue perception they committed some errors in nonverbal color tasks, since they were more sensitive to color brightness rather than hue. But such a distortion of color perception was revealed in patients with medial occipital damage on either side.
    Only few findings were known about relationship of visual perceptual impairments to agnosic symptoms. Further studies are expected concerning this problem.

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    We analysed the associations among symptoms of visual agnosia and visuospatial agnosia using standardization data of Visual Perception Test for Agnosia (VPTA). Two main factors were extracted by cluster analysis of symptoms and factor analysis of test scores. One factor is object, picture, color, and symbol recognition, and the other factor is figure and face recognition. Distribution of visual and visuospatial agnosias was concluded by combination of these two factors. That is severity sequence of visual agnosias and independence of unilateral spatial agnosia and prosopagnosia from the sequence.

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    I present a male patient who began to have slowly progressive visual agnosia and visuo-spatial agnosia at the age of 60. The visual agonosia consisted of prosopagnosia, object agnosia, picture agnosia, and cerebral dyschromatopsia. The visuo-spatial agnosia included left hemispatial neglect, psychic paralysis of gaze, and visual inattention. Because of a difficulty in copying figures and matching identical figures, the visual agnosia was considered to be the apperceptive type. On the other hand, memory disturbances, aphasia, dementia had not appeared until the end stage of the illness. All these manifestations suggested that the illness resembled posterior cortical atrophy. Neuropsychological points in this case were those as follows : 1) the visuo-spatial agnosia considerably contributed to the occurrence of the apperceptive visual agnosia ; 2) in spite of the presence of severe visual agnosia and visuo-spatial agnosia, the patient was able to walk without bumping into obstacles.

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    Recently, prosopagnosia has been discussed on its heterogeneity. Visual object agnosia is distinguished between apperceptive form and associative form, so is prosopagnosia.
    A case with apperceptive prosopagnosia was reported. Although this case did not present prosopagnosia when he met with right occipital hemorrhagic infarction attack at first, he had persistent and severe apperceptive prosopagnosia and central achromatopsia after the second attack of left occipital hematoma.
    Neuropsychological features observed in this case were as follows ; 1) Recognition deficits of familiar faces were severe and persistent. 2) There was not any sufficient evidence that the patient had covert recognition for familiar faces which he was unable to identify overtly. 3) The patient had difficulty in distinguishing among intra-class species or individuals of insects, flowers, cars, or famous architectures. However, our patient with associative prosopagnosia recognized visual stimuli other than face so well that it was safe to say that his recognition deficit was almost face-specific. 4) His ability to discriminate and learn unfamiliar face was impaired more severely than that of our patient with associative prosopagnosia. 5) His impairment of perception was more severe than that of our patient with associative prosopagnosia.
    The Visual Perception Test for Agnosia edited by the Japanese Society of Aphasiology will help to detect the difference of neuropsychological features between apperceptive and associative forms of prosopagnosia.

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    The author tried to evaluate the significance of cognitive psychology form clinical neuropsychological point of view, examining “Visual Agnosia” (1990) written by Farah. Two major problems were revealed as follows : 1) Farah insisted that in a PDP (parallel distributed processing) system the perceptual and memory representation cannot be dissociated, that means fundamental difficulty of distingushing apperceptive and associative agnosia. However there exist a few case reports of “symbolic form” of visual agnosia whose capacity of copying or matching figures were almost preserved. 2) Concerning Farah's trying to distinguish dorsal and ventral simultanagnosia, she contributed to indicate the heterogeneity of simultanagnosia but regrettably neglected the proper type of simultanagnosia described by Wolpert (1924) that is so to speak impaired comprehention of “epistemological simultaneity” rather than spacio-temporal one. It is important for cognitive psychology and clinical neuropsychology to have the true common understanding for the clinical facts and to discuss it incessantly.

