Perseveration and Other Repetitive Verbal Behaviors: Functional Dissociations

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