An access deficit or a deficit in the phonological representations themselves: What can we learn from naming errors?

Anomic aphasia is characterized by good comprehension and non-word repetition but poor naming. Two sub-types of deficits might be hypothesized: faulty access to preserved phonological representations or preserved access to impaired representations. Phonological errors may occur only when representations are impaired or in post-lexical deficits (conduction aphasia). We analysed the incidence of phonological naming errors of 30 individuals, 25 with anomic aphasia based on poor naming but good repetition and comprehension, and five with conduction aphasia based on poor naming and poor repetition. Individuals with anomic aphasia produced very few phonological errors compared to individuals with conduction aphasia (0-19.1% versus 42-66%). However, six individuals with anomia produced more than 11% phonological errors, suggesting two patterns of deficit: either impaired lexical representations or impaired access to them. The lack of phonological errors in most individuals with anomic aphasia suggests that access to the phonological output lexicon is semantically, not phonologically driven.

[Conduction aphasia in patients with glioma in the left hemisphere]. / Provodnikovaya afaziya u bol'nykh s gliomami levogo polushariya.

Background. According to Wernicke-Geschwind model, conduction aphasia following arcuate tract lesion was canonized as primary disorder of repetition in relatively intact speech. OBJECTIVE: Syndromic analysis of speech and writing disorders in patients with arcuate tract lesion using the method by A.R. Luria and their comparison with well-known types of aphasia. MATERIAL AND METHODS: Clinical and neuropsychological survey was performed in 14 patients with gliomas who underwent surgical treatment at the Burdenko Neurosurgical Center (10 gliomas of the frontal lobe and 4 tumors of the temporal lobe). All patients underwent MRI, HARDI MRI tractography and A.R. Luria's neuropsychological examination prior to surgery and after 5-6 postoperative days. Thirteen patients underwent awake craniotomy, 3 of them were examined one year after surgery. RESULTS: In all patients, the tumor was localized near arcuate tract and its infiltration was noted. No intraoperative damage to the tract was ever noted according to speech monitoring data. However, postoperative edema followed by infiltration and dislocation of the tract (in all patients), as well as local ischemia in 4 patients were observed. After resection of prefrontal and premotor gliomas, aphasia included frontal (perseveration) and temporal components (disorders of naming, auditory-speech memory). Unusual verbal paraphrases were noted. We also observed severe violation of writing (temporal type) even if spontaneous speech and repetition were preserved. In case of resection of deep posterior temporal gliomas, speech disorders included signs of frontal lobe lesion (perseveration) and writing disorders. Similar motor abnormalities were identified in writing. CONCLUSION: Arcuate tract lesion can result speech and writing disorders as signs of damage to certain cortical speech zones (frontal and temporal lobe). Violations of repetition were not predominant in any case. At the same time, interruption of connection between motor and auditory image of the word could be revealed in writing.

[A case of conduction aphasia with specific jargon utterance].

We report a patient with bilateral hemispheric lesions caused by two episodes of cerebral infarction who exhibited conduction aphasia with unique jargon. The patient was an 84-year-old, right-handed man. Beginning after the second episode of cerebral infarction (defined as the time of symptom onset), neologistic jargon and an iterative pattern of phonemic variation became prominent, whereas phonological paraphasia and conduite d'approche were observed in the patient's overall speech. Therefore, the aphasia was characterized by the combination of conduction aphasia and neologistic jargon. At 27 months after symptom onset, the neologisms and iterative pattern of phonemic variation had disappeared, but a wide variety of phonological paraphasia and conduite d'approche persisted, clarifying the pathological features of the conduction aphasia experienced by this patient. The conduction theory (Kertesz et al., 1970) provides a convincing explanation for the mechanism of the onset of neologisms in the present case. Thus, we propose the existence of a symptomatic relationship between neologisms and phonological paraphasia.

COVID-19 presenting with agraphia and conduction aphasia in a patient with left-hemisphere ischemic stroke.

