1. wernicke's Aphasia Oct 2, 2015 – DAY 16
Brain & Language
LING
NSCI
Fall 2015

2. Brain & Language - Harry Howard - Tulane University
10/02/15
Brain & Language - Harry Howard - Tulane University
Course organization
Fun with
I am still working on grading.

3. Brain & Language - Harry Howard - Tulane University
10/02/15
Brain & Language - Harry Howard - Tulane University
STS 2
review

4. A phonological network in the superior temporal sulcus
10/02/15
Brain & Language - Harry Howard - Tulane University
A phonological network in the superior temporal sulcus

5. Distinguishing speech from non-speech
10/02/15
Brain & Language - Harry Howard - Tulane University
Distinguishing speech from non-speech
{Binder et al., 2000} presented subjects with noise, tones, words, pseudo-words and reversed words while undergoing fMRI scanning.
The STS was more active in both hemispheres in response to speech (the words) than to the tones.

6. The TRACE II model of lexical retrieval or word recognition
10/02/15
Brain & Language - Harry Howard - Tulane University
The TRACE II model of lexical retrieval or word recognition

7. Brain & Language - Harry Howard - Tulane University
10/02/15
Brain & Language - Harry Howard - Tulane University
Wernicke's area

8. Brain & Language - Harry Howard - Tulane University
10/02/15
Brain & Language - Harry Howard - Tulane University
Wikipedia

9. Language areas of the brain
10/02/15
Brain & Language - Harry Howard - Tulane University
Language areas of the brain
What view of the brain is this?

10. Brain & Language - Harry Howard - Tulane University
10/02/15
Brain & Language - Harry Howard - Tulane University
Old vs. new

11. The Broca-Wernicke-Lichtheim model (of the LH)
10/02/15
Brain & Language - Harry Howard - Tulane University
The Broca-Wernicke-Lichtheim model (of the LH)

12. Wernicke's aphasia, Introduction
10/02/15
Brain & Language - Harry Howard - Tulane University
Wernicke's aphasia, Introduction
Imagine your favorite doctor joke.
They usually begin with “a guy walks into a doctor’s office …”
Now imagine that the guy, or woman, is a patient with Wernicke’s aphasia …

13. Short samples of Wernicke's aphasia
10/02/15
Brain & Language - Harry Howard - Tulane University
Short samples of Wernicke's aphasia
Clinician: “Tell me where you live.”
Patient: “Well, it’s a meender place and it has two … two of them. For dreaming and pinding after supper. And up and down. Four of down and three of up …” (Brookshire 2003:155)
Clinician: “What’s the weather like today?”
Patient: “Fully under the jimjam and on the altigrabber.” (Brookshire 2003:155)
What is broken? What is preserved?

14. A long sample of Wernicke's aphasia
10/02/15
Brain & Language - Harry Howard - Tulane University
A long sample of Wernicke's aphasia
Patient is asked what brought him to the hospital.
“Is this some of the work that we work as we did before? … All right … From when wine [why] I’m here. What’s wrong with me because I … was myself until the taenz took something about the time between me and my regular time in that time and they took the time in that time here and that’s when the the time took around here and saw me around in it’s started with me no time and I bekan [began] work of nothing else that’s the way the doctor find me that way…” (Obler & Gjerlow 1999:43)

15. Phonemic paraphasia & neologism
10/02/15
Brain & Language - Harry Howard - Tulane University
Phonemic paraphasia & neologism
Errors in the selection of phonemes include addition, omission, or change in position. For instance, Damasio (1992:535) cites
trable for table
pymarid for pyramid.
Clearly, the more such phonemic paraphasias accumulate in a word, the harder it is to understand it, to the extent that the intended word may become unidentifiable.
This is the point of neologism, illustrated in another of Damasio’s examples:
hipidomateous for hippopotamus.
Patients with severe Wernicke's aphasia may produce strings of neologisms with a sprinkling of connecting words, known as jargon

16. Wernicke's aphasia on YouTube
10/02/15
Brain & Language - Harry Howard - Tulane University
Wernicke's aphasia on YouTube

17. Brain & Language - Harry Howard - Tulane University
10/02/15
Brain & Language - Harry Howard - Tulane University
Semantic paraphasia
A patient with damage to Wernicke's region may also fail to select the proper words with which to convey her ideas, though this deficit can be compensated for by the usage of paraphrases.
Such semantic paraphasias (or empty speech) are often quite simple, such as relying on generic terms like thing or stuff to stand in for the more specific words that do not spring to mind.
Other times, they become quite elaborate.
Kandel (1995:640) cites the example of a Wernicke’s patient who was asked where he lived and answered:
“I came there before here and returned there.”
“A patient with moderate Wernicke's aphasia was attempting to explain what he had done on a shopping trip the previous day. He concluded with,
‘I went down to the thing to do the other one and she was only the last one that ever did it, so I never did.’” (Brookshire 2003:155)

18. Brain & Language - Harry Howard - Tulane University
10/02/15
Brain & Language - Harry Howard - Tulane University
Circumlocution
Some Wernicke’s patients talk around missing words, a behavior called circumlocution.
A patient with moderate Wernicke’s aphasia was attempting to tell the examiner what she had had for breakfast that morning:
Patient: “This morning for – that meal – the first thing this morning – what I ate – I dined on – chickens, but little – and pig – pork – hen fruit and some bacon, I guess.” (Brookshire 2003:156)

19. Wernicke's aphasia on YouTube
10/02/15
Brain & Language - Harry Howard - Tulane University
Wernicke's aphasia on YouTube

20. Logorrhea, press of speech
10/02/15
Brain & Language - Harry Howard - Tulane University
Logorrhea, press of speech
The ease with which Wernicke's patients produce speech, their circumlocution, and their deficient self-monitoring may contribute to their inclination to run on when they talk.
Such an overabundance of speech is referred to as logorrhea or press of speech.
Clinician: “Tell me what you do with a comb.”

21. Logorrhea, press of speech
10/02/15
Brain & Language - Harry Howard - Tulane University
Logorrhea, press of speech
Patient: “What do I do with a comb … what I do with a comb. Well a comb is a utensil or some such thing that can be used for arranging and rearranging the hair on the head both by men and by women. One could also make music with it by putting a piece of paper behind and blowing through it. Sometimes it could be used in art – in sculpture, for example, to make a series of lines in soft clay. It’s usually made of plastic and usually black, although it comes in other colors. It is carried in the pocket or until it’s needed, when it is taken out and used, then put back in the pocket. Is that what you had in mind?” (Brookshire 2003:155)

22. Aphasia checklist: Wernicke’s
10/02/15
Brain & Language - Harry Howard - Tulane University
Aphasia checklist: Wernicke’s
comprehension of spoken material
segmental phonology
word selection
word semantics
fluency (production of speech)
production of writing
use function words
grammaticality
repetition of what others say
conversational proficiency, e.g. turn taking
concern about impairment
concern about errors
short-term retention & recall of verbal materials
impaired
impaired: circumlocution
impaired: semantic paraphasia, empty speech
normal?
(overly) fluent: logorrhea
normal
normal or mildly impaired: paragrammatism
impaired: (no evidence)
little to none

23. Brain & Language - Harry Howard - Tulane University
10/02/15
Brain & Language - Harry Howard - Tulane University
NEXT TIME
Q4 on Blackboard, The sensorimotor interface