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32 Cards in this Set
- Front
- Back
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What is the diagnostic criteria for aphasia? |
Disturbance affecting all levels & modalities of language after complete development of speech functions. |
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What do 'all levels of language' mean? |
1. Sounds 2. Letters (phonemes) 3. Words (semantic) 4. Sentences (syntax) 5. Texts |
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What does 'all modalities' mean? |
1. Expressive (speaking and writing) 2. Receptive (comprehension and reading) |
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At what levels do language errors occur? |
1. Phonological (sounds) 2. Semantic (words) 3. Grammar (sentences) |
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What errors occur at phonological level? |
Phonemic paraphasias - errors in phonemes (e.g. dog --> doc) Phonemic neologisms - Too many paraphasias and create a new word (e.g. dog --> cdo) |
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What errors occur at semantic level? |
Anomia - Not being able to name things Semantic paraphasias - errors in words (e.g. dog --> cat) Semantic neologisms - e.g. dog + cat = dat |
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What errors occur at the grammar level? |
Agrammatisms - Missing grammatical functors - e.g. "Give it me" Paragrammatisms - Incorrect use of grammatical elements - e.g. "Give it for me" |
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What are the 4 general types of aphasia? |
1. Global aphasia 2. Broca aphasia 3. Wernicke's aphasia 4. Amnesic (anomic) aphasia |
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What are the symptoms of global aphasia? |
1. Mixture of all the other aphasias 2. Spontaneous speech is sparse/missing 3. Grammar is poor 4. Semanticity is impaired 5. Limited vocabulary 6. Some paraphasias 7. Many phonological level errors (phonemic paraphasias & neologisms) 8. Comprehension is severely disturbed (phonological & semantic) |
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What is the main cause of global aphasia? |
Large strokes in middle cerebral artery - Also causes both Broca's & Wernicke's |
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What are symptoms of Broca's aphasia? |
Basically a motor problem: 1. Slow, influent speech 2. Limited vocabulary with phonological errors 3. Lots of agrammatism 4. Some semantic paraphasias 5. Comprehension is slightly disturbed (at phonological level) |
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What is main cause of Broca's aphasia? |
Strokes in rostral part of middle cerebral artery - Causes lesion of Broca's area / Left perisylvian network |
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What are symptoms of Wernicke's aphasia? |
Is a sensorial aphasia 1. Many words are lost, but production remains 2. Fluent speech but lots of paragrammatism 3. Semantic & phonemic paraphasias 4. Comprehension is severely disturbed (at semantic level) |
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What is main cause of Wernicke's aphasia? |
Strokes around caudal part of middle cerebral artery - Causes lesion in Wernicke's area |
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What are main symptoms of Amnesic (anomic) aphasia? |
1. Problems connecting meanings to words 2. Speech is fluent & syntax not disturbed 3. Anomias (at semantic level) 4. Only a few phonemic paraphasias 5. Comprehension is slightly disturbed |
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What is main cause of Amnesic (anomic) aphasia |
Degenerative disorders affecting the left hemisphere |
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What are important connections related to aphasia? Hint: ABM triangle |
Arcuate Fasciculus - Connects superior temporal gyrus (STG) with lateral PFC and inferior parietal lobule (IPL) - Connections IPL to lateral PFC Summary: STG to LPFC & IPL IPL to LPFC |
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Which brain regions relate to the ABM triangle? |
A = Auditory word representations - STG (Wernicke's & Primary auditory) B = "Concept center" - LPFC? M = Motor word representations - IPL (Broca's) |
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What is Lichtheim's House? |
Conceptualizes relationship between different types of aphasias in a temporal order from auditory input to language output |
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Name the disorders occuring from lesions in the numbered areas |
1. Subcortical sensory aphasia 2. Wernicke's aphasia 3. Transcortical sensory aphasia 4. Conduction aphasia 5. Transcortical aphasia 6. Broca's aphasia 7. Subcortical motor aphasia |
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Explain subcortical sensory aphasia and where damage occurs to cause it |
Early phase of sensory aphasia. Damage to medial geniculate nucleus in thalamus or superior colliculi Since auditory input first passes through these areas |
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Explain where damage occurs to cause Wernicke's aphasia |
Damage to Wernicke's area (BA22) Since auditory info reaches cortical areas like auditory cortices and wernicke's area |
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What are 2 main pathways after Wernicke's area? |
1. Parieto-temporal junction & Angular gyrus 2. Arcuate fasciculus fibre tract |
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What is cause of transcortical sensory aphasia? |
Damage to the parieto temporal junction, often with extra damage to angular gyrus Causes disconnection between Wernicke's area and its parietal association. |
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What is the cause of conduction aphasia? |
Damage to arcuate fasciulus fibre tract connecting Wernicke's to Broca's area |
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What is the cause of Transcortical motor aphasia? |
Impairment of transmission of motor commands from supplementary motor area (SMA) to Broca's area |
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What is the cause of Broca's aphasia? |
Lesion in left perisylvian network Especially Broca's area |
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What is the cause of subcortical motor aphasia? |
Damage to internal capsule or other subcortical areas - Missing connectivity of Broca's to subcortical relay stations |
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What are symptoms of conduction aphasia? |
1. Repitition is imparied severely mostly 2. Severe phonological disturbances 3. Reduced immediate memory due to phonological loop impairment 4. Comprehension relatively preserved (less severe sensory impairment) 5. Patients aware of disturbances (unlike Wernicke's) |
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What are symptoms of transcortical sensory aphasia? |
1. Repitition fairly undisturbed 2. Spontaneous speech is fluent but many semantic paraphasias 3. Severe comprehension disturbance |
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What are symptoms of transcortical motor aphasia? |
1. Good comprehension but no/sparse spontaneous speech 2. Verbal output effortful, short, dysprosodic (monotonous) 3. Loss of grammatical functors |
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What could be a differential diagnosis and what are the symptoms of that? Why does it occur? |
Dysarthia 1. Disturbances of motor process of speech (strength, speed & complexity of speech movements) 2. Not a language deficit, but motor aspects more affected. 3. Due to dysregulation of neuronal activity innervating muscles required for producing output of language system |
