Mind map

BRODMANN'S AREA Types of

Farah Aldridge English

Map content

·
- Aphasia typically occurs suddenly after a stroke or a head injury. But it can also come on gradually from a slow-growing brain tumor or a disease that causes progressive, permanent damage (degenerative). Where and how bad the brain damage is and what caused it determine the degree of disability. (Aphasia, 2018)
- The main treatment for aphasia is speech and language therapy. The person with aphasia relearns and practices language skills and learns to use other ways to communicate. (Aphasia, 2018)
- FLUENT APHASIA
  - Lesions are typically posterior to the fissure of Rolando.
  - People with this form of aphasia may speak easily and fluently in long, complex sentences that don't make sense or include unrecognizable, incorrect or unnecessary words.  They usually don't understand spoken language well and often don't realize that others can't understand them. Also known as Wernicke aphasia, this type of aphasia is the result of damage to the language network in the middle left side of the brain. (Aphasia, 2018)
  - GENERAL CHARACTERISTICS: preserved phoneme selection, sequencing & syntax are preserved, word-finding problems affecting mainly nouns & picturable action words, poor comprehension, difficulty with word- finding, errors of word & sound substitution (Jones, 2019)
  - ANOMIC APHASIA
    - SITE OF LESION
      - -Left temporal pole, although specific locations can vary -Often in the temporoparietal area and the angular gyrus may be affected (Chapey, 2014; Jones, 2019)
    - - (PsychDB, 2019)
    - SYMTPOMS CHARATERISTICS
      - Anomic aphasia is one of the milder forms of aphasia. The term is applied to persons who are left with a persistent inability to supply the words for the very things they want to talk about, particularly the significant nouns and verbs.  (Aphasia, n.d.)
      - Their speech is fluent and grammatically correct but it is full of vague words (such as ‘thing’) and circumlocutions (attempts to describe the word they are trying to find). The feeling is often that of having the word on the tip of one’s tongue, which results in their speech having lots of expressions of frustration.  (Aphasia, n.d.)
      - People with anomic aphasia understand speech well and they can repeat words and sentences.  In most cases they can read adequately. Difficulty finding words is as evident in writing as it is in speech. (Aphasia, n.d.)
      - SIMPLE LIST
        -Impaired naming and word-finding  -Use of elaborate circumlocutions -Grammar is unaffected -Paraphasias are rare -Repetition is good -Intact auditory comprehension (Jones, 2019)
  - WERNIKE'S APHASIA
    - impaired language comprehension in listening and reading (Aphasia/Invisible, 2019)
    - - (Crampton, 2019)
    - SITE OF LESION
      - -left temporal lobe often including Wernicke’s area -posterior region of the left superior temporal gyrus (Chapey, 2014; Jones 2019)
    - SYMPTOMS CHARACTERISTICS
      - -In this form of aphasia the ability to grasp the meaning of spoken words and sentences is impaired, while the ease of producing connected speech is not very affected. Therefore Wernicke’s aphasia is also referred to as ‘fluent aphasia’ or ‘receptive aphasia’. -Reading and writing are often severely impaired. As in other forms of aphasia, individuals can have completely preserved intellectual and cognitive capabilities unrelated to speech and language.  (Aphasia, n.d.)
      - -In this form of aphasia the ability to grasp the meaning of spoken words and sentences is impaired, while the ease of producing connected speech is not very affected. Therefore Wernicke’s aphasia is also referred to as ‘fluent aphasia’ or ‘receptive aphasia’. -Reading and writing are often severely impaired. As in other forms of aphasia, individuals can have completely preserved intellectual and cognitive capabilities unrelated to speech and language.  (Aphasia, n.d.)
      - -Persons with Wernicke’s aphasia can produce many words and they often speak using grammatically correct sentences with normal rate and prosody.  -However, often what they say doesn’t make a lot of sense or they pepper their sentences with non-existent or irrelevant words. They may fail to realize that they are using the wrong words or using a non-existent word and often they are not fully aware that what they say doesn’t make sense.(Aphasia, n.d.)
