Reading in pure alexia. The effect of strategy.

A number of investigators have demonstrated that patients with pure alexia comprehend briefly presented words which they are unable to explicitly identify. We suggested previously that these patients may read by means of two distinct procedures: a laborious letter-by-letter method and a 'whole-word' procedure which, at least initially, does not support explicit word identification. We report a test of this proposal in a patient with pure alexia. We reasoned that if the patient had access to two distinct and incompatible procedures, he might be induced to switch from one to the other by changing task demands. We found that when instructed to name words, the patient employed a letter-by-letter strategy; in contrast, when instructed to make lexical decision or semantic judgements about rapidly presented words, he appeared to use a 'whole-word' strategy. These data support the hypothesis that two distinct procedures are available to this patient. We argue, further, that is necessary to suppress use of the letter-by-letter strategy to demonstrate whole word reading capability in pure alexics, and that failure to do so may account for negative findings in other cases reported in the literature.

A computational account of deep dysphasia: evidence from a single case study.

We present a case study of a patient, NC, who demonstrates the defining characteristics of deep dysphasia including semantic errors in repetition and an inability to repeat nonwords. In addition, NC's single word repetition and lexical decision performances are influenced by the imageability of the word input. NC also demonstrates a severely restricted phonological short-term memory (one digit, one word). Although his phonological discrimination is good in a minimal pairs judgment task, it becomes impaired when a delay is imposed or rehearsal is prevented between presentation of each member of a pair. NC's output is fluent but contains many formal paraphasias and neologisms. NC's total language profile is evaluated within the framework of Dell's (1986) interactive spreading activation model of language production. Adapting this output model to input processes, we account for all of NC's deep dysphasic symptoms as well as his pattern of production in a way that is more parsimonious than other attempts to model this disorder. In particular, we suggest that the semantic and formal paraphasias in naming and repetition result from a pathological increase in the rate of decay of primed nodes in the semantic-lexical-phonological network. This rapid decay increases the probability that phonologically and/or semantically related lexical nodes primed by top-down and bottom-up feedback during the operation of lexical activation and retrieval will be activated and selected instead of the lexical target. The advantages of using this model to account for aphasic symptoms and the implications for other lexical theories are discussed.

Simultanagnosia. To see but not two see.

Simultanagnosia is a disorder of visual perception characterized by the inability to interpret complex visual arrays despite preserved recognition of single objects. We report a series of investigations on a simultanagnosic patient which attempt to establish the nature of this visual processing disturbance. The patient performed normally on a feature detection task but was impaired on a test of attention-requiring visual search in which she was asked to distinguish between stimuli containing different numbers of targets. She was not impaired on a visual-spatial orienting task. She identified single briefly presented words and objects as rapidly and reliably as controls suggesting that access to stored structural descriptions was not impaired. With brief, simultaneous presentation of 2 words or drawings, she identified both stimuli significantly more frequently when the stimuli were semantically related than when they were unrelated. On the basis of these and other data, we suggest that the patient's simultanagnosia is attributable to an impairment in the process by which activated structural descriptions are linked to information coding the location of the object.

Preserved object recognition and reading comprehension in optic aphasia.

Optic aphasia is characterized by the ability to name from description and palpation but an inability to name visually-presented objects. Although originally attributed to a disconnection of visual information from object names, optic aphasia is often considered to be a mild form of visual agnosia. We describe a patient with optic aphasia who could access semantic information relevant to objects he could not name and comprehend written words he could not read. These data suggest that, at least in certain cases, this visual modality-specific naming impairment may not be attributable to impaired visual recognition. We suggest that this patient's preserved object recognition and reading comprehension was mediated by a semantic system supported by the right hemisphere.

[Nature of repetition disorders in conduction aphasia]. / Naturaleza de los trastornos de repetición en afasias de conducción.

The skeptic over the existence of this important clinical entity, are now very few. Anatomo-clinical studies and the analysis of altered cognitive procedures suggest, however, that we are dealing with a heterogeneous group. Two models of conduction apahasias are presented, in which the mechanism of the altered repetition, as well as the probable localization of the lesion, differ considerably. One has a lesion in the posterior parietal region of the left hemisphere and it exemplifies an acoustic verbal memory deficit (short term memory). The other points at a functional disconnection between the decodification and verbal processes and those of expression. In this case, we are dealing with a left temporal lesion in a left-handed individual. The analysis of our material and of the clinical literature upholds the idea of a plurality of the altered mechanisms in the verbal repetition and suggest that the conduction aphasia is a syndrome.