COVID-19 following infection by SARS-CoV-2 can affect the brain causing confusion, depression, and dementia-like signs. Nonetheless, the presence of more specific neuropsychological signs because of COVID-19 remains unexplored. We report on LA, a patient who was affected by a left-hemisphere ischemic stroke, probably because of SARS-CoV-2. The patient showed a highly specific neuropsychological profile characterized by severe agraphia and some signs of conduction aphasia. All other cognitive and sensorimotor functions remained intact. We sustain that specific neuropsychological signs can be observed in patients with COVID-19. Therefore, in-depth and comprehensive neuropsychological assessment should be included to better explore and qualify the neuropsychological consequences of COVID-19. This is a new challenge for diagnosis and rehabilitation, with important consequences for the involved neuropsychological services.

An Exploration of the Impact of Group Treatment for Aphasia on Connected Speech.

OBJECTIVE: Group treatment enables people with aphasia to practise communication skills outside the typical clinician-patient dyad. While there is evidence that this treatment format can improve participation in everyday communication, there is little evidence it impacts linguistic abilities. This project aimed to investigate the effects of 'typical' group treatment on the communication skills of people with aphasia with a focus on word retrieval in discourse. METHODS: Three people with aphasia took part in a 6-week group therapy programme. Each week focused on a different topic, and three topics also received a home programme targeting word retrieval. The six treated topics were compared with two control topics, with regard to language production in connected speech. Semistructured interviews were collected twice prior to treatment and twice following the treatment and analysed using (a) word counts; (b) the profile of word errors and retrieval in speech; (c) a measure of propositional idea density, and (d) perceptual discourse ratings. RESULTS: Two participants showed no significant improvements; one participant showed significant improvement on discourse ratings. CONCLUSIONS: This study provides limited support for group treatment, leading to improved communication as measured by semistructured interviews, even when supplemented with a home programme. We suggest that either group treatment, as implemented here, was not an effective approach for improving communication for our participants and/or that outcome measurement was limited by difficulty assessing changes in connected speech.

The effect of augmented input on the auditory comprehension of narratives for people with aphasia: a pilot investigation.

Augmented input is the strategy of supplementing expressive language with visuographic images, print, gestures, or objects in the environment. The goal of augmented input is to facilitate comprehension of spoken language. The purpose of this study was to evaluate the relative effectiveness of two different augmented input conditions in facilitating auditory comprehension of narrative passages in adults with aphasia. One condition involved the communication partner (clinician) of the adult with aphasia actively pointing (AI-PP) out key content words using visuographic supports. The second condition involved no active pointing (AI-NPP) by the communication partner (i.e., attention was not drawn to the visuographic supports). All 12 participants with aphasia listened to two narratives; one in each condition. Auditory comprehension was measured by assessing participants' accuracy in responding to 15 multiple-choice cloze-type statements related to the narratives. Of the 12 participants, seven gave more accurate responses to comprehension items in the AI-PP condition, four gave more accurate responses in the AI-NPP condition, and one scored the same in both conditions. These differences were not statistically significant (p > 0.05). Communication-partner-referenced augmented input using combined high-context and PCS symbol visuographic supports improved response accuracy for some participants. Continued research is necessary to determine partner involvement with and frequency of augmented input that improve auditory comprehension.

How to get by with half a loop - An investigation of visual and auditory codes in a case of impaired phonological short-term memory (pSTM).

