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.     

Broca aphasia: pathologic and clinical

The speech disturbance resulting from infarction limited to the Broca area has been delineated; it differs from the speech disorder called Broca aphasia, which results from damage extending far outside the Broca area. Nor does Broca area infarction cause Broca aphasia. The lesions in 20 cases observed since 1972 were documented by autopsy, computerized tomography, or arteriogram; the autopsy records from the Massachusetts General hospital for the past 20 years and the published cases since 1820 were also reviewed. The findings suggest that infarction affecting the Broca area and its immediate environs, even deep into the brain, causes a mutism that is replaced by rapidly improving dyspraxic and effortful articulation, but that no significant distrubance in language function persists. The more complex syndrome traditionally referred to as Broca aphasia, including Broca's original case, is characterized by protracted mutism, verbal stereotypes, and agrammatism. It is associated with a considerably larger infarct which encompasses the operculum, including the Broca area, insula, and adjacent cerebrum, in the territory supplied by the upper division of the left middle cerebral artery.     

Broca and the beginning of modern neurosurgery

The study presents Broca's pioneering efforts on cerebral localizations and craniotopography and their application on the first craniotomy based on cerebral localization.     

The discrimination of intonational contours in Broca’s aphasia

Abstract

The observation has been made that agrammatic speakers fail in the comprehension of various sentence types, and this behaviour has been attributed to diminished syntactic capabilities, under the unverified assumption that perception of intonation is intact. Here we re-examine this assumption experimentally with a language, Catalan, which allows for intonation to be the only variable over four sentence types (declaratives, yes-no questions, topicalisations and contrastive focus constructions). We conducted a discrimination task with 10 agrammatic and 10 age- and education-matched control subjects. The subjects were asked to decide whether sentence pairs were identical or not. The overall agrammatic performance was very accurate (89.1% versus 95.6% correct of the controls). The aphasic participants performed above chance in six out of seven conditions. The results indicate that agrammatic individuals succeeded in the task and that their perception of intonation is spared. We conclude that failure in comprehension in agrammatism cannot be attributed to prosodic disruption.     

Paul Flechsig

Ohne Zusammenfassung     

Paul Flechsig

Ohne Zusammenfassung     

Acute hypertension increases norepinephrine release in the diagonal band of Broca

In vivo microdialysis was used to measure extracellular concentrations of norepinephrine in the diagonal band of Broca (DBB) during changes in blood pressure in conscious rats. Dialysate norepinephrine concentration was significantly increased during acute hypertension (280±40% of control), but was not changed by hypotensive hemorrhage. These results are consistent with the proposal that noradrenergic innervation of the DBB is selectively activated by increased blood pressure.     

Broca and the beginning of modern neurosurgery] [In Process Citation

This study presents Broca's pioneering efforts on cerebral localizations and craniotopography and their application on the first craniotomy based on cerebral localization.     

累及Broca区低级别胶质瘤的BOLD—fMRI及语言功能区的可塑性研究（附15例分析）

目的探讨Bold—fMRI在功能区低级别胶质瘤中的应用及语言功能区的可塑性。方法对15例低级别胶质瘤及14例正常人行fMRI检查并作体素分析。病人在功能影像、术中电刺激指导下进行手术,结合语盲测评、影像评估及Karnofsky功能状态评分（KPS）等进行随访。结果病人较正常人半球激活指数（HAI）低,提示语言功能区重塑。肿瘤全切除11例,近全切除4例。术后短期内有不同程度失语7例,术后3个月均得以恢复。术后KPS评分较术前提高。结论Broca区低级别胶质瘤病人术前、术后语言功能区具有可塑性;应用术前功能影像及术中电刺激指导手术治疗,可提高肿瘤的切除程度,同时亦可保护语言功能。     

Arzt und Patient: Paul Flechsig und Daniel Paul Schreber

During his three stays in psychiatric institutions between 1884 and 1911, Daniel Paul Schreber was also twice treated in the psychiatric and neurological hospital of Leipzig University headed by Paul Flechsig. In his "Memoirs of a Nervous Patient," Schreber also described the treatment he had received there, which in his perception seemed to be of crucial importance for his later fate. Research on the Schreber case in the last 25 years, based mainly on the interpretation of his own memoirs, supported the view that in fact Flechsig was to blame to a great extent for the outbreak of Schreber's paranoid schizophrenia in February 1894. This paper aims at forwarding exonerating arguments in favor of Flechsig, concluding that what he did did not differ distinctively from the standard tenets of organic psychiatry taught at that time. Of course this does not change the fact that Schreber did not receive the right kind of treatment. However, it puts Flechsig's approach into the right perspective.     

Pressor effects of L-glutamate injected into the diagonal band of Broca of unanesthetized rats

The diagonal band of Broca (dbB) is involved in central cardiovascular control. In the present study we compared the effects of microinjections of L-glutamate into the dbB of unanesthetized rats with those observed after the injection of L-glutamate into the same area in urethane-anesthetized rats. The microinjection of L-glutamate (10, 30, 100 or 200 nmol/200 nl) into the dbB of urethane-anesthetized rats caused dose-related short-lasting depressor responses The depressor responses to L-glutamate were accompanied by dose-related heart rate reduction. The cardiovascular response to the injection of L-glutamate (10, 30 or 100 nmol/200 nl) into the dbB of unanesthetized rats was characterized as a long-lasting pressor response without consistent heart rate changes. The pressor response was dose-related and presented an ED(50) of approximately 30 nmol/200 nl. The fact that the chemical stimulation of the dbB with L-glutamate caused only dose-related pressor responses in unanesthetized rats suggests that under normal conditions the dbB is predominantly a pressor area. After the characterization of the pressor response to L-glutamate microinjected into the dbB of unanesthetized rats we studied the mechanisms involved in the mediation of these responses. The pressor response to L-glutamate (30 nmol/200 nl) into the dbB was blocked by intravenous pretreatment with the vasopressin antagonist dTyr(CH(2))(5)(Me)AVP (50 microg/kg), suggesting the involvement of circulating vasopressin in this response. Further evidence of the involvement of the endocrine vasopressin system in the pressor response to L-glutamate injected into the dbB was provided by hypophysectomy since L-glutamate (30 nmol/200 nl) microinjection into the dbB of hypophysectomized rats caused only depressor responses. We presently report that chemical stimulation of the dbB with L-glutamate caused only pressor responses in unanesthetized rats that were mediated by vasopressin release into the systemic circulation. Additionally, the results confirmed the existence of an L-glutamate-sensitive depressor system in the dbB, which is predominant in urethane-anesthetized rats or may be evidenced in unanesthetized hypophysectomized rats.