Making sense out of jargon - A neurolinguistic and computational account of jargon aphasia

Objective: To identify the cognitive and neuroanatomic bases of neologistic jargon aphasia with spared comprehension and production of written words. Methods: Detailed analysis of performance across experiments of naming, rea ding, writing, repetition, and word/picture matching by a 68-year-old woman (J.B.N.) served to identify which cognitive mechanisms underlying naming a nd word comprehension were impaired. J.B.N.'s impairments Were then simulat ed by selectively "lesioning" a computer model of word production that has semantic, word form, and subword phonologic levels of representation (descr ibed by Dell in 1986), Results: In comprehension experiments, J.B.N. made f ar more errors with spoken word input than with written word or picture inp ut (chi-square = 40-59; df = 1; p < 0.0001) despite intact auditory discrim ination, In naming experiments (with picture, definition, or tactile input) , J.B.N. made far more errors in spoken output relative to written output ( chi-square = 14-56; df = 1; p < 0.0001). These selective impairments of spo ken word processing were simulated by reducing connection strength between word-level and subword-level phonologic units but maintaining full connecti on strength between word-level and semantic units in Dell's model. The simu lation yielded a distribution of error types that was nearly identical to t hat of J.B.N., and her CT and MRI scans showed a small subarachnoid hemorrh age in the left sylvian fissure without infarct. Cerebral angiogram showed focal vasospasm in sylvian branches of the left middle cerebral artery. Con clusion: Focal left perisylvian dysfunction can result in a highly selectiv e "disconnection" between word-level and subword-level phonologic represent ations manifest as neologistic jargon aphasia with intact understanding and production of written words.