Binding in agrammatic aphasia: Processing to comprehension

Visual Attention to Semantic and Orthographic Associations in Fluent Aphasia: Evidence from Eye-Tracking

We examined the allocation of visual attention in an association task by both neurotypical participants (n = 11) and adults with fluent aphasia (n = 12). Participants were presented with a picture (e.g., a basket) followed by a semantically related association (i.e., "strawberry") and an orthographically related association (i.e., "b," the first letter of "basket"). An eye tracker recorded their eye movements for three areas of interest (AOI): the picture, the semantic associate, and the orthographic associate, over 1396 observations. Results showed that both neurotypical participants and participants with aphasia looked longer at the semantic associate than at the picture, and this difference was more pronounced for neurotypicals than for people with aphasia (PWA). Neurotypicals also looked longer than the PWA group at the orthographic associate than at the prior picture. Regarding eye fixation counts, both participant groups looked more frequently at the semantic associate than at either the picture or the orthographic associate. Notably, this pattern was more pronounced among neurotypical participants than PWA. Our findings emphasize the importance of semantic associations in fluent aphasia and suggest a potential rehabilitative approach in speech and language therapy.

Are Personal and Reflexive Pronouns Dissociated in Agrammatic Comprehension? An Individual Participant Meta-Analysis With Clinical Implications

PURPOSE

This study had three objectives: (a) to verify if Grodzinsky et al.'s (1993) findings of worse comprehension of personal than reflexive pronouns can be replicated in a larger meta-analysis of individual participant data, (b) to examine if the heterogeneity found in the patterns of pronoun comprehension in agrammatism can be attributed to task effects, and (c) to evaluate the risk of bias in the reviewed studies.

METHOD

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic literature search was performed to identify studies examining the personal-reflexive pronoun dissociation in agrammatic comprehension. Seven studies met the search criteria and were included in the meta-analysis. For each participant, individual accuracy scores for the comprehension of personal and reflexive pronouns were extracted in addition to information on the study methods. Individual accuracy data were analyzed using the Fisher's exact test and the binomial test. The risk of bias in the studies was assessed using an adapted version of the Newcastle-Ottawa Quality Assessment Scale.

RESULTS

The meta-analysis had three main findings: (a) The majority of the persons with agrammatic aphasia (89%) had no dissociation between the comprehension of personal and reflexive pronouns; (b) 8% revealed a pattern consistent with a neuropsychological dissociation, faring worse on the comprehension of personal than reflexive pronouns; and (c) 2% performed worse on reflexive than personal pronouns. The type of the task used affected pronoun comprehension accuracy and accounted for the heterogeneity in the patterns of pronoun comprehension attested across the different participants.

CONCLUSIONS

Taken together, the meta-analysis did not support a dissociation between personal and reflexive pronoun comprehension in agrammatic comprehension. When confirmed, the dissociation was driven by task effects. The clinical implications of these findings were discussed together with implications to minimize the risk of bias in future examinations of the topic.

Using lexical semantic cues to mitigate interference effects during real-time sentence processing in aphasia

We examined the auditory sentence processing of neurologically unimpaired listeners and individuals with aphasia on canonical sentence structures in real-time using a visual-world eye-tracking paradigm. The canonical sentence constructions contained multiple noun phrases and an unaccusative verb, the latter of which formed a long-distance dependency link between the unaccusative verb and its single argument (which was base generated in the object position and then displaced to the subject position). To explore the likelihood of similarity-based interference during the real time linking of the verb and the sentence's subject noun, we manipulated the animacy feature of the noun phrases (matched or mismatched). The study's objectives were to examine whether (a) reducing the similarity-based interference by mismatching animacy features would modulate the encoding and retrieval dynamics of noun phrases in real-time; and (b) whether individuals with aphasia would demonstrate on time sensitivity to this lexical-semantic cue. Results revealed a significant effect of this manipulation in individuals both with and without aphasia. In other words, the mismatch in the representational features of the noun phrases increased the distinctiveness of the unaccusative verb's subject target at the time of syntactic retrieval (verb offset) for individuals in both groups. Moreover, individuals with aphasia were shown to be sensitive to the lexical-semantic cue, even though they appeared to process it slower than unimpaired listeners. This study extends to the cue-based retrieval model by providing new insight on the real-time mechanisms underpinning sentence comprehension.

The effect of time on lexical and syntactic processing in aphasia

Processing deficits at the lexical level, such as delayed and reduced lexical activation, have been theorized as the source of breakdowns in syntactic operations and thus contribute to sentence comprehension deficits in individuals with aphasia (IWA). In the current study, we investigate the relationship between lexical and syntactic processing in object-relative sentences using eye-tracking while listening in IWA. We explore whether manipulating the time available to process a critical lexical item (the direct-object noun) when it is initially heard in a sentence has an immediate effect on lexical access as well as a downstream effect on syntactic processing. To achieve this aim, we use novel temporal manipulations to provide additional time for lexical processing to occur. In addition to exploring these temporal effects in IWA, we also seek to understand the effect that additional time has on sentence processing in neurotypical age-matched adults (AMC). We predict that the temporal manipulations designed to provide increased processing time for critical lexical items will 1) enhance lexical processing of the target noun, 2) facilitate syntactic integration, and 3) improve sentence comprehension for both IWA and AMC. We demonstrate that strengthening lexical processing via the addition of time can affect lexical processing and facilitate syntactic retrieval of the target noun and lead to enhanced interference resolution in both unimpaired and impaired systems. In aphasia, additional time can mitigate impairments in spreading activation thereby improving lexical access and reducing interference during downstream dependency linking. However, individuals with aphasia may require longer additions of time to fully realize these benefits.

