What is Aphasia?

Aphasia is a disorder that results from damage to the parts of the brain that contain language.  Aphasia can cause problems with any or all of the following: speaking, listening, reading, and writing.

Damage to the left side of the brain causes aphasia for most right-handers and about half of left-handers. Individuals who experience damage to the right side of the brain may have additional difficulties beyond speech and language. 

Individuals with aphasia may also have other problems, such as dysarthria, apraxia, or swallowing problems.

Signs and Symptoms of Aphasia

Aphasia can cause problems with spoken language (talking and understanding) and written language (reading and writing). Typically, reading and writing are more impaired than talking or understanding, but often mirror the expressive speech.

Aphasia can be mild or severe depending on the amount and the location of the damage to the brain.

Expressive Aphasia
  • Difficulty using words and sentences
  • Short or incomplete sentences (omits smaller words)
  • Use words that don't make sense (jargon)
  • May have difficulty finding words
  • May put words in the wrong order
  • May switch sounds

Receptive Aphasia
  • May struggle with both using words and understanding
  • Difficulty comprehending others

Several different types of aphasia exist depending on where the damage in the brain occurred, and the severity.  Below is a description of the several different types of aphasia disorders.

Types of Non-Fluent Aphasia
(Listed from most severe to least severe)
  1. Global Aphasia
  2. Isolation Aphasia
  3. Broca's Aphasia
  4. Transcortical Motor Aphasia

Types of Fluent Aphasia
(Listed from most severe to least severe)
  1. Wernicke's Aphasia
  2. Transcortical Sensory Aphasia
  3. Conduction Aphasia
  4. Anomia

Non-Fluent Aphasia

Damage to the language network near the left frontal area of the brain usually results in Broca aphasia, which is also called nonfluent aphasia.  Often Brocas Aphasia is accompanied by Apraxia of Speech due to the closeness in proximity in the brain. 
  • slow labored speech
  • struggle to retrieve words and/or formulate sentences
  • may have slow rate, reduced intonation, inappropriately placed, long pauses, apraxia, less varied stress patterns than typical speakers

Global Aphasia

  • Lesion in the left perisylvian Fissure or a deep subcortical area
  • No communication modality preserved
  • May have only steroptypical utterances
  • Usually in acute stage, evolves to brocas aphasia as it improves.

Isolation Aphasia

  • Lesion high in the frontal lobe
  • Some verbal output- minimal, single words
  •  Improvement is sudden
  • Can repeat
  • Naming is ok
  •  Usually occurs in the acute stage

Broca's Aphasia

  • Lesion in 3rd frontal convolution (brocas area) aka inferior frontal gyrus.
  • Relatively good auditory comprehension
  • Non-fluent, agrammatic speech= poor expression
  • Impaired repetition
  • Writing is like speech, mirrors speech
  • Frontal alexia (may have)- reading comp usually parallels aud. comprehension.
  • Awareness of errors and difficulty
  • Apraxia of speech
  • Poor naming

Transcortical Motor Aphasia

  • Mildly impaired comprehension
  • Production like brocas
  • Poor reading comprehension
  • Poor naming
  • Good repetition
  •  Lesion in motor cortex

Fluent Aphasia

Wernicke aphasia is the result of damage to the language network in the middle left side of the brain.
  • Word substitutions, neologisms, verbose verbal output.
  • Lesion in posterior portions of the left hemisphere.
  • Typical rate, intonation, pauses, and stress patterns.

Wernicke's Aphasia

  • Lesion in Heschyle’s gyrus in posterior temporal lobe
  • Speech is fluent or hyperfluent
  • Paraphasias (replacing words or sounds with others) and neologisms (making up new words)
  • No self-awareness or awareness of others
  • logorrhea (faster than press)
  • Aud comprehension is impaired
  • Repetition is poor
  • Naming is poor
  • Reading and writing is impaired and mirrors speech

Conduction Aphasia

  • Damage in the Arcuate Fasciculus
  • Speech output is fluent but there are a lot of phonemic paraphrasias which are recognized and results to unmelodic speech.
  • Poor repetition
  • Good auditory comprehension
  • Good silent reading poor aural reading (like verbal output)
  • Naming is usually impaired

Transcortal Sensory Aphasia

  • Lesion in the posterior temporal lobe extending to the visual and auditory cortex.
  • Good repetition
  • Poor auditory comprehension (varies)
  • Fluent output with some paraphasias
  • anomia (word finding difficulties)
  • Incoherent expression with circumlocutions and perseverations
  • Reading and writing impaired.

Anomic Aphasia

  • Word finding difficulties