Aphasias

Pregunta	Respuesta
What is language? What is language translated into? What three things does speech comprehension consist of? What three things does speech production consist of? What language can be acquired after brain damage? Should it be called Dysphasia or Aphasia?	Is the systematic use of sound combinations for communication purposes, the use of sound is guided by rules Other sensory modalities, these rules allow for equivalent communication through gestures, touch and visual images 1. Perceptual Analysis 2. Phoneme is matched to information in vocabulary/lexicon 3. Words are then combined syntactically (The arrangement of words or phrases) and symantically (with regard to meaning) 1.Developing a plan of message 2. Message converted into linguistic structure 3. Translated into sound (produced speech is monitored by speech comprehension system to ensure that the intended message is conveyed) the two systems interact 1. Dyslexia/Alexia = The disorder/inability with reading, 2. Disgraphia/Agraphia = Disorder/inability with writing 2. Aphasia = Disturbance in the comprehension and/or production of speech Aphasia should be inability as 'A' means without Should be Dysphasia which describes a n impairment/deficit
What is aphasia not due to? What is Disarthia? What has language been found to depend on? Name the seven classic types of aphasia:	1. Sensory disorder (deafness) 2. Perceptual problem (agnosia) 3. Thought disorder (autism) 4. Movement disorder (disarthia) Problem with speech execution due to poor control of lips, through, tongue, lungs or swallowing An extended neural network, however most language disorders occur after damage to the left cerebral hemisphere (lateralisation of function to the left side) 1. Brocas 2. Wernickes 3. Conduction 4. Anomia 5. Global 7. Transocrtical motor 8. Transcortical sensory
What is Broca's aphasia? What in intact? What is impaired? Name the famous patient Who tested the patient? What did the investigator do? Result: What is speech like in Brocas aphasia? (5 things)	A deficit in verbal output (deficit extent depends on lesion size) Speech/language comprehension Production of speech, non fluent, however expressive TAN Broca Looked at Tan's brain post mortem, whole brain A large cavity in left inferior frontal lobe and pronounced this sight as the special faculty for articulated language (only a single dissociation) 1. Non fluent 2. Effortful 3. Agrommatic 4. Dysathic (whispy, hollow) 5. Disprosodic (No melody, pauses or internation)
What is agrammatism? How can understanding a patient with Brocas aphasia appear challenging? Other problems seen in patients with Brocas aphasia: (three things)	When the word order is impaired and verbal economy happens such as missing definite articles such as 'the' and 'a' and function words such as 'of', 'to' and 'in' By syntactic ambiguities when the patient misses function words that can alter the meaning of the sentence 1. Cannot repeat speech 2. Cannot name things/objects 3. Cannot read or write (disorders in the same was as speech is)
Where is Broca's area in the brain? What does damage to Broca's area typically result in? Who investigated this? What was the historical view of Brocas area? What does this fail to explain? What did dronker et al 1996 find? What did Schnur 2009 find? What does this suggest?	Left inferior frontal gyrus or Brodmanns areas 44 and 45 Transient deficits (temporary, patients often recover) Mohr et al 1978 and found that Broca's aphasia usually only persists with additional damage to underlying white matter and basal ganglia A loss of motor forms of speech Agrammaticism That articulatory deficits are caused by lesions outside of Brocas area Brocas area may not just be for speech after finding increased activation in this area during a search task Brocas area could be more response selection
Who found Wernickes aphasia? What's it also known as? What in intact? What is impaired? What is also impaired?	Wernickes 1874 Receptive sensory or fluent aphasia Speech production (fluent but intelligible) Speech comprehension (patients don't understand verbal instruction) Comprehension of their own speech, they are not aware of their impairment or that what they are doing does not make sense and do not attempt to correct themselves
What does speech sound like in a patient with Wernickes aphasia?	1. Fluent 2. Well articulated 3. Loghorrea (excessive speech production) 4. Social rules missing (i.e. don't look at you or take turns to speak 5. Presence of neologisms (which are new made up words) 6. Paraphasia (production of unintended syllables words or phrases during effort to speak)
What are the 3 different types of paraphrasia? What are they?	1. Literal paraphasia - Lyllables of a word are produced in the wrong order or words are distorted with unintended sounds with some phonemic features preserved 2. Symantic paraphasia (unintended words used in the place of another) (sometimes a generalisation) 3. Persaverative paraphasia (substituted word for object crops up again from something just said)