Can the resource reduction hypothesis explain sentence processing in aphasia? A visual world study in German

Resource limitation has often been invoked as a key driver of sentence comprehension difficulty, in both theories of language-unimpaired and language-impaired populations. In the field of aphasia, one such influential theory is Caplan's resource reduction hypothesis (RRH). In this large investigation of online processing in aphasia in German, we evaluated three key predictions of the RRH in 21 individuals with aphasia and 22 control pparticipants. Measures of online processing were obtained by combining a sentence-picture matching task with the visual world paradigm. Four sentence types were used to investigate the generality of the findings, and two test phases were used to investigate RRH's predictions regarding variability in aphasia. The processing patterns were consistent with two of the three predictions of the RRH. Overall, our investigation shows that the RRH can account for important aspects of sentence processing in aphasia.

Effect of Lexical-Semantic Cues during Real-Time Sentence Processing in Aphasia

Using a visual world eye-tracking paradigm, we investigated the real-time auditory sentence processing of neurologically unimpaired listeners and individuals with aphasia. We examined whether lexical-semantic cues provided as adjectives of a target noun modulate the encoding and retrieval dynamics of a noun phrase during the processing of complex, non-canonical sentences. We hypothesized that the real-time processing pattern of sentences containing a semantically biased lexical cue (e.g., the venomous snake) would be different than sentences containing unbiased adjectives (e.g., the voracious snake). More specifically, we predicted that the presence of a biased lexical cue would facilitate (1) lexical encoding (i.e., boosted lexical access) of the target noun, snake, and (2) on-time syntactic retrieval or dependency linking (i.e., increasing the probability of on-time lexical retrieval at post-verb gap site) for both groups. For unimpaired listeners, results revealed a difference in the time course of gaze trajectories to the target noun (snake) during lexical encoding and syntactic retrieval in the biased compared to the unbiased condition. In contrast, for the aphasia group, the presence of biased adjectives did not affect the time course of processing the target noun. Yet, at the post-verb gap site, the presence of a semantically biased adjective influenced syntactic re-activation. Our results extend the cue-based parsing model by offering new and valuable insights into the processes underlying sentence comprehension of individuals with aphasia.

Eye Tracking Measures for Studying Language Comprehension Deficits in Aphasia: A Systematic Search and Scoping Review

Aim The aim of this scoping review is to identify the eye tracking paradigms and eye movement measures used to investigate auditory and reading comprehension deficits in persons with aphasia (PWA). Method MEDLINE via PubMed, Cochrane, CINAHL, Embase, PsycINFO, OTseeker, Scopus, Google Scholar, Grey Literature Database, and ProQuest Search (Dissertations & Theses) were searched for relevant studies. The Covidence software was used to manage the initial and full-text screening process for the search. Results and Discussion From a total of 1,803 studies, 68 studies were included for full-text screening. In addition, 418 records from gray literature were also screened. After full-text screening, 16 studies were included for this review-12 studies for auditory comprehension in PWA and four studies for reading comprehension in PWA. The review highlights the use of common eye tracking paradigms used to study language comprehension in PWA. We also discusse eye movement measures and how they help in assessing auditory and reading comprehension. Methodological challenges of using eye tracking are discussed. Conclusion The studies summarized in this scoping review provide evidence that the eye tracking methods are beneficial for studying auditory and reading comprehension in PWA.

Pronouns Are as Sensitive to Structural Constraints as Reflexives in Early Processing: Evidence From Visual World Paradigm Eye-Tracking

A number of studies in the extant literature report findings that suggest asymmetry in the way reflexive and pronoun anaphors are interpreted in the early stages of processing: that pronouns are less sensitive to structural constraints, as formulated by Binding Theory, than reflexives, in the initial antecedent retrieval process. However, in previous visual world paradigm eye-tracking studies, these conclusions were based on sentences that placed the critical anaphors within picture noun phrases or prepositional phrases, which have independently been shown not to neatly conform to the Binding Theory principles. We present results from a visual world paradigm eye-tracking experiment that show that when critical anaphors are placed in the indirect object position immediately following a verb as a recipient argument, pronoun and reflexive processing are equally sensitive to structural constraints.

