Aphasia Types

Question 1

Nonfluent Aphasias

Answer 1

Broca’s, Global, Transcortical Motor, Mixed Transcortical

Question 2

Broca’s Aphasia

Answer 2

Deficiency or absence in syntax, structural words, or functors. There is a limitation in the ability to recognize correct grammatical structures. An agrammatic aphasia.

**Damage occurs in the left posterior portion of the third frontal convolution in Brodmann’s Area 44.

Associated speech problems are apraxia of speech and dysarthria

Question 3

Broca’s Area + Language

Answer 3

-Expressive Language: Agrammatic or telegraphic speech, slow rate with uneven flow, impaired repetition, impaired confrontation naming, limited word output and reduced length of utterances, effortful + poorly articulated speech

-Receptive Language: Relatively intact auditory comprehension

-Reading: Relatively intact reading comprehension, inability to read aloud.

-Writing: Difficulty comprehending written materials, abnormal writing

-Telegraphic Speech: Small, function words are absent, nouns and verbs primarily used.

Question 4

Global Aphasia

Answer 4

The result of large lesions to anterior and posterior language areas and subcortical structures, including both Broca’s and Wernicke’s areas. The lesions extend in depth to the insula and lenticular nucleus, and even to the internal capsule. A severe depression in language modalities.

Question 5

Global Aphasia Language

Answer 5

-Expressive Language: Severely reduced fluency, speech is typically nonfluent, may be able to express through facial and manual gestures.

-Receptive Language: Comprehension is severely impaired, can be alert and aware of surroundings.

-Reading; Impaired
-Writing: Impaired

Question 6

Transcortical Motor Aphasia

Answer 6

Associated with frontal lobe lesions either in front of Broca’s area or above Broca’s area on the lateral surface at the supplementary area or at the cingulate gyrus.

Question 7

Transcortical Motor Aphasia Language

Answer 7

-Expressive Language: Muteness, reduced spontaneous speech, nonfluent/paraphasic/agrammatic/telegraphic speech, naming problems, intact repetition, relatively intact serial speech, limited word fluency, use of motor prompts to initiate speech.

-Receptive Language: Intact knowledge of grammar and meaningfulness, better comprehension than production

-Reading: Difficulty reading aloud

-Writing: Impaired

Question 8

Mixed Transcortical Aphasia

Answer 8

A rare disorder that combines symptoms and signs of motor and sensory transcortical aphasias. A global aphasia with the ability to repeat. Diffuse or multifocal pathologies in the frontal and parietal lobes can produce Mixed Transcortical Aphasia while sparing the language area.

Question 9

Mixed Transcortical Aphasia Language

Answer 9

-Expressive Language: Nonfluent speech, severely impaired naming, mostly unimpaired automatic speech, normal articulation, severely impaired fluency, intact repetition.

-Receptive Language: Echolalia, severely impaired comprehension

-Reading; Severely impaired

-Writing: Severely impaired

Question 10

Fluent Aphasias

Answer 10

Wernicke’s Aphasia, Conduction Aphasia, Transcortical Sensory Aphasia, Anomic Aphasia

Question 11

Wernicke’s Aphasia

Answer 11

-Caused by a lesion to the posterior portion of the first temporal gyrus (TI). Wernicke’s area is Area 22 (Brodmann classification).

-The supramarginal and lower temporal gyri may be included as part of the Wernicke’s area

-Persistent Wernicke’s aphasia usually involves the supramarginal and angular gyri in addition to the superior temporal lobe area.

Question 12

Wernicke’s Aphasia Language

Answer 12

• Expressive Language: Normal or abnormal speech fluency, Rapid rate of speech, Normal phrase lengths, generally intact grammatical forms, Severe word finding, Empty speech, Impaired conversational skills, Jargon, Normal prosodic features, Impaired repetition
• Receptive Language: Poor language comprehension, Lack of awareness of semantic or neologistic paraphasias
• Reading: Impaired
• Writing: Letters often combined in meaningless manner.