In the field of cognitive neuropsychology of phonological short-term memory (pSTM), a key debate surrounds the issue of how impairment on tasks deemed to tap this system imply a dissociable phonological input and output buffer system, with the implication that impairments can be fractionated across disruption to separate functional components (Nickels, Howard & Best, 1997). This study presents CT, a conduction aphasic who showed no impairment on basic auditory discrimination tasks, but had very poor nonword repetition. Clear-cut examples of such cases are very rare (see Jacquemot, Dupoux & Bachoud-Levi, 2007), and we interpret the case with reference to a pSTM model that includes input and output buffers. The dissociation between performance on auditory phonological tasks and visual phonological tasks we interpret as consistent with disruption to the link from input buffer to output buffer without concurrent damage to connections from output to input. Previous research has also shown that patients with impairments of pSTM can make visual confusions with orthographically presented items in tasks seeking to tap this mechanism (Warrington & Shallice, 1972), which might stem from having an incomplete pSTM loop. In light of this we examined whether CT's ability on tests of ISR was affected by visual orthographic similarity among list items, and this is indeed what we observed. On balance then, CT's overall profile is considered best interpreted with respect to a dual buffer pSTM model (e.g., Vallar & Papagno, 2002).

Rehabilitación neuropsicológica de un caso con sintomatología de afasia de conducción y anómica por evento isquémico / Neuropsychological rehabilitation in a case of conduction and anomic aphasia symptomatology by ischemic event

El tema de la rehabilitación de las afasias es explorado con frecuencia en la literatura de las últimas décadas, debido a que es una de las secuelas más comunes del daño cerebral y de las que más presenta variaciones dependiendo del caso, por lo cual los profesionales a cargo de los pacientes que sufren de esta condición se ven en la necesidad de buscar métodos eficaces para tratarlos. El objetivo de esta investigación es mostrar el diseño de un único caso con sintomatología de afasia de conducción y anomia pura. Se trata de un paciente masculino de 62 años de edad, con nivel académico de doctorado, diagnóstico de afasia de conducción y anomia a causa de un evento isquémico con 18 meses de evolución. Recibió tratamiento neuropsicológico en base a modelos histórico-culturales y neurocognitivos en dos periodos diferentes, una hora por semana. Se llevó a cabo una evaluación neuropsicológica antes y después del programa de rehabilitación, además se hizo uso de líneas bases en ambos periodos y se tomó en cuenta la perspectiva del paciente y su esposa. El rendimiento en la primera y segunda evaluación muestra un mejor desempeño en algunas áreas del lenguaje, mientras que en las líneas bases y en la apreciación del paciente y su esposa se observaron cambios importantes, concluyendo que el programa tuvo efectos favorables en la comunicación del paciente en el hogar.

The subject of aphasia rehabilitation is frequently explored in recent literature since it is one of the most common forms of brain damage and presents an assortment of variations depending on the specific case, making it so that professionals who are in charge of patients with this condition find themselves in need of effective treatment methods. This article aims to present the design for the single case study rehabilitation of a patient with conduction aphasia and pure anomia. The patient in question is a 62-year-old male with a P.h.D. level education, diagnosed with conduction aphasia and anomia caused by an ischemic event with an 18-month evolution, he received neuropsychological treatment following the historic-cultural and neurocognitive models, spanning two different treatment periods, one hour a week. A neuropsychological evaluation was made before and after the rehabilitation program, as well as using a baseline for both periods and taking into account the perspective of both the patient and his wife. Patient performance in the first and second evaluations shows improvement in some language areas, while the baselines, as well as the patient and his wife's assessment speak of important changes, concluding that the program had favorable effects on the patient's communication at home

The Relationship Between Confrontation Naming and Story Gist Production in Aphasia.

Purpose: The purpose of this study was to examine the relationship between picture naming performance and the ability to communicate the gist, or essential elements, of a story. We also sought to determine if this relationship varied according to Western Aphasia Battery-Revised (WAB-R; Kertesz, 2007) aphasia subtype. Method: Demographic information, test scores, and transcripts of 258 individuals with aphasia completing 3 narrative tasks were retrieved from the AphasiaBank database. Narratives were subjected to a main concept analysis to determine gist production. A correlation analysis was used to investigate the relationship between naming scores and main concept production for the whole group of persons with aphasia and for WAB-R subtypes separately. Results: We found strong correlations between naming test scores and narrative gist production for the large sample of persons with aphasia. However, the strength of the correlations varied by WAB-R subtype. Conclusions: Picture naming may accurately predict gist production for individuals with Broca's and Wernicke's aphasia, but not for other WAB-R subtypes. Given the current reprioritization of outcome measurement, picture naming may not be an appropriate surrogate measure for functional communication for all persons with aphasia. Supplemental Materials: https://doi.org/10.23641/asha.5851848.

