Aphasia

Aphasia picture naming test from Quick Aphasia Battery. Anomia
Source: Wilson et. al. (2018) A quick aphasia battery for efficient, reliable, and multidimensional assessment of language function. PLoS ONE 13(2): e0192773 (cropped).

Aphasia is a communication disorder. It results from damage or injury to language parts of the brain. It affects the ability to speak, read, or write. It is more common among older adults, in particular, and those who have suffered a stroke. Head trauma, brain tumors, or infections can also impact these same language parts of the brain.

The types of aphasia are:

• global aphasia;
• Broca's aphasia ('non-fluent aphasia');
• mixed non-fluent aphasia;
• Wernicke's aphasia ('fluent aphasia');
• anomic aphasia;
• primary progressive aphasia (PPA); and
• other varieties that "do not exactly fit into these categories."

In order to distinguish dysphagia (trouble with swallowing) and dysphasia (language disorder), the medical world often calls dysphasia by the name aphasia.

Aphasia and ME/CFS

Aphasia and dysphasia symptoms, and word-finding problems in general are patient reported comorbidities of ME/CFS and fibromyalgia. However, neither ME/CFS or fibromyalgia has any research for these language impairments.

Presentation

Communication can be nearly impossible or very mildly affected. The ability to retrieve names or objects (anomia), to put words together into sentences, or to read can all be affected. "More commonly, however, multiple aspects of communication are impaired, while some channels remain accessible for a limited exchange of information."

Prevalence

Approximately 1 million people, 1 in 250 in the United States in 2015, are living with aphasia. There are 180,000 new cases annually. There are no significant differences in incidence in men and women. However, there may be differences by type and severity of aphasia as "Wernicke’s aphasia and global aphasia occur more commonly in women, and Broca's aphasia occurs more commonly in men." Fifteen percent under the age of 65 experience aphasia after their first ischemic stroke but 43% for individuals age 85 and older.

Presentation

The main symptoms of aphasia include

• Trouble speaking
• Struggling with finding the appropriate term or word
• Using strange or inappropriate words in a conversation.

It can also present when a patient has trouble understanding what others are saying, particularly when the person is tired or in a crowded or loud environment. Although thinking skills are not affected, the patient may have problems understanding written material and have difficulties with handwriting. Using numbers and doing simple calculations can also be a problem.

Symptom recognition

Cortex

The Hummingbirds' Foundation for ME recognizes the patient reported symptoms of aphasia, Broca's due to "a complete inability to express language" and Wernicke's due to having "difficulty or an inability to understand speech" as part of their list of cognitive and neurological dysfunctions. They also note word-finding difficulties under cognitive signs and symptoms.

The Canadian Consensus Criteria lists difficulties with "word retrieval" under Neurological/Cognitive Manifestations as an optional symptom.

Possible causes

Some possible causes are:

• brain injury and stroke are usually the cause of aphasia.
• brain tumors
• brain infection
• dementia such as Alzheimer's
• epilepsy or other neurological disorder.

Other causes:

• degenerative process
• memory problems or confusion

Temporary episodes can occur due to:

• migraines
• seizures
• transient ischemic attack (TIA)

Potential treatments

Speech and language rehabilitation is usually a relatively slow process and although progress can be significant, "few people regain full pre-injury communication levels."

It is important the therapy start early. Groups settings let patients try out their communication skills. Conversations, speaking in turn, clarifying misunderstandings, and fixing conversations are practiced in a safe setting.

Currently, there are no medications to treat Aphasia but there are some studies looking into their use.

Learn more

• National Aphasia Association

See also

• Cognitive dysfunction
• Dyscalculia
• Dysphasia
• Memory problems
• Word-finding problems