Tomoyuki Kojima

In Japan, the “key word method” is often used to improve kana (phonemic characters) processing in aphasic patients who exhibit difficulty in processing kana but demonstrate the ability to process kanji (ideographic symbols). In this study, we employed a training program for phonetic reading of individual kanji letters using the key word method. The patient was a 46-year-old right-handed university professor. Fifteen months after onset of cerebral infarction, he was referred to our hospital and diagnosed with mild amnesic aphasia with severe disturbance in reading individual kanji letters phonetically despite well preserved abilities in oral reading of kanji compound words which represent concrete meanings. We started him on a training program using the key word method for reading individual kanji phonetically. In the program, he was required to form an association between a single kanji letter and a kanji compound word with the same sound in the first syllable which he could easily understand in meaning and read aloud. After five days of training, severity of his disturbance in phonetic reading of kanji letters markedly decreased. Our findings suggest that the access route to phonetic information which individual kanji letters represent is facilitated by information processing of kanji compound words, which include not only phonetic information but also semantic information. Moreover, the key word method is considered effective in the treatment of aphasic patients who have difficulty processing letters phonetically but demonstrate preserved abilities for processing words visual-semantically, not only with respect to training for kana reading but also training for reading kanji phonetically. © 1999, The Japan Society of Logopedics and Phoniatrics. All rights reserved.

Prospective and retrospective language evaluations and single photon emission computed tomography (SPECT) scans were performed in order to study the relationship between post-stroke recovery from aphasia and changes in cerebral blood flow (CBF) in groups of patients who had made a good recovery and those who]aad not. For the prospective study, 20 right-handed patients with aphasia secondary to an acute cerebrovascular accident (CVA) in the left middle cerebral artery territory received language evaluations with a Japanese Standard Language Test of Aphasia (SLTA), and SPECT scans performed twice, at a mean of 3.2 and a mean of 9.2 months post-onset. Only one slice of SPECT data was analysed. A significant correlation was observed between the severity of the initial language deficit and initial CBF on the left side, but not the right, Initial CBF was not a predictor for future language recovery in either hemisphere. There was a correlation between the change in the left mean hemispheric CBF (but not the right) and the change in the overall SLTA severity rating from 3 to 9 months poststroke. In the retrospective study, 16 right-handed patients with residual aphasia secondary to CVA in the left middle cerebral artery territory received SLTA and SPECT at a mean of 82.8 months post-onset, The patients had also received initial language evaluation with SLTA at a mean of 6.5 months post-onset. In contrast to the prospective study, the results demonstrated that the mean left hemispheric CBF at similar to 7 years post-onset did not differ between good and poor recovery groups, However, the mean right hemispheric CBF of the good recovery group was higher than that of the poor recovery group in the frontal and the thalamic regions, and also in the left frontal region. The results of these complementary studies suggest that the initial language recovery within the first year post-onset may be linked primarily to functional recovery in the dominant hemisphere, where an increase in CBF was observed at 9 months post-onset. The increased perfusion adjacent to the lesion may be crucial for early recovery in aphasia, Subsequent language recovery and the long-term recovery in aphasia may be related to slow and gradual compensatory functions in the contralateral hemisphere, specifically in the homotopic frontal and thalamic areas.

We reported a case of Wernicke's aphasia which showed approximately 10 % correct answers in naming of the patient's own family members, in spite of scoring 40 % on the naming task of the Standard Language Test of Aphasia (SLTA). First we suspected so-called "category-specific naming disorder" regarding family members ; however, on a subsequent naming test including 10 other semantic categories, the subject exhibited different severities depending on the semantic category. That is, over 75 % for the category of body parts ; from 25 to 50 % for means of transportation, fruits, vegetables, animals and musical instruments ; and less than 25 % for famous domestic places, family members, fingers and colors. The present study investigated the mechanism underlying the naming disorder by assuming a hierachical structure among semantic categories and applying to it the above results. We concluded that this case's naming disorder is not limited to a specific category but appears with different severities depending on the hierarchical structure of the semantic categories.

This study attempted to investigate within-subject stability of latency of event-related potentials (ERPs) from the stage W to the stage 1. We performed an auditory discrimination paradigm repeatedly more than three times for nine normal adults. During the experiments, the EEG was recorded simultaneously. The latencies of the N1, P2, N2 and P3 components in the averaged wave forms were measured. And we studied the stability of the latencies in the subjects in the stage W and the influence of drowsy (early stage 1) or very light sleep (late stage 1) on the variability of the latencies. As a result, (1) coefficient of variance (CV) of the latencies showed the significant difference between subjects even in the stage W, (2) Between-subject variability of CV of the latencies was more statistically eminent in the subjects in the stage 1 than those in the stage W, (3) in the stage of drowsy, instability of alpha wave during the experiment and synchronization of alpha wave after the target stimuli were considered to influence the averaged wave forms, (4) in the stage of very light sleep, the "sleep and wake" pattern which was triggered by the target stimuli was repeated, and this pattern was thought to be different from the process of attention in the awake stage in the brain.

The purpose of this study was to clarify disorders of calculation using figures in brain-damaged patients and to investigate their features and the concept of “pure” disorders of calculation. The following tests were used (1) writing and speaking of serial numbers (1–20), (2) matching tasks (number and number of circles), (3) multiplication tables, and (4) calculation with figures. The subjects were left-hemisphere-damaged patients (aphasics and non-aphasics), right-hemisphere-damaged patients (unilateral spatial neglects : USN and non-unilateral spatial neglects : non-USN), senile dementia of Alzheimer type and normal controls. Analysis of the results showed that aphasics, USNs and senile dementia of Alzheimer type patients performed significantly worse than non-aphasics, non-USNs and normal controls. We concluded that disorders of calculation using figures are caused by disorders of language information processes in aphasics, disorders of spatial information processes in USNs, and general disorders of brain function in dementia patients. The cases of “pure” acalculia reported in the literatures also could be inter preted as the results of the disturbance in the information processes discussed above Based on these findings, we believe that disorders of calculation using figures may possibly not be isolated but rather be secondary by-products of other disorders of higher brain functions. © 1992, The Japan Society of Logopedics and Phoniatrics. All rights reserved.

: We developed a notebook named “Communication-Notebook” as aid for a practical communication and investigated its use by 22 aphasic patients. The Communication-Notebook is a notebook with photographs, drawings, and/or Kanji -words of articles thought to be important in the daily lives of the patients. We investigated how the Communication-Notebook was used and examined its efficacy as a practical communication tool. The results are summarized as follows. (1) In order to utilize the Communication-Notebook effectively, a patient must maintain a satisfactory mental function, be highly motivated toward communication, be socially minded, and be in a favorable communicative environment. (2) The Communication-Notebook can be a practical communication tool from the comparatively acute stage of aphasia. (3) Since there are topics of conversation in which the Communication-Notebook is not available, alternative communication methods are necessary. (4) For optimum use of the Communication-Notebook, it should be explained not only to patients, but also to their family members and persons who take care of them in daily life. © 1991, The Japan Society of Logopedics and Phoniatrics. All rights reserved.