Anomic Aphasia

What is the clinical definition of aphasia?

A deficit in language abilities resulting from damage to the brain.

In most individuals, aphasia is an acquired disorder in the __ hemisphere.

Language-dominant (usually left)

Aphasia is strictly a deficit in language and is NOT a result of motor, psychological, or __ impairment.

Intellectual

What are the four primary modalities of language in which an individual with aphasia can display deficits?

Auditory comprehension, reading, spoken language expression, and writing.

Which specific artery supplies blood to the language areas of the brain and is frequently involved in strokes causing aphasia?

Left middle cerebral artery (MCA).

Expressive language deficits usually arise from lesions in the __ portion of the left cerebral hemisphere.

Anterior (at or near Broca's area).

Receptive language deficits usually arise from lesions in the __ portion of the left cerebral hemisphere.

Posterior (at or near Wernicke's area).

What is considered the most pervasive deficit across all types of aphasia?

Anomia

Define 'anomia' in the context of expressive language.

A deficit in word-finding abilities where the person knows the intended meaning but cannot find the appropriate word.

How does 'verbal comprehension deficit' differ from a general receptive language deficit?

It refers specifically to an inability to comprehend spoken language produced by others.

What characterizes an individual with severe verbal comprehension deficits during social interaction?

An inability to understand even single words, often describing the speech of others as sounding like a foreign language.

Define 'paraphasia' as it relates to aphasia symptoms.

Unintentional errors in expressive language (syllables, words, or phrases) linked to higher-level language deficits rather than motor impairment.

Which type of paraphasia is occurring when an individual says 'cart' instead of the target word 'dart'?

Phonemic (or literal) paraphasia.

When an individual says 'glass' instead of the target word 'cup', they are demonstrating a __ paraphasia.

Semantic

Define an 'unrelated verbal paraphasia'.

The substitution of a word that is completely unrelated in meaning to the intended word (e.g., 'lunch' for 'bicycle').

At what point is a verbal error classified as a 'neologism'?

When the produced word is entirely different from the intended word and is at least 50% indiscernible.

What is the term for a word or phrase that is produced repeatedly and inappropriately instead of the intended target?

Perseverative paraphasia.

In aphasia, what is the specific cause of 'agrammatism'?

The systematic omission of function (functor) words in utterances.

Contrast 'function words' and 'content words' in agrammatic speech.

Function words provide grammatical frame (e.g., 'a', 'the'), while content words carry the majority of meaning (nouns, verbs).

Speech consisting of short, effortful phrases containing mostly content words and lacking functor words is known as __.

Telegraphic speech

A deficit in repetition is typically localized to lesions along the __, the white matter pathway between Broca's and Wernicke's areas.

Arcuate fasciculus

Alexia

An acquired impairment in the ability to read.

Agraphia

An acquired impairment in the ability to form letters or words using letters.

Lesions to the language-dominant hemisphere at the __ often result in both alexia and agraphia.

Angular gyrus

What is a 'self-repair' in the context of aphasic speech behaviors?

An attempt to restate or revise a word or phrase to produce it error-free or refine its meaning.

How successful are individuals with aphasia at self-repairing speech errors compared to unimpaired speakers?

Significantly less successful, with success occurring in less than 50% of attempts.

What is 'automatic language'?

Overlearned or rote language (e.g., counting 1-10, swearing) that is produced somewhat reflexively in response to a stimulus.

Why is the presence of preserved automatic language considered clinically significant?

It is associated with a better prognosis for recovery and provides a starting point for therapy.

Etiologies resulting in aphasia often cause collateral damage to which specific cognitive abilities?

Arousal, attention, short-term memory, problem solving, inferencing, and executive functioning.

Identify three motor deficits that frequently concern a Speech-Language Pathologist (SLP) when treating a patient with aphasia.

Dysarthria, apraxia of speech, and dysphagia (swallowing disorders).

What determines whether an aphasia is classified as 'cortical' or 'subcortical'?

The location of the lesion (cortex vs. structures like the thalamus or basal ganglia).

List the four primary characteristics of non-fluent cortical aphasias.

Agrammatic, halting/effortful speech, use of mainly content words, and short phrases/single-word utterances.

In which specific lobe is Broca's area located?

The inferior posterior frontal lobe of the left hemisphere.

Describe the receptive language status of an individual with Broca's aphasia.

Functionally intact; they can generally understand conversations and answer simple questions.

What is the profile of an individual with Broca's aphasia regarding verbal output and repetition?

Verbal output is halting, effortful, and telegraphic, with significant deficits in repetition.

Why might a patient with Broca's aphasia experience difficulty writing with their right hand?

The left hemisphere lesion affecting language production often causes concomitant motor deficits (hemiparesis/hemiplegia) on the right side.

Which sign distinguishes Transcortical Motor Aphasia from Broca's Aphasia?

Preserved repetition abilities.

Why is repetition preserved in Transcortical Motor Aphasia despite disfluent speech?

The lesion is anterior to Broca's area, sparing the arcuate fasciculus and its connections.

