Introduction Cognitive Neuropsychology Of Language
IntroductionCognitive Neuropsychology ofLanguage Structure of the courseHistorical background to aphasiaTwo modern approachesBasic forms of aphasiaMichael ThomasBirkbeck CollegeCourseReading ListMichaeSDisorders of Language, Spring 2004Disorders of Language: Reading ListGeneral sourcesLectures 10.00am to 11.30am, ThursdaysRoom 534, Birkbeck College Main Building (note except Week 9: Room 406)Wk1 Thursday 15th JanIntroduction to aphasia and its basic formsWk2 Thursday 22nd JanAcquired Comprehension DeficitsWk3 Thursday 29th JanGuest Lecture: Dr. David Green: Aphasia inbilingualsWk4 Thursday 5th FebGuest Lecture: Dr. Cathy Price: Functional imagingof semantic retrievalWk5 Thursday 12th FebGuest Lecture: Dr. Sophie Scott: Neurobiology ofspeech perceptionWk6 Thursday 19th FebREADING WEEKWk7 Thursday 26th FebAcquired Production DeficitsWk8 Thursday 4th MarDevelopmental disorders of the language systemthWk9 Thursday 11 MarThe right hemisphere. Specialisation, plasticity, andrecovery [Note: to be held in Room 406]thWk10 Thursday 18 MarGuest Lecture: Dr. Jennifer Aydelott: Speechperception, psycholinguistics and aphasiaWk11 Thursday 25th MarConnectionist models of language deficitsRapp, B. (2001). The handbook of cognitive neuropsychology. Sussex, Hove:Psychology Press. [Chapters 8, 9, 12, 13, 17]Ellis, A. W., & Young, A. W. (1996). Human cognitive neuropsychology: A textbookwith readings. Sussex, Hove: Psychology Press. [Chapters 5, 6, 9]Hillis, A. E. (2002). The handbook of adult language disorders. Sussex, Hove:Psychology Press.Andrews, D. (2001). Neuropsychology: From theory to practice. Psychology Press:Hove, Sussex. [Chapters 1,7, 10, 11]Kolb, B. & Whishaw, I. Q. (2003). Fundamentals of human neuropsychology 5thEdition. New York: Worth Publishers. [Chapter19]Hale, S. (2002). The man who lost his language. London: Allen Lane. Category-specific deficitsTreatment of aphasiaPsycholinguistics and aphasia:Dick, F., Bates, E., Wulfeck, B., Aydelott Utman, J., Dronkers, N., & Gernsbacher,M. A. (2001). Language deficits, localization, and grammar: Evidence for adistributive model of language breakdown in aphasic patients and neurologicallyintact individuals. Psychological Review, 108(4), 759-788. Seminar 1 4-5pm on Thursday5th FebruarySeminar 2 4-5pm on Thursday4th MarchSemantic retrieval:Price, C. J., & Friston, K. J. (2002). Degeneracy and cognitive anatomy. Trends inCognitive Sciences, 6(10), 416-421.Category-specific deficits:Forde, E. M. E., & Humphreys, G. W. (2002). Category specificity in brain and mind.Hove, Sussex: Psychology Press.Pulvermuller, F. (2001). Brain reflections of words and their meaning. Trends inCognitive Sciences, 5(12), 517-524.Shelton, J. R., & Caramazza, A. (2001). The organization of semantic memory. In. B.Rapp (ed.), The handbook of cognitive neuropsychology (p. 423-443). Sussex,Hove: Psychology Press.Aphasia Same incidence as MS or Parkinson’s200,000 in UK; 1M in US90% caused by stroke, mostly in elderlyLoss of (aspects of) languageCan be accompanied by paralysis /weakness of right arm and legDevelopmental disorders:Temple, C.M. (1997). Cognitive neuropsychology and its application to children.Journal of Child Psychology and Psychiatry, 38, 27-52.Anderson, V., Northam, E., Hendy, J., & Wrennall, J. (2001). Developmentalneuropsychology: A clinical approach. Sussex, Hove: Psychology Press. [Chapter 4Bates, E., & Roe, K. (2001). Language development in children with unilateral braininjury. In Nelson, C. A. & Luciana, M. (Eds.), Handbook of developmentalcognitive neuroscience (p. 281-318). Cambridge, Mass.: MIT Press.Fowler, A. E. (1998). Language in mental retardation: Associations with anddissociations from general cognition. In J. A. Burack, R. M. Hodapp, & E. Zigler,Handbook of mental retardation and development (p. 290-333). Cambridge:Cambridge University Press. Sources for specific topics Thomas, M. S. C. & Karmiloff-Smith, A. (2002). Are developmental disorders likecases of adult brain damage? Implications from connectionist modelling.Behavioral and Brain Sciences, Vol. 25 No. 6, 727-788.Bilingual aphasia:Gollan, T. H., & Kroll, J. F. (2001). Bilingual lexical access. In. B. Rapp (ed.), Thehandbook of cognitive neuropsychology (p. 321-345). Sussex, Hove: PsychologyPress.Green, D. W. & Price, C. J. (2001). Functional imaging