—The letter by Dr Mark challenges our work on four grounds: (1) the adequacy of the Western Aphasia Battery, (2) the value of resting glucose metabolism in predicting regional dysfunction, (3) whether our conclusions regarding conduction aphasia are warranted, and (4) the failure to use dynamic subtraction studies. We will address these points individually.The purpose of our two articles1,2 was to relate glucose metabolic patterns to traditional clinical aphasic syndromes, and not to use the Western Aphasia Battery3 as a means of determining underlying neurolinguistic disturbances. The Western Aphasia Battery was developed to provide a standardized procedure to assist in clinical aphasia classification by providing fixed criteria, thus allowing for a consistent and repeatable diagnosis. Dr Mark is correct in pointing out that the test was not designed to probe the underlying "neurolinguistic" basis of aphasia. Neurolinguistic analyses are particularly important in determining the nature of the
Metter EJ, Hanson WR, Jackson CA, Kempler D. On Cerebral Metabolism and Aphasia-Reply. Arch Neurol. 1989;46(12):1272–1273. doi:https://doi.org/10.1001/archneur.1989.00520480014010
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