Kurt Goldstein and his nonlocationist thoughts on aphasia-a pioneer of early network theories at the beginning of the twentieth century?

Assessing Kurt Goldstein's lasting influence in the neuropsychology of language versus his use of aphasic symptoms as diagnostic insights into brain injuries

In the history of the neurological relationship between human behavior and brain function in Europe and North America, various perspectives on brain localization and holistic functioning have been addressed. One of the founding figures of modern neuropsychology, Professor Hans-Lukas Teuber (1916-1977) of the Massachusetts Institute of Technology, reminded the scholarly community of its negligence of preceding traditions in day-to-day research endeavors. Teuber particularly emphasized that during the development of the aphasiology field (1950s-1960s) even major figures, such as the German-American neurologist Kurt Goldstein (1878-1965), had been neglected in the scientific community's collective memory. This happened despite Goldstein's contributions to cortical blindness, vicarious brain functioning, and neurorehabilitation. The outcome of the debates regarding the neurology of language had to be incompletely relearned in later decades. Neuropsychological concerns regarding the relationship between cortical localizationism and functional holism have made recourse to Goldstein's work necessary for reviving historical answers for current conundrums. It is therefore opportune to review Goldstein's work in the light of the history of aphasiology. Contemporary scholarship has once more drawn research attention to the works of Goldstein along with Norman Geschwind (1926-1984) and his pupils. It has also resurrected the underlying research of Carl Wernicke (1848-1905). This review article explores deep and lasting questions regarding the positioning of Goldstein's holism among the contemporary holistic perspectives. It does so by firstly discussing Wernicke's traditional model of distributed localizationism. Secondly, it describes Goldstein's previous work in the German brain sciences. Thirdly, it examines his aphasiological contributions on both sides of the Atlantic. Fourthly, it addresses the advancement of a dynamic localizational perspective by Geschwind and his pupils. This article intends to render a historical analysis fruitful for those exploring modern-day problems in the neurology of aphasia and clinical speech neuropsychology.

Defining aphasia: Content analysis of six aphasia diagnostic batteries

Clear operational definitions of constructs are necessary to ensure that research findings are meaningful and interpretable. In the field of aphasiology, aphasia is often defined to the effect of "aphasia is an acquired language disorder often due to brain injury that affects expressive and receptive language." To contribute to our understanding of the construct of aphasia, we conducted a content analysis of six diagnostic aphasia tests: the Minnesota Test for the Differential Diagnosis of Aphasia, the Porch Index of Communicative Ability, the Boston Diagnostic Aphasia Examination, the Western Aphasia Battery, the Comprehensive Aphasia Test, and the Quick Aphasia Battery. These chosen tests have historical prominence, with several in regular clinical and research use today. We hypothesized that the content of the aphasia tests should be very similar since they all purport to identify and characterize (if present) aphasia, with recognition that there may be some subtle differences in test content stemming in large part to epistemological differences in the test makers' views of aphasia. Instead, we found predominantly weak Jaccard indices, a similarity correlation coefficient, between test targets. Only five test targets were found in all six aphasia tests: auditory comprehension of words and sentences, repetition of words, confrontation naming of nouns, and reading comprehension of words. The qualitative and quantitative results suggest that the content across aphasia tests may be more disparate than expected. We conclude by discussing the implication of our results for the field, including the importance of updating, if necessary, the operational definition of aphasia through conversation with a broad audience of interested and affected people.

The debate on apraxia and the supplementary motor area in the twentieth century

Hand function and apraxia are equally relevant to neurosurgeons: as a symptom, as well as through the functional anatomy of "praxis" which underlies the dexterity needed for neurosurgical practice. The supplementary motor area is crucial for its understanding. Historically, Hugo Liepmann dominated the apraxia debate at the beginning of the twentieth century, a debate that has remained influential until today. Kurt Goldstein, a contemporary of Liepmann, is regularly mentioned as the first to have described the alien hand syndrome in 1909. Wilder Penfield was a key figure in exploring the role of the fronto-mesial cortex in human motor control and coined the term "supplementary motor area". It was Goldstein who not only contributed substantially to the apraxia debate more than 100 years ago; he also established the link between the dysfunction of the fronto-mesial cortex and abnormal higher motor control in humans.