Phonological Working Memory Limitations and Agrammatism: Is There a Causal Relationship between the Two?

Syntactic processing in sentence comprehension requires some form of Working Memory (WM) resources. However, the nature of the relation between WM and sentence comprehension is controversial. One of the questions is whether WM for language is a single resource, or, alternatively, it consists of different components, each entrusted with a different linguistic function (Caplan & Waters, 1999). The aim of the study is to investigate the nature of the relation between WM and sentence comprehension by comparing sentence comprehension abilities with performance on WM tasks of four Greek-speaking patients with Broca’s aphasia. The experimental hypothesis is that patients with different performance patterns in sentence comprehension will present with different verbal WM capacity

Neuromyelitis Optica Spectrum Disease with Positive Autoimmune Indices: A Case Report and Review of the Literature

A 45-year-old female suffering from severe thoracic pain was admitted to the emergency department of our hospital. Thorough clinical examination revealed paresis of the left lower limb and sensory deficit at the level of the Th4 vertebra. MRI of the thoracic spine demonstrated a lesion at the level of Th1–Th7. Despite initial improvement following i.v. corticosteroid administration, the patient's clinical status deteriorated, with recurrence of myelitis and extension of the lesion to Th12. She developed paraparesis, hyperreflexia and spasticity of both legs, symmetrical sensory deficit below Th4, and sphincter dysfunction. Differential diagnosis included infectious, metabolic, neoplastic/paraneoplastic, and ischemic causes as well as multiple sclerosis. NMO IgG was found positive and led to the diagnosis of longitudinal extensive transverse myelitis (LETM) in the NMO spectrum disorders. Administration of immunosuppressive therapy resulted in gradual improvement of the patient's clinical status and stabilization for five years. In the setting of LETM, patients with antiaquaporin 4 IgGs can present features of coexisting systemic involvement. A thorough differential diagnosis is required to guide appropriate therapy

Syntactic predictions and asyntactic comprehension in aphasia: Evidence from scope relations

People with aphasia (PWA) often fail to understand syntactically complex sentences. This phenomenon has been described as asyntactic comprehension and has been explored in various studies cross-linguistically in the past decades. However, until now there has been no consensus among researchers as to the nature of sentence comprehension failures in aphasia. Impaired representations accounts ascribe comprehension deficits to loss of syntactic knowledge, whereas processing/resource reduction accounts assume that PWA are unable to use syntactic knowledge in comprehension due to resource limitation resulting from the brain damage. The aim of this paper is to use independently motivated psycholinguistic models of sentence processing to test a variant of the processing/resource reduction accounts that we dub the Complexity Threshold Hypothesis. According to this hypothesis, PWA are capable of building well-formed syntactic representations, but, because their resources for language processing are limited, their syntactic parser fails when processing complexity exceeds a certain threshold. The source of complexity investigated in the experiments reported in this paper is syntactic prediction. We conducted two experiments involving comprehension of sentences with different types of syntactic dependencies, namely dependencies that do not require syntactic prediction (i.e. unpredictable dependencies in sentences that require Quantifier Raising) and dependencies whose resolution requires syntactic predictions at an early stage of processing based on syntactic cues (i.e. predictable dependencies in movement-derived sentences). In line with the predictions of the Complexity Threshold Hypothesis, the results show that the agrammatic patients that participated in this study had no difficulties comprehending sentences with the former type of dependencies, whereas their comprehension of sentences with the latter type of dependencies was impaired

Why is it difficult to predict language impairment and outcome in patients with aphasia after stroke?

One of the most devastating consequences of stroke is aphasia. Communication problems after stroke can severely impair the patient's quality of life and make even simple everyday tasks challenging. Despite intense research in the field of aphasiology, the type of language impairment has not yet been localized and correlated with brain damage, making it difficult to predict the language outcome for stroke patients with aphasia. Our primary objective is to present the available evidence that highlights the difficulties of predicting language impairment after stroke. The different levels of complexity involved in predicting the lesion site from language impairment and ultimately predicting the long-term outcome in stroke patients with aphasia were explored. Future directions and potential implications for research and clinical practice are highlighted

Verbal memory and sentence comprehension in aphasia: a case series

This case series explores the relationship between verbal memory capacity and sentence comprehension in four patients with aphasia. Two sentence comprehension tasks showed that two patients, P1 and P2, had impaired syntactic comprehension, whereas P3 and P4’s sentence comprehension was intact. The memory assessment tasks showed that P1 and P2 had severely impaired short-term memory, whereas P3 and P4 performed within the normal range in the short-term memory tasks. This finding suggests an association between short-term memory deficit and sentence comprehension difficulties. P1 and P3 exhibited impaired comparable working memory deficits, suggesting a dissociation between working memory and sentence comprehension

Investigating silent pauses in connected speech: integrating linguistic, neuropsychological, and neuroanatomical perspectives across narrative tasks in post-stroke aphasia

IntroductionSilent pauses are regarded as integral components of the temporal organization of speech. However, it has also been hypothesized that they serve as markers for internal cognitive processes, including word access, monitoring, planning, and memory functions. Although existing evidence across various pathological populations underscores the importance of investigating silent pauses’ characteristics, particularly in terms of frequency and duration, there is a scarcity of data within the domain of post-stroke aphasia.MethodsThe primary objective of the present study is to scrutinize the frequency and duration of silent pauses in two distinct narrative tasks within a cohort of 32 patients with chronic post-stroke aphasia, in comparison with a control group of healthy speakers. Subsequently, we investigate potential correlation patterns between silent pause measures, i.e., frequency and duration, across the two narrative tasks within the patient group, their performance in neuropsychological assessments, and lesion data.ResultsOur findings showed that patients exhibited a higher frequency of longer-duration pauses in both narrative tasks compared to healthy speakers. Furthermore, within-group comparisons revealed that patients tended to pause more frequently and for longer durations in the picture description task, while healthy participants exhibited the opposite trend. With regard to our second research question, a marginally significant interaction emerged between performance in semantic verbal fluency and the narrative task, in relation to the location of silent pauses—whether between or within clauses—predicting the duration of silent pauses in the patient group. However, no significant results were observed for the frequency of silent pauses. Lastly, our study identified that the duration of silent pauses could be predicted by distinct Regions of Interest (ROIs) in spared tissue within the left hemisphere, as a function of the narrative task.DiscussionOverall, this study follows an integrative approach of linguistic, neuropsychological and neuroanatomical data to define silent pauses in connected speech, and illustrates interrelations between cognitive components, temporal aspects of speech, and anatomical indices, while it further highlights the importance of studying connected speech indices using different narrative tasks