Cortical and structural-connectivity damage correlated with impaired syntactic processing in aphasia

Agrammatism in aphasia is not a homogeneous syndrome, but a characterization of a nonuniform set of language behaviors in which grammatical markers and complex syntactic structures are omitted, simplified, or misinterpreted. In a sample of 71 left-hemisphere stroke survivors, syntactic processing was quantified with the Northwestern Assessment of Verbs and Sentences (NAVS). Classification analyses were used to assess the relation between NAVS performance and morphosyntactically reduced speech in picture descriptions. Voxel-based and connectivity-based lesion-symptom mapping were applied to investigate neural correlates of impaired syntactic processing. Despite a nonrandom correspondence between NAVS performance and morphosyntactic production deficits, there was variation in individual patterns of syntactic processing. Morphosyntactically reduced production was predicted by lesions to left-hemisphere inferior frontal cortex. Impaired verb argument structure production was predicted by damage to left-hemisphere posterior superior temporal and angular gyrus, as well as to a ventral pathway between temporal and frontal cortex. Damage to this pathway was also predictive of impaired sentence comprehension and production, particularly of noncanonical sentences. Although agrammatic speech production is primarily predicted by lesions to inferior frontal cortex, other aspects of syntactic processing rely rather on regional integrity in temporoparietal cortex and the ventral stream.

Verb and sentence processing patterns in healthy Italian participants: Insight from the Northwestern Assessment of Verbs and Sentences (NAVS)

We developed an Italian version of the Northwestern Assessment of Verbs and Sentences (NAVS, Thompson, 2011), a test assessing verb and sentence deficits typically found in aphasia, by focusing on verb-argument structure and syntactic complexity effects, rarely captured by standard language tests. Twenty-one young healthy individuals underwent a computerized experimental version of the NAVS, including three subtests assessing production/comprehension of verbs with different number (one, two, three) and type (obligatory or optional) of arguments, and two investigating production/comprehension of sentences with canonical/non-canonical word order. The number of verb arguments affected participants' reaction times (RTs) in verb naming and comprehension. Furthermore, verbs with optional arguments were processed faster than verbs with only obligatory arguments. Comprehension accuracy was lower for object-cleft vs. subject-cleft sentences. Object clefts and object relatives also elicited longer RTs than subject clefts and subject relatives, respectively. The study shows that the NAVS is sensitive to linguistic aspects of verb/sentence processing in Italian as in the English language. The study also highlights some differences between languages in the verb/sentence processing patterns of healthy individuals. Finally, the study contributes to the understanding of how information about verb-argument structure is represented and processed in healthy individuals, with reference to current models of verb processing.

Prepositions and pronouns in connected discourse of individuals with aphasia

The lexical-grammatical divide has been a widely addressed topic in aphasia. Speech parts are generally classified as either belonging to a lexical or a grammatical category based on the frequency of acquisition of new members in their paradigms (open vs. closed classes), thus neglecting heterogeneity within categories. Such an approach has led to contradictory findings. First, prepositions form closed classes, but are classically taken as lexical items. Pronouns, also belonging to a closed class, are analyzed as grammatical elements. Second, both within the group of prepositions and pronouns, forms with different syntactic and semantic properties co-exist. Following the theoretical notions granted by a usage-based theory of grammar, the ProGram theory, and taking focalizability as the classification criteria, we hypothesize that individuals with non-fluent aphasias will experience more severe problems with grammatical prepositions and pronouns, given that these elements are secondary and dependent, whereas informants in the fluent group will experience more severe trouble with lexical forms, potentially primary and independent. We focused on the performance of nine Spanish-speaking individuals with aphasia from the Rosell (2005) corpus. Samples of 300 words were transcribed and analyzed. As predicted, grammatical prepositions were found to be more severely compromised in the speech output of individuals with deficits of motor predominance, whereas lexical prepositions are more severely affected in individuals with deficits of sensory predominance. Although less conclusively, the same tendency holds in the case of pronouns. Our results, consistent with previous findings, confirm the heterogeneity of prepositions and pronouns, which should no longer be analyzed en bloc.

Proform-Antecedent Linking in Individuals with Agrammatic Aphasia: A Test of the Intervener Hypothesis

PURPOSE

To evaluate processing and comprehension of pronouns and reflexives in individuals with agrammatic (Broca's) aphasia and age-matched control participants. Specifically, we evaluate processing and comprehension patterns in terms of a specific hypothesis -- the Intervener Hypothesis - that posits that the difficulty of individuals with agrammatic (Broca's) aphasia results from similarity-based interference caused by the presence of an intervening NP between two elements of a dependency chain.

METHODS

We used an eye tracking-while-listening paradigm to investigate real-time processing (Experiment 1) and a sentence-picture matching task to investigate final interpretive comprehension (Experiment 2) of sentences containing proforms in complement phrase and subject relative constructions.

RESULTS

Individuals with agrammatic aphasia demonstrated a greater proportion of gazes to the correct referent of reflexives relative to pronouns and significantly greater comprehension accuracy of reflexives relative to pronouns.

CONCLUSIONS

These results provide support for the Intervener Hypothesis, previous support for which comes from studies of Wh- questions and unaccusative verbs, and we argue that this account provides an explanation for the deficits of individuals with agrammatic aphasia across a growing set of sentence constructions. The current study extends this hypothesis beyond filler-gap dependencies to referential dependencies and allows us to refine the hypothesis in terms of the structural constraints that meet the description of the Intervener Hypothesis.