Question 13

Conduction Aphasia

Answer 13

Caused by lesions in the supramarginal gyrus and the arcuate fasciculus, a ban of cortical fibers connecting anterior and posterior speech areas which separate the Broca’s area from the Wernicke’s area.

Question 14

Conduction Aphasia Language

Answer 14

• Expressive Language: Fluent spontaneous speech that may contain phonemic paraphasias (sound substitutions), severely impaired repetition, difficulty with confrontational naming, paraphasic speech.
• Receptive language: Good comprehension
• Reading: Reading aloud is abnormal, reading comprehension is usually good to normal
• Writing; impaired writing

Question 15

Transcortical Sensory Aphasia

Answer 15

The site of lesion is to the border zone
region of the parietotemporal junction.

TSA symptoms bear a striking similarity to
Wernicke’s aphasia

In TSA, the thalamus may be the subcortical structure involved.

The basal ganglia and the thalamus are known to be directly connected to Broca’s areas and Wernicke’s areas, respectively

Question 16

Transcortical Sensory Aphasia Language

Answer 16

-Expressive Language: Fluent but in many cases meaningless or unintelligible speech with many neologisms and paraphasias, Generally good syntactic skills, Impaired naming, Echolalic behavior, Repetition of utterances ranges from good to excellent

-Receptive Language: Impaired comprehension, once initiated, normal acquisition of speech.

-Reading and writing are defective

Question 17

Anomic Aphasia

Answer 17

Frequently appears with Broca’s aphasia

Characterized by: The inability to find names of people or objects. Usually aware of the nature of the object, but cannot name it upon request. Slightly impaired comprehension. Fluent syntactically coherent utterances that are weakened by the disturbance in word retrieval.

May be associated with lesions in the posterior language areas, particularly the angular gyrus in the left parietal lobe near the superior edge of the temporal lobe or the middle temporal gyrus.

Question 18

Anomic Aphasia Types

Answer 18

Word production anomia: Characterized by the patient’s inability to produce the name of an object presented. With cuing, patient be able to use the cue and produce the appropriate name. Seen in nonfluent aphasia.

Word selection anomia: The inability to name an object although the patient can demonstrate or explain its use

Semantic anomia: The inability to retrieve the appropriate word from the lexicon. Difficulty understanding his or her own name when spoken or written.

Category-specific anomia: Characterized by the patient’s inability to name items in some categories
while being able to name items in other categories.

Modality specific anomia: The inability of the patient to name objects presented to one sensory
modality (vision, for example) but not other

Question 19

Transcortical Aphasias

Answer 19

Transcortical Motor (nonfluent), Transcortical Sensory (fluent) , Transcortical Mixed (nonfluent)

Relatively rare.

Repetition is much better than would be expected from comprehension and spontaneous speech.

These aphasia classifications result from an isolation of the speech areas from the rest of the cortex caused by multiple infarcts or diffuse lesions.

Question 20

Other Aphasia Types

Answer 20

-Anomic Aphasia

-Pure Aphasia (alexia w/o agraphis, agraphia w/o alexia)

-Crossed Aphasia (Occurs when a right-handed person has lesions in the right hemisphere)

-Subcortical Aphasias (Global aphasia has been observed in patients with subcortical lesions in the, basal ganglia, posterior internal capsule, temporal isthmus, periventricular white matter in the left hemisphere)

-Subcortical Aphasia with Thalamic Lesions (Word finding difficulty, Reduced verbal output, Disturbances in rhythm and modulation of speech, Short-term memory disturbances, Naming errors, Neologisms)

-Progressive Nonfluent Aphasia (Degeneration of frontal lobes)

Question 21

Sign Language Aphasia

Answer 21

Associated with lesion in Broca’s Area.

Similar to aphasia in oral language users

Deaf sign language users who suffer posterior temporal damage may have difficulty understanding signs

Impaired comprehension may be associated with sign production skills

Damage to the left anterior frontal lobe may result in signing that is effortful and dysfluent

May exhibit hand shape paraphasia and may omit movements