Handbook of Neurolinguistics

Harry A. Whitaker, Brigitte Stemmer

• Publisher: Academic Press
• Year: 1998
• Print ISBN: 9780126660555
• eBook ISBN: 9780080533131
• Topic: Languages & Linguistics
• Subtopic: Sociolinguistics
• Index: Languages & Linguistics

The Handbook of Neurolinguistics is a state-of-the-art reference and resource book; it describes current research and theory in the many subfields of neurolinguistics and its clinical application. Thorough and clearly written, the handbook provides an excellent overview of the field of neurolinguistics and its development. The book is organized into five parts covering the history of neurolinguistics, methods in clinical and experimental neurolinguistics, experimental neurolinguistics, clinical neurolinguistics, and resources in neurolinguistics. The first four parts contain a wide range of topics which discuss all important aspects of the many subfields of neurolinguistics. Also included are the relatively new and fast developing areas of research in discourse, pragmatics, and recent neuroimaging techniques. The resources section provides currently available resources, both traditional and modern. The handbook is useful to the newcomer to the field, as well as the expert searching for the latest developments in neurolinguistics. - Clearly written and well organized - Provides extensive resources - Discusses both history and current research - Covers the many subfields of neurolinguistics as well the developing areas of research

Part I

History of Neurolinguistics

Chapter 1

Neurolinguistics from the Middle Ages to the Pre-Modern Era: Historical Vignettes

Harry A. Whitaker Department of Psychology, Northern Michigan University, Marquette, Michigan 49855

1-1 MEDIEVAL AND RENAISSANCE NEUROLINGUISTICS

Historical observations of disorders of language have been reported in Pharaonic medical papyrus texts circa 3000 B.C., a Hittite cuneiform tablet text circa 1500 B.C., the Hippocratic corpus circa 400 B.C., Latin texts circa the first century A.D., Latin texts in the Middle Ages (10th to the 14th century), Renaissance texts such as the Schenck compendium of 1558, various 17th-century texts such as Schmidt and Rommel and 18th-century ones such as the Wepfer compendium of 1727. The early 19th-century phrenological contributions of Gall, Spurzheim, and Hood, as well as the more orthodox medical work of Lallemand, Bouillaud, Lordat, and Dax, inaugurated a period of intense interest in the brain localization of language functions, culminating in the classic work of Broca, Meynert, Wernicke, Bastian, Jackson, and others during the late 19th century. Although questioned on occasion by holistic views (Head, Goldstein), the localization model persevered until, by the second half of the 20th century, classical neurolinguistics became firmly entrenched in both clinical and experimental neuroscience research. A glance at the cover of the third edition of Kandel, Schwartz, and Jessell’s 1991 textbook, Principles of Neural Science, will suffice to support this contention.

The most durable model of functional brain localization so far has been the Medieval Cell Doctrine. Derived originally from ideas of Herophilus (c. 270 B.C.) and Erasistratus (c. 260 B.C.), Medieval Cell Doctrine, and its particular variant, ventricular theory, were developed by Galen (130-200), the church fathers Nemesius (c. 400), Posidonius (c. 370), and Saint Augustine (354-430), with additional Arab contributions, particularly from Avicenna (980-1037). Ventricular theory was a model based on fluids and fluid flow for the apparent reason that thoughtful early scientists realized that something in the brain must move around in order to accomplish brain functions— something passes from sense organs to effectors, and the “animal spirits” were as good a candidate as any available. It was sufficiently entrenched to have endured well into the 17th century—for example, in the hydraulic model of brain function advocated by Descartes (1596-1650). Certain principles of Medieval Cell Doctrine and ventricular theory (e.g., modular functions localized in different brain regions, as well as other vestiges of this two-millenia-old idea) remain as features of every model of brain function up to those of contemporary cognitive neuroscience.

