失语患者的句子理解实验研究

目的分析失语患者句子语义加工特点,为言语康复训练提供依据。方法将研究对象分为2组,即20例失语患者(失语组)和20例无失语患者(对照组);实验1考察句子语义结构判断,实验2为不同句法难度句子的语义加工,实验3是复句的逻辑语义判断。结果实验组对语义结构加工明显不及对照组;对于句法难度不同的句子语义加工,实验组与对照组对于不同类型句子判断的难度顺序一致,但判断能力上有一定的差异;实验组对于关联词语与肢命题的逻辑语义关系的分析能力明显不及对照组。结论失语患者句子语义加工特点不同,应作为针对性制定康复计划的客观依据。     

非流利型失语患者汉语反身代词指称理解障碍浅析

目的通过对比人称代词和反身代词在句子中指称理解受损表现的差异,分析汉语非流利型失语症患者反身代词指称理解障碍的特点,用以指导康复治疗。方法采用北京医科大学汉语失语症标准化检查法,将诊断为非流利型失语症的患者作为测试对象。设计相应（ABCDE型）句子,A型句和C型句含人称代词,B型句和D型句将人称代词替换汉语反身代词。通过听句子-配正确图和听句子-配错误图进行上述句子测试,把被试者测试的分数进行统计分析。结果10例失语症患者听句子-配图理解得分数明显低于对照组;失语症患者在听句子-配正确图理解所得分数中B型句组低于A型句组（P〈0.05）;D型句组低于C型句组（P〈0.05）。结论汉语失语症患者的反身代词的指称受损伤程度相对于人称代词的指称受损伤程度较重,含反身代词的句子理解和加工过程具有独特性。     

汉语失语症患者主语问句和宾语问句理解和表达障碍的特点

目的观察汉语失语症患者疑问句理解和表达障碍的特点，探讨其理解及表达障碍的机制，为失语症患者的诊断及康复训练方法提供依据。方法根据《汉语语法量表》选择10例失语法性失语症患者作为失语法性失语组（简称失语法组），选择14例非失语法性失语症患者作为非失语法性失语组（简称非失语法组），另外选取24例正常人作为正常对照组。用经过设计的主语问句和宾语问句（各20句）对患者进行理解能力和表达能力的测试。结果失语法组患者两种疑问句的理解正确率间差异无统计学意义（P〉0．05），失语法组患者两种疑问句的表达正确率间差异有统计学意义（P〈0．05）；失语法组患者对两种疑问句的理解能力和表达能力明显低于非失语法组患者和对照组（P〈0．05）。结论汉语失语法性失语症患者对疑问句的理解和表达障碍有其自身特点，可能为以后失语患者康复计划的制定及预后判断提供有用资料。     

重型颅脑外伤后失语患者认知功能特点分析

目的探讨重型颅脑外伤后失语患者认知功能特点。方法选择我院2012-08—2015-08收治的78例重型颅脑损伤患者为研究对象,根据是否合并失语症分为失语组(n=48)及未失语组(n=30)。2组均结合实际病情予以救治,比较2组并发症发生率、失语症与认知功能测评结果。结果失语组肺部感染率为22.9%(11/48),未失语组为16.7%(5/30),差异无统计学意义(P0.05)。失语组CRRCAE总评分为(85.6±10.1)分,低于未失语组(102.3±9.7)分,差异有统计学意义(P0.05)。观察组定向障碍发生率为56.3%,明显高于对照组的30.0%,差异有统计学意义(P0.05);视知觉、空间知觉、动作运用、视运动组织、逻辑思维组织等发生率高于对照组,但差异无统计学意义(P0.05)。结论重型颅脑外伤后失语患者往往认知功能更差,尤其时定向力认知,这一发现为临床治疗提供有用信息,利于预后的改善。     