Electrophysiology of prosodic and lexical-semantic processing during sentence comprehension in aphasia

Event-related potentials (ERPs) were used to examine how individuals with aphasia and a group of age-matched controls use prosody and themattic fit information in sentences containing temporary syntactic ambiguities. Two groups of individuals with aphasia were investigated; those demonstrating relatively good sentence comprehension whose primary language difficulty is anomia (Individuals with Anomic Aphasia (IWAA)), and those who demonstrate impaired sentence comprehension whose primary diagnosis is Broca's aphasia (Individuals with Broca's Aphasia (IWBA)). The stimuli had early closure syntactic structure and contained a temporary early closure (correct)/late closure (incorrect) syntactic ambiguity. The prosody was manipulated to either be congruent or incongruent, and the temporarily ambiguous NP was also manipulated to either be a plausible or an implausible continuation for the subordinate verb (e.g., "While the band played the song/the beer pleased all the customers."). It was hypothesized that an implausible NP in sentences with incongruent prosody may provide the parser with a plausibility cue that could be used to predict syntactic structure. The results revealed that incongruent prosody paired with a plausibility cue resulted in an N400-P600 complex at the implausible NP (the beer) in both the controls and the IWAAs, yet incongruent prosody without a plausibility cue resulted in an N400-P600 at the critical verb (pleased) only in healthy controls. IWBAs did not show evidence of N400 or P600 effects at the ambiguous NP or critical verb, although they did show evidence of a delayed N400 effect at the sentence-final word in sentences with incongruent prosody. These results suggest that IWAAs have difficulty integrating prosodic cues with underlying syntactic structure when lexical-semantic information is not available to aid their parse. IWBAs have difficulty integrating both prosodic and lexical-semantic cues with syntactic structure, likely due to a processing delay.

Development of an eye-tracking method to assess mental set switching in people with aphasia

BACKGROUND

Deficits in cognitive flexibility contribute to impaired functional communication in people with aphasia. Understanding the relationship between functional communication and cognitive flexibility in people with neurologic communication disorders is important. However, traditional methods to assess mental set switching pose significant linguistic, cognitive and motoric response confounds. Eye-tracking methods have great potential to address these challenges.

AIMS

The goal of this study was to develop and validate an eye-tracking method to index mental set switching in individuals without neurological impairment based upon performance on a nonlinguistic switching task.

METHODS

Eye movements of 20 adults without communication disorders were recorded as they completed a switching task, requiring participants to match stimuli to one or two search criteria (colour or shape) in single- and mixed-task conditions. Differences between single and mixed conditions were assessed with eye-tracking measures. Performance on the eye-tracking task was compared to standardized measures of cognitive flexibility.

RESULTS

Eye-tracking measures indexed significant differences between nonswitch and switch trials within and between single- and mixed-task condition. Some standardized assessment measures correlated significantly with the eye movement measures.

CONCLUSIONS

Results support the construct validity of the novel eye-tracking method for assessing cognitive switching in language-normal adults. Clinical and research implications are discussed.

The influence of sense-contingent argument structure frequencies on ambiguity resolution in aphasia

Verbs with multiple senses can show varying argument structure frequencies, depending on the underlying sense. When acknowledge is used to mean 'recognise', it takes a direct object (DO), but when it is used to mean 'admit' it prefers a sentence complement (SC). The purpose of this study was to investigate whether people with aphasia (PWA) can exploit such meaning-structure probabilities during the reading of temporarily ambiguous sentences, as demonstrated for neurologically healthy individuals (NHI) in a self-paced reading study (Hare et al., 2003). Eleven people with mild or moderate aphasia and eleven neurologically healthy control participants read sentences while their eyes were tracked. Using adapted materials from the study by Hare et al. target sentences containing an SC structure (e.g. He acknowledged (that) his friends would probably help him a lot) were presented following a context prime that biased either a direct object (DO-bias) or sentence complement (SC-bias) reading of the verbs. Half of the stimuli sentences did not contain that so made the post verbal noun phrase (his friends) structurally ambiguous. Both groups of participants were influenced by structural ambiguity as well as by the context bias, indicating that PWA can, like NHI, use their knowledge of a verb's sense-based argument structure frequency during online sentence reading. However, the individuals with aphasia showed delayed reading patterns and some individual differences in their sensitivity to context and ambiguity cues. These differences compared to the NHI may contribute to difficulties in sentence comprehension in aphasia.

The curious case of processing unaccusative verbs in aphasia

BACKGROUND

Individuals with agrammatic Broca's aphasia (IWBA) exhibit a delay in lexical activation in S-V-O word order sentences and delayed lexical reactivation in sentences that contain syntactic dependencies. This pattern is in contrast to neurologically unimpaired individuals who immediately evince lexical reactivation at the gap in sentences that contain syntactic dependencies. However, in the case of sentences that contain unaccusative verbs, neurologically unimpaired individuals also exhibit a delay in lexical reactivation. This delay provides a unique opportunity to further examine lexical delays in IWBA.

