Writing Errors in Broca’s and Wernicke’s Aphasias as a Manifestation of Functional Strategies for Writing
1,2 Elena G. Ivanova, 3 Anatoly А. Skvortsov, 1,2,4 Yuri V. Mikadze
1 Pirogov Russian National Research Medical University, Moscow, Russian Federation
2 Federal Center for Brain and Neurotechnology, Moscow, Russian Federation
3 National Research University «Higher School of Economics», Moscow, Russian Federation
4 Moscow State University named after M.V. Lomonosov, Moscow, Russian Federation
The research is devoted to the study of functional rearrangements in the structure of agraphia syndrome, depending on the contentof the written task.Aim: To identify the variability of writing disorders in sensory and motor efferent agraphia in the conditions of performing differenttypes of writing in terms of functional orientation.Materials and methods. The study involved 51 participants with post stroke aphasia and agraphia (29 people with with Wernickeaphasia). The severity of speech syndromes ranged from mild to moderate. All patients were right-handed. The native language forall participants was Russian. The study was carried out on the basis of inpatient departments of the Center for Speech Pathology andNeurorehabilitation in Moscow. Experimental methods included specially designed tasks that actualize the communicative, mnesticand regulatory functions of written speech. The productivity of writing when performing these tasks was compared with the assessmentof the performance of diagnostic tasks traditionally used in clinical practice. Written errors were assessed at the level of individualgraphemes, words and sentences. Statistical error analysis was carried out by intraindividual comparison of errors using nonparametricChi-square tests and Wilcoxon’s test with subsequent correction for multiple comparisons using the Holm-Bonferroni method.Results. It was shown that in the group of patients with sensory agraphia, changes in the error structure were leading due to theincreased load on the operation of auditory-speech analysis. In the group of patients with efferent motor dissociation agraphia identifiedwhen comparing different kinds of syntax errors. A common pattern for both groups was the use of compensatory strategies thatoptimize the writing process. Patients of both groups resorted to elliptical (incomplete, abbreviated) writing, used phrases of simplesyntactic constructions, trying to reduce the number of written errors. The patients also resorted to a high variability of the communicativetask, choosing the vocabulary that was most solidified in the past experience, which made it possible to avoid writing errors.Conclusion. Writing errors due to aphatic syndromes can be not only a manifestation of structural disorders of the component structureof speech function, but also a manifestation of the action of functional strategies of written communication.
Keywords: agraphia, aphasia, functional communication, writing strategies, syntax errors
For citation: Ivanova E.G., Skvortsov А.А., Mikadze Yu.V. Efferent Motor or Sensory Agraphia Errors as a Manifestation of Functional Strategies for Writing Activities. Bulletin of Rehabilitation Medicine. 2021; 20(1): 51-59. https://doi.org/10.38025/2078-1962-2021-20-1-51-59
- Leont’ev A.N., Zaporozhec A.V. Vosstanovlenie dvizheniya. Psihofiziologicheskoe issledovanie vosstanovleniya funkcii ruki posle raneniya [Psychophysiological study of the restoration of hand function after injury]. Moscow. Sovetskaya nauka. 1945: 231 p. (In Russ.).
- Zinchenko P.I. Neproizvol’noe zapominanie [Involuntary memorization]. Moscow. Progress. 1961: 564 p. (In Russ.).
- Gippenrejter Yu.B. O dvizhenii chelovecheskogo glaza [About the movement of the human eye]. Moscow. MGU. 1978: 256 p. (In Russ.).
- Zaporozhec A.V. Psihologiya dejstviya [The psychology of action]. Moscow. NPO MODEK. 2000: 736 p. (In Russ.).
- Gusev A.N., Utochkin I.S. Rol’ aktivacii sub”ekta v reshenii sensornyh zadach razlichnoj slozhnosti: resursnyj i funkcional’nyj podhody [The role of subject activation in solving sensory tasks of varying complexity: resource and functional approaches]. The Moscow University Herald. Series 14. Psychology. 2006; (4): 21-31 (In Russ.).
- Utochkin I.S. Teoreticheskie i empiricheskie osnovaniya urovnevogo podhoda k vnimaniyu [The role of subject activation in solving sensory tasks of varying complexity: resource and functional approaches]. Psychology. Journal of the Higher School of Economics. 2008; 5(3): 31-66 (In Russ.).
- Ivanova E.G., Skvorcov A.A., Mikadze Yu.V. Variativnost’ klinicheskoj kartiny efferentnoj motornoj agrafii pri realizacii razlichnyh kul’turnyh funkcij pis’mennoj rechi [Variability of the clinical picture of efferent motor agraphia in the implementation of various cultural functions of written speech]. Clinical Psychology and Special Education. 2020; 9(1): 121-141. https://doi.org/10.17759/cpse.2020090107 (In Russ.).
- Cvetkova L.S., Ahutina T.V., Pylaeva N.M. Metodika ocenki rechi pri afazii [Methodology for assessing speech in aphasia]. Moscow. MGU. 1981: 67 p. (In Russ.).
- Kolk H.H., Van Grunsven M.M. Agrammatism as a variable phenomenon. Cognitive Neuropsychology. 1985; 2(4): 347-384. https://doi. org/10.1080/02643298508252666
- Roeltgen D. Agraphia., In Heilman K.M., Valenstein E. Clinical Neuropsychology. New York: Oxford University Press. 1985: 75-95.
- Luzzatti C. Acquired Reading and Writing Disorders. Handbook of the Neuroscience of Language. 2008: 209-218. https://doi.org/10.1016/B978-0-08-045352-1.00020-3
- Heeschen C. Strategies of decoding actor-object-relations by aphasic patients. Cortex: A Journal Devoted to the Study of the Nervous System and Behavior. 1980; 16(1): 5-19. https://doi.org/10.1016/S0010-9452(80)80018-9
- Heeschen C. Agrammatism versus paragrammatism: a fictitious opposition. Agrammatism. New York. Academic Press. 1985.
- Butterworth H. Hesitation and the production of verbal paraphasias and neologisms in jargon aphasia. Brain and Language. 1979; 8(2): 133-161. https:// doi.org/10.1016/0093-934x(79)90046-4
- Margolin D.I., Marcel A.J., Carlson N.R. Common mechanisms in dysnomia and post-semantic surface dyslexia: processing deficits and selective attention. Surface Dyslexia: Neuropsychologicul and Cognitive Studies of Phonological Reading. London. Laurence Erlbaum. 1985.
- Kolk H., Heeschen C. Agrammatism, paragrammatism and the management of language. Language and Cognitive Processes. 1992; 7(2): 89-129. https:// doi.org/10.1080/01690969208409381
- Miceli G., Silveri M.C., Romani C., Caramazza A. Variation in the pattern of omissions and substitutions of grammatical morphemes in the spontaneous speech of so-called agrammatic patients. Brain and Language. 1989; 36(3): 447-492. https://doi.org/10.1016/0093-934X(89)90079-5
- Linebarger M.C., Schwartz M.F., Saffran E.M. Sensitivity to grammatical structure in so-called agrammatic aphasics. Cognition. 1983; 13(3): 361-392. https://doi.org/10.1016/0010-0277(83)90015-X
- Vygotskij L.S. Psihologiya razvitiya cheloveka [Human developmental psychology]. Moscow. Eksmo, Smysl. 2004: 1136 p. (In Russ.).
- Lukatela G., Gligorijevic B., Kostic A., Turvey M. Representation of inflected nouns in the internal lexicon. Memory and Cognition. 1980; 8(5): 415-423. https://doi.org/10.3758/BF03211138