What is 'Global Aphasia'?

The most severe form of aphasia, resulting from damage to and loss of most of the 'zone of language' (Broca's, Wernicke's, and arcuate fasciculus).

What is the typical verbal output for an individual with Global Aphasia?

Little to no expressive ability, possibly limited to 1-2 words, neologisms, or perseverations.

Where is the site of lesion for Wernicke's Aphasia?

The superior temporal gyrus of the left hemisphere.

What is 'anosognosia', often seen in Wernicke's aphasia?

The inability to recognize that a deficit exists (a lack of awareness of their own errors).

Describe 'empty speech' in fluent aphasia.

Speech that is abundant and follows normal prosodic patterns but is void of meaning due to paraphasias and circumlocutions.

What is 'logorrhea'?

A near-nonstop, often meaningless and tangential output of speech common in Wernicke's aphasia.

Which specific characteristic distinguishes Transcortical Sensory Aphasia from Wernicke's Aphasia?

Relatively intact repetition abilities.

What is the hallmark repetition profile of Conduction Aphasia?

A significant deficit in repetition despite relatively intact auditory comprehension and fluent spontaneous speech.

Define 'conduit d'approche' in Conduction Aphasia.

A 'zeroing-in' behavior where the patient makes repeated, unsuccessful attempts to self-repair, with each attempt getting closer to the target word.

What are the three core features of Anomic Aphasia?

Fluent speech, intact receptive language, and a disproportionately severe deficit in naming (anomia).

Where is the damage typically located in a patient diagnosed with Anomic Aphasia?

It can be produced by damage anywhere within the language areas of the left hemisphere.

Thalamic aphasia is characterized by almost fluent speech and significant anomia in __ speech, but less so in confrontational naming.

Spontaneous

How long is the period of 'spontaneous recovery' following a stroke or brain injury causing aphasia?

Approximately 6 months post-onset.

What is the primary goal of restorative therapy approaches in aphasia?

To help the patient regain lost abilities or skills by reducing the actual level of the deficit via neuroplasticity.

Describe Schuell's Stimulation Approach.

A restorative therapy using the auditory modality to stimulate and reestablish disrupted language skills in other modalities.

What is Melodic Intonation Therapy (MIT) designed to exploit?

The intact melodic and prosodic processing skills of the right hemisphere to cue word retrieval and expressive language.

What is the core principle of 'Errorless Learning Therapy' in aphasia treatment?

Preventing the patient from making errors during therapy to avoid the reinforcement of incorrect language productions.

The primary form of compensatory therapy used in aphasia is __.

Augmentative and Alternative Communication (AAC).

Contrast 'augmentative' and 'alternative' communication strategies.

Augmentative complements remaining language; alternative replaces the language system entirely.

Provide two examples of 'low-tech' AAC.

Gestures, drawing pictures, or pointing to communication boards/folders.

Provide an example of 'high-tech' AAC.

Programmable voice-generating devices (e.g., Lingraphica) or specialized tablet apps (e.g., Proloquo2Go).

Social therapy approaches focus on reducing __ to communication for individuals with aphasia.

Barriers

The ability to repeat words originates with the __, which stretches between Broca's and Wernicke's areas.

Arcuate fasciculus

Primary Progressive Aphasia (PPA) is a neurodegenerative condition; what are its two main subtypes according to the source?

Progressive Nonfluent Aphasia and Semantic Dementia.

What is 'Crossed Aphasia'?

Aphasia resulting from a right hemisphere lesion in a right-handed individual.

Why is 'confrontational naming' tested in suspected Anomic Aphasia?

To identify disproportionate deficits in naming relative to otherwise fluent speech and intact comprehension.

What does the root word 'praxis' mean in the term apraxia?

To act or to move.

Apraxia of speech is characterized by a lack of movement or action for __ production despite intact muscle strength.

Speech

Which cortical area is typically damaged in cases of acquired apraxia of speech?

The left inferior-posterior frontal lobe (Broca's area).

Unlike dysarthria, individuals with apraxia of speech often have 'islands' of __.

Intact articulation

What is the purpose of an 'oral motor evaluation' in assessing neurogenic communication disorders?

To differentiate between language deficits (aphasia) and motor speech deficits (apraxia/dysarthria).

In 'Constraint-Induced Aphasia Therapy', what is restricted or 'constrained'?

The use of compensatory strategies (like gesturing), forcing the patient to use verbal language.

What role does the 'angular gyrus' play in language processing?

It is essential for translating written language into auditory code (reading) and vice-versa (writing).

Which aphasia is characterized by 'logorrhea' and 'anosognosia'?

Wernicke's aphasia.

A patient can follow complex directions but cannot name a pen when shown one; which aphasia profile is most likely?

Anomic aphasia.

Which subcortical structure, if damaged, can result in aphasia featuring almost fluent speech but impaired receptive language?

Thalamus

Define 'idiopathic' in the context of neurogenic etiologies.

An etiology that is unknown or obscure.