Brain-Behavior Relationships

Overview of Topics

Dysfunctions caused by Lesions
Assessment
References

Wernicke's Area

A region of the brain located in the posterior, superior temporal gyrus, adjacent to the cortical region for hearing. This area seems to be of focal importance for language and is involved in the recognition of the auditory patterns of language.

1. Speech may be very rapid, with rhythm, grammar and articulation preserved, but devoid of content. (1)
2. The patient may fail to use the correct word and substitute circumlocutory phrases and "empty words" (e.g.,"thing"). (1)
3. Verbal paraphasia -- substitution of one word or phrase for another, sometimes related in meaning(1)
4. Literal (phonemic) aphasia -- substitution of incorrect sounds in otherwise correct words. (1)
5. A lesion in Wernicke's Area can produce a severe loss of understanding, even though hearing of nonverbal sounds and music may be fully normal. (1)
6. Damage to Wernicke's Area causes difficulties in the comprehension of both spoken and written language since auditory pattern can't be aroused(1)
7. Disturbance of auditory analysis and syntheses which leads to the loss of phonemic hearing. (2)
8. Impaired ability to match an auditorily presented word to its equivalent picture when presented in an array of phonemically similar test items. (3)
9. Normal articulation, prosody and average phrase-length; rate of speaking normal or increased; frequent verbal neologistic or unclassifiable paraphasias; periods of jargon and severe disturbance in verbal comprehension. (4)
10. Word-comprehension disorders. (5, 6)
11. A case in which a right-handed male with a completely destroyed Wernicke's Area in the left hemisphere, did not result in aphasia. This case is first validated case of language dominance in the right hemisphere of a right-handed individual. (7)
12. Impairment in the comprehension of language and associated mental decrement. (8)
13. Disruption of the ability to obtain meaning from a stimulus and to use it as a basis for orderly symbol formation. (9)
14. Impaired naming repetition, and comprehension in the presence of fluent speech. The speech pattern is markedly circumlocutory and void of specific semantic content. Production of neologistic jargon is also observed. (10)
15. Disturbances in reading, writing, naming, repetition, and comprehension of the spoken language(11)
16. A patient, though his hearing is normal, is unable to understand spoken speech. (12)
17. Perseveration may occur, in which the same word is used repeatedly. (12)
18. Accelerated speech may be one of the factors which leads to perseveration and lack of inhibition may be another. (13)
19. Disturbance of the understanding of speech, defects in the repetition of words and the naming of objects, impairment in writing. (14)
20. Patients displaying breakdown in the discrimination of speech sounds and consequent difficulties in the comprehension of speech and of word meanings, but without impairment of hearing per se, are most likely to have lesions in Wernicke's Area. (15)
21. Comprehension deficit attributed to a selective impairment in phonological perception. (2)
22. Proper auditory feedback is absent. (16)
23. A Lesion in "the centre of auditory images" gives the classical Wernicke's aphasia (fluent speech, poor comprehension, and poor reception) (17)
24. A lesion which interrupts the pathway from the primary auditory area to Wernicke's Area produces "pure word deafness." The patient has fluent and normal spontaneous speech but he cannot comprehend or repeat spoken language. Although he can comprehend written language and read aloud. (18)

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B. Tests for Aphasia

1. Porch Index of Communicative Ability (PICA) (19)
2. Token Test (20)
3. Token Test (3E-item version) (21)
   • Appears to be a useful and convenient device to diagnose aphasia impairment of language comprehension.
4. Boston Diagnostic Aphasia Battery (22)
5. Western Aphasia Battery (23)
6. Minnesota Test for Differential Diagnosis of Aphasia (24)
7. Halstead-Wepman Aphasia Screening Test (25)
8. Head's Serial Tests (26)
9. Language Modalities Test (27)
10. Illinois Test of Psycholinguistic Abilities (23)
11. Michigan Picture Language Inventory(29)
12. Functional Communication Profile (30)
13. Examining for Aphasia (31)
14. Sklar Aphasia Scale (32)
15. Neurosensory Center Comprehensive Examination for Aphasia (33)

