Cognitive assessment of post-stroke patients with and without aphasia: The Hebrew version of the Cognitive Assessment for Stroke Patients (CASP) vs. the Montreal Cognitive Assessment (MoCA).

Cognitive screening assessments for neurological deficits are critical to the initial assessment of post-stroke patients. However, most measures are not designed for post-stroke patients and in particular not for people with aphasia (PWA), because they rely on language functions. The Cognitive Assessment for Stroke Patients (CASP) is a screening test that can also be administered to PWA, and was recently adapted into Hebrew. The current study aimed to compare the performance of post-stroke patients on the Hebrew versions of the CASP and the Montreal Cognitive Assessment (MoCA). Forty medical records of post-stroke patients were retrospectively examined: Twenty participants without aphasia and 20 PWA. The data included demographics, total CASP and MoCA scores, and scores in specific cognitive domains. Correlations were found between total CASP and MoCA scores, for all participants as well as for each group separately. Comparisons between groups revealed significantly higher performance of the participants without aphasia on the MoCA, but not on the CASP. Clinically, these findings suggest that the Hebrew version of the CASP can be implemented as a formal cognitive screening test for post-stroke patients, including PWA. It can help identifying PWA's cognitive state and differentiate between language and cognitive impairments, hence, contributing in planning targeted treatment.

Plague and the Mongol conquest of Baghdad (1258)? A reevaluation of the sources.

This paper reexamines the sources used by N. Fancy and M.H. Green in "Plague and the Fall of Baghdad (1258)" (Medical History, 65/2 (2021), 157-177). Fancy and Green argued that the Arabic and Persian descriptions of the Mongol sieges in Iran and Iraq, and in particular, in the conquest of Baghdad in 1258, indicate that the besieged fortresses and cities were struck by Plague after the Mongol sieges were lifted. This, they suggested, is part of a recurrent pattern of the outbreak of Plague transmitted by the Mongol expansion across Eurasia. Fancy and Green concluded that the primary sources substantiate the theory driven by recent paleogenetic studies indicating that the Mongol conquests of the thirteenth century set the stage for the massive pandemic of the mid-fourteenth century. The link between the Plague outbreak and the Mongol siege of Baghdad relies on three near-contemporaneous historical accounts. However, our re-examination of the sources shows that the main text (in Persian) has been significantly misunderstood, and that the two other texts (in Syriac and Arabic) have been mis-contextualized, and thus not understood properly. They do not support the authors' claim regarding Plague epidemic in Baghdad in 1258, nor do other contemporary and later Arabic texts from Syria and Egypt adduced by them, which we re-examine in detail here. We conclude that there is no evidence for the appearance of Plague during or immediately after the Mongol conquests in the Middle East, certainly not for its transmission by the Mongols.

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.

Language in Healthy Ageing: A Comparison across Language Domains.

INTRODUCTION: Life expectancy has been increasing in recent decades. Therefore, it is important to understand the functional changes during healthy ageing. Most research has mainly focused on one linguistic domain at a time. The current study aimed at investigating whether changes in language performance in healthy ageing occur in some language domains more than in others. METHODS: Twenty-three older healthy Hebrew-speaking adults, exhibiting no cognitive decline, were examined on tasks aimed at testing their performance in different language and cognitive domains: lexical retrieval, complementation information, syntax, theory of mind (a domain related to pragmatic aspects of language), and short-term memory. We compared their performance at both the group and the individual levels. Comparisons were made between the performance of the older adults and control data of young adults, and between the older adults' performance in the different linguistic domains. In addition, correlations between the older adults' phonological short-term memory abilities and their performance in various linguistic domains were examined. RESULTS: A decline was found in several linguistic domains among the older adults, while in other domains no decline was found. However, no unequivocal decline in linguistic functioning was found due to relatively large variance in their performance. CONCLUSION: Not all linguistic domains are equally vulnerable in ageing, and not all older adults are equally affected. The research has both clinical and theoretical implications.

Atypical phonological processes in naming errors of children with language impairment.

The current study explored the characteristics of phonological errors of preschool children with DLD (Developmental Language Disorder), distinguishing between typical versus atypical phonological processes in segmental, syllabic and word levels. The analysis included 87 responses of words with phonological errors from a naming test, produced by 13 preschool children with DLD, aged 4;4-6;3 years. These responses included 166 phonological processes, which were classified into typical and atypical processes at the levels of: segments, syllables, and prosodic words. The findings revealed that 70% of the phonological processes were atypical. Furthermore, ten children produced more atypical processes, and there were more atypical than typical processes in segmental and word levels. It is suggested that some children with DLD represent phonological processes that are similar to those that children with speech and sound disorders produce. Therefore, clinically, the results emphasise the importance of analysing the typical and atypical characteristics of phonological errors as part of language assessment.

[FROM THEORY TO THE CLINIC - IS IT POSSIBLE TO DETECT DIFFERENT TYPES OF ANOMIA ACCORDING TO THE LEXICAL RETRIEVAL MODEL?]

INTRODUCTION: The lexical retrieval model describes the process of naming - from the level of an abstract concept representation to the production of the word. Lexical retrieval includes several distinct levels. A deficit in any of these levels causes anomia, a naming deficit, and deficits in different levels cause different types of anomia. AIMS: To examine whether the theoretical model can be applied in the clinic. Namely, whether it is possible to identify, for a specific patient, the exact impaired lexical retrieval level, and to show that different patients are impaired in different levels. METHODS: The performance of 24 participants with aphasia, with lexical retrieval deficits, were analyzed. The analysis included performance on a naming test - including analysis of error types and of the effects that modulate naming errors. We also analyzed the performance in other language tasks that examine the different levels of lexical retrieval, including tasks that do not involve naming. RESULTS: Different types of anomia were found for the different participants. The various types of anomia are reflected in different sorts of naming errors, in different effects that modulate naming errors, and in different performance patterns in the other language tasks. CONCLUSIONS: The theoretical model of lexical retrieval can underpin descriptions of clinical phenomena. The findings support the view that the relations between theory and clinic are bidirectional - theories constitute an anchor for the description of clinical phenomena, and clinical findings can support, or refute, theory. DISCUSSION: The distinction between the different types of anomia is important for choosing the appropriate treatment for each patient.