精神分裂症患者语义加工N400成分异常及与思维形式障碍的关联研究

目的:探索精神分裂症患者语义加工时N400成分异常与思维形式障碍(FTD)的关系。方法:对21例伴有FTD的精神分裂症患者(SZ-FTD组)、16例不伴FTD精神分裂症患者(SZ-n FTD组)及19名健康对照者(对照组)进行语义启动任务时的脑电事件相关电位检测,分析各组在3种语义启动任务下(图片-词语一致、相关、不相关)N400波幅和潜伏期。结果:3种语义启动任务下精神分裂症患者N400波幅显著低于对照组(F(1,54)=9.60,P0.01),潜伏期显著长于对照组(F(1,54)=4.20,P0.05);当图片-词语不相关时,SZ-FTD组N400波幅显著低于对照组,顶区N400潜伏期显著长于对照组(P均0.05);SZ-n FTD组与对照组N400波幅及潜伏期比较差异无统计学意义。结论:精神分裂症患者语义加工时的N400活动异常,伴有FTD的患者语义加工损害更严重。     

强迫症患者与精神分裂症患者的神经认知功能特征比较

目的 比较强迫症患者与精神分裂症患者神经认知损害的特点和严重程度. 方法 选择中山大学附属第三医院精神心理科自2011年8月至2012年2月住院的30例强迫症患者(强迫症组)、30例精神分裂症患者(精分症组)及同期30名体检健康者(对照组)为研究对象,采用连线测验、Stroop色字词测验、韦氏记忆测验、改良版威斯康辛卡片分类测验对其进行神经认知功能评定,并应用统计学方法比较. 结果 (1)在连线测验中,强迫症组的连线B测验用时(s)和连线A/B测验用时差要明显差于对照组,差异有统计学意义(P＜0.05);除连线B测验错误次数外,强迫症组其余指标均明显优于精分症组,差异有统计学意义(P＜0.05);精分症组各项指标均明显差于对照组,差异有统计学意义(P＜0.05).(2)在Stroop色字词测验中,强迫症组的色词测验错误率和色词测验用时明显差于对照组,差异有统计学意义(P＜0.05);强迫症组的字测验错误数和字测验用时明显优于精分症组,差异有统计学意义(P＜0.05);精分症组各项指标均明显差于对照组,差异有统计学意义(P＜0.05).(3)在韦氏记忆测验中,强迫症组的图片回忆、再认、联想学习、短时记忆和记忆商数明显差于对照组,差异有统计学意义(P＜0.05);除长时记忆、再认、联想学习和触觉记忆外,强迫症组的其余指标均明显优于精分症组,差异有统计学意义(P＜0.05);精分症组各项指标均明显差于对照组,差异有统计学意义(P＜0.05).(4)在改良版威斯康辛卡片分类测验中,强迫症组(除随机错误数外)和精分症组各项指标与对照组相比均明显差,差异有统计学意义(P＜0.05);强迫症组各项指标均明显优于精分症组,差异有统计学意义(P＜0.05). 结论 强迫症患者的神经认知缺陷特征主要表现在注意狭窄和转换困难,短时记忆和视空间记忆障碍;精神分裂症则表现为全面的神经认知功能损害;强迫症患者总体神经认知功能水平比精神分裂症患者高.     

血管性痴呆患者神经心理学分析

目的 研究血管性痴呆患者的神经心理学特点并探讨其意义.方法 对34例脑血管性痴呆患者和40例对照组进行简易精神状态检查量表和日常生活能力量表,并结合临床进行分析.结果 血管性痴呆组MMSE总分显著低于对照组(P＜0.05);血管性痴呆组MMSE时间定向力、地点定向力、语言即刻记忆、注意和计算以及短时记忆能力评分显著低于对照组评分(P＜0.01), 语言复述能力、语言理解和表达及图形描述能力较对照组明显衰退(P＜0.05),而物体命名和阅读理解与对照组相比无显著差异(P＞0.05);ADL量表检测表明VaD病人日常生活能力的明显衰退.结论 血管性痴呆病人存在一定的认知功能的障碍, 同时表现出明显的日常生活能力的障碍.     

