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Semin Speech Lang 2004; 25(4): 295-307
DOI: 10.1055/s-2004-837243
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Perseveration and Other Repetitive Verbal Behaviors: Functional Dissociations

Sarah S. Christman1 , 2 , Frank R. Boutsen2 , Hugh W. Buckingham3
  • 1Associate Professor, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
  • 2Department of Communication Sciences and Disorders, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
  • 3Department of Communication Sciences and Disorders, College of Arts and Sciences, Louisiana State University, Baton Rouge, Louisiana
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Publication History

Publication Date:
15 December 2004 (online)

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ABSTRACT

This article will review types of perseveration from a neurolinguistic perspective. During the course of the article, continuous, stuck-in-set, and recurrent perseveration will be placed in contradistinction to several other types of repetitive behaviors commonly associated with neurogenic communication disorders. These include echolalia in mixed transcortical aphasia; conduite d’approche and conduite d’ecart in fluent aphasias; lexical and nonlexical automatisms in nonfluent aphasias; palilalia in neuromotor disorders, such as Parkinson's disease (PD); and sound, syllable, word, and phrase repetitions in neurogenic stuttering. When differentiating these phenomena from perseveration, it is helpful to consider the salient factors that condition observed behaviors in individual patients, such as overall speech fluency, inventory of available utterances, nature of eliciting tasks, and propositionality of responses. Information such as communication disorder diagnosis, underlying etiology, and known sites of lesion from each patient's total clinical profile may also assist with differentiation.

KEYWORDS

Aphasia - echolalia - lexical automatisms - nonlexical automatisms - conduite d’approche - conduite d’ecart - palilalia - neurogenic stuttering