in the study of recoverypatterns in bilingual aphasia. Bilingualism: Language and Cognition, 4, 191-201. Language in the right hemisphereSeminar Readings Seminar 1: Category-specific deficitsSartori, G., Job, R., & Zago, S. (2002). A case of domain-specific semantic deficits. InE. M. E. Forde & G. W. Humphreys (Eds.), Category specificity in brain andmind (p. 25-49). Hove, Sussex: Psychology Press.Whatmough, C., & Chertkow, H. (2002). Category-specific recognition impairmentsin Alzheimer’s disease. In E. M. E. Forde & G. W. Humphreys (Eds.), Categoryspecificity in brain and mind (p. 181-210). Hove, Sussex: Psychology Press.Gainotti, G. (2002). The relationships between anatomical and cognitive locus oflesion in category-specific disorders. In E. M. E. Forde & G. W. Humphreys(Eds.), Category specificity in brain and mind (p. 403-426). Hove, Sussex:Psychology Press. Seminar 2: Treatment.Mitchum, C. C., Haendiges, A. N., & Berndt, R. S. (1995). Treatment of thematicmapping in sentence comprehension: implications for normal processing.Cognitive Neuropsychology, 12, 503-547. [Reprint in Ellis & Young, 1996,p. 592-639]Horton, S., & Byng, S. (2002). “Semantic therapy” in day-to-day clinical practice:Perspectives on diagnosis and therapy related to semantic impairments in aphasia.In. A. E. Hillis (Ed.), The handbook of adult language disorders (p. 229-249).Sussex, Hove: Psychology Press.Semel, E. & Rosner, S. R. (2003). Understanding Williams syndrome: Behavioralpatterns and interventions. Mahwah, New Jersey: Lawrence Erlbaum Associates.Chapter 3 (p. 64-107).Small, S. L. (2002). Biological approaches to the treatment of aphasia. In. A. E. Hillis(Ed.), The handbook of adult language disorders (p. 397-411). Sussex, Hove:Psychology Press.Tomkins, C. A., Fassbinder, W., Lehman-Blake, M. T., & Baumgaertner, A., (2002).The nature and implications of right hemisphere language disorders. In. A. E.Hillis (Ed.) The handbook of adult language disorders (p. 429-448). Sussex,Hove: Psychology Press.Andrews, D. (2001). Neuropsychology: From theory to practice. Psychology Press:Hove, Sussex. [Chapter 7]. Recovery and rehabilitationAndrews, D. (2001). Neuropsychology: From theory to practice. Psychology Press:Hove, Sussex. [Chapters 10, 11]History Egyptians, Greeks, Romans 2800 BC: loss of language treatment in Egyptian papyrusHippocrates 400 BC: loss of speech ‘aphonia’Valerius Maximus, AD 30: selective problems with readingConfused with paralysis of tongue, deafness,mutism, stutteringRelation to brain? heart seen as engine of thought (Aristotle)mind seen as controlled by non-physical spirit (Descartes)1
History 19th century Gall well-developed mental facultiescorrespond to large areas of cortex;language in frontal lobes1825 French physician Jean-BaptisteBouillaud delivers scientific paper withsame conclusion1830 Marc Dax, language in lefthemisphereHistory History Orienting our brain areasHistory1884 Carl Wernicke post-mortem reports of two patients withimpaired language functionTan (named after one of few utterances)1863, 8 more patientsAll cases, damage left anterior lesionAdditional patient, right anterior lesion nolanguage impairmentConclusion impaired language productionassociated with left anterior damage to thirdfrontal gyrusSuggestion of second type: posterior damage,impaired associations between language andthoughtDid not offer specific localisation 1861 Paul BrocaAphasia predominant difficulty withcomprehension lesions to left superiortemporal lobeFurther type predicted, due to disconnectionbetween anterior and posterior areas(conduction aphasia)History 1965: Geschwind extends theory to produce“Wernicke-Geschwind” model1885: Lichtheim proposes diagrammaticform of model2
HistoryThe Wernicke-Geschwind model 1885-1965: Why the 60-year delay?Early writings of Broca and Wernickecontroversial e.g. Pierre Marie (1906) proposed that: All aphasia has some comprehension deficitBroca’s aphasics interference with more posterior zoneBroca’s area purely for motor aspects of speechCritical lesions in Broca’s aphasia are sub-corticalThe brain of Paul Broca’s patient, Tan Note the gross subcortical extent ofthe lesion in the coronal section –Tan case study supports Marie?Two modern approachesWhy the 60-year delay? (cont) 1860s John Hughlings Jackson - rejection oflocalisationist approach Head (1926) - more psychologicaldescription of aphasia, irrespective ofneural correlates 1940s - Behaviourist approach rejectsmentalistic analysis External S-R schedules of reinforcementSyndrome approach Groups patients according to symptoms, looks forcommon patterns of underlying damageCognitive neuropsychology Single case studies looking for dissociations betweenpsychological components of language systemLess concerned with relation to underlying substrateApproaches interact; imaging may bring themtogether by showing distributed networks of brain areas thatimplement functional modules3