AIM

The purpose of the current studies is to investigate the online comprehension of sentences that contain unaccusative verbs in IWBA and in a group of age-matched control (AMC) individuals.

METHODS AND PROCEDURES

Cross-modal picture priming was used to test for priming of a displaced lexical item (direct object noun) immediately after the unaccusative verb (at the gap) during the ongoing auditory stream and at three additional time points downstream from the verb (500 ms, 750 ms, and 1,250 ms).

OUTCOMES AND RESULTS

Delayed reactivation of the displaced lexical item downstream from the gap (similar to prior reports of delayed reactivation with younger unimpaired listeners) for both the AMCs and the IWBA was found.

CONCLUSION

These results provide support that IWBA do not evince a delayed time course of lexical reactivation for unaccusative verbs compared to neurologically unimpaired individuals.

Tracking sentence comprehension: Test-retest reliability in people with aphasia and unimpaired adults

PURPOSE

Visual-world eyetracking is increasingly used to investigate online language processing in normal and language impaired listeners. Tracking changes in eye movements over time also may be useful for indexing language recovery in those with language impairments. Therefore, it is critical to determine the test-retest reliability of results obtained using this method.

METHODS

Unimpaired young adults and people with aphasia took part in two eyetracking sessions spaced about one week apart. In each session, participants completed a sentence-picture matching task in which they listened to active and passive sentences (e.g., The [N1+Auxwoman was] [Vvisiting/visited] [NP/PP2(by) the man]) and selected between two pictures with reversed thematic roles. We used intraclass correlations (ICCs) to examine the test-retest reliability of response measures (accuracy, reaction time (RT)) and online eye movements (i.e., the likelihood of fixating the target picture in each region of the sentence) in each participant group.

RESULTS

In the unimpaired adults, accuracy was at ceiling (thus ICCs were not computed), with moderate ICCs for RT (i.e., 0.4 - 0.58) for passive sentences and low (<0.4) for actives. In individuals with aphasia, test-retest reliability was strong (0.590.75) for RT for both sentence types. Similarly, for the unimpaired listeners, reliability of eye movements was moderate for passive sentences (NP/PP2 region) and low in all regions for active sentences. But, for the aphasic participant group, eye movement reliability was excellent for passive sentences (in the first second after sentence end) and strong for active sentences (V and NP/PP2 regions).

CONCLUSION

Results indicated moderate-to-low reliability for unimpaired listeners; however, reliable eye movement patterns were detected for processes specific to passive sentences (e.g., thematic reanalysis). In contrast, individuals with aphasia exhibited strong and stable performance across sentence types in response measures and online eye movements. These findings indicate that visual-world eyetracking provides a reliable measure of online sentence comprehension, and thus may be useful for investigating sentence processing changes over time.

Retrieval Interference in Syntactic Processing: The Case of Reflexive Binding in English

It has been proposed that in online sentence comprehension the dependency between a reflexive pronoun such as himself/herself and its antecedent is resolved using exclusively syntactic constraints. Under this strictly syntactic search account, Principle A of the binding theory—which requires that the antecedent c-command the reflexive within the same clause that the reflexive occurs in—constrains the parser's search for an antecedent. The parser thus ignores candidate antecedents that might match agreement features of the reflexive (e.g., gender) but are ineligible as potential antecedents because they are in structurally illicit positions. An alternative possibility accords no special status to structural constraints: in addition to using Principle A, the parser also uses non-structural cues such as gender to access the antecedent. According to cue-based retrieval theories of memory (e.g., Lewis and Vasishth, 2005), the use of non-structural cues should result in increased retrieval times and occasional errors when candidates partially match the cues, even if the candidates are in structurally illicit positions. In this paper, we first show how the retrieval processes that underlie the reflexive binding are naturally realized in the Lewis and Vasishth (2005) model. We present the predictions of the model under the assumption that both structural and non-structural cues are used during retrieval, and provide a critical analysis of previous empirical studies that failed to find evidence for the use of non-structural cues, suggesting that these failures may be Type II errors. We use this analysis and the results of further modeling to motivate a new empirical design that we use in an eye tracking study. The results of this study confirm the key predictions of the model concerning the use of non-structural cues, and are inconsistent with the strictly syntactic search account. These results present a challenge for theories advocating the infallibility of the human parser in the case of reflexive resolution, and provide support for the inclusion of agreement features such as gender in the set of retrieval cues.

The comprehension of sentences with unaccusative verbs in aphasia: a test of the intervener hypothesis

BACKGROUND

It is well accepted that individuals with agrammatic Broca's aphasia have difficulty comprehending some sentences with filler-gap dependencies. While investigations of these difficulties have been conducted with several different sentence types (e.g., object relatives, Wh-questions), we explore sentences containing unaccusative verbs, which arguably have a single noun phrase (NP) that is base-generated in object position but then is displaced to surface subject position. Unaccusative verbs provide an ideal test case for a particular hypothesis about the comprehension disorder-the Intervener Hypothesis-that posits that the difficulty individuals with agrammatic Broca's aphasia have comprehending sentences containing filler-gap dependencies results from similarity-based interference caused by the presence of an intervening NP between the two elements of a syntactic chain.

