Aphasia comes from the Greek root word "aphatos", meaning speechless, is an acquired language disorder in which there is an impairment of any language modality. This may include difficulty in producing or comprehending spoken or written language.
In technical terms, aphasia suggests the total impairment of language ability, and dysphasia a degree of impairment less than total. However, the term dysphasia is commonly confused with dysphagia, a swallowing disorder, and thus aphasia has come to mean both partial and total language impairment in common use.
Depending on the area and extent of brain damage, someone suffering from aphasia may be able to speak but not write, or vice versa, or display any of a wide variety of other deficiencies in language comprehension and production, such as being able to sing but not speak. Aphasia may co-occur with speech disorders such as dysarthria or apraxia of speech, which also result from brain damage.
BROCA’S APHASIA
The History of Broca’s aphasia
Expressive aphasia was first identified by the French neurologist Paul Broca. By examining the brains of deceased individuals who acquired expressive aphasia in life, he concluded that language ability was localized in the ventroposterior region of the frontal lobe. One of the most important aspects of Paul Broca's discovery was the observation that the loss of proper speech in expressive aphasia was due to the brain's loss of ability to produce language as opposed to the mouth's loss of ability to produce words.
The discoveries of Paul Broca were made during the same period of time as the German Neurologist Carl Wernicke who was also studying brains of aphasiacs post-mortem and identified the region now known as Wernicke's area. Discoveries of both men contributed to the concept of localization which states that specific brain functions are all localized to a specific area of the brain. While both men made significant contributions to the field of aphasia, it was Carl Wernicke who realized the difference between patients with aphasia who could not produce language and those who could not comprehend language (the essential difference between expressive and receptive aphasia).
The Brain Area of Broca’s Aphasia
In most people the Broca's area is in the lower part of the left frontal lobe. It is one of the main language areas in the cerebral cortex because it controls the motor aspects of speech. Persons with a Broca aphasia can usually understand what words mean, but have trouble performing the motor or output aspects of speech. Thus, other names for this disorder are 'expressive' and 'motor' aphasia. Depending on the severity of the lesion to Broca's area, the symptoms can range from the mildest type (cortical dysarthria) with intact comprehension and the ability to communicate through writing to a complete loss of speaking out loud.
Characteristics of Broca’s Aphasia
Individuals with Broca's aphasia frequently speak short, meaningful phrases that are produced with great effort. Broca's aphasia is thus characterized as a nonfluent aphasia. Affected people often omit small words such as "is", "and", and "the". For example, a person with Broca's aphasia may say, "Walk dog" which could mean "I will take the dog for a walk", "You take the dog for a walk" or even "The dog walked out of the yard". Individuals with Broca's aphasia are able to understand the speech of others to varying degrees. Because of this, they are often aware of their difficulties and can become easily frustrated by their speaking problems. It is associated with right hemi aresis, meaning that there can be paralysis of the patient's right face and arm.
The Causes of Broca’s Aphasia
The most common cause of expressive aphasia is stroke. A stroke is caused by hypoperfusion (lack of oxygen) to an area of the brain, which is commonly caused by thrombosis or embolism. Some form of aphasia occurs in 34-38% of stroke patients. Expressive aphasia occurs in approximately 12% of new cases of aphasia caused by stroke. In most cases, expressive aphasia is caused by a stroke in Broca's area or the surrounding vicinity. However, cases of expressive aphasia have been seen in patients with strokes in other areas of the brain. Patients with classic symptoms of expressive aphasia generally have more acute brain lesions while patients with larger, widespread lesions exhibit a variety of symptoms which may be classified as global aphasia or left unclassified.
Expressive aphasia can also be caused by trauma to the brain, tumor, cerebral hemorrhage, by extradural hematoma.
Understanding lateralization of brain function is important for understanding what areas of the brain cause expressive aphasia when damaged. In the past, it has been believed that the area for language production differs between left and right-handed individuals. If this were true, damage to the homologous region of Broca's area in the right hemisphere should cause aphasia in a left-handed individual. More recent studies have shown that even left-handed individuals typically have language functions only in the left hemisphere. However, left-handed individuals are more likely to have a dominance of language in the right hemisphere.
