href="#ulink_33219b18-4c8f-5df6-89ac-60ed7231bcaf">Fig. 1). He erroneously read the first kanji meaning gate for “ka-n,” which is a name for other characters similar in form (Fig. 2). The second kanji meaning outside he read as “ga-i,” which is wrong in this sentence but is one of the correct readings of the character (Fig. 3). The third kanji meaning tree should be read as “ki,” but he misread it as “ho-n,” probably confusing it with the visually similar fifth character (Fig. 2). The fourth kanji meaning three he read correctly as “sa-n.” The fifth kanji is usually used as postposition for numbers when counting long objects such as trees or sticks. His reading “po-n” is not acceptable in this context but one of its correct readings (Fig. 3). For example, one tree is counted as “i-ppo-n,” 2 trees as “ni ho-n”, and 3 trees as “sa-n bo-n.”
Fig. 1. Reading performance of Imura’s case E. The first row of the table shows a sentence from a contemporary primary school textbook which is written in mixed kanji and kana characters. Underlined characters are kanji. Others are kana. The second row shows its pronunciation in romanized letters (romaji). Each kana pronunciation is shown separately for the purpose of easy correspondence. Underlined parts correspond to kanji portion. The third row is reading by the patient. Errors are shown in italics and underlines. For details, see text. The fourth row is an English translation of the text [13].
Fig. 2. Reading performance of Imura’s case E. Confusion of kanji forms. The patient misread the first kanji “mo-n” in Figure 1 as “ka-n” which is like in form with such characters meaning quiet, between, or barrier. Also he misread the third kanji “ki” in Figure 1 as “ho-n,” which is similar in form.
Fig. 3. Reading performance of Imura’s case E. Selection errors of pronunciation. The upper kanji in the table has 5 ways of pronunciation. The lower kanji has four. The patient read the upper one (the second kanji in Figure 1) meaning outside as “ga-i, ” which is one of 5 correct readings for the character but wrong for the text. It should be read as “soto.” Similarly, he read the lower kanji (the fifth kanji in Figure 1) as “po-n” which is wrong, although the pronunciation itself for the character is correct. It should be “bo-n.”
Writing
He wrote his name and address correctly. He could write a few words with kana for dictation but impossible with kanji.
Copying Characters
He showed no difficulty in copying characters either in kanji or kana.
As this illustrative case demonstrates, the most conspicuous linguistic symptom of Gogi aphasia manifests itself in the patient’s verbal behavior. A typical patient would spontaneously respond to a question by picking up and repeating the substantive word in the question he does not understand. This peculiar verbal behavior was repeatedly confirmed and emphasized as a hallmark of Gogi aphasia by later researchers [7, 8]. The author’s experience coincides with the opinion [9].
Thus, the patient could grasp an acoustic form of the word quite easily but could not understand what it means. His spontaneous tendency to repeat the word suggests he is trying to stabilize the sound image of the word in his mind. Imura insisted this difficulty in grasping word meaning in the face of normal capacity to grasp its sound form is an isolated difficulty because their ability to deal with syntax is intact. Later studies support this claim [8, 10].
Historical Background
When he proposed the concept of Gogi syndrome, he cited semantic aphasia proposed by Head [11], or Namenaphasie by Kleist [12] or mixed transcortical aphasia by Goldstein [13] for discussion but did not identify it with them. Of these, Imura regarded Goldstein’s mixed transcortical aphasia most akin to Gogi aphasia [14]. Although Imura failed to mention, almost identical aphasic symptom complex had been reported by Arnold Pick in 1898 [15]. In this article, Pick introduced Arnaud’s contribution. According to Pick, this Arnaud described a type of transcortical aphasia he termed as “surdite verbale representative.” As the name suggests, this “representative verbal deafness” is characterized by good grasp of spoken word and inability to comprehend its meaning as if it were completely foreign. The patient would correctly repeat an incomprehensible word he just heard. It is not the problem of word sound reception, but the problem of understanding the sound as a symbol of concept. Pick himself described several cases of this type of aphasia. One of them (case F, 67-year-old female) grasped a word sound correctly and repeated the word consciously as if asking its meaning. For instance, she responded to a command to close her eyes, by repeating the word eyes: “What are eyes?” Likewise, to a command to bring a piece of soap, she questioned: “What is soap?”
The existence of Gogi aphasia has been repeatedly confirmed in Japan [8]. Unfortunately, this has not been the case in Europe and America. This may be due to the difference of the mode of spoken language. Indo-European languages belong to a group called reflected language, while Japanese is one of the agglutinated languages in which semanteme (substantive words) and morpheme (grammatical words) are clearly separated [4].
Neuropsychological Interpretation
Imura thought the essential trouble in Gogi aphasia is an impairment of the “dictionary” meaning of words, which is rather fixed and has relatively independent meaning even in a sentence. He asserted that impairment of sentence comprehension even if present is only secondary, compared to the primary impairment of word comprehension [16].
He further argued that word meaning should not be regarded as referent or things meant. In other words, meaning is not an entity. Rather it is a relation between a name and its concept. A name evokes a mental image, while at the same time the evoked image evokes back the name. This “close co-occurrence” of 2 psychological processes is the basis of meaning. In Gogi aphasia, this co-occurrence becomes unstable. This is reflected in the patient’s difficulty not only in comprehending word meaning but also in evoking a sound image of the word [16,