From the 11th century through the Renaissance, one finds textual discussions usually in the form of neuropsychological case reports as well as graphic representations of Medieval Cell Doctrine and ventricular theory. Diagrams from the Middle Ages were typically crude and childlike, whereas those from the Renaissance period were often ornate works of art in their own right. These studies typically, although not invariably, accepted the standard model that placed memory in the third ventricle; the authors then “fit” the lesion evidence from brain-damaged subjects to that model. Language, or, more precisely, speech output, was also situated in the third cell or ventricle, an association that may have originated from Galen’s belief that motor functions were a property of the cerebellum. The psychological link between memory and language may have been the cause or the result of a conception of memory as verbal memory; whichever, it is clear that they were so closely connected that memory disorders were interpreted as language disorders and vice versa. For example, consider this case from an 11th-century manuscript: Guillaume de Conches (1080-1150) reported that Solinus had spoken of a man who suffered traumatic injury to the last cell of the brain and who fell into an amnesia so profound that he had forgotten his own name. Many of these cases were compiled by Johannes Schenck (1584) and Johannes Wepfer (1727), both of whom are discussed in this chapter. Others are compiled in Jules Soury, Le système Nerveux Central (1899).

Eventually, the overt form of Medieval Cell Doctrine and ventricular theory fell by the wayside, the demise beginning in the 17th century, as some of its key components (e.g., animal spirits flowing through hollow nerves or between empty ventricles) were challenged by both experimental and theoretical arguments. However, other aspects of the model—for example, the concepts of a modular functional localization, of information flow, of the close links between memory, language, and motor function, and the idea that memories are stored images—were not only never challenged but seem to have become absorbed into post-Renaissance models of brain function.

From at least the 16th century, a correlation between language disorders and particular cerebral lesions (rather than “ventricular,” or simply generally “in the brain”) has been recognized. The late-Renaissance physician Johannes Schenck von Grafenberg (1530-1598) published Observationes medicae de capite humano in 1584; it is a treasure of neuropsychological observations including many observations on language disorders. It includes contributions from 20 Greek, 5 classic Latin, 11 medieval Arabic and Jewish, 37 medieval Latin, 292 recent Latin, and 139 classic nonmedical authors, as well as 64 unpublished cases reported by Schenck’s contemporaries. His encyclopedic collection of clinical information, all with an explicit bibliographic citation, has no counterpart in its time. At least 16 of Schenck’s observations mention symptoms of language disorders. Although some case descriptions are superficial, many include quite explicit observations, showing that neurolinguistic knowledge was in fact more advanced than one might have believed. Armand Trousseau, a contemporary of Broca, cited Schenck as an early physician who appreciated the essential nature of aphasia. A sampling of Schenck’s cases (see Luzzatti & Whitaker [1996a]) illustrates the level of description in this early neurolinguistic work. Reporting a 14th- century case from Gentile da Foligno and a 16th-century case from Cristobal de Vega, Schenck notes the selective loss of the alphabet and object names, accompanied by loss of reading and writing. Another 16th-century case from Tertius Damianus reports that a patient studied his letters again, as an effort at rehabilitation. Schenck recorded an impressive 16th-century description by Conrad Lycosthenes of his own right hemiplegia and aphasia, described as a loss of voice. The inability to speak lasted 12 days and the severe motor deficits lasted 3 months. Lycosthenes had even lost rote- memorized passages such as the Mass but had retained internal language and thinking; he was able to communicate by pointing, with his left hand, to letters in sequence to form words. Evidently, one of his friends had hit upon the idea of writing the alphabet down on a board as a communication aid. Citing Jakob Oethaeus, Schenck observes that the tongue may retain its motor functions when word memories have been lost, thus establishing quite early the dissociation between articulatory control and language production. Clearly, the Renaissance legacy to the 17th century’s Age of Reason and scientific discovery was considerable insofar as neurolinguistics is concerned.