Developmental conduction aphasia after neonatal stroke.

OBJECTIVE: Impairment of speech repetition following injury to the dorsal language stream is a feature of conduction aphasia, a well-described "disconnection syndrome" in adults. The impact of similar lesions sustained in infancy has not been established. METHODS: We compared language outcomes in term-born individuals with confirmed neonatal stroke (n = 30, age = 7-18 years, left-sided lesions in 21 cases) to matched controls (n = 40). Injury to the dorsal and/or ventral language streams was assessed using T1 - and T2 -weighted magnetic resonance imaging (MRI) and diffusion tractography. Language lateralization was determined using functional MRI. RESULTS: At the group level, left dorsal language stream injury was associated with selective speech repetition impairment for nonwords (p = 0.021) and sentences (p < 0.0001). The majority of children with significant repetition impairment had retained left hemisphere language representation, but right hemisphere dominance was correlated with minimal or absent repetition deficits. Post hoc analysis of the repetition-impaired group revealed additional language-associated deficits, but these were more subtle and variable. INTERPRETATION: We conclude that (1) despite the considerable plasticity of the infant brain, early dorsal language stream injury can result in specific and long-lasting problems with speech repetition that are similar to the syndrome of conduction aphasia seen in adults; and (2) language reorganization to the contralateral hemisphere has a protective effect. Ann Neurol 2018;83:664-675 Ann Neurol 2018;83:664-675.

Phonotactic processing deficit following left-hemisphere stroke.

The neural basis of speech processing is still a matter of great debate. Phonotactic knowledge-knowledge of the allowable sound combinations in a language-remains particularly understudied. The purpose of this study was to investigate the brain regions crucial to phonotactic knowledge in left-hemisphere stroke survivors. Results were compared to areas in which gray matter anatomy related to phonotactic knowledge in healthy controls. 44 patients with chronic left-hemisphere stroke, and 32 controls performed an English-likeness rating task on 60 auditory non-words of varying phonotactic regularities. They were asked to rate on a 1-5 scale, how close each non-word sounded to English. Patients' performance was compared to that of healthy controls, using mixed effects modeling. Multivariate lesion-symptom mapping and voxel-based morphometry were used to find the brain regions important for phonotactic processing in patients and controls respectively. The results showed that compared to controls, stroke survivors were less sensitive to phonotactic regularity differences. Lesion-symptom mapping demonstrated that a loss of sensitivity to phonotactic regularities was associated with lesions in left angular gyrus and posterior middle temporal gyrus. Voxel-based morphometry also revealed a positive correlation between gray matter density in left angular gyrus and sensitivity to phonotactic regularities in controls. We suggest that the angular gyrus is used to compare the incoming speech stream to internal predictions based on the frequency of sound sequences in the language derived from stored lexical representations in the posterior middle temporal gyrus.

rTMS treatments combined with speech training for a conduction aphasia patient: A case report with MRI study.

RATIONALE: To date, little is known regarding the neural mechanisms of the functional recovery of language after repetitive transcranial magnetic stimulation (rTMS) in aphasia. Our aim was to investigate the mechanism that underlies rTMS and speech training in a case report. PATIENT CONCERNS AND DIAGNOSES: We report the case of a 39-year-old woman who was initially diagnosed with conduction aphasia following a left hemisphere stroke. INTERVENTIONS: The rTMS location comprised the left Broca area, and a frequency of 5 Hz for 20 min/d for 10 days during a 2-week period was used. She had received speech rehabilitation training 1 month after stroke. Functional magnetic resonance imaging (fMRI) and diffusion tensor imaging were used to investigate the functional and microstructural changes before and after rTMS treatment. OUTCOMES: The results demonstrated that the Western Aphasia Battery scores significantly improved for language ability at 2 weeks post-treatment, and the gains were steadily increased at 2.5 months post-treatment. The fMRI results indicated a more focused activation pattern and showed significant activation in the left dominant hemisphere relative to the right hemisphere, especially in the perilesional areas, post-treatment during 2 language tasks compared with pretreatment. Moreover, the fractional anisotropy increased in the left superior temporal gyrus, which comprises an important area that is involved in language processing. LESSONS: Our findings suggest that rTMS combined with speech training improved the speech-language ability of this chronic conduction aphasia patient and enhanced the cerebral functional and microstructural reorganization.

