Ling 411 – 03 History of Aphasiology 1. Early Workers 2. Broca, Wernicke, Lichtheim 3. Reactions to Connectionism 4. Goldstein, Luria and Geschwind 5. Recent Workers Outline of major historical periods 1. Early studies: Up to Broca 2. Broca, Wernicke, Lichtheim – Connectionism 3. The decades following Wernicke & Lichtheim 4. Goldstein, Luria, Geschwind • The return of connectionism a. b. c. d. Goodglass Benson and Ardila Damasio Psychologists 5. Present and recent past 1. Early Studies From ancient Egypt to Broca An Egyptian surgeon, ca. 3000 B.C. “If you examine a man with a broken temple, … when you speak to him, he does not answer, he has lost his use of words.” Early European thinking Aristotle • Heart is the center of intelligence • Brain is for cooling blood Galen (Greek, 130(?) – 201(?) a.d.) • Dissected animals • Brain is center of thinking and feeling Vesalius (16th century, worked on cadavers) Steno (Late 17th century) • Brain is the seat of both thought and soul Franz Joseph Gall By early 1800’s, aphasia became a focus of intellectual speculation Franz Joseph Gall (1758–1828) • Started career in Vienna, later moved to Paris • Localization of function • good idea! Phrenology bad idea! Gall’s Phrenology Theory Wrong, of course! (Why?) Yet the idea of localization is a good one Reactions to Gall Pierre Flourens – Attacked Gall • The brain functions holistically Supporters of Gall • Jean-Baptiste Bouillard (1825–1881) • Ernst Aubertin (son-in-law of Bouillard) • Pierre Gratiolet A decades-long debate Locationism vs. Holism Started with reactions to Gall Gall: a naïve locationist At first, it was assumed that all locationalism was necessarily naïve The only alternative seen was holism Debate flourished for decades • Mainly in France, England, Germany Marc Dax In unublished work of 1836 he anticipated the later major contribution of Broca Probably influenced Broca Jean-Baptiste Bouillard (France) 1825-1881 Improved Gall’s methods Anticipated later theories Did post-mortem exams of aphasics Proposed left frontal lobe (sometimes right) as the locus of speech Ernst Auburtin (France) Son-in-law of Bouillard Supported the theory of localization of brain functions in discrete brain areas Presented an important paper in 1861 • Broca was in the audience • Broca invited Aubertin to examine one of his patients 2. Broca, Wernicke, Lichtheim The rise of connectionism: A sophisticated form of locationalism Pierre Paul Broca (French, 1824-1880) Pierre Paul Broca (1824–1880) Heard important presentation by Auburtin in 1861 Two days later, he got a patient who • Couldn’t talk • Had malfunction of right side of body • Died 5 days later Broca performed autopsy • Found lesion in “third frontal convolution” Second patient, also aphasic, also had lesion in inferior frontal gyrus Principal cortical gyri (schematic) Pierre Paul Broca (cont’d) One patient had right hemisphere damage, but no speech disturbance In 1870’s, started localizing other functions Did neuroanatomical studies of dogs to investigate localization hypotheses Also recognized a different language disorder – “verbal amnesia” – but didn’t propose a location Was criticized on the grounds that some aphasics didn’t have lesion in 3rd frontal gyrus Broca’s major contributions Cerebral dominance • “We speak with the left side of our brains” Inferior frontal gyrus for speech production (“Broca’s area”*) Localization of function based on convolutional anatomy *Broca did not himself propose this designation Karl Wernicke (German, 1848-1905) The most important figure in 19th century aphasiology Karl Wernicke (1848-1905) Studied neuroanatomy with Meinert in Vienna Important paper published in 1874 (at age 26) Generally supported Broca Identified “Broca’s aphasia” as difficulty with speech production, especially of function words Also identified a posterior language area Wernicke’s posterior language area In posterior superior temporal lobe Important for speech comprehension If damaged, comprehension impaired If damaged, speech is repetitive • Patient is unaware of his errors Locus of auditory images of words Now known as Wernicke’s area Two basic language areas Primary Somatosensory Area Primary Motor Area Broca’s area Primary Auditory Area Wernicke’s area Primary Visual Area Two basic language areas Primary Somatosensory Area Primary Motor Area Phonological Production Primary Auditory Area Phonological Recognition Primary Visual Area Wernicke: