What Do Language Disorders Reveal about Brain-Language Relationships? From Classic Models to Network Approaches.

Studies of language disorders have shaped our understanding of brain-language relationships over the last two centuries. This article provides a review of this research and how our thinking has changed over the years regarding how the brain processes language. In the 19th century, a series of famous case studies linked distinct speech and language functions to specific portions of the left hemisphere of the brain, regions that later came to be known as Broca's and Wernicke's areas. One hundred years later, the emergence of new brain imaging tools allowed for the visualization of brain injuries in vivo that ushered in a new era of brain-behavior research and greatly expanded our understanding of the neural processes of language. Toward the end of the 20th century, sophisticated neuroimaging approaches allowed for the visualization of both structural and functional brain activity associated with language processing in both healthy individuals and in those with language disturbance. More recently, language is thought to be mediated by a much broader expanse of neural networks that covers a large number of cortical and subcortical regions and their interconnecting fiber pathways. Injury to both grey and white matter has been seen to affect the complexities of language in unique ways that have altered how we think about brain-language relationships. The findings that support this paradigm shift are described here along with the methodologies that helped to discover them, with some final thoughts on future directions, techniques, and treatment interventions for those with communication impairments. (JINS, 2017, 23, 741-754).

Charcot and aphasia: contributions of his assistants / Charcot e afasia: contribuições de seus assistentes

The ideas and concepts regarding language and its disorders have a longstanding history. However, it was possible to consider the 19th century as the period when the main milestones on the subject begun to be settled, with Paul Broca's and Carl Wernicke's pivotal findings. Albeit language disorders (aphasia) were not, apparently, his preferential interest, Charcot engaged himself in the issue, and after thorough studies delivered a series of lectures on this theme at the Salpêtrière Hospital, transcribed by two of his assistants, Charles Féré and Gaetano Rummo, and then published. Other three assistants, inspired in Charcot's teachings, Désiré Bernard, Gilbert Ballet and Pierre Marie, contributed independently with papers or books.The lectures and the contributions of those collaborators were partially incorporated in the Oeuvres Complètes published by Charcot.

As ideias e os conceitos sobre a linguagem e suas desordens possuemuma história de longa duração. Entretanto, é possível considerar o século XIX como o período no qual os principais marcos sobre o tema começaram a ser estabelecidos, com os achados fulcrais de Paul Broca e Carl Wernicke. Embora desordens da linguagem (afasia) não tenham sido, aparentemente, seu interesse predileto, Charcot se envolveu no assunto e, depois de aprofundados estudos, ministrou uma série de lições sobre o tema no Hospital da Salpêtrière, transcritas por dois de seus assistentes, Charles Féré e Gaetano Rummo, sendo publicados em seguida. Outros três assistentes, inspirados nos ensinamentos de Charcot, Désiré Bernard, Gilbert Ballet e Pierre Marie, contribuíram de modo independente com artigos ou livros. As lições e as contribuições desses colaboradores foram parcialmente incorporadas nas Oeuvres Complètes publicadas por Charcot.

Theory and practice in action: the contributions of Michael Perkins to clinical linguistics.

This article reviews the scholarly contributions of Michael R. Perkins in the discipline of clinical linguistics and provides some indication of the reasons that he has been so successful. Three primary attributes were described through an analysis of his publications.

Advancing description and explanation in clinical linguistics: a legacy of Martin J. Ball.

This article asserts the importance of explication of order and disorder in language as a privileged objective of clinical linguistics and service delivery and reviews the contributions of Martin Ball in advancing this agenda.

The birth and growth of a scientific journal.

Clinical Linguistics & Phonetics (CLP) and its namesake field have accomplished a great deal in the last quarter of a century. The success of the journal parallels the growth and vitality of the field it represents. The markers of journal achievement are several, including increased number of journal pages published annually; greater diversity of topics related to the core mission of the journal; expanding cross-language coverage; and healthy interactions among editors, reviewers and contributors; and - for better or worse - journal impact factors. A journal is in a competitive dynamic with other journals that share its general domain of scholarship, which is a major reason why an apparent imbalance may emerge in the topic content of any particular journal. The content of a journal is determined by the nature and number of submitted manuscripts. As far as linguistic content goes, CLP's centre of gravity appears to have been mostly in phonology and phonetics, but certainly not to the exclusion of syntax, semantics and pragmatics. The clinical scope is broad, both in terms of concepts and types of disorder. CLP has secured its place among journals in the field, and it is an outlet of choice for many researchers throughout the world.

Clinical linguistics: its past, present and future.

