传导性失语四例报告

本文首次报道广州话传导性失语（conduction aphasia）四例，均为右利手、其中一例交叉性传导性失语，四例表现与国内外报道基本相符，口语为流利型，有大量音素错语，有明显复述障碍及理解相对好。全部患者有复杂句理解障碍。一例双语失语者两话表达均极差，但能较好保存其互译功能，互诱出正确发音及语句，其广州话朗读理解比普通话朗读理解差。病灶部位，一例主要位于有岛叶，一例为左颞顶枕皮质区，余二例位于左顶叶。     

传导性失语患者的复述和朗读障碍

目的 探讨传导性失语患者复述和朗读障碍特点。方法 分析１３例传导性失语患者的词笔述和朗读障碍特点。结果 虽１３例传导性失语患者复述错误主要是音位性错语（６８．４％），但其朗读错误则以词义性错语（２项作业分别为５５．６％和５７．８％）为主，即属深部失读。结论 传导性失语患者复述和朗读是经两条不同的途径及机制激活语音的。     

外侧裂周失语的临床与CT分析

失语是脑血管病常见并发症之一 ,外侧裂周失语是失语症中的一大类型失语 ,按其不同的特征分为运动性失语 (Ｂｒｏｃａ失语 )、感觉性失语 (Ｗｅｒｎｉｃｋｅ失语 )、传导性失语 (Ｃｏｎｄｕｃｔｉｏｎ)。其共同的临床特点是复述障碍、错语、新语及不同程度的朗读、书写障碍。现就 2 3例外侧裂周失语病人头颅ＣＴ损害的部位及临床特点作一下分析 :1　资料及方法1 1　临床资料　 2 3例失语病人中男 18例 ,女 5例 ,脑出血 8例 ,脑梗死 15例。文化程度 :小学 7例 ,中学 14例 ,大学 2例。患者病前均讲普通话 ,全部是右利手。语言功能检查在发病 2…     

传导性失语患者理解障碍的研究

传导性失语有理解障碍,如具体分析则发现对含语法词的句有严重理解障碍。本 文分析20例传导性失语患者的听理解障碍。 对象和方法 20例患者均为北京医科大学第一医院1988年8月～1995年1月的急性脑血管病病例。男14例,女6例,35～73岁,平均53.5岁。文化程度:文盲2例,小学9例,初中7例,大专以上2例。右利18例,混合利2例。用汉语失语检查法(ABC)检查语言,分析失语的临床模式均符合传导性失语诊     

传导性失语临床与CT

目的　观察传导性失语的临床特点及与脑受损部位及大小在头颅 Ｃ Ｔ 表现的关系,并探讨其发生机理。方法　采用汉语失语检查法评定出４３ 例传导性失语病人。根据他们的头颅 Ｃ Ｔ 片确定病灶大小及部位,并记录各例病人的临床表现。结果　传导性失语的病人口语表达有错语,复述、朗读明显障碍。书写有不同程度的保留。头颅 Ｃ Ｔ 上的受损层面主要在侧脑室体部及侧脑室顶部层面的白质部位。结论　传导性失语有明显的复述及朗读障碍,口语错语可以在声母或在韵母。病灶的部位主要在白质,而病灶的大小影响着神经系统伴发症的严重程度。     

传导性失误的临床与机制研究

目的：探讨传导性失语的临床特点、机制与病灶部位的对应关系。方法：应用北京医科大学第一医院神经教研室高素荣教授编制的汉语失语检查法对8例脑梗死或脑出血引起的传导性失语患者进行失语检查、评测。按照Senson分类法做失语分类。结果：本文8例患者口语为流利型或中间型,理解障碍轻而复述明显困难,伴命名、书写、阅读障碍,意向性运动性失用1例,符合传导性失语的诊断。O证明病灶部位4例病灶位于预叶及皮层下,其中累及颞叶4例。结论：传导性失语理解障碍的程度与病变是否波及颞叶（即wernicke区）有关,复述困难与听感知障碍有相关性,可因听感知缺陷引起。大多患者的病灶位于顶叶缘上回及皮质下,是传导性失语的常见部位,支持联系中断学说。     