Connectionism Proposed the theory of connectionism (with Lichtheim) Involves localization of function, but in a more sophisticated form than predecessors Accepted Meinert’s postulation of a fiber bundle connecting the two basic language areas – arcuate fasciculus Arcuate Fasciculus Wernicke: Connectionism and the arcuate fasciculus Wernicke had learned about it from Meinert in Vienna Predicted “Conduction Aphasia” • Would result from damage to this bundle • Such a patient would be unable to transmit • auditory identification to speech production area Hence, impaired repetition Later, he encountered a patient with just this problem Ludwig Lichtheim (German, 1845-1928) Worked with Wernicke Proposed a connectionist-locationist scheme with now-famous diagram, 1885 • Accepted by Wernicke • The birth of connectionism • This scheme was widely criticized for several • subsequent decades Revived by Norman Geschwind in 1960’s The Wernicke-Lichtheim model (1885) A – Auditory M – Motor B – Ideation Numbers indicate areas in which disconnection would produce distinct disorder From Lichtheim 1885 Hickok’s revised diagram (Gregory Hickock, 2000) Conceptual Representations M A Linguistic Representation Sensory-Motor Periphery The Wernicke-Lichtheim model (1885) Arcuate fasciculus Several different areas Broca’s area Wernicke’s area Mouth region of primary motor area Primary auditory area Wernicke and Connectionism “Based on on his discoveries and those of Broca, Fritsch, and Hitzig, Wernicke proposed (1876) that only the most basic mental functions, those concerned with simple perceptual and motor activities, are localized to single areas of the cortex, and that more complex intellectual functions result from interconnections between several functional sites. In placing the principle of localized function within a connectionist framework, Wernicke appreciated that different components of a single behavior are processed in different regions of the brain. He thus advanced the first evidence for the idea of distributed processing, which is now central to our understanding of brain function.” (Kandel et al. 1995:13) Big lesson – Remember this! 3. The Decades following Wernicke & Lichtheim From Marie to Goldstein (Benson & Ardila include Goldstein and Luria in this third period) Jules Dejerine (French) 1901: Accepted basic ideas of Wernicke and Lichtheim But rejected the concept center depicted in their diagram – no anatomical basis Added account of reading problems: alexia • Visual-verbal zone in left angular gyrus Diverse Views after Wernicke & Lichtheim Pierre Marie (France) Jules Dejerine (France) J. Hughlings Jackson (England) Henry Head (England) Kurt Goldstein (Germany) Aleksandr Luria (Russia) Color Code: Attacked Wernicke Supported Wernicke Independent innovator 4. Goldstein, Luria, Geschwind The return of connectionism Kurt Goldstein (1878-1965) German Studied with Wernicke Influenced by Gestalt psychology (Koffka 1935) Adopted a “holistic” approach • • Became the best-known spokesman for this approach Important publication in 1948 • • Not the arcuate fasciculus but a central area Proposed the term ‘Central Aphasia’ Criticized the Wernicke-Lichtheim view of conduction aphasia Now we see that there are really two kinds of conduction aphasia Another basic language area? Central Sulcus Broca’s area Primary Auditory Area Central area Wernicke’s area Primary Visual Area Another basic language area? Central Sulcus Broca’s area Primary Auditory Area Goldstein’s area Wernicke’s area Primary Visual Area Luria’s position according to Benson & Ardila Luria … took a midway stance between the localizationist and holistic approaches. He considered language to be a complex functional system, requiring many different steps in both comprehension and production; simultaneous participation of multiple cortical areas would be required for language processing. Although each cortical area performs a specific process, it also participates in different functional systems. Thus, the first temporal gyrus participates in phoneme discrimination, and its damage causes difficulty in all functional systems requiring phoneme discrimination… Benson & Ardila 1996:19-20 Question: Is this really a “midway stance”? Good and bad localizationist models Bad (e.g., Gall’s phrenology) • Each local center does a fairly large job, all by itself Good (e.g. Wernicke-Lichtheim) • Each local center does a very small job • Large jobs get