Exam 2: Aphasia
Terms in this set (47)
What is Aphasia?
Multidimensional concept that can be defined from a neurological, neurolinguistic, cognitive, and functional perspective.
Literally means "without language".
Commonly accepted elements of an operational definition:
Affects input and output modes
Multimodal in nature
Caused by a CNS dysfunction
An acquired selective impairment of language modalities and functions resulting from a focal brain lesion in the language-dominant hemisphere that affects the person's communicative and social functioning, quality of life, and the quality of life of his or her relatives and caregivers.
Results from neurological damage or brain injury.
Stroke: most common cause - blood supply providing nutrients and oxygen to the brain is interrupted (when language area of the brain is affected, aphasia can happen).
Exposure to toxins or poisons
Nutritional or metabolic disorders
What is the most common cause of Aphasia?
Stroke: blood supply providing nutrients and oxygen to the brain is interrupted (when language area of the brain is affected, aphasia can happen).
How is Aphasia Classified?
Aphasia types should be grouped or classified (taxonomy), but some debate over how to do this.
1. Categorization by cause and location of the brain damage
2. Categorization based on the language characteristics
-fluent vs. non-fluent speech
-receptive vs. expressive deficits
Behavioral Symptoms of Aphasia
Most professionals classify aphasia types based on distinct behaviors:
Fluency of expression
Reading and Writing
Motor Output Behavioral Symptoms
Are the motor systems involved with speech affected? This indicates a concomitant motor-speech disorder.
Reading and Writing Behavioral Symptoms
To what extent is reading and writing affected? This usually reflects the overall impact of aphasia on language more generally.
Expression of thoughts using a smooth, uninterrupted flow and rate of speech.
Fluent Aphasic Patients
Normal or near normal speech rates, and use a variety of different grammatical constructions; function words and grammatical inflections are present, and usually syntactically appropriate. Intonation patterns are present and usually appropriate.
-Generally results from posterior damage.
Nonfluent Aphasic Patients
Slow and labored speech. The variety of grammatical constructions is often restricted and intonation may be reduced or absent; function words and grammatical affixes may be omitted, and patients may rely a lot on nouns.
-Generally results from anterior damage.
Ability to understand spoken messages. Influenced by:
-Amount of information
-Frequency of word usage
-Personal relevance of information
-Part of speech
Based on this ability, aphasia can be classified as predominantly receptive or predominantly expressive.
Ability to accurately reproduce verbal stimuli.
In order to display this ability, one must:
-Receive and process incoming stimulus
-Convey the information to regions of brain that formulate and plan motor sequence for speech
-Articulate to reproduce the initial stimulus
Repetition skills can subcategorize a more general classification.
Ability to retrieve and produce a targeted word.
Disturbance in the ability to name. Most pervasive and most persistent deficit.
Paraphasias (patterns of speech errors): Phonemic
Substitution or transposition of targeted phonemes in a word (non-fluent, expressive aphasia group).
Paraphasias (patterns of speech errors): Semantic
Error is related or in the same category but is incorrect (fluent, receptive aphasia group).
Reading and Writing
Written language disturbances usually parallel spoken language impairments.
Non-fluent speakers will also be non-fluent in writing and reading.
Individuals with auditory comprehension problems also have problems comprehending written information.
Caused by lesion at the angular gyrus.
Acquired impairment of reading.
Congenital impairment of reading.
Inability to form letters or words.
More refined labeling of the aphasias facilitates communication across professional disciplines.
Described based on the defining, salient characteristics.
Include: -Broca's -transcortical motor
-conduction -transcortical sensory
Paul Broca's description of his patient, Tan:
"He could no longer produce but a single syllable, which he usually repeated twice in succession; regardless of the question asked him, he always responded: tan, tan, combined with varied expressive gestures. This is why, throughout the hospital, he is known only by the name Tan".
Broca's Aphasia: Location of Damage
Posterior part of the inferior frontal gyrus, insula, frontal operculum, premotor and prefrontal areas of the cortex.
Broca's Aphasia Symptoms
Slowed, labored, telegraphic speech; short phrases, agrammatical speech.
Expressive problems are hallmark of this type, but also receptive deficits.
Repetition and naming difficulties range from mild to severe.
Reading is slowed and laborious, writing is effortful and oversized (macrographia).
Transcortical Motor Aphasia
Transcortical Motor Aphasia: Location of Damage
Frontal region anterior or superior to Broca's area, supplementary motor area, cingulate gyrus
Transcortical Motor Aphasia Symptoms
Characteristics are the same as Broca's aphasia except these clients show far better repetition skills.
Also show strong performance in oral reading and preserved comprehension.
Impaired reading aloud and writing.
Non-fluent, both receptive and expressive
Global Aphasia: Location of Damage
Large portion of the perisylvian area
Global Aphasia Symptoms
Severely impaired nonfluent speech, comprehension, naming, repetition, reading, and writing.
Severe problems communicating.
Wernicke's Aphasia: Location of Damage
Posterior part of the superior temporal region, adjacent parietal and temporal areas
Wernicke's Aphasia Symptoms
Spontaneous speech with normal prosody, sometimes even logorrhea, but meaningful content is limited.
Semantic paraphasias, neologisms, jargon.
Poor auditory comprehension, repetition, and naming (use circumlocution), writing is fluent but message is unclear (like verbal).
Transcortical Sensory Aphasia
Transcortical Sensory Aphasia: Location of Damage
Border of the temporal and occipital lobes or the parietal lobe (superior region).
Transcortical Sensory Aphasia Symptoms
Characteristics are the same as Wernicke's aphasia except these clients show far better repetition skills.
Sometimes even frequent verbal repetitions of random auditory stimuli (echolalia).
Sometimes even frequent verbal repetitions of random auditory stimuli.
Conduction Aphasia: Location of Damage
Temporal-parietal region, supramarginal gyrus, white matter pathway called the arcuate fasciculus.
Conduction Aphasia Symptoms
Relatively fluent speech with phonemic paraphasias and word-finding difficulties, conduite d'approche, poor repetition, naming, reading aloud and writing, relatively spared comprehension.
Anomic Aphasia: Location of Damage
Posterior language areas, including the angular gyrus or the middle temporal gyrus.
Anomic Aphasia Symptoms
Impaired naming, fluent speech with word-finding difficulties, frequent pauses and circumlocutions, spared repetition, comprehension, and reading aloud.
Anomic Aphasia Example
Clinician: "What is this object called?"
Patient: "I know what it does...You use it to anchor a ship."