We undertook a long-term follow-up study of 38 severe aphasics. The subjects were all right-handed and had damage in the left cerebral hemisphere. Their scores at their most recovered stage( “plateau level”) on the Standard Language Test of Aphasia (SLTA) were distributed between 0 and 3 points. Their passable items were comprehension and reading aloud of words and letters. They did not show recovery in speech or writing tasks. These results indicate that predicting long-term recovery is difficult during the early stage after onset of aphasia. Protracted aphasic therapy does not always result in good recovery. However, because factors affecting prognosis are not clear, it is necessary to attempt to recover language functions over the long term.

View full abstract

   The present study investigated the nature of semantic errors using a single-word auditory comprehension test with semantic distracters administered to 18 participants with aphasia. First, distribution of the semantic and other errors in the auditory comprehension test was examined. Most errors were semantic rather than nonsemantic or no response, suggesting that most participants could at least receive partial semantic information even if they failed to chose the correct item. Second, the majority of the semantic errors showed cueing effects by re-stimulation. This cueing effect might support the hypothesis that the underlying semantic impairment is deficit of activation of semantic information rather than structural disorganization of the semantic store. Third, the relationships between the semantic errors and semantic ability measured by a non-verbal semantic judgment test were examined. Participants with low semantic ability showed more semantic errors than participants with high semantic ability, whereas the two groups did not show significant difference for other types of error. In addition, the number of semantic errors in the auditory comprehension test showed a significant negative correlation with the score on the semantic judgment test. These findings support the validity of regarding semantic errors in the auditory comprehension process in aphasia as an index of impairment of the semantic system to some extent.

View full abstract

   The ability to interpret emotional cues has been argued to play an important role in maintaining successful relationships and healthy psychological functioning. We focused on age-related changes detected through emotions from photographs of eyes. The nonverbal Eyes test of TOM (theory of mind) investigates ability to determine another's thought or feeling from a picture of their eyes. The previous studies found that the elderly were worse at detecting complex emotions and mental states from photographs of eyes. In the current study, the elderly were tested on the ability to detect happiness expression through visual information from photographs of faces. The results suggest that the ability to interpret happiness expression through visual information from photographs of faces shows specific age-related deficits. However, no age effects on the recognition happiness expression through visual information, if the elderly use information of other facial areas (ex. lips) .

View full abstract

   A Japanese boy aged 7 years and 11months exhibited learning disability in writing of both Kanji and Kana. He was also diagnosed with attention-deficit hyperactivity disorder and developmental coordination disorder. His intelligence, oral language and reading skills developed normally. Neuropsychological tests showed that his basic functions to acquire writing skills (i.e. visual cognitive function, constructional ability and motor function for writing) were normal. The feature of his Kanji dysgraphia was incomplete reproduction. When we tested his visual memory using complex figure, he showed disorganized copy, poor reproduction and good recognition. When we showed him colored complex figure and asked him to copy with colored pencils, his performance of reproduction was remarkably improved. Thus, his failure in learning Kanji was due to a lack of strategic encoding rather than a failure of retrieval from visual memory. The feature of his Kana dysgraphia was non-response. It is generally thought that Kana depend on kinesthetic images rather than visual images because Kana are simple figures and consist of multiple strokes (Iwata, 1979) . Therefore, the association between phonological (more precisely syllabic) images and kinesthetic images is important for Kana. We tested the subject's kinesthetic images of Kana through kinesthetic reading. The pattern of his performance in kinesthetic reading correlated with his performance in Kana writing rather than that of visual reading. Thus, we speculated that his deficit in learning Kana was due to a failure to create kinesthetic images or an association between syllabic and kinesthetic images. Because his dysgraphia showed different obstacle mechanisms for Kanji and Kana, we hypothesize that different neural substrates or networks may be responsible for acquisition of handwriting of Kanji and Kana.