REFERENCES

  • 1 Allison R, Hurwitz L. On perseveration in aphasics.  Brain. 1967;  90 429-448
    PubMedGoogle Scholar
  • 2 Goldberg E. Varieties of perseveration: a comparison of two taxonomies.  J Clin Exp Neuropsychol. 1986;  8 710-726
    PubMedGoogle Scholar
  • 3 Hudson A J. Perseveration.  Brain. 1968;  91 571-582
    PubMedGoogle Scholar
  • 4 Luria A R. Two kinds of motor perseveration in massive injury of the frontal lobes.  Brain. 1965;  88 1-10
    PubMedGoogle Scholar
  • 5 Emery P A, Helm-Estabrooks N. The role of perseveration in aphasic confrontation naming. In: Prescott T Proceedings of the Conference of Clinical Aphasiology Austin, TX; Pro Ed 1989: 271-280
    Google Scholar
  • 6 Christman S S. Dynamic systems theory: application to language development and acquired aphasia. In: Daniloff RG Connectionist Approaches to Clinical Problems in Speech and Language: Therapeutic and Scientific Applications Mahwah, NJ; Lawrence Erlbaum Associates 2002: 111-146
    Google Scholar
  • 7 Duffy J R. Motor Speech Disorders: Substrates, Differential Diagnosis, and Management. St. Louis; Mosby 1995
    Google Scholar
  • 8 Rapin I, Dunn M. Language disorders in children with autism.  Semin Pediatr Neurol. 1997;  4 86-92
    PubMedGoogle Scholar
  • 9 Rapin I, Katzman R. Neurobiology of autism.  Ann Neurol. 1998;  43 7-14
    CrossrefPubMedGoogle Scholar
  • 10 Buckingham H, Whitaker H, Whitaker H. Alliteration and assonance in neologistic jargon aphasia.  Cortex. 1978;  14 365-380
    PubMedGoogle Scholar
  • 11 Joanette Y, Keller E, Lecours A R. Sequences of phonemic approximations in aphasia.  Brain Lang. 1980;  11 30-44
    CrossrefPubMedGoogle Scholar
  • 12 Kohn S E. The nature of the phonological disorder in conduction aphasia.  Brain Lang. 1984;  23 97-115
    CrossrefPubMedGoogle Scholar
  • 13 Kohn S E, Smith K L. Distinctions between two phonological output deficits.  Applied Psycholinguistics. 1994;  15 75-95
    PubMedGoogle Scholar
  • 14 Valdois S, Joanette Y, Nespoulous J-L. Intrinsic organization of sequences of phonemic approximations: a preliminary study.  Aphasiology. 1989;  3 55-73
    PubMedGoogle Scholar
  • 15 Code C. Neurolinguistic analysis of recurrent utterances in aphasia.  Cortex. 1982;  18 141-152
    PubMedGoogle Scholar
  • 16 Code C. Language, Aphasia, and the Right Hemisphere. London; Wiley 1987
    Google Scholar
  • 17 Code C. Recurrent utterances and automatisms in aphasia. In: Code C The Characteristics of Aphasia London; Taylor and Francis 1989: 155-177
    Google Scholar
  • 18 Code C, Ball M J. Syllabification in aphasic recurring utterances: contributions of sonority theory.  Journal of Neurolinguistics. 1994;  8 257-265
    CrossrefPubMedGoogle Scholar
  • 19 Benke T, Hohenstein C, Poewe W, Butterworth B. Repetitive speech phenomena in Parkinson's disease.  J Neurol Neurosurg Psychiatry. 2000;  69 319-325
    CrossrefPubMedGoogle Scholar
  • 20 Hozumi A, Hirata K, Tanaka H, Yamazaki K. Perseveration for novel stimuli in Parkinson's disease: an evaluation based on event-related potentials topography.  Mov Disord. 2000;  15 835-842
    CrossrefPubMedGoogle Scholar
  • 21 Helm N A, Butler R B, Benson D F. Acquired stuttering.  Neurology. 1978;  28 1159-1165
    PubMedGoogle Scholar
  • 22 Rosenbek J, Messert B, Collins M, Wertz R T. Stuttering following brain damage.  Brain Lang. 1978;  6 82-96
    CrossrefPubMedGoogle Scholar
  • 23 Wallesch C W. Repetitive verbal behavior: functional and neurological considerations.  Aphasiology. 1990;  4 133-154
    PubMedGoogle Scholar
  • 24 Albert M L, Sandson J. Perseveration in aphasia.  Cortex. 1986;  22 103-115
    PubMedGoogle Scholar
  • 25 Helm-Estabrooks N, Albert M L. Manual of Aphasia Therapy. Austin, TX; Pro-Ed 1991
    Google Scholar
  • 26 Helm-Estabrooks N, Albert M L. Manual of Aphasia and Aphasia Therapy, 2nd ed. Austin, TX; Pro-Ed 2004
    Google Scholar
  • 27 Santo Pietro M J, Rigrodsky S. Patterns of oral-verbal perseveration in adult aphasics.  Brain Lang. 1986;  29 1-17
    CrossrefPubMedGoogle Scholar
  • 28 Albert M L. The role of perseveration in language disorders.  Journal of Neurolinguistics. 1989;  4 471-476
    CrossrefPubMedGoogle Scholar
  • 29 Helm-Estabrooks N, Ramage A, Bayles K A, Cruz R. Perseverative behaviour in fluent and non-fluent aphasic adults.  Aphasiology. 1998;  12 689-698
