Agrammatic Broca's aphasia is not associated with a single pattern of comprehension performance.

One influential hypothesis posits that the brain regions implicated in Broca's aphasia are responsible for specific syntactic operations that are necessary for the comprehension and production of sentences (Grodzinsky, 1986, 1990, in press). The empirical basis of this hypothesis is the claim that Broca's aphasics have no difficulty understanding sentences in the active voice (and other "canonical" sentence types, such as subject relatives and clefts with negative predicates), but perform at chance level with passive voice constructions (and other "noncanonical" sentences such as object-gap relatives and object clefts). In the face of well-established results indicating that Broca's aphasics can exhibit several different performance patterns on these sentence types, Grodzinsky, Piñango, Zurif, and Drai (1999) argued that these conflicting results do not challenge the theory when the data are analyzed appropriately. They carried out a creative statistical analysis of the comprehension performance of published cases of Broca's aphasia and concluded that all of these cases are in agreement with the predicted pattern: chance on passives and 100% correct on actives. Here we show that the statistical reasoning adopted by Grodzinsky et al. (1999) is flawed. We also show that the comprehension performance of a substantial number of the Broca's aphasics in their own sample does not conform to the pattern required. Rather, contrary to these authors' claim, Broca's aphasia is not associated with a consistent pattern of sentence comprehension performance, but allows for a number of distinct patterns in different patients.

Quantitative analysis of aphasic sentence production: further development and new data.

The narrative production of patients with Broca's aphasia and age-and education-matched control subjects was analyzed using the Quantitative Production Analysis (Saffran et al., 1989), a procedure designed to provide measures of morphological and structural characteristics of aphasic production. In addition to providing data for a larger number of subjects than in the original study, we provide data on interrater and test-retest reliability. The data were also submitted to factor and cluster analyses. Two factors characterized the data and the cluster analysis yielded four sets of patients who performed differently on these factors. In particular, there is evidence that agrammatic patients can differ in their production of free and bound grammatical morphemes, substantiating earlier claims in the literature.

How "regular" is sentence comprehension in Broca's aphasia? It depends on how you select the patients.

Grodzinsky, Piñango, Zurif, and Drai (1999) argue that a statistical analysis of pooled sentence comprehension data from published studies of Broca's aphasic patients supports the dominance of a differential pattern of performance on active and passive voice structures. They argue that these results counter a previous study in which individual patient data from published studies were analyzed. However, Grodzinsky et al. have not carried out a true test of their hypothesis, but have biased the outcome by selecting samples for analysis that support their claims.

Patterns of sentence comprehension in aphasia: a consideration of three hypotheses.

Three hypotheses concerning the functional source of aphasic patients' difficulty comprehending semantically reversible sentences were tested using declarative sentences in active and passive voice and sentences with center-embedded relative clauses. Each of the three hypotheses is predicated on relative patterns of impairment and sparing of patient performance on these (and other) sentence types, yet the three hypotheses make somewhat different predictions about performance patterns across these types. Results from 5 Broca's aphasic patients were not consistent with the predictions of the linguistically motivated Trace Deletion Hypothesis or of a hypothesis based on an impairment involving grammatical morphemes. The hypothesis that aphasic comprehension impairments reflect a general limitation of working memory capacity was given partial support by the ordinal pattern of difficulty for a mixed group of 10 patients, but failed to account for patterns obtained from individual patients. Results are interpreted as having relevance for methodological as well as theoretical aspects of research on aphasic sentence comprehension.

Verb retrieval and sentence processing: dissociation of an established symptom association.

A patient is described with severe anomia who produces verbs significantly better than nouns in action/object naming tasks, but who also has difficulty comprehending and producing semantically reversible sentences. This pattern differs from the frequently-reported association of symptoms involving relative verb/noun retrieval and sentence processing: impaired verb retrieval is typically associated with poor sentence processing, and preserved verb retrieval with spared sentence processing. Brain imaging reveals areas of cerebral ischemia in portions of the, territories supplied by the anterior, middle and posterior cerebral arteries. An earlier ischemic episode and extensive cortical collateral circulation are hypothesized to have contributed to this unusual pattern of left cerebral hemisphere damage. The previously-reported association of symptoms that dissociated in this patient was interpreted as reflecting a hemodynamically-influenced probability of joint involvement of neuroanatomical regions subserving functionally distinct aspects of language processing.

Verb retrieval in aphasia. 1. Characterizing single word impairments.