循证护理对脑梗塞偏瘫失语患者早期康复的效果

目的探究循证施护对脑梗塞偏瘫失语患者语言与肢体早期康复效果。方法选择我院98例脑梗塞偏瘫失语患者,随机分为对照组与研究组,每组各49例。两组患者均采用相同的基础治疗方案,按照脑梗塞偏瘫病护理常规给予两组患者相同的基础护理干预,研究组则在此基础上实施循证护理,分别采用失语商(AQ)和Fugl-meyer评定量表(FMA)评估对比两组患者语言及肢体恢复效果。结果对照组患者治疗总有效率为61.2%,研究组患者治疗总有效率为87.7%,两组相比差异具有统计学意义(P0.05);两组患者实施护理干预前AQ值无显著差异性(P0.05);实施护理干预后,研究组患者AG值明显低于对照组,差异具有统计学意义(P0.05);两组患者实施护理干预前FMA评分无显著差异性(P0.05);实施护理干预后,研究组患者FMA评分明显高于对照组,差异具有统计学意义(P0.05)。结论循证施护能明显改善脑梗塞偏瘫失语患者语言及肢体恢复效果,对改善患者生存质量具有重要作用。     

护理干预对脑梗死运动性失语患者语言康复的影响

目的探讨护理干预对脑梗死运动性失语患者语言康复的影响,为改善患者语言功能提供参考。方法根据患者(或家属)意愿,将85例患者分为观察组(45例)和对照组(40例)。对照组采用常规治疗和护理方法,观察组在对照组治疗的基础上,围绕个性化康复方案进行护理干预。比较2组护理干预30d后完全失语、重度失语、中度失语、轻度失语和正常例数。结果护理干预30d后,观察组护理效果明显优于对照组,差异有统计学意义(P0.05)。2组完全失语患者比例差异无统计学意义(P0.05)。结论护理干预可较好的促进脑梗死运动性失语患者语言功能康复,值得临床推广应用。     

失语患者的事件相关电位研究

目的探讨失语症研究的新途径，从不同的方面和层级描述失语的病态内部语言过程。方法采用视听两模式下的事件相关电位（ＥＲＰｓ）分析了１２例失语症、５０名健康人及１１例左侧脑血管病无失语者。结果失语患者中存在着视听Ｐ３潜伏期变化不一致的现象。以听理解障碍为主的失语者，其听觉模式Ｐ３潜伏期明显延长，而视觉Ｐ３潜伏期则无差异。以阅读障碍为主的失语者，其变化正好相反。结论失语症患者可能存在着具有通道特异性的短时记忆障碍。其发生的层级可能始于对感觉信息进行知觉加工的阶段；ＥＲＰｓ作为一个电生理学指标能客观地反映出失语症的某些心理过程和不同的特点。     

The processing of morphology and syntax in aphasia: A test of the fast decay and slow activation hypotheses

Abstract

Two tasks were designed to test the hypothesis that the syntactic processing deficit of non-fluent agrammatic aphasic patients may be due to either the fast decay or slow activation of syntactic information. Eight non-fluent aphasics, 11 fluent aphasics, and 15 age-matched normal control subjects participated in two auditory lexical decision tasks as well as a grammaticality judgement task. In three types of sentence structures the sentence-final word created either a grammatical sentence or a violation of a particular syntactic rule or constraint. To examine possible deficits in computational speed, the interval between the sentence frame and the sentence-final target word was set at either 100 ms (short ISI) or 1000 ms (long ISI) in the lexical decision tasks. Increased reaction time to targets in ungrammatical sentences is indicative of sensitivity to syntactic violations. With fast decay of syntactic information, sensitivity would be predicted at short but not long ISIs. With slow activation, sensitivity would be expected at long but not short ISIs. Surprisingly, results indicated that all three groups of subjects demonstrated comparable patterns of sensitivity to grammaticality as reflected in increased latencies to target words in ungrammatical contexts. The findings do not provide support for either the fast decay or the slow activation hypothesis. Possible reasons for the unexpected findings are considered.     

