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Handbook of Clinical Neurology 2018This chapter offers a perspective on the origin, operational definition, historic vicissitudes, and current status of Gerstmann syndrome. The main issues and controversy... (Review)
Review
This chapter offers a perspective on the origin, operational definition, historic vicissitudes, and current status of Gerstmann syndrome. The main issues and controversy accompanying Gerstmann syndrome throughout the years are reviewed. The clinical picture of Gerstmann syndrome as it emerges from a series of modern-day pure cases is described. In current clinical practice, a diagnosis of Gerstmann syndrome indicates the concomitant presence of four acquired symptoms: finger agnosia, acalculia, left-right disorientation, and agraphia. Finally, based on empiric work conducted in recent years, the chapter concludes with a new interpretation of Gerstmann syndrome. If seen as an instance of intraparietal disconnection, this classic parietal syndrome will acquire fresh clinical and theoretic significance.
Topics: Gerstmann Syndrome; History, 20th Century; History, 21st Century; Humans
PubMed: 29519471
DOI: 10.1016/B978-0-444-63622-5.00020-6 -
International Journal of Language &... Nov 2020Every language has certain specific idiosyncrasies in its writing system. Cross-linguistic analyses of alexias and agraphias are fundamental to understand commonalities...
BACKGROUND
Every language has certain specific idiosyncrasies in its writing system. Cross-linguistic analyses of alexias and agraphias are fundamental to understand commonalities and differences in the brain organization of written language. Few reports of alexias and agraphias in the Spanish language are currently available.
AIMS
To analyse the clinical manifestations of alexias and agraphias in Spanish, and the effect of demographic variables.
METHODS & PROCEDURES
Spanish versions of the Western Aphasia Battery (WAB) and Boston Diagnostic Aphasia Examination (BDAE) were used for language assessment. Lesion localization was obtained by using computed axial tomography and magnetic resonance imaging. The final sample included 200 patients: 195 (97.5%) right-handed and five (2.5%) left-handed; 119 men and 81 women with a mean age of 57.37 years (SD = 15.56), education of 13.52 years (SD = 4.08), and mean time post-onset of 6.58 months (SD = 12.94). Using the WAB, four quotients were calculated: aphasia quotient (AQ), reading-writing quotient (RWQ), language quotient (LQ) and cortical quotient (CQ).
OUTCOMES & RESULTS
The types of aphasia were: global = 11 patients (5.5%), Broca = 31 (15.5%), Wernicke = 30 (15.0%), conduction = 22 (11.0%), transcortical sensory = 17 (8.5%), transcortical motor = 3 (1.5%), amnesic or anomic = 54 (27.0%) and mixed non-fluent = 32 (16.0%). The degree of oral and written language impairment differed across the various aphasia types. Most severe reading and writing difficulties were found in global, mixed non-fluent and transcortical motor aphasia; fewer difficulties were observed in amnesic, Broca and conduction aphasia. The severity of the written language impairments paralleled the severity of the oral language disturbances. Age negatively, while schooling positively, correlated with the scores in reading and writing tests. No effect of sex and time since onset was found.
CONCLUSIONS & IMPLICATIONS
In Spanish-speaking aphasia patients, difficulties in reading and writing are similar to oral language difficulties. This similarity of performance is mostly based on severity rather than the participants' patterns of errors. What this paper adds What is already known on the subject There is limited information about alexia and agraphia in Spanish. What this paper adds to existing knowledge An extensive study with a large sample of patients. What are the potential or actual clinical implications of this work? The study contributes to the clinical management of patients with reading and writing disturbances.
Topics: Agraphia; Brain; Chile; Databases, Factual; Dyslexia, Acquired; Female; Humans; Language; Language Tests; Linguistics; Male; Middle Aged; Reading; Tomography, X-Ray Computed
PubMed: 32735061
DOI: 10.1111/1460-6984.12566 -
Handbook of Clinical Neurology 2022This chapter gives a broad overview of the description and theorizing of a wide range of language disorders resulting from brain damage, commonly classified under the... (Review)
Review
This chapter gives a broad overview of the description and theorizing of a wide range of language disorders resulting from brain damage, commonly classified under the umbrella term "aphasia." It covers works written in Antiquity up to the 20th century. Moreover, it looks at disturbances in various language modalities such as speech, language comprehension, reading, writing, and sign language. In addition, also forms of the more recently discovered primary progressive aphasia are discussed. Finally, important developments in the history of assessment and rehabilitation of language disorders are described. To properly characterize disorders of language, these developments are discussed from the perspectives of neurology, psychology, and linguistics.