1-2 A PERIOD OF TRANSITION: THE 17TH AND 18TH CENTURIES

Johannes Jakob Wepfer (1620-1695), was an acquaintance of Thomas Willis and, although less well known than Schenck, was in fact one of the most important “neurologists” of the 17th century. He authored several papers and books; the one relevant to our interests is Observationes medico-practicae de affectionis capitis internis c& externis, which was written around 1690 but only available in a posthumously published version of 1727. The book is notable for its accuracy, colorful clinical descriptions, and systematic organization. In observation 98, “loss of memory,” Wepfer describes a transient language disorder with selective impairment of proper names, accompanied by a syntactic disorder; no acalculia nor other neuropsychological deficits were observed. The following is translated and paraphrased from the Latin:

A 53-year-old man returning from a walk vomited several times. He spoke both in Latin and German, but his words did not relate to the topic of conversation, nor were they answers to questions put to him. He continuously repeated the same utterances, stuck on the pronunciations of words, and frequently complained that he could not express his thoughts in words. A month later he suddenly forgot all names, even his own. He could not name any object, neither in Latin nor in German. He gave the impression that he was able to recognise objects and people but the words he uttered were alien and incoherent. After one more month, his memory was almost completely restored; his faculty of hearing and repeating was adequate and he could count, add, subtract and divide without error. Occasionally, he could not find the proper names of a person or a place as quickly as usual and from time to time he could not find some of the little words of the sentence. He is able read again and writes full texts without hesitation. His faculty of judgement is normal and he was able to fulfill his duties as before. When he was talking, I could observe him from time to time violate syntactic rules and, against the structure of German sentences, he would antepose one word to another [word-order errors] and sometimes he could not complete some little word [inflectional morphology errors]. In general, he recognised his errors and corrected them. (Luzzatti & Whitaker, 1996a, pp. 161-162)

In addition to its interest as an early study of agrammatism, Wepfer’s case is also exemplary of most, but not all, classical aphasia research on grammatical or syntactic disorders up until the 1970s: a descriptive summary of the omission or misuse of function words or inflections in spontaneous or elicited speech samples of patients with an expressive aphasia. It is exemplary as well as an analysis that made no attempt to explain the disorder but rather to describe it, a tradition in neuropsychology that still has its advocates. Wepfer’s observation 102, a loss of memory followed by melancholia, is instructive for the neuropsychological insight:

A most reverend 44-year-old cleric sat in judgement on a controversy proposed by a peasant; however, when he tried to express his judgement, he could not find the words he wanted to communicate his thoughts. From that moment on, he lost his memory so much that he no longer was able to call the onlooker by his name nor he could name any object. He clearly saw the colours and features of objects and drawings presented to him, but he could neither read nor combine letters. All his remaining outward and inner sensations were normal. He recognised his loss of memory and the errors he made while speaking. There was no trace of paralysis; he could pronounce every letter, even the R. The site of suffering is neither in any nerve pertaining to both types of sensation, because he hears, sees, tastes, etc., nor in the nerve subserving speech, because he can pronounce all sounds, even the R, nor in the brain stem or spinal cord, because there is no trace of movement disorder. It seems to be located in that part of the brain where the images of objects are organised. These may be retrieved, as from a store, and, when required, supplied by means of the mnestic faculty. What part of the brain this might in fact be, cannot be defined, but clearly it is not an involvement of the entire brain, because the patient is not drowsy, and has lost neither his ingenuity nor his understanding. (Luzzatti & Whitaker, 1996a, p. 162)

Compared to the similar collection (organization and focus) of clinical cases compiled by Schenck, Wepfer’s cases seem to have been more carefully selected; many were followed by an autopsy description, and the etiological-pathogenic commentary is quite advanced in relation to the Zeitgeist of the 17th century, particularly in comparison with Wepfer’s contemporary Thomas Willis. Wepfer is arguably the first scientist to discuss the nature of cognitive functions using a modern neuropsychological approach. To our knowledge, he was the first to consistently report the side of lesion and the presence or absence of aphasia, although he does not overtly express the relation between language disorder and left hemisphere lesions, despite the fact that he often wrote, paralisys dextri lateris, cum loquelae impedimentum. Perhaps the cultural-philosophical milieu in which Wepfer was working did not allow him to understand the relevance of his own observations, or perhaps his silence on the matter of hemispheric asymmetry was out of concern for an unwelcome reception by the church. Galileo had been accused less than 30 years earlier and the squares of Europe still smelled of the stakes of the Inquisition.