WERNICKE’S APHASIA
Wernicke's aphasia is a language disorder that impacts language comprehension and the production of meaningful language. The disorder is related to damage to the Wernicke&'s Area. Individuals with Wernicke'&'s aphasia have difficulty understanding spoken language but are able to produce sounds, phrases, and word sequences. While these utterances have the same rhythm as normal speech, they are not language because no information is conveyed.
CHARACTERISTICS
Wernicke's aphasia is named after Carl Wernicke who described a type of aphasic disorder; Wernicke described the disorder as an amnesiac disorder characterized by fluent but disordered speech, with a similar disorder in writing, and impaired understanding of oral speech and reading. He called this disorder sensory aphasia, which became known as Wernicke's aphasia.
Wernicke’s aphasia is known as a fluent aphasia because the patient does not appear to have any difficulty articulating speech, but may be paraphasic. However, comprehension of speech is impaired and sometimes as much as single words are not comprehended. The patient may even speak in meaningless jargon, known as neoligistic jargon, devoid of any content but free use of verb tenses, clauses, and subordinates.
A person with this aphasia speaks normally, but uses random or invented words, leaves out key words, substitute’s words or verb tenses, pronouns or prepositions, and their sentences don’t make sense. They can also have a tendency to talk excessively. A person with this aphasia cannot understand the spoken words of others or read written words. Speech is preserved, but language content is incorrect. Substitutions of one word for another (paraphasias, e.g. “telephone” for “television”) are common Comprehension and repetition is poor.
Patients who recover from Wernicke’s aphasia report that, while aphasic, they found the speech of others to be unintelligible and, despite being cognizant of the fact that they were speaking, they could neither stop themselves nor understand their own words
The ability to understand and repeat songs is usually unaffected, as these are processed by the opposite hemisphere. Melodic Intonation Therapy (MIT) has been pursued for some years with aphasic patients under the belief that it helps stimulate the ability to speak normally. There is some question as to the effectiveness of MIT. But more recent, and more rigorously conducted, research has revealed that MIT can be very effective at recovering language function.
Patients also generally have no trouble purposefully reciting anything they have memorized. The ability to utter profanity is also left unaffected; however the patient typically has no control over it, and may not even understand their own profanity.
The symptoms of Wernicke’s Aphasia reveal how important language is because people with the aphasia cannot express their thoughts. Some patients with the disorder do find a way to overcome this road block, and use facial expression and motor gestures to communicate instead.
Speech
Speech is characterised as fluent, with a heigh (even abnormally heigh) rate og output and a tendency to run on even in the face of efforts on the part of the examiner to intervene (logorrea). Phonological phrase-lenght is normal, with good control of intonation and articulatory targets. Grammatical structure may appear normal at the first sight but is sometimes marked by inappropriate stem-affix formations, such as is louding for is loud/ is talking loudly. It is also usually lacking in specific content-words and is therefore described as ‘empty’.
Reading
Reading comprehension is always impaired and maybe severely affected; but it is not always in parralel with auditory comprehension, and some rather striking dissociation between auditory comprehension have been reported. Reading aloud is variably performed, depending on the level of reading comprehension; written word-object matching is generally rather better.
Writting
Writting output consist of well-formed letter, in fluent sweeps, but an attempt at picture description typically contains largely unintelligible sequences mixed with recognisable words; in many ways a written analogue of the spontaneous-speech output. Dictation of words is also poor, with many paraphasias. Copying a written sentence is eassier. Finally, spelled-word recognition is severely impaired.
Treatement
Currently, there is no standard treatment for expressive aphasia. Most aphasia therapy is individualized based on a patient's condition and needs as assessed by a speech therapist. The majority of patients go through a period of spontaneous recovery following brain injury in which they regain a great deal of language function. In the months following injury or stroke, most patients receive traditional therapy for a few hours per day. Among other exercises, patients practice the repetition of words and phrases. Mechanisms are also taught in traditional therapy to compensate for lost language function such as drawing and using phrases which are easier to pronounce. Emphasis is placed on establishing a basis for communication with family and caregivers in everyday life. The following treatments are currently being studied to determine the best possible method for treating aphasia.