Topics: Agraphia; Aphasia; Humans; Language; Reading; Speech
PubMed: 35078608
DOI: 10.1016/B978-0-12-823384-9.00017-7 -
Cerebellum (London, England) Feb 2015As early as the beginning of the nineteenth century, a variety of nonmotor cognitive and affective impairments associated with cerebellar pathology were occasionally... (Review)
Review
As early as the beginning of the nineteenth century, a variety of nonmotor cognitive and affective impairments associated with cerebellar pathology were occasionally documented. A causal link between cerebellar disease and nonmotor cognitive and affective disorders has, however, been dismissed for almost two centuries. During the past decades, the prevailing view of the cerebellum as a mere coordinator of autonomic and somatic motor function has changed fundamentally. Substantial progress has been made in elucidating the neuroanatomical connections of the cerebellum with the supratentorial association cortices that subserve nonmotor cognition and affect. Furthermore, functional neuroimaging studies and neurophysiological and neuropsychological research have shown that the cerebellum is crucially involved in modulating cognitive and affective processes. This paper presents an overview of the clinical and neuroradiological evidence supporting the view that the cerebellum plays an intrinsic part in purposeful, skilled motor actions. Despite the increasing number of studies devoted to a further refinement of the typology and anatomoclinical configurations of apraxia related to cerebellar pathology, the exact underlying pathophysiological mechanisms of cerebellar involvement remain to be elucidated. As genuine planning, organization, and execution disorders of skilled motor actions not due to motor, sensory, or general intellectual failure, the apraxias following disruption of the cerebrocerebellar network may be hypothetically considered to form part of the executive cluster of the cerebellar cognitive affective syndrome (CCAS), a highly influential concept defined by Schmahmann and Sherman (Brain 121:561-579, 1998) on the basis of four symptom clusters grouping related neurocognitive and affective deficits (executive, visuospatial, affective, and linguistic impairments). However, since only a handful of studies have explored the possible role of the cerebellum in apraxic disorders, the pathophysiological mechanisms subserving cerebellar-induced apraxia remain to be elucidated.
Topics: Agraphia; Apraxias; Cerebellum; Humans; Mastication; Radiography; Radionuclide Imaging; Speech Disorders
PubMed: 25382715
DOI: 10.1007/s12311-014-0620-1 -
Journal of Psycholinguistic Research Dec 2023Research regarding dysgraphia, an impairment in writing, is attaining more attention in recent times. The existing studies on dysgraphia draw insights from cognitive,...
Research regarding dysgraphia, an impairment in writing, is attaining more attention in recent times. The existing studies on dysgraphia draw insights from cognitive, behavioural, neurological, and genetic fields of knowledge. However, these multiple studies on dysgraphia fail to illustrate how these cognitive, behavioural, neurological, and genetic systems interact and intersect in dysgraphia. Therefore, the studies could not offer a comprehensive understanding of dysgraphia. In order to fill this gap, the review attempts to study dysgraphia using the notion of modularity by accommodating insights from cognitive, behavioural, neurological, and genetic aspects of dysgraphia. Such a profound understanding could facilitate an early diagnosis and holistic intervention towards dysgraphia.
Topics: Humans; Agraphia; Writing
PubMed: 37930468
DOI: 10.1007/s10936-023-10029-6 -
Parkinsonism & Related Disorders May 2016This review on micrographia aims to draw the clinician's attention to non-Parkinsonian etiologies, provide clues to differential diagnosis, and summarize current... (Review)
Review
INTRODUCTION
This review on micrographia aims to draw the clinician's attention to non-Parkinsonian etiologies, provide clues to differential diagnosis, and summarize current knowledge on the phenomenology, etiology, and mechanisms underlying micrographia.
METHODS
A systematic review of the existing literature was performed.
RESULTS
Micrographia, namely small sized handwriting has long been attributed to Parkinson's disease. However, it has often been observed as part of the clinical picture of additional neurodegenerative disorders, sometimes antedating the motor signs, or following focal basal ganglia lesions without any accompanying parkinsonism, suggesting that bradykinesia and rigidity are not sine-qua-non for the development of this phenomenon. Therefore, micrographia in a patient with no signs of parkinsonism may prompt the clinician to perform imaging in order to exclude a focal basal ganglia lesion. Dopaminergic etiology in this and other cases is doubtful, since levodopa ameliorates letter stroke size only partially, and only in some patients. Parkinsonian handwriting is often characterized by lack of fluency, slowness, and less frequently by micrographia. Deviations from kinematic laws of motion that govern normal movement, including the lack of movement smoothness and inability to scale movement amplitude to the desired size, may reflect impairments in motion planning, possible loss of automaticity and reduced movement vigor.
CONCLUSIONS
The etiology, neuroanatomy, mechanisms and models of micrographia are discussed. Dysfunction of the basal ganglia circuitry induced by neurodegeneration or disruption by focal damage give rise to micrographia.
