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Impairments of procedures for implementing complex language are due to disruption of frontal attention processes

Published online by Cambridge University Press:  22 March 2006

MICHAEL P. ALEXANDER
MICHAEL P. ALEXANDER
Affiliation:
Harvard Medical School, Behavioral Neurology Unit, Beth Israel Deaconess Medical Center, Boston, Massachusetts
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Abstract

Production of complex discourse—lengthy, open-ended utterances and narratives—requires intact basic language operations, but it also requires a series of learned procedures for construction of complex, goal-directed communications. The progression of clinical disorders from transcortical motor aphasia to dynamic aphasia to discourse impairments represents a progression of procedural deficits from basic morpho-syntax to complex grammatical structures to narrative and a progression of lesions from posterior frontal to polar and/or lateral frontal to medial frontal. Two cases of impaired utilization of language exemplify the range of impairments from clearly aphasic agrammatic, nonfluency to less and less “aphasic” and more and more executive impairments from transcortical motor aphasia to dynamic aphasia to narrative discourse disorder. The clinical phenomenology of these disorders gradually comes to be more accurately defined in the terminology of executive deficits than that of aphasia. The executive deficits are, in turn, based on impairments in various components of attention. Specific impairments in energizing attention and setting response criteria associated, respectively, with lesions in superior medial and left ventrolateral frontal regions may cause defective recruitment of the procedures of complex language assembly. (JINS, 2006, 12, 236–247.)

Keywords

DiscourseExecutive functionAttentionAphasiaCerebellumCaudate
Type
SYMPOSIUM
Information
Journal of the International Neuropsychological Society , Volume 12 , Issue 2 , March 2006 , pp. 236 - 247
Copyright
© 2006 The International Neuropsychological Society

