Language and the Brain (Aphasia lecture)

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Language and the Brain (Aphasia lecture)
2013-12-14 10:44:07
Aphasia Neuro SLP
Brief description of language functions in the brain
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  1. Organization of Language in Adults
    What is the function of:
    Broca's area, 44, & 45?
    The motor strip?
    Arcuate Fasciculus?
    Wernicke's area?
    Angular Gyrus?
    Supramarginal Gyrus?
    • Planning and organizing speech; phonological processing and language production; semantic processing
    • Activation of muscles for articulation
    • Connects Wernicke's/Broca's and is important in the expression of concepts (transmission of info)
    • Language comprehension; subareas involved with responding to spoken words/sounds; words spoken by someone else, and producing speech; important in the storage/retrieval of auditory phonological images of words and their meaning.
    • Reading, writing, semantic processing, important in phonological decoding of orthographic info
    • writing and phonological/articulatory word processing
  2. Characteristics of Aphasia Syndromes
    Describe the (1) Verbal output (2) Repetition (3) Comprehension (4) Naming for
    Transcortical Motor
    Transcortical Sensory
    • 1. Nonfluent, impaired, normal, marginally impaired
    • 2. fluent, impaired, impaired, impaired 
    • 3. fluent, impaired, normal, impaired (paraphasic) 
    • 4. nonfluent, normal, normal, impaired
    • 5. fluent, normal, impaired, impaired
    • 6. Fluent, normal, normal, impaired 
    • 7. nonfluent, impaired, impaired, impaired
    • 8. variable, normal, variable, variable
  3. Broca's Aphasia 
    Other Names:
    Areas damaged: 
    • Expressive or non-fluent aphasia
    • telegraphic or agrammatical speech, they use content words and not functor words, they can understand syntactically simple sentences, but not complex. 
    • 44, 45, white matter, basal ganglia (Premotor area, parts of frontal lobe) usually concomitant with hemiplegia or hemiparesis of the right side
    • Impairment in comprehension may be in memory/parahippocampus. STM allows us to recall syntactical elements in sentences
  4. Wernicke's Aphasia
    Other names:
    Characteristics (impaired/normal): 
    May also have:
    • Receptive or fluent aphasia
    • Impaired: comprehension, empty speech, paraphasias, neologisms, repetition, unaware. Normal: fluent and grammatical speech, prosody, melody, intonation, rate 
    • Impaired
    • Right Visual Neglect
  5. Conduction Aphasia
    • Impaired repetition, fluent, paraphasias, good comprehension (reading/spoken), impaired naming, writing is poor has paraphasias
    • Broca's and Wernicke's intact, arcuate fasciculus damage, damage to supra marginal gyrus (writing)
  6. Transcortical Aphasias
    Ability to ______ remains intact
    often occur with lesions to the _______ areas, not in the ________ area 
    • repeat spoken sentences
    • watershed
    • perisylvian 
    • Nonfluent, difficulty initiating and organizing responses, comprehension intact, writing sometimes damaged 
    • lesion disconnects broca's from supplementary motor cortex 
    • fluent aphasia, difficulty comprehending, reading, and writing
    • lesion disconnects wernicke's and posterior language areas
  7. Other Aphasias
    • Anomic:
    • Impaired word finding, naming, circumlocutions, writing/reading intact 
    • damage to temporal parietal area 
    • Global:
    • All aspects of language are severely impaired, 3rd most common
    • Wernicke's and Broca's involvement 
    • Subcortical:
    • Variable language difficulties, if the damage is in the anterior BG then speech is nonfluent with arctic impairments (motor) if the damage is in the thalamus then symptoms can be similar to transcortical sensory or Wernicke's (sensation)
  8. Reading and Writing Disorders
    Define Alexia with Agraphia:
    Where is the damage?
    Define Alexia without Agraphia:
    Where is the damage?
    • Cannot read, write or spell
    • damage is to the angular gyrus or supramarginal gyrus
    • Cannot read, but can write and spell. 
    • damage to the connections between the angular gyrus/supramarginal gyrus and visual input centers
  9. Right Hemisphere Damage
    List some cognitive-communication problems seen with RHD (4): 
    What occurs when there is damage to the R. Homologous Broca's area?
    What occurs when there is damage to the R. Homologous Wernicke's area?
    • Affective components of speech (suprasegmentals), understanding metaphors, appreciating humor/sarcasm, social judgements/pragmatics 
    • Flat affect
    • understanding the affective components of other speakers.
  10. Wernicke-Geshwind model
    What is it?
    List areas of the brain that pass along information in order:
    1. speaking a written word
    2. speaking a heard word
    • A simple model of how linguistic information is processed by multiple areas of the brain
    • 1. Primary visual: angular gyrus (word recognition): Wernicke's (word comprehension)
    • 2. Thalamus (medial geniculate nucleus): primary/secondary auditory cortex (word analyzation): Wernicke's (word comprehension): Broca's (motor programming/planning): primary motor cortex (motor execution)
  11. Distribution/a Parallel model of Language
    What is the premise?
    What does distribution and parallel mean?
    • The Wernicke-Geshwind model is far too simple
    • Langauge is processed in discrete areas and in parallel, meaning that discrete areas of the brain react to the same stimuli at the same time
  12. Children with focal brain damage
    How does the child brain react to damage?
    Give some specific examples of how the child's brain reacts differently than the adult brain:
    • Children may not show the same relation between bran lesions and behavioral patterns as adults do; early unilateral damage may not hinder language performance; the right hemisphere can assume the responsibilities of language; brain pruning has not occurred yet because experience is limited.
    • Right hemisphere damage leads to damaged comprehension, Wernicke's area damage results in expressive difficulties.