i classifications of aphasia ii laterality iii varieties of anomia iv reading and writing n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
I. Classifications of Aphasia II. Laterality III. Varieties of Anomia IV. Reading and Writing PowerPoint Presentation
Download Presentation
I. Classifications of Aphasia II. Laterality III. Varieties of Anomia IV. Reading and Writing

Loading in 2 Seconds...

play fullscreen
1 / 57

I. Classifications of Aphasia II. Laterality III. Varieties of Anomia IV. Reading and Writing - PowerPoint PPT Presentation


  • 124 Views
  • Uploaded on

Ling 411 – 06. I. Classifications of Aphasia II. Laterality III. Varieties of Anomia IV. Reading and Writing. Problems of classification. Different aphasics almost never share the same set of symptoms (Benson&Ardila 111) Variations “are so plentiful as to be the rule” (B&A 117)

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'I. Classifications of Aphasia II. Laterality III. Varieties of Anomia IV. Reading and Writing' - oshin


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
i classifications of aphasia ii laterality iii varieties of anomia iv reading and writing

Ling 411 – 06

I. Classifications of AphasiaII. LateralityIII. Varieties of AnomiaIV. Reading and Writing

problems of classification
Problems of classification
  • Different aphasics almost never share the same set of symptoms (Benson&Ardila 111)
    • Variations “are so plentiful as to be the rule” (B&A 117)
    • A single type of aphasia may have distinctly different loci of pathology (B&A 117)
      • Conduction aphasia (117)
        • Parietal lobe
        • Arcuate fasciculus
      • Transcortical motor aphasia (118)
  • Differing interpretations of sets of symptoms
  • Different approaches to classification
wide variation in classification schemes
Wide variation in classification schemes
  • Influential ones in history of aphasiology:
    • Wernicke-Lichtheim 1881, 1885
    • Head 1926
    • Goldstein 1948
    • Luria 1966
    • Benson 1979
    • Benson & Ardila 1996
    • Damasio 1998
  • But ..
    • All recognize just a small number of basic syndromes
    • Most of the variation in classification schemes is just terminological (Benson&Ardila 120)
damasio s classification 1998 34ff
Damasio’s Classification (1998:34ff)
  • Wernicke’s aphasia
  • Broca’s aphasia
  • Conduction aphasia
  • Transcortical sensory aphasia
  • Transcortical motor aphasia
  • Global aphasia
  • Anomic aphasia
  • Alexia
  • Pure word deafness
  • Atypical aphasias
the 1996 benson ardila classification b a 119
The 1996 Benson & Ardila Classification(B&A: 119)

Pre-Rolandic Post-Rolandic

Peri-

Sylvian

Extra-

Sylvian

Not included in above scheme:

(1) Problems with reading & writing

(2) Anomic aphasia

(3) Global aphasia

features of the 1996 b a classification b a 119
Features of the 1996 B&A Classification(B&A: 119)
  • Based on two anatomical dichotomies:
    • Pre- vs post-Rolandic
    • Perisylvian vs. extrasylvian
  • For every type, two subtypes
    • But the two subtypes can be just two ends of a continuous scale, not distinct subtypes
  • Alternatives to usual terms:
    • “Extrasylvian” instead of “transcortical”
    • “Broca” instead of “Broca’s”
    • ‘Wernicke” instead of “Wernicke’s”
a major anatomical functional dichotomy front anterior vs back posterior
A major anatomical-functional dichotomy:Front (anterior) vs. Back (posterior)
  • Front
    • Action and planning of action
    • Process oriented
  • Back
    • Perception
    • Perceptual integration
    • Object oriented
damasio vis vis benson ardila
Damasio

Wernicke’s aphasia

Broca’s aphasia

Conduction aphasia

Transcortical sensory aph.

Transcortical motor aph.

Global aphasia

Anomic aphasia

Alexia

Benson & Ardila

Wernicke aphasia

Broca aphasia

Conduction aphasia

Extrasylvian sensory aph.

Extrasylvian motor aph.