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References

1. Geschwind, N. Language and the brain. Scientific American, 1972, 226, (4), 76-83.
2. Luria, A. R. Traumatic Aphasia. Houton, The Hague, 1970.
3. Blumstein, S. E., Baker, E., and Goodglass, H. Phonological factors in auditory comprehension in aphasia. Neuropsychologia, 1977, 15(1), 19-39.
4. Gloning, K. Handedness and aphasia. Neuropsychologia, 1977, 15 (2), 355-358.
5. Luria, A.R,. The working brain. London: Allen Lane, The Penguin Press, 1973.
6. Goodglass, H., & Geschwind, N. Language disorders (aphasia). In E. C. Catarette and M. P. Friedman (Eds.). Handbook of Perception (Vol. 7): Language. New York: Academic Press, 1976.
7. Boller, F. Destruction of Wernicke's Area without language disturbance. Neuropsychologia.1973,11(2), 243-240.
8. Cole, M. The anatomical basis of aphasia as seen by Pierre Marie. Cortex, 1968, 4(2), 172-183.
9. Wepnan, J., and Jones, L. Studies in aphasia: an approach to testing. Chicago: University of Chicago Education - Industry Service, 1961.
10. Blumstein, S. Some phonological implications of aphasic speech. In H. Goodglass and S. Blumstein (Eds ) Pscholinguistics and Aphasia. Baltimore: Johns Hopkins University Press, 1973.
11. Green, E. Phonological and grammatical aspects of jargon in an aphasic patient: a case study. In H. Goodglass ane s. Blumstein (Eds.), Psycholinguistics and aphasia. Baltimore: Johns Hopkins University Press, 1973.
12. Brain, W. R. Speech disorders (2nd ed). London: Butterworths, 1965.
13. Pick, A. In T. Weisenburg and K. McBride (Eds) Aphasia: A clinical and psychological study. New York: Hafner Publishing Company, 1964.
14. Luria, A. R. Factors and form of aphasia. In A. V. S. de Reuck and F.O'Connor (Eds.), Disorders of language, London: Churchill, Ltd.,1964.
15. Osgood, C. E., and Meron, M. S. (Eds:) Approaches to the study of aphasia. Urbana, Ill.: University of Ill. Press, l963.
16. Buckingham, H. W., Jr., Avakian-Whitaker, H., and Whitaker, H. A. Alliteration and assonance in neologistic jargon aphasia. Cortex, 1978, 14 (3), 365-38O.
17. Lichtheim, L. On aphasia.Brain,1885,1,433-484.
18. Benson, D.F., and Geschwind, H. The aphasias and related disturbances. In A. B. Baker and L. H. Baker (Eds.), Clinical Neurology I. New York: Harper and Row, 1971.
19. Porch, B. Porch Index of Communicative Ability. Palo Alto: Consulting Psychologists Press, 1971.
20. de Renzi, E., and Vignolo, L. A. The Token Test: a sensitive test to detect receptive disturtances in aphasics. Brain, 1962, 85,
21. 665-678.
22. de Renzi, E., and Faglioni, P. Normative data and screening power of a shortened version of the Token Test. Cortex, 1978, 14 (1),
23. 41-49.
24. Goodglass, H., and Kaplan, E. The assessment of aphasia and related disorders. Philadelphia: Lea and Febiger, 1972.
25. Kertesz, A. and Poole, E. The aphasia quotient: the taxonomic approach to measurement of aphasic disability. Canadian Journal of Neurological Sciences, 1974, 1, 7-16.
26. Schuell, H. The Minnesota Test for Differential Diagnosis of Aphasia. Minneapolis: University of Minnesota Press, l965.
27. Halstead,W.C., and Wepman,J.M. The Halstead- Wepman aphasia screening test. Journal of Speech and Hearing Disorders, 1949, 14,
28. 9-15.
29. Head, H. Aphasia and kindred disorders of speech. University Press and Macmillan, 1926.
30. Wepman, J. and Jones, L. Studies in Aphasia: an approach to testing. Chicago: University of Chicago Education - Industry Service,
31. 1961.
32. McCarthy, J. J., and Kirk, S. A. Illinois Test of Abilities: Examiners Manual. Urbana Ill.: 1961.
33. Lerea, L. Assessing language development. Journal of Speech and Hearing Research, 1958, 1.
34. Taylor, M. Functional Communication Profile. New York: New York University Medicine and Rehabilitation, 1953.
35. Spreen, O., and Benton, A. L. Neurosensory Center Comprehensive Examinationtion for aphasia. , Victoria, Neuropsychology Laboratory, 1969.