done by the operation of several • or many such local centers working together, partly in serial, partly in parallel — distributed processing A local center can participate in several different kinds of larger jobs, depending on what other centers are working together with it Norman Geschwind (1926-1984) Born in New York City Trained: Harvard medical school and London’s National Hospital Career: • • • • Boston VA hospital Chief of neurology Boston University, neurology Established Boston U Aphasia Research Center Trained a generation of leading neurologists Revived the Wernicke-Lichtheim theory Norman Geschwind on Wernicke (1966) Wernicke’s reasoning was simple. He applied Meynert’s teaching on the fiber tracts of the brain to the problem of aphasia. The phrenologists, he argued, had been wrong in their attempt to localize such complex mental attributes as magnanimity or filial love; what was actually localizable were much simpler perceptual and motor functions. All the complex array of human intellectual attributes must somehow be woven from these few threads of different texture. The cortex could … provide two means of achieving this higher integration: it could store sensory traces in cells … and, by means of association fiber tracts, it could link together different parts of the system. Norman Geschwind on Wernicke (1966) (cont’d) Meynert had already pointed out that what lay anterior to the fissure of Rolando was motor in function, what lay behind it was sensory. It seemed most reasonable to assume that traces of sensory impressions or of motor patterns should somehow be stored in regions adjacent to the appropriate elementary zones in the cortex. Norman Geschwind on Wernicke (1966) (cont’d) The application to speech was immediate. Hitzig had already shown that at the lower end of the Rolandic cortex was a zone which, when stimulated on one side, led to bilateral movements of the mouth and the tongue. It was reasonable to assume that immediately in front of this zone lay a region where patterns of articulatory movements might be stored. This was exactly where Broca had placed the lesions in his cases, a localization repeatedly to be confirmed. Norman Geschwind on Wernicke (1966) (cont’d) Meynert had asserted that the central end of the acoustic pathways lay in the vicinity of the Sylvian fissure. Thus it was reasonable to assume that traces of words should be stored near this zone. If this were the case, then an aphasia with loss of comprehension should result from lesions in this neighborhood. Necropsy of the patients recorded in Wernicke’s paper amply confirmed these hypotheses. Intellectual lineages Leading Aphasiologists Wernicke Lichtheim Goldstein Geschwind (Boston) Luria (Moscow) Goodglass Benson Damasio Ardila Intellectual lineages Leading Aphasiologists Wernicke Germany Lichtheim Goldstein Geschwind (Boston) Russia Luria (Moscow) Goodglass Benson Damasio Ardila U.S.A. 5. Present and Recent Past Ardila Benson Goodglass Damasio Psychologists Other contemporaries The Great Divide Clinical Aphasiologists • Largely accept modern reformulations of • Geschwind-Lichtheim connectionism, following Geschwind E.g., Goodglass, Benson, Damasio Psychologists • E.g. Blumstein, Caramazza, Pinker • Tend to reject Wernicke-Geschwind thinking • Sometimes make unsophisticated • assumptions without evidence Some try to make use of Chomsky’s formulations about language Modern attacks on Wernicke-Geschwind connectionism John Pinel • Surgical excisions of important language areas fail to result in aphasia Blumstein, Pinker, Pulvermüller • Erratic speech output of Wernicke’s aphasics Broca’s Area: Not for Speech Production? Surgical excision was done in two stages. Following completion of the second stage, no speech-related problems were reported. Patient D.H. John Pinel, Biopsychology (1990:560), Adapted from Penfield & Roberts, 1959 Broca’s Area: Not for Speech Production? What Pinel neglects to mention, but it is in Penfield & Roberts: Patient D.H. was a young boy who had been having seizures, originating in this part of his brain. Patient D.H. John Pinel, Biopsychology (1990:560), Adapted from Penfield & Roberts, 1959 More on patient D.H. Eighteen years old at time of surgery Had suffered from seizures causing an inability to speak from the age of 3 1/2 Apparently, “the congenital abnormality had caused displacement of function” Penfield & Roberts Speech and Brain Mechanisms (1959: 163) end