AIM

To assess a particular account of the comprehension deficit in agrammatic Broca's aphasia-the Intervener Hypothesis.

METHODS & PROCEDURES

We used a sentence-picture matching task to determine if listeners with agrammatic Broca's aphasia (LWBA) and age-matched neurologically unimpaired controls (AMC) have difficulty comprehending unaccusative verbs when placed in subject relative and complement phrase (CP) constructions.

OUTCOMES & RESULTS

We found above-chance comprehension of both sentence constructions with the AMC participants. In contrast, we found above-chance comprehension of CP sentences containing unaccusative verbs but poor comprehension of subject relative sentences containing unaccusative verbs for the LWBA.

CONCLUSIONS

These results provide support for the Intervener Hypothesis, wherein the presence of an intervening NP between two elements of a filler-gap dependency adversely affects sentence comprehension.

Cue Recognition and Integration - Eye Tracking Evidence of Processing Differences in Sentence Comprehension in Aphasia

Purpose

We aimed at further elucidating whether aphasic patients’ difficulties in understanding non-canonical sentence structures, such as Passive or Object-Verb-Subject sentences, can be attributed to impaired morphosyntactic cue recognition, and to problems in integrating competing interpretations.

Methods

A sentence-picture matching task with canonical and non-canonical spoken sentences was performed using concurrent eye tracking. Accuracy, reaction time, and eye tracking data (fixations) of 50 healthy subjects and 12 aphasic patients were analysed.

Results

Patients showed increased error rates and reaction times, as well as delayed fixation preferences for target pictures in non-canonical sentences. Patients’ fixation patterns differed from healthy controls and revealed deficits in recognizing and immediately integrating morphosyntactic cues.

Conclusion

Our study corroborates the notion that difficulties in understanding syntactically complex sentences are attributable to a processing deficit encompassing delayed and therefore impaired recognition and integration of cues, as well as increased competition between interpretations.

Mechanisms underlying syntactic comprehension deficits in vascular aphasia: new evidence from self-paced listening

Sixty-one people with aphasia (pwa) and 41 matched controls were tested for the ability to understand sentences that required the ability to process particular syntactic elements and assign particular syntactic structures. Participants paced themselves word-by-word through 20 examples of 11 spoken sentence types and indicated which of two pictures corresponded to the meaning of each sentence. Sentences were developed in pairs such that comprehension of the experimental version of a pair required an aspect of syntactic processing not required in the corresponding baseline sentence. The need for the syntactic operations required only in the experimental version was triggered at a "critical word" in the experimental sentence. Listening times for critical words in experimental sentences were compared to those for corresponding words in the corresponding baseline sentences. The results were consistent with several models of syntactic comprehension deficits in pwa: resource reduction, slowed lexical and/or syntactic processing, abnormal susceptibility to interference from thematic roles generated non-syntactically. They suggest that a previously unidentified disturbance limiting the duration of parsing and interpretation may lead to these deficits, and that this mechanism may lead to structure-specific deficits in pwa. The results thus point to more than one mechanism underlying syntactic comprehension disorders both across and within pwa.

A Computational Evaluation of Sentence Processing Deficits in Aphasia

Individuals with agrammatic Broca's aphasia experience difficulty when processing reversible non-canonical sentences. Different accounts have been proposed to explain this phenomenon. The Trace Deletion account (Grodzinsky, 1995, 2000, 2006) attributes this deficit to an impairment in syntactic representations, whereas others (e.g., Caplan, Waters, Dede, Michaud, & Reddy, 2007; Haarmann, Just, & Carpenter, 1997) propose that the underlying structural representations are unimpaired, but sentence comprehension is affected by processing deficits, such as slow lexical activation, reduction in memory resources, slowed processing and/or intermittent deficiency, among others. We test the claims of two processing accounts, slowed processing and intermittent deficiency, and two versions of the Trace Deletion Hypothesis (TDH), in a computational framework for sentence processing (Lewis & Vasishth, 2005) implemented in ACT-R (Anderson, Byrne, Douglass, Lebiere, & Qin, 2004). The assumption of slowed processing is operationalized as slow procedural memory, so that each processing action is performed slower than normal, and intermittent deficiency as extra noise in the procedural memory, so that the parsing steps are more noisy than normal. We operationalize the TDH as an absence of trace information in the parse tree. To test the predictions of the models implementing these theories, we use the data from a German sentence-picture matching study reported in Hanne, Sekerina, Vasishth, Burchert, and De Bleser (2011). The data consist of offline (sentence-picture matching accuracies and response times) and online (eye fixation proportions) measures. From among the models considered, the model assuming that both slowed processing and intermittent deficiency are present emerges as the best model of sentence processing difficulty in aphasia. The modeling of individual differences suggests that, if we assume that patients have both slowed processing and intermittent deficiency, they have them in differing degrees.

