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  1. 1. Aphasia
  2. 2. Definitions of aphasia There are many definitions about aphasia. • Darley, Aronson & Brown (1975) assert that ‘aphasia is a multi-modality reduction in the capacity to decode and encode meaningful linguistic elements’. • Kertesz (1985) defined ‘aphasia as an acquired loss of language due to cerebral damage, characterized by errors in speech, impaired comprehension, and wordfinding difficulties’.(Benson & Ardila, 1996) • Finally, aphasia has arisen by brain damage which causes language disorders. It is associated with an amount of deficits in language comprehension and production. (Gazzaniga et al, 1998) • The term aphasia can be called sometimes dysphasia. (Smyth et al, 1996)
  3. 3. Characteristics Some of the general characteristics of aphasia are the following: • Lack of understanding • Lack of producing spoken language (e.g. conversations) • Reading & writing problems Finally, aphasia seems to has direct impact on personal relationships, employment, and social rehabilitation. (Townend et al, 2007)
  4. 4. Etiology • Seizure disorders (Landav-Kleffner syndrome) • Vascular disorders (ischemic stroke/hemorrhagic stroke) • Traumatic disorders (head injury) • Brain tumors • Cancer treatments (radiotherapy/chemotherapy) • Infectious conditions (viral, bacterial microorganisms) • Hypoxic disorders (anoxia) • Metabolic disorders (Farah & Feinberg, 2000).
  5. 5. Types of aphasia • • • • • • • • • Broca Wernicke Conduction Global Transcortical motor Transcortical sensory Mixed transcortical Anomic striatocapsular Thalamic (Biller, 2008)
  6. 6. Diagnosis of aphasia Many tools can be used for diagnosis of aphasia : • Boston Diagnostic aphasia examination • Western Aphasia battery • Aphasia Diagnostic profiles • Examining of aphasia • Aphasia language Performance Scale • Sklar Aphasia Scale • Bedside Evaluation & Screening test of aphasia • Minnesota test for the differentical diagnosis of aphasia (Johnson, 2007)
  7. 7. Study on aphasia • Miceli et al (2004) in order to understand the association between phonological & morphological procedure, they investigated in depth the continual performance of 26 members. • They appeared morphological errors in a specific screening battery of aphasia. • The relation between morphological & phonological errors is incoherent. • The members who made morphological errors also made phonological, whereas some aphasics who made phonological errors did not produce morphological.
  8. 8. Broca’s aphasia During 19th century phrenologists found out that specific brain injuries are possible to cause specific functional damages (Gazzaniga et al, 1998). A main separation has been done between Broca’s and Wernicke’s aphasia.
  9. 9. Broca’s aphasia • Broca’s aphasia is also known as expressive aphasia. • It was found out by the French surgeon Paul Broca in 1861. • Broca examined patients after a stroke, who were not often capable to express themselves by more than a word at a time. • Although, nouns & verbs were usually pronounced, they had difficulty in articles, conjunctions & agrammatical inflections. (Canoll, 1999)
  10. 10. Broca’s aphasia • • • Broca’s area in the left frontal region is very near to that part of the motor strip that controls the tongue & lips and damage to Broca’s area cause the aphasic syndrome, called Broca’s aphasia. (Gleason, 1997) It has been known that Broca’s aphasia is caused by damage in Broca’s area, while Mohr has indicated that damage constrained to the Broca’s area produce only transient language disorders. Broca’s aphasia follows larger damages involving Broca’s area (Gianfranco, 1998). However the question whether there is a correlation between Broca’s aphasia & Broca’s area is still ambiguous (Gazzaniga et al, 1998).
  11. 11. Broca’s aphasia Some distinctive characteristics of Broca’s aphasia are: i. Broca’s aphasics encounter speaking problems such as pauses & slips of the tongue. ii. They have difficulty in words, such as “a, the , of”’. iii. They make ungrammatical sentences. iv. They have difficulty in using syntactic information v. Good comprehension (Hunt & Ellis, 1999, Gleason, 1997).
  12. 12. Studies on broca’s aphasia • • • • • • Braber et al (2005) based on previous research of Bird et al, examined 10 non-fluent aphasic patients. The main purpose was to use a large framework of errors caused by the aphasics in skills such as reading, repetition & sentence completions for regular & irregular verbs. The aim was to expand their comprehension of the association between morphological & phonological impairments. The patients were administered with 3 different tasks related to speech: single world reading, immediate repetition & sentence completion. The central phonological deficits of patient were direct affected by the big amount of errors in repetition, reading & sentence completion, it could be ranked as either similar or non similar phonological errors. The majority of errors is connected with regular past-tenses forms due to a hidden phonological rather than a morphological deficit.
  13. 13. Studies on broca’s aphasia • Researchers tested the understanding of complementizers such as that & if and verb inflections by English agrammatic broca’s aphasics speakers. • The study involved 2 experiments. In the 1st experiment members heard clause sentences, while in the 2nd experiment they heard sentences with finite auxiliaries & sentences with finite verbs & control sentences with uninflected verbs. • According to the results there is a separation in the classes of functional morphology. Grammaticality assessment for complementizers is relatively spared. • The perception of verbal inflection is more influenced. • The specific results confirm previous surveys & show that the patients with agrammatic broca’s aphasia incline to some but not all kinds of syntactic structure. (Dickey et al 2005)
  14. 14. Wernicke’s aphasia • Another type of aphasia is Wernicke’s aphasia which is a result from injury to an area in the temporal lobe in the left hemisphere (Best, 1999). • Another name of Wernicke’s aphasia is receptive aphasia (Canoll, 1999).
