Neuropsychology of Language

Question 1

How is language developed?

Answer 1

It is developed through social interactions and with exposure to others

Question 2

How is speaking different from reading and writing?

Answer 2

Speaking is innate; reading and writing are taught

Question 3

What is aphasia?

Answer 3

The loss or impairment in speech production or comprehension due to brain damage

Question 4

What are the main brain systems involved in auditory language?

Answer 4

Broca’s Area (BA 44 & 45), Wernicke’s Area (BA 22), the arcurate fascilicus, and the angular gyrus

Question 5

What is agraphia?

Answer 5

The loss or impairment of writing due to brain damage

Question 6

What is acquired dyslexia/alexia?

Answer 6

The loss or impairment of reading caused by brain damage

Question 7

What did Paul Broca surmise based on his observations of his patient “Tan?”

Answer 7

• Aphasia is not due to a loss of motor functioning or paralysis of muscles around the face
• the deficit is specifically linguistic in nature
• lesion to Broca’s area causes impairment in speech production

Question 8

What is a syndrome-based approach?

Answer 8

A description of clinical evidence

Question 9

What does disarthric mean?

Answer 9

Difficulty forming words, but not with conveying meaning (this difficulty is due to muscle tissue as opposed to the brain regions responsible for language processing)

Question 10

Describe Broca’s aphasia. Mention its distinguishing characteristics as well as the brain regions which are typically affected to produce this deficit.

Answer 10

• speech is non-fluent, and laborious to talk
• specifically linguistic
• telegraphic speech is observed
  
  • content words like noun and verbs are used, whereas conjunctions, prepositions and word endings are neglected
• word retrieval difficulty
• normal comprehension of written and spoken language
• awareness of deficit (and are often depressed)
• speech is meaningful and makes sense
• due to damage in the anterior to central fissure, and anterior to motor strip responsible for facial control (damage also extends to surrounding white matter and subcortical connections)

Question 11

Describe Wernicke’s aphasia. Mention its distinguishing characteristics as well as the brain regions which are typically affected to produce this deficit.

Answer 11

• speech is fluent and contains proper intonations and superficial structure
• no content to speech
• comprehension deficit
• unawareness of deficit
• poor comprehension in spoken and some written language
• due to damage at the junction of the temporal lobe with parietal and occipital regions, near Heschl’s gyrus (damage also extends to surrounding white matter and subcortical connections)

Question 12

How can we assess the extent of the aphasia?

Answer 12

Using open ended questions, such as by asking the patient to describe a picture (ex. Cookie Theft)

Question 13

What is anomic aphasia?

Answer 13

Deficit in naming

• usually present when presented with a confrontational question, such as “how old are you?” (i.e. there is only one right answer
  
  • difficulty retrieving a word (ex. clock becomes “the thing to tell the time)

Question 14

What is paraphasia?

Answer 14

Error producing a specific word

Question 15

What is verbal paraphasia?

Answer 15

Substituted word has a related meaning (ex. barn is substituted for house)

Question 16

What is phonemic paraphasia?

Answer 16

Substituted word has a similar sound (ex. bekan instead of began)

Question 17

What is a neologism?

Answer 17

A made up word that follows the rules for combining sounds in the language of the speaker (ex. galump or trebbin)

Question 18

What is Broca’s aphasia also sometimes called?

Answer 18

Motor aphasia (due to difficulty in fluency), agrammatic aphasia, anterior aphasia

Question 19

What is Wernicke’s aphasia also sometimes called?

Answer 19

Sensory aphasia (due to difficulty in comprehension), receptive aphasia, posterior aphasia

Question 20

What is the arcurate fascilicus responsible for?

Answer 20

It is the white matter pathway involved in the communication between Broca’s Area and Wernicke’s Area

Question 21

What is the angular gyrus responsible for?

Answer 21

It processes semantic meaning in language

Question 22

Describe the Wernicke-Geschwind model?

Answer 22

it is the way that neuroscientists used to understand language processing

1. the input of spoken word > areas 41 & 42 (primary auditory cortex and secondary auditory cortex) > Wernicke’s area (BA 22) > hear and comprehend word
2. the input of answering a question (cognition) > Wernicke > Broca > face > cranial nerve > speak
3. written word > area 17 (primary visual cortex) > areas 18 & 19 (secondary visual cortices) > area 39 (angular gyrus) > wernicke > read

Question 23

What is the problem with the Wernicke-Geschwind model?

Answer 23

It oversimplifies the view of language deficits following brain damage

Question 24

What is conduction aphasia?

Answer 24

It is the inability to repeat spoken words due to a disconnection syndrome (between Broca’s area and Wernicke’s area)

• speech production and comprehension are maintained
• due to damage to the arcurate fascilicus
• semantic paraphasia

Question 25

What is global aphasia?

Answer 25

The inability to comprehend and produce language, due to left hemisphere damage

Question 26

What is the two node, one connection model?

Answer 26

It describes the path from the two nodes (Broca and Wernicke) to the connection (the arcurate fascilucus)

Question 27

What are the problems with the two node, one connection model?

Answer 27

• specific lesion does not equal pattern of language impairment
• there exists bi-directional connections
• aphasia does not exist in pure forms
• aphasia is not always due to damage in those areas (there is a huge amount of variability in the description of exactly where these areas are found)