Aphasia

Clinic

• Aphasia is an inability to comprehend or formulate language with brain origin.
• For diagnosis, person's speech must be significantly impaired in one (or several) of the four communication modalities:

1. Auditory comprehension
2. Verbal expression
3. Reading and writing
4. Functional communication

Aphasia vs Dysarthria

• Aphasia has not motor or sensory deficits . It is a cognitive problem, therefore is not related to the mechanics of speech. Although a person can have both problems.
• All disorders that lead to Listening / Comprehension / Speaking / Reading / Writing / Social communication performance, can be the cause of aphasia.
• Unlike aphasia, Dysarthria is a neurological movement disorder of speech organs.
• Apraxia is the loss of the ability to perform purposeful voluntary actions

Aphasia problems

Aphasia is an entity that include some SSPs such as cognitive dysfunction

• Anomia: Inability to name

• Inability to comprehend language
• Inability to pronounce, not due to muscle paralysis or weakness
• Inability to speak spontaneously
• Inability to form words
• Poor enunciation
• Excessive creation and use of personal neologisms
• Inability to repeat a phrase
• Stereotypies, Recurrent utterances/ Speech automatism: Persistent repetition of one syllable, word, or phrase
• Paraphasia: Substituting letters, syllables or words
• Agrammatism: Inability to speak in a grammatically correct fashion
• Dysprosody: Alterations in inflexion, stress, and rhythm
• Incomplete sentences
• Inability to read / write
• Limited verbal output

Anatomy

• Built on an analogy between the visual and auditory systems, the following dual stream model for language processing was suggested recently:
  • Dorsal stream is involved in mapping sound to articulation (Phonological form-to-articulation)
  • Ventral stream in mapping sound to meaning (Phonological form-to-meaning)
• Speech production is impaired primarily as a result of damage to the dorsal stream whereas speech comprehension is more likely associated with ventral stream damage. Nevertheless, many clinical tests of aphasia involve multiple processes that rely on both streams, which can result in poor performance due to damage affecting different sections of the cortical speech and language network.
• Damage to specific cortical hubs such as Broca’s area, SMG/angular gyrus, and posterior STG affects performance at least 6 months after stroke on several different aphasia tests and should be explored in future studies of prognosis in aphasia.

• Sublexical repetition of speech is subserved by a dorsal pathway, connecting the superior temporal lobe and premotor cortices in the frontal lobe via the arcuate and superior longitudinal fascicle.
• In contrast, higher-level language comprehension is mediated by a ventral pathway connecting the middle temporal lobe and the ventrolateral prefrontal cortex via the extreme capsule.

Miasms

• Aphasia:

1. JE
2. PLV, BKV, LAC, TBE, VZV
3. MMP

• Mouth speech difficult:

1. PLV, MMP, CJD
2. HCV, HSV-1, HSV-2, VSV

• Word- Hunting : PLV
  

Related entities

• Dysarthria: CJD, FFI, GSS, NVCJD

Related disease

Autism

Types of Aphasia

1. Global Aphasia: It is the most severe type of aphasia. It is caused by injuries to multiple parts of the brain that are responsible for processing language. Patients with global aphasia can only produce a few recognizable words. They can understand very little or no spoken language. However, they may have fully preserved cognitive and intellectual abilities that are not related to language or speech. Global aphasia may be apparent immediately following a stroke or brain trauma. While this type of aphasia can improve as the brain heals, there may be lasting damage.
2. Broca’s Aphasia = Non-fluent = Expressive aphasia. They have partial loss of their language ability. They have difficulty speaking fluently and their speech may be limited to a few words at a time. Because they can only get a few words out at a time, their speech is described as halting or effortful. They are usually able to understand speech well and maintain the ability to read but may have limited writing abilities.
3. Mixed Non-Fluent Aphasia: Patients with this type of aphasia have limited and effortful speech, similar to patients with Broca’s aphasia. However, their comprehension abilities are more limited than patients with Broca’s aphasia. They may be able to read and write, but not beyond an elementary school level.
4. Wernicke’s Aphasia= Fluent aphasia = Receptive aphasia: These individuals have an impaired ability to comprehend spoken words, they do not have difficulty producing connected speech. However, what they say may not make a lot of sense and they’ll use nonsense or irrelevant words in their sentences. Often, they do not realize that they are using the incorrect words. Someone with Wernicke’s aphasia will probably have an impaired ability to read and write and lose much of their language comprehension ability.
5. Anomic Aphasia: A person who suffers from anomic aphasia is unable to come up with the right words for what they want to talk about. They have a grasp on grammar and speech output, but they simply cannot find the words to discuss what they want to. When they speak, it is often vague and they might seem like they are “talking around” the thing they can’t describe. They also have difficulty finding words when they write.
6. Primary Progressive Aphasia: PPA is a neurological syndrome in which someone loses their ability to use language slowly and progressively. While most other forms of aphasia are caused by stroke, PPA is caused by neurodegenerative diseases like Alzheimer’s Disease. PPA progresses as the tissue in the language centers of the brain deteriorates over time. Because this form of aphasia is associated with degenerative disorders, PPA is eventually accompanied by other symptoms of dementia or memory loss.

Miasmatic research

• CJD: Broca’s Aphasia
• HSV-1: Wernicke’s Aphasia , Global Aphasia
• PLV: Wernicke’s Aphasia
• JE: Global Aphasia
• Anomic Aphasia: PLV