Aphasia In Dextrals Research Articles

Shorter Survival in Logopenic Progressive Crossed Aphasia in Dextrals (2155)

Shorter Survival in Logopenic Progressive Crossed Aphasia in Dextrals (2155)

Investigation of Speech and Language in a Persian Patient with Crossed Aphasia in Dextrals: A Case Report

Introduction: In the current study, we report a patient of crossed aphasia in dextrals (CAD) that presented with aphasia and typical neuropsychological deficits following right hemisphere brain damage. To the best of the authors’ knowledge, it is the first Persian language patient of CAD reported internationally. Case Presentation: The patient was a 59-year-old right-handed female with no history of left-handedness or ambidexterity in her family. Right handedness was measured in the current patient by the Edinburgh right-handedness inventory. Speech and language functions were measured by the Persian Western-Aphasia Battery (P-WAB) and the Bilingual Aphasia test (BAT). Also, the bedside version of Persian WAB (P-WAB-1) was used. Hemianopia/neglect was investigated by line bisection, painting, and cancellation tasks that confirmed left visuospatial neglect. Telegraphic speech was her dominant output feature. She had a problem with sentence construction; also, her morphological derivation skills were impaired. The syntactic structures of utterances were very simple. In writing tasks, her sample was unintelligible semantically. The auditory comprehension of the patient was impaired at the level of semi-complex and complex commands. It should be mentioned that difficulty in topic maintenance was observed in storytelling. Left visuospatial neglect was confirmed in the patient by assessments. The results confirmed the presence of neglect and language disorder, typologically consistent with Broca’s aphasia. Conclusions: The current study patient represented the typical symptoms of language dominant left hemisphere damage and a range of deficits indicating right hemisphere pathology. Analysis of patient symptoms confirmed the right hemisphere language dominance.

High Frequency of Crossed Aphasia in Dextral in an Italian Cohort of Patients with Logopenic Primary Progressive Aphasia.

Primary progressive aphasia (PPA) has been described as a neurodegenerative language disorder mainly affecting the left hemisphere. Few cases of right hemisphere damage in right-handed PPA subjects have been reported. This condition, named crossed aphasia in dextral (CAD), is relatively rare and probably related to an alteration during neurodevelopment of language networks. To explore the prevalence of CAD in an Italian cohort of 68 PPA patients, in order to evaluate whether right hemisphere language lateralization could be a risk factor for PPA. Clinical-demographic and cerebral [18F]-fluorodeoxyglucose positron emission tomography ([18F]FDG-PET) scan were analyzed, resulting in 23 logopenic variant (lvPPA) patients, 26 non-fluent variant (nfvPPA) patients, and 19 semantic variant (svPPA) patients. SPM single subject routine was performed for diagnostic purposes in order to identify the hypometabolic pattern of each patient. Based on brain metabolic profile, PPA patients were divided in right and left lvPPA, nfvPPA, and svPPA. [18F]FDG-PET group analyses were performed with SPM two-sample t-test routine. 26% of lvPPA cases were identified as CAD based on right hypometabolic pattern. CAD patients did not differ from left lvPPA regarding demographic features and general cognitive performance; however, they performed better in specific working memory tasks and showed brain hypometabolism limited to the superior, middle, and supramarginal temporal gyri. Atypical lateralization of language function could determine a vulnerability of the phonological language loop and in that way could be a risk factor for lvPPA.

