[Communication disorders after decline in sub-cortical aphasia: the role of fronto-sub-cortical disconnection?].

INTRODUCTION

Pragmatic analysis of Language difficulties examines the pertinence and adaptation of the spoken Language which can be disturbed even when phonologic, syntactic and semantic functions, taken separately, appear normal. Disorders of pragmatic Language function remain poorly explored and the few published papers in adult neuropsychology have been devoted to patients with traumatic frontal lesions.

METHODS

In the present study we report the case of a patient admitted for right hemiplegia with "dissident" aphasia related to a capsulo-lenticular hematoma. Aphasic disorders progressively improved but with the occurrence of speech disorders which were assessed by pragmatic indices.

RESULTS

There was no difference between free and directed interview with the exception for the non-contingencies which were significantly more frequent in the directed interview. As compared with the spoken Language of a normal individual, highly significant differences were noted for incoherent lexical proximities, non-contingencies and markers of difficulty.

DISCUSSION: and conclusion. For some Authors, the pragmatic speech disorders observed in this patient during the directed interview are linked to abnormal executive functions, also noted in the patient. The difficulties to adjust to speech constraints of the interview context could be related to a fronto-subcortical disconnection resulting in this patient to the left capsulo-lenticular lesion.