Intro to Aphasia study notes20240916lc.pdf

Introduction to Aphasia study notes

1. A,
LB
C .
Self study notes on Aphasia

on Chapter 18
Clinical Neuropsychology - a pocket handbook for assessment
by Parsons and Hammeke

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2. Aphasia
language processing disrupted due to functional impairment in certain parts of the brain

Aphasia = Language Impairment = Impairment in Language Understanding or

OR = Expression disorder or
OR = Language comprehension disorder + Expression disorder (both)

Vs Language disorders ~ associated with an impairment in the ability to understand,
formulate, and produce oral, written, and physical/symbolic expressions

No single behavioral manifestation

Injuries severity varies depending on brain injury location and extent

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3. Differential Diagnosis |

Disorder of Language

Vs. Disorder of Speech Vs. Dysarthria

Vs. Mutism Vs. Aphonia
Vs.
Aphemia

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4. Differential Diagnosis II

Vs Schizophrenia’s Disorganized speech

Speech disorders in people with schizophrenia are mostly thought
content disorders or executive dysfunction in controlling language
linguistics and speech operations, rather than language disorders.

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5. Etiology |

Note its onset and course of development (acute or slow) >

Left-handers after right brai Aphasia is mostly related

damage: aphasia less severe to lesion in left brain

vs right-handers after left .

brain damage Over 95% normal right-
handers and 60%-70%

Aphasia following damage to left-handers have their

right brain is relatively more left brain as the language

rare (but can be found in dominant brain

right-handers, in which case
is crossed aphasia)

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6. Etiology Il

ewe Stroke Epilepsy
OX - Most common EN Transient aphasia may occur
- Acute or sudden ( in dominant hemisphere
+ Usually relate to cerebral during/ after seizure or TIA
vascular incident
Tumor Usually

Traumatic brain Injury Neurodegeneration related to
subacute or

# Infection Slow oñesl
Inflammation Aphasia

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7. Neuropsychological assessment

Comprehen
sion&

comprehens
ion

1 E)
BSpontaneoug Repetition
speech iti
; E A 4 Writing 6
\ Rn e Re — à Aphasia
laming assessment,
battery

8. Spontaneous speech

Fluency

Word Retrieval

Word Selection

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9. Types of Aphasia

Broca’s aphasia

Wernicke’s aphasia

Global aphasia

Anomic aphasia

Transcortical sensory aphasia

Transcortical motor aphasia

Conduction aphasia

Isolation aphasia

Sub-Cortical Aphasia
Gersmann syndrome

Alexia without Agraphia

Primary Progressive Aphasia (PPA) — 3 subtypes:
* logopenic variant PPA (IvPPA),
* nonfluent agrammatic PPA (nfaPPA), and
* semantic variant PPA (svPPA),

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10. Different Types of Aphasia - Symptoms severity

Syndrome __ Fluency
Broca’s Nonfluent G Poor Rare-literal

Transcortical Nonfluent Good Good Poor Rare
Motor

Global Nonfluent Poor Poor Poor Freq.-mixed
Isolation Nonfluent Poor Good Poor Freq.-mixed

Vernicke's Fluent Poor Poor Poor Freq.-mixed

Transcortical Fluent Poor Good Poor Freg—mixed
Sensory

Conduction Fluent Good Poor Poor Literal

Anomic Fluent Good Good Poor Rare

Source: Table 18-2 p.426
Parsons, M. W., Hammeke, T. A., & Snyder, P. J. (Eds.). (2014). Clinical
neuropsychology: A pocket handbook for assessment(3rd ed.). American

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11. Rehabilitation for Aphasia

Degree of rehab depends on the pathophysiological mechanisms and
processes underlying aphasia, aphasia characteristics and, and the extent of
the underlying brain damage.

e Very rapid (within minutes) recovery ~ when aphasia cause is transient &
reversible (e.g. aphasia under complex partial seizures or hemi-sedation
used in the Wada test).

e Rehab taking a few months to a year ~ usually an incomplete rehab, when
the cause of aphasia is acute, and involves devastating brain injury (e.g.,
ischemic or hemorrhagic stroke)

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12. Rehabilitation for Aphasia

e Some spontaneous recovery ~ Aphasia due to certain destructive brain
lesions may improve within 3 months after onset. Initial fluent aphasics
may eventually become anomic-like aphasia (word-finding and naming
difficulties remain, but speech fluency and language comprehension
recover relatively well)

e Poor Rehab ~ Global aphasia associated with brain injury, incl aphasia
involving subcortical tissue, often has persistent disabling symptoms

e Rehab unlikely / expect progressive deterioration in language ability ~
when cause of aphasia is persistent and progressive (e.g., brain tumors,
PPA-related neurodegenerative diseases)

e Persistent aphasia - disfluent at onset, usually also accompanied by
cerebral hemiplegia

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13. Rehabilitation for Aphasia

1. Speech & language therapy

2. Brain plasticity

3. Patience

14. Reference

Parsons, M. W., Hammeke, T. A., 8 Snyder, P. J. (Eds.). (2014). Clinical
neuropsychology: A pocket handbook for assessment (3rd ed.).
American Psychological Association. https://doi.org/10.1037/14339-000

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