Lateralization of Cognitive Functions in Aphasia after Right Brain Damage

PurposeThe lateralization of cognitive functions in crossed aphasia in dextrals (CAD) has been explored and compared mainly with cases of aphasia with left hemisphere damage. However, comparing the neuropsychological aspects of CAD and aphasia after right brain damage in left-handers (ARL) could potentially provide more insights into the effect of a shift in the laterality of handedness or language on other cognitive organization. Thus, this case study compared two cases of CAD and one case of ARL.Materials and MethodsThe following neuropsychological measures were obtained from three aphasic patients with right brain damage (two cases of CAD and one case of ARL); language, oral and limb praxis, and nonverbal cognitive functions (visuospatial neglect and visuospatial construction).ResultsAll three patients showed impaired visuoconstructional abilities, whereas each patient showed a different level of performances for oral and limb praxis, and visuospatial neglect.ConclusionBased on the analysis of these three aphasic patients' performances, we highlighted the lateralization of language, handedness, oral and limb praxis, visuospatial neglect and visuospatial constructive ability in aphasic patients with right brain damage.

脳血管障害に起因する成人右利き交叉性失語 6 症例の検討

脳血管障害に起因する成人右利き交叉性失語 6 症例の検討

Crossed Aphasia and Visuo-Spatial Neglect Following a Right Thalamic Stroke: A Case Study and Review of the Literature

Crossed aphasia in dextrals (CAD) following pure subcortical lesions is rare. This study describes a right-handed patient with an ischemic lesion in the right thalamus. In the post-acute phase of the stroke, a unique combination of ‘crossed thalamic aphasia’ was found with left visuo-spatial neglect and constructional apraxia. On the basis of the criteria used in Mariën et al. [67], this case-report is the first reliable representative of vascular CAD following an isolated lesion in the right thalamus. Furthermore, this paper presents a detailed analysis of linguistic and cognitive impairments of ‘possible’ and 'reliable' subcortical CAD-cases published since 1975. Out of 25 patients with a pure subcortical lesion, nine cases were considered as ‘possibly reliable or reliable’. A review of these cases reveals that: (1) demographic data are consistent with the general findings for the entire group of vascular CAD, (2) the neurolinguistic findings do not support the data in the general CAD-population with regard to (a) the high prevalence of transcortical aphasia and (b) the tendency towards a copresence of an oral versus written language dissociation and a ‘mirror-image’ lesion-aphasia profile, (3) subcortical CAD is not a transient phenomenon, (4) the lesion-aphasia correlations are not congruent with the high incidence of anomalous cases in the general CAD-population, (5) neuropsychological impairments may accompany subcortical CAD.

Language and visuospatial impairment in a case of crossed aphasia

Crossed aphasia in dextrals (CAD) constitutes an interesting model for understanding the lateralisation and interaction of language with other cognitive functions in the brain. The authors present a study of a right-handed patient with Wernicke's aphasia following a right hemisphere cerebrovascular accident, who also had impairment in visuospatial skills. Although the patient presented a remarkable improvement in language symptoms on longitudinal follow-up, the combination of linguistic, visuospatial, and attentional impairments ultimately resulted in a persisting inability to perform complex tasks. The study of mild residual disturbances can improve our understanding of the interaction of language with other cognitive functions, going some way towards explaining the particular features found in CAD.

Adult Crossed Aphasia in Dextrals Revisited

The clinical study of crossed aphasia in dextrals (CAD) may shed light on the discreteness and modularity of several cognitive functions, such as language, gestures and visual spatial abilities, with respect to hemispheric lateralisation. Since 1975 over 180 cases have been described, employing, however, different criteria of assessment and classification. The purpose of this paper is to review them and to propose a set of diagnostic criteria that may be useful to single out a series of reliable CAD cases on which research can be safely carried out. A detailed analysis of such series is dealt with in terms of a number of characteristics concerning both the language disorder and the associated nonverbal cognitive impairments.

Acquired Crossed Aphasia in Dextral Children Revisited

In contrast to the estimated low incidence of crossed aphasia in dextral adults (among 1%), crossed aphasia in children has been considered a common finding for almost a century. However, reviewing the literature on crossed aphasia in dextrals (CAD) and its related topics from 1975 onward, we encountered only 5 children in a corpus of 180 cases (2.7%). Critical analysis rendered three of the reported cases ambiguous and hence not suitable to draw potentially relevant conclusions. In this review, the neurobehavioral manifestations of the two representative childhood CAD cases are analyzed and compared with adult CAD and acquired childhood aphasia (ACA). In the light of our findings, which support the position of innate cerebral specialization for language, the long-standing controversy as to whether lateralized hemispheric specialization for language is innate or develops progressively during maturation is briefly discussed.