The ability of aphasic patients to produce words from the grammatical classes of nouns and verbs was investigated in tasks that elicited these types of words in isolation. Eleven chronic aphasic patients produced nouns and verbs in picture naming, videotaped scene naming, sentence completion, naming from definition, and oral reading. Comprehension of the meanings of nouns and verbs was tested in word/picture and word/video scene matching, and appreciation of noun/verb grammatical class differences was tested with two metalinguistic tasks. Five patients demonstrated significantly more difficulty producing verbs than nouns, two patients were significantly more impaired producing nouns than verbs, and the remaining four patients showed no difference between the two classes. There was no improvement in verb production when naming actions presented on videotape, suggesting that selective verb impairments are not attributable to conceptual difficulty in identifying actions in static pictures. Selective noun impairments occurred in the context of severe anomia, as reported in previous studies. Selective verb impairments were demonstrated for both agrammatic and fluent (Wernicke) patients, indicating that such deficits are not necessarily associated with the nonfluent and morphologically impoverished production that is characteristic of agrammatism. There was no indication that single word comprehension was affected in these patients in a manner consonant with their production impairments. Results are interpreted in light of current models of lexical organization and processing.

Verb retrieval in aphasia. 2. Relationship to sentence processing.

Sentence comprehension and production were evaluated for 10 chronic aphasic patients who have been shown to demonstrate one of three patterns in the relative case of retrieval of nouns and verbs. Although these patterns of noun/verb production were not entirely predictable from patients' clinical classifications, they were found here to be significantly correlated with several structural indices of sentence production and with failure to comprehend semantically reversible sentences. Noun/ verb retrieval patterns were not strongly correlated with speech fluency nor with morphological characteristics of sentence production. Patients with relative impairment in the production of verbs were found to rely on high frequency, semantically empty, "light" verbs when producing sentences and to favor simple syntactic structures in which verbs do not require inflections. When forced to produce substantive verbs (in picture and scene descriptions), verb retrieval continued to undermine the production of well-formed sentences for the verb-impaired patients. In addition, two of five such patients also showed some evidence of poor realization of noun arguments for verbs they could not produce. Results are interpreted as indicating multiple contribution to patients' sentence processing impairments, one of which may be selective difficulty retrieving verbs.

Lexical-semantic organization: evidence from aphasia.

The emerging field of clinical neuroscience requires the combination of diverse theoretical and methodological approaches to the study of brain function. The study of neurogenic language disorders has played a central role in the development of models of language/brain relationships. These contributions are reviewed with regard to the study of word processing impairments in aphasia, where data from brain-damaged patients has been used to guide the development of models of lexical/semantic organization. It is argued that the study of aphasic patients will continue to occupy a central role in both neuroscience and clinical research as new technologies are developed for functional brain imaging and as theoretically driven treatments for aphasia are designed and tested.

Modality-specific processing streams in verbal working memory: evidence from spatio-temporal patterns of brain activity.

The present study was concerned with whether there are separate, modality-specific processing "streams" in verbal working memory for information that is heard or read. We used event-related brain potentials (ERPs) recorded from scalp of normal humans to show between-modality differences in spatio-temporal patterns of brain activity during retention in working memory of aurally or visually presented verbal information. The ERP patterns suggested that a sustained, automatically maintained auditory store was activated by auditory presentation and a transient, visual-verbal store was activated by visual presentation. In addition to these modality-specific differences, the ERPs indicated that the phonological loop was activated in both modalities and further suggested that the onset of phonological loop activation was earlier for auditory presentation.

Reading lexically without semantics: evidence from patients with probable Alzheimer's disease.

Recent modifications of the lexical model of oral reading make the prediction that under conditions where sublexical reading processes alone cannot achieve the target pronunciation (i.e., when words have exceptional spellings or when sublexical processes are impaired), patients with severe semantic impairment should have more difficulty reading aloud semantically impaired words than semantically retained words. In a battery of lexical-semantic and reading tasks, two neurologically normal control subjects and two subjects with probable Alzheimer's disease (AD) and only moderate semantic impairment read aloud all words accurately. One AD subject with severe semantic impairment was impaired in word reading but demonstrated no difference in reading words with regular and exceptional spellings. Another AD subject with severe semantic impairment read aloud without error virtually all regular and exception words. Neither severely impaired AD subject demonstrated any relationship between oral reading accuracy and semantic knowledge of exception words. These findings support a model of word reading incorporating lexical, nonsemantic processes by which lexical orthographic input representations directly activate lexical phonological output representations without the necessity of semantic mediation.

Comprehension of reversible sentences in "agrammatism": a meta-analysis.

