Receptive aphasia
Encyclopedia
Receptive aphasia, also known as Wernicke’s aphasia, fluent aphasia, or sensory aphasia, is a type of aphasia
traditionally associated with neurological damage to Wernicke’s area
in the brain, (Brodmann area 22
, in the posterior part of the superior temporal gyrus
of the dominant hemisphere). However, the key deficits of receptive aphasia do not come from damage to Wernicke's area; instead most of the core difficulties are proposed to come from damage to the medial temporal lobe and underlying white matter. Damage in this area not only destroys local language regions but also cuts off most of the occipital, temporal, and parietal regions from the core language region.
People with receptive aphasia can speak with normal grammar, syntax, rate, intonation and stress, but their language content is incorrect. They may use the wrong words, insert nonexistent words into speech (neologisms), or string normal words together randomly (word salad
). They retain the ability to sing or to recite something memorized. This aphasia was first described by Carl Wernicke and its understanding substantially advanced by Norman Geschwind
.
Receptive aphasia is not to be confused with Wernicke-Korsakoff syndrome
.
Speech is preserved, but language
content is incorrect. Substitutions of one word for another (paraphasia
s, e.g. “telephone” for “television”) are common. Comprehension and repetition are poor.
Patients who recover from Wernicke’s aphasia report that, while aphasic, they found the speech of others to be unintelligible and, despite being cognizant of the fact that they were speaking, they could neither stop themselves nor understand their own words.
The ability to understand and repeat songs is usually unaffected, as these are processed by the opposite hemisphere. Melodic intonation therapy
(MIT) has been pursued for some years with aphasic patients under the belief that it helps stimulate the ability to speak normally. There is some question as to the effectiveness of MIT. But more recent, and more rigorously conducted, research has revealed that MIT can be very effective at recovering language function.
Patients also generally have no trouble purposefully reciting anything they have memorized. The ability to utter profanity is also left unaffected, however the patient typically has no control over it, and may not even understand their own profanity.
Damage to the posterior portion of the left hemisphere’s superior and middle temporal lobe or gyrus and the temporoparietal cortex can produce a lesion to Wernicke’s area and may cause fluent aphasia, or Wernicke’s aphasia. If Wernicke’s area is damaged in the non-dominant hemisphere, the syndrome resulting will be sensory dysprosody
— the inability to perceive the pitch, rhythm, and emotional tone of speech.
Patients who communicated using sign language before the onset of the aphasia experience analogous symptoms.
The symptoms of Wernicke’s Aphasia reveal how important language is because people with the aphasia cannot express their thoughts. Some patients with the disorder do find a way to overcome this road block, and use facial expression and motor gestures to communicate instead.
proposed that this type of aphasia has three characteristics.
Klein, Stephen B., and Thorne. Biological Psychology. New York: Worth, 2007. Print.
Saladin, Kenneth S. Anatomy & Physiology: the Unity of Form and Function. New York: McGraw-Hill Higher Education, 2010. Print.
Aphasia
Aphasia is an impairment of language ability. This class of language disorder ranges from having difficulty remembering words to being completely unable to speak, read, or write....
traditionally associated with neurological damage to Wernicke’s area
Wernicke's area
Wernicke's area is one of the two parts of the cerebral cortex linked since the late nineteenth century to speech . It is involved in the understanding of written and spoken language...
in the brain, (Brodmann area 22
Brodmann area 22
Brodmann area 22 is one of Brodmann's cytologically defined regions of the brain. It is involved in auditory processing.-Human:Brodmann area 22 is a region of the human brain . On the left side of the brain this area helps with generation and understanding of individual words...
, in the posterior part of the superior temporal gyrus
Superior temporal gyrus
The superior temporal gyrus is one of three gyri in the temporal lobe of the human brain, which is located laterally to the head, situated somewhat above the external ear.The superior temporal gyrus is bounded by:* the lateral sulcus above;...
of the dominant hemisphere). However, the key deficits of receptive aphasia do not come from damage to Wernicke's area; instead most of the core difficulties are proposed to come from damage to the medial temporal lobe and underlying white matter. Damage in this area not only destroys local language regions but also cuts off most of the occipital, temporal, and parietal regions from the core language region.
People with receptive aphasia can speak with normal grammar, syntax, rate, intonation and stress, but their language content is incorrect. They may use the wrong words, insert nonexistent words into speech (neologisms), or string normal words together randomly (word salad
Word Salad
Word Salad is a 1979 debut album by Fischer-Z. John Watts and Steve Skolnik formed the band in 1976 whilst at Brunel University. John Watts had been travelling up and down the country playing the club circuit. Fischer-Z was playing a crossover of the New Wave, Punk and Reggae genres...