    PubMedGoogle Scholar
  • 30 Sandson J, Albert M L. Varieties of perseveration.  Neuropsychologia. 1984;  22 715-732
    CrossrefPubMedGoogle Scholar
  • 31 Sandson J, Albert M L. Perseveration in behavioral neurology.  Neurology. 1987;  37 1736-1741
    PubMedGoogle Scholar
  • 32 Hughlings-Jackson J. On affections of speech from disease of the brain.  Brain. 1879;  2 323-356
    PubMedGoogle Scholar
  • 33 Christman S. Uncovering phonological regularity in neologisms: contributions of sonority theory.  Clin Linguist Phon. 1992;  6 219-247
    PubMedGoogle Scholar
  • 34 Benson D F, Ardila A. Aphasia: A Clinical Perspective. New York; Oxford University Press 1996
    Google Scholar
  • 35 Kertesz A. Tutorial review: language cortex.  Aphasiology. 1991;  5 207-234
    PubMedGoogle Scholar
  • 36 Brickner R M. The human cortical area producing repetitive phenomena when stimulated.  J Neurophysiol. 1940;  3 128-130
    PubMedGoogle Scholar
  • 37 Morris J G, Leicester J. Clonic perseveration.  Clin Exp Neurol. 1987;  23 39-45
    PubMedGoogle Scholar
  • 38 Albert M L, Bachman D L, Morgan A, Helm-Estabrooks N. Pharmacotherapy for aphasia. Neurology.  1988;  36 877-879
    PubMedGoogle Scholar
  • 39 McNamara P, Albert M L. Neuropharmacology of verbal perseveration.  Semin Speech Lang. 2004;  25 309-322
    Article in Thieme ConnectPubMedGoogle Scholar
  • 40 Cools R, Barker R A, Sahakian B J, Robbins T W. Mechanisms of cognitive set flexibility in Parkinson's disease.  Brain. 2001;  124 2503-2512
    CrossrefPubMedGoogle Scholar
  • 41 Liepmann H MO. Action and the left hemisphere [in German].  Munchener Medizinische Wochenschrisft. 1905;  49 2322-2378
    PubMedGoogle Scholar
  • 42 Hudson A J. Perseveration.  Brain. 1968;  91 571-582
    PubMedGoogle Scholar
  • 43 Cohen L, Dehaene S. Competition between past and present: assessment and interpretation of verbal perseverations.  Brain. 1998;  121 1641-1665
    CrossrefPubMedGoogle Scholar
  • 44 Buckingham H W, Christman S S. Phonemic carryover perseveration: word blends. Semin Speech Lang 2004 25: 363-374
    Google Scholar
  • 45 Buckingham H, Whitaker H, Whitaker H. Alliteration and assonance in neologistic jargon aphasia.  Cortex. 1978;  14 365-380
    PubMedGoogle Scholar
  • 46 Huber W, Poeck K, Weniger D. Aphasie. In: Poeck K Klinische Neuropsychologie Stuttgart; Thieme 1982
    Google Scholar
  • 47 Bayles K A, Tomoeda C K, Kaszniak A W, Stern L Z, Eagans K K. Verbal perseveration of dementia patients.  Brain Lang. 1985;  25 102-116
    CrossrefPubMedGoogle Scholar
  • 48 Barr W B, Bilder R M, Goldberg E, Kaplan E, Mukherjee S. The neuropsychology of schizophrenic speech.  J Commun Disord. 1989;  22 327-349
    CrossrefPubMedGoogle Scholar
  • 49 Crider A. Perseveration in schizophrenia.  Schizophr Bull. 1997;  23 63-74
    PubMedGoogle Scholar
  • 50 DeLisi L E. Speech disorder in schizophrenia: review of the literature and exploration of its relation to the uniquely human capacity of language.  Schizophr Bull. 2001;  27 481-496
    PubMedGoogle Scholar
  • 51 Ridley R M. The psychology of perseverative and stereotyped behavior.  Prog Neurobiol. 1994;  44 221-231
    CrossrefPubMedGoogle Scholar
  • 52 Stern E, Silbersweig D A, Chee K Y et al.. A functional neuroanatomy of tics in Tourette's syndrome.  Arch Gen Psychiatry. 2000;  57 741-748
    PubMedGoogle Scholar
  • 53 Frank S M. Psycholinguistic findings in Gilles de la Tourette syndrome.  J Commun Disord. 1978;  11 349-363
    CrossrefPubMedGoogle Scholar
  • 54 Martindale C. Syntactic and semantic correlates of verbal tics in Gilles de la Tourette's syndrome: a quantitative study.  Brain Lang. 1977;  4 231-247
    CrossrefPubMedGoogle Scholar
  • 55 Fodor J A. The Modularity of Mind: An Essay on Faculty Psychology. Cambridge, MA; The MIT Press 1983
    Google Scholar
  • 56 Basso A. Perseveration or the Tower of Babel.  Semin Speech Lang. 2004;  25 375-390
    Article in Thieme ConnectPubMedGoogle Scholar
  • 57 Critchley M. The neurology of psychotic speech.  Br J Psychiatry. 1964;  110 353-364
    PubMedGoogle Scholar
  • 58 Denny-Brown D. Positive and negative aspects of cerebral cortical function.  N C Med J. 1956;  17 295-303
    PubMedGoogle Scholar
  • 59 Luria A R. Higher Cortical Functions in Man. New York; Basic Books 1966
    Google Scholar
