Receptive aphasia
Template:DiseaseDisorder infobox
|
WikiDoc Resources for Receptive aphasia |
|
Articles |
|---|
|
Most recent articles on Receptive aphasia Most cited articles on Receptive aphasia |
|
Media |
|
Powerpoint slides on Receptive aphasia |
|
Evidence Based Medicine |
|
Cochrane Collaboration on Receptive aphasia |
|
Clinical Trials |
|
Ongoing Trials on Receptive aphasia at Clinical Trials.gov Trial results on Receptive aphasia Clinical Trials on Receptive aphasia at Google
|
|
Guidelines / Policies / Govt |
|
US National Guidelines Clearinghouse on Receptive aphasia NICE Guidance on Receptive aphasia
|
|
Books |
|
News |
|
Commentary |
|
Definitions |
|
Patient Resources / Community |
|
Patient resources on Receptive aphasia Discussion groups on Receptive aphasia Patient Handouts on Receptive aphasia Directions to Hospitals Treating Receptive aphasia Risk calculators and risk factors for Receptive aphasia
|
|
Healthcare Provider Resources |
|
Causes & Risk Factors for Receptive aphasia |
|
Continuing Medical Education (CME) |
|
International |
|
|
|
Business |
|
Experimental / Informatics |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Receptive aphasia, also known as Wernicke’s aphasia, fluent aphasia, or sensory aphasia in clinical neuropsychology and cognitive neuropsychology, is a type of aphasia often (but not always) caused by neurological damage to Wernicke’s area in the brain (Brodman area 22, in the posterior part of the superior temporal gyrus of the dominant hemisphere). This is not to be confused with Wernicke’s encephalopathy or Wernicke-Korsakoff syndrome. The aphasia was first described by Carl Wernicke and its understanding substantially advanced by Norman Geschwind.
Presentation
If Wernicke’s area is damaged in the non-dominant hemisphere, the syndrome resulting will be sensory dysprosody - the lack of ability to perceive the pitch, rhythm, and emotional tone of speech.
Speech is preserved, but language content is incorrect. This may vary from the insertion of a few incorrect or nonexistent words to a profuse outpouring of jargon. Grammar, syntax, rate, intonation and stress are normal. Substitutions of one word for another (paraphasias, e.g. “telephone” for “television”) are common. Comprehension and repetition are poor.
Example:
- I called my mother on the television and did not understand the door. It was too breakfast, but they came from far to near. My mother is not too old for me to be young.
If excessive, this may be confused with the psychiatric signs of “pressure of speech” and “word salad.”
Regarding speech and comprehension, people with Wernicke’s aphasia may:
- string words together to make senseless sentences
- make up words
- be unaware of mistakes made while speaking
- be able to deliver words in a normal melodic line, even if they do not make sense
- articulate their words normally
- have difficulty repeating phrases
- add words when trying to repeat someone
- interrupt others and speak rapidly
Difficulty with spoken language may not carry over to other aspects of brain functioning. Aphasia is different from a disease like Alzheimer’s, in which many of the brain’s functions diminish over time. Those with Wernicke’s aphasia may:
- have severely impaired reading and writing ability
- understand visual materials better than written or spoken words
- maintain cognitive abilities other than those associated with language
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 that 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" had been pursued for some years with aphasic patients under the belief that it helps stimulate the ability to speak normally, but in 2003 this was found to not be so.[1]
Patients also generally have no trouble purposefully reciting anything they have memorized, a key difference from Alzheimer Dementia. 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.
Patients are usually physically independent in the absence of other focal neurological deficits.
Luria's theory on Wernicke's aphasia
Luria proposed that this type of aphasia has three characteristics.[2]
- 1) A deficit in the categorization of sounds. In order to hear and understand what is said, one must be able to recognize the different sounds of spoken language. For example, hearing the difference between bad and bed is easy for native English speakers. The Dutch language however, makes no difference between these vowels, and therefore the Dutch have difficulties hearing the difference between them. This problem is exactly what patients with Wernicke’s aphasia have in their own language: they can't isolate significant sound characteristics and classify them into known meaningful systems.
- 2) A defect in speech. A patient with Wernicke's aphasia can and may speak a great deal, but he or she confuses sound characteristics, producing “word salad”: intelligible words that appear to be strung together randomly.
- 3) An impairment in writing. A person who cannot discern sounds cannot be expected to write.
Treatment
Treatment is mainly comprised of speech and language therapy, which is most effective when started as soon as possible post injury. The aim of treatment is to enable the patient to make best use of their remaining language function, improve language skill, and learn how to communicate in other possible ways so their wants and needs can be articulated and addressed.[3] It often involves group therapy.
However, treatment is particularly challenging due to the fact that patients with aphasia suffer from impaired comprehension, which limits their perception of their degree of impairment.
When the cause of aphasia is a stroke, recovery of language function peaks within two to six months, after which further progress is limited. However, efforts should still be made, as an improvement in aphasia has been recorded long after a stroke.
Family support and social support are crucial to a positive outcome. Treatment of post-stroke depression and post-stroke cognitive issues, as well as of other neurological disorders such as neglect, agnosia, and hemiparesis, should be worked on during rehabilitation to further improve patient outcome.
See also
References
- ↑ Hébert, S. & Racette, A., Gagnon, L. & Peretz, I. (2003). Revisiting the dissociation between speaking and singing in aphasia. Brain, 126, 1838-1850. http://brain.oxfordjournals.org/cgi/reprint/126/8/1838
- ↑ Kolb & Whishaw: Fundamentals of Human Neuropsychology (2003), pages 503-504. The whole paragraph on Luria's theory is written with help of this reference.
- ↑ "The neurophysiology of language: Insights from non-invasive brain stimulation in the healthy human brain". Brain and Language.