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Grodzinsky's latest stand – or, just how specific are “lesion-specific” deficits?



Deficits observed in Broca's aphasia are much more general than Grodzinsky acknowledges. Broca's aphasics have a broad range of problems in lexical and morphological comprehension; furthermore, the classic “agrammatic” syntactic profile is observed over many populations. Finally, Broca's area is implicated in the performance of many linguistic and nonlinguistic tasks.
Grodzinsky’s Latest Stand - or, just how specific are
"lesion-specific" deficits?
Frederic Dick & Elizabeth Bates
Center for Research in Language, University of California, San Diego,
La Jolla, CA 92092-0526. --
The Behavioral and Brain Sciences, 2000, 23(1), 29-29.
Deficits observed in Broca's aphasia are much more general than Grodzinsky acknowledges. Broca's aphasics have a broad
range of problems in lexical and morphological comprehension; furthermore, the classic "agrammatic" syntactic profile is
observed over many populations. Finally, Broca's area is implicated in the performance of many linguistic and non-
linguistic tasks.
Yosef Grodzinsky (YG) has penned a highly
imaginative account of aphasic deficits and their neural
correlates, the latest in a series of proposals that he has
put forward in the last 15 years for a grammar-specific
faculty in the human brain (e.g. Grodzinsky, 1984).
His proposals are famous for their strength, clarity and
falsifiability. Below we provide evidence that falsifies
his latest stand.
First, YG claims that the receptive deficit in
Broca’s aphasia is restricted primarily (perhaps exclu-
sively) to grammar (e.g. “the patients seem to have no
impairment to their lexicon in comprehension, namely,
the part of the lexicon that interacts with sentence
grammar is intact.” Section 2.1). This is misleading.
It is well established that Broca’s aphasics have marked
deficits in both phonological and lexical processing,
receptively and expressively (Goodglass, 1993). In fact,
some of the first demonstrations of impaired lexical
priming in Broca’s aphasia were conducted at the same
institution where YG conducts his English-language
work (e.g. reduced, delayed or deviant word-word prim-
ing in Prather, Shapiro, Zurif, & Swinney, 1991; see
also Milberg, Blumstein & Dworetzky, 1988).
Second, YG asserts (Section 2.1) that the gram-
matical comprehension deficit in Broca’s aphasia is
quite restricted, affecting syntactic movement operations
while leaving other aspects of grammar intact (such as
computation of agreement and case). This is simply
untrue. There is now a large cross-linguistic literature
showing that Broca’s aphasics (and other groups as
well) are markedly impaired in the use of agreement and
case information to assign agent-patient roles (Bates,
Friederici, & Wulfeck, 1987; Heeschen, 1980; Mac-
Whinney, Osmán-Sági, & Slobin, 1991). Furthermore,
although these patients often perform above chance on
grammaticality judgment tasks, they are significantly
less accurate in detecting subject-verb agreement errors
than violations of movement (Devescovi et al., 1997;
Wulfeck, Bates, & Capasso, 1991).
Third, the core of YG’s argument revolves around a
specific type of syntactic deficit that is supposed to be
unique to Broca’s aphasia: a deficit in the movement
operations associated with (inter alia) the processing of
non-standard word order. This is supposed to result in
chance performance on passives and object clefts despite
above-chance performance on actives and subject clefts.
In fact, this very pattern has been observed in all forms
of aphasia. For example, Dick, Bates, Wulfeck and
Dronkers (1998) compared a large number of anomics,
Wernicke’s, conduction, and Broca’s aphasics and found
cases with YG’s signature “agrammatic profile” in all
aphasic groups, including anomics (i.e. patients with
word-finding deficits who do not display clinically
significant signs of expressive agrammatism). The
presence or absence of this agrammatic profile also
failed to correlate with any particular lesion site, and
appeared often in patients with lesions sparing Broca’s
area. We note that the same profile is observed in
children who are still acquiring their language, and it
can be reproduced in college students who have to
perform exactly the same task under “stressful” con-
ditions (e.g. a combination of low-pass filtering and
compression of speech). In short, this profile has
absolutely no localizing value.
