P-2-04-11
Detailed Examination of Intelligence and Apraxia in Patients with Aphasia.
Atsuko Ogata, Kazumi Kawahira, Nobuyuki Tanaka (Department of Rehabilitation and Physical Medicine, Faculty of Medicine Kagoshima University, Japan)
In patients with l-hemispheric damage, aphasia and ideational apraxia (IA) have been frequently reported to exist simultaneously. So these patients show very low verbal and non verbal (Kohs cubic test etc.) IQ test and are frequently evaluated as dementia. We, however, think the core of intelligence exists in memory and interpretation. In addition, because of the aphasia, it is still unknown whether IA in these patients is exactly compatible to the definition of IA, i.e., apraxia under complete recognition of tool utility. In this study, we tried to classify the IA with aphasia into some subgroups using non-verbal examinations to select correct pictures. IA was assessed by the actual use of a single tool by the left hand, pencil, teeth brush, chop sties, comb and spoon etc.
<subjects and methods> Subjects were 26 patients of left brain damage (mean age 57 years, 17 men, 9 women). All of the patients had different types and degrees aphasia and r-hemiplegia. Aphasia was evaluated by SLTA. IA was assessed by the actual use of a single tool by the left hand, pencil, teeth brush, chop sties, comb and spoon etc. Classification of IA was basically consisted of following 2 steps. Test 1; To choose the same picture of 8 pictures of offered object (visual cognition of tool). Test 2; To choose the picture showing correct utility of 5 pictures of offered tool (understanding of tool utility). Before each test, examiner plays 1 or 2 times how to choose the correct picture. As an intelligence and a constructional test, the Raven colored progressive matrices (RCPM) test and the block design test were also used.
<Results> All patients showed different kinds of aphasia and 7 patients showed IA with single object. No patients failed to choose the pictures of offered objects and the pictures showing correct utility, so they were considered to have neither visual agnosia nor memorial disturbance. Apraxic patients had low score on RCPM.
P-2-04-12
Clinical Significance of Memory Test - Evaluation in MRI of Verbal Paired Associated Learning Test-
Katsuyoshi SETSU (Fukuoka University, Fukuoka, Japan), Hirofumi ABE, Takao IWASAKI, Chisato OKU, Hiroyuki KAMEI and Katsuya NISHIMARU
Purpose: Clinical significance of verbal paired associated learning test was evaluated in MRI.
Subjects and methods: Of subjects who visited the brain evaluation facility at our hospital, selected for the study were 101 patients (63 males and 38 females, mean age: 57.8±12.4) in whom MRI and verbal paired associated learning test among higher cortical function tests were conducted at the same period. In the verbal paired associated learning test, an easy test and hard test were repeated three times each (mean of the total of 3 easy tests: 27.7±4.3 points, hard tests: 9.9±6.8 points). Patients were divided into two groups of well-performed and poorly performed in either test, and also divided into three groups of well-performed or poorly- performed in both tests, and dissociated. Age, sex, MRI images were studied in the three groups. In addition, the relationship was studied with other higher cortical function tests (other memory tests, frontal lobe test and intellectual function tests).
Results: There were no differences in age and number of lesions among groups. Many patients in the dissociated group in the verbal paired associated learning tests had lesions around the posterior horn of the lateral ventricle. The posterior horn was found to be enlarged.
Conclusion: The results suggested that the temporal deep white matter might play a role in the ability of new association.
