In conjunction with studies concerning time-course analysis of language function in aphasics, we investigated the super long-term follow-up data of 270 right-handed aphasics with left lateral damage. Among the 270 aphasics followed for more than two years, we excluded those more than 70 years old at the time of final assessment. We thus analyzed the data of 151 aphasics. The severity of aphasia was evaluated using the general scores on the Standard Language Test of Aphasia (SLTA) . In 37 of the 151 aphasics (24.5 %) , the general scores on the SLTA declined during the period of language therapy or after the end of language therapy. The score of 19 aphasics decreased 1 point, and the score of 18 aphasics decreased more than 2 points from their scores at their most recovered stage.
     Approximately 90% of these aphasics failed to maintain the scores recovered through the language therapy. These findings suggest that functional restoration of language by therapy is not stable but rather fragile.

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     The patient was a 68-year-old female who had landmark agnosia caused by a lesion of the medial occipitotemporal area.
     A visual perception test demonstrated preserved fundamental visual function and normal recognition for simply presented objects, but she showed simultanagnosia. She was unable to integrate elements of stimuli and to perceive their global configuration in recognizing and remembering a landscape. In order to understand large-scale topographical representations, it is necessary to recognize buildings and the layout of the landscape integrating this with partial information. The patient had severe deficits of visual integration regarding layout and context of the landscape, and as a result might appear to have landmark agnosia. The landmark agnosia and simultanagnosia that she presented are similar, and this similarity is thought to be associated with proximity of their neural bases.

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To study the environmental effects on agraphia in mild cognitive impairment and dementia, we compared elderly Japanese subjects living in Japan and Brazil. We retrospectively analyzed the database of the Prevalence Study 1998 in Tajiri (n=625, Miyagi, Japan) and the Prevalence Study 1997 of elderly Japanese immigrants living in Brazil (n=327, migrated from Japan and living in the São Paulo Metropolitan Area) . In three Clinical Dementia Rating (CDR) groups, i. e., CDR 0 (healthy) , CDR 0.5 (questionable dementia) , and CDR 1+ (dementia) , the Mini-Mental State Examination (MMSE) item of spontaneous writing and the Cognitive Abilities Screening Instrument (CASI) domain of dictation were analyzed with regard to the pragmatic errors. The immigrants in Brazil wrote similar numbers of Kanji or Kana characters compared to the residents of Japan. In spontaneous writing, no remarkable differences were noted between the two populations so did the CDR groups. In writing from dictation, the immigrants CDR 0 group showed more replacement errors of Kana compared with the CDR 0 group in Japan, and the immigrants CDR 1+ group disclosed more omission errors of Kana compared with the CDR 1+ group in Japan. Immigrants had lower educational level, and use Kanji and Kanji less frequently, thus the written characters was affected. For Kanji, the effect of dementia was considered.

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We assessed the use of the dysexecutive questionnaire (DEX) for the behavioral assessment of dysexecutive syndrome (BADS) , and also conducted executive function tests such as the Wisconsin Card Sorting Test (WCST) , Trail Making Test (TMT) , and Paced Auditory Serial Addition Test (PASAT) in 29 patients with Parkinson's disease (PD) and 22 age-matched control subjects. Eight out of the 20 DEX items in PD patients were significantly different from those of control subjects. In addition, all results of WCST, TMT, and PASAT were abnormal in PD patients. Six out of the 8 items in the DEX were significantly correlated with the results of either WCST, TMT, or PASAT in PD patients. From the logistic regression analysis, the validity of these 6 items in the DEX was confirmed. Therefore, we suggest that these 6 items in the DEX are useful to evaluate everyday executive function in PD patients.