What we can learn from naming errors of children with language impairment at preschool age.

Naming is a complex, multi-level process. It is composed of distinct semantic and phonological levels. Children with naming deficits produce different error types when failing to retrieve the target word. This study explored the error characteristics of children with language impairment compared to those with typical language development. 46 preschool children were tested on a naming test: 16 with language impairment and a naming deficit and 30 with typical language development. The analysis compared types of error in both groups. In a group level, children with language impairment produced different error patterns compared to the control group. Based on naming error analysis and performance on other language tests, two case studies of contrasting profiles suggest different sources for lexical retrieval difficulties in children. The findings reveal differences between the two groups in naming scores and naming errors, and support a qualitative impairment in early development of children with naming deficits. The differing profiles of naming deficits emphasise the importance of including error analysis in the diagnosis.

Patterns of visual dyslexia.

This study reports two Hebrew-speaking individuals with acquired visual dyslexia. They made predominantly visual errors in reading, in all positions of the target words. Although both of them produced visual errors, their reading patterns crucially differed in three respects. KD had almost exclusively letter substitutions, and SF also made letter omissions, additions, letter position errors, and between-word migrations. KD had difficulties accessing abstract letter identity in single-letter tasks, and in letter naming, unlike SF, who named letters well. KD did not show lexical effects such as frequency and orthographic neighbourhood effects and produced nonword responses, whereas SF showed lexical effects, with a strong tendency to produce word responses. We suggest that these two patterns stem from two different deficits - KD has letter identity visual dyslexia, which results from a deficit in abstract letter identification in the orthographic-visual analysis system, yielding erroneous letter identities, whereas SF has visual-output dyslexia, which results from a deficit at a later stage, a stage that combines the outputs of the various functions of the orthographic-visual analyzer.

The representation of lexical-syntactic information: evidence from syntactic and lexical retrieval impairments in aphasia.

This study explored lexical-syntactic information - syntactic information that is stored in the lexicon - and its relation to syntactic and lexical impairments in aphasia. We focused on two types of lexical-syntactic information: predicate argument structure (PAS) of verbs (the number and types of arguments the verb selects) and grammatical gender of nouns. The participants were 17 Hebrew-speaking individuals with aphasia who had a syntactic deficit (agrammatism) or a lexical retrieval deficit (anomia) located at the semantic lexicon, the phonological output lexicon, or the phonological output buffer. After testing the participants' syntactic and lexical retrieval abilities and establishing the functional loci of their deficits, we assessed their PAS and grammatical gender knowledge. This assessment included sentence completion, sentence production, sentence repetition, and grammaticality judgment tasks. The participants' performance on these tests yielded several important dissociations. Three agrammatic participants had impaired syntax but unimpaired PAS knowledge. Three agrammatic participants had impaired syntax but unimpaired grammatical gender knowledge. This indicates that lexical-syntactic information is represented separately from syntax, and can be spared even when syntax at the sentence level, such as embedding and movement are impaired. All 5 individuals with phonological output buffer impairment and all 3 individuals with phonological output lexicon impairment had preserved lexical-syntactic knowledge. These selective impairments indicate that lexical-syntactic information is represented at a lexical stage prior to the phonological lexicon and the phonological buffer. Three participants with impaired PAS (aPASia) and impaired grammatical gender who showed intact lexical-semantic knowledge indicate that the lexical-syntactic information is represented separately from the semantic lexicon. This led us to conclude that lexical-syntactic information is stored in a separate syntactic lexicon. A double dissociation between PAS and grammatical gender impairments indicated that different types of lexical-syntactic information are represented separately in this syntactic lexicon.

When is gender accessed? A study of paraphasias in Hebrew anomia.

This study explored access to grammatical gender during naming in Hebrew. Studies of anomia and tip-of-the-tongue states (TOT) found that speakers of various languages (Italian, Spanish, German, Dutch) have information about the grammatical gender of words they fail to retrieve. In Hebrew, on the other hand, a TOT study found that Hebrew speakers could not provide gender information. To test access to gender in single words in Hebrew we used an implicit measure--the analysis of paraphasias of anomic patients with respect to whether or not they preserved the grammatical gender of the target word. The rationale behind this measure was that when a paraphasia is created, it generally conforms to the partial knowledge the speaker has on the target word. If speakers have gender knowledge when they fail to name, they should produce paraphasias that match their partial information, and thus match the gender of the target. Such gender preservation in paraphasias was found in German for individuals with anomia, and in Arabic, French and German for slips of the tongue. Participants were 22 Hebrew-speaking aphasic patients with phonological, semantic or conceptual anomia, who produced 532 paraphasias. None of the participants showed gender preservation in their paraphasias. Even phonological anomics, who have access to semantic information, did not preserve grammatical gender in a single-word naming task. We suggest that this difference between Hebrew and previously studied languages relates to the fact that in Hebrew bare nouns are allowed, and therefore gender is not accessed in single-word naming, whereas in languages in which a noun should be produced as a full NP (with a determiner or case-marking for example) gender has to be accessed even in single-word tasks. We propose a hypothesis according to which gender is accessed if and only if the noun is incorporated into a syntactic tree (or a chunk of a tree) that includes an agreement phrase.