Finally, YG insists that the neural tissue in and
around Broca's area is specialized for and dedicated to
these syntactic operations, declaring that “the neuro-
linguistic localizing schema of language perception may
not have permeated the clinical literature, yet it is
currently accepted in cognitive neuroscience.” In fact,
very much the opposite is true. Not only do functional
imaging studies show language-related activation in
widely distributed and overlapping networks (see
Müller, this volume, for further comments), but a
steadily increasing number of studies show that regions
in and around Broca’s area are activated during non-
linguistic tasks, such as object manipulation, mental
imagery of tools, and sequential finger tapping cued by
a drawn hand (Krams, Rushworth, Deiber, Frackowiak,
& Passingham, 1998; Rizzolatti & Arbib, 1998). Such
"promiscuity" of activation does not lend much support
to a language-specific role for Broca's area.
To summarize: The “core data” of agrammatism
that YG uses to define the putative role of Broca’s area
is observed in a wide range of populations, with dif-
ferent etiologies, including normal adults processing
under stress. Patients with damage in and around this
region display a range of deficits inside and outside of
the grammar. Finally, imaging studies of normals
show that Broca’s area itself is involved in many
different linguistic and nonlinguistic tasks. In short,
the pattern of selective deficits and activations that are
essential to YG's proposal are not so selective after all.
*Supported by NIDCD R01-DC00216 and by an
NIDCD fellowship to FD.
Bates, E., Friederici, A., & Wulfeck, B. (1987). Com-
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Devescovi, A., Bates, E., D'Amico, S., Hernandez, A.,
Marangolo, P., Pizzamiglio, L., & Razzano, C.
(1997). An on-line study of grammaticality judge-
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Dick, F., Bates, E., Wulfeck, B., & Dronkers, N.
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complex sentences in normals under adverse pro-
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Goodglass, H. (1993). Understanding aphasia. San
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Heeschen, C. (1980). Strategies of decoding actor-
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Krams, M., Rushworth, M.F., Deiber, M.P., Fracko-
wiak, R.S., & Passingham, R.E. (1998). The
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movements in the human brain. Experimental
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MacWhinney, B., Osmán-Sági, J., & Slobin, D.I.
(1991). Sentence comprehension in aphasia in two
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Milberg, W., Blumstein, S., & Dworetzky, B. (1988).
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... Firstly, there is no one-to-one correlation between a diagnosis of Broca's aphasia and a lesion in Broca's region (e.g. Caplan, 2000;Dick & Bates, 2000). Secondly, and relatedly, symptoms related to agrammatism have been reported for a range of aphasic syndromes and lesion sites (e.g. ...
... Secondly, and relatedly, symptoms related to agrammatism have been reported for a range of aphasic syndromes and lesion sites (e.g. Caplan, 2000;Dick & Bates, 2000;Penke & Wimmer, 2012), thus leading Dick and Bates (2000, p. 29) to conclude that ''this profile has absolutely no localizing value''. Thirdly, recent studies employing voxel-based lesion-symptom mapping (VLSM, Bates et al., 2003) to examine correlations between lesion site and linguistic performance in relatively large samples of patients point to temporal rather than inferior frontal lesions as detrimental to syntactic aspects of language comprehension (English: Dronkers et al., 2004;Icelandic: Magnusdottir et al., 2012). ...
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We present a new dorsal-ventral stream framework for language comprehension which unifies basic neurobiological assumptions (Rauschecker & Scott, 2009) with a cross-linguistic neurocognitive sentence comprehension model (eADM; Bornkessel & Schlesewsky, 2006). The dissociation between (time-dependent) syntactic structure-building and (time-independent) sentence interpretation assumed within the eADM provides a basis for the division of labour between the dorsal and ventral streams in comprehension. We posit that the ventral stream performs time-independent unifications of conceptual schemata, serving to create auditory objects of increasing complexity. The dorsal stream engages in the time-dependent combination of elements, subserving both syntactic structuring and a linkage to action. Furthermore, frontal regions accomplish general aspects of cognitive control in the service of action planning and execution rather than linguistic processing. This architecture is supported by a range of existing empirical findings and helps to resolve a number of theoretical and empirical puzzles within the existing dorsal-ventral streams literature.