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    We investigated remote memory in 9 patients with mild and 9 with moderate dementia of Alzheimer type (DAT). For this purpose, we used a modified version of assessment of autobiographical memory described by Kopelman et al (1989). Public events memory was evaluted using the Dead/Alive test (Kapur et al 1989) , applying to Japanese personalities. Performance on both autobiographical memory and Dead/Alive test showed a temporal gradient with better retention of more remote information in both groups. These findings provide evidence of the temporal gradient in cases of mild and moderate DAT. The mild DAT differed significantly from the moderate DAT in autobiographical memory test results, but there was no dissociation among these two kinds of DAT groups with regard to the Dead/Alive test results. These results may not only be attributed to a simple difference in the conditions of responses on the two tests (recall or recognition) , but rather to a greater impairment of the complex hierarchical organization of autobiographical memory in the moderate relative to the mild DAT cases.

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    We reported a case of facilitating oral naming by “written naming” (output using writing only) in a 58-year-old, right-handed male. CT scan revealed an extensive infarction lesion in the left temporoparietal region. Neurological examination found mild hemiparesis, mild sensory disturbance and sensory aphasia. The patient's spontaneous speech and verbal fluency were preserved with some paraphasias. His auditory comprehension was extremely poor. Object naming, repetition, oral reading and writing were also severely impaired. Reading of words was spared. Four months after the onset, his naming ability remained poor, but written naming was often observed rather than oral naming. As he increased using this writing-to-sound processing, his naming ability improved. Thus written naming facilitated his oral naming at the same time. This result suggests that written naming may be realized without phonological processing, so that even if the phonological route is impaired, the nonphonological route may be used for correct oral naming.

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    We have detected and reported the following findings for the SLTA rating scales 3 and 4 as follows : (1) As points 3 and 4 express the recovery process of aphasia, it is possible to predict the possibility of recovery. (2) It is possible to discriminate between fluctuations and aggravation of aphasic symptoms. (3) The scale ratings manifest a severe aphasic communication level.
    In this report we compare the scores of SLTA with those of CADL, to confirm that the scores of rating scales 3 and4 indicate an aphasic's ability in daily communication.
    The results indicate that recognition of speech and letters (input) , scores from CADL are superior to those for SLTA. This means that even when high scores are obtained from SLTA, aphasic patients can have difficulty in understanding everyday communication. At the same time, however, with speaking and writing (output) SLTA scores are higher than those of CADL. But when the scores for scales 3 and 4 are added, SLTA is correlative to CADL.
    These results confirm that scales 3 and 4 reflect an aphasic's expressive ability in communication.

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    We assessed language function in patients with Alzheimer's disease (AD) using the Japanese version of the Western Aphasia Battery. The results in 156 patients with probable AD were compared with those in 16 age-, sex-and education-matched cognitively normal aged volunteers. The mean Aphasia Quotient (AQ) was 78.9 in the patients with AD and 96.0 in the controls. The means of AQ and all subtest scores were significantly lower in the patients with AD than those in the controls, and related highly to Mini-Mental State Examination score, Alzheimer's Disease Assessment Scale score and Clinical Dementia Rating score. The features of language disturbance in AD included fluent speech, well-preserved repetition and comprehension abilities, and impaired naming, reading and writing abilities. The language disturbance was classified as anomic aphasia in 123 patients, Wernicke's aphasia in 14 patients, transcortical sensory aphasia in 11 patients and conduction aphasia in 2 patients. The language disturbance in 6 patients did not fit into any classic categories of aphasia.

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    To investigate age changes in naming ability for line drawings divided into semantic categories (SCs) , 117 normal subjects in ten age groups (second grade schoolchildren to sexagenarians) were assessed using a 300-word naming test consisting of 30 SCs. The second grade schoolchildren had the lowest average scores (245.2 words). The mean scores of the older groups steadily increased through the group in their thirties, who had the highest scores (296.9 words) , then decreased, with the group in their sixties having a score of 288.0 words.
    A total of 5 SCs were found to have been acquired by second grade schoolchildren and were uninfluenced by age. Thirteen SCs were acquired in the three age groups (third-year high school students, twenties and thirties). Six SCs had deteriorated in the group in their sixties. We also investigated whether there was any correlation between SCs in which patients with semantic memory impairment or aphasia exhibited a specific deficit, and SCs which demonstrated delayed “age of vocabulary acquisition” (i. E., acquisition more than age of second-year junior high school) or vocabulary deterioration with aging.
    Results showed no correlation with category-specific impairment for animate objects, but the possibility of a correlation for inanimate objects could not be ruled out.

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