Assignment 2.1

Aphasia Definitions

Aphasia is an impairment of language, affecting the production or

comprehension of speech and the ability to read or write. Aphasia is

always due to injury to the brain-most commonly from a stroke,

particularly in older individuals. But brain injuries resulting in aphasia

may also arise from head trauma, from brain tumors, or from

infections.

Aphasia can be so severe as to make communication with the patient

almost impossible, or it can be very mild. It may affect mainly a

single aspect of language use, such as the ability to retrieve the

names of objects, or the ability to put words together into sentences,

or the ability to read. More commonly, however, multiple aspects of

communication are impaired, while some channels remain accessible

for a limited exchange of information.

It is the job of the professional to determine the amount of function

available in each of the channels for the comprehension of language,

and to assess the possibility that treatment might enhance the use of

the channels that are available.

Below you can find more information on the different types of aphasia

such as Global, Broca’s, Wernicke’s, Primary Progressive, Anomic,

and Mixed Non-fluent aphasia.

Global Aphasia

This is the most severe form of aphasia and is applied to patients who can produce few recognizable words and understand little or no spoken language. Persons with Global Aphasia can neither read nor write. Like in other milder forms of aphasia, individuals can have fully preserved intellectual and cognitive capabilities unrelated to language and speech.

Global Aphasia is caused by injuries to multiple language- processing areas of the brain, including those known as Wernicke’s and Broca’s areas. These brain areas are particularly important for

understanding spoken language, accessing vocabulary, using grammar, and producing words and sentences.

Global aphasia may often be seen immediately after the patient has suffered a stroke or a brain trauma. Symptoms may rapidly improve in the first few months after stroke if the damage has not been too extensive. However, with greater brain damage, severe and lasting disability may result. It is important to speak with your doctor about finding speech and language therapy as soon as possible after Global Aphasia has been diagnosed.

Broca’s (Expressive) Aphasia

Individuals with Broca’s aphasia have trouble speaking fluently but their comprehension can be relatively preserved. This type of aphasia is also known as non-fluent or expressive aphasia.

Patients have difficulty producing grammatical sentences and their speech is limited mainly to short utterances of less than four words. Producing the right sounds or finding the right words is often a laborious process. Some persons have more difficulty using verbs than using nouns.

A person with Broca’s aphasia may understand speech relatively well, particularly when the grammatical structure of the spoken language is simple. However they may have harder times understanding sentences with more complex grammatical construct. For example the sentence “Mary gave John balloons” may be easy to understand but “The balloons were given to John by Mary” may pose a challenge when interpreting the meaning of who gave the balloons to whom.

Individuals with this type of aphasia may be able to read but be limited in writing.

Broca’s aphasia results from injury to speech and language brain areas such the left hemisphere inferior frontal gyrus, among others. Such damage is often a result of stroke but may also occur due to brain trauma. Like in other types of aphasia, intellectual and cognitive capabilities not related to speech and language may be fully preserved.

Broca’s aphasia is named after the French scientist, Paul Broca, who first related a set of deficits associated with this type of aphasia to localized brain damage. He did this in 1861, after caring for a patient who could only say the word “tan”.

Mixed Non-fluent Aphasia

Mixed non-fluent aphasia applies to persons who have sparse and effortful speech, resembling severe Broca’s aphasia. However, unlike individuals with Broca’s aphasia, mixed non-fluent aphasia patients remain limited in their comprehension of speech, similar to people with Wernicke’s aphasia. Individuals with mixed non-fluent aphasia do not read or write beyond an elementary level.

Wernicke’s (Receptive) Aphasia

In this form of aphasia the ability to grasp the meaning of spoken words and sentences is impaired, while the ease of producing connected speech is not very affected. Therefore Wernicke’s aphasia is also referred to as ‘fluent aphasia’ or ‘receptive aphasia’.

Reading and writing are often severely impaired. As in other forms of aphasia, individuals can have completely preserved intellectual and cognitive capabilities unrelated to speech and language.

Persons with Wernicke’s aphasia can produce many words and they often speak using grammatically correct sentences with normal rate and prosody. However, often what they say doesn’t make a lot of sense or they pepper their sentences with non-existent or irrelevant words. They may fail to realize that they are using the wrong words or using a non-existent word and often they are not fully aware that what they say doesn’t make sense.

Patients with this type of aphasia usually have profound language comprehension deficits, even for single words or simple sentences. This is because in Wernicke’s aphasia individuals have damage in brain areas that are important for processing the meaning of words and spoken language. Such damage includes left posterior temporal regions of the brain, which are part of what is knows as Wernicke’s area, hence the name of the aphasia.

Wernicke’s aphasia and Wernicke’s area are named after the German neurologist Carl Wernicke who first related this specific type of speech deficit to a damage in a left posterior temporal area of the brain.