"My Mind Is Doing It All"

Gail A. Robinson, Brian Butterworth, Lisa Cipolotti
2015 Cognitive and Behavioral Neurology  
Objective: To study whether pressure of speech in jargon aphasia arises out of disturbances to core language or executive processes, or at the intersection of conceptual preparation. Background: Conceptual preparation mechanisms for speech have not been well studied. Several mechanisms have been proposed for jargon aphasia, a fluent, well-articulated, logorrheic propositional speech that is almost incomprehensible. Methods: We studied the vast quantity of jargon speech produced by patient J.A.,
more » ... who had suffered an infarct after the clipping of a middle cerebral artery aneurysm. We gave J.A. baseline cognitive tests and experimental word-and sentencegeneration tasks that we had designed for patients with dynamic aphasia, a severely reduced but otherwise fairly normal propositional speech thought to result from deficits in conceptual preparation. Results: J.A. had cognitive dysfunction, including executive difficulties, and a language profile characterized by poor repetition and naming in the context of relatively intact single-word comprehension. J.A.'s spontaneous speech was fluent but jargon. He had no difficulty generating sentences; in contrast to dynamic aphasia, his sentences were largely meaningless and not significantly affected by stimulus constraint level. Conclusions: This patient with jargon aphasia highlights that voluminous speech output can arise from disturbances of both language and executive functions. Our previous studies have identified three conceptual preparation mechanisms for speech: generation of novel thoughts, their sequencing, and selection. This study raises the possibility that a "brake" to stop message generation may be a fourth conceptual preparation mechanism behind the pressure of speech characteristic of jargon aphasia. The cognitive baseline tests measured J.A.'s nonverbal intelligence, visual memory, visual perception, and executive function. His low average performance on the Coloured Progressive Matrices test (Raven, 1976) (19/36, FIGURE 1. Patient J.A.'s computed tomogram of the head on postsurgical Day 18. Panel A: Localizer image. Panels B-D: Axial images in sequential order from inferior (B) to superior (D) show clipping of the aneurysm in his right middle cerebral artery.
doi:10.1097/wnn.0000000000000080 pmid:26705270 fatcat:o7eoqsuqhzfvlpag4erpdohlqy