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References

REFERENCES

Alexander, G.E., DeLong, M.R., & Strick, P.L. (1986). Parallel organization of functionally segregated circuits linking basal ganaglia and cortex. Annual Review of Neuroscience, 9, 357–381.CrossRefGoogle Scholar
Alexander, M.P., Naeser, M.A., & Palumbo, C. (1990). Broca's area aphasia. Neurology, 40, 353–362.CrossRefGoogle Scholar
Alexander, M.P., Stuss, D.T., Shallice, T., Picton, T., & Gillingham, S. (2005). Impaired concentration due to frontal lobe damage from two distinct lesion sites. Neurology, 65, 572–579.CrossRefGoogle Scholar
Allen, G., Buxton, R.B., Wong, E.C., & Courchesne, E. (1997). Attentional activation of the cerebellum independent of motor involvement. Science, 275(5308), 1940–1943.CrossRefGoogle Scholar
Brownell, H.H., Simpson, T.L., Bihrle, A.M., Potter, H.H., & Gardner, H. (1990). Appreciation of metaphoric alternative word meanings by left and right brain-damaged patients. Neuropsychologia, 28(4), 375–383.CrossRefGoogle Scholar
Burgess, P.W., Simons, J.S., Dumontheil, I., & Gilbert, S.J. (2005). The gateway hypothesis of rostral prefrontal cortex (Area 10) function. In J. Duncan, L. Phillips, & P. McLeod (Eds.), Speed, control and age: In honour of Patrick Rabbitt (pp. in press). Oxford: Oxford University Press.
Chapman, S.B., Levin, H.S., Wanek, A., Weyrauch, J., & Kufera, J. (1998). Discourse after closed head injury in young children. Brain and Language, 61, 420–449.CrossRefGoogle Scholar
Chapman, S.B., Max, J.E., Gamino, J.F., McGlothlin, J.H., & Cliff, S.N. (2003). Discourse plasticity in children after stroke: Age at injury and lesion effects. Pediatric Neurology, 29, 34–41.CrossRefGoogle Scholar
Chapman, S.B. & Ulatowska, H.K. (1989). Discourse in aphasia: Integration deficits in processing reference. Brain and Language, 36, 651–668.CrossRefGoogle Scholar
Chatterjee, A., Yapundich, R., Mennemeier, M., Mountz, J.M., Inampudi, C., Pan, J.W., & Mitchell, G.W. (1997). Thalamic thought disorder: On being “a bit addled.” Cortex, 33, 419–440.Google Scholar
Costello, A.L. & Warrington, E.K. (1989). Dynamic aphasia. The selective impairment of verbal planning. Cortex, 25, 103–114.Google Scholar
Crosson, B., Sadek, J.R., Maron, L., Gokçay, D., Mohr, C.M., Auerbach, E.J., Freeman, A.J., Leonard, C.M., & Briggs, R.W. (2001). Relative shift in activity from medial to lateral frontal cortex during internally versus externally guided word generation. Journal of Cognitive Neuroscience, 13, 272–283.CrossRefGoogle Scholar
Crozier, S., Sirigu, A., Lehericy, S., van de Moortele, P.F., Pillon, B., Grafman, J., Agid, Y., Dubois, B., & LeBihan, D. (1999). Distinct prefrontal activations in processing sequence at the sentence and script level: An fMRI study. Neuropsychologia, 37, 1469–1476.CrossRefGoogle Scholar
Cummings, J.L. (1993). Frontal-subcortical circuits and human behavior. Archives of Neurology, 50, 873–880.CrossRefGoogle Scholar
Davis, G.A., O'Neil-Pirozzi, T.M., & Coon, M. (1997). Referential cohesion and logical coherence of narration after right hemisphere stroke. Brain and Language, 56, 183–210.CrossRefGoogle Scholar
Diamond, A. (2002). Normal development of prefrontal cortex from birth to young adulthood: Cognitive functions, anatomy and biochemistry. In D.T. Stuss & R.T. Knight (Eds.), Principles of frontal lobe function, (pp. 466–503). Oxford: Oxford University Press.
Ewing-Cobbs, L., Brookshire, B., Scott, M.A., & Fletcher, J.M. (1998). Children's narratives following traumatic brain injury: Linguistic structure, cohesion, and thematic recall. Brain and Language, 61, 395–419.CrossRefGoogle Scholar
Fiez, J.A., Raife, E.A., Balota, D.A., Schwarz, J.P., Raichle, M.E., & Petersen, S.E. (1992). Impaired non-motor learning and error detection associated with cerebellar damage. Brain, 115, 155–178.CrossRefGoogle Scholar
Freedman, M., Alexander, M.P., & Naeser, M.A. (1984). Anatomic basis of transcortical motor aphasia. Neurology, 34, 409–417.CrossRefGoogle Scholar
Freeman, F.R. (1971). Akinetic mutism and bilateral anterior cerebral artery occlusion. Journal of Neurology, Neurosurgery and Psychiatry, 34, 693–698.CrossRefGoogle Scholar