Global aphasia

Anomic aphasia

Wernicke II or Posterior extrasylvian

Damasio vis-à-vis Benson & Ardila
front back dichotomy and aphasia alternative terms emphases
Fluent

Receptive*

Sensory

Posterior

Non-fluent

Expressive*

Motor

Anterior

Front-Back dichotomy and aphasia: Alternative terms/emphases

*But: (1) Very few aphasic patients are completely free of receptive difficulties

(2) Virtually no aphasic is entirely without expressive problems

(B&A 112)

damasio s categories as anterior vs posterior aphasias or pre rolandic vs post rolandic
Broca’s aphasia

Transcortical motor aphasia

Wernicke’s aphasia

Conduction aphasia

Transcortical sensory aphasia

Alexia

Pure word deafness

Damasio’s Categories asAnterior vs Posterior Aphasias(Or: Pre-Rolandic vs Post-Rolandic)

Anterior Posterior

Others:

Global Aphasia: Both anterior and posterior

Anomic aphasia: Can be either or both

Atypical aphasias

cerebral dominance for language
Cerebral dominance for language
  • Linguistic abilities are subserved by the left hemisphere in about 97% of people
    • 99% of right-handed people
  • But this is just a first approximation
more refined look
More refined look
  • Some information is bilaterally represented
    • Highly entrenched items
    • Initial consonants of high-frequency words (?)
    • Some people have more bilateral representation than others
    • Women and left-handers tend to have more bilateral representation than men and righties
  • Pitch, intonation, and other prosodic features subserved by RH
  • Semantic information is in both LH and RH
    • But different aspects of semantic information
  • Metaphor, irony, sarcasm, pragmatic features, inferencing, subserved by RH
left dominance for language in left handers
Left dominance for language in left-handers
  • Wada test (Milner 1975), on left-handers
    • 69% aphasic after injection of left brain
    • 18% aphasic after injection of right brain
    • 13% aphasic after injection on each side

Goodglass 1993:57

right dominance for language in right handers
Right dominance for language in right-handers
  • Crossed aphasia: Term for right-handers who suffer aphasia after RH injury
  • Incidence of crossed aphasia is estimated at 1%

Goodglass 1993:58

the genetics of laterality
The genetics of laterality
  • Matings of left-handed parents produce no more than about 50% left-handed offspring
  • Annett’s theory (1985)
    • A single right-shift gene (rs+)
    • If rs++, right-handed (LH dominant)
    • If rs+-, right handed (LH dominant)
    • If rs-- (right-shift gene absent)..
      • Can go either way
      • Depends on environment, experience
      • 50% probability of becoming left-handed
left hemisphere vs right hemisphere
Left hemisphere

Analytical thinking

Digital

Heightened contrast

Proof

Right Hemisphere

Holistic thinking

Analog

Fuzzy boundaries

Hunches, intuition

Left hemisphere vs. right hemisphere

Question:

What anatomical differences are responsible?

separated right and left hemispheres
Separated right and left hemispheres
  • Cutting corpus callosum separates them
  • Isolated RH:
    • Limited one-word reading comprehension
      • Some grasp of meanings
      • But unable to make judgments about sound
  • Isolated LH:
    • Awareness of both sound and meaning
2 cases of rapp caramazza 1995
2 Cases of Rapp & Caramazza (1995)
  • E.S.T. (901b)– Left temporal damage
    • “Meaning spared, couldn’t say the word”: R&C
  • J.G. (902a)– Left posterior temporal-parietal
    • Meaning spared, couldn’t spell the word correctly, but phonological recognition okay

Cf. Rapp & Caramazza,

Disorders of lexical processing

and the lexicon (1995)

patient e s t rapp caramazza 1995 901b
Patient E.S.T. (Rapp&Caramazza 1995:901b)
  • Left temporal damage
  • Shown picture of a snowman
    • Unable to name it
    • “It’s cold, it’s a ma… cold … frozen.”
  • Shown picture of a stool
    • “stop, step … seat, small seat, round seat, sit on the…”
  • Shown written form ‘steak’
    • “I’m going to eat something … it’s beef … you can have a [së] … different … costs more …”
  • What can we conclude?
assessment of e s t by rapp caramazza
Assessment of E.S.T. by Rapp & Caramazza
  • Responses of E.S.T. indicate awareness of the meanings (SNOWMAN, STOOL, STEAK)
  • Therefore, “meaning is spared” (acc. To R&C)
warning proceed with caution
Warning: Proceed with caution
  • The assumption of Rapp&Caramazza is easy to make
    • I.e., thatmeaning (conceptual information) is spared
  • But there’s more to this than meets the eye!
  • As we have seen, conceptual information is widely distributed
  • We only have evidence that some of the conceptual information is spared
patient e s t a closer look
Patient E.S.T. – a closer look
  • Left temporal damage
  • Picture of a snowman
    • “It’s cold, it’s a ma… cold … frozen.”
  • Picture of a stool
    • “stop, step … seat, small seat, round seat, sit on the…”
  • Written form ‘steak’
    • “I’m going to eat something … it’s beef … you can have a [së] … different … costs more …”
  • These are not definitions
  • This is connotative information
    • Vague semantic notions about the meanings
compare patient j g 902a
Compare patient J.G. (902a)
  • Damage: Left posterior temporal-parietal
  • Meaning spared, couldn’t spell the word correctly, but phonological recognition okay
    • digit:
      • D-I-D-G-E-T
      • “A number”
    • thief:
      • T-H-E-F-E
      • “A person who takes things”
  • These are actual definitions
the role of rh in semantics
The Role of RH in semantics
  • Conceptual information, even for a single item, is widely distributed
    • A network
    • Occupies both hemispheres
  • RH information is more connotative
    • LH information more exact
connotative information in rh
Connotative information in RH
  • Tests on patients with isolated RH resulting from callosotomy
  • RH has information about (many) nouns and verbs
    • Not as many as in LH
  • Semantic information differently organized in RH
  • Zaidel (1990): “… the right hemisphere is characteristically connotative rather than denotative … . The arcs [of the semantic network] connect more distant concepts … and the organizing semantic relationships are more loosely associative and dependent on experience” (125)