      - -Patients with this type of aphasia usually have profound language comprehension deficits, even for single words or simple sentences. This is because in Wernicke’s aphasia individuals have damage in brain areas that are important for processing the meaning of words and spoken language.  -Such damage includes left posterior temporal regions of the brain, which are part of what is knows as Wernicke’s area, hence the name of the aphasia. (Aphasia, n.d.)
      - SIMPLE LIST
        -Comprehension severely impaired -Speech is fluent, semantically inappropriate, and paraphasic -Comprehension and expression tend to be equally impaired -Articulation is normal -Paragrammatical errors -Dissociation between sound and sight of words and their meanings -Speech is emptyRepetition is poor (Jones, 2019)
        -Confrontation naming is impaired -Reading and writing may be impaired if angular gyrus is compromised -Written content output is similar to speech output  -Rapid speech -Anosognosia (Jones, 2019)
  - TRANSCORTICAL SENSORY APHASIA
    - SITE OF LESION
      - -Involvement of the angular gyrus and the posterior sector of the middle temporal gyrus -In Broca's area, Wernike's area and the arcuate fasciculus left intact but cut off from the rest of the brain (Chapey, 2014; Jones, 2019)
    - SYMPTOMS CHARACTERISTICS
      - Similar to Wernicke's aphasia, with the exception of a strong ability to repeat words and phrases. The patient may repeat questions rather than answer them (also known as “echolalia”). (PsychDB, 2019)
      - A distinct entity that features fluent output that is often contaminated by considerable paraphasia, including both neologistic and semantic substitutions. Comprehension of spoken language is severely disturbed. In striking contrast, repetition is intact.  (Swanberg, 2007)
      - The patient is often echolalic, repeating most of the examiner's utterances with apparent unawareness of what is said. Naming is disturbed. Reading out loud may be preserved but is usually contaminated with paraphasic errors. Reading comprehension is defective. Writing is also abnormal. (Swanberg, 2007)
      - Sensory abnormalities usually of the cortical type are found as well as a visual field defect. Occasionally, patients with transcortical sensory aphasia have a normal neurological examination and are misdiagnosed as schizophrenic. (Swanberg, 2007)
      - SIMPLE LIST
        -Preserved repetition -Impaired comprehension -No propositional speech -Impaired reading-Impaired writing---Tends to "echo" communication partners (Jones, 2019)
    - - (PsychDB, 2019)
  - CONDUCTION APHASIA
    - SITE OF LESION
      - -Supramarginal gyrus in the left hemisphere -Damage to the arcuate fasciculus -Possibly in the left perisylvian area (Chapey, 2014; Jones, 2019)
    - SYMPTOMS CHARACTERISTICS
      - Conduction Aphasia is a fluent aphasia with a significant impairment with repetition. The patient can express themselves reasonably well, with some word-finding issues, and comprehension can be good.  (PsychDB, 2019)
      - However, the patient will show significant difficulty repeating phrases, particularly as they increase in length and complexity. They may stumble over words they are attempting to pronounce. (PsychDB, 2019)
      - SIMPLE LIST
        -Fluent spontaneous speech -Frequent literal paraphasias -Good auditory comprehension -Good reading comprehension -Poor repetition -Fluent speech is restricted to brief runs -Good articulation -Normal intonation -Difficulty sequencing phonemes (Jones, 2019)
    - - (PsychDB, 2019)
- NON-FLUENT APHASIA
  - Lesions are typically anterior to the fissure of Rolando. 