Historiography is a growing area of research within the discipline of linguistics, but so far the subfield of clinical linguistics has received virtually no systematic attention. This article attempts to rectify this by tracing the development of the discipline from its pre-scientific days up to the present time. As part of this, I include the results of a survey of articles published in Clinical Linguistics & Phonetics between 1987 and 2008 which shows, for example, a consistent primary focus on phonetics and phonology at the expense of grammar, semantics and pragmatics. I also trace the gradual broadening of the discipline from its roots in structural linguistics to its current reciprocal relationship with speech and language pathology and a range of other academic disciplines. Finally, I consider the scope of clinical linguistic research in 2011 and assess how the discipline seems likely develop in the future.

Amyotrophic lateral sclerosis and language dysfunction: kana, kanji and a prescient report in Japanese by Watanabe (1893).

Although Charcot described amyotrophic lateral sclerosis (ALS) in the 1870s, he did not focus on language. And language problems in ALS with or without dementia were long ignored. A recent report by Caselli et al. [Ann Neurol 1993;33:200-207] is accurately regarded as a major breakthrough in studies of language in ALS. However, we discovered a Japanese account written by Watanabe in 1893 describing paragraphia of an aphasic nature, and this is interesting for two reasons. (1) Watanabe's paper is, we believe, the first report of an aphasia associated with motor neuron disease, and predates other reports by 100 years. (2) It sheds light on the dissociated involvement of the two Japanese writing systems: kana (Japanese simple phonograms) and kanji (Japanese morphograms with complex character derived from Chinese characters). In the aphasia reported by Watanabe, the phonograms are more affected than the morphograms. Thus, Watanabe's clinical observation may predict current theories of the way in which these two writing systems involve different intrahemispheric pathways.

The arcuate fasciculus and the disconnection theme in language and aphasia: history and current state.

Few themes have been more central to neurological models of aphasia than the disconnection paradigm and the role of the arcuate fasciculus. Introduced by luminaries of 19th Century neurology and resurrected by the charismatic work of Norman Geschwind, the disconnection theme has triggered spectacular advances of modern understanding of language and aphasia. But the disconnection paradigm had alternate fortunes, ranging from irrational exuberance to benign neglect, and its followers have not always shared the same view on its functional consequences and anatomical correlates. Our goal in this paper is, first, to survey the 19th Century roots of the connectionist approach to aphasia and, second, to describe emerging imaging technologies based on diffusion tensor imaging (DTI) that promise to consolidate and expand the disconnection approach to language and its disorders.

Language and memory disorder in the case of Jonathan Swift: considerations on retrospective diagnosis.

The cause of behavioural changes described by Alzheimer for his original case, Auguste D., has been recently reconfirmed by histological examination. However, there has been active speculation regarding the cause of behavioural changes exhibited by the political satirist Jonathan Swift (1667-1745) during the final three years of his life for over 250 years. Swift's symptoms of cognitive changes, memory impairment, personality alterations, language disorder and facial paralysis have all been apportioned differing levels of significance in various attempts at retrospective diagnosis. The various medical arguments put forward from the 18th through 20th centuries will be critically examined. The diagnoses considered refer to evolving theories of insanity, phrenology, localization of cortical function, hydrocephalus, psychoanalysis, aphasia, dementia and depression in ageing. Re-consideration of the attempts to re-diagnose Swift's final mental state by the leading neurological thinkers of the day, including Wilde (The Closing Years of Dean Swift's Life. Dublin: Hodges and Smith, 1849), Bucknill (1882), Osler [Osler's textbook Principles and Practice of Medicine (1892); published in St Thomas's Hospital Gazette (London) 1902; 12: 59-60), Brain (Irish Med J 1952: 320-1 and 337-346) and Boller and Forbes (J Neurol Sci 1998; 158: 125-133) reveal the changing attitudes regarding the significance of behavioural symptoms to neurological diagnosis from the 18th century to the present day.

Schizophrenia and the structure of language: the linguist's view.

Patients with schizophrenia often display unusual language impairments. This is a wide ranging critical review of the literature on language in schizophrenia since the 19th century. We survey schizophrenic language level by level, from phonetics through phonology, morphology, syntax, semantics, and pragmatics. There are at least two kinds of impairment (perhaps not fully distinct): thought disorder, or failure to maintain a discourse plan, and schizophasia, comprising various dysphasia-like impairments such as clanging, neologism, and unintelligible utterances. Thought disorder appears to be primarily a disruption of executive function and pragmatics, perhaps with impairment of the syntax-semantics interface; schizophasia involves disruption at other levels. Phonetics is also often abnormal (manifesting as flat intonation or unusual voice quality), but phonological structure, morphology, and syntax are normal or nearly so (some syntactic impairments have been demonstrated). Access to the lexicon is clearly impaired, manifesting as stilted speech, word approximation, and neologism. Clanging (glossomania) is straightforwardly explainable as distraction by self-monitoring. Recent research has begun to relate schizophrenia, which is partly genetic, to the genetic endowment that makes human language possible.

