Enhancement of naming in nonfluent aphasia through gesture.

In a number of studies that have examined the gestural disturbance in aphasia and the utility of gestural interventions in aphasia therapy, a variable degree of facilitation of verbalization during gestural activity has been reported. The present study examined the effect of different unilateral gestural movements on simultaneous oral-verbal expression, specifically naming to confrontation. It was hypothesized that activation of the phylogenetically older proximal motor system of the hemiplegic right arm in the execution of a communicative but nonrepresentational pointing gesture would have a facilitatory effect on naming ability. Twenty-four aphasic patients, representing five aphasic subtypes, including Broca's, Transcortical Motor, Anomic, Global, and Wernicke's aphasics were assessed under three gesture/naming conditions. The findings indicated that gestures produced through activation of the proximal (shoulder) musculature of the right paralytic limb differentially facilitated naming performance in the nonfluent subgroup, but not in the Wernicke's aphasics. These findings may be explained on the view that functional activation of the archaic proximal motor system of the hemiplegic limb, in the execution of a communicative gesture, permits access to preliminary stages in the formative process of the anterior action microgeny, which ultimately emerges in vocal articulation.