Other 17th-century neurolinguistic reports worth mentioning include one by Johann Schmidt (1624-1690), a case of severe fluent paraphasia with right hemiparesis; the patient showed good recovery of oral language and agraphia, but not for his reading disorders.

A leading citizen among us, Nicholas Cambier, an old man of 65 years, was seized with a very severe attack of apoplexy which all his attendants feared would lead to his death.… Upon his return home, it was evident that his right side was paralyzed and that he had difficulty in speaking. He muttered a good deal but was incapable of expressing the feelings of his mind; he substituted one word for another so that his attendants had difficulty in determining what he wanted.… He could not read written characters, much less combine them in any way. He did not know a single letter nor could he distinguish one from another. But it is remarkable that, if some name were given to him to be written, he could write it readily, spelling it correctly. However, he could not read what he had written even though it was in his own hand. Nor could he distinguish or identify the characters. For if he were asked what letter this or that was or how the letters had been combined, he could answer only by chance or through his habit of writing.… No teaching or guidance was successful in inculcating recognition of letters in him. It was otherwise with a certain stone cutter in our country. Wilhelm Richter came to see me after his apoplexy receded because he was not able to read at all or to recognize letters. However, he learned the alphabetic elements of the language again in a short time. He then combined them and attained perfection in his reading. (Benton & Joynt, 1960, p. 209)

Another 17th-century report is Peter Rommel’s (1643-1708) 1682 study of a patient whose spontaneous output was reduced to a few automatisms, but serial speech, prayers, and comprehension were preserved (Benton & Joynt, 1960, pp. 209-210). Considering the cases by Schmidt, Rommel, Schenck, and Wepfer, it is clear that scientists of the 16th and 17th centuries were able to clearly distinguish language disorders from general cognitive deficits, production versus comprehension deficits, lexical from sound or letter errors, and both syntactic and morphological impairments. Although the neuropsychological modeling needed to complete these analyses did not come until the beginning of the 19th century, the 17th century also witnessed a fair degree of progress on the neuroanatomical front. For example:

1. Experimental brain research flourished, as seen in more accurate dissections, more careful observations, and comparisons of brains of different species, while ventricular theory was being replaced by models that localized functions to the brain substance. Nicolaus Steno (a.k.a. Niels Stensen [1638-1686]) could be regarded as a transition figure; he is remembered for his Discourse on the Brain (1669), which provides some evidence of the state of neuropsychology in the 17th century. Steno was convinced that wherever fibers are found in the brain, they maintain a certain pattern among themselves, of greater or lesser complexity according to the functions for which they are intended. His comments on the brain’s white matter should be interpreted as prefiguring David Hartley’s ideas of functional specificity and modularity (see Aubert & Whitaker, 1996).

2. More systematic clinico-pathological observations of memory disorders and language disorders, with frequent reports of the co-occurrence of aphasia with right-sided paralysis, accompany the first formal teaching of clinical- pathological correlations for the purpose of determining the causes of disease (Boerhaave), to be later developed by Morgagni in the 18th century.

3. Early ideas of domain specificity of functions in the brain were further developed in the work of David Hartley in the 18th century, incorporating Isaac Newton’s vibration model of nerve function; Newton’s model depended on the view that nerves were solid, not hollow. The Renaissance view that nerves transmit information to and from the brain was retained, but the idea of encoding of information—different vibrations for different ideas—was added.

1-3 LOCALIZATION COMES OF AGE: FRANZ JOSEPH GALL AND HIS TIMES

Whatever else may be said of the 18th century, it is clear that by its end, medicine had clearly accepted the idea of the discrete localization of funct...

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright page
• Contributors
• Preface
• Prologue
• Part I: History of Neurolinguistics
• Part II: Clinical and Experimental Methods in Neurolinguistics
• Part III: Experimental Neurolinguistics
• Part IV: Clinical Neurolinguistics
• Part V: Resources in Clinical and Experimental Neurolinguistics and Related Fields
• References
• Index