Topics: Agraphia; Basal Ganglia; Handwriting; Humans; Hypokinesia; Nerve Net; Parkinson Disease
PubMed: 26997656
DOI: 10.1016/j.parkreldis.2016.03.003 -
BMJ Case Reports Apr 2017
Topics: Agraphia; Alopecia; Brain Neoplasms; Fatal Outcome; Female; Head and Neck Neoplasms; Humans; Language Disorders; Magnetic Resonance Imaging; Melanoma; Middle Aged; Scalp; Skin Neoplasms
PubMed: 28400390
DOI: 10.1136/bcr-2017-220215 -
Handbook of Clinical Neurology 2018The development and change of knowledge on the function of the parietal lobe from the second half of the 19th century to the early 1970s are reviewed. Motor and... (Review)
Review
The development and change of knowledge on the function of the parietal lobe from the second half of the 19th century to the early 1970s are reviewed. Motor and somatosensory functions were initially localized in a broad frontoparietal region. At the beginning of the 20th century the motor cortex was restricted to the posterior frontal lobe. The separate attribution of somatosensory functions to the parietal lobe was initially based on anatomic considerations, but mostly on localized bodily sensations elicited by electric stimulation in awake patients. Patients and nonhuman primates with anterior parietal damage showed deficits in somatic sensation (tactile discrimination and position sense, less markedly pain and thermal sensitivity). Somatosensory evoked potentials demonstrated in all mammals that the body is orderly and multiply represented in the anterior parietal cortex. The parietal lobe was divided into an anterior and a posterior cortex (PPC). The PPC is particularly developed in primates, where it includes a superior and an inferior parietal lobule. The PPC was initially thought to be a higher-order region for somatosensory information processing, but its functional specialization proved soon to be greater and more complex. PPC damage in humans gives rise to a variety of neuropsychologic disorders: pain asymbolia, sensory extinction, spatial neglect, optic ataxia and limb apraxia, alexia and agraphia. Single-neuron recordings in freely behaving monkeys furnished the complementary information that the PPC is involved in body-environment interactions, for visual exploration and hand use as a sensor and a tool. The PPC is now believed to underpin higher-order processes of sensory inputs, multisensory and sensorimotor integration, spatial attention, intention, and the conjoint representation of external space and the body. The symptoms in which disorders of these processes manifest after PPC damage are considerably different in humans and nonhuman primates.
Topics: Animals; History, 19th Century; History, 20th Century; Humans; Neurology; Neurophysiology; Parietal Lobe
PubMed: 29519464
DOI: 10.1016/B978-0-444-63622-5.00001-2 -
Behavioural Neurology 2019Acalculia is an acquired disorder in calculation abilities, usually associated with left posterior parietal damage. Two types of acalculic disorders are usually... (Review)
Review
Acalculia is an acquired disorder in calculation abilities, usually associated with left posterior parietal damage. Two types of acalculic disorders are usually distinguished: (1) primary acalculia or anarithmetia, where the patient presents a loss of numerical concepts (difficulties are observed both in oral and written calculations), and (2) secondary acalculia due to a different disturbance in cognition and affecting mathematical abilities. Secondary acalculias are associated with aphasia, alexia, agraphia, executive function disorders, or visuospatial difficulties. This paper is a proposal for clinical intervention to rehabilitation of acquired primary and secondary acalculias.
Topics: Cognition; Cognition Disorders; Dyscalculia; Humans; Mathematics; Neuropsychological Tests
PubMed: 31093301
DOI: 10.1155/2019/3151092 -
Archives of Clinical Neuropsychology :... Dec 2014Gerstmann's syndrome includes the clinical tetrad of finger agnosia, agraphia, acalculia, and right-left confusion. Some disagreement remains with regard to the exact... (Review)
Review
Gerstmann's syndrome includes the clinical tetrad of finger agnosia, agraphia, acalculia, and right-left confusion. Some disagreement remains with regard to the exact localization of the syndrome, but most probable it involves the left angular gyrus with a subcortical extension. Several authors have suggested that a defect in mental spatial rotations could simultaneously account for acalculia, right-left disorientation, and finger agnosia. It has been also suggested that semantic aphasia is always associated with acalculia; as a matter of fact, left angular gyrus has a significant involvement in semantic processing. In this paper, it is proposed that Gerstmann's syndrome should include: acalculia, finger agnosia, right-left disorientation, and semantic aphasia, but not agraphia. When the pathology extends toward the superior parietal gyrus, agraphia can be found. A fundamental defect (i.e., an impairment in verbally mediated spatial operations) could explain these apparently unrelated clinical signs.
Topics: Gerstmann Syndrome; Humans
PubMed: 25377466
DOI: 10.1093/arclin/acu056