Phineas Gage, ‘Tan’ y la importancia de los casos clínicos / Phineas Gage, ‘Tan’and the importance of case reports

Introducción. Las descripciones originales de la lesión frontal de Phineas Gage (1848) y del tumor de crecimiento lento de ‘Tan’, el famoso paciente de Broca (1861), son ejemplos de cómo un sencillo caso clínico puede enseñar valiosas lecciones, algunas de ellas discutidas todavía siglo y medio después. Desarrollo. En este artículo se revisan y resumen las fuentes originales de estos dos casos primigenios, en Boston y París. Se analizan las lecciones que estos dos pacientes dejaron sobre la localización de funciones cerebrales y se ubican en el contexto de la moderna medicina basada en evidencias

Introduction. The original descriptions of the frontal lobe injury of Phineas Gage (1848) and the slowly growing tumor of ‘Tan’, Broca’s famous patient (1861), are examples of how a simple case report can teach important lessons, some of them still discussed a century and a half later. Development. In this article, the original sources of both of these seminal cases, in Boston and Paris, have been reviewed and are briefly summarized. The lessons learned from them in the effort to localize brain functions are explained and set in the context of modern evidence-based medicine

The challenge of language assessment for african american english-speaking children: a historical perspective.

The diagnostic problem of how validly to assess the language of children who speak dialects different from Mainstream American English (MAE) has challenged the field of communication disorders for several decades. The key to its solution is to recognize differences due to dialect or development and remove them from the initial diagnosis of a disorder. A new approach to the puzzle, implemented jointly by University of Massachusetts scholars and the Psychological Corporation (TPC), takes two directions: (1) it provides new normative data on African American English (AAE) development, and (2) it proposes a level of analysis deeper than dialect for the discovery of alternate markers of a disorder. We present three objectives for a language assessment instrument designed to solve this longstanding problem: (1) to answer the problem/no problem question for a given child; (2) to provide explanatory data about the nature of the problem; and (3) to achieve objectives 1 and 2 in a way that is culturally and linguistically fair to both speakers of MAE and speakers of other dialects of English such as AAE.

The history of written language disorders: Reexamining Pitres' case (1884) of pure agraphia.

The first clinical description of pure agraphia was reported by the French neurologist Pitres in 1884. Pitres used the case study evidence to argue for modality-specific memory representations and the localization of writing. This article reviews Pitres's contribution to the study of acquired writing disorders, the components of writing models and the cerebral localization which subserve writing, in light of the views entertained by his contemporaries and current authors. Although numerous cases have been reported throughout this century, the view that writing can be impaired while other language functions and motor activities remain intact is still challenged.

The generativist-interactionist debate over specific language impairment: psycholinguistics at a crossroads.

Certain defining problems in psychology force us to clarify both the origins and the limits of a paradigm that has long governed our thinking in a particular area of research. The current debate over the nature and causes of specific language impairment is proving to be just such an issue. In particular, the existence of the KE family, 15 of whose 37 members suffer from specific language impairment, has raised far-reaching questions about the conceptual foundations of our current views about language deficits and, indeed, about language development in general.

Voices of the mad: patients' letters from the Royal Edinburgh Asylum, 1873-1908.

BACKGROUND: This paper is based on a rich archive of 1151 letters by patients, who were admitted to the Royal Edinburgh Asylum during the reign of Thomas Clouston (1873-1908). METHODS: All letters were examined for evidence of psychopathology, and the material obtained was organized under the various psychopathological categories, such as delusions or hallucinations, as defined by Sims (1988). RESULTS: A descriptive account of patient symptomatology is given. It is found that nineteenth century psychopathology is very similar to that of the modern day, and that most forms of morbid mental phenomena can be found in the patients' letters. More specifically, most of the cardinal symptoms of schizophrenia were described in the patients' correspondence. The letters also illustrate how mental symptoms reflect the cultural and scientific concerns of their time. CONCLUSIONS: The evidence in the patients' letters argues for the unchanging nature of mental illness across time, at least for the last 120 years. It also demonstrates that patients admitted to the Royal Edinburgh Asylum suffered from serious mental illness, and it undermines the view that the Asylum was simply a dumping ground for society's disaffected.