Familial sinistrality in crossed aphasia: A new case and review of the available literature

From the earliest descriptions onwards, the phenomenon of familial sinistrality (FS) has been strongly implicated in the concept of crossed aphasia in dextrals (CAD). In the early literature on CAD, a positive tract of FS (FS+) was generally regarded as the most important cause of anomalous language lateralisation in dextrals. Although in the more recent literature FS+ is generally regarded a strong exclusion criterion for CAD, in a corpus of 180 published CAD cases we encountered 26 patients with FS+ (14.4%). Critical analysis revealed that only a minority of these cases (5/26; 19%) sufficiently met the adopted criteria for an unambiguous diagnosis of vascular CAD (reliable CAD). One personal observation, reported in this paper, also fulfilled these criteria and is added to this group. To evaluate the presumed impact of FS+ on the anatomoclinical configurations of vascular CAD, all "reliable" CAD cases with FS+ were analysed in a three-epoch time-frame model for aphasia and matched for both aphasia type and lesion-aphasia profile with a representative group of vascular "reliable" CAD cases with negative FS (FS-). Close analysis of the aphasia characteristics revealed that the FS variable did not induce semiological differences between both FS groups. Although the limited study sample does not allow strong conclusions to be drawn, our findings seem to indicate that FS does not act as a strong determinant of lesion- behaviour relationships in CAD.

Absence of aphasia in a dextral with a left hemisphere lesion: A case report

Abstract Right-handed patients with aphasia due to a right hemisphere lesion, or sinistral aphasics with a left hemisphere lesion, are referred to as crossed aphasics (Bramwell 1899). Since left damaged sinistrals with aphasia are the rule (Brown and Hecaen 1976), it is the dextral with a right hemisphere lesion that has received most of the attention. When we reviewed the topic of crossed aphasia in dextrals some years ago in relation to a case report (Brown and Wilson 1973). only seven other cases could be found that satisfied the minimal criteria of a clearcut aphasia dextrality and a negative family history ofleft handedness, but since this paper there have been many additional observations (e.g. Assal, Perentes and Dervaz 1981, Donoso, Santander and Pavez 1984, Pillon, Desi and Lhermitte 1979, Wechsler 1976; see Joanette, Puel, Nespoulos, Rascol and Lecours [1982] and Castro-Caldas and Confraria [1984] for review).

Age and type of crossed aphasia in dextrals due to stroke

Thirty-nine cases (37 from the literature and 2 personal) of crossed aphasia in dextrals due to stroke were reviewed concerning age, sex, and type of aphasia. Results showed that Broca's aphasics are younger than the remaining group, males predominate, and several types of aphasia have been described similarly to the aphasias due to left-hemisphere lesions in dextrals.

Crossed aphasia in dextrals: A case report with special reference to site of lesion

A strictly right-handed man showed aphasia and left hemiplegia following a deep infarct of the right hemisphere. Aphasic semeiology was characterized by an oral and written jargon while comprehension was almost intact. Several hypotheses previously put forward fail to account for the patient's aphasia. Emphasizing the frequency of deep structures involvement in the published cases of crossed dextral aphasias, it is suggested that site of lesion may have a certain part to play in the accurrence of such aphasias.

Crossed aphasia in dextrals

Crossed aphasia in dextrals

Crossed aphasia in dextrals

Crossed aphasia in dextrals

Two cases of crossed aphasia in dextrals

Two cases of crossed aphasia in dextrals are reported, in one of which right hemisphere dominance was confirmed by an intracarotid amytal test. The possibility of a partial dissociation between oral and graphic expression is considered.