Strategy and impairment in sentence understanding by Broca's and Wernicke's aphasics

15 Broca's aphasics and 14 Wernicke's aphasics, both German and Dutch speaking patients, were presented with a sentence-picture matching task. Both syntactic and semantic distractor pictures were used. Sentences were either reversible or non-reversible, had a topicalized or a non-topicalized word order and contained either of three types of prepositions that were labelled 'syntactic' (case-marking), 'obligatory' (subcategorized) and 'lexical' (locative). Results indicated (a) a significant difference between reversible and non reversible sentences for both Broca's and Wernicke's; (b) no significant differences between these two groups in the differences scores reversible minus non-reversible; (c) an above-chance performance on reversible sentences for both groups. To explain the pattern of differences between the various types of sentences, two schemes of interpretation are presented. The first scheme assumes that both Broca's and Wernicke's have lost basic (but different) syntactic abilities and that they can understand reversible sentences by non-syntactic strategies only. The second scheme assumes that there is no such loss, but that the impairment in Broca's and Wernicke's aphasia is such that the more syntactic analysis is required, the more errors are made. Patients are assumed to approach this task by trying to limit their syntactic analysis to the beginning of the sentence.     

Thematic role assignment in patients with Broca's aphasia: sentence-picture matching electrified

An event-related brain potential experiment was carried out to investigate on-line thematic role assignment during sentence-picture matching in patients with Broca's aphasia. Subjects were presented with a picture that was followed by an auditory sentence. The sentence either matched the picture or mismatched the visual information depicted. Sentences differed in complexity, and ranged from simple active semantically irreversible sentences to passive semantically reversible sentences. ERPs were recorded while subjects were engaged in sentence-picture matching. In addition, reaction time and accuracy were measured. Three groups of subjects were tested: Broca patients (N=10), non-aphasic patients with a right hemisphere (RH) lesion (N=8), and healthy aged-matched controls (N=15). The results of this study showed that, in neurologically unimpaired individuals, thematic role assignment in the context of visual information was an immediate process. This in contrast to patients with Broca's aphasia who demonstrated no signs of on-line sensitivity to the picture-sentence mismatches. The syntactic contribution to the thematic role assignment process seemed to be diminished given the reduction and even absence of P600 effects. Nevertheless, Broca patients showed some off-line behavioral sensitivity to the sentence-picture mismatches. The long response latencies of Broca's aphasics make it likely that off-line response strategies were used.     

Syntactic Processing Deficits in Aphasia

Four aphasic patients were tested in several tasks to determine their ability to use syntactic information. Two patients classified as Broca's aphasics and presenting markedly different levels of severity of aphasia were deficient in their ability to use syntactic information in sentence comprehension and construction. It is argued that the syndrome of Broca's aphasia undermines patients' ability to perform the syntactic analyses that are necessary to understand and to produce sentences in both language modalities. a third patient tested was a conduction aphasic who presented a pattern of sentence comprehension similar to the Broca patient, but produced no other evidence of syntactic impairment. The argument is advanced that the conduction patient's apparently selective impairment of syntactic .processing in comprehension is actually a reflection of a severe auditory-verbal short-term memory deficit. The fourth patient was classified as a mildly-impaired Wernicke's aphasic, who presented no evidence of a selective disturbance of syntactic processing abilities. These results are interpreted as support for the hypothesis that the syndrome of Broca's aphasia results from an impairment to the syntactic component of the language processing system.     

Lexical biases in aphasic sentence comprehension: An experimental and corpus linguistic study

Background: This study investigates the role of lexical information in normal and aphasic sentence comprehension. Effects of verb biases in normal comprehension have been well documented in previous studies (e.g., Spivey-Knowlton & Sedivy, 1995; Trueswell, Tanenhaus, & Kello, 1993), but their role in aphasic language processing has largely been ignored (with the exceptions of Menn et al., 1998, and Russo, Peach, & Shapiro, 1998). Aims: The aim of the study is to test the lexical bias hypothesis, i.e., the hypothesis that sentence comprehension is influenced by lexical biases in aphasic listeners, as well as in normals. Method & Procedures: Using a sentence plausibility judgement task, we probe for sensitivity to verb transitivity bias, i.e., the likelihood, as estimated from corpus counts, that a verb will be transitive, rather than intransitive. Five normal controls and eighteen participants with aphasia (six with Broca's aphasia, four with Wernicke's aphasia, two with conduction aphasia, and six with anomic aphasia) are included in the study. Based on the lexical bias hypothesis, we predicted that participants would make more errors in sentences with a mismatch of verb bias and syntactic structure, such as a transitive sentence containing a verb with intransitive bias. Outcomes & Results: Both the group of normal controls and the mixed group of aphasic patients make significantly more errors on sentences in which there is a mismatch between verb bias and syntactic structure, as predicted by the lexical bias hypothesis. Specifically, patients with fluent aphasia types, particularly anomic aphasia, show a sensitivity to verb bias, contrary to earlier findings. Conclusions: These results are consistent with the view that lexical factors, not purely syntactic ones, are to blame for many previously observed patterns in aphasic comprehension. The results are further consistent with the view that many aphasic errors differ not qualitatively but quantitatively from normal comprehension errors.     