几种主要失语综合征的病灶部位和言语障碍特征

类别病灶部位自发言语言语理解口语复述能力物品(人物)命名阅读理解能力书写能力运动性失语优势额下回后部皮质或皮质下不流利、费力部分障碍差部分障碍到完全障碍朗读困难、理解好中等度障碍感觉性失语优势侧颞上回后1/3区域及其周围部分流利、言语错乱完全障碍差部分障碍到完全障碍朗读困难、理解差差,空洞传导性失语优势侧颞叶峡部岛叶皮质下的弓状束和联络纤维流利、言语错乱接近正常很差严重障碍朗读困难、理解差中等度障碍命名性失语优势侧颞、枕、顶结合区流利、空洞正常正常完全障碍稍差或正常轻度障碍经皮质运动性失语优势侧额叶内…     

后部失语的鉴别诊断

失语为高级皮质言语中枢损害而引起的表达，理解等方面的障碍，以大脑外侧裂为界，将此以前的病变引起的言语障碍称为“前部失语”在此以后病变所致的言语障碍称“后部失语”。临床上后部失语均有命名障碍，流利性言语，理解障碍及不同程度的复述障碍，在作“感觉性失语”“命名性失语”及“传导性失语”时常易混淆，本文将以具体病例对上述问题进行讨论。     

传导性失语理解障碍的特点(附4例报告)

传统认为传导性失语以自发言语为流利型、理解完全正常或轻度受损而复述严重困难为主要特点。国外刘传导性失语理解障碍的研究已有多年,认为绝大多数传导性失语的病人     

传导性失语复述障碍机制的研究进展

传导性失语以严重的复述障碍、听理解能力相对较好为特点,同时有语音错误及命名障碍。本文从传导性失语的病变部位及关于传导性失语复述障碍机制的经典理论:联系中断学说、中心性失语理论、短时记忆缺损模式及双向分布模式,阐述了传导性失语复述障碍机制的研究进展。     

Broca aphasia with neologisms]

Patients with jargon aphasia generally have fluent speech with poor comprehension. However, outstanding jargons may appear in non-fluent aphasics. We report a 69-year-old left-handed woman with non-fluent jargon aphasia due to lesions in the right frontoparietal area. Features of her speech included non-fluent meaningless sequences of syllables, i. e., phonetic jargon, which was obvious in all the tasks including spontaneous speech, repetition, naming and reading. Her utterance was sparse, but not effortful or anarthric. She understood most of spoken single words, but was confused by complex sentences. Brain CTs revealed acute lesions affecting the inferior and middle frontal gyri, insular cortex, precentral and postcentral gyri, and a part of the angular gyrus in the right hemisphere. Old infarcts were also noted in the right frontal pole and prefrontal area. The unique feature of her language impairment suggested somewhat deviated lateralization and localization of her language function.     

Planum temporale: where spoken and written language meet

Functional magnetic resonance imaging studies on spoken versus written language processing were performed in 20 right-handed normal volunteers on a high-field (3.0-tesla) system. The areas activated in common by both auditory (listening) and visual (reading) language comprehension paradigms were mapped onto the planum temporale (20/20), primary auditory region (2/20), superior temporal sulcus area (2/20) and planum parietale (3/20). The study indicates that the planum temporale represents a common traffic area for cortical processing which needs to access the system of language comprehension. The destruction of this area can result in comprehension deficits in both spoken and written language, i.e. a classical case of Wernicke's aphasia.     

Written language impairments in primary progressive aphasia: a reflection of damage to central semantic and phonological processes

Connectionist theories of language propose that written language deficits arise as a result of damage to semantic and phonological systems that also support spoken language production and comprehension, a view referred to as the "primary systems" hypothesis. The objective of the current study was to evaluate the primary systems account in a mixed group of individuals with primary progressive aphasia (PPA) by investigating the relation between measures of nonorthographic semantic and phonological processing and written language performance and by examining whether common patterns of cortical atrophy underlie impairments in spoken versus written language domains. Individuals with PPA and healthy controls were administered a language battery, including assessments of semantics, phonology, reading, and spelling. Voxel-based morphometry was used to examine the relation between gray matter volumes and language measures within brain regions previously implicated in semantic and phonological processing. In accordance with the primary systems account, our findings indicate that spoken language performance is strongly predictive of reading/spelling profile in individuals with PPA and suggest that common networks of critical left hemisphere regions support central semantic and phonological processes recruited for spoken and written language.     