Cognitive neuropsychologySemanticSystemInput(e.g., picture ofobject)JCU has deficitEST okJJ has deficitPhonologicalOutput LexiconJCU has deficitEST has deficitJJ has deficitOrthographicOutput LexiconJJ okSyndrome approach Let’s identify the broad types of languagebreakdownFirst, what are the language ‘areas’ of thebrain?Patient JCU: naming problem with semantic errors (Howard & Orchard-Lisle, 1984)Patient EST: could give precise semantic info about objects unable to name (Kay & Ellis, 1987)Patient JJ: naming problems, unable to give meanings, but could write word forms(Hillis & Caramazza, 1991)The language areas Electrical mapping: Penfield and Roberts (1959)The language areas Electrical mapping: Ojemann et al. (1989)nos. in circles consistent failure in naming following lity?Cross-species comparisonLanguage areas(cousins)4
Types of Aphasia:The Wernicke-Geschwind modelBasic forms of aphasia Predicts three types of aphasia Broca’s aphasia Wernicke’s aphasia Broca’s aphasia Subcortical aphasiaRight hemisphere damageBroca’s aphasiaDifficulties in production (lack of function words and inflections),some problems in comprehension of syntax (e.g., reversiblesentences)Non-fluent / AgrammatismRepetition difficultiesIn excess of Broca’s area. Arterial system means motor areastypically also damagedProblems with simple model: 1. Lesion location – need to damage more than original Broca’sarea; Broca’s alone articulation difficulties2. Term too broad, individual variability of agrammatism: small vs.large Broca’s patients; function word/inflection deficit dissociatefrom word order deficit; (syntactic) comprehension deficitsBroca’s aphasic Transcortical motor aphasiaTranscortical sensory aphasiaType of damage: ExtrasylvianaphasiasSymptoms: Jargon aphasiaConduction aphasiaWord deafnessGlobal aphasiaThe Transcortical aphasias ThePerisylvianaphasiasAgrammatismCinderella’s story(from Saffran, Berndt, and Schwartz, 1989)“a mother/ three kids/ bad mother/one kid beautiful/ rich/Italian/ mother/ stepmother/ talk about Cinderella/Cinderella/clean myhouse/ you Cinderella/close the door/ Cinderella like jail/ mother three kids/ I love mother/ Cinderella walk ball/ people ball/ rich people/ man and Cinderella dance dance dance party/ one/ dance dance dance/ dance every time/ ball beautiful people/ people watched Cinderella/ Cinderella beautiful clothes andgarments/ twelve o’clock night/ Cinderella/ oh no/ oh no/ I’m sorry/I’m sorry people/ I love you baby/ walk walk/ tumble/ one shoebye-bye/ Cinderella pumpkin cab/ oh shoe/ oh please/ oh well/walk pumpkin car/.”Patient with small Broca’s aphasia Initial speech assessmentHH:DA:HH:DA:HH:(Andrewes, 2001, p.309)Sometimes I say “yes” [halts in mid sentence] when I mean“no”. I realise immediately afterwards that I have said thewrong thing and correct myself.Does this happen often? [Appears to be thinking about what to say and lunges forwardas if forcing out the word] “No” (we both saw the humour in thesituation, but he refrains from elaborating).How does this affect your everyday life?It’s a problem when converse with the mates.5
Wernicke’s aphasia(Subtler) comprehension deficits Problems with syntactic aspects of comprehension Symptoms: “Point to the picture that goes with The brown dog is chased bythe white horse” Type of damage: Problems with simple model: Wernicke’s :Can you tell me your address, Tom?Four and pleasant, Plain Sodars. [There is no such district]How long have you lived there?I think that was only five, no eight prentices. Small plut be in there.How old are you?80, 85 no 83 cheldren. [His age is 83 years old]What month is it?Today? Well that would be ten. If I say, it used to be called Naym Prentice.If I said it was May, what would you say?That’s correct, Naym Prentice.Could you count up to ten?A, B, C, D, E, F, M, P, M.No, say