Refractory semantic access dysphasia resulting from resection of a left frontal glioma

Abstract

The existence of semantic access disorders is now well established, however the precise cognitive and anatomical underpinnings are still debated. Here we describe the case of a patient that became aphasic after the resection of a left frontal glioma. Detailed lesion reconstruction indicates that the lesion was mostly restricted to the left dorsal and ventral prefrontal cortices and the underlying white matter, but sparing temporal lobes. Critically, the patient showed all the signs of refractory semantic access dysphasia, supporting the association between this syndrome and damage to left prefrontal areas likely to subserve retrieval and selection mechanisms for verbal material.

What we talk about when we talk about access deficits

“…Access deficit patients perform much better when the distractors are unrelated to the target than when they are related. This has been shown in word-topicture matching [12,15,[18][19][20][21][22]24,32,33] and spoken-to-written word matching [16,18,25,26,32,33,35,36]. In addition, participants with non-fluent aphasia have been reported to exhibit exaggerated slowing when naming pairs of semantically related pictures than unrelated pictures [37,38].…”

“…Participants with access deficits perform much better when this 'response-stimulus interval' (RSI) is long than when it is short, but the performance of storage deficit (SD) patients is not affected by this manipulation of presentation rate. This pattern has been shown in spoken word-to-picture matching [12][13][14][15][17][18][19][20][21][22][23][24], spoken-to-written word matching [16,25,26], picture naming [9,23,27,28], reading [29] and matching of non-verbal sounds to pictures or words [30].…”

“…By contrast, storage deficit (SD) patients tend to exhibit highly consistent performance-for a particular stimulus, they tend to either respond correctly on all presentations or incorrectly on all presentationssignificantly deviating from a binomial distribution. This pattern has been shown in word-to-picture matching [12,14,15,18,19,21,22,24], spoken-to-written word matching [16,17], picture-topicture matching [18], picture naming [27], word reading [31] and matching of non-verbal sounds to pictures or words [30].…”

“…Summary of key access deficit phenomena, tasks in which they have been shown, and patients (or patient groups) that have shown the effect. phenomenon task patients sensitivity to cueing picture naming 10/10 SA patients [8] a ; 4/4 SA patients [9] a ; 6/6 SA patients [10] a object use 8/8 SA patients [11] a sensitivity to presentation rate spoken word-to-picture matching AA [12]; HEC [13]; VER [14]; YOT [15]; AZ [17,18]; UM-103 [19]; HA, DZ [20];…”

“…JM [21]; MH, RS b [22]; BM [23]; 7/10 pre-and 6/8 postsurgery glioma patients [24] c spoken-to-written word matching MED [16]; AZ [25,26] picture naming 4/4 SA patients [9] a ; BM [23]; FAS [27]; 18 aphasic patients [28] d,e reading VYG [29] matching non-verbal sounds to pictures or words AZ, BBB [30] performance inconsistency spoken word-to-picture matching AA [12]; HEC [13]; VER [14]; YOT [15]; MED [16]; AZ [18]; UM-103 [19] JM [21]; MH, RS b [22]; 9/9 pre-and 5/6 postsurgery glioma patients [24] c spoken-to-written word matching AZ [17]; MED [16] picture-to-picture matching AZ [18] picture naming FAS [27] word reading VEM [31] matching non-verbal sounds to pictures or words AZ, BBB [30] negative serial position effect spoken word-to-picture matching AA [12]; HEC [13]; AZ [17,32]; JM [21]; RS b [22]; VER [14]; IRQ [33]; 2/9 pre-and 2/7 postsurgery glioma patients [24] c spoken-to-written word matching AZ [17,25,26,32]; MED [16]; IRQ [33]; JM [34] picture naming FAS …”