Aphasia is language planning disorder, a disorder in the formulation or comprehension of language caused by a breakdown in the two-way mediation process of thought and language. Aphasia can be related to acoustic, vocal, written or figurative material at the morphological (phonemic sequences), lexical (meaning) or syntactic (grammar) levels.
The classical taxonomy of aphasias, which is derived from the clinical observations and theoretical interpretations of Wernicke (1874) and Lichtheim (1885), recognizes about seven forms of aphasia diagnosed on the basis of the patient’s verbal behavior in four different areas. : the type of oral production (fluent or non-fluent), repetition, comprehension and naming.
Among the types of aphasia we find Broca’s aphasia or major motor aphasia, transcortical motor aphasia, conduction aphasia, global aphasia, amnestic or nomic aphasia and Wernicke’s aphasia. In this Psychology-Online article we will delve into Wernicke’s aphasia, what it is, its symptoms, causes and treatment.
What is Wernicke’s aphasia
Wernicke’s aphasia is essentially a lack of understanding of the language without any loss of conceptualization capacity. However, in this type of aphasia there is also the impaired language production spoken and written. Therefore, Wernicke’s area should not be considered a center for solely “acoustic” understanding of language; Comprehension, in fact, involves acoustic, phonological, syntactic and lexical analyses, it is a series of analyzes that take place in many other cortical regions where the Wernicke area It is connected through a widely distributed network.
Wernicke’s area analyzes spoken sounds in order to transfer conceptual meanings into words and vice versa, with the consequence that the full acoustic understanding of its product occurs in a later phase as a consequence of the operation of the entire system. Below we will see the main characteristics of Wernicke’s aphasia with examples.
Symptoms of Wernicke’s aphasia
In Wernicke’s aphasia, language is typically fluent, well articulated, syntactically and prosodically correct and is accompanied by a slight opening of the language and/or mild dysarthria. In addition, the following symptoms are present in Wernicke’s aphasia:
- Inability to find the appropriate name for objects (anomia).
- Neologisms.
- Paraphasias of letters. For example: “olifante” instead of elephant.
- Semantic paraphasias. For example: “binoculars” instead of glasses.
- Tendency to add several syllables in a word or several words in a sentence with the end result of logorrhea and incomprehensible and meaningless language.
The patient with Wernicke’s aphasia, contrary to Broca’s aphasia, He does not understand his own language or that of others and is not aware of his disorder.. He has anosognosia of spoken language. Unlike Broca’s aphasia, Wernicke’s aphasia is rarely accompanied by motor deficits (right hemiparesis) and frequently by field-metric defects (right superior homonymous quadtrantopsia).
If you want to know more about the types of aphasia depending on the affected area, in this article we explain the , which will help you understand the differences between Wernicke’s and Broca’s aphasia.
Causes of Wernicke’s aphasia
Why does Wernicke’s aphasia occur? The causes of aphasia are multiple: in fact, any pathology that affects the brain can cause it, as long as said pathology affects the dominant hemisphere and, above all, the areas that are responsible for the development of language. The most common pathological event related to aphasia is cerebral stroke (responsible for approximately 80% of stroke cases); Cerebral infarctions are generally responsible for aphasia of notable severity. Among the causes we must mention:
- Hemorrhages cerebral.
- Tumors located in the left, frontal or temporal hemisphere.
- The Brain atrophy (condition that can be due to different types of pathologies such as dementia, Huntington’s chorea, leukodystrophy, multiple sclerosis, Pick’s disease, etc.).
- Trauma cranial injury causing intracranial hematomas, brain contusions or post-traumatic arterial thrombosis.
- infectious processes that cause brain abscess or encephalitis.
- Epileptic seizures partial (in this case the disorder has a very short duration).
- Migraine attacks with aura (the eventuality is not frequent, but the probabilities are not zero).
- Transient ischemic attacks (however, aphasia tends to regress for a few hours).
Areas affected in Wernicke’s aphasia
Wernicke’s aphasia is associated with a vascular lesion of Wernicke’s area with variable extension to the surrounding cortical and subcortical structures. The Wernicke area (Brodmann area 22) is a “rear sensory system” located in the posterior part of the superior temporal gyrus adjacent to the first gyrus of Heschl (primary acoustic area).
Damage to this area causes sensory or perceptual aphasia, which seriously affects the understanding of written and spoken language. The lesional pathology responsible for Wernicke’s aphasia is responsible for left lateral superior temporal gyruswhich in the most severe cases causes a disconnection of the association fibers between the auditory cortex and the angular turn of the parietal lobe.
Treatment of Wernicke’s aphasia
Aphasia is a complex disorder, of various forms and facets and, as is well understood, it can seriously affect the quality of life of the affected individual and their family members. The treatment of aphasia can be summarized as follows:
- Treatment of the cause. Treatment of some lesions can be very effective (for example, corticosteroids if a mass lesion causes vasogenic edema).
- Speech therapy. The effectiveness of aphasia treatment itself is not well defined, but most doctors believe that treatment by qualified speech therapists is helpful and that patients treated immediately after onset improve further.
- Augmentation communication devices. Patients who cannot regain basic language skills and their caregivers are sometimes able to exchange messages using augmentative communication devices (for example, a book or communication card containing pictures or symbols that represent the patient’s daily needs). patient, i.e. computer-based devices).
In many subjects, treatment leads to excellent results, in other cases, unfortunately, recovery is not optimal: patients with Wernicke’s aphasia generally improve over time, recovering expression and understanding. The factors that affect recovery are:
- The initial severity and extent of the injury
- The causes that have determined aphasia
- Logopedic treatment (language treatment)
- The motivation of the subject
Other factors that in the past were considered important in relation to the chances of recovery, such as age, left-handedness, and education, have recently been reduced.
Exercises for Wernicke’s aphasia
The main exercises and therapeutic activities for Wernicke’s aphasia are the following depending on the phase:
Preliminary
In the preliminary phase, the exercises indicated for Wernicke’s aphasia are:
- Attention exercises
- Temporospatial orientation exercises
- Auditory discrimination exercises
- Memory exercises (immediate and remote auditory, immediate and remote visual, immediate and remote tactile
- Exercises for understanding and executing simple orders
- Object classification exercises
Production
In the phase aimed at the production and conscious activity of voice and speech, the activities for Wernicke’s aphasia are:
- Breathing exercises
- Phonation exercises
- Orofacial exercises
Rehabilitation
In the systematic language rehabilitation phase, the exercises for Wernicke’s aphasia are:
- Controlled auditory stimulus
- Exercises to expand vocabulary to prepositional language
- Reaffirmation of vocabulary through writing
- Vocabulary reinforcement with reading rehabilitation
- Sentence completion exercises with verbal stimulation
- Calculation exercises
This article is merely informative, at Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.
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