  - Damage to the language network near the left frontal area of the brain usually results in Broca aphasia, which is also called non-fluent aphasia.  People with this disorder struggle to get words out, speak in very short sentences and omit words. A person might say "Want food" or "Walk park today."  A listener can usually understand the meaning. (Aphasia, 2018)
  - People with Broca aphasia may understand what other people say better than they can speak. They're often aware of their difficulty communicating and may get frustrated.  People with Broca aphasia may also have right-sided paralysis or weakness. (Aphasia, 2018)
  - GENERAL CHARACTERISTICS: telegraphic speech, short sentence length, limited to nouns & verbs, speech is labored & slow, melodic contour if flat, articulatory agility is impaired, simplification of constant clusters, literal paraphasias, repetition is impaired, word finding is impaired (Jones, 2019)
  - TRANSCORTICAL MOTOR APHASIA
    - SITE OF LESION
      - not always predictable, but often times they are more anterior than those found in Broca’s aphasia (Chapey, 2014)
      - -Typically smaller than those that cause Broca's Apahsia -Communication between Broca's and pre-motor area is cut off -Links between Broca's and basal ganglia and/or thalamus may also be cut off -Communication between Broca's and limbic system can be affected (Jones, 2019)
    - SYMPTOMS CHARACTERISTICS
      - Similar to Broca's aphasia, but repetition skills are intact. The deficit is usually due to a small subcortical lesion superior to Broca's area, or the anterior superior frontal lobe in the perisylvian area of the left hemisphere. The patient may have difficulty spontaneously answering a question but can repeat long utterances without difficulty. (PsychDB, 2019)
      - SIMPLE LIST
        -Repetition intact with grammar and articulation normal -Articulation is fair to good -Little to no paraphasias -Confrontation naming is preserved -Auditory comprehension is fair to excellent (Jones, 2019)
    - - (PsychDB, 2019)
  - BROCA'S APHASIA
    - difficulty with speaking and language (Aphasia/Invisible, 2019)
    - SITE OF LESION
      - posterior inferior frontal gyru in the left hemisphere (Chapey, 2014)
      - -Broadmann's area 44 and 45 -Makes up the lower part of the pre-motor cortex -Some cases, it extends down into the white mater and posteriorly to the inferior part of the motor strip (Jones, 2019)
    - - (Smith, 2018)
    - SYMPTOMS CHARACTERISTICS
      - expressive language impairment mostly affects speaking and writing – the two ways we produce, or express, language (What is Broca's, 2017)
      - Comprehension of language remains relatively intact in Broca’s aphasia, while repetition of words and sentences is usually poor.  People with Broca’s aphasia are often very aware of their difficulties, and that can lead to high levels of frustration and sometimes depression. (What is Broca's, 2017)
      - Speech is effortful and sounds rather stilted, with most utterances limited to 4 words or less.  A person with Broca’s aphasia relies mostly on important key words (nouns and verbs) to communicate their message.  Function words, such as prepositions and articles, are often omitted. This pattern of using only content words creates what’s known as telegraphic speech – recalling a time when people paid for each word when sending a telegram. (What is Broca's, 2017)
      - SIMPLE LIST
        Telegraphic Speech Impaired Syntax & MorphologyShort Sentence LengthLabored & Slow SpeechImpaired RepetitionFlat Melodic ContourImpaired Word-FindingImpaired Naming(Jones, 2019)
        Mildly Or Not Impaired Auditory Comprehension Hemiplegia/HemiparesisLow Frustration ToleranceTypically Better Recovery Of Language FunctionIn Broca's As Compared To Other Aphasias(Jones, 2019)
- OTHER APHASIA'S
  - Not considered fluent or non-fluent (Jones, 2019)
  - SUBCORTICAL APHASIA
    - SITE OF LESION
      - subcortical regions such as the thalamus, internal capsule, and the basal ganglia (Subcortical Aphasia, n.d.).               Subcortical Aphasia. (n.d.).     
    - SYMPTOMS CHARACTERISTICS
      - The symptoms can mirror those arising from cortical lesions, and subcortical damage can also co-occur with cortical lesions.  (Subcortical Aphasia, n.d.)
      - Aphasic symptoms can arise from diaschisis (remote effects), such as subcortical inputs to the frontal lobe being altered, or may directly stem from damage to subcortical areas that support language processing. (Subcortical Aphasia, n.d.)
