Overview Of Acquired Aphasia And Cog D/O Flashcards
Lesion in Broca’s area(BA 44, 45, inferoposterior portion of frontal lobe)
Broca’s Aphasia
deficit in formulating and processing syntax
Agrammatism
Broca’s Aphasia speech
Telegraphic speech: missing function words; mostly content words
problems with word finding
Anomia
Lesions in multiple areas: frontal, parietal, temporal areas receiving MCA blood supply
Global Aphasia
Communication is carried out largely through gesture, tone of voice, and facial expression
Global Aphasia
Transcortical Motor Lesion
Lesion in the anterior watershed area of left frontal lobe, extending to prefrontal areas (BA 6, 8, 9, 10 ,46)
Intact repetition compared with broca’s aphasia
Transcortical Motor
lesion of mixed transcortical
likely multifocal lesions in frontal and temporal watershed regions
Intact repetition compared with global aphasia
Mixed transcortical
WA lesion
Lesions in Wernicke’s area (BA 22, superior temporal lobe)
Signs of WA
● Fluent
● Neologisms: new words
● Paraphasias
● Relatively intact syntax than nonfluent aphasias
● Logorrhea
Transcortical sensory lesions
Lesion in angular gyrus/area surrounding the Wernicke’s area, excluding the Wernicke’s area itself (BA 39); and posterior portion of middle temporal gyrus (BA 37) [watershed regions of temporal lobe]
Intact repetition compared with Wernicke’s aphasia
Transcortical sensory
Conduction Aphasia lesion
Lesions in arcuate fasciculus (BA 40, within supramarginal gyrus)
Conduction Aphasia symptoms
● Impaired repetition (more di culty with longer and moe complex stimuli)
● Good comprehension and spontaneously production of spoken and written language
● Awareness of errors
● Common phonemic paraphasias
Lesion in angular gyrus
Anomic aphasia
Signs of anomic aphasia
● Comprehension and syntactic production
are relatively spread
● Circumlocutions, use of generic terms
Any form of aphasia due to damage to RH instead of LF in a person who is right-handed
Crossed Aphasia
Lesion below the cortex (thalamus, basal ganglia, cerebellum)
Subcortical Aphasia
● Frontal lobe is likely a ected during TBI
● Left and right orbital frontal lobe injury →
frontal lobe symptoms
FL syndrome
● Executive function deficits: challenges with
self-regulation, reasoning, making judgements and decisions, goal setting, planning, strategizing, being aware of strengths and weakness, organizing, sequencing, allocating attention, inhibiting inappropriate behaviors
● Pragmatic deficits: problem with social use of language
FL syndrome
Perceptual and Attentional Deficits
● Left hemispatial deficits
● Prosopagnosia
RHD
A ffective Deficits
● Di culty expressing emotions
● Di culty recognizing emotions of others
● Depression
● Apparent lack of motivation
RHD
Communicative Deficits
● Di fficulty with word retrieval
● Impaired auditory-verbal comprehension
● Reading and writing deficits
● Impaired prosodic features of speech
● Di fficulty with pragmatics
● dysarthria
RHD
Cognitive deficits
● Disorientation
● Impaired attention
● Di fficulty with memory
● Poor integration of info
● Di fficulty with logic, reasoning, planning,
and problem solving
● Impaired comprehension of inferred
meanings
● Di fficulty understanding humor
RHD
● Prosopagnosia
● Anosognosia
● Anosodiaphoria
● Constructional impairments
● Memory deficits
● Topographical and disorientation
geographical
● Planning, problem solving, and organizing deficits
RHD
● Progressive di use brain atrophy and accumulation of beta-amyloid plaques and neurofibrillary tangles
● Gradual onset
● Memory, attention, Efs
AD
● AKA Ischemic dementia
● 2nd most common
● Caused by blood supply problems to brain
● Stepwise progression (due to series of
strokes or TIAs)
● There is evidence of multi-infarct dementia
(multiple focal lesions)
VASCULAR DEM.
3rd most common, M>F
Abnormal protein (alpha-synuclein) deposits
Confusion, variable states of awareness and alertness, memory loss, ANS problems, visual hallucinations
Many have neuromuscular problems common to PD (muscle rigidity, tremors, balance problems)
DLB
Atrophy of anterior frontal and temporal lobes
Most likely to occur in ages <65 (Onset typically in 40-60s)
Symptoms determined by associated functions of a ected specific areas of brain PPA and certain type of movement disorders are also associated with some forms of FTD
EL and RL deficits
Behavioral variant FTD
FTD
Hereditary condition
Chorea, psychiatric and cognitive-linguistic problems
Poor language organization, anomia, emotional lability
Huntington’s Disease
Cortical atrophy caused by thiamine (vitamin B1) deficiency, most commonly due to chronic alcohol abuse
STM and LTM deficits and confabulation
Korsako ’s Syndrome
Rare, rapidly progressive, degenerative viral disease
Common bodily protein, prion, forms into misshapen configuration that destroy brain cells
Rapid loss of cog and linguistic abilities and cortical and cerebellar muscular coordination, mood changes
CreutzfeltJacob Disease
Challenges in EFs, pragmatic abilities, attention, memory
HIV-associated MCI is mild version of this condition
AIDS Dementia Complex
Ongoing loss of language abilities in the face of relatively preserved cognitive abilities
Caused by neurodegenerative disease
PPA
has insidious onset, rather than sudden onset
PPA
symptoms get progressively words, rather than improve or stabilize
PPA
tend to be linguistic (e.g. word-finding) in the face
of relatively intact cognitive abilities
PPA
● Challenges in wordfinding (esp. confrontational naming) and comprehension (even at single-word level)
● Verbal output, syntax relatively good
● Tends not to have concomitant motor
speech impairments
SEMANTIC PPA
Problems with word finding, especially in spontaneously conversation
Logopenic PPA
● Di culty with syntax (esp. in expression relative to comprehension)
● Often have concomitant AOS
● AKA Nonfluent PPA
AGRAMMATIC PPA
what is neuroplasticity?
Capacity of the nervous system for change
What is intrinsic learning?
Internally, there will be change in their practice patterns because of their feedback mechanisms
What is extrinsic learning?
provide them with strategies and activities that will stimulate them in the perspective of motor speech. We’re going to provide them with motor experience to learn speech motor movements and to develop their PRAXIS and execution.
6 guiding frameworks of Mayo Clinic
- ICF
- Motor Speech Treatment Hierarchy
- Neuromuscular Treatment Principles
- Motor Learning Principles
- Treatment Process
- EBP
International Classification of Function (ICF) general groupings are:
- Health Condition
- Body Functions and Structures
- Activity and Participation
- Contextual Factors
Domain: Oral and Auditory Mechanisms, Task:
Task:
1. Oral structure exam.
2. Cranial nerve exam
3. Assessment of speech processes
4. Hearing test
5. Case history
Domain: Speech like oro-motor function, Task:
- DDK
- Single word sample
- Polysyllabic words
- Non-word repetition test
Domain: speech accuracy, task:
- CS sampling
- Consistency
- Stimulability
Domain: prosody, task:
Ax of prosody
Domain: RL/EL, phonological awareness, task:
Task: Language/Cognitive Skills
Domain: related cognitive skills, task:
Task: speech perception testing, verbal working memory