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     The present study reports a case of selective impairment of verbal short-term memory. The patient was a 59-year-old non-right-handed male native speaker of Japanese. He demonstrated no signs of aphasia even immediately after the onset of left-hemisphere infarction. Standardized examinations of intelligence, attention, and frontal lobe function revealed the patient's performances were within normal range and clinical observations indicated that his visual-spatial cognition and memories of daily activities were preserved. In contrast, his digit span scores were limited to three or four.
     In-depth examinations of his repetition revealed the following ; (1) repetition of meaningful sentences with phonological sequences identical to those used in the digit span test was better than that of the digit span test ; (2) when each set of digits in the digit span test was presented as a single number (i. e., “274 (two hundred seventy four)” for “2,7,4”) repetition performance was better compared to that of the digit span test ; (3) recall of high-frequency two-syllable word sequences was better than recall of two-syllable nonsense word sequences consisting of the same syllables.
     The findings suggest a possibility that the capacity of verbal short-term memory is determined by the number of chunks and processing efficiency of the chunks rather than the amount of segmental phonological information, which is consistent with previous reports. Further discussion on the effects of stimulus materials and presentation rate were provided and a clinico-anatomical examination suggested anatomical basis of verbal short-term memory was in the vicinity of the transverse temporal gyrus and operculum temporale of the dominant hemisphere.

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The “Spatial Comprehension Test” was devised in order to examine ability of understanding spoken sentences which describe spatial relationships between two or more objects. We examined whether this new test can detect deficits of sentence processing which cannot be explained by deterioration in syntax ability and which have often been reported in left parietal damaged patients. The subjects consisted of a left parietal damaged aphasia group (5 mild fluent aphasics) , a non-left parietal damaged aphasia group (3 mild fluent aphasics and 2 mild non-fluent aphasics) , and an age-matched group of 10 normal controls. While both control groups showed good performance in the Spatial Comprehension Test, all patients in the left parietal damaged group were impaired. However, their sentence comprehension as evaluated using the Token Test, Syntax Test of Aphasia, and Particle Comprehension Test was preserved. In the left parietal damaged group, performance in the Spatial Comprehension Test and in ordinary sentence comprehension tests on the above were not correlated. These results suggested that the Spatial Comprehension Test may be able to detect impairment of sentence comprehension relating to spatial relationships, which is distinguishable from syntactical aspects of sentence processing.

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The purpose of this study was to measure capability of sentence production in fluent aphasia. The subjects were six stroke patients with Wernicke's aphasia who had presented mistakes of particles in production of sentences. A test was designed in order to produce utterances in sentences. There were two types of sentences used in this test : (1) sentences which had verbs with alternating transitivity (e. g., koma-ga-mawaru [ A top spins ] / koma-wo-mawasu [ One spins a top ] ) and (2) sentences which had verbs with non-alternating transitivity (e. g., inu-ga-aruku [ A dog walks ] / ji-wo-kaku [ One writes a character ]) . The subjects were presented with pictures that showed eighty patterns of action, and they were asked to describe the pictures in sentences. Performances with the two kinds of sentences were compared, and the results were as follows. The two patients showed lower scores in the sentences with the verbs having alternative transitivity. They had difficulty in matching case particles and suffixes. However, production of verb stems was not affected by verb type. The above findings indicated that sentence construction in the alternating transitivity condition is more difficult than in the non-alternating transitivity condition. They also suggested that the nature of the disorder in sentence production is in syntactic operation when correlating a case particle to a suffix.

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Gogi aphasia, which was first described by Imura in 1943, is a form of transcortical sensory aphasia characterized by intact repetition, poor verbal comprehension, verbal paraphasia, and specific impairment of kanji processing. Recently, Gogi aphasia has often been discussed in the context of semantic dementia, a form of frontotemporal lobar degeneration. However, the relation between Gogi aphasia and semantic memory impairment has not been fully elucidated. We tested various semantic memory tasks in a patient with Gogi aphasia after extensive venous infarction involving the left temporal lobe. She did not exhibit any semantic memory impairment as far as we could determine. The findings suggested that Gogi aphasia is not identical with semantic dementia and that impairment of reciprocal coding between lexical items and semantic memory, or symbol and referent, can result in symptoms compatible with Gogi aphasia.

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