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Victor W. Mark, MD
Department of Neurology University of Maryland 22 S Greene St Baltimore, MD 21201

Arch Neurol. 1989;46(12):1271-1272.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Metter et al¹ and Kempler et al² recently characterized the regional cerebral metabolic profiles of the perisylvian aphasias, strictly using the Western Aphasia Battery³ classification scheme. For illuminating the physiologic processes of neurolinguistic disturbances, this is unsatisfactory, since the Western Aphasia Battery uses inconsistent measures of fluency and repetition, while the comprehension assessment does not exclude errors arising from defective motor planning, spatial inattention, or visual imperception.

The authors also predicted hypometabolic Broca's area in conduction aphasia from interruption of the arcuate fasciculus, but observed this in only half their patients²; therefore, they questioned the disconnection hypothesis.⁴ This is unwarranted, since the hypothesis does not predict hypometabolic Broca's area. In conduction aphasia this area continues to organize speech output via input from other regions,⁵ with no fluency change. The authors' assumption that resting patterns in metabolic studies may reflect those in . . . [Full Text PDF of this Article]

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