A case of crossed aphasia in a dextral patient with polycythemia]

We report a 72-year-old right-handed man who was diagnosed as having crossed aphasia. He had polycythemia, hypertension and an old cerebral infarction in the right occipital lobe. He was admitted to our hospital because of muscle weakness in the left extremities at the age of 71. In the laboratory data, red blood cells(689 x 10(4)/microliter) and platelets(87.6 x 10(4)/microliter) were increased in number. Brain CT detected a right putaminal hematoma and an old infarct in the occipital lobe on the right. After admission, he developed non-fluent speech, and impairments of auditory comprehension, writing and naming due to the infarction in his right cerebral hemisphere including the middle cerebral artery distribution. The standard language test of aphasia(SLTA) revealed marked impairments in the language function, except for reading kana and kanji words. This writing was severely impaired compared with other language dysfunctions. Auditory comprehension, repetition and reading were impaired at the sentence level rather than at the kana word level. Furthermore, he suffered from left hemiparesis and left unilateral spatial neglect. We diagnosed his impairments of language function as crossed aphasia based on his right-handedness, CT findings and the results of SLTA. His language center was considered to be located in both cerebral hemispheres. Compared with typical findings in reported cases of crossed aphasia, the presence of both non-fluent speech and mutism were consistent with previous observations. However, the marked impairments of auditory comprehension, repetition and naming were different. Polycythemia and hypertension were considered to be the risk factors of cerebral infarction in our patient.     

Aphasia Following Right Striato-insular Infarction in a Left-handed Child: a Clinico-radiological Study

The case of six-year-old girl with non-fluent aphasia following a subcortical right-hemispheric cerebrovascular accident is reported. Examination by computerised tomographic scan revealed a right paraventricular area of diminished density involving the internal capsule, lenticular nucleus and the insula. The speech disturbance was followed by typical right-hemispheric signs and by left-channel extinction in dichotic listening tests. The aphasia cleared in two weeks, paralleled by an improvement in left-channel performance, suggesting that language recovery was dependent on right-hemispheric structures.     

Positive effects of a computerised working memory and executive function training on sentence comprehension in aphasia

Aphasia, the language disorder following brain damage, is frequently accompanied by deficits of working memory (WM) and executive functions (EFs). Recent studies suggest that WM, together with certain EFs, can play a role in sentence comprehension in individuals with aphasia (IWA), and that WM can be enhanced with intensive practice. Our aim was to investigate whether a combined WM and EF training improves the understanding of spoken sentences in IWA. We used a pre–post-test case control design. Three individuals with chronic aphasia practised an adaptive training task (a modified n-back task) three to four times a week for a month. Their performance was assessed before and after the training on outcome measures related to WM and spoken sentence comprehension. One participant showed significant improvement on the training task, another showed a tendency for improvement, and both of them improved significantly in spoken sentence comprehension. The third participant did not improve on the training task, however, she showed improvement on one measure of spoken sentence comprehension. Compared to controls, two individuals improved at least in one condition of the WM outcome measures. Thus, our results suggest that a combined WM and EF training can be beneficial for IWA.     

Neuropsychological and neuroimaging findings of developmental dysphasia: A longitudinal case study

This article presents an unusual and interesting neuropsychological and neuroimaging longitudinal study of a child who showed a relatively specific developmental language disorder in the absence of any other significant cognitive, emotional or neurological disturbance. The neuropsychological assessment included tests of intelligence, memory, language and frontal lobe functions. Our patient had a marked developmental language disorder characterized by severe impairment of oral and written language and a restricted vocabulary, even though the comprehension of both spoken and written language was relatively preserved. Moreover, his non-verbal intellectual ability was normal and he showed superior visuoconstructive and visuospatial abilities which suggested good development of right temporoparietal functions. On computerized tomography and magnetic resonance imaging there were no structural abnormalities in those cerebral areas concerned with language, although both neuroimaging studies did show a feasible reversed asymmetry or further atrophy on the left sylvian. It is noticeable that at age 17 a severe deficit in the expressive aspects of language remains. In contrast, visuo-constructive functions have improved. These results suggest a functional reorganization of the brain by increasing non-verbal capabilities. The prognosis in dysphasic syndromes is worse than in acquired aphasia in children, since despite speech therapy, an important language impairment persists during adulthood.     

