Question

You are a speech-language pathologist working in a hospital and are asked to evaluate a patient for aphasia.

1) What would you ask this patient to do and what symptoms would you be looking for in order (both in terms of what is missing and what is preserved) to diagnose whether or not they have Broca's aphasia? If you determined they had Broca's aphasia, what part of the brain would you determine has been affected?

2) What symptoms would lead you to diagnose this patient with Wernicke's aphasia instead of Broca's aphasia? What part of the brain would you determine has been affected in this case?

3) What test would you ask the patient to perform to determine if they have conduction aphasia? What part of the brain would you determine has been affected in this case?

Answer 1

1- Broca's area

First of all, the patient will be made to talk and his speech will be closely observed, and later made to read as well. In the case of Broca's aphasia, the production of speech will be missing while speech comprehension is preserved. In other words, the person can comprehend and understand what is being said while he cannot produce speech distinctly. Some of the common symptoms include

1- Poor or absent grammar

2- Difficulty producing complete sentences

3- Ommition of certain preposition such as "a", "an" and "is"

4- Difficult to articulate words and sounds

5- Difficulty reading

The diagnosis of Broca's aphasia requires an MRI or CT scan. These tests will help to determine and evaluate the exact area of the brain that is affected, as well as the extent of the damage. When the patient is diagnosed with Broca's aphasia, the left frontal side of the brain is usually affected. It resides in the inferior frontal lobe in Brodmann's area 44 and 45.

2- Wernicke's Aphasia

In the same way, the patient will be made to talk and his speech will be closely observed. People with Wernicke's aphasia will have problems with language comprehension wherein the person can speak full sentences but will have no meaning since the person is not able to comprehend or understand other's speech. Some common symptoms include

1- Makes up words that have no meaning.

2- Deliver words in a normal manner but the sentences will make no sense.

3- Be unaware of the mistakes in one's speech.

For people with Wernicke's aphasia, the temporal lobe (left middle side ) of the brain is damaged. The superior temporal gyrus in Brodmann's area 22 is the area of the Wernicke's.

3- Conduction aphasia

For diagnosis, the verbal fluency, comprehension, repetition, reading, writing, and naming of the patient should be carefully assessed. The person should also get his CT and MRI scan done to confirm the damage. In conduction aphasia, the arcuate fasciculus which connects Broca's and Wernicke's area of the brain is damaged. The injury to that area results in impaired repetition wherein the patient can comprehend the speech and dialogues well but cannot transmit and understand the information of the speech production centers in Broca's area which will allow repetition to occur.

References

1- Acharya, A. B. (2020, April 24). Conduction Aphasia - StatPearls - NCBI Bookshelf. NCBI. https://www.ncbi.nlm.nih.gov/books/NBK537006/#:%7E:text=During%20the%20assessment%20of%20aphasia,repetition%20may%20have%20conduction%20aphasia.

2- Silver, N. (436 C.E., October 9). Wernicke’s Aphasia. Healthline. https://www.healthline.com/health/wernickes-aphasia#:%7E:text=Wernicke’s%20aphasia%20is%20the%20most,the%20brain%20controls%20human%20language.

3- Whelan, C. (630, September 20). Broca’s Aphasia. Healthline. https://www.healthline.com/health/brocas-aphasia#other-types