Other problems seen in Wernikes aphasia? (three things) Where it Wernickes area? Which are must be lesioned to result in WA and who found this? What did Naeser et al 1987 find?	1. Speech repetition 2. Naming 3. Reading and writing Left posterior superior temporal gyrus Posterior superior temporal lesion - Kaetsz 1993 A correlation between severity of comprehension loss and the amount of lesion in Wernickes area but not overall temporal-parietal lesion size
What is conduction aphasia? Who found it? What is intact? What is impaired? What it the main deficit and who found it? What can they repeat well? What do the repeat poorly?	Wernickes 1874 Speech comprehension and production Naming (anomia) Inability to repeat non-meaningful words and word sequences that are heard Goodglass 1993 who also found that the ability to repeat frequently used phrases may be preserved Single meaningful words and short meaningful phrases Non-words and irrelevant word phrases
Who was the famous patient? Who studied them? What was wrong with them? What is believed to cause conduction aphasia?	ORF McCarthy and Warrington 1984 Single non-word repetition was only 39% correct A lesion to arcuate fasciculus, which are the fibre bundles that connect brocas and wernickes areas
Name another patient Who studied them? What did they investigate? What was impaired? What was intact?	JL Beavois et al 1980 What the route between Wernickes and Brocas was for Non-word repetition and learning new words Speech, comprehension and word repetition
Who investigate how patients with conduction aphasia know how to repeat known words? What did he propose? What can this explain?	Geschwind 1965 Through the use of mental representation that a patient hears the word, makes a mental representation, Brocas area accesses the mental image and repeat for every word Why perception of non-words fails to produce an image, you can not mentally represent something that does not exist
Evidence that conduction aphasia is not a disconnection syndrome: What did Schuen et al 1995 find? What did Anderson et al 1999 find?	Some patients with lesions to the arcuate fasiculus do not have conduction aphasia Cortical lesions without subcortical extension may also produce conduction aphasia
Problems understanding anatomy (four problems)	1. Few patients have been studied in detail 2. Lesions are rarely found in identical locations or restricted/discreet regions 3. Immediately after incident symptoms are severe but considerably improvement is seen over time (plasticity, need to study right away, more focused on rehab than experiments, immediate study too traumatic) 4. The production and comprehension of language is dependent on interactions between many regions covering large amounts of cortex/subsocortex
What five things were found to produce increased activation in the left hemisphere and who found this?	1. Listening to words (Lasson et al 1978) 2. Word recognition (Peterson et al 1990) 3. Word association task (Marcus and Bolland 1992) 4. Grammatical processing (Embik et al 2000) 5. Production of spoken/signed language (Halwitz et al 2003)
What did Posner et al 1994 find? What is crossed aphasia? What is crossed aphasia? Who studied this?	That visual and auditory stimuli are processed in different modularity specific areas A type of aphasia that occurs when a person's language centers are not in the expected hemisphere. In most right-handed individuals, language centres are located in the left hemisphere, when someone is left handed 15% of language representation is in the right hemisphere compared to 4% for right handed Aphasia arising from damage to the right hemisphere this has been found to link to handedness (which hand you write with) Rasmussen and Milner 1977
SPLIT BRAIN PATIENTS: Suffers of what often have split-brain surgery? What is cut? What happens? Who studied it?	Epilepsy Corpus Callosum Specialised functions in each hemisphere can no longer pass intercommunications with the other hemisphere Sperry et al 1969
What can happen in some split-brain patients and what does this show? What are some differences between split brain patients?	Some language can emerge from the right hemisphere - The right hemisphere cannot produce speech or understand syntax but can extract basic meaning Some patients will say nothing when items are presented in the left hand, others experience rudimentary description (basic) i.e. Zaidel 1994 found that patients given a ball with comment round
In the majority of people which hemisphere is specialised for phonological and syntactic processing? What did Gardener 1994 find and what research question did this lead to?	Left Patients with right hemisphere damage do not perform as well as controls on many language tasks Is there language in the right hemisphere?
What six things can effect communication when there is damage to the right hemisphere? What does this suggest? Why is there difficulty studying this?	1. Responsiveness (excessive or narrow) 2. Non-literal language 3. Narrative (can't communicate story line) 4. Pragmatic (miss social cues) 5. Prosody (rhythm, tone missing, dull lifeless speech production) 6. Affect and humour There is no obvious of localisation of language processes within the right hemisphere Processing by large networks rather than discreet areas

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