Baynes & Eliason, The visual lexicon: its access and organization is commissurotomy patients (1998)

semantic information e s t and j g
Semantic information: E.S.T. and J.G.
  • Patient J.G. – real definitions
    • digit: “A number”
    • thief: “A person who takes things”
  • Patient E.S.T. – connotative information
    • snowman: “It’s cold, it’s a ma… cold … frozen.”
    • stool: “ … seat, small seat, round seat, sit on the…”
    • steak: “I’m going to eat something … it’s beef … you can have a [së] … different … costs more …”
conclusion about e s t
Conclusion about E.S.T.
  • RH semantic information is intact
  • LH semantic information is wiped out
  • Phonological information is spared in both hemispheres
  • Question: Why can’t the RH semantic information be conveyed to LH phonology?
brain damage and nominal concepts
Brain damage and nominal concepts
  • Access to nominal concepts is impaired in extra-sylvian sensory aphasia
  • Type I – Damage to temporal-parietal-occipital junction area
    • I.e., lower angular gyrus and upper area 37
    • Poor comprehension
    • Naming strongly impaired
    • Semantic paraphasia
  • Type II –Damage to upper angular gyrus
    • Variable ability to comprehend speech
    • Naming strongly impaired
    • Few semantic paraphasias
    • Many circumlocutions
conceptual category dissociation i
Conceptual category dissociation I
  • J.B.R. and S.B.Y. (905b-906a)
  • Herpes simplex encephalitis
  • Both temporal lobes affected
  • Could not define animate objects
    • ostrich, snail, wasp, duck, holly
  • Much better at defining inanimate objects
    • tent, briefcase, compass, wheelbarrow, submarine, umbrella
  • How to explain?
conceptual category dissociation ii
Conceptual category dissociation II
  • J.J. and P.S. (Hillis & Caramazza 1991) (906-7)
    • J.J. – left temporal, basal ganglia (CVA)
      • Selective preservation of animal concepts
    • P.S. – mostly left temporal (injury)
      • Selective impairment of animate category

P.S

J.J.

alexia and agraphia
Alexia and Agraphia
  • Alexia with agraphia
    • Reading and writing both impaired
    • A rare disorder
      • Patients with both impairments usually also have Wernicke’s aphasia or transcortical sensory aphasia
  • Alexia without agraphia, a.k.a. pure alexia
    • Reading impaired, writing okay
    • Can write spontaneously or to dictation
    • Some can copy writing but with difficulty
misprint in antonio damasio reading
Misprint in Antonio Damasio Reading
  • Antonio Damasio, Signs of Aphasia
  • P. 38: “As the designation implies, patients presenting alexia with agraphia become unable to read while they continue to be able to write…”
  • Should be “…alexia without agraphia…”
more on patient j g
More on patient J.G.
  • Damage: Left posterior temporal-parietal
  • Meaning spared, phonological recognition okay, but couldn’t spell the word correctly
    • digit:
      • D-I-D-G-E-T
      • “A number”
    • thief:
      • T-H-E-F-E
      • “A person who takes things”
  • These spellings are not correct, but..
reading relating writing to speech
Reading – relating writing to speech

