;)
;)
WERNICKE’S APHASIA
(receptive aphasia, fluent aphasia, sensory
aphasia):
Wernicke's
area is an area of the brain, located in the temporal lobe
on the posterior portion of the superior temporal gyrus, that is associated
with the ability to understand and produce meaningful speech; damage to this
area will cause Wernicke's aphasia
If Wernicke’s area
is damaged in the non-dominant hemisphere, the syndrome resulting will be
sensory dysprosody
- the lack of ability to perceive the pitch, rhythm, and emotional tone of
speech.
Characteristics
ü
Speech, while fluent, is
semantically inappropriate with incorrect language content. This may vary from the
insertion of a few incorrect or nonexistent words to a profuse outpouring of
jargon. The form of the patient's speech may sound normal, however, the content
is long, grammatically well formed utterances that contain almost no meaning
ü
Grammar, syntax, rate,
intonation and stress are normal.
ü
Multiple Paraphasias are
common.
§
Literal
Phonological paraphasia
– More than half of the spoken words said correctly. Errors consist of mispronunciation, syllables
out of sequence, etc. (e.g. "I
slipped on the lice (ice) and broke my arm.")
§
Verbal
Semantic paraphasia -
The substituted word is related to the intended word. (e.g. "I spent the
whole day working on the television… I mean computer.")
§
Remote
Semantic paraphasia -
The substituted word is not related to the intended word. (e.g. "You
forgot your lamp… I mean umbrella.")
§
Neologistic
paraphasia - More severe mispronunciation, in which less
than half the word is said correctly, if at all.
ü
Auditory comprehension and retention
is poor. The patient may repeat the
examiner's words without understanding them.
ü
The major impairment is semantic. The speech of Wernicke's
patients is sometime called cocktail hour speech.
ü
Comprehension and
expression tend to be equally impaired.
ü
Wernicke's patients can
process the main point in conversations but miss the specific details.
ü
Articulation is normal,
ü
Melodic Line is unaffected
ü
Short term memory recall is typically
poor
ü
Word retrieval impairment is common.
ü
Confrontational naming is typically
impaired.
ü
Alexia with agraphia may be
present.
ü
Press of Speech phenomenon
is common: Patients may speak very rapidly, interrupting
others. It may seem as though the patient is striving for a sense of closure or
a sense that (s)he has actually communicated what (s)he intended to say.
ü
The ability to understand
and repeat songs
is usually unaffected,
as these are processed by the opposite hemisphere. "Melodic intonation
therapy" can help stimulate the ability to speak with a normal rhythm and
tone and recall information that is stored in a musical or rhythmic form.
ü
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.
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 that fact that they were speaking, they could neither stop themselves nor
understand their own words
LURIA'S THEORY ON
WERNICKE'S APHASIA
Luria 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 no difference between
these vowels, and therefore the Dutch have difficulties hearing the
difference between them. 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
salad”: 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.