Language Disorder

continued

Introduction to Neuropsychology
29.06.2016

What is aphasia?
From the ancient Greek aphatos, meaning without speech;
speechless
Aphasia can destroy, or impoverish to a greater or lesser ex
tent, any or all or some components of verbal language;
Speech
Writing
Auditory comprehension
Reading
(Hale, 2007)

Silent in sadness
Egypt 2800 BC

(Hale, 2007)

Brocas Area

Where is Brocas area locate

d?

In the frontal part of the left he

misphere of the brain
Designated Area 44 in Brodma
n's classification
Area 44 can be distinguished fr
om surrounding cortex and rep
resents an intermediate degree
of differentiation between pre
motor cortex and primary moto
r cortex.
(Reinvang, 1985)

(Grodzinsky, Y., & Amunts, K., 2006)

Brocas Area

Where is Brocas area locate

d?

In the frontal part of the left he

misphere of the brain
Designated Area 44 in Brodma
n's classification
Area 44 can be distinguished fr
om surrounding cortex and rep
resents an intermediate degree
of differentiation between pre
motor cortex and primary moto
r cortex.
(Reinvang, 1985)

(Grodzinsky, Y., & Amunts, K., 2006)

Brocas Area
What is it responsible for?

Wernicke (1874) believed that

Brocas area receives sensory in
puts from the musculature.
It has the function of storing m
emory (images) of performed
movements.
These images can be aroused vi
a association fibers from other
cortical areas, thus giving rise t
o speech.

(Reinvang, 1985)

(Grodzinsky, Y., & Amunts, K., 2006)

Brocas Aphasia
The oldest and perhaps best-studied form of aphasia, also
known as:

anterior aphasia
nonfluent aphasia
expressive aphasia
agrammatic aphasia
motor aphasia (Sarno, 1998)

First described by Paul Broca in the 19th century after perfor

ming an autopsy on a patient who for several years before
his death could speak only a single word, "tan."
(Gazzaniga, M., Ivry, R., & Mangun, G., 2014)

Brocas Aphasia
Speech

nonfluent speech made up of poorly

articulated short phrases produced with
hesitations and effort, particularly in
initiation

Comprehens good, but not completely normal

ion
Repetition

Ability to repeat and name is impaired,

but often better than the ability to
produce words in spontaneous speech

Reading

relatively good

Writing

always impaired

(Reinvang, 1985)

Brocas Aphasia
The melodic contour is flat.
The general appearance of speech is telegraphic, due to bo
th the selective deletion of many functor words and disturb
ances of canonical word order.
Patients are often depressed and may respond to testing fa
ilures with "catastrophic" reactions, like sudden weeping a
nd refusal to proceed with the examination.
(Sarno, 1998)

Broca's aphasics are aware of their errors and have a low t

olerance for frustration.
(David C. Race & Argye E. Hillis, 2015)

Agrammatism
Brocas aphasics can also have comprehension deficits relat
ed to..
syntax.
Often only the most basic and overlearned grammatical for
ms are produced and comprehended, a deficit known as a
grammatic aphasia.
"The boy kicked the girl" vs. "The boy was kicked by the
girl.

Whats really happening?

Brocas Aphasia and Motor Impairment

Production of a spoken word requir

es motor planning and execution of
the muscles used for speech.
Impairment in motor planning and
programming of speech articulation
is most closely associated with the i
nferior frontal gyrus, portions of the
insular gyrus, the supplementary co
(Grodzinsky, Y., & Amunts, K., 2006
rtex, and the premotor cortex.
Damage to these regions is associated with deficits in speech praxis, or
orchestration of motor plans of the lips, tongue, jaw, palate, vocal fold
s, and muscles of respiration to articulate speech.
(David C. Race & Argye E. Hillis, 2015)

Brocas Aphasia and Motor Impairment

Broca's aphasia is often asso
ciated with damage that ext
ends out of the posterior inf
erior frontal cortex into surro
unding cortex.
As primary motor cortex lies
next to Broca's area, patients
often have a muscle weakne
ss or paralysis.
This typically affects the right
side of the body.
(David Groome et al., 2014)

Correspondence between Broca's area and Broca's aphasia

There is not necessarily a correspondence between Broca's area and
Broca's aphasia.
However, to have a full clinical profile of Broca's aphasia, more exte
nsive damage is required.
Mohr et al. (1978) looked at twenty lesions at autopsy and related t
he clinical speech problems that the people suffered in life to their
acquired brain damage.
He found that a lesion to Broca's area itself caused transient speech
mutism.
This may well have been transient, because of plasticity in the brain,
or because the right hemisphere regions start to be recruited.
(David Groome et al., 2014)

Aphasia Causes
90% of aphasias are caused by strok
e.
Other causes include:
o cysts, infections, inflammations, car
accidents, gunshot wounds, or taki
ng ecstasy.
Although the majority of aphasics are
elderly, the incidence of young aphasi
a is rising due to improved survival rat
es after road accidents and drug abus
e.

The preserved brain of Leborgne (Broca

s patient Tan), which is maintained in
a Paris museum.
(Gazzaniga, M., Ivry, R., & Mangun, G., 201
4)

How Aphasia develops?

Initially, all cases are mute and unable to write legi
bly with either hand.
All patients emerged from mutism into stereotype
utterances, which soon became agrammatic laconi
c efforts at spontaneous speech.

(Grodzinsky, Y., & Amunts, K., 2006)

Thank You

References
David C. Race & Argye E. Hillis. (2015). The Neural Mechanisms Underlying Naming. In
A. Hillis, The Handbook of Adult Language Disorders (pp. 151-160). New York: Ps
ychology Press.
David Groome et al. (2014). An Introduction to Cognitive Psychology: Processes and Disor
ders-. London & New York: Psychology Press.
Gazzaniga, M., Ivry, R., & Mangun, G. (2014). Cognitive Neuroscience: The Biology of th
e Mind. USA: W. W. Norton & Company.
Grodzinsky, Y., & Amunts, K. (2006). Broca's Region . New York: Oxford University Pres
s.
Hale, S. (2007). The Man Who Lost His Language: A Case of Aphasia. London & Philadel
phia: Jessica Kingsley Pub.
Reinvang, I. (1985). Aphasia and Brain Organization . New York: Plenum Press.
Sarno, M. T. (1998). Acquired Aphasia. New York: Academic Press.