after me: 1, 2.In excess of original Wernicke’s area. Posterior superior temporal gyrusstill appears crucialPatients appear to be aware of meaning they are trying to produce: Notsemantic deficit but communication with phonological output system?Lack of awareness of jargon implies ‘unconscious’ route to productionComprehension in Wernicke’s aphasiaSP:Frank:SP:Frank:Patient with Wernicke’s (jargon) aphasiaComprehension difficultiesFluent (sometimes excessive), word finding difficulties, paraphasias,excess of grammatical words but paucity of meaning; some syntacticdifficultiesSevere: ‘jargon’ aphasia: neologisms (new words) lack of awarenessRepetition difficultiesCould you tell me where you are? Yes, er, I just don’t feel too good.Are you in hospital at the present time? That is really one thing, really I feel bad you know. Mm I’m not reallyfeeling too good.What’s wrong with you, Frank?Well I don’t know, to be honest you just er, there will be a few days I feel shy.Saturday was bad, I get bad, Sunday and today.Where do you live? I don’t know, to be honest, we’ve got a lot of things my dad.Do you live in East Keilor? Sorry? Yeh well fair outside things, you can’t do warn. I can talk but I can’tshow up myself. I can’t put the voice. It would be one thing if I could talk. ButI can’t talk so people can see it.Are you married, Frank? I was news to due to be.Comparison Broca’s vs. Wernicke’s aphasics[Tom then proceeds to count fluently with only a few errors]6
Wernicke’s vs. Broca’s aphasiaCookie theft (from Boston aphasia exam) Description of cookie theft story Wernicke’s patient (Goodglass, 1983)“Well this mother is away here working her work out o’here to get herbetter, but when she’s looking, the two boys looking in the other part.One their small tile into her time here. She’s working another timebecause she is getting, too.” Broca’s patient (Helm-Estabrooks et al., 1981)“Well see girl eating no cookie no ah school no stool ah tip over and ah cookie jar ah kid no see waterall over spilled over yuck Mother daydreaming.”Basic forms of aphasia Broca’s aphasia Wernicke’s aphasia Jargon aphasiaConduction aphasiaWord deafnessGlobal aphasiaThe Transcortical aphasias AgrammatismConduction aphasiaThePerisylvianaphasias Symptoms: ExtrasylvianaphasiasComprehension and production relatively intactRepetition is predominant impairment Type of damage: Problems with simple model: Transcortical motor aphasiaTranscortical sensory aphasia Supramarginal gyrus and insula (close to arcuate fasciculus)W-G model suggests disconnection but why is expression okay?Shouldn’t concepts be disconnected from syntax and articulation,impairing production?Possibly problem with working or short-term memorySubcortical aphasiaRight hemisphere damageConduction aphasiaOther perisylvian aphasias Global aphasia Type of damage: Damage of all language areasPure word deafness Complete loss of languageIf recovery, comprehension before production, to state likeBroca’sPatients unable to hear phonological form of wordsProduction may be faultlessType of damage: Bilateral lesions to posterior temporal plane (Heschl's gyrus)7
Global aphasiaTranscortical aphasias Known since Wernicke’s time that aspects of Broca’sand Wernicke’s aphasia could appear in patients whohad a preserved ability to repeat back.Due to damage outside perisylvian area – watershedinfarctionPosition of damage (anterior / posterior) determinestype of deficit Transcortical aphasiasTranscortical motor aphasia (Broca-like)Transcortical sensory aphasia (Wernicke-like)Transcortical aphasias Transcortical Motor Aphasia Type 1 Type 2 Transcortical aphasias Dysexecutive production problems (echolalia,perseveration)Prefrontal lesion superior to Broca’s areaMotor initiation symptomsReduced motivation and drive, lower limb paralysisLesions in anterior cingulate and left supplementarymotor areaTSA vs. Conduction vs. Wernicke’s aphasiaTranscortical Sensory Aphasia Type 1 Comprehension problems, extreme difficulty namingobjects / pictures, semantic paraphasias, visual objectagnosiaDamage inferior and posterior to Wernicke’s areaType 2 Word finding difficulties, few content words, difficultywith complex relational sentencesSuperior angular gyrus and posterior parietal damage8