). They retain the ability to sing or to recite something memorized. This aphasia was first described by Carl Wernicke and its understanding substantially advanced by Norman Geschwind
Norman Geschwind
Norman Geschwind pioneered behavioral neurology in America. He is best known for his exploration of behavioral neurology through disconnection models based on lesion analysis.- Early life :...
.
Receptive aphasia is not to be confused with Wernicke-Korsakoff syndrome
Wernicke-Korsakoff syndrome
Wernicke–Korsakoff syndrome is a manifestation of thiamine deficiency, or beriberi. This is usually secondary to alcohol abuse...
.
Presentation
When we want to speak, we formulate what we are going to say in Wernicke’s area which then transmits our plan of speech to Broca’s area where the plan of speech is carried out. Wernicke’s Area is located posterior to the lateral sulcus, typically in the left hemisphere, between the visual, auditory, and somesthetic areas of the cerebral cortex. A person with this aphasia speaks normally, but uses random or invented words, leaves out key words, substitutes words or verb tenses, pronouns or prepositions, and their sentences don’t make sense. They can also have a tendency to talk excessively. A person with this aphasia cannot understand the spoken words of others or read written words.Speech is preserved, but language
Language
Language may refer either to the specifically human capacity for acquiring and using complex systems of communication, or to a specific instance of such a system of complex communication...
content is incorrect. Substitutions of one word for another (paraphasia
Paraphasia
Paraphasia is a feature of aphasia in which one loses the ability of speaking correctly, substitutes one word for another, and changes words and sentences in an inappropriate way. It often develops after a stroke or brain injury. The patient's speech is fluent but is error-prone, e.g...
s, e.g. “telephone” for “television”) are common. Comprehension and repetition are poor.
Patients who recover from Wernicke’s aphasia report that, while aphasic, they found the speech of others to be unintelligible and, despite being cognizant of the fact that they were speaking, they could neither stop themselves nor understand their own words.
The ability to understand and repeat songs is usually unaffected, as these are processed by the opposite hemisphere. Melodic intonation therapy
Melodic intonation therapy
Melodic Intonation Therapy is a therapeutic process used by music therapists and speech pathologists to help patients with communication disorders caused by brain damage...
(MIT) has been pursued for some years with aphasic patients under the belief that it helps stimulate the ability to speak normally. There is some question as to the effectiveness of MIT. But more recent, and more rigorously conducted, research has revealed that MIT can be very effective at recovering language function.
Patients also generally have no trouble purposefully reciting anything they have memorized. The ability to utter profanity is also left unaffected, however the patient typically has no control over it, and may not even understand their own profanity.
Damage to the posterior portion of the left hemisphere’s superior and middle temporal lobe or gyrus and the temporoparietal cortex can produce a lesion to Wernicke’s area and may cause fluent aphasia, or Wernicke’s aphasia. If Wernicke’s area is damaged in the non-dominant hemisphere, the syndrome resulting will be sensory dysprosody
Prosody (linguistics)
In linguistics, prosody is the rhythm, stress, and intonation of speech. Prosody may reflect various features of the speaker or the utterance: the emotional state of the speaker; the form of the utterance ; the presence of irony or sarcasm; emphasis, contrast, and focus; or other elements of...
— the inability to perceive the pitch, rhythm, and emotional tone of speech.
Patients who communicated using sign language before the onset of the aphasia experience analogous symptoms.
The symptoms of Wernicke’s Aphasia reveal how important language is because people with the aphasia cannot express their thoughts. Some patients with the disorder do find a way to overcome this road block, and use facial expression and motor gestures to communicate instead.
Luria's theory on Wernicke's aphasia
LuriaAlexander Luria
Alexander Romanovich Luria was a famous Soviet neuropsychologist and developmental psychologist. He was one of the founders of neuropsychology and the jointly led the Vygotsky Circle.- Biography :...
proposed that this type of aphasia has three characteristics.
- 1) A deficit in the categorization of sounds. In order to hear and understand what is said, one must be able to recognize the different sounds of spoken language. For example, hearing the difference between bad and bed is easy for native English speakers. The Dutch language however, makes a much greater difference in pronunciation between these vowels, and therefore the Dutch have difficulties hearing the difference between them in English pronunciation. This problem is exactly what patients with Wernicke’s aphasia have in their own language: they can't isolate significant sound characteristics and classify them into known meaningful systems.