A longitudinal study of sentence comprehension difficulty in primary progressive aphasia

CONTEXT: Patients with primary progressive aphasia have sentence comprehension difficulty, but the longitudinal course of this deficit has not been investigated. OBJECTIVE: To determine how grammatical, single word meaning, and working memory factors contribute to longitudinal decline of sentence comprehension in primary progressive aphasia. We hypothesised partially distinct patterns of sentence comprehension difficulty in subgroups of patients with progressive non-fluent aphasia (PNFA) and semantic dementia (SD). DESIGN: Cohort. SETTING: Institutional out patient referral centre. PATIENTS: PNFA (n = 14), SD (n = 10). MAIN OUTCOME MEASURE: Sentence comprehension accuracy. RESULTS: PNFA patients were significantly impaired at understanding grammatically complex sentences when first seen, and this was more evident than impairment of their comprehension of grammatically simple sentences (p<0.05). Comprehension of grammatically complex sentences correlated with their working memory deficit at presentation (p<0.05). PNFA patients showed modest decline over time in grammatical comprehension. In SD, comprehension of grammatically complex sentences was not more impaired than comprehension of grammatically simple sentences when first seen, but these patients demonstrated a significant longitudinal decline in understanding grammatically complex sentences (p<0.05). Cox regression analyses showed that a deficit in single word meaning contributes to the progressive impairment for grammatically complex sentences in SD (p<0.05), but working memory does not contribute to longitudinal decline in PNFA. CONCLUSION: Patients with PNFA and SD have sentence comprehension difficulty, but distinct factors contribute to this impairment during the course of their disease.     

Semantic and syntactic processing in Chinese sentence comprehension: evidence from event-related potentials

An ERP experiment was conducted to explore semantic and syntactic processes as well as their interplay in Chinese sentence comprehension. Participants were auditorily presented with Chinese ba sentences, which were either correct, semantically incorrect, syntactically incorrect, or both semantically and syntactically incorrect. The syntactic violation, which was created by eliminating the object-noun phrase from a preposition-object phrase structure, elicited an early starting anterior negativity which merged into a sustained negativity over anterior sites and a temporally limited centro-parietal negativity. The semantic violation elicited an early starting N400 effect. The combined violation in which the syntactic phrase structure violation and the semantic violation were crossed elicited an early staring sustained anterior negativity similar to the pure syntactic effect, and a centro-parietal negativity which was more negative than those of the syntactic condition and the semantic condition. No P600 was obtained neither for the syntactic nor for the combined condition. The results suggest that the syntactic processes (at about 50 ms) appear earlier than the semantic processes (at around 150 ms). They are independent from each other in the early time window (150-250 ms) but interact in a later processing phase (250-400 ms) during Chinese ba sentence comprehension. The broadly distributed negativity, which occurred during the N400 latency range observed in the three violation conditions, is thought to reflect thematic integration processes in the sentence-final position.     

Tests of syntactic comprehension in aphasia: An investigation of task effects

Background: Consistency of performance across tasks that assess syntactic comprehension in aphasia has clinical and theoretical relevance. In this paper we add to the relatively sparse previous work on how sentence comprehension abilities are influenced by the nature of the assessment task.

