This is the most serious form of aphasia and is applied to patients who can produce few recognisable words and understand little/no spoken language. People with Global Aphasia can neither read nor write. Like in other milder forms of aphasia, individuals can have fully preserved intellectual and cognitive capabilities unrelated to language and speech.
Global Aphasia is caused by injuries to multiple language-processing areas of the brain, including those known as Wernicke’s and Broca’s areas. These brain areas are particularly important for understanding spoken language, accessing vocabulary, using grammar, and producing words and sentences.
Global aphasia may often be seen immediately after the patient has suffered a stroke or a brain trauma. Symptoms may rapidly improve in the first few months after stroke if the damage has not been too extensive. However, with greater brain damage, severe and lasting disability may result. It is important to speak with your doctor about finding speech and language therapy as soon as possible after Global Aphasia has been diagnosed.
Broca’s (Expressive) Aphasia
A person with Broca’s aphasia have trouble speaking fluently but their comprehension can be relatively preserved. This type of aphasia is also known as non-fluent or expressive aphasia.
Patients have difficulty producing grammatical sentences and their speech is limited mainly to short utterances of less than four words. Producing the right sounds or finding the right words is often a strenuous process.
A person with Broca’s aphasia may understand speech relatively well, particularly when the grammatical structure of the spoken language is simple. A person with this type of aphasia may be able to read but be limited in writing.
Broca’s aphasia results from injury to speech and language brain areas such the left hemisphere inferior frontal gyrus, among others. Such damage is often a result of stroke but may also occur due to brain trauma. Like in other types of aphasia, intellectual and cognitive capabilities not related to speech and language may be fully preserved.
Mixed Non-fluent Aphasia
Mixed non-fluent aphasia applies to persons who have laboured speech, resembling severe Broca’s aphasia. However, unlike a person with Broca’s aphasia, mixed non-fluent aphasia patients remain limited in their comprehension of speech, similar to people with Wernicke’s aphasia. A person with mixed non-fluent aphasia do not read or write beyond an primary school level.
Wernicke’s (Receptive) Aphasia
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.
Individuals with Wernicke’s aphasia can produce many words and they often speak using grammatically correct sentences with normal rate. 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 realise 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.
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 known as Wernicke’s area, hence the name of the aphasia.
Wernicke’s aphasia and Wernicke’s area are named after the German neurologist Carl Wernicke who first related this specific type of speech deficit to a damage in a left posterior temporal area of the brain.
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. 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.
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.
Primary Progressive Aphasia
What is Primary Progressive Aphasia (PPA)?
Primary Progressive Aphasia (PPA) is a neurological syndrome in which language capabilities become slowly and progressively impaired. Unlike other forms of aphasia that result from stroke or brain injury, PPA is caused by neurodegenerative diseases, such as Alzheimer’s Disease or Frontotemporal Lobar Degeneration. PPA results from deterioration of brain tissue important for speech and language. Although the first symptoms are problems with speech and language, other problems associated with the underlying disease, such as memory loss, often occur later.
PPA commonly begins as a subtle disorder of language, progressing to a nearly total inability to speak, in its most severe stage. The type or pattern of the language deficit may differ from patient to patient. The initial language disturbance may be fluent aphasia (i.e., the person may have normal or even increased rate of word production) or non-fluent aphasia (speech becomes effortful and the person produces fewer words). A less common variety begins with impaired word-finding and progressive deterioration of naming and comprehension, with relatively preserved articulation.
As with aphasia that results from stroke or brain trauma, the manifestations of PPA depend on what parts of the left hemisphere are relatively more damaged at any given point in the illness. The person may or may not have difficulty understanding speech. Eventually, almost all patients become mute and unable to understand spoken or written language, even if their behavior seems otherwise normal.
Signs and symptoms of other clinical syndromes are not found through tests used to determine the presence of other conditions. PPA is not Alzheimer’s disease. Most people with PPA maintain ability to take care of themselves, pursue hobbies, and, in some instances, remain employed.
Is there any treatment or assistance for people with PPA?
People with primary progressive aphasia are fighting against a condition in which they will continue to lose their ability to speak, read, write, and/or understand what they hear. Usually people with aphasia that results from stroke or head injury will experience improvement over time, often aided by speech therapy. This is not the case for people with primary progressive aphasia. However, individuals with PPA may benefit during the course of their illness by acquiring new communication strategies from speech-language pathologists. Some families have also learned new strategies through participation in Aphasia Community Groups.
Many people with aphasia find it helpful to carry identification cards and other materials that can help explain the person’s condition to others. ID cards are available from the the National Aphasia Association website. Some communication-assistive devices may also be helpful. Non-verbal techniques for communicating, such as gesturing and pointing to pictures, may help people with PPA express themselves.