Wernicke's aphasia, when talking becomes a problem

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Egbert Haynes
Wernicke's aphasia, when talking becomes a problem

In 1874 Karl Wernicke first described this type of aphasia. Remember that an aphasia is a pathological state in which language is altered as a result of a brain injury. At first glance, someone with Wernicke's aphasia may appear to have normal speech, as their speech is fluent. However, not everything is what it seems.

Throughout this article we will delve into what Wernicke's aphasia consists of, what are its main alterations and their causes. As well as the evolution and treatment.

Contents

  • Wernicke's aphasia: main disorders
    • Oral expression
    • Writing
    • Understanding
    • Repetition
    • Denomination, reading and reading comprehension
  • Causes and neuroanatomical correlate
  • Evolution and treatment
    • Evolution
    • Treatment
  • Bibliography

Wernicke's aphasia: main disorders

Oral expression

There is a normal joint and prosody. Wernicke's aphasia patients show the ability to maintain a melodic line with proper inflections of the voice. In the grammatical structure paragrammatism is appreciated. That is, omissions or substitutions of verbal and nominal grammatical morphemes. As well as the incorrect use of prepositions and ellipsis that cause the meaning of the phrase to be altered.

Paraphasia are also seen, an alteration that consists of omitting, deforming or substituting a phoneme, syllable or word of the vocabulary. In Wernicke's aphasia, paraphasia makes access to the semantic store difficult, which affects the input of information from the lexical store. In this way, neologisms are the most frequent paraphasias. Due to the difficulty in finding the words, patients end up "invented" new terms. For example: say "cotodor" instead of "speedy" (Arnedo, Bebibre and Triviño, 2013).

Writing

Written expressive language appears altered. Among these alterations it is common to find: letter rotations, substitutions or omissions. As Arendo, Bembibre and Triviño (2013) point out, "the letters are linked like words and often include real words. The final result can be as unintelligible as their verbal production".

Understanding

In Wernicke's aphasia, understanding is severely impaired. The fatigue effect occurs, which is that the patient has the ability to understand several words. However, but when their number is increased, he is unable to find a coherent meaning in them. Thus, understanding spans a short period of time.

The patient frequently uses certain extralinguistic cues from the interlocutor to try to help him understand. Among these keys can be found the tone of voice, facial expression, body or facial gestures, etc..

Repetition

Repetition is also altered. Comprehension and repetition are related. If a patient has severely impaired repetition, comprehension will also be impaired. What is called amplification also occurs. This alteration consists of adding words or phrases through neologisms or unimportant insertions.

Denomination, reading and reading comprehension

The naming is almost always abnormal. It only improves if the experimenter facilitates it through phonetic cues through visual confrontation. Reading and reading comprehension are almost always altered.

Causes and neuroanatomical correlate

The causes can be acute or chronic. Among the acute we find cerebral infarcts, head injuries, neoplasms, etc. Chronic causes include, for example, Alzheimer's disease.

In all cases, the temporal lobes (areas of Brodman 41, 42, 22 and 37) and parietal (areas of Brodman, 40 and 39) of the left hemisphere are damaged. According to various authors, two types of aphasia can occur: pure deafness for words and Wernicke's aphasia. In pure word deafness only Wernicke's area (area 22) is affected, while in Wernicke's aphasia proper, it includes Wernicke's area and adjacent areas including the white matter.

Nieto and Barroso (2009), along with other authors, mention that pure deafness for words would not be a type of aphasia since the alteration "does not affect the language system itself, but rather the input in a specific modality, in in this case the reception of oral language ".

Evolution and treatment

Evolution

Bakheit's team (2007) points out that after suffering a stroke the first six months are essential for improving language functions. Cognitive alterations are considered to stabilize after one year. In case of an improvement it will be slight. Nieto and Barroso (2009) point out that "in general, verbal expression in Wernicke's aphasia varies considerably over time, and jargon tends to decrease or even disappear".

Treatment

The treatments in this type of aphasia are not completely established. Altschuler (2006) points out that there is still no scientifically proven treatment that is fully effective. However, there are treatments that help your recovery. The most applied treatment is a compensatory rehabilitation method called situational therapy. This method is based on intervention in a real context setting.

These patients often retain the knowledge they had prior to brain damage. Thanks to this they have a lot of semantic information about everything that surrounds them. They also preserve the linguistic functions of the right hemisphere, such as understanding signals, postures and facial expressions, which can be key when it comes to helping them interact with the environment..

Bibliography

  • Altschuler, E., Multari, A., Hirstein, W. and Ramchandran, V. (2006). Situational therapy for Wernicke's aphasia. Med Hipotheses, 67: 713-716.
  • Arnedo, M., Bembibre, J. and Triviño, M. (2013) Neuropsychology. Through clinical cases. Madrid: Editorial Médica Panamericana.
  • Nieto, A. and Barroso, J. (2009). Neuropsychology Manual. Madrid: Synthesis.

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