Singing and melodic intonation therapy
Melodic intonation therapy was inspired by the observation that individuals with non-fluent aphasia sometimes can sing words or phrases that they normally cannot speak. This phenomenon has been noticed for the past 250 years. In some studies patients were able to sing entire songs with provided text that they could not speak with normal intonation. It is believed that this is because singing capabilities are stored in the right hemisphere of the brain, which is likely to remain unaffected after a stroke in the left hemisphere. The goal of melodic intonation therapy is to utilize singing to access the language-capable regions in the right hemisphere and use these regions to compensate for lost function in the left hemisphere. Because patients are better at singing phrases than speaking them, the natural musical component of speech is used to engage the patients ability to voice phrases. Melodic intonation therapy has been shown to work particularly well in patients with large lesions in the left hemisphere.
MIT therapy on average lasts for 1.5 hours per day for five days per week. At the lowest level of therapy, simple words and phrases (such as "water" and "I love you") are broken down into a series of high and low pitch syllables. With increased treatment, longer phrases are taught and less support is provided by the therapist. Patients are taught to say phrases using the natural melodic component of speaking and continuous voicing is emphasized. The patient is also instructed to use their left hand to tap the syllables of the phrase while the phrases are spoken. Tapping further triggers the rhythmic component of speaking to utilize the right hemisphere.
The efficacy of melodic intonation therapy has been proven by studies that show that MIT can result in greater recovery when compared to non intonation therapy. FMRI studies have proven that melodic intonation therapy uses both sides of the brain to recover lost function as opposed to traditional therapies that only utilize the left hemisphere. Furthermore, it has been seen that in MIT, individuals with small lesions in the left hemisphere seem to recover by activation of the left hemisphere perilesional cortex while in individuals with larger left-hemisphere lesions, there is a recruitment of the use of language-capable regions in the right hemisphere.
Mechanisms of recovery
Mechanisms for recovery differ from patient to patient. Some mechanisms for recovery occur spontaneously after damage to the brain while others are caused by the effects of language therapy. FMRI studies have shown that recovery can be partially attributed to the activation of tissue around the damaged area and the recruitment of new neurons in these areas to compensate for the lost function. Recovery may also be caused in very acute lesions by a return of blood flow and function to damaged tissue that has not died around an injured area. It has been stated by some researchers that the recruitment and recovery of neurons in the left hemisphere apposed to the recruitment of similar neurons in the right hemisphere is superior for long term recovery and continued rehabilitation. It is thought that because the right hemisphere is not intended for full language function, using the right hemisphere as a mechanism of recovery is effectively a "dead-end" and can only lead to partial recovery.
Among all types of therapies it has been proven that one of the most important factors and best predictors for a successful outcome is the intensity of the therapy. By comparing the length and intensity of various methods of therapies, it was proven that intensity was a better predictor of recovery than the method of therapy used.
Source: wikipedia.org/talk:expressive_aphasia
Question
1. How is the thought of Wernicke’s aphasia sufferers?
2. How do we treat aphasia? Can they use puzzle?
3. Can the aphasic sufferer using verbal language?
4. What are the differences between Broca’s and Wernicke’s aphasia?
Answer!
1. There is a problem in their brains. It makes them difficult to understand other person speech and they do not understand what they speak.
2. There are some treatments that can be used to stimulate it. One of them is MIT (Melodic Intonation Therapy). In this therapy, the patient will sing starting from simple words and phrases. The phrase can be longer after that. It can stimulae the patients to spaek normally again.
No, they cannot use a puzzle because there is a problem in their brains
3. Broca’s aphasia patients can use sign language. It is because they understand what they are saying but it is difficult to said. They can use the sign language to express what they want to say.
4. The patients of Broca’s aphasia can understand other person speech but find difficulty to speak. They speak very slowly. Their left posterior inferior frontal gyrus of brain get injured. On the other hand, the Wernicke’s aphasia patients cannot understand other person speech but tehy can speak very fast. The posterior part of the superior temporal gyrus of brain gets problem.
Conclusion
After we read the whole text, we can conclude that aphasia is an acquired language disorder in which there is an impairment of any language modality. There are two kinds of aphasia that are broca’s aphasia and wernick’s aphasia which is both of them has their own differences and characteristics. Because basically these two kinds of aphasia is different, the way of helping patient or giving treatment is also different related to what kind of aphasia that they got and also related to the level of fatality of their sick. For this time, there is no standard treatment for expressive aphasia. Most aphasia therapy is individualized based on a patient's condition and needs as assessed by a speech therapist.