    - - (Jackson, 2015)
  - MIXED NON-FLUENT APHASIA
    - Isolation Aphasia
    - SITE OF LESION
      - Result of damage that isolates the language areas (Broca’s, Wernicke’s, and the arcuate fasciculus) from other brain regions. Broca’s, Wernicke’s, and the arcuate fasiculus are left intact; however, they are isolated from other brain regions. (Brookshire, 2007)
      - Lesions are typically smaller than those that cause Broca's Aphasia. Communication between Broca's and pre-motor area is cut off. Links between Broca's and basal ganglia and/or thalamus may be cut off. Communication between Broca's and limbic system may also be affected. (Jones, 2019)
    - - (PsychDB, 2019)
    - SYMPTOMS CHARACTERISTICS
      - Mixed non-fluent aphasia applies to persons who have sparse and effortful speech, resembling severe Broca’s aphasia.  However, unlike individuals with Broca’s aphasia, mixed non-fluent aphasia patients remain limited in their comprehension of speech, similar to people with Wernicke’s aphasia. Individuals with mixed non-fluent aphasia do not read or write beyond an elementary level. (Aphasia, n.d.)
      - Severe speaking and comprehension impairment, but with preserved repetition. People who suffer mixed transcortical aphasia struggle greatly to produce propositional language or to understand what is being said to them, yet they can repeat long, complex utterances or finish a song once they hear the first part.  (Mixed transcortical aphasia, 2019)   
      - Persons with mixed transcortical aphasia are often nonfluent, and in most cases do not speak unless they are spoken to, do not comprehend spoken language, cannot name objects, and cannot read or write. However, they often have the ability to repeat what is said to them. In fact, persons with mixed transcortical aphasia often repeat in a parrot-like fashion.  (Mixed transcortical aphasia, 2019)   
      - Some patients with this disorder can experience many different types neurological symptoms including, bilateral paralysis, lack of voluntary speech, and difficulty with producing spontaneous speech. (Mixed transcortical aphasia, 2019)
      - SIMPLE LIST
        Repetition intact with normal grammar and articulation Articulation is fair to good Little to no paraphasias Confrontation naming is preserved Auditory comprehension is fair to excellent (Jones, 2019)
  - GLOBAL APHASIA
    - Global aphasia results from extensive damage to the brain's language networks. People with global aphasia have severe disabilities with expression and comprehension. (Aphasia, 2018)
    - SITE OF LESION
      - frontal, parietal and temporal regions of the left hemisphere (Chapey, 2014)
    - SYMPTOMS CHRACTERISTICS
      - -Severe language difficulties with impairments to both receptive (taking information in) and expressive (getting information out) communication skills.  -These difficulties span all aspects of language – reading, writing, speaking, and understanding spoken word – making functional communication very challenging indeed. (Global Aphasia, 2017)
    - - (PsychDB, 2019)
- SIGNS AND SYMPTOMS
  - Aphasia usually occurs after a hemorrhage in the left hemisphere, because in 90% of mankind this is where the language area is situated. Strokes that damage the frontal and parietal lobes in the right hemisphere of the brain can cause a person to have difficulty expressing and processing language. (Aphasia/Invisible, 2019)
  - TALKING
    - -Can't think of the words you want to say -Say the wrong word -Say something related (fish/chicken) -Say a word that does not make much sense (radio/ball) -Switch sounds in words (wish dasher/dishwasher) -Use made-up words -Hard time saying sentences (single words may be easier) -Put made-up words and real words together into nonsense sentences  (Aphasia, n.d.)
  - READING & WRITING
    - -Reading forms, books, and computer screens -Spelling and putting words together to write sentences -Using numbers or doing math (tell time, count money, or add and subtract) (Aphasia, n.d.)
  - UNDERSTANDING
    - -Not understand what others say (more when they speak fast)  -Have more trouble with longer sentences -Hard to understand what others say when it is noisy or in a group setting  -Have trouble understanding jokes (Aphasia, n.d.)
- (Min, 2019)
FOR INFORMATION ON APHASIA VS DYSPHASIA
- http://aphasiahope.wpengine.com/aphasia-article/?link_id=2564 (Bell Marra Health, 2017)
VIDEO RESOURCES
- - (Green, 2015)
- - (Fridriksson 2012)
·
- (Aphasia, What We Need To Know, 2017)