Aphasia Test 1

fluent types of aphasia

wernicke's
conduction
transcortical sensory
anomia

non-fluent types of aphasia

broca's
transcorical motor
transcortical mixed
global

types of stroke

ischemic
hemorrhagic

symptoms of stroke (sudden onset)

weakness
numbness
aphasia
vision loss
double vision
vertigo
imbalance
incoordination

types of paraphasia

global
semantic
neologism
phonetic
jargon
circumlocution

global (verbal) paraphasia

entire word is substituted for intended word (unrelated word)

semantic paraphasia

word belongs to the same semantic field

neologism paraphasia

a novel or newly coined word

phonetic (literal) paraphasia

phoneme is added or substituted for the correct phoneme

jargon paraphasia

long stream of verbal output that is incomprehensible

circumlocution paraphasia

describing the intended word

wernicke's aphasia

- poor auditory and reading comprehension
- poor repetition
- poor naming
- poor writing
- poor monitoring
- logorrhea (overload of verbal output)

paraphasias:
- neologism
- jargon
- semantic
- phonemic (literal)

conduction aphasia

+ intact comprehension
- impaired repetition
- impaired naming
- impaired writing

paraphasias:
- literal/phonemic

transcortical sensory aphasia

- poor auditory comprehension
- poor confrontation naming
+ good repetition

paraphasias:
- global
- neologism

anomic apahasia

+ good auditory and reading comprehension
+ good repetition
- poor naming/word retrieval

paraphasias:
- circumlocution

broca's aphasia

+ good auditory and reading comprehension
- poor repetition
-poor naming
- poor writing and reading aloud
- limited vocabulary
- right hemiparesis
- telegraphic speech (agrammatism)
- self aware of errors --> depression, frustration

paraphasias:
- phonemic/literal

transcortical motor aphasia

+ good auditory and reading comprehension
+ good repetition
+ good naming
- may perseverate
- impaired writing and reading aloud
- syntactic errors
- mild dysarthria

paraphasias:
- phonemic/literal

transcortical mixed aphasia

- poor auditory and reading comprehension
+ good repetition
- poor naming
- may perseverate
* rare type of aphasia *

global aphasia

- poor auditory and reading comprehension
- poor repetition
- poor naming
- restricted vocabulary
- limited understandable communication/output
- stereotypic utterances
* some people may start out with a diagnosis of global but develop into a different type over time *

exceptional aphasias

basal ganglia (subcortical)
thalamic (subcortical)
crossed
primary progressive

basal ganglia aphasia

- comprehension deficits
- dysarthria
- motor impairments

thalamic aphasia

- non fluent
- good comprehension
- semantic paraphasia

crossed aphasia

- right-handed individuals with right hemisphere lesions
- similar to other aphasias but with right hemisphere deficits
- visual neglect on left side
- trouble understanding jokes

primary progressive aphasia

- gradual progression without evidence of non-language impairments
- involves left hemisphere perisylvian region

general definition of aphasia

an acquired language disorder that is neurological in origin and not a problem of intellect or sensation

Fredric Darley's definition of aphasia

aphasia is an impairment (caused by brain damage) of the person's capacity for interpretation and formation of language symbols; results in a reduction in efficiency of interpreting and forming language symbols but it is not a problem of loss

Papathanasiou's definition of aphasia

results from a focal brain lesion in the language dominant hemisphere and affects the person's communicative and social functioning as well as the quality of life of the relatives and care persons

localizationism

belief that the brain relies on centers and pathways

holism

belief that the brain is a unitary function and that everything is connected; if something is not working properly it will affect the function of the brain

people who believed in localizationism

- Bouillaud located speech as a part of the frontal lobe
- Broca located where speech and language occur in the brain (BA 44, 45)
- Wernicke located the posterior area of the perisylvian region as where auditory reception/processing of language occurs (BA 22)
- Geschwind created the Boston classification of aphasia

people who believed in holism

- Jackson believed language faculty was intertwined with memory and discussed hemispheric asymmetry
- Head discussed aphasia regarding assessments

objections to localizationism

- assumes that if the lesion site is different, the symptoms will always be different although there could be variability in symptoms across patients with the same lesion site
- pure localization does not explain some phenomena like the variability in loss/ability, pure localization would mean total loss of ability

definition of neuroplasticity

the brain's capacity to change at the micro level (neural plasticity) and the macro level (behavioral plasticity) in response to environmental changes or changes in the organism itself

adaptive vs maladaptive plasticity

adaptive = efficient rerouting

maladaptive = inefficient rewiring resulting in the persistence of aphasic symptoms and poor recovery

Wernicke's aphasia lesion site

posterior half of first temporal gyrus

conduction aphasia lesion site

left supra marginal gyrus

transcortical sensory aphasia lesion site

angular and posterior middle temporal gyrus

anomia aphasia lesion site

no specific site; typically inferior parietal lobe

Broca's aphasia lesion site

left inferior frontal gyrus

transcortical motor aphasia lesion site

Connection of supplementary motor area and frontal perisylvian areas

transcortical mixed aphasia lesion site

Broca’s & Wernicke’s intact, but “isolated” by damage of perisylvian association cortex

global aphasia lesion site

Perisylvian association cortex

subtypes of ischemic stroke

- cardioembolic
- atherothrombotic cerebrovascular disease
- lacunar
- cryptogenic

subtypes of hemorrhagic stroke

- intracerebral (bleeding inside brain)
- subarachnoid (bleeding around brain)

10 principles of experience based neuroplasticity

1. use it or lose it
2. use it and improve it
3. specificity (nature of training experience dictates nature of plasticity)
4. repetition
5. intensity
6. time
7. salience (experience must be important)
8. age
9. transference (one training experience can enhance acquisition of similar behaviors)
10. interference

definition of stroke

sudden onset of focal brain dysfunction caused by a disruption in blood flow and oxygen to the brain

TIA

transient ischemic attack
- mini stroke
- symptoms last less than 24 hours

common stroke syndromes

- left MCA stroke (middle cerebral artery)
- right MCA stroke

left MCA stroke

- aphasia
- left gaze deviation
- right side numbness/weakness
- right visual field loss

right MCA stroke

- contralateral neglect (inability to attend to stimuli on one side of space)
- denial of weakness/impairment
- right gaze deviation
- left visual field loss
- left side numbness/weakness

cardioembolic ischemic stroke

results from blood clot forming in another area of the body and being carried through the bloodstream, lodging in an artery supply blood to the brain and blocking blood flow

atherothrombotic cerebrovascular disease (ischemic stroke)

can cause stroke when normal blood flow is disrupted by severe arterial blockage from plaque buildup in arteries and clotting occurs

lacunar ischemic stroke

results from occlusive disease of small penetrating arteries of the brain

cryptogenic ischemic stroke

underlying etiology of stroke remains obscure

intracerebral hemorrhagic stroke

occurs when a defective artery in the brain ruptures the surrounding area fills up with blood

subarachnoid hemorrhagic stroke

occurs when a blood vessel on the surface of the brain ruptures and causes bleeding around the brain