Gainotti Guido
Center for Neuropsychological Research and Institute of Neurology of the Catholic University of Rome, Italy; IRCCS Fondazione Santa Lucia, Department of Clinical and Behavioral Neurology, Rome, Italy.
Cortex. 2014 Apr;53:78-89. doi: 10.1016/j.cortex.2014.01.009. Epub 2014 Jan 28.
From the first research on aphasia, it has been shown that, in addition to verbal communication disorders, aphasic patients often have difficulty on non-verbal cognitive tasks, which can actually be solved without the use of language. In this survey, I will discuss in a historical perspective the different interpretations provided by classical and contemporary authors to explain this puzzling observation. First, I will take into account the different positions of classical authorities on this topic, starting from the first debates (mainly based on anatomo-clinical observations) on the organisation of language in the brain. Then, I will attempt to summarize the work of authors who have tackled this complex issue more recently, in systematic investigations using methods drawn from experimental psychology, to clarify the meaning of non-verbal cognitive disorders in aphasia. Finally, in the last part of the survey, I will discuss the interpretation of proponents of the 'semantic hub' hypothesis who have tried to analyse and explain the differences between the non-verbal semantic defects of patients with semantic dementia and aphasic stroke patients. The hypothesis which assumes that most non-verbal cognitive disorders observed in aphasic patients are due to a preverbal conceptual disorder, which cannot be attributed to a loss of semantic representations but rather to a defect in their controlled retrieval, seems substantially confirmed. Nevertheless, two main issues must still be clarified. The first is that some of the non-verbal cognitive defects of aphasic patients seem due to the negative influence of language disturbances on abstract non-verbal cognitive activities, rather than to a preverbal conceptual disorder. The second issue concerns the exact nature and the neuroanatomical correlates of the defective controlled retrieval of unimpaired conceptual representations, which should subsume most of the non-verbal cognitive disorders of aphasic patients.
从关于失语症的首次研究开始，就已表明，除了言语交流障碍外，失语症患者在非言语认知任务上也常常存在困难，而这些任务实际上无需使用语言就能解决。在本次综述中，我将从历史角度探讨古典和当代作者为解释这一令人困惑的观察结果所提供的不同解读。首先，我将考虑古典权威在该主题上的不同立场，这始于关于大脑中语言组织的首次辩论（主要基于解剖学临床观察）。然后，我将尝试总结最近处理这一复杂问题的作者的工作，他们在使用实验心理学方法进行的系统研究中，以阐明失语症中非言语认知障碍的意义。最后，在综述的最后一部分，我将讨论“语义中枢”假说支持者的解读，他们试图分析和解释语义性痴呆患者与失语性中风患者非言语语义缺陷之间的差异。认为在失语症患者中观察到的大多数非言语认知障碍是由于言语前概念障碍的假说，似乎得到了充分证实，这种障碍不能归因于语义表征的丧失，而应归因于其受控检索的缺陷。然而，仍有两个主要问题需要澄清。第一个问题是，失语症患者的一些非言语认知缺陷似乎是由于语言障碍对抽象非言语认知活动的负面影响，而不是由于言语前概念障碍。第二个问题涉及未受损概念表征的有缺陷的受控检索的确切性质及其神经解剖学关联，这应该涵盖失语症患者的大多数非言语认知障碍。