Phonological

word image

Phonemes Letters

The “Phonics” route

reading relating writing to speech1
Reading – relating writing to speech

Phonological Graphic

word image word image

Letters

The “whole word” route

two pathways for relating writing to speech
Two pathways for relating writing to speech

Phonological Graphic

word image word image

Phonemes Letters

Redundancy?

two pathways for relating writing to speech1
Two pathways for relating writing to speech
  • The “whole word” route is necessary for
    • caught
    • island
    • sign
  • The “phonics” route is needed for long unfamiliar words
    • commissurectomy
    • prosopagnosia
    • magnetoencephalography
the spelling attempts of j g one more look
The spelling attempts of J.G.(one more look)
  • digit:
    • D-I-D-G-E-T
    • “A number”
  • thief:
    • T-H-E-F-E
    • “A person who takes things”
  • J.G. has damaged “whole word” route but intact “phonics” route
  • Evidence that the two routes are separately represented in the cortex
more evidence on phonological and graphic forms
More evidence on phonological and graphic forms
  • Patient P.W. (905)
    • Damage: anterior parietal & posterior frontal
    • Tested on identifying spoken words
      • [skirt]: “S-O-C-K, skirt
        • Verbal paraphasia in spelling but not in speech
      • [brush]: “B-R-U-S-H, comb”
        • Verbal paraphasia in speech but not in spelling
      • [knife]: “S-P-O-O-N, fork”
        • Verbal paraphasia in both modalities
    • Paraphasias are semantically related
patient d r b 902b 903a
Patient D.R.B. (902b-903a)
  • Left middle cerebral artery infarct
  • Able to discriminate words and pseudo-words
    • Either visual or auditory input
  • Test: Two words – synonyms or not?
    • For written input, 95% accurate
    • For spoken input, only 61% accurate
  • Evidence that representations of written words can have direct connections to semantic information
graphic representation and meaning
Graphic representation and meaning
  • The traditional view: speech is primary, writing secondary
    • History
    • Development
  • Might suggest that writing has access to meaning only via phonological representation
  • But evidence from brain damage indicates that (at least some) written forms have direct access to meaning, independently of phonology
pathway to meaning
Pathway to meaning

Conceptual

information

Phonological Graphic

word image word image

Phonemes Letters

pathways to meaning
Pathways to meaning

Conceptual

information

Does this pathway also exist?

Phonological Graphic

word image word image

Phonemes Letters

evidence for direct connections between meaning and graphic form
Evidence for direct connections between meaning and graphic form
  • Patient D.R.B. (above)
    • Judgments of synonymy better for pairs of written words than pairs of spoken words
  • Patient H.W. (904)
    • Damage: left parietal and occipital
    • Tested on identifying written words
      • Interest:
        • “bank”
        • “You go to the bank and put it in and you get more money … not very much now”
more evidence for direct connections between meaning and graphic form
More evidence for direct connections between meaning and graphic form
  • Patient R.G.B. (904)
    • Damage: left frontoparietal
    • Tested on identifying written words
      • Records:
        • “radio”
        • “You play ‘em on a phonograph … can also mean notes you take and keep”
    • Understands meaning from written input, but has impaired phonological information or impaired connection to phonological information
phonological graphic connections the angular gyrus
Phonological-Graphic Connections:The Angular Gyrus

The angular gyrus and the white matter below it appear to be uniquely important for all aspects of graphic language that involve its linkage to writing, to spoken language, and to word meaning. Injury to this area disrupts not only the ability to understand the written word, but also disrupts related knowledge such as oral spelling and letter-sound correspondence, and therefore disrupts the ability to write.

Harold Goodglass

Understanding Aphasia 1993:51

the angular gyrus
The angular gyrus

Superior parietal lobule

connecting to output
Connecting to output

Phonological

production

Phonological Graphic

word image word image

Phonemes Letters

Broca’s area

Angular gyrus

Arcuate fasciculus

connecting to spoken and written output
Connecting to Spoken and Written Output

Exner’s area

Superior longitudinal fasciculus

Graphic

production

Phonological

production

Phonological Graphic

word image word image

Phoneme Letter

images images

Broca’s area

Angular gyrus

Arcuate fasciculus

exner s area

Wernicke’s area

Exner’s Area

Angular gyrus

Broca’s area

Superior parietal lobule

systems for speech and writing
Systems for Speech and Writing

Exner’s area

Superior longitudinal fasciculus

Graphic

production

Phonological

production

Phonological Graphic

word image word image

Phoneme Letter

images images

Broca’s area

Angular gyrus

Arcuate fasciculus