Communication is how we share our feelings and ideas. Most people would agree that it's vital. Yet every now and then, our words get stuck. Everyone's experienced the feeling of having a word on the tip of your tongue, and usually, we're able to figure it out eventually. But imagine feeling this all the time, knowing exactly what you want to express, but being unable to share it.
These are some symptoms of aphasia, a language impairment that disrupts all forms of communication. Skills that you and I take for granted, like reading this post, become incredibly difficult. People with aphasia may communicate in sentences that are incomplete or incomprehensible. Some become confused and swap one word or sound for another. In extreme cases, the ability to communicate is completely lost. What's even more debilitating is that aphasia doesn't affect intelligence. People with aphasia may find it hard to express themselves, but their thoughts and feelings are still the same.
Aphasia is caused by damage to Brocha's and Wernicke's areas. Named for the physicians who discovered them, they are found on the left hemisphere of the brain and are the main areas responsible for language. Broca's area is responsible for speech production, while Wernicke's area is linked to language comprehension.
A stroke is the most common cause of injury, in which case the aphasia comes on immediately. Brain tumours and some infections can also cause aphasia, but it is a much more gradual process. In this case, the symptoms worsen as the disease progresses.
Whatever the cause, brain trauma blocks and ruptures blood vessels, which prevents oxygen and nutrient flow to the neurons. Without these supplies, the brain cells die, creating incomplete or missing connections between neurons. This results in the affected individual's inability to communicate. The signals are physically unable to be transmitted. Moreover, neurons are postmitotic cells, and for the most part, are unable to regenerate. Once a connection is severed, it is disabled permanently.
The areas of the brain that are injured determine the type of aphasia an individual has. There are many types but I will focus on the three major ones.
Fluent, or receptive, aphasia is when an individual has difficulty understanding the meaning of communication but is still able to produce connected speech. However, though their speech has regular intonation and grammar, they may insert irrelevant or made-up words. In this form of aphasia, Wernicke's area is affected.
Non-Fluent, or Broca's aphasia, is when an individual can comprehend language but has difficulty expressing themselves. Finding the right words to use takes concentration and may cause frustration. When they do speak, their sentences are short and simple.
Global aphasia occurs when both Broca's and Wernicke's areas are damaged. This is the most severe type of aphasia. People with this type of aphasia can neither read, nor write. They are unable to produce more than a few recognizable words, and their comprehension of language is extremely limited.
Diagnosis of aphasia, including which type a patient has, is determined fairly quickly. Following a brain injury, physicians perform MRI and CT scans to access the extent of the damage. From the results, they can give a diagnosis. If the patient is found to have aphasia, then a speech-language pathologist will perform more in-depth tests to determine the type and severity of the aphasia. These may include naming objects, engaging in conversation, and answering questions, as well as testing the patient's ability to read and write. Individual treatment is based on the results of these tests.
In the ancient past, treatments of ailments, including aphasia, involved draining "excess" fluids. It was believed that illness was caused by the imbalance of these fluids, known as humours. Though our understanding of diseases like aphasia improved throughout the following centuries, the science of aphasia wasn't developed until the 19th century. This was when we began to understand how different regions of the brain are responsible for different functions and Wernicke and Broca's areas were discovered. It wasn't until the 20th century that any real aphasia treatment was developed, mainly in the form of speech therapy.
Even now, the present treatment for aphasia is speech and language therapy. There are multitudes of different methods that target reading, writing, and verbal communication. Therapy can be with a group, one on one with a speech therapist, or use computer software. Treatment is tailored to each individual to best improve the identified problems, strengthen the skills they still have, and compensate for the loss of brain function. Repetition and recall of words, teaching other forms of communication such as gestures and images, and a very interesting type of therapy called melodic intonation therapy (MIT) are common types of treatment. MIT is where patients are taught to "sing" what they want to say, and believe it or not, it helps.
So far, there is no cure for aphasia, but there are ways to improve the condition. Going to regular therapy can greatly improve symptoms and having support is a great comfort. In the future, stem cells could grow into new neurons that replace the ones that were lost. Medications containing neurotransmitters, such as Nootropil, Aricept, and Dexedrine, may improve concentration and enhance learning and memory ability. They may also increase metabolism around the ends of severed neurons, thereby increasing neuroplasticity. These drugs are available and used today to treat aphasia, but there is little data from human test subjects so we don't know how effective they are. They may be improved in the future to fix any shortcomings they have.
Questions for further discussion...
Why do you think that melodic intonation therapy (try to answer the question before clicking on the link!) would help someone with aphasia? How does singing differ from speech?
We've come a long way in medical science since the humour theory. With the benefit of 20/20 hindsight their medical procedures seem absolutely barbaric, but they truly believed they were right. In the future, do you think they will look back to our time and think the same thing? If so, then do you think this will be true of other aspects of our day to day lives? If not, then what makes us different from the physicians of the past?
Questions for further discussion...
Why do you think that melodic intonation therapy (try to answer the question before clicking on the link!) would help someone with aphasia? How does singing differ from speech?
We've come a long way in medical science since the humour theory. With the benefit of 20/20 hindsight their medical procedures seem absolutely barbaric, but they truly believed they were right. In the future, do you think they will look back to our time and think the same thing? If so, then do you think this will be true of other aspects of our day to day lives? If not, then what makes us different from the physicians of the past?
Bibliography:
American Speech-Language-Hearing Association. (n.d.). Aphasia: Treatment. Retrieved October 23, 2019, from https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934663§ion.
Aphasia. (2018, April 3). Retrieved October 17, 2019, from https://www.mayoclinic.org/diseases-conditions/aphasia/symptoms-causes/syc-20369518.
Aphasia Definitions. (n.d.). Retrieved October 17, 2019, from https://www.aphasia.org/aphasia-definitions/.
Aphasia (Speech Problems): Types, Causes, Symptoms, Treatments. (n.d.). Retrieved October 17, 2019, from https://www.webmd.com/brain/aphasia-causes-symptoms-types-treatments#1.
Code, C. (n.d.). A Short History of the Past and Future of Aphasia Therapy. ResearchGate. doi: 10.13140/2.1.3036.3840
Longe, J. L. (2016). The Gale encyclopedia of psychology (3rd ed., Vol. 1). Farmington Hills, MI: Gale, Cengage Learning.
Research and Hope for Stroke. (n.d.). Melodic Intonation Therapy. Retrieved October 23, 2019 from http://researchandhope.com/melodic-intonation-therapy/.
American Speech-Language-Hearing Association. (n.d.). Aphasia: Treatment. Retrieved October 23, 2019, from https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934663§ion.
Aphasia. (2018, April 3). Retrieved October 17, 2019, from https://www.mayoclinic.org/diseases-conditions/aphasia/symptoms-causes/syc-20369518.
Aphasia Definitions. (n.d.). Retrieved October 17, 2019, from https://www.aphasia.org/aphasia-definitions/.
Aphasia (Speech Problems): Types, Causes, Symptoms, Treatments. (n.d.). Retrieved October 17, 2019, from https://www.webmd.com/brain/aphasia-causes-symptoms-types-treatments#1.
Code, C. (n.d.). A Short History of the Past and Future of Aphasia Therapy. ResearchGate. doi: 10.13140/2.1.3036.3840
Longe, J. L. (2016). The Gale encyclopedia of psychology (3rd ed., Vol. 1). Farmington Hills, MI: Gale, Cengage Learning.
Research and Hope for Stroke. (n.d.). Melodic Intonation Therapy. Retrieved October 23, 2019 from http://researchandhope.com/melodic-intonation-therapy/.