A novel eye-tracking method to assess attention allocation in individuals with and without aphasia using a dual-task paradigm

Numerous authors report that people with aphasia have greater difficulty allocating attention than people without neurological disorders. Studying how attention deficits contribute to language deficits is important. However, existing methods for indexing attention allocation in people with aphasia pose serious methodological challenges. Eye-tracking methods have great potential to address such challenges. We developed and assessed the validity of a new dual-task method incorporating eye tracking to assess attention allocation. Twenty-six adults with aphasia and 33 control participants completed auditory sentence comprehension and visual search tasks. To test whether the new method validly indexes well-documented patterns in attention allocation, demands were manipulated by varying task complexity in single- and dual-task conditions. Differences in attention allocation were indexed via eye-tracking measures. For all participants significant increases in attention allocation demands were observed from single- to dual-task conditions and from simple to complex stimuli. Individuals with aphasia had greater difficulty allocating attention with greater task demands. Relationships between eye-tracking indices of comprehension during single and dual tasks and standardized testing were examined. Results support the validity of the novel eye-tracking method for assessing attention allocation in people with and without aphasia. Clinical and research implications are discussed.

LEARNING OUTCOMES

Readers will be able to: (1) summarize the nature of dual-task paradigms, (2) identify shortcomings of existing dual-task measures of attention allocation for application to people with aphasia, (3) describe how eye-tracking measures may be recorded and analyzed to reflect differences in attention allocation across conditions, and (4) summarize potential clinical applications for eye-tracking measures of attention allocation.

Losing track of time? Processing of time reference inflection in agrammatic and healthy speakers of German

BACKGROUND

Individuals with agrammatic aphasia (IWAs) have problems with grammatical decoding of tense inflection. However, these difficulties depend on the time frame that the tense refers to. Verb morphology with reference to the past is more difficult than with reference to the non-past, because a link needs to be made to the past event in discourse, as captured in the PAst DIscourse LInking Hypothesis (PADILIH; Bastiaanse, R., Bamyaci, E., Hsu, C., Lee, J., Yarbay Duman, T., Thompson, C. K., 2011. Time reference in agrammatic aphasia: A cross-linguistic study. J. Neurolinguist. 24, 652-673). With respect to reference to the (non-discourse-linked) future, data so far indicate that IWAs experience less difficulties as compared to past time reference (Bastiaanse, R., Bamyaci, E., Hsu, C., Lee, J., Yarbay Duman, T., Thompson, C. K., 2011. Time reference in agrammatic aphasia: A cross-linguistic study. J. Neurolinguist. 24, 652-673), supporting the assumptions of the PADILIH. Previous online studies of time reference in aphasia used methods such as reaction times analysis (e.g., Faroqi-Shah, Y., Dickey, M. W., 2009. On-line processing of tense and temporality in agrammatic aphasia. Brain Lang. 108, 97-111). So far, no such study used eye-tracking, even though this technique can bring additional insights (Burchert, F., Hanne, S., Vasishth, S., 2013. Sentence comprehension disorders in aphasia: the concept of chance performance revisited. Aphasiology 27, 112-125, doi:10.1080/02687038.2012.730603).

AIMS

This study investigated (1) whether processing of future and past time reference inflection differs between non-brain-damaged individuals (NBDs) and IWAs, and (2) underlying mechanisms of time reference comprehension failure by IWAs.

METHODS AND PROCEDURES

A visual-world experiment combining sentence-picture matching and eye-tracking was administered to 12 NBDs and 6 IWAs, all native speakers of German. Participants heard German sentences with periphrastic future ('will+V') or periphrastic past ('has+V-d') verb forms while they were presented with corresponding pictures on a computer screen.

RESULTS AND DISCUSSION

NBDs scored at ceiling and significantly higher than the IWAs. IWAs had below-ceiling performance on the future condition, and both participant groups were faster to respond to the past than to the future condition. These differences are attributed to a pre-existing preference to look at a past picture, which has to be overcome. Eye movement patterns suggest that both groups interpret future time reference similarly, while IWAs show a delay relative to NBDs in interpreting past time reference inflection. The eye tracking results support the PADILIH, because processing reference to the past in discourse syntax requires additional resources and thus, is problematic and delayed for people with aphasia.

The time-course of lexical activation during sentence comprehension in people with aphasia

PURPOSE

To investigate the time-course of processing of lexical items in auditorily presented canonical (subject-verb-object) constructions in young, neurologically unimpaired control participants and participants with left-hemisphere damage and agrammatic aphasia.

METHOD

A cross modal picture priming (CMPP) paradigm was used to test 114 control participants and 8 participants with agrammatic aphasia for priming of a lexical item (direct object noun) immediately after it is initially encountered in the ongoing auditory stream and at 3 additional time points at 400-ms intervals.

RESULTS

The control participants demonstrated immediate activation of the lexical item, followed by a rapid loss (decay). The participants with aphasia demonstrated delayed activation of the lexical item.

CONCLUSION

This evidence supports the hypothesis of a delay in lexical activation in people with agrammatic aphasia. The delay in lexical activation feeds syntactic processing too slowly, contributing to comprehension deficits in people with agrammatic aphasia.