Lexical stress contrast marking in fluent and non-fluent aphasia in Spanish: The relationship between acoustic cues and compensatory strategies.

This study sought to investigate stress production in Spanish by patients with Broca's (BA) and conduction aphasia (CA) as compared to controls. Our objectives were to assess whether: a) there were many abnormal acoustic correlates of stress as produced by patients, b) these abnormalities had a phonetic component and c) ability for articulatory compensation for stress marking was preserved. The results showed abnormal acoustic values in both BA and CA's productions, affecting not only duration but also F0 and intensity cues, and an interaction effect of stress pattern and duration on intensity cubes in BA, but not in CA or controls. The results are interpreted as deriving from two different underlying phenomena: in BA, a compensatory use of intensity as a stress cue in order to avoid 'equal stress'; in CA, related to either a 'subtle phonetic deficit' involving abnormal stress acoustic cue-processing or to 'clear-speech' effects.

Terapia de restricción inducida en afasia: diseño de sujeto único en afasia de conducción / Induced Aphasia Therapy Restriction: Design Single Subject in Conduction Aphasia / Terapia de restrição induzida em afasia: desenho de sujeito único em afasia de condução

Introducción: la terapia de restricción inducida en afasia (TRIA) es un método terapéutico para la recuperación funcional del lenguaje expresivo en pacientes con afasia, cuyo efecto ha sido comprobado a partir de estudios de corte experimental desde hace más de una década en países como Estados Unidos y Alemania y, más recientemente, se ha instaurado en la práctica profesional del fonoaudiólogo en Colombia. Objetivo: el presente artículo muestra un diseño de sujeto único en afasia de conducción, en el cual se estima el efecto de un protocolo de terapia de restricción inducida del lenguaje. Materiales y métodos: se trata de una paciente de género femenino de 49 años de edad, con nivel de educación superior y con afasia de conducción, resultado de un accidente cerebro vascular de 2 años de evolución, quien recibió TRIA, con una intensidad de 2 horas diarias, cinco días a la semana, durante 4 semanas. Como parte del protocolo de TRIA, fueron presentados 40 estímulos verbales diferentes cada cinco sesiones (grupo de estímulos 1 y 2: verbos y sustantivos, grupo 3: expresiones frecuentes y grupo 4: antónimos) para un total de 160 estímulos, con estrategias de estimulación y facilitación del lenguaje oral, pero con restricción de las formas no verbales de la comunicación. Se tomaron mediciones antes y después de la TRIA, mediante el uso de pruebas estandarizadas. Resultados: el rendimiento comparativo pre- y pos- de las pruebas indican una mejoría en varios dominios del lenguaje expresivo, tales como la fluidez verbal, la longitud de frase, la línea melódica, la forma gramatical, la producción de estructuras sintácticas de mayor complejidad, el incremento en el uso de conectores, sustantivos, adjetivos y verbos y la disminución de neologismos, parafasias, dubitaciones y muletillas. La hipótesis inicial plantea que la TRIA induce cambios en el desempeño verbal de los pacientes; sin embargo, se requiere de una exposición sostenida en el tiempo para inducir generalización de los aprendizajes.

