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The present retrospective analysis reports two studies. In Study 1, clinical aspects of aphasia are compared in right-handed (RH) and non-right-handed (NRH) patients; in Study 2, recovery from aphasia is compared in RH and NRH aphasic patients with a minimum of 5 months of daily language rehabilitation. From a continuous series of 1200 brain-damaged subjects, 24 NRH patients with a vascular lesion documented by computerized tomography were selected. In 19 cases the lesion was in the left hemisphere and in 5 cases in the right hemisphere. For 14 NRH patients, a RH subject with similar lesion, matched for age, education, length of illness, etiology (ischemic vs. hemorrhagic), and, when possible, sex was found. Presence and type of aphasia were compared in the two patients of the same pair and were found similar except for Pair 14; the RH subject had global aphasia and the NRH had conduction-like aphasia. Fifteen NRH patients were rehabilitated and reexamined at least 5 months after the first examination. Recovery of the 12 patients with a left-hemisphere lesion was compared with recovery of a group of RH subjects and no significant differences were found. Recovery of the three patients with right-hemisphere lesions is described. It is concluded that differences in type of aphasia and recovery between RHs and NRHs have been overemphasized in the past and must be reconsidered.

It is known that focal damage of the left hemisphere causes poor performances in a number of tasks devoid of overt verbal connotation, often referred to as “non-verbal intelligence”, “association” or “abstract attitude” tasks. However, it is not clear whether the existence of a unitary basic functional defect to account for the faulty performances outlined above can be supposed. In this investigation we have compared the behaviour of left-hemisphere damaged patients grouped according to aphasia type and have studied the extent to which two different, widely used tests of this supposed “non-verbal basic ability” (i.e. the Weigl Sorting Test and the Raven Progressive Matrices) overlap in their predictive power of the performance of a non-verbal association task, i.e. the Colour-Figure Matching Test. Notwithstanding the identical level of performance in the three tests between groups having different aphasia types, a clear-cut dissociation was found between Broca's and Wernicke's aphasics; in the former group the Colour-Figure Matching Test was highly correlated only with Weigl Sorting Test and in the latter only with Progressive Matrices. The conclusions are that in this case the breakdown of non-verbal basic resources does not coincide in patients with different types of aphasia, and the hypothesis of the existence of a unitary basic defect caused by left hemisphere damage is not in line with our findings.

Three hundred and eighty-eight aphasic patients (250 rehabilitated and 138 non-rehabilitated) were subjected to a study whose aim was to analyze the relationship between recovery in 4 specific language skills: oral and written expression and comprehension. By means of Cohen's K coefficient of agreement we sought to ascertain whether recovery of one out of these language skills significantly affected recovery of the remaining 3 language modalities. In rehabilitated patients recovery of oral and written comprehension and expression always turned out to be linked; in non-rehabilitated patients oral comprehension recovery was not associated with recovery of oral expression, reading and writing. Regarding the evolution of aphasia type, none of the experimental subjects changed from a fluent to a non-fluent form of aphasia.

Seven strongly right-handed patients developed aphasia following a right hemisphere vascular lesion documented by computerized tomography. One patient had a severe unilateral neglect, indication of its presence were evident in three and absent in three patients. The Token Test scores were significantly higher than in matched controls. Two patients had Broca aphasia, four had Wernicke aphasia and one had agraphia. The correlation between type of aphasia and locus of lesion was not much different from that normally found in standard left hemisphere brain demaged aphasics.