Without a doubt, Broca's aphasia is one of the best known. The study of aphasias began to be studied in 1861 by Paul Broca (1924-1980), although he called them epidemic. The term aphasia was not introduced until 1884 by Armand Trousseau (1801-1867). But, what is an aphasia? Is about a pathological state in which language is altered as a result of a brain injury.
There are different types: Broca's aphasia, from Wernicke, of conduction, global, etc. Each of them with different characteristics although with one element in common, the language disturbance. Throughout this article you will deepen the Broca's Aphasia.
- 1 How does Broca's aphasia occur?
- 2 Broca's Aphasia and Broca's Aphasia
- 3 Alterations
- 4 Neuropsychological evaluation
- 5 Evolution and treatment
- 6 Bibliography
How does Broca's aphasia occur?
The most frequent causes are the ictus in the area of the left middle cerebral artery. It is an artery that irrigates the areas of language, so when it is affected, it directly affects the language. Other causes may also be brain tumors, infections, surgical interventions or traumatic brain damage.
Aphasia of the Broca Area and Aphasia of Broca
Injuries limited to drill bit area (areas 44 and 45 of Brodmann) are not enough to produce aphasia itself. In this case there are slight defects in the agility of articulation, a certain "foreign accent" and a reduction in the ability to find words. Hemiparesis and apraxia are usually minimal. It is a restricted form of Broca's aphasia called Type I, minor or Aphasia of the Bronca Area.
"Language is the dress of thoughts".
The Broca's aphasia in its extensive form it is observed if the damage extends to the opercular region, the anterior insult, the precentral gyrus and the white paraventricular and periventricular substance. It is called extended or type II.
There is a lack of fluency. His communication is based on the use of single words and short phrases produced with slowness, difficulty and great effort. Phonological paraphasias are observed due to errors in the selection of phonemes. Omissions and simplifications of consonant groups also often appear frequently (González and González, 2012).
Dysarthria is also usually seen, that is, problems in the motor execution of speech, so all of the above can be worsened. Agramatical expression is another of Broca's aphasia symptoms. This causes the appearance of agramatism,that is defined as "the difficulty of the patient to use correct constructions from the morphosyntactic point of view (Arnedo, Bembibre and Triviño, 2012) ".
"The limits of my language are the limits of my mind".
Nor does the use of functional terms such as "a", "he", "some" usually occur, just as grammatical or auxiliary markers are not usually appreciated. There is frustration and helplessness on the part of these patients who try to speak but find it very expensive to express themselves normally.
The anomie It is also another characteristic of patients with Broca's aphasia, in fact, it is one of the primary symptoms. Anomie refers to the difficulty of finding the correct word from the alteration that occurs in the ability to select the specific programs of each individual word.
The denomination It is usually poor, although it is usually improved if the patient is supported with contextual and phonetic aids.
The reading In this type of patients it is slow, choppy and is performed with great difficulty. Reading aloud is quite altered and compression is similar to oral.
The writing is altered. Spelling errors such as omissions and spelling substitutions occur. Motor and aphasic agraphia is shown.
The alteration of understanding is attributed to a deficit in syntactic processing. In reversible passive phrases, difficulty in understanding is also observed. Arnedo, Bembibre and Triviño (2012) highlight that "the agramaticality in the production that accompanies Broca's aphasia seems to alter the ability of patients to use, in turn, such grammatical information in understanding, such as computer action a series of words to decode the meaning of the phrase ".
An example of neuropsychological evaluation of Broca's aphasia can be the following (Arnedo, Bembibre and Triviño, 2012):
- Boston Test for the Diagnosis of Aphasia (Goodglass and Kaplan, 2005). Explore all areas of language. Evaluate: language production, melodic line, sentence length, articulatory agility, grammatical content, paraphrases and anomies. As well as listening comprehension, oral expression, denomination, word reading and oriations, written language and non-linguistic tests (drawing, figures ...).
- Token test(De Renzi and Fagoli, 1978). Evaluate the understanding of orders of increasing difficulty through the identification of shapes and colors.
- Boston Vocabulary Test (Kaplan and Goodglas, 1972). Linguistic ability is assessed through verbal and graphic stimuli. Specifically, the evaluation revolves around: oral production, listening comprehension, understanding of written language and production of written language.
- Verbal fluency tests.
- Assessment at the intellectual level.
- Information processing speed.
- Assessment of attention and concentration.
- Personal, spatial and temporal orientation.
- Assessment of memory in all its modalities.
- Perceptual functions
- Motor and executive functions.
Evolution and treatment
As the brain recovers, a rapid restoration occurs, which is known as spontaneous recovery. This recovery is explained by two causes: brain plasticity repair damaged tissue. Basso (2003) proposes that this phase can last between one and six months.
Traumatic aphasias show a better prognosis than vascular ones for several reasons:
- They rarely involve all linguistic areas.
- They are smaller.
- They usually occur in young people.
According Martinell (2011), the treatment of a patient with aphasia is an integrated set of interventions that are aimed at:
- The language and the communication.
- Cognitive behavioral and patient adaptation aspects.
- The intervention with the family.
- The social aspects
Junqué and his team (2004) propose that intervention in patients with this type of aphasia should be the following objectives:
- Unlocking the linguistic functions preserved with maximum enhancement of them: comprehension of oral language, comprehension of written language, manual gesturing, simple calculation and drawing.
- Stimulation for the recovery of the deficits of the injured area. In this case, work would be done on: bucofacial apraxia, the capacity for sequencing, writing, agramatism and complementary activities.
- Arnedo, M., Bembibre, J. and Triviño, M. (2013). Neuropsychology Through clinical cases. Madrid: Pan American Medical Editorial.
- González, P. and González, B. (2012). Aphasia. From the theory to the practice. Mexico: Pan American Medical Editorial.
- Junqué, C. and Barroso, J. (2009). Neuropsychology Manual. Madrid: Synthesis.
- Junqué, C., Bruna, O. and Mataró, M. (2004) Neuropsychology of language. Normal and pathological functioning. Rehabilitation. Barcelona: Masson.
- Martinell, M. (2011). Language, aphasias and communication disorders. Neuropsychological Rehabilitation, 14, 61-81.
- Depression test
- Goldberg depression test
- Self-knowledge test
- how do others see you?
- Sensitivity test (PAS)
- Character test