Introduction: Constraint-induced therapy in aphasia (CITA) is a therapeutic method for functional recovery of expressive language in aphasia patients, whose effect has been found from experimental studies in countries as Germany and United States of America for more than one decade and it has been established in the practice of the speech- language therapist in Colombia. Objective: This research consists on a case study of conduction aphasia which estimates the effect of a protocol constraint-induced therapy on language performance. Materials and methods: The patient is a female 49 years with superior education level that has conduction aphasia results of stroke with two years of evolution; she received CITA with an intensity of two hours per day, five days week, for four weeks. As part of the protocol of CITA, 40 different verbal stimuli were presented in five sessions (Set 1 and Set 2: verbs and nouns, Set 3: expressions and Set 4: antonyms) conforming 160 stimuli to strategies of stimulation and facilitation of oral language but using restriction of nonverbal forms of communication. Measurements were taken before and after the CITA using standardized tests. Results: The pre and pos comparative performance tests indicate an improvement in multiple domains of expressive language such as: verbal fluency related to sentence length, grammatical melodic line and form, production of more complex syntactic structures, better employment of connectors, nouns, adjectives and verbs into the oral productions; and decreased neologisms, anomies, hesitations and interjections. The hypothesis is CITA induces positive changes in the verbal performance of aphasia patients; however, it requires a sustained exposure over time to induce generalization of learning.

Introdução: a terapia de restrição induzida em afasia (TRIA) é um método terapêutico para a recuperação funcional da linguagem expressiva em pacientes com afasia, cujo efeito tem sido comprovado a partir de estudos de corte experimental desde há mais de uma década em países como os Estados Unidos e a Alemanha e, mais recentemente, se tem instaurado na prática profissional do fonoaudiólogo na Colômbia. O presente artigo mostra um desenho de sujeito único em afasia de condução, no qual se estima o efeito de um protocolo de terapia de restrição induzida da linguagem. Materiais e métodos: trata-se de uma paciente de gênero feminino de 49 anos, com nível de educação superior e com afasia de condução resultado de um acidente cerebrovascular de dois anos de evolução, quem recebeu TRIA com uma intensidade de duas horas diárias, cinco dias à semana, durante quatro semanas. Como parte do protocolo de TRIA foram apresentados 40 estímulos verbais diferentes cada cinco sessões (grupo de estímulos 1 e 2: verbos e substantivos, grupo 3: expressões frequentes e grupo 4: antónimos) para um total de 160 estímulos, com estratégias de estimulação e facilitação da linguagem oral, mas com restrição das formas não verbais da comunicação. Tomaram-se medições antes e depois da TRIA, mediante o uso de provas estandardizadas. Resultados: o rendimento comparativo pré- e pós- das provas indicam uma melhoria em vários domínios da linguagem expressivo, tais como: a fluidez verbal, a longitude de frase, a linha melódica, a forma gramatical, a produção de estruturas sintáticas de maior complexidade, o incremento no uso de conetores, substantivos, adjetivos e verbos, e a diminuição de neologismos, parafasias, dubitações e batologias. A hipótese inicial apresenta que a TRIA induz mudanças no desempenho verbal dos pacientes; no entanto, requer-se de uma exposição sustentada no tempo para induzir generalização das aprendizagens.

Neural organization of spoken language revealed by lesion-symptom mapping.

Studies of patients with acquired cognitive deficits following brain damage and studies using contemporary neuroimaging techniques form two distinct streams of research on the neural basis of cognition. In this study, we combine high-quality structural neuroimaging analysis techniques and extensive behavioural assessment of patients with persistent acquired language deficits to study the neural basis of language. Our results reveal two major divisions within the language system-meaning versus form and recognition versus production-and their instantiation in the brain. Phonological form deficits are associated with lesions in peri-Sylvian regions, whereas semantic production and recognition deficits are associated with damage to the left anterior temporal lobe and white matter connectivity with frontal cortex, respectively. These findings provide a novel synthesis of traditional and contemporary views of the cognitive and neural architecture of language processing, emphasizing dual routes for speech processing and convergence of white matter tracts for semantic control and/or integration.