Subcortical aphasia Can aphasia be due to sub-cortical damage (e.g.,to thalamus)?Does it play a processing role or justconnectivity?Nadeau and Crosson (1997) have arguedsubcortical damage associated with Anomia in spontaneous languagePoor verbal fluencyProblems in confrontation namingRight hemisphere could be remote effects on distant cortical areasor metabolic effects on adjacent cortical areasthalamus may play role in boosting focus orselectivity of functionmay be part of sub-cortical circuit for complexmotor articulationThe Wernicke-Geschwind modelSwearing, emotionally charged words, singing, stereotypedphrasesDeficits in thematic inferencesDeficits in non-literal language processingReduced sense of humourModifications to Wernicke-Geschwind model ButRH comprehends overall context or themeRH damage associated with Damage to RH associated with deficits in prosody(production and comprehension)Limited speech expression Subcortical aphasia1. Broca’s area associated with articulation deficits.Agrammatism requires larger area of damage2. Broca’s aphasics also have comprehension deficits forinformation related to syntax3. Conduction aphasia not disconnection but impairmentin phonological working memory4. Jargon aphasia implies dissociable conscious andunconscious routes from posterior areas to productionareas5. Subcortical structures implicated in connectivitybetween regions6. Right hemisphere plays a role in prosody and thematicprocessingModified model (Andrewes, 2001)RIGHT HEMISPHEREProsodyCoarse semanticencoding of theme9
1 Cognitive Neuropsychology of Language Michael Thomas Birkbeck College Introduction Structure of the course Historical background to aphasia Two modern approaches Basic forms of aphasia Course Disorders of Language, Spring 2004 Lectures 10.00am to 11.30am, Thursdays
Both cognitive and clinical aspects of neuropsychology are addressed to illustrate the advances scientists are making (on many fronts) in . 1 The foundations of neuropsychology 3 Introduction 3 Neuropsychology as a distinct discipline 3 The (re)emergence of neuropsychology 12 Chapter summary 19 2 Methods in neuropsychology 21
Theme 1. Self-reported use and knowledge of child neuropsychology theory and practice 45 Theme 2. Views on inclusion of neuropsychology teaching during the initial EP training 47 Theme 3. Experiences of neuropsychology teaching during the initial EP training course 49 Theme 4. Views on Paediatric
1 Introduction: Philosophy of Science and the Nature of Philosophy 1.1 Three Views on Philosophy and Psychology . Cognitive neuropsychology is the branch of cognitive psychology in which models of, or theories about, normal cognitive processes are developed, evaluated, and refined, in the light of data provided by the empirical .
Cognitive Neuropsychology of Language Michael Thomas Birkbeck College Introduction nStructure of the course nHistorical background to aphasia nTwo modern approaches nBasic forms of aphasia Course Disorders of Language, Spring 2005 Thomas, M. S. C. & Karmiloff Lectures 11.30am to 1.00pm, Thursdays Room 534, Birkbeck College Main Building mind
2 Methods in Cognitive Neuropsychology: A Tool Kit 23 3 Principles and Issues in Cognitive Neuropsychology 43 4 Neglect & Attention 69 5 Apraxia & Motor-Planning 95 6 Visual Agnosia & Object Recognition 113 7 Prosopagnosia & Face Processing 141 8 Amnesia & Memory 173 9 Executive Functions 209 10 Aphasia, Dyslexia & Language
Introduction While a cognitive neuropsychological approach is widely used in aphasia clinics throughout the UK and other countries to assess and treat people with . Cognitive neuropsychology first emerged as a coherent discipline in the 1970s as a reaction to the then dominant approach in neuropsychology. This earlier
Classes 1-3: Introduction, Methods and Anatomy Jan 11: INTRODUCTION AND HISTORY Class 1 Welcome, Course Syllabus Review Lecture Topics: Neuropsychology and Clinical Neuroscience History of Neuropsychology Readings: Zillmer, Spiers & Culbertson: Chapter 1: A History of Neuropsychology Jan 18: No Class – Martin Luther King, Jr. Day
Jadi osteologi adalah cabang dari anatomi yang memelajari tentang tulang. Dalam memelajari tulang sering pula dijumpai istilah “skeleteon”, yang berasal dari bahasa latin yang berarti kerangka. Tulang atau kerangka bagi manusia mempunyai fungsi yang amat besar, antara lain: a. Melindungi organ vital b. Penghasil darah tertentu c. Menyimpan dan mangganti kalsium dan fosfat d. Alat gerak .
