Cases reported "Language Disorders"

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1/41. Neuropsychological consequences of cerebellar tumour resection in children: cerebellar cognitive affective syndrome in a paediatric population.

    Acquired cerebellar lesions in adults have been shown to produce impairments in higher function as exemplified by the cerebellar cognitive affective syndrome. It is not yet known whether similar findings occur in children with acquired cerebellar lesions, and whether developmental factors influence their presentation. In studies to date, survivors of childhood cerebellar tumours who demonstrate long-term deficits in cognitive functions have undergone surgery as well as cranial irradiation or methotrexate treatment. Investigation of the effects of the cerebellar lesion independent of the known deleterious effects of these agents is important for understanding the role of the cerebellum in cognitive and affective development and for informing treatment and rehabilitation strategies. If the cerebellar contribution to cognition and affect is significant, then damage in childhood may influence a wide range of psychological processes, both as an immediate consequence and as these processes fail to develop normally later on. In this study we evaluated neuropsychological data in 19 children who underwent resection of cerebellar tumours but who received neither cranial irradiation nor methotrexate chemotherapy. Impairments were noted in executive function, including planning and sequencing, and in visual-spatial function, expressive language, verbal memory and modulation of affect. These deficits were common and in some cases could be dissociated from motor deficits. Lesions of the vermis in particular were associated with dysregulation of affect. Behavioural deficits were more apparent in older than younger children. These results reveal that clinically relevant neuropsychological changes may occur following cerebellar tumour resection in children. Age at the time of surgery and the site of the cerebellar lesion influence the neurobehavioural outcome. The results of the present study indicate that the cerebellar cognitive affective syndrome is evident in children as well as in adults, and they provide further clinical evidence that the cerebellum is an essential node in the distributed neural circuitry subserving higher-order behaviours.
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ranking = 1
keywords = visual
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2/41. Establishing joint visual attention and pointing in autistic children with no functional language.

    Joint visual attention is defined as looking where someone else is looking. The purpose of this study was to examine the conditions for establishing joint visual attention in autistic children who have no functional speech. An experimenter, sitting facing the child, looked at one of six pictures near the child. Analysis showed that joint visual attention to stimuli behind the child and therefore outside of the visual field occurred at a higher rate when the visual angle between the stimuli was about 60 degrees. Spontaneous pointing at the target object increased with training which included feedback and physical guidance. These results are discussed in terms of the effects of environmental variables and perceptual mechanisms on the emergence of joint visual attention in autistic children. The possibility of using an adult's social cues and expanding the child's visual field as a remedial procedure is also addressed.
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ranking = 11
keywords = visual
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3/41. Crossed nonaphasia in a dextral with left hemispheric lesions: a functional magnetic resonance imaging study of mirrored brain organization.

    BACKGROUND: General conclusions concerning mechanisms of cerebral lateralization may be learned from the investigation of functional brain organization in patients with anomalous lateralization. CASE DESCRIPTION: The functional organization of language, attention, and motor performance was investigated in a 42-year-old patient with crossed nonaphasia by means of functional MRI. The strongly right-handed man experienced a left middle cerebral artery infarction documented by MRI without exhibition of aphasia. However, the left hemispheric stroke was accompanied by visuospatial impairment, right-sided slight sensory and motor paresis, and right homonymous hemianopia. No history of familial sinistrality or prior neurological illness was present. Functional MR language mapping revealed strong right hemispheric activation in inferior frontal and superior temporal cortices. Finger tapping with the right hand recruited ipsilateral premotor and motor areas as well as supplementary motor cortex. A Stroop task, usually strongly associated with left-sided inferior frontal activation in dextrals, resulted in strong right hemispheric frontal activation. CONCLUSIONS: From our data there is clear evidence that different modalities, such as language perception and production, attention, and motor performance, are processed exclusively by 1 hemisphere when atypical cerebral dominance is present.
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ranking = 11.028870619541
keywords = cortex
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4/41. sign language in childhood epileptic aphasia (landau-kleffner syndrome).

    Acquired epileptic aphasia (AEA, or landau-kleffner syndrome) is a unique condition in which children can lose oral language (OL) comprehension and expression for a prolonged period. These children can benefit from visual forms of language, mainly sign language (SL), but the quality of SL has never been analyzed. The case is reported here of a boy with AEA who lost speech comprehension and expression from 3 years 6 months to 7 years and was educated in SL from the age of 6 years. His SL was evaluated at the age of 13 years and 6 months and compared with a control child with congenital sensorineural deafness. It was found that: (1) our patient achieved the same proficiency in SL as the control child with deafness; (2) SL learning did not compete with, but perhaps even hastened, the recovery of OL. Intact ability to learn a new linguistic code such as SL suggests that higher-order language areas were preserved and received input from a separate visual route, as shown by neuropsychological and functional imaging research in deaf and hearing signers.
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ranking = 2
keywords = visual
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5/41. Late plasticity for language in a child's non-dominant hemisphere: a pre- and post-surgery fMRI study.