The functional source(s) of agrammatic aphasic patients' difficulty comprehending semantically reversible active and passive sentences was investigated in a meta-analysis of published sentence/picture matching data from patients with agrammatic production. The analysis revealed approximately equal distributions of three distinct patterns of performance on active and passive voice sentences relative to what would be expected by chance: both structures comprehended better than chance; both structures comprehended no better than chance; active voice sentences comprehended better than chance, while passive voice sentences were comprehended at levels no better than (or worse than) chance. These results are in conflict with explanations of aphasic sentence comprehension failure in which a single pattern of relative performance on active and passive voice structures is asserted to be characteristic of the comprehension of all agrammatic speakers. They also highlight the difficulty of identifying any single causal factor to account for sentence comprehension failure in patients with "agrammatic" sentence production. Results are interpreted with regard to the role of data from aphasic patients in the testing of hypotheses about the organization of normal language processes.

Assessing the elements contributing to a "mapping" deficit: a targeted treatment study.

Aphasic patients with excellent comprehension of word meanings frequently fail to understand simple declarative sentences in which either of two nouns could reasonably serve as agent of a transitive action. This study employed targeted treatment of this comprehension problem in a chronic aphasic patient (E.A.) in an attempt to isolate the source or sources of his comprehension failure. Treatment exercises that relied on error feedback in sentence-picture matching or verification initially were not effective. Comprehension of active and passive sentences improved only after both structures were explicitly compared and linked to a picture. Subsequently E.A. maintained consistently accurate interpretation of both sentence types in the treatment exercises as long as the full sentence was available to him. E.A. learned to assign thematic roles using a limited set of cues in the surface structure. Although improvement was reported in untreated sentences, the degree of generalization and the level of performance differed across tasks and appeared to be attributable to cognitive impairments that were not addressed by the treatment. Results are interpreted as evidence suggesting that multiple impairments contribute to failure of sentence comprehension tasks.

Functional pronunciation units in English words.

Two distinct factors limit the orthographic regularity of English words: (a) Most characters can correspond to several different sounds and (b) characters can either stand alone or be combined in various ways for pronunciation as a single phoneme. This study addresses the second of these issues through the analysis of a large corpus of English words. Data are presented describing the frequency that each character (or character cluster) functioned in the corpus as a correspondent of a single phoneme rather than being combined with other characters (or decomposed). Examples are provided regarding potential applications of these data in the construction of stimulus materials for cognitive studies, in neuropsychological investigations of dyslexia, and in computational models of word naming.

Clinical linguistics, cognitive neuropsychology and aphasia therapy.

Recent approaches to the study of language disorders in adults with focal brain damage (aphasia) have interpreted aphasic symptoms as impairments of particular aspects of the normal language system. Two distinct approaches along these lines, clinical linguistics and cognitive neuropsychology, have developed in parallel. Although there are differences between these approaches, there is also considerable methodological and substantive overlap. These similarities and differences are reviewed, with particular emphasis on the contributions of each approach to the development, implementation and interpretation of treatments for aphasic disorders of sentence production. It is argued that the field of clinical linguistics has defined and addressed numerous problems that cognitive neuropsychologists are beginning to confront as they attempt to use models of normal language processing to motivate treatment for aphasia.

Short-term memory and sentence comprehension. An investigation of a patient with crossed aphasia.

The relationship between short-term memory impairment and sentence comprehension is explored in a right-handed patient with a focal temporoparietal lesion of the right hemisphere. The general clinical profile, as well as characteristics of the patient's immediate memory for word lists, suggests the occurrence of a 'mirror image' crossed aphasia. Detailed analysis of the patient's ability to repeat and to comprehend sentences, however, indicates some important differences between this case and previously reported patients with short-term memory impairment. It is suggested that these differences, which may be related to an unusual pattern of neuroanatomical organization of cognitive functions, involve symptom dissociations with implications for models of normal language/memory interactions.

Modelling acquired dyslexia: a software tool for developing grapheme-phoneme correspondences.

In extending a computer model of acquired dyslexia, it has become necessary to develop a way to group printed characters in a word so that the character groups essentially have a one-to-one correspondence with the word's phonemes (speech sounds). This requires deriving a set of correspondences (legal character groupings, legal associations of character groups with phonemes, etc.) that yield a single grouping or "segmentation" of characters when applied to any English word. To facilitate and partially automate this task, a segmentation program has been developed that uses an interchangeable set of correspondences. The program segments words according to these correspondences and tabulates their success over large sets of words. The program has been used successfully to segment a 20,000 word corpus, demonstrating that this approach can be used effectively and efficiently.