The successful of our therapy is much influence by the intensity and the correct method that we use to the patient.
In technical terms, aphasia suggests the total impairment of language ability, and dysphasia a degree of impairment less than total. However, the term dysphasia is commonly confused with dysphagia, a swallowing disorder, and thus aphasia has come to mean both partial and total language impairment in common use.
Depending on the area and extent of brain damage, someone suffering from aphasia may be able to speak but not write, or vice versa, or display any of a wide variety of other deficiencies in language comprehension and production, such as being able to sing but not speak. Aphasia may co-occur with speech disorders such as dysarthria or apraxia of speech, which also result from brain damage.
BROCA’S APHASIA
The History of Broca’s aphasia
Expressive aphasia was first identified by the French neurologist Paul Broca. By examining the brains of deceased individuals who acquired expressive aphasia in life, he concluded that language ability was localized in the ventroposterior region of the frontal lobe. One of the most important aspects of Paul Broca's discovery was the observation that the loss of proper speech in expressive aphasia was due to the brain's loss of ability to produce language as opposed to the mouth's loss of ability to produce words.
The discoveries of Paul Broca were made during the same period of time as the German Neurologist Carl Wernicke who was also studying brains of aphasiacs post-mortem and identified the region now known as Wernicke's area. Discoveries of both men contributed to the concept of localization which states that specific brain functions are all localized to a specific area of the brain. While both men made significant contributions to the field of aphasia, it was Carl Wernicke who realized the difference between patients with aphasia who could not produce language and those who could not comprehend language (the essential difference between expressive and receptive aphasia).
The Brain Area of Broca’s Aphasia
In most people the Broca's area is in the lower part of the left frontal lobe. It is one of the main language areas in the cerebral cortex because it controls the motor aspects of speech. Persons with a Broca aphasia can usually understand what words mean, but have trouble performing the motor or output aspects of speech. Thus, other names for this disorder are 'expressive' and 'motor' aphasia. Depending on the severity of the lesion to Broca's area, the symptoms can range from the mildest type (cortical dysarthria) with intact comprehension and the ability to communicate through writing to a complete loss of speaking out loud.
Characteristics of Broca’s Aphasia
Individuals with Broca's aphasia frequently speak short, meaningful phrases that are produced with great effort. Broca's aphasia is thus characterized as a nonfluent aphasia. Affected people often omit small words such as "is", "and", and "the". For example, a person with Broca's aphasia may say, "Walk dog" which could mean "I will take the dog for a walk", "You take the dog for a walk" or even "The dog walked out of the yard". Individuals with Broca's aphasia are able to understand the speech of others to varying degrees. Because of this, they are often aware of their difficulties and can become easily frustrated by their speaking problems. It is associated with right hemi aresis, meaning that there can be paralysis of the patient's right face and arm.
The Causes of Broca’s Aphasia
The most common cause of expressive aphasia is stroke. A stroke is caused by hypoperfusion (lack of oxygen) to an area of the brain, which is commonly caused by thrombosis or embolism. Some form of aphasia occurs in 34-38% of stroke patients. Expressive aphasia occurs in approximately 12% of new cases of aphasia caused by stroke. In most cases, expressive aphasia is caused by a stroke in Broca's area or the surrounding vicinity. However, cases of expressive aphasia have been seen in patients with strokes in other areas of the brain. Patients with classic symptoms of expressive aphasia generally have more acute brain lesions while patients with larger, widespread lesions exhibit a variety of symptoms which may be classified as global aphasia or left unclassified.
Expressive aphasia can also be caused by trauma to the brain, tumor, cerebral hemorrhage, by extradural hematoma.
Understanding lateralization of brain function is important for understanding what areas of the brain cause expressive aphasia when damaged. In the past, it has been believed that the area for language production differs between left and right-handed individuals. If this were true, damage to the homologous region of Broca's area in the right hemisphere should cause aphasia in a left-handed individual. More recent studies have shown that even left-handed individuals typically have language functions only in the left hemisphere. However, left-handed individuals are more likely to have a dominance of language in the right hemisphere.
WERNICKE’S APHASIA
Wernicke's aphasia is a language disorder that impacts language comprehension and the production of meaningful language. The disorder is related to damage to the Wernicke&'s Area. Individuals with Wernicke'&'s aphasia have difficulty understanding spoken language but are able to produce sounds, phrases, and word sequences. While these utterances have the same rhythm as normal speech, they are not language because no information is conveyed.