    The ability of the right hemisphere to sustain the acquisition or the recovery of language after extensive damage to the left hemisphere has been essentially related to the age at the time of injury. Better language abilities are acquired when the insult occurs in early childhood (perinatal insults) compared with later occurrence. However, while previous studies have described the neuropsychological pattern of language development in typical cases, the neural bases of such plasticity remain unexplored. Non-invasive functional MRI (fMRI) is a unique tool to assess the neural correlates of brain plasticity through repeated studies, but the technique has not been widely used in children because of methodological limitations. Plasticity of language was studied in a boy who developed intractable epilepsy related to Rasmussen's syndrome of the left hemisphere at age 5 years 6 months, after normal language acquisition. The first fMRI study at age 6 years 10 months showed left lateralization of language networks during a word fluency task. After left hemispherotomy at age 9 years, the child experienced profound aphasia and alexia, with rapid recovery of receptive language but slower and incomplete recovery of expressive language and reading. Postoperative fMRI at age 10 years 6 months showed a shift of language-related networks to the right during expressive and receptive tasks. Right activation was seen mainly in regions that could not be detected preoperatively, but mirrored those previously found in the left hemisphere (inferior frontal, temporal and parietal cortex), suggesting reorganization in a pre-existing bilateral network. In addition, neuropsychological data of this case support the hypothesis of innately more bilateral distribution of receptive than expressive language. This first serial fMRI study illustrates the great plasticity of the child's brain and the ability of the right hemisphere to take over some expressive language functions, even at a relatively late age. It also suggests a limit for removal of the dominant hemisphere beyond the age of 6 years, a classical limit for the critical period of language acquisition.
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ranking = 11.028870619541
keywords = cortex
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6/41. Differential functional magnetic resonance imaging language activation in twins discordant for a left frontal tumor.

    Eight-year-old twins, one with a left frontal tumor and aphasic seizures, the other neurologically normal, underwent serial assessment of expressive language with functional magnetic resonance imaging and neuropsychology. The affected twin showed a significant amount of right hemisphere activation coincident with behavioral deterioration in expressive language and late growth in the tumor. This pattern of language dysfunction and the left language dominance of her co-twin suggested that the affected twin was also left dominant for language, and the significance of her right activation is discussed. We postulate that the right hemisphere activation represents a stabilizing mechanism in the context of a developmental and progressive lesion in language cortex rather than language transfer per se.
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ranking = 11.028870619541
keywords = cortex
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7/41. Semantic fields in low-functioning autism.

    Restricted semantic fields and resultant stimulus overselectivity are often thought to be typical of low-functioning autism, as is a strong visual processing preference. However, these conclusions may in part be an artifact of testing methodology. A 12-year-old, low-functioning and nonverbal autistic boy was tested on an auditory word-to-picture selection task. The picture foils were chosen to have visual features, semantic features, both, or neither in common with the correct answer. Errors were made more often to semantically than to visually related items, and he showed generalization to items that had not been explicitly trained. This is taken as evidence that his semantic fields are broader than otherwise apparent, and that he was capable of expanding his semantic representations independently of specific training.
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ranking = 3
keywords = visual
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8/41. Category-specific semantic deficits do not reflect the sensory/functional organization of the brain: a test of the "sensory quality" hypothesis.

    We report the performance of a herpes simplex encephalitis patient, EA, who shows a dissociation between poor performance for living things and spared performance for sensory quality categories, when appropriate measures are taken to control for baseline differences among categories in task difficulty and when we eliminate the contribution of visual processing deficits in the recognition of objects. This pattern of performance is problematic for theories of category-specific deficits that are based on the assumption that these deficits reflect selective damage to modality-specific semantic subsystems but is consistent with domain-specific accounts and theories based on the assumption that the structure of conceptual knowledge reflects the correlational structure among object properties.
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ranking = 1
keywords = visual
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9/41. Slowed lexical access in nonfluent aphasia: a case study.

    A list priming paradigm (LPP) was used to examine the hypothesis that nonfluent aphasics are literally slowed down in automatic access to lexical information. In this paradigm, words are presented visually, and the subject's task is to make a lexical decision on each word as quickly as possible after its presentation. As soon as a lexical decision is made on one word, that word is removed and, after a predetermined interword interval, the next word is presented. In this way, a continuous "list" effect is obtained. Prior studies with both college-age and elderly subjects using the LPP have shown that, independently of age, on the LPP, priming obtains at interword delays of 500 to 800 msec, but not at either shorter or longer interword delays. In the study reported here, the LPP was used to examine delays at which priming obtained for LD, a nonfluent aphasic with a lesion primarily in the left frontal region. Examining interword delays ranging from 500 to 1800 msec, the subject showed priming only at a delay of 1500 msec, a considerably longer delay than that at which neurologically intact subjects have shown priming. Based on these results, it is argued that while automatic access is retained, that access is much slower in a nonfluent aphasic than in neurologically intact elderly subjects. These results are discussed in terms of how slowed lexical access might impact on discourse comprehension.
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ranking = 1
keywords = visual
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10/41. Alzheimer's disease.

    In this case study, we describe the symptoms, neuropsychological testing, and brain pathology of a man with Alzheimer's disease (AD). AD commonly presents with impairment of memory and language function. In this case, language difficulties were noted more prominently than was memory impairment. Throughout the limbic system and neocortex of the patient were large numbers of senile plaques and neurofibrillary tangles, the pathological hallmarks of AD.
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ranking = 11.028870619541
keywords = cortex
(Clic here for more details about this article)
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