Galski, T., Tompkins, C., & Johnston, M.V. (1998). Competence in discourse as a measure of social integration and quality of life in persons with traumatic brain injury. Brain Injury, 12, 769–782.CrossRefGoogle Scholar
Gasparini, M., Di Piero, V., Ciccarelli, O., Cacioppo, M.M., Pantano, P., & Lenzi, G.L. (1999). Linguistic impairment after right cerebellar stroke: A case report. European Journal of Neurology, 6, 353–356.CrossRefGoogle Scholar
Gelmers, H.J. (1983). Non-paralytic motor disturbances and speech disorders: The role of the supplementary motor area. Journal of Neurology, Neurosurgery and Psychiatry, 46, 1052–1054.CrossRefGoogle Scholar
Godefrey, O., Rousseaux, M., Leys, D., Desteé, A., Scheltens, P., & Pruvo, J.P. (1992). Frontal lobe dysfunction in unilateral lenticulostriate infarcts: Prominent role of cortical lesions. Archives of Neurology, 49, 1285–1289.CrossRefGoogle Scholar
Goel, V., Grafman, J., Tajik, J., Gana, S., & Danto, D. (1997). A study of the performance of patients with frontal lobe lesions in a financial planning task. Brain, 120, 1805–1822.CrossRefGoogle Scholar
Goodglass, H. & Kaplan, E. (1983). The assessment of aphasia and related disorders. Philadelphia: Lea & Febiger.
Grindrod, C.M. & Baum, S.R. (2005). Hemispheric contributions to lexical ambiguity resolution in a discourse context: Evidence from individuals with unilateral left and right hemisphere lesions. Brain and Cognition, 57, 70–83.CrossRefGoogle Scholar
Huttenlocher, P.R. (1979). Synaptic density in human frontal cortex—developmental changes and effects of aging. Brain Research, 163, 195–205.Google Scholar
Kaczmarek, B.L.J. (1984). Neurolinguistic analysis of verbal utterances in patients with focal lesions of frontal lobes. Brain and Language, 21, 52–58.CrossRefGoogle Scholar
Kaplan, E., Goodglass, H., & Weintraub, S. (1983). The Boston Naming Test. Philadelphia: Lea & Febiger.
Luria, A.R. & Tsevtkova, L.S. (1967). Towards the mechanism of “dynamic aphasia.” Acta Neurologica Psychiatrica Belgica, 67, 1045–1067.Google Scholar
Mackenzie, C. (2000). Adult spoken discourse: The influences of age and education. International Journal of Language and Communication Disorders, 35, 269–285.CrossRefGoogle Scholar
Marien, P., Engelborghs, S., Fabbro, F., & De Deyn, P.P. (2001). The lateralized linguistic cerebellum: A review and a new hypothesis. Brain and Language, 79, 580–600.CrossRefGoogle Scholar
Marien, P., Saerens, J., Nanhoe, R., Moens, E., Nagels, G., Pickut, B.A., Dierckx, R.A., & De Deyn, P.P. (1996). Cerebellar induced aphasia: Case report of cerebellar induced prefrontal aphasic language phenomena supported by spect findings. Journal of Neurological Sciences, 144, 34–43.CrossRefGoogle Scholar
Masdeu, J.C., Schoene, W.C., & Funkenstein, H.H. (1978). Aphasia following infarction of the left supplementary motor area. Neurology, 28, 1220–1223.CrossRefGoogle Scholar
Mega, M.S. & Alexander, M.P. (1994). The core profile of subcortical aphasia. Neurology, 44, 1824–1829.CrossRefGoogle Scholar
Middleton, F.A. & Strick, P.L. (2000). Basal ganglia and cerebellar loops: Motor and cognitive circuits. Brain Research Review, 31, 236–250.CrossRefGoogle Scholar
Mohr, J.P., Pessin, M.S., Finkelstein, S., Funkenstein, H.H., Duncan, G.W., & Davis, K.R. (1978). Broca's aphasia: Pathologic and clinical. Neurology, 28, 311–324.CrossRefGoogle Scholar
Nadeau, S. (1988). Impaired grammar with normal fluency and phonology. Brain, 111, 1111–1137.CrossRefGoogle Scholar
Novoa, O.P. & Ardila, A. (1987). Linguistic abilities in patients with prefrontal damage. Brain and Language, 30, 206–225.CrossRefGoogle Scholar
Petersen, S.E., Fox, P.T., Posner, M.I., Mintum, M.A., & Raichle, M.E. (1989). Positron emission tomograpic studies of the processing of single words. Journal of Cognitive Neuroscience, 1, 153–170.CrossRefGoogle Scholar
Pinker, S. (1991). Rules of language. Science, 253, 530–535.CrossRefGoogle Scholar
Reilly, J.S., Bates, E.A., & Marchman, V.A. (1998). Narrative discourse in children with early focal brain injury. Brain and Language, 61, 335–375.CrossRefGoogle Scholar