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The ability to speak is a unique human capacity, but where is it located in our brains? This question is closely connected to the pioneering work of Pierre Paul Broca in the 1860s. Based on post-mortem observations of aphasic patients' brains, Broca located language production in the 3rd convolution of the left frontal lobe and thus reinitiated the localizationist view of brain functions. However, contemporary neuroscience has partially rejected this view in favor of a network-based perspective. This leads to the question, whether Broca's findings are still relevant today. In this mini-review, we discuss current and historical implications of Broca's work by focusing on his original contribution and contrasting it with contemporary knowledge. Borrowing from Broca's famous quote, our review shows that humans indeed “speak with the left hemisphere”– but Broca's area is not the sole “seat of articulatory language”.
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... 80). Pick was prophetic: From the 1960s until today, based primarily on studies of English, receptive and expressive agrammatism have been identified primarily with Broca's aphasia, and by extension, grammatical processing has been ascribed to regions of left frontal cortex (Caplan & Waters 1999a,b;Dick & Bates 2000; see papers in Kean 1985, Kim et al 1997. ...
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Cross-linguistic studies are essential to the identification of universal processes in language development, language use, and language breakdown. Comparative studies in all three areas are reviewed, demonstrating powerful differences across languages in the order in which specific structures are acquired by children, the sparing and impairment of those structures in aphasic patients, and the structures that normal adults rely upon most heavily in real-time word and sentence processing. It is proposed that these differences reflect a cost-benefit trade-off among universal mechanisms for learning and processing (perception, attention, motor planning, memory) that are critical for language, but are not unique to language.
A number of previous studies have indicated that Broca's area has an important role in understanding and producing syntactically complex sentences and other language functions. If Broca's area is critical for these functions, then either infarction of Broca's area or temporary hypoperfusion within this region should cause impairment of these functions, at least while the neural tissue is dysfunctional. The opportunity to identify the language functions that depend on Broca's area in a particular individual was provided by a patient with hyperacute stroke who showed selective hypoperfusion, with minimal infarct, in Broca's area, and acutely impaired production of grammatical sentences, comprehension of semantically reversible (but not non-reversible) sentences, spelling, and motor planning of speech articulation. When blood flow was restored to Broca's area, as demonstrated by repeat perfusion weighted imaging, he showed immediate recovery of these language functions. The identification of language functions that were impaired when Broca's area was dysfunctional (due to low blood flow) and recovered when Broca's area was functional again, provides evidence for the critical role of Broca's area in these language functions, at least in this individual.
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This study explored the relationship between on-line processing of phonological information and lexical access in aphasic patients. A lexical decision paradigm was used in which subjects were presented auditorily with pairs of words or word-like stimuli and were asked to make a lexical decision about the second stimulus in the pair. The initial phonemes of the first word primes, which were semantically related to the real word targets, were systematically changed by one or more than one phonetic feature, e.g., cat-dog, gat-dog, wat-dog. Each of these priming conditions was compared to an unrelated word baseline condition, e.g., nurse-dog. Previous work with normals showed that even a nonword stimulus receives a lexical interpretation if it shares a sufficient number of phonetic features with an actual word in the listener's lexicon. Results indicated a monotonically decreasing degree of facilitation as a function of phonological distortion. In contrast, fluent aphasics showed priming in all phonological distortion conditions relative to the unrelated word baseline. Nonfluent aphasics showed priming only in the undistorted, related word condition relative to the unrelated word baseline. Nevertheless, in a secondary task requiring patients to make a lexical decision on the nonword primes presented singly, all aphasics showed phonological feature sensitivity. These results suggest deficits for aphasic patients in the various processes contributing to lexical access, rather than impairments at the level of lexical organization or phonological organization.
