The recovery process was investigated in 20 aphasic patients who had been under speech therapy for more than one year. The study reveled that comprehensive function improved better than expressive ability, which recovered slowly over a long period. On the other hand, repetition of sentences showed no improvement, which might be related to memory disturbance. It was difficult to detect deficiency in writing and reading kana letters by S. L. T. A. Several factors which are deemed necessary to continuing the therapy were indicated.

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    The purpose of the study is to determine the defective site along the visual perceptive process, successive process dealing with mental representation and response process underlying the unilateral spatial neglect (USN), and to define the influence of the space given visual stimulation. Five patients with leftside USN from the lesions in the right cerebral hemisphere were examined utilizing of the visual discrimination of pairs of figures. Subjects were required to judge mentally and to answer verbally whether pairs of visually presented figures were same or different each others. These trials were carried out in three different conditions of the space given visual stimulation. In this experiment, all the patients showed positive for USN regardless of the different space given visual stimulation. No prominent influence for the space given visual stimulation was detected. Consequently, these findings are indicating that USN is the result of a disorder in visual perceptive process and/or successive process dealing with mental representation, and it is not adequate to regard response process as the nature of USN. And it is clearly showed that USN is appeared independ-ently of the space given visual stimulation, however, further study should be carried out to answer the question whether the quantity of USN is changed by means of the space given visual stimulation.

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    It is a follow-up study of a right-handed 41-year-old male patient in whom a left hemispherectomy was perfomed 31 years ago. The study was mainly focused on his neuropsychological functions. The operation was done at the age of 9 years and 11 months due to severe uncontrollable epileptic seizures which occurred at 5 years of age, followed by right hemiplegia, mental retardation and severe violent behaviors.
    The patient spoke almost accurately soon after the operation. This was considered to be the results of the compensation of the right hemisphere after the first seizure at the age of 5. However, the level of his language did not improve more than that of the daily conversation. He also had difficulties in understanding complex tasks which required high level of conceptualization. His constructional activity was also disturbed. These findings suggested that his intellectual functions were disturbed in genenal.
    At the age of 25, the increases of IQ score, writing ability and calculation skill were remarkable after intensive training for 3 months, but now he is 41 years old, these abilities have reduced to pre-training level.
    If the continuous and systematic neuropsychological training had started immediately after the operation, his neuropsychological abilities, especially writing and calculation, might have sustained the considerable level.

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    We have recently designed a neuropsychological test battery to assess higher brain functions, containing the following tests : 5 minute memory, animal name listing, serial sevens, similarity test, digit span and kana pick-up test.
    We evaluated brain damaged patients using this test battery serially and compared the results with those obtained by other dementia rating scales and WAIS.
    Dementia patients and patients with disturbed consciousness scored 0 points except for the digit span test. We refer to this as the “dementia pattern” . When patients with disturbed consciousness recovered, they improved in 5 minute memory and serial sevens, which are both related to memory. But in the animal name listing, similarity test and kana pick-up test, which are related to higher brain functions, no improvement was shown.
    At the chronic stage, frontal lobe lesions showed especially lower scores for the kana pick-up test, while temporal lobe lesions showed 5 minute memory disturbance. These findings may assist in locating cerebral lesions.

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    We compared the nonverbal repetitive oral movements of 3 cases with pure anarthria, 4 cases with paretic dysarthria and 8 normals. No patient had buccofacial apraxia.
    Simple nonverbal repetitive tasks were movements of one part of articulatory apparatus, i.e., (1) protrusion and retraction of the tongue, (2) movement of the tongue from side to side, (3) movement of the tongue up and down, (4) making click-sound by the tongue, (5) bilateral protrusion and retraction of the lips, (6) explosion of the lips, and (7) making click-sound by the teeth. Complex nonverbal repetitive tasks were a combination of the movements of individual parts of the articulatory apparatus, i.e., (8) explosion of the lips and click by the tongue, (9) explosion of lips and click by the teeth, (10) click by the tongue and click by the teeth. Frequency of the movements during 5 seconds was measured.
    There was no differences among the frequency of the movements of the three groups on the tasks of simple movements. Oral movements, however, of the cases with pure anarthria were significantly slower in the tasks of complex movements. The results indicated that, in pure anarthria, the mechanism adjusting the timing of movements of individual parts of articulatory apparatus (e.g. lips and tongue) is disturbed, and this disturbance of nonverbal movements is one of the causes of their articulatory disorder in pure anarthria.

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    A 65 year-old right-handed patient was admitted to our hospital for treatment of right-sided hemiparesis and speech disturbance 14 days after onset. He had been taking antihyper-tensive drugs. Neurological examinations at admission revealed slight right hemiparesis, mild trans-cortical sensory aphasia and a tetrad of Gerstmann's syndrome as examined by verbal and non-verbal methods. The aphasia and hemiparesis were almost fully cured at two months after onset, but the tetrad of Gerstmann's syndrome (agraphia, acalculia, right and left agnosia, finger agnosia) was still observed. Xray-CT showed left thalamic hemorrhage, and MRI in the chronic stage revealed a localized high intensity area in the left thalamus (Fig. 3). IMP-SPECT showed an extensive decrease (10˜20%) of cerebral blood flow in the left hemisphere including the angular gylus (Fig. 4). The Gerstmann's syndrome almost disappeared 4 months after onset. In this case, Gerstmann's syndrome occurred from subcortical lesion localized in the left thalamus. But the SPECT showed extensive low perfusion in the left hemisphere. These findings suggested that Gerstmann's syndrome nay occur due to functional damage of the thalamo-cortical ascending pathway. Only two cases of Gerstmann's syndrome traced to thalamic hemorrhage have been reported.

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    Word fluency ability in two different categories (phonological and semantic) was studied in patients with mild to moderate dementia : Alzheimer type dementia (52 patients), multi-infarct dementia (41 patients) and other types of dementia (7 patients). The major results included the following : (1) The dementia group retrieved significantly fewer words than the control group in both phonological and semantic categories and the number of retrieved words decreased significantly as the severity of dementia progressed. (2) While the control group retrieved more words from the semantic category than from phonological category, the performance of the dementia group showed a reversal of the pattern of the control group. (3) On the other hand, basically the same patterns of performance between the control and dementia groups occurred in the frequency with which given words were retrieved and the kinds of words retrieved in both phonological and semantic categories. Results (1) and (2) taken together indicate the structural and functional alteration of semantic memory in the dementia patients. On the other hand, the result (3) suggests that the maior words in a given category tend to be retrieved more frequently than the minor words even in the dementia patients who have an altered semantic memory as well as in the control group.

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    In a case of transcortical aphasia some various compulsive behaviours were observed ; for example, compulsive picking up and manipulating of goods on the table during speech therapy, compulsive repetition of the question in the conversation (auditory echolalia), compulsive reading aloud of letters which came in his visual field (visual echolalia) and stereotypic iterations of actions and utterances of some empty phrases. The authers discussed the symptomatological implication of “Hypermetamorphose” (Wernicke), “formulation verbale” (Pick), “Freiheitsverlustsyndrom” (Scheller), “Environmental dependency syndrome” (Lhermitte) and “Distan-zlosigkeitssyndrom ” (Hadano et al.), stressing important meanings of such a psychiatric approach to the study of compulsive behaviours.

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