Tracking Passive Sentence Comprehension in Agrammatic Aphasia

People with agrammatic aphasia often experience greater difficulty comprehending passive compared to active sentences. The Trace Deletion Hypothesis (TDH; Grodzinsky, 2000) proposes that aphasic individuals cannot generate accurate syntactic representations of passive sentences and, hence, use an agent-first processing strategy which leads to at-chance performance. We tested this claim using the eyetracking-while-listening paradigm in order to reveal online processing routines. Ten agrammatic aphasic participants and 10 age-matched controls listened to passive and active sentences and performed a sentence-picture matching task (i.e., selecting between two pictures with reversed thematic roles), while their eye movements were monitored. Control participants' performance was at ceiling, whereas accuracy for the aphasic participants was above chance for active sentences and at chance for passive sentences. Further, for the control participants, the eye movement data showed an initial agent-first processing bias, followed by fixation on the correct picture in the vicinity of the verb in both active and passive sentences. However, the aphasic participants showed no evidence of agent-first processing, counter the predictions of the TDH. In addition, in active sentences, they reliably fixated the correct picture only at sentence offset, reflecting slowed processing. During passive sentence processing, fixations were at chance throughout the sentence, but different patterns were noted for correct and incorrect trials. These results are consistent with the proposal that agrammatic sentence comprehension failure involves lexical processing and/or lexical integration deficits.

Time reference in agrammatic aphasia: A cross-linguistic study

It has been shown across several languages that verb inflection is difficult for agrammatic aphasic speakers. In particular, Tense inflection is vulnerable. Several theoretical accounts for this have been posed, for example, a pure syntactic one suggesting that the Tense node is unavailable due to its position in the syntactic tree (Friedmann & Grodzinsky, 1997); one suggesting that the interpretable features of the Tense node are underspecified (Burchert, Swoboda-Moll, & De Bleser, 2005; Wenzlaff & Clahsen, 2004, 2005); and a morphosemantic one, arguing that the diacritic Tense features are affected in agrammatism (Faroqi-Shah & Dickey, 2009; Lee, Milman, & Thompson, 2008). However recent findings (Bastiaanse, 2008) and a reanalysis of some oral production studies (e.g. Lee et al., 2008; Nanousi, Masterson, Druks, & Atkinson, 2006) suggest that both Tense and Aspect are impaired and, most importantly, reference to the past is selectively impaired, both through simple verb forms (such as simple past in English) and through periphrastic verb forms (such as the present perfect, 'has V-ed', in English). It will be argued that reference to the past is discourse linked and reference to the present and future is not (Zagona, 2003, in press). In-line with Avrutin's (2000) theory that suggests discourse linking is impaired in Broca's aphasia, the PAst DIscourse LInking Hypothesis (PADILIH) has been formulated. Three predictions were tested: (1) patients with agrammatic aphasia are selectively impaired in use of grammatical morphology associated with reference to the past, whereas, inflected forms which refer to the present and future are relatively spared; (2) this impairment is language-independent; and (3) this impairment will occur in both production and comprehension. Agrammatic Chinese, English and Turkish speakers were tested with the Test for Assessing Reference of Time (TART; Bastiaanse, Jonkers, & Thompson, unpublished). Results showed that both the English and Turkish agrammatic speakers performed as hypothesized, showing a selective deficit for production of inflected forms referring to the past, despite the typological difference between the languages. The Chinese agrammatic speakers were poor in reference to the past as well, but reference to the present and future also was severely impaired. For comprehension, the results were strikingly similar for the three languages: reference to the past was impaired for all. These results confirmed our hypothesis that reference to the past is discourse linked and, therefore, grammatical morphology used for reference to the past is impaired in agrammatic aphasia, whether this is done through Tense and/or Aspect markers.

Pronominal resolution and gap filling in agrammatic aphasia: evidence from eye movements

This paper reports the results of three studies examining comprehension and real-time processing of pronominal (Experiment 1) and Wh-movement (Experiments 2 and 3) structures in agrammatic and unimpaired speakers using eyetracking. We asked the following questions: (a) Is off-line comprehension of these constructions impaired in agrammatic listeners?, (b) Do agrammatic, like unimpaired, listeners show eye movement patterns indicative of automatic pronominal reference resolution and/or gap-filling?, and (c) Do eyetracking patterns differ when sentences are correctly versus incorrectly interpreted, or do automatic processes prevail in spite of comprehension failure? Results showed that off-line comprehension of both pronoun and Wh-movement structures was impaired in our agrammatic cohort. However, the aphasic participants showed visual evidence of real-time reference resolution as they processed binding structures, including both pronouns and reflexives, as did our unimpaired control participants. Similarly, both the patients and the control participants showed patterns consistent with successful gap filling during processing of Wh-movement structures. For neither pronominal nor movement structures did we find evidence of delayed processing. Notably, these patterns were found for the aphasic participants even when they incorrectly interpreted target sentences, with the exception of object relative constructions. For incorrectly interpreted sentences, we found end of sentence lexical competition effects. These findings indicate that aberrant lexical integration, rather than representational deficits or generally slowed processing, may underlie agrammatic aphasic listener's comprehension failure.