22].
But it has to be emphasized that Pick’s disease is not the only cause of Gogi aphasia. Imura’s 2 other cases suffered from non-progressive brain pathology, that is, hemorrhage and infarction. The patient of Sasanuma and Monoi [5] suffered from a head trauma. A surgical operation confirmed the presence of brain contusion as well as hematoma in the left second and third temporal gyri and the parietal lobe. Tanabe’s experience includes a case of herpes simplex encephalitis [7]. Such non-progressive etiology continues to be reported. For instance, Matsuda et al. [10] described 2 cases of stroke and one case of head trauma with MRI confirmation. Funayama described a case of cerebral infarction caused by sinus thrombosis [23].
Thus, it seems there are 2 types of Gogi aphasia. One is progressive, and wider mental deterioration eventually ensues. This type is closely associated with Pick’s disease of temporal lobe type [20]. The lesion involves bilateral temporal lobes even though the atrophy of the left side is much more prominent. The other is caused by various etiologies such as stroke, trauma, and encephalitis involving the lower temporal lobe. Symptoms of this type either remain stable or improve. The herpes simplex case and traumatic cases almost certainly must have suffered from bilateral damage of the temporal lobes. Even with stroke cases, bilateral lesions were demonstrated by MRI studies [10]. Thus, bilateral lesions of the temporal lobes seem to be a necessary condition for the emergence of Gogi aphasia. But the possibility of a left unilateral lesion causing this unique loss of lexical meaning cannot be easily discarded [23].
Gogi Aphasia and Semantic Dementia
In 1989, Snowden et al. [24] reported three cases of “semantic dementia,” characterized by progressive breakdown in language and visual perception. All three showed loss of symbolic meaning affecting both verbal and non-verbal domains. All suffered from progressive lobar degeneration limited to bilateral anterior temporal lobes (temporal lobe type of Pick’s disease in older terminology). The linguistic part of the syndrome is characterized by impaired comprehension and naming, but with well articulated speech with normal syntax and preserved repetition [24]. Based on experiences of 5 cases, Hodges et al. [25] further elaborated the nature of this “semantic dementia” as characterized by fluent dysphasia with severe anomia, reduced vocabulary, and prominent impairment of single-word comprehension. Of course, the concept of “semantic dementia” implies combined deterioration of linguistic meaning such as words and non-linguistic meaning such as faces, the linguistic part of the clinical picture corresponds with Gogi aphasia [26, 27].
Preferred occurrence of single-word meaning loss by damage of the left temporal lobe at a certain stage of progressive lobar degeneration suggests that a yet to be identified region or regions in the lobe occupies a pivotal part of a distributed neural network responsible for such a complex cognitive experience as “meaning” of a word.
References
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2Panse F, Shimoyama T: Zur Auswirkung aphasischer Störungen im Japanischen. I. Agrammatisums und Paragrammatismus. Arch f Psychiatr u Z Neur 1955;193:131–138.
3Panse F, Shimoyama T: Zur Auswirkung aphasischer Störungen im Japanischen. II. Schreib- und Lesestörungen. Arch f Psychiatr u Z Neur 1955;193:139–145.
4Panse F, Shimoyama T: On the effects of aphasic disturbance in Japanese: agrammatism paragrammatism; in Goodglass H, Blumstein S (eds): Psycholinguitics and Aphasia. Baltimore, MA, The Johns Hopkins University Press, 1973, pp 171–182.
5Sasanuma S, Monoi H: The syndrome of Gogi (word-meaning) aphasia. Selective impairment of Kanji processing. Neurology 1975;25:627–632.
6Imura T: Apraktische Ersheinungen bei Aphasikern. Folia Psychiatrica et Neurologica Japonica 1940;44:393–426. (in Japanese with German title)
7Tanabe H, Ikeda M, Nakagawa Y, Yamamoto H, Ikejiri Y, Kazui H, Hashikawa K, Harada K: Gogi (word meaning) aphasia and semantic memory for words. Higher Brain Funct Res 1992;12:153–167. (in Japanese with English abstract)
8Tanabe H, Nakagawa Y, Ikeda M, Hashimoto M, Yamada N, Kazui H, Nishikawa T, Okuda J: Selective loss of semantic memory for words; in Ishikawa K, McGaugh LI, Sakata H (eds): Brain Process and Memory. Amsterdam, Elsevier Science B.V., 1996, pp 141–152.
9Yamadori A: Aphasia in ideograph readers: the case of Japanese; in Coppens P, Lebrun Y, Basso Y (eds): Aphasia in Atypical Populations. London, Lawrence Erlbaum, 1998, pp 143–174.
10Matsuda M, Mizuta H, Hara K, Kumakura I: Three cases with transcortical sensory aphasia presenting disturbance of word comprehension as a cardinal feature. Higher Brain Funct Res 1993;13:279–287. (in Japanese with English abstract)
11Head H: Aphasia and Kindred Disorders of Speech, vol. II. New York, NY, Hafner Publishing Company, 1963, pp xix–xxiv. (originally published in 1928 by Cambridge University)
12Kleist K: Gehirn Pathologie Vornehmlich auf Grund der Kriegserfahrungen. Verlag von Johann Ambrosiuas Barth, 1934, pp 748–780.
13Goldstein K: Language and Language Disturbances. New York, NY, Grune and Stratton, 1948, pp 301–303. (Original idea on mixed transcortical aphasia published in 1915.)
14Imura T, Nogami Y, Asakawa K: Gogi aphasia – a semantic form of aphasia; in Imura T (ed): Studies on Psychiatry Volume 2. Tokyo, Misuzu Shobo Publishers, 1967, pp 292–303 (in Japanese).
15Pick A: Studien zur Lehre vom Sprachverständnis. Beitrage zur Pathologie und pathologischen Anatomie des Centralnervensystems mit Bemerkungen zur normalen Anatomie desselben. S. Karger, Berlin, 1898 (translated into Japanese by Kurachi M, Enokido H; in Akimoto H, Ohashi H, Sugishita M, Torii H (eds): The Origins of Neuropsychology. Aphasia Part 2. Tokyo, Souzou Shuppan Publishers, 1984, pp 71–113.