CHARACTERISTICS
Wernicke's aphasia is named after Carl Wernicke who described a type of aphasic disorder; Wernicke described the disorder as an amnesiac disorder characterized by fluent but disordered speech, with a similar disorder in writing, and impaired understanding of oral speech and reading. He called this disorder sensory aphasia, which became known as Wernicke's aphasia.
Wernicke’s aphasia is known as a fluent aphasia because the patient does not appear to have any difficulty articulating speech, but may be paraphasic. However, comprehension of speech is impaired and sometimes as much as single words are not comprehended. The patient may even speak in meaningless jargon, known as neoligistic jargon, devoid of any content but free use of verb tenses, clauses, and subordinates.
A person with this aphasia speaks normally, but uses random or invented words, leaves out key words, substitute’s words or verb tenses, pronouns or prepositions, and their sentences don’t make sense. They can also have a tendency to talk excessively. A person with this aphasia cannot understand the spoken words of others or read written words. Speech is preserved, but language content is incorrect. Substitutions of one word for another (paraphasias, e.g. “telephone” for “television”) are common Comprehension and repetition is poor.
Patients who recover from Wernicke’s aphasia report that, while aphasic, they found the speech of others to be unintelligible and, despite being cognizant of the fact that they were speaking, they could neither stop themselves nor understand their own words
The ability to understand and repeat songs is usually unaffected, as these are processed by the opposite hemisphere. Melodic Intonation Therapy (MIT) has been pursued for some years with aphasic patients under the belief that it helps stimulate the ability to speak normally. There is some question as to the effectiveness of MIT. But more recent, and more rigorously conducted, research has revealed that MIT can be very effective at recovering language function.
Patients also generally have no trouble purposefully reciting anything they have memorized. The ability to utter profanity is also left unaffected; however the patient typically has no control over it, and may not even understand their own profanity.
The symptoms of Wernicke’s Aphasia reveal how important language is because people with the aphasia cannot express their thoughts. Some patients with the disorder do find a way to overcome this road block, and use facial expression and motor gestures to communicate instead.
Speech
Speech is characterised as fluent, with a heigh (even abnormally heigh) rate og output and a tendency to run on even in the face of efforts on the part of the examiner to intervene (logorrea). Phonological phrase-lenght is normal, with good control of intonation and articulatory targets. Grammatical structure may appear normal at the first sight but is sometimes marked by inappropriate stem-affix formations, such as is louding for is loud/ is talking loudly. It is also usually lacking in specific content-words and is therefore described as ‘empty’.
Reading
Reading comprehension is always impaired and maybe severely affected; but it is not always in parralel with auditory comprehension, and some rather striking dissociation between auditory comprehension have been reported. Reading aloud is variably performed, depending on the level of reading comprehension; written word-object matching is generally rather better.
Writting
Writting output consist of well-formed letter, in fluent sweeps, but an attempt at picture description typically contains largely unintelligible sequences mixed with recognisable words; in many ways a written analogue of the spontaneous-speech output. Dictation of words is also poor, with many paraphasias. Copying a written sentence is eassier. Finally, spelled-word recognition is severely impaired.
Treatement
Currently, there is no standard treatment for expressive aphasia. Most aphasia therapy is individualized based on a patient's condition and needs as assessed by a speech therapist. The majority of patients go through a period of spontaneous recovery following brain injury in which they regain a great deal of language function. In the months following injury or stroke, most patients receive traditional therapy for a few hours per day. Among other exercises, patients practice the repetition of words and phrases. Mechanisms are also taught in traditional therapy to compensate for lost language function such as drawing and using phrases which are easier to pronounce. Emphasis is placed on establishing a basis for communication with family and caregivers in everyday life. The following treatments are currently being studied to determine the best possible method for treating aphasia.
