Receptive Aphasia - Presentation

Presentation

When we want to speak, we formulate what we are going to say in Wernicke’s area, which then transmits our plan of speech to Broca’s area, where the plan of speech is carried out. Wernicke’s Area is located posterior to the lateral sulcus, typically in the left hemisphere, between the visual, auditory, and somesthetic areas of the cerebral cortex. A person with this aphasia speaks normally but uses random or invented words; leaves out key words; substitutes words or verb tenses, pronouns, or prepositions; and utters sentences that do not make sense. They have normal sentence length and intonation but without true meaning. They can also have a tendency to talk excessively. A person with this aphasia cannot understand the spoken words of others or read written words. Speech is preserved, but language content is incorrect. Substitutions of one word for another (paraphasias, e.g. “telephone” for “television”) are common. Comprehension and repetition are poor.

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 the fact that they were speaking, they could neither stop themselves nor understand their own words.

The ability to understand and repeat songs is usually unaffected, as these are processed by the opposite hemisphere. Melodic intonation therapy (MIT) has been pursued for some years with aphasic patients under the belief that it helps stimulate the ability to speak normally. There is some question as to the effectiveness of MIT. But more recent, and more rigorously conducted, research has revealed that MIT can be very effective at recovering language function.

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.

Damage to the posterior portion of the left hemisphere’s superior and middle temporal lobe or gyrus and the temporoparietal cortex can produce a lesion to Wernicke’s area and may cause fluent aphasia, or Wernicke’s aphasia. If Wernicke’s area is damaged in the non-dominant hemisphere, the syndrome resulting will be sensory dysprosody — the inability to perceive the pitch, rhythm, and emotional tone of speech.

Patients who communicated using sign language before the onset of the aphasia experience analogous symptoms.

The symptoms of Wernicke’s Aphasia reveal how important language is because people with the aphasia cannot express their thoughts. Some patients with the disorder do find a way to overcome this road block, and use facial expression and motor gestures to communicate instead.