Neuropsychological and neuroimaging findings of developmental dysphasia: A longitudinal case study

This article presents an unusual and interesting neuropsychological and neuroimaging longitudinal study of a child who showed a relatively specific developmental language disorder in the absence of any other significant cognitive, emotional or neurological disturbance. The neuropsychological assessment included tests of intelligence, memory, language and frontal lobe functions. Our patient had a marked developmental language disorder characterized by severe impairment of oral and written language and a restricted vocabulary, even though the comprehension of both spoken and written language was relatively preserved. Moreover, his non-verbal intellectual ability was normal and he showed superior visuoconstructive and visuospatial abilities which suggested good development of right temporoparietal functions. On computerized tomography and magnetic resonance imaging there were no structural abnormalities in those cerebral areas concerned with language, although both neuroimaging studies did show a feasible reversed asymmetry or further atrophy on the left sylvian. It is noticeable that at age 17 a severe deficit in the expressive aspects of language remains. In contrast, visuo-constructive functions have improved. These results suggest a functional reorganization of the brain by increasing non-verbal capabilities. The prognosis in dysphasic syndromes is worse than in acquired aphasia in children, since despite speech therapy, an important language impairment persists during adulthood.     

The effects of direct and indirect speech on discourse comprehension in Dutch listeners with and without aphasia

Background: Research on language comprehension in aphasia has primarily focused on comprehension of isolated words and sentences. Even though previous studies have provided insights into comprehension abilities of individuals with aphasia at the word and grammatical level, our understanding of the nature and extent of their language comprehension (dis)abilities is not yet complete. In contrast to the highly restricted semantic and syntactic interpretation of sentences, discourse comprehension requires additional pragmatic and non-linguistic skills.

Aims: The purpose of this study was to assess language comprehension in individuals with and without aphasia at the discourse level. In particular, it addressed the question of whether the use of direct speech, compared to indirect speech, affects comprehension of narrative discourse in Dutch aphasic and non-brain-damaged (NBD) listeners.

Methods & Procedures: The Direct Speech Comprehension (DISCO) test was developed to examine the effects of manipulating direct vs. indirect speech on discourse comprehension. Twenty-three individuals with aphasia and 20 NBD participants were presented with spoken narratives that contained either direct or indirect speech reports. The narratives were presented audio-visually on an iPad, and comprehension was assessed with yes/no questions.

Outcomes & Results: The performance of the participants with aphasia was significantly poorer than that of the NBD participants. Moreover, a main effect for condition type was found, indicating that narratives with direct speech reports were better understood than narratives with indirect speech reports by listeners with and without aphasia. There was no interaction between group and condition type indicating that this main effect held for both the aphasic and the NBD listeners. However, for the participants with aphasia, there was an interaction between condition and Token Test error score indicating that the positive effect of direct speech constructions diminishes for individuals with poorer comprehension.

Conclusions: Direct speech constructions facilitate language comprehension in listeners with and without aphasia. One explanation for this finding is the occurrence of additional “layers” of communication, such as intonation and facial expression, often accompanying direct speech constructions. An alternative account is the degree of grammatical complexity: In Dutch, the syntactic construction of indirect speech requires embedding, whereas in direct speech the introductory sentence and the quote are both main clauses. The finding that the beneficial effect of direct speech on language comprehension diminishes for individuals with severe aphasia may indicate that the DISCO is too difficult for them to reveal an effect of a subtle manipulation such as that of condition type.     

Sign language aphasia due to left occipital lesion in a deaf signer

Localization of sign language production and comprehension in deaf people has been described as similar to that of spoken language aphasia. However, sign language employs a visuospatial modality through visual information. We present the first report of a deaf signer who showed substantial sign language aphasia with severe impairment in word production due to a left occipital lesion. This case may indicate the possibility of other localizations of plasticity.