Robinson, G., Blair, J., & Cipolotti, L. (1998). Dynamic aphasia: An inability to select between competing verbal responses? Brain, 121, 77–89.Google Scholar
Rubens, A.B. (1976). Transcortical motor aphasia. Studies in Neurolinguistics, 1, 293–306.Google Scholar
Schmahmann, J.D. & Sherman, J.C. (1998). The cerebellar cognitive affective syndrome. Brain, 121, 561–579.CrossRefGoogle Scholar
Schwartz, M.F., Reed, E.S., Montgomery, M.W., Palmer, C., & Mayer, N.H. (1991). The quantitative description of action disorganization after brain damage: A case study. Cognitive Neuropsychology, 8, 381–414.CrossRefGoogle Scholar
Shallice, T. & Burgess, P.W. (1991). Deficits in strategy application following frontal lobe damage in man. Brain, 114, 727–741.CrossRefGoogle Scholar
Silveri, M.C., Leggio, M.G., & Molinari, M. (1994). The cerebellum contributes to linguistic production: A case of agrammatic speech following a right cerebellar lesion. Neurology, 44, 2047–2050.CrossRefGoogle Scholar
Sirigu, A., Cohen, L., Zalla, T., Pradat-Diehl, P., Van Eeckhout, P., Grafman, J., & Agid, Y. (1998). Distinct frontal regions for processing sentence syntax and story grammar. Cortex, 34, 771–778.CrossRefGoogle Scholar
Sowell, E.R., Delis, D., Stile, J., & Jernigan, T.L. (2001). Improved memory functioning and frontal lobe maturation childhood and adolescence: A structural MRI study. Journal of the International Neuropsychology Society, 7, 312–322.CrossRefGoogle Scholar
Sowell, E.R., Thompson, P.M., Holmes, C.J., Batth, R., Jernigan, T.L., & Toga, A.W. (1999). Localizing changes in brain structure between childhood and adolescence using statistical parametric mapping. NeuroImage, 9, 587–597.CrossRefGoogle Scholar
Stuss, D.T., Binns, M., Murphy, K.J., & Alexander, M.P. (2002). Dissociations within the anterior attentional system: Effects of task complexity and irrelevant information on reaction time and accuracy. Neuropsychology, 16, 500–513.CrossRefGoogle Scholar
Stuss, D.T., Alexander, M.P., Hamer, L., Palumbo, C., Dempster, R., Binns, M., Levine, B., & Izukawa, D. (1998). The effects of focal anterior and posterior brain lesions on verbal fluency. Journal of the International Neuropsychology Society, 4, 265–278.Google Scholar
Stuss, D.T., Alexander, M.P., Palumbo, C., Buckle, L., & Pogue, J. (1994). Organizational strategies of patients with unilateral and bilateral frontal lobe injury in word list learning tasks. Neuropsychology, 8, 355–373.CrossRefGoogle Scholar
Stuss, D.T., Alexander, M.P., Shallice, T., Picton, T., Binns, M., Macdonald, R., Borowiec, A., & Katz, D.I. (2005). Multiple frontal systems controlling response speed. Neuropsychologia, 43, 396–417.CrossRefGoogle Scholar
Stuss, D.T., Floden, D., Alexander, M.P., Levine, B., & Katz, D.I. (2001). Stroop performance in focal lesion patients: Dissociation of processes and frontal lesion location. Neuropsychologia, 39, 771–786.CrossRefGoogle Scholar
Stuss, D.T., Shallice, T., Alexander, M.P., & Picton, T. (1995). A multidisciplinary approach to anterior attentional functions. Annals of the New York Academy of Sciences, 769, 191–212.CrossRefGoogle Scholar
Ulatowska, H.K., Freedman-Stern, R., Doyel, A.W., Macaluso-Haynes, S., & North, A.J. (1983). Production of narrative discourse in aphasia. Brain and Language, 19, 317–334.CrossRefGoogle Scholar
Ullman, M.T., Corkin, S., Coppola, M., Hickok, G., Growdon, J.H., Koroshetz, W.J., et al. (1997). A neural dissociation within language: Evidence that the mental dictionary is part of declarative memory, and the grammatical rules are processed by the procedural system. Journal of Cognitive Neuroscience, 9, 266–276.CrossRefGoogle Scholar
Van Donegan, H.R., Loonen, M.C.B., & Van Donegan, K.J. (1985). Anatomical basis for acquired fluent aphasia in children. Annals of Neurology, 17, 306–309.Google Scholar
Von Stockert, T.R. (1974). Aphasia sine aphasie. Brain and Language, 1, 277–282.CrossRefGoogle Scholar
Yakovlev, P.I. & Locke, S. (1961). Limbic nuclei of the thalamus and connections of limbic cortex. iii. Corticocortical connections of the anterior cingulate gyrus, the cingulum and the subcallosal bundle in monkey. Archives of Neurology, 5, 364–400.CrossRefGoogle Scholar