  • 60 Rubens A B. Aphasia with infarction in the territory of the anterior cerebral artery.  Cortex. 1975;  11 239-250
    PubMedGoogle Scholar
  • 61 Buckingham H B. Phonological production deficits. In: Kohn SE Conduction Aphasia. Hillsdale, NJ; Lawrence Erlbaum Associates 1992: 77-116
    Google Scholar
  • 62 Christman S S, Buckingham H W. Jargonaphasia. In: Code C The Characteristics of Aphasia London; Taylor and Francis 1989: 111-130
    Google Scholar
  • 63 Ardila A, Rosselli M. Conduction aphasia and verbal apraxia.  Journal of Neurolinguistics. 1990;  5 1-14
    CrossrefPubMedGoogle Scholar
  • 64 Benson D F, Ardila A. Aphasia: A Clinical Perspective. New York; Oxford University Press 1996
    Google Scholar
  • 65 Brown J W. The problem of repetition: a study of “conduction” aphasia and the “isolation” syndrome.  Cortex. 1975;  11 37-52
    PubMedGoogle Scholar
  • 66 Kertesz A. Aphasia and Associated Disorders. New York; Grune and Stratton 1979
    Google Scholar
  • 67 Luria A R. Basic Problems in Neurolinguistics. The Hague; Mouton 1976
    Google Scholar
  • 68 Simmons N M. Conduction aphasia. In: LaPointe LL Aphasia and Related Neurogenic Language Disorders. New York; Thieme 1990: 54-77
    Google Scholar
  • 69 Van Lancker D. Nonpropositional speech: neurolinguistic studies. In: Ellis AW Progress in the Psychology of Language. Vol. III London; Erlbaum 1987
    Google Scholar
  • 70 Boutsen F R, Christman S S. Prosody in apraxia of speech.  Semin Speech Lang. 2002;  23 245-256
    Article in Thieme ConnectPubMedGoogle Scholar
  • 71 de Bleser R, Poeck K. Analysis of prosody in the spontaneous speech of patients with CV-recurrent utterances.  Cortex. 1985;  18 141-152
    PubMedGoogle Scholar
  • 72 Boller F, Boller M, Denes G et al.. Familial palilalia.  Neurology. 1973;  23 1117-1125
    PubMedGoogle Scholar
  • 73 Kent R D, LaPointe L L. Acoustic properties of pathologic reiterative utterances: a case study of palilalia.  J Speech Hear Res. 1982;  25 95-99
    PubMedGoogle Scholar
  • 74 Benke T, Hohenstein C, Poewe W, Butterworth B. Repetitive speech phenomena in Parkinson's disease.  J Neurol Neurosurg Psychiatry. 2000;  69 319-325
    CrossrefPubMedGoogle Scholar
  • 75 Benke T, Butterworth B. Palilalia and repetitive speech: two case studies.  Brain Lang. 2001;  78 62-81
    CrossrefPubMedGoogle Scholar
  • 76 Van Borsel J, Schelpe L, Santens P, De Vos N, De Vos C. Linguistic features in palilalia: two case studies.  Clin Linguist Phon. 2001;  15 663-677
    PubMedGoogle Scholar
  • 77 Ackerman H, Ziegler W, Oertel W. Palilalia as a symptom of L-dopa induced hyperkinesias.  J Neurol Neurosurg Psychiatry. 1989;  52 805-807
    PubMedGoogle Scholar
  • 78 LaPointe L L, Horner J. A descriptive study of pathological reiterative utterances.  J Speech Hear Disord. 1981;  46 34-38
    PubMedGoogle Scholar
  • 79 Helm-Estabrooks N. Stuttering associated with acquired neurological disorders. In: Curlee RF, Stuttering and Related Disorders of Fluency, 2nd ed. New York; Thieme Medical Publishers 1999
    Google Scholar
  • 80 Helm N A, Butler R B, Benson D F. Acquired stuttering.  Neurology  1978;  28 1159-1165
    PubMedGoogle Scholar
  • 81 Rosenbek J, Messert B, Collins M, Wertz R T. Stuttering following brain damage.  Brain Lang. 1978;  6 82-96
    CrossrefPubMedGoogle Scholar
  • 82 Buckingham H W, Kertesz A. Neologistic Jargon Aphasia. Amsterdam; Swets and Zeitlinger 1976
    Google Scholar
  • 83 Lebrun Y, Leleux C, Rousseau J-J, Devreux F. Acquired stuttering.  J Fluency Disord. 1983;  8 323-330
    CrossrefPubMedGoogle Scholar
  • 84 Rosenbek J C. Stuttering secondary to nervous system damage. In: Curlee RF, Perkins WH Nature and Treatment of Stuttering: New Directions San Diego, CA; College-Hill 1984
    Google Scholar
  • 85 Eisenson J. A perseverative theory of stuttering. In: Eisenson J, Stuttering: A Symposium New York; Harper and Row 1958
    Google Scholar
  • 86 Eisenson J, Pastel E. A study of the perseverating tendency in stutterers.  Q J Speech. 1936;  22 626-631
    PubMedGoogle Scholar
  • 87 King P T. Perseveration in stutterers and nonstutterers.  J Speech Hear Res. 1961;  4 346-357
    PubMedGoogle Scholar
  • 88 Martin R R. Stuttering and perseveration in children.  J Speech Hear Res. 1962;  5 332-339
    PubMedGoogle Scholar

Sarah S ChristmanPh.D. 

P.O. Box 26901, Oklahoma City

OK 73190.

Email: sarah-christman@ouhsc.edu