We report a patient with non-fluent spontaneous speech after multiple cerebral infarction of white matter. A 69-year-old, right-handed female showed non-fluent spontaneous speech with restatements, repeats of the same word, and interjections. Brain MRI showed multiple infarcts in the cerebral white matter and stenosis of the proximal portion of the left middle cerebral artery.
  In order to analyze the mechanism of her speech disorder, we evaluated her abilities regarding word finding and sentence composition, and cognitive functions such as the frontal lobe function, attention, and a process of thinking, which can influence speech.
  Word finding during spontaneous speech was markedly impaired, but visual naming, auditory naming, and word finding were only mildly impaired. On the other hand, sentence composition was moderately disturbed, although the grammatical ability was not apparently associated with expression. Moreover, frontal lobe symptoms such as fixed thinking and poor flexibility could also be associated with non-fluent spontaneous speech.
  The lesions of cerebral infarction were circumscribed within the cerebral white matter, whereas the areas of low perfusion were broadly disseminated in left frontal, parietal, and temporal lobes. Her non-fluent spontaneous speech might be caused by broad ischemic cerebral lesions or disconnection between cerebral cortical areas affected by infarction in the cerebral white matter.

  Patients with left neglect dyslexia (ND) may omit letters and words at the beginning of the line on the neglected side. Previous studies have shown that patients with preserved syntactic and semantic knowledge may reduce omissions when urged to allocate attention to the neglected side to ensure that the syntactic and semantic requirements of the sentence are met. This study aimed to test if the position of line break of the sentences determines whether the leftmost letters or words of the following line are missed. The subjects of the study were ten right-handed patients (six males and four females) with left unilateral spatial neglect (USN) caused by right hemisphere stroke and ten right-handed healthy adults (four males and six females) as controls. To assess the effect of positions of line break on left ND, we created five texts comprising 60 lines that break at the word boundaries (word boundary task) and five texts comprising 60 lines that break at the non-word boundaries (non-word boundary task) . Seven among the ten patients omitted letters or words at the beginning of the line, demonstrating left ND. Three among the seven patients omitted significantly more letters or words in the word boundary task than in the non-word boundary task. Our result showed that Japanese lexical knowledge may affect the reading of some patients with left ND.

  Patients with left unilateral spatial neglect may have a wide range of attentional deficits not restricted to spatial inattention towards the left side. Previous studies showed that auditory non-verbal stimulation might activate the ability to maintain arousa (l alertness) and improve patientsʼ leftward search. However, there has been no study that clarified the effects of auditory-verbal stimulation. The purpose of this study was to test whether task-related auditory-verbal stimulation would improve patientsʼ performance.
  The subjects were seven right-handed patients (five males and two females) with left unilateral spatial neglect caused by right hemisphere stroke. We used a red circle cancellation task and asked the patients to cross out all the red circles on the test paper. Then we set four experimental conditions: (1) the control condition which presented no auditory stimulus, (2) the irrelevant word condition which presented an irrelevant word (kie) , (3) the target word condition which presented a word indicating the target color (red) , and (4) the direction word condition which presented a word indicating the direction (left) . We also employed a simple response task to assess the non-spatial attentional abilities.
  The cancellation rates of the direction word and target word conditions were significantly higher than that of the control condition. Four among the seven patients showed a non-spatial attentional deficits. The correlations between HDS-R scores and the cancellation rates of the experimental conditions which presented auditory verbal stimul (iirrelevant word condition, target word condition, direction word condition) were higher than that of the control condition.
  The results suggest that auditory-verbal stimulation may activate a wide range of attention and improve the performance of patients with left unilateral spatial neglect. Results also suggest the effects of auditory-verbal stimulation may depend on the level of patientʼs intellectual function.

  We examined a 45-year-old right-handed man whose major complaint was that his typing speed had reduced after a left thalamic hemorrhage. He did not show any symptoms of aphasia, apraxia, or agnosia. His general intellectual functioning was normal, apart from a decrease in his processing speed. We conducted assessments of his phonological manipulation, writing, and typing abilities two months after the onset. When entering Japanese into PC, we need to convert Japanese phonetics to kana letters and kana letters to Roman letters, however the process varies depending on the proficiency of Roman letter writing and typing. These assessments showed that his performance on the phonological manipulation, dictation of kana, and conversion of kana characters to Roman letter was better than that of Roman letter dictation. He had a tendency to make mistakes in oral reading of Roman letters. Due to retardation of bidirectional processing process between phonological representation and Roman letters representation, mild typing impairment was observed. The fact that his typing ability was better than his Roman letter writing might be due to preserved procedural memory that he was able to use when converting phonological representations directly to kinetic engrams.

  Background : Impaired self-awareness following a traumatic brain injury (TBI) has a strong negative impact on social rehabilitation. We report how a patient improved in recognition and behavior after undergoing a psychoeducation program called The Understanding Brain Injury (UBI) , in which a small group of patients participate and learn about the brain and their own brain injuries.
  Subject : A man with TBI in his 50s who exhibited irritability, fatigue and occasional outbursts of anger in addition to mild attention and memory disorder.
  Results and Discussion : The patient was provided a chance to disclose and share his challenges and get positive feedback from other participants in the UBI, and thereby managed to understand the impact from his brain injury and reduce his anxiety and feelings of isolation. In addition, he showed improvement in self-reflection and became motivated toward rehabilitation. Furthermore, he established a stronger bond with his own group.
  Conclusion : The UBI program can create and guarantee a safe and comfortable environment, increase self-awareness of oneʼs state and instill a positive attitude toward rehabilitation in order to reintegrate into society earlier and more effectively.

  The present study proposed a quantitative way to assess writing action and writing disorder using a tablet device. The proposed method revealed that (a) inter-stroke time interval was longer in patients with writing disorder, (b) the number of local minima in the tangential velocity was larger in the patients regardless of their symptoms, (c) several patients had different relationships between inter-stroke time and distance from the control group, and (d) the relationship between inter-stroke time and distance in the control group was relatively stable. Based on these findings, the efficacy of the proposed method was discussed.