View full abstract

   We report a case of echopaligraphia following subarachnoid hemorrhage caused by rupture of a right middle cerebral aneurysm. The patient was a right-handed 46-year-old male. Echographia was first reported by Pick in 1900 and was classified into auditory echographia, which noted spoken sounds, and optic echographia, which copied visual characters (Sittig 1928) . Auditory echographia and optic echographia were observed in this case and were combined with paligraphia (repeating the characters that the patient himself had written) ; i. e., the subject presented echopaligraphia. He also exhibited various neuropsychopathic symptoms (grasping phenomenon, utilization behavior, stereotypy behavior, hypermetamorphosis, etc.) . Forty-three days after his stroke, brain CT scans revealed a low-density area in the frontal and anterior temporal lobes in the right hemisphere, as well as enlargement of the third ventricle and lateral ventricles on both sides.
   The characteristics of echopaligraphia in this case were as follows. (1) Echopaligraphia was transient, and the appearance of echopaligraphia changed during the progression of hydrocephalus that aggravated his consciousness disorder. (2) In echolalia, the echo-forms of complete echolalia, mitigated echolalia and partial echolalia have been reported (Hadano et al. 1987) . Echographia in this case exhibited echo-forms that were similar to echolalia. (3) Echographia changed as follows : complete and mitigated echographia (fcomplete and mitigated and atypical echographia (atypical and partial echographia. (4) In the paligraphia of the current case, only slight repetition was observed quantitatively at first, but it increased in repetitions later and decreased thereafter. This report describes the case in detail and discusses the symptomatological characteristics, the appearance aspects and the neuropsychological mechanisms of echopaligraphia.

View full abstract

   We developed a modified version of Rey's Auditory Verbal Learning Test for Japanese children of pre-school ages in order to clarify developmental changes in auditory verbal memory. The subjects were 99 children aged 4 to 6 years old. There was a significant age difference with respect to the total number of words recalled in 5 trials (p <. 05) and the effect of word position (p <.05) , while no significant difference was found among the different ages in terms of the number of recalled words (p =.842) or effect of serial position (p =.115 ~.417) in immediate recall. For the delayed recall task and post-interference recall task, significant differences in the number of words recalled were found between 4 and 6 year-old children (p <.01) . The number of words recognized from the original list increased with age, and a significant difference was found between 4 and 5 year olds (p <.01) We found that the modified AVLT for Japanese pre-school children can be used to analyze various aspects of their auditory verbal memory.

View full abstract

   We described a 59-year old woman who presented initially with speech changes reminiscent of an English speaker speaking the Japanese language with an English accent (foreign accent syndrome : FAS) . The FAS was followed by personality change, emotional flatness and aberrant social conducts that were characteristic of frontotemporal dementia. Language tests revealed economy of speech and a trace of non-fluent aphasia with speech apraxia. Although brain MRI did not suggest any specific atrophic patterns, SPECT showed that the brunt of brain degeneration was located at the right orbital frontal cortex and posterior frontal convexity. The left posterior-superior medial frontal regions were also involved, but the speech areas including the left frontal operculum and lower precentral gyrus remained intact on SPECT through the observation period of two years. Review of the literature suggested that degenerative diseases such as FTD have not yet been nominated as a causative disease of FAS.
   Phonologic-linguistic analyses of FAS in the present patient revealed both segmental and suprasegmental abnormalities. The segmental factors included frequent omission of postpositional particles and “sokuon” [short utterance with a glottal stop] as well as mild speech apraxia and phonological paraphasia. The suprasegmental abnormalities consisted of intonation changes that resulted from the segmental abnormalities and a marked defect in expression of emotional prosody. Comparison of phonological characteristics of the present and previously reported FAS patients suggested that the denominators in FAS occurring in the Japanese language may be frequent omission of postpositional particles and “sokuon”. Given the vast backgrounds of FAS, degenerative diseases including FTD can be additional causes of FAS. The present patient may represent the first FTD case presenting with FAS, a possible novel sign of FTD.

View full abstract

   We undertook a long-term recovery case study of a 22-year-old, right-handed female with severe Broca's aphasia. She developed aphasia and right hemiplegia following cerebral infarction in the left hemisphere. At the 41st day after onset, we started examination of her language impairments and training of her language functions. Language impairments were examined using the Standard Language Test for Aphasia (SLTA) We found that language therapies get good results even beyond 5 years after onset. Performance on the SLTA indicates that recovery extends over a long period, with the course and time of recovery varying according to language modalities. We thereby showed that therapeutic effects of aphasia are not only limited to short periods after onset; it is necessary to treat them with language therapies over a long period of time.

View full abstract