- 2) A defect in speech. A patient with Wernicke's aphasia can and may speak a great deal, but he or she confuses sound characteristics, producing “word saladWord SaladWord Salad is a 1979 debut album by Fischer-Z. John Watts and Steve Skolnik formed the band in 1976 whilst at Brunel University. John Watts had been travelling up and down the country playing the club circuit. Fischer-Z was playing a crossover of the New Wave, Punk and Reggae genres...
” in extreme cases: intelligible words that appear to be strung together randomly.
- 3) An impairment in writing. A person who cannot discern sounds cannot be expected to write.
Receptive aphasia in popular culture
- “Failure to Communicate,” an episode of Fox’s medical television series House, M. D.House (TV series)House is an American television medical drama that debuted on the Fox network on November 16, 2004. The show's central character is Dr. Gregory House , an unconventional and misanthropic medical genius who heads a team of diagnosticians at the fictional Princeton-Plainsboro Teaching Hospital in...
, featured a patient experiencing both receptive aphasia and agraphia. (The episode first aired on January 10, 2006.) - In “BabelBabel (DS9 episode)"Babel" is the 5th episode of the science fiction television series Star Trek: Deep Space Nine.-Overview:A mysterious virus plagues the station that disrupts people's mind connection between the mundane things which are seen and their mental comprehension...
,” an episode of Star Trek: Deep Space NineStar Trek: Deep Space NineStar Trek: Deep Space Nine is a science fiction television series set in the Star Trek universe...
, a virus causes this type of aphasia. - In an episode of Boston LegalBoston LegalBoston Legal is an American legal dramedy created by David E. Kelley, which was produced in association with 20th Century Fox Television for the ABC...
, Alan Shore is diagnosed with word saladWord SaladWord Salad is a 1979 debut album by Fischer-Z. John Watts and Steve Skolnik formed the band in 1976 whilst at Brunel University. John Watts had been travelling up and down the country playing the club circuit. Fischer-Z was playing a crossover of the New Wave, Punk and Reggae genres...
which arises during periods of anxiety. Shore struggles with word salad for the rest of the show. - The character of Samuel T. Anders suffers from a form of word saladWord SaladWord Salad is a 1979 debut album by Fischer-Z. John Watts and Steve Skolnik formed the band in 1976 whilst at Brunel University. John Watts had been travelling up and down the country playing the club circuit. Fischer-Z was playing a crossover of the New Wave, Punk and Reggae genres...
in Season 4 of Battlestar GalacticaBattlestar GalacticaBattlestar Galactica is an American science fiction franchise created by Glen A. Larson. The franchise began with the Battlestar Galactica TV series in 1978, and was followed by a brief sequel TV series in 1980, a line of book adaptations, original novels, comic books, a board game, and video games...
after being hit in the head with a bullet during the mutiny aboard Galactica. - In the television series The Twilight ZoneThe Twilight ZoneThe Twilight Zone is an American television anthology series created by Rod Serling. Each episode is a mixture of self-contained drama, psychological thriller, fantasy, science fiction, suspense, or horror, often concluding with a macabre or unexpected twist...
, the episode "Wordplay" shows the point of view of a man gradually developing a form of receptive aphasia.
See also
- Expressive aphasiaExpressive aphasiaExpressive aphasia , also known as Broca's aphasia in clinical neuropsychology and agrammatic aphasia in cognitive neuropsychology, is caused by damage to or developmental issues in anterior regions of the brain, including the left posterior inferior frontal gyrus known as Broca's area...
: also known as Broca’s aphasia - Schizophasia
- Conduction aphasiaConduction aphasiaConduction aphasia, also called associative aphasia, is a relatively rare form of aphasia. An acquired language disorder, it is characterized by intact auditory comprehension, fluent speech production, but poor speech repetition. Patients will display frequent errors during spontaneous speech,...
- LogorrhoeaLogorrhoeaLogorrhoea or logorrhea may refer to:*Logorrhoea, a synonym of verbosity*Logorrhea , a communication disorder resulting in incoherent talkativeness...
- AphasiaAphasiaAphasia is an impairment of language ability. This class of language disorder ranges from having difficulty remembering words to being completely unable to speak, read, or write....
- Agraphia
- ParagrammatismParagrammatismParagrammatism is the inability to form grammatically correct sentences. It is characteristic of fluent aphasia, most commonly Wernicke's aphasia.Paragrammatism is sometimes called "extended paraphasia," although it is different from paraphasia...
External links
- Aphasia Center of California in Oakland, CA, U.S.
Klein, Stephen B., and Thorne. Biological Psychology. New York: Worth, 2007. Print.
Saladin, Kenneth S. Anatomy & Physiology: the Unity of Form and Function. New York: McGraw-Hill Higher Education, 2010. Print.