What happens in bilingual aphasia

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What happens in bilingual aphasia?

• (Freud, On Aphasia, 1891)
• Pitres, 1895
• Minkowski, 1927, 1963
• Charlton, 1964
• Gloning and Gloning, 1965
• Paradis, 1977
• Albert and Obler, 1978
• Fabbro, 2001

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Freud, On Aphasia, 1891

• First-learned language, of course, returns first
• Other languages return depending on
• age of acquisition
• practice

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Pitres, case 6

• Officer, age 36
• Injury followed by stroke, hemiplegia
• French mother tongue
• English and German reasonably well
• Agrammatism in French

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Agrammatism

• That form of non-fluent aphasic production
• -consisting of simplified structures
• -in which functors and affixes are
  particularly likely to be omitted or substituted
  for
• (e.g., Saffran et al., 1989)

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• Instead of
• The man walked to the store
• Man walk store
• Man walking to store

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Pitres, case 6

• Officer, age 36
• Injury followed by stroke, hemiplegia
• French mother tongue
• English and German reasonably well
• Agrammatism in French
• Trouble with reading comprehension, writing
• Could tell if English or German were being
  spoken, but
• Could not speak, comprehend, or translate them

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Differential recovery

• Rule of Pitres
• The language being USED MOST around the time of
  aphasia onset returns first
• In Freuds terms, practice is more important than
  age of acquisition

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• Rule of Ribot (1881, book on Memory)
• The first-learned language returns first

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Obler and Albert, 1977

• Rule of Pitres holds with greater than chance
  accuracy
• Rule of Ribot does not
• USAGE matters more than early learning

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but

• Most aphasic multilinguals show aphasia
  comparable to pre-morbid proficiency (e.g.,
  Charlton, 1964)

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SO, we conclude

• Brain organization for bilingualism differs
  across bilinguals
• For many, the 2 or more languages are quite
  similarly organized or accessed
• For some, they are not
• For the latter, USE patterns somewhat more
  important than EARLY LEARNING

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What happens in Russian-speaking bilinguals?

• Martin Albert and Loraine Obler,
• The Bilingual Brain Neuropsychological and
  Neurolinguistic Aspects of Bilingualism,
  Academic Press, 1978.

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Charcot, 1884

• Officer
• Russian MT
• Educated French and German
• Sudden loss of F and G
• Comprehension fine in all 3
• French later returns partially

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Chlenov, 1948

• Translator, teacher of E
• MT Russian
• Also knew G, F, Latin, Old Gothic
• Age 34, encephalitis
• Sensory aphasia, some agrammatism, alexia,
  agraphia
• E more impaired than R the rest impossible

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Chlenov, 1948 continued

• Russian best
• Pitres

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Chlenov, 1948

• Salesman, printer
• MT German
• Spoke, read, wrote French
• School English and Spanish
• Spoke and wrote Russian
• Worked as an interpreter with E in 20s
• Age 40 left parietal-occipital lesion, hemiplegia

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Chlenov, 1948 cont.

• Spoke only E initially, then S and G E regressed
• Word-finding difficulties
• Accent changed
• G best at age 43, E quite good
• Pitres? Ribot? Emotional factors?
• E strongest!

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Gil and Goral, 2004

• 57-year old engineer
• Left fronto-parietal stroke
• Russian MT, with wife and friends
• Hebrew L2 age 35
• Intensive training and use at work
• Both languages in daily life

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• Expressive-Receptive aphasia both
• Therapy in L2 3.5 months
• Receptive aphasia in Hebrew
• Amnestic (anomic) aphasia in Russian
• Therapy in L1 1.5 months
• Amnestic in both languages

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• Pitres? Ribot?
• Therapy effective?
• Spontaneous recovery?
• Differential impairment? Recovery?
• Effect of therapy in LX on LY?

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• In sum, in Russian-speaking bilinguals, aphasia
  is just like in any other language
• Most show parallel recovery
• Most cases of differential recovery follow
  Pitres rule amount of recent use
• Some follow Ribots rule first-learned
• Some follow neither

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Early articles insufficient

• Not enough information about
• - Language history
• - Aphasic language performance
• - Aphasic language recovery patterns
• Need linguists and speech-language pathologists
  (logopedes)
• 1970s to present

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V. Case studies of a trilingual with agrammatism
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Agrammatism

• That form of non-fluent aphasic production
• -consisting of simplified structures
• -in which functors and affixes are
  particularly likely to be omitted or substituted
  for
• (e.g., Saffran et al., 1989)

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• Instead of
• The man walked to the store
• Man walk store
• Man walking to store

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Participant

• Native Hebrew speaker, English then French in
  school, and during years of adult life abroad.
• Successful, highly educated physicist who had
  learned languages for fun and work

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ECs language history
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ECs peak proficiency

• -little accent
• -excellent fluency
• -strong lexicon
• -fine comprehension
• IN ALL THREE LANGUAGES

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• Left CVA, age 42
• Massive left fronto-temporo-parietal lesion
• Initially, severe agrammatism in all three
  languages, HgtEgtF
• Quite good comprehension
• Works hard with therapists and grammars
• Steady recovery in all three languages

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Of note

• L1 Hebrew recovers best (despite infrequent use
  in decades pre-onset)
• contra Pitress rule (1895, Obler and Albert,
  1977)
• L3 French recovers least (despite high
  proficiency and frequent use in decades pre-onset
  and use at home with family)

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ECs language history
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• Bilingual Aphasia Test performance
• 4 years post stroke

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Pre-treatment Bilingual Aphasia Test
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