It has been widely argued that Broca's aphasics suffer from a loss of grammatical knowledge, accounting for the co-occurrence of expressive agrammatism (i.e. reduced, telegraphic speech with few inflections and function words) and specific problems with grammatical elements in sentence comprehensive. This idea is challenged by cross-linguistic studies showing that agrammatic patients retain detailed structural properties of their native language in comprehension and production, and by studies showing that these patients can make judgements of grammaticality that would be difficult to explain if they had lost grammatical knowledge. The present study compares sensitivity to errors of subject-verb and noun-adjective agreement in Italian, in agrammatic Broca's aphasics, fluent Wernicke's and anomic aphasics, college students and elderly controls. Stimuli vary in amount of grammatical context (i.e. the number of cues available to signal an agreement contrast), and in degree of violation (i.e. violation of only one morphological dimension, e.g. person, number or gender, vs violations that involve more than one dimension). Errors are detected ‘on-line’, yielding information about reaction time as well as accuracy. Results confirm that Broca's aphasics perform above chance, at levels equal to fluent patients with expressive agrammatism, providing further evidence against central agrammatism. Differential effects of grammatical context and degree of violation are observed in accuracy and reaction times for normals and patient groups. Implications for processing accounts of language breakdown in aphasia are discussed.
We argue that the lesion localizing value of disruptions to modular information processing systems emerges most clearly from on-line analyses of processing. In this respect we seek to show that left anterior (but not left posterior) damage causes slowed information access and we discuss the manner in which this slowing might yield some of the specific syntactic limitations charted in Broca's aphasia. The general possibility we raise is that the cortical area implicated in Broca's aphasia is not necessarily the locus of syntactic representations, but rather sustains particular time-based operating characteristics that in turn sustain normal real-time parsing.
Crosslinguistic studies of sentence comprehension and production in Broca's aphasia have yielded two complementary findings: (1) grammatical morphology appears to be more impaired than word order principles in every language studied, but (2) the degree to which grammatical morphology is retained by aphasic patients depends upon the "strength" or importance of those morphemes in the patient's premorbid language. In an earlier study comparing violations of word order and agreement, we found that English-speaking Broca's aphasics showed greater sensitivity to errors of ordering than to errors of agreement, providing further evidence for the selective vulnerability of morphology. However, because English is a rigid word order language with a relatively weak inflectional system, it could be argued that word order is resilient to brain damage because it is the strongest source of information in this language. The present study compared the performance of English-speaking Broca's aphasics and normal controls with their Italian counterparts in the same grammaticality judgment experiment. Four predictions relating to our previous work were confirmed. (1) Italian aphasics, like their English-speaking counterparts, showed general preservation of grammatical knowledge and (2) they were able to use this knowledge in an "on-line" fashion. (3) Within each language, Broca's aphasics showed greater impairment in their ability to recognize errors of morphological selection (i.e., agreement) compared with errors made by moving the same words to an incorrect position downstream. Nevertheless (4), crosslinguistic differences observed in previous studies of comprehension and production were also observed in this grammaticality judgment task: a processing advantage for agreement errors in Italian normals and aphasics, and a processing advantage for ordering errors in English normals and aphasics.
Studies of aphasia in Indo-European languages point to a selective vulnerability of morphological case marking in sentence comprehension. However, in case-marking languages such as German and Serbo-Croatian, the use of case marking to express formal grammatical gender diminishes the clarity of grammatical role marking. In Hungarian and Turkish, there are simple and reliable markings for the direct object. These markings are not linked to grammatical gender. Compared to Hungarian, the Turkish accusative marking is somewhat lower in availability, but somewhat higher in detectability. The processing of these cues by aphasics was tested using the design of MacWhinney, Pléh, and Bates (1985. Cognitive Psychology, 17, 178-209). Simple sentences with two nouns and one transitive verb were read to Broca's and Wernicke's aphasics, anomics, and control subjects in both Turkey and Hungary. The main effect of case marking was extremely strong. However, this was not true for all groups. The aphasics used the case cue far less than the normals, with the Hungarian Wernicke's group showing the greatest loss. Word order variations were largely ignored in all groups whenever the case-marking cue was present. When case marking was absent, Turkish subjects had a clear SOV interpretation for NNV sentences and Hungarians had a clear SVO interpretation for NVN sentences, in accord with basic patterns in their languages. When there was a contrast between the animacy of the two nouns, subjects choose the animate nouns significantly more often. The effect of animacy was particularly strong in Turkish, in accord with basic facts of Turkish grammar. In Hungarian, VNN sentences without case marking were interpreted as VOS when the first noun was inanimate. In Turkish, VNN sentences without case marking were often interpreted as VSO. In general, the aphasic subjects showed a clear preservation of virtually all aspects of their native languages, albeit in a much noisier form. Despite the high reliability of the case-marking cue, it was damaged more than the word order cue in English subjects. The near-chance processing of the case cue by the Wernicke's aphasics in Hungarian can probably be attributed to the relatively greater difficulty involved in detecting the Hungarian accusative suffix.
