APHASIA

What is it?  “Acquired language dysfunction due to neurological injury or disease”  Most common cause is stroke (about 25-40% of stroke patients acquire aphasia)  Other causes include head injury, brain tumor, and degenerative neurological disease  Can be a symptom of epilepsy  Aphasia affects about one million Americans (1 in 250 people)  More than 100,000 Americans acquire the disorder each year  More common than Parkinson's Disease, cerebral palsy or muscular dystrophy

Common Symptoms  Problems talking  Speaking in short, fragmented phrases  Putting words in the wrong order  Using incorrect grammar  Switching sounds or words  Speaking in nonsense  Anomia (word-finding problems; words "on the tip of the tongue")  Problems understanding oral language  Needing extra time to process language  Difficulty following very fast speech  Taking the literal meaning of a figure of speech  Problems reading  Problems writing

Associated Brain Anatomy  90% of individuals are left hemisphere dominant for language  Expressive language = inferior frontal lobe  Receptive language = inferior temporo-parietal cortex  Non-dominant hemisphere plays significant role in prosodic aspects of language  Expressive prosody = non-dominant frontal lobe  Receptive prosody = non-dominant temporo- parietal lobe

Types of Aphasias Nonfluent Aphasias 1.Global Aphasia 2.Mixed Transcortical Aphasia 3.Broca’s Aphasia 4.Transcortical Motor Aphasia Fluent Aphasias 1.Wernicke’s Aphasia 2.Transcortical Sensory Aphasia 3.Conduction Aphasia 4.Anomic Aphasia

Broca’s Aphasia Lesion

Broca’s Aphasia  Fluency : almost a complete lack of coherent speech to slow halting speech with few content words and few verbs or adjectives.  Comprehension : Comprehension of single words, short phrases, and reading intact. The more grammatically complex, the more impairments  Repetition, Naming, Writing : Impaired Broca’s Aphasia Patient taking the Boston Naming Test

Wernicke’s Aphasia Lesion

Wernicke’s Aphasia  Fluency : Speech is fluent, but unintelligible. Speech output is effortless, rapid, and sentence length is normal, but content is unintelligible  Comprehension : Impaired - typically have trouble answering yes/no questions and following one-step commands  Repetition and Naming : Impaired  Writing : Letters are being written, but content is unintelligible Patient with Wernicke’s Aphasia

Treatment  Depends on a variety of factors:  Age  Type of aphasia  Cause of aphasia  Position and size of brain lesion

Treatments  Speech and language Therapy (most common)  Melodic Intonation Therapy (MIT)  Melodic intonation of words  Rhythmic tapping of each syllable using the left hand while phrases are repeated  Art Therapy  Visual Speech Perception Therapy – associating pictures with words  Family Counseling  Medications to improve blood flow in the brain ABC News Clip – Music Therapy

Healthy non-musician Healthy professional singer Patient with chronic non-fluent aphasia before MIT Patient with chronic non-fluent aphasia after MIT