Language and Hearing Centre
Broca's Area |
Major region for expressive language - i.e. formulation & production |
Heschl's Gyrus |
primary auditory cortex - i.e. hearing |
Wernicke's Area |
Major region for receptive language - i.e. comprehension |
Neurogenic communication disorders
different types of communication disorders, depending on which areas of the nervous system are damaged.
➢ Acquired Language Disorders
- Aphasia
- Cognitive-Communication Disorders
- difficult to understand language
➢ Motor Speech Disorders
- Dysarthria
- Apraxia
- Know what they want to say but difficult to physically produce speech |
Neurogenic communication disorders in Adults
Stroke |
Foremost cause of neurological damage |
Injury to blood vessels in the brain |
Thrombosis |
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embolism |
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haemorrhage |
stroke occurs when a part of your blood flow is blocked
➢ The blood provides glucose and oxygen to the brain and nutrients which are vital for their functions
➢ No blood to the brain tissue
➢Block could be from the narrowing of the artery (thrombosis)
➢Blood clot (embolism)
➢Bleeding, artery ruptures (hemorrhage)
➢Brain tissue dies
Aphasia
Aphasia |
➢ Language impairment caused by a brain damage |
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➢ Usually acquired in adulthood |
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➢ Site and size of the brain damage strongly associated with aphasia severity |
Language network in the brain has a complex organisation |
it is not restricted to one area, it is interconnected |
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Posterior language areas
Posterior cortex |
Contains Wernicke’s area |
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Responsible for understanding |
Damage effects on language comprehension |
Difficulty comprehending speech |
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Possible reading problems |
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causes fluent aphasia |
Wernicke's area is responsible for understanding language
Posterior language areas, temporal lobe
Anterior language areas
Frontal lobe |
Contains Broca’s area |
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Responsible for speaking |
Damage effects on language production: |
Slow, laboured speech |
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Word retrieval difficulties |
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Lacks flow and intonation |
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causes non fluent aphasia |
Broca's area is responsible for speaking
Putting sounds together to create speech
Classification of Aphasia
➢ Type of aphasia depends primarily on location and extent of damage
– BUT not clear cut
– BUT need to consider entire range of language problems |
Classification of Aphasia
Fluent Aphasia |
Wernicke’s Aphasia |
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Anomic Aphasia |
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Conduction Aphasia |
Non-fluent Aphasia |
Broca’s Aphasia |
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Global Aphasia |
Wernicke’s Aphasia
Salient features: |
➢ Impaired spoken and written comprehension |
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➢ Fluent speech: |
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➢ Speech lacks content |
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➢ Paraphasias |
Speech is fluent and well-articulated but it doesn’t make sense, making up words
Lack of content and meaning
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Anomic Aphasia
Acomic Aphasia |
damage to a variety of brain regions in the language network |
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includes regions in the frontal, temporal and parietal cortex |
Speech is typically fluent and produced with seeming ease |
• will typically speak in complete, grammatically correct sentences |
However, the individual might have trouble retrieving specific words |
• especially nouns and verbs, often able to successfully communicate using strategies to work around their wordfinding difficulties |
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usually have good comprehension; can understand spoken messages, They usually are able to read |
There is content an meaning but just cannot find the right words sometimes
Conduction Aphasia
Conduction Aphasia |
lesion is assumed to be in the tracts connecting Wernicke's area to Broca's area |
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➢ Fluent conversational speech |
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➢ Relatively intact comprehension |
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➢ Significant impairment in repetition |
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➢ Conversational speech frequently marked by paraphasias |
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➢ Have good comprehension & awareness of mistakes |
Recovery
➢ Neurological dysfunction at its worst immediately post-stroke
➢ Recovery begins within a few days
• Some injured cells begin to function more normally again
“Penumbra” = Areas of the brain that were damaged but not yet dead
→ possible to rescue brain tissue with appropriate therapies (→ increasing
oxygen transport & delivery to cells in the danger zone → limiting cell death)
➢ We cannot predict exact course or nature of recovery |
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Broca’s Aphasia
➢ Relatively intact auditory and reading comprehension
→ often able to understand most of what is said to them, but they have trouble responding
➢ person knows what they want to say but is unable to produce the words or sentence
➢ Non-fluent aphasia because speech is effortful
Salient features:
• Paucity of speech
• Agrammatism
= usually missing function words and word endings
- small words like prepositions, articles and conjunctions are especially difficult and often left out
= sentences produced often have incorrect syntax, or word order and grammar
• Word retrieval deficits
• Substitutions can occur
• Slow, laboured speech
• Writing abilities often mirror speech (see slide: Writing)
• Single words non-fluent sentences
• Not full sentence |
Global Aphasia
Most severe form of aphasia
➢ All language modalities are affected
= speaking, comprehension, reading, and writing
➢ Results from lesions in both anterior and posterior language areas
➢ Mixed effects of Broca’s and Wernicke’s aphasias
• Severe comprehension and production deficits
• Impaired naming and repetition
➢ People with global aphasia usually have a limited number of utterances
• Very few or no spoken words
• If words are spoken, it is likely to be a single word and might contain errors, such as
paraphasias (word & sound substitutions)
• Difficulty repeating words
• Understanding language is very difficult |
The person with aphasia: Other issues
➢ Sensory and motor problems
• Impaired hearing, balance
• Impaired mobility, eating, dressing, writing
➢ May be subtle personality changes |
Frequent Family Problems
➢ Non-aphasic spouse has no time alone
➢ Financial difficulties
➢ New spousal roles as a result of aphasia
➢ Dealing with issues of dependence/ independence for the aphasic spouse
➢ Rehabilitation is important to the whole family, not just person who has aphasia |
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