Broca's aphasics and normal controls were tested to determine relative sparing and impairment of word order, grammatical morphology, and semantic information in a sentence interpretation task. Patients were native speakers of English, German, or Italian, languages that vary drastically in the "cue validity" or information value of these three sources of information. Word order was selectively spared while grammatical morphology was selectively impaired in all three languages. Nevertheless, language-specific patterns of sentence interpretation remained in Broca's aphasics, even within the impaired morphological component, supporting an interpretation in terms of "accessing" rather than a "loss." Testing with Wernicke's aphasics, anomics, and some additional age-matched controls suggested that the selective vulnerability of morphology is not specific to agrammatic patients, at least in this paradigm.
A new characterization of agrammatism is suggested, based on new data from Hebrew speaking agrammatic aphasics, and a reexamination of data from Russian and Italian. This characterization is formed in relation to linguistic levels of representation. First, the description of agrammatism as omission of closed-class items is challenged on the basis of the data, and a new description is suggested-viewing agrammatism as mis-selection of items + default: in English the default procedure may always be used, but in the other languages discussed, the patient is forced, for structural reasons, to unconscious guessing that results, in many instances, in syntactically aberrant sentences in which each lexical item is well formed. Second, after discussing issues concerning the proper relation between linguistic theories and processing models, a condition on a syntactic level (S-structure) in linguistic theory (Chomsky, 1981) is proposed, to account for agrammatic data from all the languages considered. It is then shown that agrammatic performance in a variety of tasks (including comprehension) is explained naturally as a consequence of this condition. Finally, several related processing issues are discussed. In particular, the relationship between the proposed structural account and the model offered by Bradley et al. (1980).
By means of a sentence-picture matching task, 22 Broca-aphasics, 22 Wernicke-aphasics, 16 patients with damage to the right hemisphere and 16 neurologically normal subjects were tested for their ability to understand the actor-object-relation within a sentence. The 4 groups were approximately matched for sex, education, age and general severeness of disease. The stimulus sentences were constructed in such a way that the actor-object-relations were unambiguously clear by morphological means as e.g. case endings; thus, no error should be made by a subject operating on a purely algorithmic grammatical basis. One half of the sentences were irreversible, the other half reversible, i.e. the identification of the actor-object-relation was helped by a semantic cue in one half of the sentences, in the other half not. Crossed with this semantic factor was the syntatic factor "constituent order": one half of the sentences were presented in the normal order "actor-action-object", the other half in the topicalized form "object-action-actor" which is quite possible in German because of its free word order. Overall, the Broca-aphasics made less errors than the Wernicke-patients. The error pattern of the aphasics suggests that both aphasic groups remain responsive to semantic constraints as well as to constituent order: both groups made more errors in reversible than in irreversible sentences and both groups made more errors in topicalized than in normal sentences. There were no significant group differences in these two respects. The only group difference was that Broca-aphasics tended to neglect the syntactic aspect of constituent order if a semantic cue was given, while the Wernicke-aphasics continued to take the constituent order into account even in sentences where a semantic cue was present. In the light of the findings of the experiment, the hypothesis that Broca's aphasia is characterized by a supramodal blockade of syntax is disputed.