Transcript AssociationsDissociations copy

Aphasia and Intelligence
Pierre Marie
They hear and comprehend all that one says to them; they all have their
intelligence; they emit vocal sounds with ease; they execute with their tongue
and their lips movements much more extensive and energetic than those
required for the articulation of sounds, and yet the perfectly sensible response
that they would want to make is reduced to a very small number of articulated
sounds, always the same and always performed in the same manner; their
vocabulary, if we can call it that, is composed of a short series of syllables,
sometimes of a monosyllable that expresses everything, or rather that
expresses nothing, for this unique word is most often a stranger to all
vocabularies.
Paul Broca
QUestion 1
(review)
Which component or
components represent the
form of a word?
a) Centre A only
B) CENTRE M ONLY
C) CENTRES A AND M
D) CENTRES A, M AND IDEATION.
There are no language centres!
“The third left frontal convolution
plays no special role in language”
I deny that there exists in the left hemisphere a verbal
auditory sensory centre localized either in the foot or in the
middle part of the first temporal lobe.
I deny that there exists in the foot of the third left frontal
convolution a verbal motor centre.
MARIE PAPER TEST
“Of the three unequal pieces of
paper placed in this table: you will
give me the largest one, you will
crumple the middle-sized one and
throw it down, and as for the smallest
one, you will put it in your pocket”
“The physician must pantomime
the different parts of the order,
and then tell the patient to reproduce
the series of acts which he has just seen. In
severe cases (...of aphasia...)
the patient is generally incapable of
carrying out this task in full”.
“In the case of aphasia there is
something much more important
and much more grave than the loss of
the meaning of words; it is a very marked
diminution in intellectual
capacity in general”.
Marie was arguing that left hemisphere
damage did not impair language but
intelligence.
The problem of ‘mere associations’
Language impairment
Language + other
impairments
No better example could be chosen of
the manner in which the writers of
that period were compelled to lop and
twist their cases to fit the procrustean
bed of their hypothetical conceptions.
QUESTION 2
“PROCRUSTEAN” MEANS:
A) Enforcing uniformity without regard to lawful variation or
individual differences
B) The claim that language centres are all localizable to specific
regions of the brain
c) The claim that language can be understood by means
of abstract diagrams
The term ‘procrustean’ means ‘enforcing uniformity without regard to
lawful variation or individual differences’. And it is true if you think about
the problem, that the diagrams were intended to represent a universal
architecture of the brain that was the same from person to person. Is
this biologically plausible, especially when it is generally true that
neurological damage never produces exactly the same profile of
impairments across individuals? How do we theoretically interpret a
very unusual pattern of deficits in the language domain? Should we
assume that one case provides evidence for a general theory that
applies to all brains or is there variation in the way language
architectures might develop between individuals?
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35
No better example could be chosen of
the manner in which the writers of
that period were compelled to lop and
twist their cases to fit the procrustean
bed of their hypothetical conceptions.
QUESTION 2
“PROCRUSTEAN” MEANS:
A) Enforcing uniformity without regard to lawful variation or
individual differences **
B) The claim that language centres are all localizable to specific
regions of the brain
c) The claim that language can be understood by means
of abstract diagrams
The diagrams were intended to represent a universal
architecture of the brain that was the same from person to
person.
Is this biologically plausible, especially when it is generally
true that neurological damage never produces exactly the
same profile of impairments across individuals? How do we
theoretically interpret a very unusual pattern of deficits in
the language domain?
Should we assume that one case provides evidence for a
general theory that applies to all brains or is there variation
in the way language architectures might develop between
individuals?
This kind of functional
architecture...
....Enforces uniformity without regard to lawful
variation or individual differences
PHONOLOGICAL AND SURFACE DYSLEXIA
TOGETHER MAKE
UP A DOUBLE DISSOCIATION BETWEEN THE
LEXICAL AND
NON-LEXICAL READING ROUTE.
THE EXISTENCE OF THESE TWO READING
DISORDERS PROVIDES
EVIDENCE THAT THESE TWO ROUTES FROM PRINT
TO SOUND
ARE SEPARATE FUNCTIONAL COMPONENTS
(MODULES) OF THE READING SYSTEM.
ANOTHER WAY TO STATE THIS IS THAT THE LEXICAL
AND NON-LEXICAL READING ROUTES ARE DOUBLY
DISSOCIABLE.