Aims: Our aims are: (1) to compare linguistic performance across sentence–picture matching, enactment, and truth‐value judgement tasks; (2) to investigate the impact of pictorial stimuli on syntactic comprehension.

Methods & Procedures: We tested a group of 10 aphasic speakers (3 with fluent and 7 with non‐fluent aphasia) in three tasks (Experiment 1): (i) sentence–picture matching with four pictures, (ii) sentence–picture matching with two pictures, and (iii) enactment. A further task of truth‐value judgement was given to a subgroup of those speakers (n = 5, Experiment 2). Similar sentence types across all tasks were used and included canonical (actives, subject clefts) and non‐canonical (passives, object clefts) sentences. We undertook two types of analyses: (a) we compared canonical and non‐canonical sentences in each task; (b) we compared performance between (i) actives and passives, (ii) subject and object clefts in each task. We examined the results of all participants as a group and as case‐series.

Outcomes & Results: Several task effects emerged. Overall, the two‐picture sentence–picture matching and enactment tasks were more discriminating than the four‐picture condition. Group performance in the truth‐value judgement task was similar to two‐picture sentence–picture matching and enactment. At the individual level performance across tasks contrasted to some group results.

Conclusions: Our findings revealed task effects across participants. We discuss reasons that could explain the diverse profiles of performance and the implications for clinical practice.     

Differential task effects on semantic and syntactic processes as revealed by ERPs

Two experiments investigated the time-course of semantic and syntactic processes in auditory language comprehension as well as their possible functional dependencies, using event-related brain potentials (ERPs). Participants listened to sentences which were either correct, semantically incorrect, syntactically incorrect, or both semantically and syntactically incorrect. In experiment 1, participants judged the overall correctness of these sentences. The semantic violation elicited an N400 whereas the syntactic phrase structure violation elicited an early anterior negativity followed by a P600. Sentences in which the critical element violated both semantic and syntactic constraints elicited the same pattern of ERPs as the syntactic violation alone, not evoking an N400. In experiment 2, participants judged the same sentences for semantic coherence, required to ignore syntactic violations. Again, an early anterior negativity was elicited for those sentences containing phrase-structure errors. In contrast to experiment 1, however, combined violations elicited both an early negativity and an N400. Together, the results suggest that the N400 associated with semantic aspects of sentence comprehension reflects controlled processes whereas initial parsing processes associated with the early anterior negativity are independent of semantic constraints and task requirements.     

Auditory language comprehension in children with developmental dyslexia: evidence from event-related brain potentials

In the present study, event-related brain potentials (ERPs) were used to compare auditory sentence comprehension in 16 children with developmental dyslexia (age 9-12 years) and unimpaired controls matched on age, sex, and nonverbal intelligence. Passive sentences were presented, which were either correct or contained a syntactic violation (phrase structure) or a semantic violation (selectional restriction). In an overall sentence correctness judgment task, both control and dyslexic children performed well. In the ERPs, control children and dyslexic children demonstrated a similar N400 component for the semantic violation. For the syntactic violation, control children demonstrated a combined pattern, consisting of an early starting bilaterally distributed anterior negativity and a late centro-parietal positivity (P600). Dyslexic children showed a different pattern that is characterized by a delayed left lateralized anterior negativity, followed by a P600. These data indicate that dyslexic children do not differ from unimpaired controls with respect to semantic integration processes (N400) or controlled processes of syntactic reanalyses (P600) during auditory sentence comprehension. However, early and presumably highly automatic processes of phrase structure building reflected in the anterior negativity are delayed in dyslexic children. Moreover, the differences in hemispheric distribution of the syntactic negativity indicate different underlying processes in dyslexic children and controls. The bilateral distribution in controls suggests an involvement of right hemispherically established prosodic processes in addition to the left hemispherically localized syntactic processes, supporting the view that prosodic information may be used to facilitate syntactic processing during normal comprehension. The left hemispheric distribution observed for dyslexic children, in contrast, suggests that these children do not rely on information about the prosodic contour during auditory sentence comprehension as much as controls do. This finding points toward a phonological impairment in dyslexic children that might hamper the development of syntactic processes.