The relationship between verbal and nonverbal auditory signal processing in conduction aphasia: behavioral and anatomical evidence for common decoding mechanisms.

The processing of nonverbal auditory stimuli has not yet been sufficiently investigated in patients with aphasia. On the basis of a duration discrimination task, we examined whether patients with left-sided cerebrovascular lesions were able to perceive time differences in the scale of approximately 150 ms. Further linguistic and memory-related tasks were used to characterize more exactly the relationships in the performances between auditory nonverbal task and selective linguistic or mnemonic disturbances. All examined conduction aphasics showed increased thresholds in the duration discrimination task. The low thresholds on this task were in a strong correlative relation to the reduced performances in repetition and working memory task. This was interpreted as an indication of a pronounced disturbance in integrating auditory verbal information into a long-term window (sampling disturbance) resulting in an additional load of working memory. In order to determine the lesion topography of patients with sampling disturbances, the anatomical and psychophysical data were correlated on the basis of a voxelwise statistical approach. It was found that tissue damage extending through the insula, the posterior superior temporal gyrus, and the supramarginal gyrus causes impairments in sequencing of time-sensitive information.

Phonological, lexical, and semantic errors produced by impairment at the output buffer in a Spanish aphasic patient.

We present a single case of a right-handed female patient, RH, who was categorized as suffering from conduction aphasia. She presented no articulatory problems during spontaneous speech but made a significant number of phonological paraphasias in naming and repetition tasks. The number of errors increased for long words and pseudowords. This pattern of results points to damage in the "Phonological Output Buffer" (POB) as the basis of this disorder. However, this patient did not make mistakes when reading words and pseudowords aloud, even when we introduced a delay between the presentation of the word and its production to test the working memory resources of the phonological buffer. Furthermore, the patient's ability to name objects, repeat words, and write to dictation improved with her degree of familiarity with the items. The damage could be situated at the point where phonemes are selected and ordered to produce words. We posit that the deficits observed in this patient, and the differences encountered between her performance and that of others described in the literature, in particular in reading tasks, can be explained by considering POB damage to be gradual in nature. According to this explanation, the performance of patients with damage to the POB will depend on the amount of information provided by the stimulus (word/nonword), the language particularities (regular/irregular), and the nature of the task demands (repetition, writing, naming, or reading).

Conduction aphasia with intact visual object naming.

Conduction aphasia, most often caused by damage to the inferior parietal lobe and arcuate fasciculus, is usually characterized by mildly dysfluent speech with frequent phonemic paraphasic errors, impaired repetition, and impaired word finding and naming, but with relatively spared comprehension. We report an 86-year-old right-handed man with conduction aphasia caused by an infarction that damaged his right temporoparietal region. On testing with the Western Aphasia Battery, however, he named objects almost perfectly. To test his naming ability further, we showed him half the items in the Boston Naming Test; we described or defined the other half of the items, but did not show them to the patient. He performed excellently when naming the objects that he could see, but he had difficulty naming the objects that were only described or defined. These observations suggest that visual word naming may be mediated by a network that is somewhat independent of the networks that mediate spontaneous word finding and word finding based on verbal descriptions or definitions.

Afasia: una perspectiva clínica / Aphasia: a clinical perspective

Language is a complex and dynamic system of conventional signs that results from the functioning of different brain areas located mainly in the left hemisphere. Clinical evaluation of aphasia implicates the examination of oral and written language. Aphasia is an acquired language disorders due to a brain damage that affect all modalities: oral expression, auditory comprehension, reading and writing. Various types of aphasias can be induced, each with well defined clinical characteristics that can be correlated with specific areas of the brain. The prognosis depends mainly on the etiology, size of the lesion, type of aphasia and its severity. Treatment objectives include: satisfying the communicational needs of the patient, and achieving psychosocial adaptation of the subject and his family. Both objectives improve the quality of life of our patients...