QUESTION 3
ACCORDING TO THE DIAGRAM OF THE READING SYSTEM:
PATIENTS WITH SEVERE DAMAGE TO THE SEMANTIC SYSTEM
WHO WERE
FULLY LITERATE BEFORE THE DAMAGE, SHOULD STILL BE ABLE
TO READ EXCEPTION WORDS LIKE ACHE, BEAD, PINT AND
LEOPARD
CORRECTLY, EVEN THOUGH THEY NO LONGER UNDERSTAND
THE MEANING
OF THESE WORDS
A) TRUE
B) FALSE
QUESTION 3
ACCORDING TO THE DIAGRAM OF THE READING SYSTEM:
PATIENTS WITH SEVERE DAMAGE TO THE SEMANTIC SYSTEM
WHO WERE
FULLY LITERATE BEFORE THE DAMAGE, SHOULD STILL BE ABLE
TO READ EXCEPTION WORDS LIKE ACHE, BEAD, PINT AND
LEOPARD
CORRECTLY, EVEN THOUGH THEY NO LONGER UNDERSTAND
THE MEANING
OF THESE WORDS
a)TRUE **
b) FALSE
QUESTION 4
IN FACT THOUGH, MANY PATIENTS WITH DEMENTIA (AND SEVERE
SEMANTIC IMPAIRMENT) DO HAVE DIFFICULTY READING
EXCEPTION WORDS. THUS — SURFACE DYSLEXIA IS QUITE
COMMON
IN PATIENTS WITH ALZHEIMER’S DISEASE AND SEMANTIC
DEMENTIA WHO
PREVIOUS TO THEIR DEMENTIA WERE FULLY LITERATE.
a)TRUE
b)FALSE
Consider the following result: Many patients with dementia (for
example, in cases of Alzheimer’s disease, or in cases of
semantic dementia) have semantic impairments (in the
Wernicke-Lichtheim diagram, Ideation is impaired). That is, word
meaning is impaired. Such patients generally also have difficulty
reading words with irregular spelling-to-sound patterns (for
example, dough, colonel, yacht). The worse the comprehension
impairment in dementia, the poorer the ability of the patient to
correctly read orthographically
irregular words aloud.
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35
QUESTION 4
IN FACT THOUGH, MANY PATIENTS WITH DEMENTIA (AND SEVERE
SEMANTIC IMPAIRMENT) DO HAVE DIFFICULTY READING
EXCEPTION WORDS. THUS — SURFACE DYSLEXIA IS QUITE
COMMON
IN ALZHEIMER’S DISEASE AND SEMANTIC DEMENTIA.
a)TRUE **
b)FALSE
QUESTION 5
BUT OCCASIONALLY, SOME PATIENTS WITH DEMENTIA (AND
SEVERE
SEMANTIC IMPAIRMENTS) HAVE NO DIFFICULTY READING
EXCEPTION WORDS. IN THESE PATIENTS, READING EXCEPTION
WORDS
IS INTACT (NORMAL) DESPITE SEVERE IMPAIRMENT TO THE
SEMANTIC
SYSTEM.
a)TRUE
b)FALSE
QUESTION 5
BUT OCCASIONALLY, SOME PATIENTS WITH DEMENTIA (AND
SEVERE
SEMANTIC IMPAIRMENTS) HAVE NO DIFFICULTY READING
EXCEPTION WORDS. IN THESE PATIENTS, READING EXCEPTION
WORDS
IS INTACT (NORMAL) DESPITE SEVERE IMPAIRMENT TO THE
SEMANTIC
SYSTEM.
a)TRUE **
b)FALSE
The problem of associations of
impairments
Consider the following result: Many patients with dementia (for example, in cases of
Alzheimer’s disease, or in cases of semantic dementia) have semantic impairments
(in the Wernicke-Lichtheim diagram, Ideation is impaired). That is, word meaning is
impaired. Such patients generally also have difficulty reading words with
irregular spelling-to-sound patterns (for example, dough, colonel,
yacht). The worse the comprehension impairment in dementia, the
poorer the ability of the patient to correctly read orthographically
irregular words aloud.
Except for the undeniable fact that occasionally a
patient with severe dementia shows no such
reading impairment; irregular words, even
uncommon words like jeopardy, tortoise, and
pharaoh are read aloud correctly, even though
the patient no longer retains any grasp of their
meaning.
Which result do we use to draw a conclusion
about the functional architecture of the reading
mechanism:
(i) The overwhelming majority of cases who show an
association between impaired comprehension and
reading aloud or
(ii) the handful of patients who show a dissociation?
General Atrophy in dementia affects the whole system
The alternative