A History of Neuropsychology. Группа авторов

A History of Neuropsychology - Группа авторов


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that have restrictive meaning such as names of object or content.

      Second, in spontaneous speech the patient would show word amnesia, verbal paraphasia, and a kind of paragrammatism. The anomia is most prominent for names of concrete things and proper names. Unlike amnesic aphasia, the patient would show difficulty in recognition of the name even if the correct one is produced. Generally, speech is fluent and articulation clear. But sentences produced are incoherent and incomplete. No difficulty is seen in the use of grammatical words.

      Third, ability to repeat spoken language is sufficiently preserved. The way the patient repeats cannot be considered as automatic echolalia. It implies his intention for comprehension.

      Fourth, there is a unique difficulty in oral reading and writing. Imura summarized this difficulty as “oral reading without comprehension” and “writing without comprehension.” The difficulty manifests itself as a dissociated ability to handle kanji and kana. Kana can be read or written rather easily without comprehension, while kanji is difficult in both comprehension and writing.

      Overall, Imura considered this symptom complex belongs to the category of transcortical sensory aphasia in Wernicke-Lichtheim diagram, but nonetheless emphasized its uniqueness because the difficulty is most conspicuous in comprehension of the meaning of substantive words rather than comprehension of spoken language in general and insisted it should be treated as a separate aphasic syndrome.

      An Illustrative Case

      Case E. is a 57-year-old businessman. He had been forgetful the previous year, and recently started having difficulty in reading. He also became obstinate and short tempered. No physical neurological signs were found on admission.

      Comprehension of Spoken Language

      He did not understand the examiner’s questions. For example, when asked to tell his address, he responded, “What is address?”

      When asked whether he travels by airplane, he responded, “What is airplane?”

      When asked to tell his hobby, he said, “What is hobby?”

      When asked to choose a brush from a group of 10 pictures, he responded, “What is brush?”

      When asked to choose a picture of a comb, he said, “What is comb?”

      Naming of Objects

      Very Difficult. He seemed to know the concept of an object that was shown but could not recall an appropriate name. For example, when asked to give the name of a matchbox, he responded, “this is not tobacco. Make a fire. Tobacco.”

      Repetition

      Almost always correct. Non-sense words could also be correctly repeated.

      Oral Reading

      Reading aloud kana words and sentences was on the whole correct, but reading aloud kanji words was severely impaired. As mentioned, a kanji has more than two ways of reading but only one of them is appropriate when it is embedded in a particular kanji-kana mixed sentence. The patient simply misread the kanji part of a sentence, either producing a correct but inappropriate name for the sentence, or confusing it with another kanji similar in form.

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      Writing

      He wrote his name and address correctly. He could write a few words with kana for dictation but impossible with kanji.

      Copying Characters

      He showed no difficulty in copying characters either in kanji or kana.


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