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Global aphasia

Speech is non-fluent. There is no comprehension or repetition.


Mixed transcortial aphasia
Speech is non-fluent. There is no comprehension, but repetition is
intact.
Broca's aphasia
Speech is non-fluent. There is comprehension, but repetition is
not intact.
Transcortical motor aphasia
Speech is non-fluent. Comprehension and repetition are
preserved.
Wernike's aphasia
Speech is fluent, but comprehension and repetition are not intact.
Transcortical sensory aphasia
Speech is fluent. There is no comprehension, but repetition is
preserved.
Conduction aphasia
Speech is fluent. Comprehension is preserved, but repetition is
not intact.
Anomic aphasia
Speech is fluent. Comprehension and repetition are preserved.

Appendix: Common Classifications of Aphasia


Broca's
A type of nonfluent aphasia, so called because speech
production is halting and effortful. Damage is typically in the
anterior portion of the left hemisphere. The dominant feature
is agrammatism (impaired syntax). Content words (nouns,
verbs) may be preserved but sentences are difficult to
produce due to the problems with grammar, resulting in
"telegraphic speech." In its more severe form, spoken
utterances may be reduced to single words. Comprehension is
typically only mildly to moderately impaired, and impairments
are primarily due to difficulty understanding complex
grammar. Repetition of words and sentences is usually poor.
Wernicke's
A type of fluent aphasia. Damage is typically in the posterior
portion of the left hemisphere. Comprehension is poor and the
person often produces jargon, or nonsensical words and
phrases when attempting to speak. These utterances typically
retain sentence structure but lack meaning. The person is
usually unaware of how they are speaking and may continue
to talk even when they should pause to allow others to speak;
this is often referred to as "press of speech." Repetition of
words and sentences is poor.
Global
A type of nonfluent aphasia with severe impairment of both
expressive and receptive skills. Usually associated with a large
left hemisphere lesion. People are often alert and may be able
to express themselves through facial expressions, intonation,
and gestures.
Conduction
A type of fluent aphasia with a prominent impairment with
repetition. Damage typically involves the arcuate fasciculus
and the left parietal region. The patient may be able to
express him- or herself fairly well, with some word-finding
issues, and comprehension can be functional. However, the
patient will show significant difficulty repeating phrases,
particularly as the phrases increase in length and complexity
and as they stumble over words they are attempting to
pronounce. This type of aphasia is rare.

Anomic
A mild form of aphasia. The most prominent difficulty is in
word-finding, with the person using generic fillers in
utterances, such as nonspecific nouns and pronouns (e.g.,
"thing"), or circumlocution, where the person describes the
intended word. Comprehension and repetition of words and
sentences is typically good; however, the person may not
always recognize that a word they have successfully retrieved
is the correct word, indicating some difficulty with word
recognition.
Transcortical Sensory
A type of fluent aphasia similar to Wernicke's with the
exception of a strong ability to repeat words and phrases. The
person may repeat questions rather than answer them
("echolalia").
Transcortical Motor
A type of nonfluent aphasia similar to Broca's aphasia, but
again with strong repetition skills. The person may have
difficulty spontaneously answering a question but can repeat
long utterances without difficulty.
Mixed Transcortical
A combination of the two transcortical aphasias where both
reception and expression are severely impaired but repetition
remains intact.
Crossed
A type of aphasia that occurs when a person's language
centers are not in the expected hemisphere. In most righthanded individuals, language centers are located in the left
hemisphere. This is also true for a majority of left-handed
people, although there are exceptions for both groups. An
example of crossed aphasia would be a right-handed person
who has a right hemisphere stroke which results in aphasia.
Subcortical
A form of aphasia that results from damage to subcortical
regions such as the thalamus, internal capsule, and the basal
ganglia. The symptoms can mirror those arising from cortical
lesions, and subcortical damage can also co-occur with
cortical lesions. Aphasic symptoms can arise from diaschisis
(remote effects), such as subcortical inputs to the frontal lobe
being altered, or may directly stem from damage to
subcortical areas that support language processing.
Primary Progressive Aphasia (ppA)

Primary Progressive Aphasia (PPA): A focal dementia (or focal


cortical atrophy syndrome) characterized by gradual loss of
language function in the context of relatively well-preserved
memory, visual processing, and personality until the advanced
stages. Symptoms usually begin with word-finding problems
and
progress
to
impaired
grammar
(syntax)
and
comprehension (sentence processing and semantics).
Symptoms associated with impaired speech production can
also accompany PPA, such as dysarthria and apraxia of
speech. Typically, a diagnosis of PPA is made following a 2year decline in language function not accompanied by any
marked decline in other cognitive functions. (However, a 2year hiatus in making a definitive diagnosis should not delay
proactive management of the aphasia and general life
planning.) Structural and physiological abnormalities are
typically noted only in the left hemisphere language-related
cortices (i.e., frontal, parietal and temporal regions). PPA is not
due to neoplastic, vascular, or metabolic etiologies nor to
infectious disease (Mesulam, 2001; Rogers, 2004).

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