  15. 15. Wernicke’s aphasia Some of characteristics are the below: i. Fluent , rapid speech ii. Well-structured syntax iii. Function words iv. Articulatory problems v. Prosodic difficulties vi. Repetition problems vii. Comprehension is poor viii. Word-finding problems ix. Paragrammatic errors (Field, 2003, Yudofsky & Hales, 2004, Harley, 1996, Gleason, 1997)
  16. 16. Study • • • • • • • A study conducted by Nakano & Blumstein (2004) examined how normal people & broca’s & wernicke’s aphasics unite thematic information increasingly using syntax, lexical-semantics & pragmatics in an active declarative sentence. 3 experiments were carried out with the use of an auditory lexical decision task in which members made a lexical decision on a “target” prefaced by a prime. Normal participants appeared evidence for connective thematics important & larger percentage of thematic priming. Also, they appeared inclination to both syntactic structures & pragmatics. Although, broca’s aphasics didn’t appear important priming for any situation nor did they appear similarity in the magnitude of priming among the conditions, nonetheless they showed sensitivity to pragmatics. Wernicke’s patients tend to show substantial priming for all conditions, but did not appear differences in the magnitude of priming among the conditions. Also, they showed tendency to sentence grammaticality & pragmatics.
  17. 17. Conduction aphasia • Conduction aphasia is caused by lesions in either the superior temporal or inferior parietal areas (Bradley, 2003).
  18. 18. Conduction aphasia Patients with conduction aphasia disorder have: 1. Inability to repeat 2. Normal speech comprehension & production Aphasics people have the aknowledgement that they have language problems & will try to correct their errors (Emilier et al, 2004, Martin, 2006)
  19. 19. Studies on conduction aphasia • Balasubramanian (2005) examines the word level writing in 2 conduction aphasics and tries to explore the parallel association between speech production deficits and deficits in written expression. • They were a 66-year-old female with left posterior parietal lobe lesion & a 65-year-old female with a left posterior temporo-parietal lobe lesion. • Both cases were examined by Boston Naming Test (BNT) & written naming task (JHDB). • Both patients have appeared phonological & semantic paraphasias on BNT,although a 65-year-old woman had better performance than that of 66-year-old woman. • 66-year-old female appeared many reactions to stimuli compared to 65-year-old female. • 65-year-old woman’s performance on the written naming task was worst to that of 66-year-old woman.
  20. 20. Studies on conduction aphasia • Hickok et al (2000) tested the hypothesis that at least 1 form of conduction aphasia is caused from damage to cortical fields in the left posterior superior temporal gyrus, which is involved not only in speech perception, but also in phonemic aspects of speech production. • The researchers conducted 4T fMRI in which members named visually presented objects subvocally. • The results indicate that the majority of participants appeared activation in 2 regions on the dorsal portion of the left posterior superior temporal gyrus.
  21. 21. References Balasubramanian. V. (2005). Dysgraphia in two forms of conduction aphasia. Brain and cognition, 57, 8-15. Benso. D. F. & Ardila. A. (1996). Aphasia: A clinical perspective. UK: Oxford University Press Best. J. B. (1999). Cognitive Psychology. (5th ed). USA: Wadsworth Publishing Company Biller. J. (2008). Practical Neurology. USA: Lippincot Williams & Wilkins Braber. N.et al. (2005). The relationship between phonological and morphological deficits in Broca’s aphasia: Further evidence from errors in verb inflection. Brain and language, 92, 278-287 Bradley. W. G.et al. (2003). Neurology in clinical practice. UK: Taylor & Francis Canoll. D. W. (1999). Psychology of language (3rd ed). USA: Brooks/cole publishing Dickey. M. W.et al. (2005). Perception of functional morphology in agrammatic Broca’s aphasia. Brain and Language, 95, 82-83 Emilier. G.et al. (2004). Memory: neuropsychological, imaging and psychopharmacological perspectives. UK: Psychology Press Farah. M. J. & Feinberg. T. E. (2000). Patient-based approaches to cognitive neuroscience USA: MIT Press
  22. 22. References Field. J. (2003). Psycholinguistics: A resource book for students. London: Routledge Gazzaniga. M. S.et al. (1998). Cognitive neuroscience. USA: W.W. Norton and Company Gianfranco. D. (1998). Handbook of clinical and experimental neuropsychology. UK: Psychology Press Gleason. J. B. (1997). The development of language (4th ed). USA: Allyn and Bacon Harley. T. A. (1996). The Psychology of Language. UK: Psychology Press Hickok. G.et al. (2000). A functional magnetic resonance imaging study of the role of left posterior superior temporal gyrus in speech production: implications for the explanation of conduction aphasia. Neuroscience letters, 287, 156-160 Hunt. R. R. & Ellis. H. C. (1999). Fundamentals of cognitive psychology (6th ed). USA: McGraw-Hill College Johnson. A. F. (2007). Medical Speech language pathology: A practitioner’s guide. USA: Thieme Martin. G. N. (2006). Human neuropsychology. UK: Pearson educations Miceli. G.et al. (2004). The relationships between morphological and phonological errors in aphasic speech: data from a word repetition task. Neuropsychologia, 42, 273-287 Nakano. H. & Blumstein. S. E. (2004). Deficits in thematic integration processes in Broca’s and Wernicke’s aphasia. Brain and language, 88, 96-107 Smyth. M. M.et al. (1996). Cognition in action (2nd ed). UK: Psychology Press Yudofsky. S. C. & Hales. R. E. (2004). Essentials of neuropsychiatry and clinical neurosciences. USA: American Psychiatric Pub.