Singing and melodic intonation therapy
Melodic intonation therapy was inspired by the observation that individuals with non-fluent aphasia sometimes can sing words or phrases that they normally cannot speak. This phenomenon has been noticed for the past 250 years. In some studies patients were able to sing entire songs with provided text that they could not speak with normal intonation. It is believed that this is because singing capabilities are stored in the right hemisphere of the brain, which is likely to remain unaffected after a stroke in the left hemisphere. The goal of melodic intonation therapy is to utilize singing to access the language-capable regions in the right hemisphere and use these regions to compensate for lost function in the left hemisphere. Because patients are better at singing phrases than speaking them, the natural musical component of speech is used to engage the patients ability to voice phrases. Melodic intonation therapy has been shown to work particularly well in patients with large lesions in the left hemisphere.
MIT therapy on average lasts for 1.5 hours per day for five days per week. At the lowest level of therapy, simple words and phrases (such as "water" and "I love you") are broken down into a series of high and low pitch syllables. With increased treatment, longer phrases are taught and less support is provided by the therapist. Patients are taught to say phrases using the natural melodic component of speaking and continuous voicing is emphasized. The patient is also instructed to use their left hand to tap the syllables of the phrase while the phrases are spoken. Tapping further triggers the rhythmic component of speaking to utilize the right hemisphere.
The efficacy of melodic intonation therapy has been proven by studies that show that MIT can result in greater recovery when compared to non intonation therapy. FMRI studies have proven that melodic intonation therapy uses both sides of the brain to recover lost function as opposed to traditional therapies that only utilize the left hemisphere. Furthermore, it has been seen that in MIT, individuals with small lesions in the left hemisphere seem to recover by activation of the left hemisphere perilesional cortex while in individuals with larger left-hemisphere lesions, there is a recruitment of the use of language-capable regions in the right hemisphere.
Mechanisms of recovery
Mechanisms for recovery differ from patient to patient. Some mechanisms for recovery occur spontaneously after damage to the brain while others are caused by the effects of language therapy. FMRI studies have shown that recovery can be partially attributed to the activation of tissue around the damaged area and the recruitment of new neurons in these areas to compensate for the lost function. Recovery may also be caused in very acute lesions by a return of blood flow and function to damaged tissue that has not died around an injured area. It has been stated by some researchers that the recruitment and recovery of neurons in the left hemisphere apposed to the recruitment of similar neurons in the right hemisphere is superior for long term recovery and continued rehabilitation. It is thought that because the right hemisphere is not intended for full language function, using the right hemisphere as a mechanism of recovery is effectively a "dead-end" and can only lead to partial recovery.
Among all types of therapies it has been proven that one of the most important factors and best predictors for a successful outcome is the intensity of the therapy. By comparing the length and intensity of various methods of therapies, it was proven that intensity was a better predictor of recovery than the method of therapy used.
Source: wikipedia.org/talk:expressive_aphasia
Question
1. How is the thought of Wernicke’s aphasia sufferers?
2. How do we treat aphasia? Can they use puzzle?
3. Can the aphasic sufferer using verbal language?
4. What are the differences between Broca’s and Wernicke’s aphasia?
Answer!
1. There is a problem in their brains. It makes them difficult to understand other person speech and they do not understand what they speak.
2. There are some treatments that can be used to stimulate it. One of them is MIT (Melodic Intonation Therapy). In this therapy, the patient will sing starting from simple words and phrases. The phrase can be longer after that. It can stimulae the patients to spaek normally again.
No, they cannot use a puzzle because there is a problem in their brains
3. Broca’s aphasia patients can use sign language. It is because they understand what they are saying but it is difficult to said. They can use the sign language to express what they want to say.
4. The patients of Broca’s aphasia can understand other person speech but find difficulty to speak. They speak very slowly. Their left posterior inferior frontal gyrus of brain get injured. On the other hand, the Wernicke’s aphasia patients cannot understand other person speech but tehy can speak very fast. The posterior part of the superior temporal gyrus of brain gets problem.
Conclusion
After we read the whole text, we can conclude that aphasia is an acquired language disorder in which there is an impairment of any language modality. There are two kinds of aphasia that are broca’s aphasia and wernick’s aphasia which is both of them has their own differences and characteristics. Because basically these two kinds of aphasia is different, the way of helping patient or giving treatment is also different related to what kind of aphasia that they got and also related to the level of fatality of their sick. For this time, there is no standard treatment for expressive aphasia. Most aphasia therapy is individualized based on a patient's condition and needs as assessed by a speech therapist.
The successful of our therapy is much influence by the intensity and the correct method that we use to the patient.
