13 Language, Aphasia & Frontal Lobe Disorders

Question 1

What is aphasia?

Answer 1

an acquired disturbance of the comprehension and formulation of language caused by dysfunction in specific brain regions
- acquired after completed development
- can result from huge variety of CNS diseases
- supramodal disorder (not restricted to single sense)
- severely impairs communication, social functioning and activities of daily life
- primary progressive forms may be precursors of dementia
- “not speaking what you are thinking”

Question 2

What is language?

Answer 2

a formal system
- of signs
- governed by grammatical rules of combination
- to communicate meaning
phonology, syntax, semantics, lexicon, phonotactics, pragmatics

Question 3

Which 2 brain areas are mainly involved in language?

Answer 3

• Broca’s area (production/formulation)
• Wernicke’s area (comprehension)
• both left hemisphere
• area around fissure between temporal and frontal lobe

Question 4

What’s the most common cause of aphasia?

Answer 4

• lesions by stroke
• 1/3 of patients with stroke in left hemisphere have acute language problems
• 1/2 of these persistent language disorder

Question 5

other causes of communication deficits

Answer 5

• non-aphasic communicative disorder
• phonological loop
• foreign languages
• apraxia of speech
• dyslexia (problems reading)
• pure word deafness (hearing intact, but not able to understand spoken language)
• dysarthria (poor articulation of phonemes due to damaged motor-speech system)

Question 6

Prosody

Answer 6

• study of elements of speech that are not individual phonetic segments (vowels and consonants) but which are properties of syllables and larger units of speech, including linguistic functions such as intonation, stress, and rhythm
• pitch of the voice, length of sounds, loudness/prominence, timbre/phonatory quality
• key factor how children learn language,
• conveys information on emotion, structure and syntax
• prosodic marking is relevant for understanding

Question 7

amnestic aphasia

Answer 7

• major issue: retrieval of word memory

Question 8

aphasia symptoms - paraphasia

Answer 8

substituting letters, syllables or words
- phonetic/phonological/literal: make up words or exchange sounds
- neologistic: substitution with a non-English or gibberish word, follow pauses indicating word-finding difficulty
- semantic/verbal: confusions of words or the replacement of one word by another real word, say giraffe instead of elephant
distortion of sound and meaning due to impairment of lexical access

Question 9

aphasia symptoms - agrammatism

Answer 9

inability to speak in a grammatically correct fashion characterized by speech containing mainly content words, with a lack of function words
- “Peter went to town to watch the soccer game.” -> “Peter go town watch soccer” OR “Peter town soccer”

Question 10

aphasia symptoms - paragrammatism

Answer 10

inability to form grammatically correct sentences
- “Peter went to town to watch the soccer game.” -> “Peter he was gone into town to go to London yesterday, when he want to see, you know, for the game”

Question 11

Broca’s aphasia

Answer 11

• non-fluent
• effortful
• agrammatism
• phonematic paraphasias (make up words or exchange sounds)
• combined with AOS/dysarthria

Question 12

Wernicke’s aphasia

Answer 12

• fluent/logorrhic
• paragrammatism
• semantic ( confusions or replacement of words) /phonematic (make up words or exchange sounds) paraphasias
• neologisms
• repetition
• impaired comprehension

Question 13

different aphasias - effect on comprehension and fluency, cardinal symptom

Answer 13

• Broca: intact comprehension, impaired fluency, agrammatism
• Wernicke: impaired comprehension, intact fluency, paragrammatism
• amnestic: intact comprehension, good fluency, word retrieval
• global: impaired comprehension and fluency, recurring utterances
• conduction: impaired repetition